Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NS 119 > Test 2 Pharmacology Part 1 > Flashcards

Test 2 Pharmacology Part 1 Flashcards

1
Q

Bronchoconstriction

A
  • results from release of ACH, histamine, and inflammatory mediators
  • Vagus nerve releases ACH
  • ACH triggers release of pulmonary secretions
    • Treated with sympathomimetics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Inflammatory Mediators of the Respiratory Tract

A
  • histamine
  • Eosinophilic chemotactic factor of anaphylaxis (ECF-A)
  • Prostaglandins and leukotrienes
  • Slow-reacting substance of anaphylaxis (SRS-A)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Drugs that act on the respiratory system include…

A
  • bronchodilators
  • anticholinergics
  • mast cell stabilizers
  • corticosteroids
  • cromoglycates
  • leukotriene receptor antagonists
  • antihistamines
  • cough preparations
  • nasal decongestants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

MDIs

A

Metered Dose Inhalers

  • pressurized devices that deliver a measured dose of drug with each activation
  • with CFC or non-CFC propellant
  • hand-mouth coordination is required
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

DPIs

A

Dry-powder inhalers (DPIs)

  • include Turbohalers and Accuhalers
  • Drugs are in the form of dry, microionized powder
  • no propellant
  • breath activated, much easier to use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Nebulizers

A
  • small machine to convert a drug solution into a mist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Bronchodilators

A
  • Drugs used to relieve bronchospasms associated with respiratory disorders
  • Includes
    • adrenoceptor agonists
      • selective B2-agonists and other adrenoceptor agonists
    • Antimuscarinic bronchodilators
    • Xanthine derivatives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Bronchodilators: Beta-Agonists

A
  • large group, sympathomimetics
  • used during acute phase of asthmatic attacks
  • quickly reduce airway constriction and restore normal airflow
  • stimulate beta2 adrenergic receptors throughout the lungs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

3 types of Beta-Agonists

A
  • nonselective adrenergics
    • stimulate alpha, beta1 (cardiac), and beta2 (respiratory) receptors
    • Example: epinephrine
  • Nonselective beta-adrenergics
    • stimulate both beta1 and beta2 receptors
    • Example: isoproterenol (Isuprel)
  • Selective beta2 drugs
    • stimulate only beta2 receptors
    • Example: albuterol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Beta-Agonists Side Effects

A
  • Alpha-Beta (i.e. epinephrine)
    • insomnia, restlessness, anorexia, cardiac stimulation, vascular headache
  • Nonselective: Beta1 and Beta 2 (i.e.: isoproterenol)
    • cardiac stimulation
    • hypotension
    • tremor
    • anginal pain
    • vascular headache
  • Beta2 (i.e.: albuterol)
    • vascular headache
    • tremor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Short Acting Agents

A
  • Albuterol (Proventil, Ventolin): MDI, neb
  • Levalbuterol (Xopenex): neb only
  • Bitolterol (Tornalate): neb only
  • Pirbuterol (Maxair): neb only
  • Salbutamol (oral tablet)
  • Terbutaline (oral tablet)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Long Acting Agents

A
  • Salmeterol (avialable only in combination)
  • Formoterol (Foradil Aerolizer) : DPI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Oral Agents

A
  • Albuterol: Tablets, extended tabs, syrup
  • Terbutaline: Tablets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bronchodilators: Nursing Alerts

A
  • at least one minute between puffs
  • inform pt that salmeterol and formoterol, and oral B-2 agonists should be taken on a fixed schedule, not PRN
  • instruct pt to report chest pain and changes in heart rhythm or rate, because B-2 agonists can cause cardiac stimulation
  • contact physician if symptoms such as nervousness, insomnia, restlessness, and tremor become sever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Anticholinergics

A
  • Ipratropium bromide (Atrovent) is the only anticholinergic used for respiratory disease
  • Slow and prolonged action
  • used to prevent vasoconstriction
  • Not used for acute asthma exacerbations
  • Side effects
    • dry mouth or throat distress
    • gastrointestinal
    • headache
    • coughing
    • anxiety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Anticholinergics (examples)

A
  • Ipratropium (Atrovent)
    • Onset 30 minutes, lasts 6 hours
    • MDI, neb
    • Combivent MDI: combo with albuterol
    • Also available intranasally for allergic rhinitis
  • Tiotropium (Spiriva)
    • Newer, lasts longer
    • DPI (handi-haler)
17
Q

