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Pharm 2 > Unit 4 > Flashcards

Unit 4 Flashcards

1
Q

List of Bronchodilators

A 
Sympathomimetics or beta adrenergic agonists 
Xanthine bronchodilators 
Leukotriene receptor antagonists 
5- lipoxygenase inhibitors 
Anticholinergic S
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2
Q

Bronchodilators

A

Antigen combines with a mast cell to form a sensitized mast cells

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3
Q

Bronchoconstriction

A

Indirectly to stimulate the release of acetylcholine causing smooth muscle contraction

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4
Q

Beta-adrenergic agonists

A

Treats acute bronchoconstriction
Selective for beta 2 receptors in the lung
Increase in formation of cyclic adenosine; causing smooth muscle relaxation

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5
Q

Cardiac considerations of beta adrenergic agonists

A

Tachycardia
Increased myocardial contractility
Monitor for changes in cardiac function and BP

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6
Q

Epinephrine should not be used in patients with

A

Heart disease

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7
Q

Contraindications for sympathomimetics

A

MAOI inhibitors
CAUTION: tricyclics antidepressants
Antihistamines
Levothyroxine sodium

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8
Q

Sympathomimetics

A

Short acting:produces bronchodilation immediately only lasts 2-3 hours
Isuprel
Bronkosol

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9
Q

Short acting sympathomimetics

A

Lasts 5-6 hours
Metaprel
Brethine
Maxair

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10
Q

Immediate acting sympathomimetics

A

Lasts up to 8 hours
Albuterol
Levabuterol
Bitolterol

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11
Q

Long acting sympathomimetics

A

Lasts up to 12 hours doesn’t act as quick
Serevent
Foradil

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12
Q

Routes of sympathomimetics

A

Inhaled

Given orally a longer duration of action (increase risk for tachycardia)

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13
Q

Nursing considerations of sympathomimetics

A 
Do not give with dysrhythmias or MI 
Limit caffeine
Immediately report:: difficulty breathing
Heart palpitations 
Tremors
Vomiting
Nervousness
Vision changes
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14
Q

Xanthine bronchodilators

A 
Interfere with phosphodiesterase 
Results in increase in cAMP and bronchodilation 
Not used often
Narrow margin of safety
Interacts with large number of drugs
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15
Q

Adverse effects of xanthine bronchodilators

A 
Tachycardia
Dysrhythmias 
Diuresis (loss of Potassium)
Insomnia
Hyper excitability
N/V
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16
Q

Theophylline agents

A

PO: used for long term; persistent asthma
IV: status asthmaticus; has not responded to fast acting sympathomimetics

17
Q

Theophylline levels

A

10-20

Labs drawn every 6-12 months

18
Q

Nursing considerations with theophylline

A

GI status
PO doses with food
Monitor I&O
Increased sensitivity in elderly

19
Q

Leukotriene receptor antagonists

A

Treats asthma
Accolate
Singulair

20
Q

Singulair

A 
10 mg tabs 
Once daily 
In evening 
6-14 years old 5 mg once 
NOT taken for acute asthma exacerbation
21
Q

Accolate

A

Stable mild persistent reactive airway disease

Prophylaxis of asthma exacerbation

22
Q

Drug interactions with accolate

A

Increase half life of coumadin

Decreases serum blood levels of erythromycin and theophylline

23
Q

Side effects of accolate

A

Headache
Drowsiness
Fatigue
GI disturbances

24
Q

Nursing considerations for accolate

A

Not used for acute exacerbation
Side effects are infrequent
Take as long as 1 week to reach therapeutic benefits

25
Q

5 lipoxygenase inhibitors

A

Also effects leukotrienes
Inhibits formation of leukotrines
Inhibit cancer growth

26
Q

Zyflo

A

Used in adults
600 mg after meals and at bedtime
NOW OFFERED IN SR FORMULA SO BID
Combination with other medications to treat asthma

27
Q

Zyflo monitor closely if taking

A

Propranolol
Warfarin
Theophylline
MAY INCREASE TOXICITY

28
Q

Anticholinergics

A

Blocking parasympathetic nervous system
Stimulates sympathetic nervous system
Cause bronchodilation
Atrovent used for asthma

29
Q

Atrovent

A

Inhalation
Dry mouth
Constipation
NOT used with patient with glaucoma or BPH

30
Q

Spiriva HandHaler

A

Exerts a local site specific bronchodilation
Longer duration
Once daily for maintenance

31
Q

Adverse effects of Spiriva HandHaler

A 
Dry mouth 
Pharyngitis 
Abdominal pain
URI
Anxiety
Nasal congestion 
Coughing
32
Q

Intal, Fivent

Tilade

A 
Used for prophylaxis 
No bronchodilator activity 
Poorly absorbed in GI
Inhalation 
Not for acute asthma attacks
Taken consistency 
Max. Therapeutic benefit May take several weeks
2 puffs QID
Patients may report a bitter unpleasant taste
33
Q

Corticosteroids

A

Prophylactic. Treatment of. Bronchial. Asthma
IV and oral
Prednisone: PO
Methyleprednisone: PO or IV
Decrease number of inflammatory cells in respiratory
Inhibit bronchoconstriction
Inhaled corticosteriods use has less systemic SE
Adrenal insufficiency especially weaning pt from oral to inhalation
Oral therapy lasts more than 10 days can have significant AE

34
Q

Adverse effects of systemic therapy longer than 2 weeks with corticosteriods

A 
Adrenal gland atrophy 
Peptic ulcer disease
Hyperglycemia
Increased for infection 
Growth retardation 
Increase weight
Cushing syndrome
Osteoporosis 
Cataracts 
Psychosis
35
Q

SE of inhalation of corticosteriods

A

Oral candidiasis
Reflexcough
Dysphonia (speech and hoarseness )
High doses of systemic absorption

36
Q

Inhaled corticosteriods

A

Bconase
Flunisolide
Advair
Azmacort

37
Q

Nursing considerations with cortocosteriods

A

Take med as ordered
Inhaled forms need to be taken daily
Nurse should assess body weight, note any S/SX of infection
Rinse mouth out after inhalation
DM should monitor BS carefully
Oral and IV doses will be tapered not to stop abruptly

Pharm 2 (4 decks)

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