Therapeutic interventions for wounds, fungal, protozoan infections

Question 1

fiO2

Answer 1

Fraction of inspired O2

Question 2

O2 of RA

Answer 2

21%

Question 3

Asthma characterized by

Answer 3

Bronchconstriction and inflamm

Sudden contraction of smooth muscle that causes acute dyspnea
Thick, viscous secretions
Edema
Caused by engorgement of pulmonary blood vessels

Question 4

Drugs are given for asthma with the goal of

Answer 4

Terminanting or preventing an epidsodes

Question 5

Systemic side effects and inhalation

Answer 5

Less common

Question 6

Beta 2 receptor stimulation =

Answer 6

Bronchodialtion

Question 7

Duration of action for asthma drug

Answer 7

Ultra short-acting – work almost immediately but only last 2 to 3 hours. (Ventolin)
Short acting- act quickly last 5-6 hours (terbutaline)
Intermediate-acting – slower onset, 8 hr duration (
Long-acting – lasts up to 12 hours

Question 8

Salmeterol

Answer 8

Long-acting beta2 agonist indicated for prevention of asthma episodes in patients with severe persistent asthma
or Chronic bronchitis

causing bronchodialaiton

Not great in acute attack (15-20 mins onset)

Prophlactic use with exercise

Question 9

Adverse effects of Salmeterol

Answer 9

Nervousness
Restlessness

Serious adverse effects
- Tachycardia, chest pain, arythmias

Question 10

Salbutamol (Ventolin)

Answer 10

a short-actingβ2adrenergic receptor agonistwhich works by causing relaxation of airwaysmooth muscle

Treats asthma and related, COPD, onset in 15 minutes

Question 11

Methylxanthines

Answer 11

long-term management of asthma when beta agonists, anticholinergics do not work
Chemically similar to caffeine

Nausea, vomiting, CNS stimulation are common adverse effect

Avoid caffeine

Question 12

Inhaled anticholinergics

Answer 12

Promote bronchodilation by blocking muscarinic Ach receptors
alternative to short-acting beta2 agonists
Can be combined with beta2 agonists
Atrovent, Spiriva

Question 13

Ipratropium (Atrovent)

Answer 13

Relieving and preventing bronchospasm of asthma and chronic bronchitis
Can relieve acute bronchospasm in minutes, peaks in 1-2 hours and continues for up to 6 hours.

Intransal admin blocks parasymp receptors, reduces nasal hypersecretion

Question 14

Adverse effects of Ipratropium

Answer 14

Dry mouth
Urinary retention
Tachycardia
Caution with BPH

Question 15

Nursing interventions for asthma

Answer 15

Maintain an environment as free from triggers
FLuids
VIts and minerals

Question 16

Beclomethasone

Answer 16

Therapeutic effects and uses
Asthma
Allergic rhinitis

Mech of action
Glucocoriticoid that reduces

Question 16

Durgs used to preventa asthma episodes

Answer 16

Focus is on reducing inflammation

Glucocorticoids Inhaled or PO
Most effective and commonly used
Mast Cell Stabilizers
Leukotriene Modifiers
Monoclonal antibodies

Must be taken a certain amount of time (weeks) to be effective

Question 17

Adverese effects of Beclomethasone

Answer 17

Dry mouth, hoarseness, change to sense of taste, masks infection
Can cause fungal infections

Question 18

How to avoid fungal infections from Beclomethasone

Answer 18

Wait a bit and then rinse out mouth

Question 19

Common inhaled steroids

Answer 19

Flovent (fluticasone) a steroid
Pulmicort (budesonide)- a steroid
Advair ( fluticasone and salmeterol- a long-acting beta agonist) must be taken twice per day to be effective.
Symbicort ( budesonide a steroid and formoterol a long-acting beta agonist LABA)

Question 20

Solu-Medrol

Answer 20

Sterioid injection

used to treat a number of different conditions, such as inflammation (swelling), severe allergies, adrenal problems, arthritis, asthma,

Question 21

Steroids important to know

Answer 21

Serious side effects if taken long term

Less concerned about inhaled

Rinse out mouth after inhaled

Taper dose for PO meds (For adrenal system)

Monitor ss of infection

Increase blood glucose in diabetics

Cause peptic ulcers

Question 22

Mast cell stabalizer

Answer 22

Used in PREVENTION of attacks
Not helpful in treatment

cells respond to environmental triggers (allergens) by releasing histamine which causes inflammation of bronchi

Question 23

Leukotrienes

Answer 23

promote inflammation and recruit WBCs to sites of injury

Reduce inflammation through two mechanisms

Question 24

Monoclonal antibodies

Answer 24

Prevent release of histamine by mast cells through a different mechanism from mast cell stabilizers Last resort medications for severe perssistant asthma

Question 25

For any inhaler prescribed, ensure that the patient is able to ?

Answer 25

Provide demonstration and return demonstration Ensure the patient knows the correct time intervals for inhalers Provide a spacer if the patient has difficulty coordinating breathing with inhaler activation Expiration, Slow, deep inspiration Avoid harmonica sound! (slow down intake breathe)

Question 26

Metered dose inhalers

Answer 26

Pressurized devices that deliver a measured dose of drug with each activation Hold breath for 10 seconds after each puff. When 2 or more puffs are needed, wait 2 minutes between puffs

Question 27

Spacers

Answer 27

Used with MDIs Increase delivery of drug to the lungs & decrease deposition of drug on the oropharyngeal mucosa Especially important for inhaled coricosteriods - decreases risk of aquiring fungal infection

Question 28

Dry powder inhalers

Answer 28

Include Turbuhalers & Accuhalers Drugs are in the form of dry, micronized powder No propellant is employed Breath activated, much easier to use

Question 29

Nebulizer

Answer 29

Include Turbuhalers & Accuhalers Drugs are in the form of dry, micronized powder No propellant is employed Breath activated, much easier to use Droplets in the mist are much finer than those produced by inhalers Take several minutes to deliver the same amount of drug contained in 1 puff from an inhaler Remember it should be gentle mist flow

Question 30

Antitussives

Answer 30

Antitussives are used to manage non-productive coughs (we don;t supress a productive cough) Opiod or Non-opiodi

Question 31

Opioid Antitussives

Answer 31

Raise the cough threshold in CNS More effective than non-opioids; used for severe coughs Codeine Doses are low so less likely to cause dependance.

Question 32

Non-opioid antitussives

Answer 32

Dextromethorphan Benzonate

Question 33

Robitussin

Answer 33

Raises threshold of non-producive cough Adverse effects CNS: Ataxia, slurred speech etc.

Question 34

Drugs to treat COPD

Answer 34

Mucolytics and expectorants Bronchodilators Anti-inflammatory agents Similar to those used to treat asthma

Question 35

Normally ____________ is the main stimulus to breathe.

Answer 35

accumulation of carbon dioxide

Question 36

Carbon diozide necrosis

Question 37

What increases the metabolism in people with COPD

Answer 37

Increased inflammation

Question 37

Nutritional therapy for COPD pts

Answer 37

Eat 5 to 6 small meals Rest 30 min. before eating Use a bronchodilator before meals Foods that are easy to prep Fluid 2-3L per day between meals unless they have heart failure. Fluids should be taken between meals Cold foods /decreased feeling of fullness Avoid foods that cause gas Late stage increased calories. High calorie, high protein Pulmonary Formulas- enteral formulas designed for use in COPD with higher fat lower carb content because carbon dioxide production is lower when fat is consumed.

Question 38

Sx therapy for COPD

Answer 38

Lung volume reduction Lung transplant