Bronchodilators: Xanthine Derivatives

A
  • main xanthine used clinically is theophylline
  • Theophylline is a bronchodilator which relaces smooth muscle of the bronchi, it is used for reversible airway obstruction
  • one proposed mechanism of action is that is acts by inhibiting phosphodiesterase, thereby increasing cAMP, leading to bronchodilation
  • another example is aminophylline
18
Q

Adverse effects of Xanthine Derivatives

A
  • toxicity is related to theophyline levels (usually 5 - 15µg/ml)
  • 20-25 µg/ml: nausea, vomiting, diarrhea, insomnia, restlessness
  • >30 µg/ml: serios adrevese effects including dysrhythmias, convulsions, cardiovascular collapse which may result in death
19
Q

Xanthine Derivatives: Nursing alerts

A
  • Plasma theophylline levels should be monitored to keep it in therapeutic range, usually 5 - 15 µg/ml. Dosage should be adjusted to keep theophylline levels below 20µg/ml.
  • If pt misses a dose, the following dose should not be doubled
  • Instruct the pt that sustained-release formulations should be swallowed intact
  • Caution patients in consuming caffeine b/c it can intesnsify the adverse effects and decrease the metabolism of theophylline
20
Q

Corticosteroids

A
  • used for prophylaxis of chronic asthma
  • suppressing inflammation
    • decrease synthesis and release of inflammatory mediators
    • decrease infiltration and activity of inflammatory cells
    • decrease edema of the airway mucosa
  • decrease airway mucus production
  • increase the number of bronchial beta2 receptors and ther responsiveness to beta2 agonists
21
Q

Corticosteroids: Examples, Adverse Effects, Nursing Alerts

A
  • Exampels
    • Beclomethasone
    • Budesonide
    • Fluticasone
  • Adverse Effects
    • Inhaled corticosteroids
      • candidiasis of the mouth or throat
      • hoarseness
      • can slow growth in children
      • adrenal suppresion may occur in long-term, high-dose therapy
      • increases the risk of cataracts
  • Nursing Alerts
    • rinse and spit after taking
    • if taking bronchodilators by inhalation, use bronchodilators several minutes before the corticosteroids to enhance application of the corticosteroid into the bronchial tract
22
Q

Chromoglycates

A
  • Stabilize mast cells and prevent the release of bronchoconstrictive and inflammatory substances when mast cells are confronted with allergens and other stimuli
  • only for prophylaxis of acute asthma attacks
23
Q

Chromoglycates: examples, adverse effects, nursing alerts

A
  • Examples: Chromoglycate Na, Nedocromil Sodium
  • Adverse effects: transient bronchospasm, coughing, throat irritation
  • Nursing Alerts:
    • A selective B2 agonist such as salbutamol or terbutaline may be inhaled a few minutes before hand
    • for long term prophylaxis. administer of regular schedule, full therapeutic effects may take several weeks to develop
    • contraindicated in patients who are hypersensitive to the drugs
24
Q

Mast Cell Stabilizers: Nursing Implications

A
  • prophylactic use only
  • contraindicated in acute exacerbations
  • not recommended for children under 5
  • therapeutic effects may not be seen for up to 4 weeks
  • teach patients to gargle and rinse mouth with water afterward to minimize irritation to throat and oral mucosa
25
Q

Leukotrienes Receptor Antagonists

(aka antileukotrienes)

A
  • act by supressing the effects of leukotrienes, compounds that promote bronchoconstriction as well as eosinophil infiltration, mucus productions, and airway edema
  • help to prevent acute asthma attacks induced by allergens and other stimuli
  • indicated for long-term treatment of asthma
26
Q

Antilukotrienes: Examples, adverse effects, nursing alerts

A
  • Examples
    • montelukast (Singulair)
    • zafirlukast (Accolate)
    • zileuton (Zyflo)
  • Adverse Effects
    • GI disturbances, hypersensitivity reactions, restlessness and headache, upper resp. tract infections, avoid during pregnancy and breastfeeding
  • Nursing Alerts
    • Ensure drug is being use for chronic management of asthma, not acute
    • Teach the patient the purpose of therapy
    • improvement should be seen in about 1 week
    • Check with physician before taking OTC or prescribed meds–many interactions
    • Assess liver function before beginning therapy
    • Meds should be taken every night ona continuous schedule, even if symptoms improve

NS 119 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions