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1 Pharmacology > Upper Respiratory > Flashcards

Upper Respiratory Flashcards

1
Q

Upper Resp Drug Classes

A 
Made in Georgia!
Mucolytics
Antitussives
Decongestants
Expectorants

Glucocorticoids (Nasal)
Anti-Histamines H1

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2
Q

Mucolytics

drug names

A 
1 acetylcysteine (Liq/Neb)
2 hypertonic saline
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3
Q

acetylcysteine, hypertonic saline [mucolytics]

MOA

A

thin + enhance the flow of secretions in the respiratory passages

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4
Q

acetylcysteine, hypertonic saline [mucolytics]

Tx

A
  • acute/chronic pulmo disorders
  • cystic fibrosis
  • COPD
  • prevent x-ray dye nephropathy
  • schizophrenia
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5
Q

acetylcysteine, hypertonic saline [mucolytics]

A/E

A
  • aspiration
  • bronchospasm from PO
  • dizzy
  • drowsy
  • hypotension
  • tachycardia
  • NV
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6
Q

acetylcysteine, hypertonic saline [mucolytics]

CI

A
  • GI bleed

- caution w asthma

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7
Q

acetylcysteine, hypertonic saline [mucolytics]

RN/teaching

A
  • suction setup for inhalation (Neb)
  • admin PO or IV for APAP toxicity
  • acetylcysteine smells bad
  • have suction available (emesis/aspiratn)
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8
Q

acetylcysteine smells like rotten eggs, so what type of drug would you admin prior?
what would you have nearby?

A

,

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9
Q

2 categories of Antitussive

A

Opioid
–codeine, hydrocodone
Nonopioid
–dextromethorphan [DM], benzonatate

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10
Q

Antitussive-Opioid

drug names

A

codeine, hydrocodone

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11
Q

codeine, hydrocodone [anti-tuss-opd]

MOA

A
  • brain opioid receptors (cough reflex)

- incr cough threshold

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12
Q

codeine, hydrocodone [anti-tuss-opd]

Tx

A

chronic non-productive (dry) cough

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13
Q

codeine, hydrocodone [anti-tuss-opd]

A/E

A
  • CNS effects (dizzy, drowsy, RR depress)
  • NV
  • constipation
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14
Q

codeine, hydrocodone [anti-tuss-opd]

CI

A
  • avoid ETOH
  • avoid CNS depress
  • no codeine for kids
  • breastfeeding
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15
Q

codeine, hydrocodone [anti-tuss-opd]

RN/teaching

A

-avoid activities that require alertness

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16
Q

codeine for children

A

black box warning

-no codeine for kids

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17
Q

antitussive - non opioid

drug names

A

dextromethorphan [DM]

benzonatate

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18
Q

dextromethorphan, benzonatate [anti-tuss]

MOA

A

chemical mimic of opioids but isnt one

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19
Q

dextromethorphan, benzonatate [anti-tuss]

Tx

A

cough

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20
Q

dextromethorphan, benzonatate [anti-tuss]

A/E

A

mild nausea

sleepiness

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21
Q

dextromethorphan, benzonatate [anti-tuss]

CI

A

preg risk

cat C

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22
Q

dextromethorphan, benzonatate [anti-tuss]

RN/teaching

A
  • potential for abuse
  • –can still cause euphoria in high doses
  • no prescription is needed
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23
Q

Decongestants

drug name

A

ephedrine
phenylephrine
pseudoephedrine
oxymetazoline

24
Q

Decongestants [eph’s + o]

MOA

A
  • sympathomimetic

- case vasoconstriction> subsequent reduction in inflammation in nasal membranes

25
Q

Decongestants [eph’s + o]

Tx

A

rhinitis

sinustitis

26
Q

Decongestants [eph’s + o]

A/E

A
  • rebound congestion
  • CNS stim (systmc): agitation, nervousness, uneasiness
  • vasoconstriction
27
Q

Decongestants [eph’s + o]

