Unit 4: Wk 14 Flashcards
Action of opioids
Suppress cough reflex at brain stem (antitussive)
Action of benzonatate
Anesthetic effect on vagal nerve endings in the airway
Reduces the effects of irritation that starts the cough reflex (antitussive)
Rehab concerns: Antitussives
- OVERUSE AND DEPENDENCE
- may limit a “productive cough”
- sedation
- dizziness
- GI upset
Antihistamine action
Block Histamine type 1 receptor : decrease effects of histamine on upper respiratory tract
What are antihistamines used for?
Histamine mediated coughing, sneezing, irritation (seasonal allergies/colds)
Primary problem if an antihistamine drug does cross the BBB?
Sedation and fatigue
Lack of coordination
Blurred vision ‘limit a productive cough’
Decongestants action
Stimulate alpha one receptor on vascular arterials
(VASOCONSTRICTORS!!) — they vasoconstrictors the nasal mucosa (OTC)
Decongestants primary concerns
- headache nausea and nervousness
- Cardiovascular stimulation!!! (Increased BP) — SYSTEMIC
DEPENDENCE AND OVERUSE
Decongestants used commonly in OTC products are designed to cause _____ in nasal mucosa, but systemic use can also cause serious ____ in certain pts.
- vasoconstriction
- increase in BP
Mucolytics action
Breaks up mucous, decrease viscosity of mucous, makes it easier to raise and expel secretions
Expectorants action
Increase production of a thinner, more liquid phlegm
Primary problems of mucolytics and expectorants
- not much , usually well tolerated unless there’s excessive use
Types of bronchodilators
Beta-Adrenergic agonists:
Xanthine derivatives:
Anticholinergics:
Beta-Adrenergic agonists action
stimulate beta 2 receptors on airway smooth muscle and increase production of cyclic AMP and tells smooth muscle to cell to relax and bronchodilate
Beta-Adrenergic agonists primary problems
Bronchial irritation/constriction
Cardiac stimulation
CNS stimulation
Should you give a beta Adrenergic agonist before or after postural drainage?
Before
Xanthine Derivatives action
Were not sure how but it inhibits cAMP breakdown, blocks adenosine stimulation and has anti inflammatory effects - has caffeine like effects - can get it from strongly brewed tea
Primary problem of Xanthine theophylline
Theophylline toxicity — plasma >15ug/ml ; serious >20 guys/ml
Cardiac arrhythmias, and seizures; nausea, confusion, irritability, and restlessness
Anticholinergics actions
Ach stimulates bronchial smooth muscle contraction so Anticholinergics block Ach receptors throughout body
Anti inflammatory steroids action
Inhibit virtually all components of the inflammatory response
Primary systemic problems of beta Adrenergic agonists
- general catabolic effects —> muscle wasting, osteoporosis
- altered glucose metabolism, adrenal suppression
What is a good combo of two products to help with COPD and ASTHMA
Bronchidilator and anti inflammatory steroid
- they can be given by MDI or dry powder inhaler
Whenever possible, anti-inflammatory steroids should be administered by inhalation because of…
- less systemic, catabolic, and metabolic effects and a lower therapeutic dose
Cromones Action
Prevents release of histamine, inflammatory mediators from pulmonary mast cells
- can prevent attack if taken before exposure to initiating agent activity
