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Pharmacology Test 2 > Test 2 Respiratory Meds > Flashcards

Test 2 Respiratory Meds Flashcards

1
Q

acetylcysteine: class

A
  • antidote to acetaminophen
  • mucolytic
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2
Q

acetylcysteine: MOA

A
  • substitutes for depleted glutathione in the rxn that converts the toxic metabolite of acetaminophen to its non toxic form
  • as a mucolytic, it makes mucus more watery, so it’ll help make cough more productive
    • lowers the viscosity of mucus
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3
Q

acetylcysteine: indication

A
  • liver injury from acetaminophen
  • when ppl get certain tests done with contrast dye, they will give this prophylactically to protect the kidneys from the dye
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4
Q

acetylcysteine: ADRs

A
  • bronchospasm
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5
Q

acetylcysteine: nursing implications

A
  • IV: when given w/in 8-10 hours of acetaminophen overdose, it is 100% effective at preventing severe liver injury
  • PO: can provide protection if given w/in 24 hours after poisoning
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6
Q

albuterol: class

A
  • beta 2 adrenergic agonist
  • noncatecholamine
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7
Q

albuterol: MOA

A
  • causes beta 2 mediated bronchodilation–>reduces airway resistance
  • albuterol is relatively selective for beta 2 receptors, and does not produce much activation of cardiac beta 1 receptors, but if take in large doses, then albuterol may lose selectively and bind to some beta 1 receptors
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8
Q

albuterol: indications

A
  • asthma
    • taken PRN to abort an ongoing attack
  • COPD
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9
Q

albuterol: SEs

A
  • SEs are minimal at therapeutic doses
    • tremor is common
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10
Q

albuterol: ADRs

A
  • tachycardia
    • if dosage is excessive and albuterol binds to and activates beta 1 receptrs in the heart
  • paradoxical bronchospasms
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11
Q

albuterol: nursing implications

A
  • contraindicated in pts with tachydysrhythmias or tachycardia associated with digitalis toxicity
  • teach pts to use the inhalers
    • may need to use a spacer in pts with poor hand/breath coordination
    • if need 2 inhalations, then need to wait at least 1 minute between inhalations
  • take it with meals
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12
Q

theophylline: class

A
  • methylxanthine
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13
Q

theophylline: MOA

A
  • produces bronchodilation by relaxing smooth muscle of the bronchi
    • most likely due to blockade of receptors for adenosine
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14
Q

theophylline: indications

A
  • maintenance of chronic stable asthma
    • longer duration than beta 2 agonists
    • can dec frequency and severity of asthma attacks
    • most appropriate when pts have nocturnal attacks
  • COPD
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15
Q

theophylline: SEs

A
  • nausea
  • vomiting
  • diarrhea
  • insomnia
  • restlessness
    • same SEs as caffeine
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16
Q

theophylline: ADRs

A
  • severe dysrhythmias (ventricular fibrillation)
  • convulsions
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17
Q

theophylline: nursing implications

A
  • contraindicated in pts with untreated seizure disorders or PUD, dysrhythmias
  • should NOT consume caffeine b/c caffeine can intensify the effects
  • tobacco and marijuana can inc clearance
  • end of the line medication for COPD–last thing you would try
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18
Q

fluticasone: class

A
  • anti-inflammatory
  • inhaled glucocorticoid
  • anti-asthma
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19
Q

fluticasone: MOA

A
  • prevent major symptoms of allergic rhinitis: congestion, rhinorrhea, sneezing, nasal itching, erythema
  • prevent asthma syptoms by suppressing inflammation:
    • dec synthesis and secretion of inflammatory mediators
    • dec infiltration and activity of inflammatory cells (ie. eosinophils, leukocytes)
    • dec edema of airway mucosa
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20
Q

fluticasone: indications

A
  • prophylaxis of chronic asthma
    • must be done on a fixed schedule, should be used daily
  • prevention and tx of seasonal and perinneal rhinitis
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21
Q

fluticasone: SEs

A
  • drying of nasal mucosa
  • burning, itching sensation
  • sore throat
  • epistaxis
  • nosebleed
  • oropharyngeal candidiasis
  • dysphonia
  • slowed growth in children
  • cataracts/glaucoma
22
Q

fluticasone: ADRs

A
  • adrenal suppression
  • bone loss
  • anaphylaxis
  • angioedema
23
Q

inhaled glucocorticoids: nursing implications

A
  • contraindicated for patients with persistently positive sputum cultures for Candida albicans
  • make sure pts administer on an ongoing schedule
  • teach pt how to use inhaler
    • use spacer or else can cause medicine to sit in mouth and can cause oral thrush
  • to prevent dysphonia and candidiasis, rinse mouth and gargle
  • make sure taking Ca and vitamin D and doing weight bearing exercise
24
Q

mometasone: class

A
  • anti-inflammatory
  • inhaled glucocorticoid
  • anti-asthma
25
Q

mometasone: MOA

A
  • prevent major symptoms of allergic rhinitis: congestion, rhinorrhea, sneezing, nasal itching, erythema
  • prevent asthma syptoms by suppressing inflammation:
    • dec synthesis and secretion of inflammatory mediators
    • dec infiltration and activity of inflammatory cells (ie. eosinophils, leukocytes)
    • dec edema of airway mucosa
26
Q

mometasone: indications

A
  • prophylaxis of chronic asthma
    • must be done on a fixed schedule, should be used daily
  • prevention and tx of seasonal and perinneal rhinitis
27
Q

mometasone: SEs

A
  • drying of nasal mucosa
  • burning, itching sensation
  • sore throat
  • epistaxis
  • nosebleed
  • oropharyngeal candidiasis
  • dysphonia
  • slowed growth in children
  • cataracts/glaucoma
28
Q

mometasone: ADRs

A
  • adrenal suppression
  • bone loss
  • anaphylaxis
29
Q

prednisone: class

A
  • oral glucocorticoids
  • anti-asthmatics
  • anti-inflammatory
30
Q

prednisone: MOA

A
  • prevent asthma syptoms by suppressing inflammation:
    • dec synthesis and secretion of inflammatory mediators
    • dec infiltration and activity of inflammatory cells (ie. eosinophils, leukocytes)
    • dec edema of airway mucosa
31
Q

prednisone: indications

A
  • COPD
  • asthma
32
Q

prednisone: SEs

A
  • osteoporosis
  • infection: especially Pneumocystic pneumonia
  • glucose intolerance
  • myopathy, muscle weakness
  • fluid and electrolyte disturbance–>HTN, edema
  • growth delay (in children)
  • psychological disturbances: insomnia, anxiety
  • cataracts, glaucomas
33
Q

prednisone: ADRs

A
  • adrenal insuffiency
  • psychological disturbances: hallucinations, suicide
  • peptic ulcer dz
    • b/c inhibits PG synthesis
  • Cushing’s
    • moon face, buffalo hump, potbelly, hyperglycemia, osteoporosis, muscle wasting
  • thromboembolism
34
Q

prednisone: nursing implications

A
  • contraindicated in pts with fungal infections and receiving live vaccines
  • DO NOT drink with grapefruit juice
  • avoid taking aspirin with it
  • should be taken with food to prevent gastritis
  • do not stop abruptly
  • inform pts about early signs of infection: fever, sore throat
  • educate pt about S/S of fluid retention (weight gain, swelling of extremities) and hypokalemia (muscle weakness, irregular pulse, cramping)
  • notify doc if vision becomes cloudy, blurred
  • notify doc if black, tarry stool
  • notify pt about possible psychologic rxns
  • watch for signs of compression fractures and fractures of other bones
  • take w/ Ca and vitamin D to prevent osteoporosis
  • also should have bone scans
  • evaluate growth of children
  • pt should receive eye exams
  • watch for signs of hyperglycemia
  • watch for thinning of the skin, especially in older pts
35
Q

guaifenesin: class

A
  • allergy, cold, cough remedy
  • expectorant
36
Q

guaifenesin: MOA

A
  • renders cough more productive by stimulating the flow of respiratory tract secretions
    • so thins mucus and causes you to cough it out–causes the productive cough
37
Q

guaifenesin: indications

A
  • Coughs associated with viral upper respiratory tract infections.
38
Q

guaifenesin: SEs

A
  • dizziness
  • headache
  • nausea
  • diarrhea
  • rash
39
Q

guaifenesin: nursing implications

A
  • contraindicated in pts with PKU if drug contains aspartame or in pts with alcohol intolerance if drug contains alcohol
  • Administer each dose of guaifenesin followed by a full glass of water to decrease viscosity of secretions.
  • do not give if breast feeding or to children under 4 yo
40
Q

montelukast: class

A
  • leukotriene modifier (receptor blocker)
  • allergy, cough, cold
  • bronchodilators
41
Q

montelukast: MOA

A
  • high affinity for leukotriene receptors in the airway and on proinflammatory cells such as eosinophils
    • drug occupies these receptors so drug blocks receptor activation by the body’s leukotrienes
42
Q

montelukast: indications

A
  • prophylaxis and maintenance therapy of asthma in patients at least 1 yo
  • prevention of exercise induced bronchospasm (EIB) in pts at least 15 yo
  • relief of allergic rhinitis
  • **cannot be used for quick relief of asthma b/c effects develop too slowly
43
Q

montelukast: SEs

A
  • mood changes
  • nausea
  • diarrhea
44
Q

montelukast: ADRs

A
  • Churg Strauss syndrome
  • suicidal thoughts
  • Stevens Johnson syndrome
  • toxic epidermal necrolysis
45
Q

montelukast: nursing implications

A
  • watch for suicidal thoughts, depression, irritability
  • take daily in the evening or at least 2 hours before exercise even not experiencing asthma
  • cannot use to treat acute asthma attacks
    • pt should carry rapid acting bronchodilator
46
Q

benzonatate: class

A
  • antitussive
  • allergy, cough, and cold
  • “Tesslon Pearls”
47
Q

benzonatate: MOA

A
  • decreases sensitivity of respiratory tract stretch receptors
  • Anesthetizes cough or stretch receptors in vagal nerve afferent fibers found in lungs, pleura, and respiratory passages
48
Q

benzonatate: indications

A
  • Relief of nonproductive cough due to minor throat or bronchial irritation from inhaled irritants or colds.
49
Q

benzonatate: SEs

A
  • sedation
  • dizziness
  • constipation
  • confusion
  • chest numbness
  • hallucinations
50
Q

benzonatate: ADRs

A
  • overdose can cause seizures, dysrhythmia, and death
51
Q

benzonatate: nursing implications

A
  • do not chew capsules: can cause bronchospasm, laryngospasm, circulatory collapse
  • in children under 2, accidental ingestion of 1-2 capsules can be fatal
  • avoid irritants like cigarette smoke
  • avoid alcohol
  • DO NOT give to COPD pts, b/c it suppresses your cough, and you want these pts to cough

Pharmacology Test 2 (9 decks)

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