CI

A
  • closed angle glaucoma
  • HTN
  • CVA
  • CAD
  • dysrythmias
28
Q

Decongestants [eph’s + o]

RN/teaching

A
  • check BP first
  • short term: no more than 3-5 days
  • taper; using one nostril at a time
  • report CNS symptm
  • instill drops in lateral head low position to prevent swallowing
29
Q

pseudoephedrine + ephedrine can produce ____ like effects

A

amphetamine

30
Q

expectorant

drug name

A

guaifenesin

31
Q

guaifenesin [expctrnt]

MOA

A

expectorant w mucolytic properties

32
Q

guaifenesin [expctrnt]

Tx

A

promotes incr cough production to spit out secretion

33
Q

guaifenesin [expctrnt]

A/E

A
  • GI upset
  • drowsy
  • rash
34
Q

guaifenesin [expctrnt]

CI

A
  • caution in asthma> bronchospasm

- allergy to PKU

35
Q

*guaifenesin [expctrnt]

RN/teaching

A

drink lots of fluids

36
Q

Glucocorticoids [nasal}

drug names

A

mometasone
fluticasone
budesonide

37
Q

mometasone, fluticasone, budesonide [nasal glcrtcds]

MOA

A

decrease inflammation

38
Q

mometasone, fluticasone, budesonide [nasal glcrtcds]

Tx

A
  • 1st line for nasal congestion
  • allergic rhinitis
  • sinusitis
39
Q

mometasone, fluticasone, budesonide [nasal glcrtcds]

A/E

A
  • sore throat
  • nosebleed
  • headache
  • burning in nose
40
Q

mometasone, fluticasone, budesonide [nasal glcrtcds]

CI

A

preg category B + C

41
Q

mometasone, fluticasone, budesonide [nasal glcrtcds]

RN/teaching

A

metered-dose spray to admin
–can take 7 days to get max relief for seasonal rhinitis
–use humidifier if epistaxis
clear blocked nasal passages w topical decongestant prior to glucocorticoid admin

42
Q

1st Generation H1

drug names

A

diphenydramine

promethazine

43
Q

2nd Generation H1

drug names

A

loratadine
cetirizine
fexofenadine
desloratadine

44
Q

H1 Anti-Histamine

MOA

A

blocks H1 receptors

-mostly small capillaries to decr histamine

45
Q

H1 Anti-Histamine

Tx

A
  • itching
  • sneezing
  • seasonal allergic rxn
  • rhinorrhea
  • urticaria
  • motion sickness
  • anaphylaxis
  • bronchospasm
  • insomnia
  • laryngeal edema
46
Q

1st Gen H1 has similar A/E as 2nd Gen, except it also causes…

A
  • CNS: tachy
  • anti-ACH: drowsy, confusion, hallucination, constipation, drymouth
  • GI upset
47
Q

H1 Anti-Histamine

A/E

A
  • acute toxicity
  • excitation
  • incoordination
  • seizures in kids
48
Q

H1 Anti-Histamine

CI

A

-3rd trimester
-breastfeeding
-promethazine if Hx of dysrhythmia
-<2YO
-BPH
glaucoma

49
Q

H1 Anti-Histamine

RN/teaching

A

give activated charcoal + cathartic + ice packs for fever

50
Q

promethazine is a __ generation H1 anti histamine

A

1st

51
Q

promethazine

A/E

A

resp depress
NMS
extravasation risk

52
Q

promethazine

CI

A
  • <2YO or breastfeeding
  • caution w <6YO
  • caution w CNS depress
  • COPD
  • OSA
  • no driving or machinery after
53
Q

promethazine lowers the ____

A

seizure threshold

54
Q

____ potentiates the action of opiods

A

benadryl

-watch out for drug seekers

55
Q

____ potentiates the action of opioids

A

Benadryl

-watch out for drug seekers

56
Q

preferred route for promethazine

A

IM

-monitor for burning or pain at IV site

1 Pharmacology (33 decks)

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