Week 9 Respiratory Flashcards
albuterol (Ventolin, Proventil) class
Beta2-Adrenergic Agonists
albuterol (Ventolin, Proventil) EPA
Stimulates beta2-adrenergic receptors in the smooth muscle of the bronchi and bronchioles, resulting in bronchodilation
albuterol therapeutic use
Rescue medication used to treat or prevent bronchospasm in people with asthma or other obstructive airways diseases
albuterol ADRs
chest pain, palpitations, nervousness, restlessness, tremors, agitation
albuterol contraindications and interactions
cardiac tachydysrhythmias
coronary artery disease
MAOIs and tricyclic antidepressants increase risk of ADRs
ipratropium (Atrovent) class
inhaled anticholinergic
ipratropium (Atrovent) EPA
Blocks the muscarinic Ach receptors in the smooth muscles of the bronchi in the lungs, inhibiting bronchoconstriction and mucus secretion (very similar to atropine)
ipratropium (Atrovent) therapeutic use
Long-term management of asthma or other conditions (COPD) that cause bronchoconstriction and increase in secretions.
ipratropium (Atrovent) ADRs
dry mouth, increased intraocular pressure, urinary retention
ipratropium (Atrovent) contraindications and interactions
glaucoma
prostatic hyperplasia or bladder neck obstruction
theophylline (Theolair) class
Methylxanthines
theophylline (Theolair) EPA
Relaxes the bronchial smooth muscle, promoting bronchodilation
theophylline (Theolair) therapeutic use
Second line treatment for chronic lung disorders that cause bronchoconstriction (COPD)
theophylline (Theolair) ADRs
Tachycardia, agitation and seizures. Toxicity-Ventricular dysrhythmias or convulsions
theophylline (Theolair) contraindications and interactions
heart disease
liver dysfunction
use caution with seizure disorders
theophylline (Theolair) interventions
monitor serum levels - narrow therapeutic range
beclomethasone (QVAR) class
inhaled glucocorticoid
beclomethasone (QVAR) EPA
Suppress the release of inflammatory mediators and decrease the recruitment of airway eosinophils. Increases the number and sensitivity of beta2-adrenergic bronchodilators
beclomethasone (QVAR) therapeutic use
Prophylactic management of asthma with inhaled steroids. Acute asthma flare-ups, systemic corticosteroids used.
beclomethasone (QVAR) ADRs
Pharyngitis, cough, dry mouth, and candidiasis (thrush)
beclomethasone (QVAR) contraindications and interactions
recent live virus immunization
oral candidiasis
beclomethasone (QVAR) interventions
rinse mouth and throat with water after use to avoid thrush
use a spacer
inhaler administration education
prednisone class
glucocorticoid
prednisone EPA
affect the inflammatory process to reduce inflammation
prednisone therapeutic use
decreases inflammatory symptoms and alters immune response
asthma, COPD, arthritis, rhinitis, cancer, IBD, spinal cord injury
prednisone ADRs
CNS stimulation
adrenocortical insufficiency: fainting, weakness, hypotension
adrenocortical excess
cardio symptoms: heart failure, shock, dysrhythmias
increased appetite, hyperglycemia
delayed wound healing, fragile skin
prednisone contraindications and interactions
live vaccines, fungal infections, antibiotic-resistant infections
prednisone interactions and education
treats symptoms, not underlying disease
take as directed, do not stop abruptly
take with food
montelukast (Singulair) class
Anti-Inflammatory/Leukotriene Modifiers
montelukast (Singulair) EPA
Prevents leukotrienes from binding to its receptors therefore reducing bronchoconstriction, inflammation, and mucus production
montelukast (Singulair) therapeutic use
Used in patients with asthma that do not respond to other treatments. Used as a long acting antiasthmatic med. Only tablet approved for exercise-induced asthma. Can also treat allergies
montelukast (Singulair) ADRs
neuropsychiatric behavioral changes: aggressive behavior, hallucinations, insomnia and suicidal ideation
montelukast (Singulair) contraindications
liver disease
montelukast (Singulair) interventions
does not manage acute asthma attacks
take 2 hours prior to exercise to prevent bronchoconstriction
take in evenings daily to prevent allergies
diphenhydramine (Benadryl) class
First Generation/Sedating Antihistamines
diphenhydramine (Benadryl) therapeutic use
Treat allergic reactions, anaphylaxis, motion sickness, and insomnia
diphenhydramine (Benadryl) EPA
Structurally like histamine and occupy the same receptor sites preventing histamine acting on target tissues and thus preventing histamine response. Binds to central H1 receptors
diphenhydramine (Benadryl) ADRs
CNS depression=drowsiness & sedation
paradoxical effect causing CNS stimulation and anticholinergic effects
diphenhydramine (Benadryl) contraindications and interactions
children <2
breastfeedig women
do not take with alcohol or CNS depressants
diphenhydramine (Benadryl) interventions
do not take with alcohol or CNS depressants
assess LOC
advise against driving or operating machinery
can cause dry mouth, urinary retention, constipation, blurred vision
cetirizine (Zyrtec) class
Second Generation/nonsedatingAntihistamines
cetirizine (Zyrtec) therapeutic use
Treats seasonal allergies, minor allergies and urticaria
cetirizine (Zyrtec) EPA
Binds to histamine receptors to prevent histamine response, but binds to peripheral, not central H1 receptors. Therefore, does not cause drowsiness like the first-generation agents.
cetirizine (Zyrtec) ADRs
Drowsiness & fatigue (higher doses), and anticholinergic effects
cetirizine (Zyrtec) interventions and client education
take once a day with water
cetirizine (Zyrtec) contraindications and interactions
breastfeeding women
impaired kidney or liver function
phenylephrine (Neo-Synephrine) class
Sympathomimetics: Nasal Decongestants
phenylephrine (Neo-Synephrine) therapeutic use
Relieves pressure, swelling and congestion of the nasal mucosa
phenylephrine (Neo-Synephrine) EPA
Alpha1-adrenergic agonist, causes vasoconstriction of the blood vessels… causing the nasal turbinates in the nares to shrink, in turn opening nasal passages and relieving nasal congestion.
phenylephrine (Neo-Synephrine) ADRs
CNS excitation - tachycardia, insomnia, dizziness, palpitations, urinary retention
phenylephrine (Neo-Synephrine) contraindications and interactions
heart disease
dysrhythmias
HTN
narrow angle glaucoma
older adults
caffeine
phenylephrine (Neo-Synephrine) interventions and education
do not use more than 5 days
assess for cardiac symptoms
rebound effec
dextromethorphan (Delsym) class
Antitussives-nonnarcotic
dextromethorphan (Delsym) therapeutic use
suppress nonproductive cough
dextromethorphan (Delsym) EPA
depress the cough reflex in the brain
dextromethorphan (Delsym) ADRs
CNS depression - drowsiness and sedation
dextromethorphan (Delsym) contraindications and interactions
MAOIs
SSRIs
alcohol
dextromethorphan (Delsym) interventions and education
avoid alcohol
be aware of med interactions
codeine class
Antitussives-Narcotic
codeine therapeutic use
relief of cough
codeine EPA
Depresses the cough reflex in the brain
codeine ADRs
nausea, vomiting, respiratory sedation, constipation, dizziness
codeine contraindications and interactions
respiratory impairment
head injury
seizure disorder
alcohol
codeine interventions and education
assess GI and respiratory status
avoid in patients with asthma or head injuries
guaifenesin (Mucinex) class
expectorant
guaifenesin (Mucinex) therapeutic use
loosens mucus from respiratory tract in a productive cough
guaifenesin (Mucinex) EPA
reduces viscosity of secretions
guaifenesin (Mucinex) contraindications
inability to expectorate
guaifenesin (Mucinex) interventions and education
give with food and water
stay hydrated
swallow whole
change position carefully
guaifenesin (Mucinex) ADRs
Dizziness, drowsiness, headache, skin rash
acetylcysteine (Acetadote) class
Mucolytics
acetylcysteine (Acetadote) therapeutic use
liquefy mucus in the respiratory tract
acetylcysteine (Acetadote) EPA
Attacks protein bonds in the mucus, reducing viscosity
acetylcysteine (Acetadote) ADRs
Bronchospasm, GI distress (due to rotten egg smell and ingestion of secretions)
acetylcysteine (Acetadote) contraindications and interactions
inability to expel secretions
asthma
antidote to acetaminnophen
acetylcysteine (Acetadote) interventions and education
assess respiratory status
difficulty breathing could be due to bronchospasm or inability to expel secretions
hydration