Wk 1 URI Flashcards
What are the upper respiratory conducting passages?
Nasal cavity, larynx, pharynx
What are the low respiratory conducting passages?
Trachea, primary bronchi, lungs
Allergic rhinitis is also known as
Seasonal allergies or hay fever
Allergic rhinitis is an __ disorder
Inflammatory
What structures can allergic rhinitis affect?
Upper airways, nasal passages, AND lower airways
The same allergens that can trigger allergic rhinitis can also trigger __.
asthma
What are the signs and symptoms of allergic rhinitis?
sneezing, rhinorrhea, pruritus, nasal congestion, and watery, itchy eyes
What is rhinorrhea?
thin, mostly clear nasal drainage
What is pruritus?
itching
Allergic rhinitis is triggered by allergens that bind to what type of antibodies?
IgE
What type of cells are the antibodies located that trigger allergic rhinitis?
mast cells
Give examples of environmental triggers for allergic rhinitis
dust mites, mold
In allergic rhinitis, when the antigen binds with the antibody on the mast cell, what happens next?
inflammatory mediators are released
What is the inflammatory mediator that is responsible for the signs and symptoms of allergic rhinitis?
histamine
Causes the majority of symptoms associated with allergic reactions
histamine
What can cause allergic reactions?
Drugs, food, interactions with the environment
What is the medical name for hives?
urticaria
Where is histamine stored?
mast cells and basophils
Where are mast cells located?
skin and soft tissue
Where are basophils located?
blood
Release of activated histamines can cause dilation of blood vessels resulting in __ and __.
erythema and hypotension
Release of activated histamines can cause bronchoconstriction which leads to __.
dyspnea
Why are patients with indigestion given antihistamines?
Histamine increases the secretion of acid in the stomach
What are signs specific to a bacterial URI?
White spots on tonsils, swollen tonsils, red throat, swollen uvula, gray furry tongue
What are signs specific to a viral URI?
Red swollen throat and tonsils
8 examples of upper respiratory infections
1) Viral
2) Self-limiting disorders
3) Rhinitis
4) Sinusitis
5) Laryngitis
6) Laryngotracheobronchitis (Croup)
7) Acute bronchitis
8) Influenza
What is the common cold called?
Rhinitis
How is rhinitis spread?
Respiratory droplets
What are the symptoms of rhinitis?
Low grade fever, headache, fatigue, nasal congestion, rhinorrhea, cough
Sinusitis is often __.
bacterial
Sinusitis if usually a __ infection.
secondary
Sinusitis can happen if there is some sort of blockage in the…
drainage of the sinuses (bacteria can harbor)
What can increase the risk of sinusitis?
Anything that is put up the nose, like NG tubes
Why would an NG tube put a patient at higher risk for sinusitis?
Because the tube can block the drainage of the sinuses
What virus is typically the cause for the common cold?
Rhinovirus
How long can the rhinovirus live outside the body?
3 hours
Where can rhinovirus live outside the body?
On the skin and on objects (door knobs)
How does rhinovirus spread?
Droplet and through touch of contaminated objects
What are the symptoms of sinusitis?
Pain around the eyes and jaw
Cloudy green/yellow discharge
Congestion
Throat irritation
Why is sinusitis hard to treat with antibiotics?
Hard for drugs to get into the sinuses
How long does it take to treat a sinus infection?
7 or more days
What is the best way to treat sinusitis?
Decongestions, increased fluid intake to keep secretions thin
Inflammation and infection of the pharynx
pharyngitis
What parts are included in the pharynx?
palate, tonsils, uvula
Pharyngitis can be __ or __ or __
viral or bacterial or fungal
How to test for pharyngitis
cultures and rapid strep test
Fungal pharyngitis is not usually seen unless that patient is __
immunocompromised, such as medications, disease processes
Inflammation of the vocal cords
Laryngitis
Who develops croup?
Children
What does croup involve?
Larynx, trachea, bronchioles
Medical name for croup
laryngotracheobronchitis
What is distinct about croup?
Children will have a “bark like” cough
If you listen to the lungs of a child with croup, what sound might you hear?
Stridor and expiratory wheezing
Inflammation of the bronchial tree
acute bronchitis
What is most notable about acute bronchitis?
Cough and increased sputum production
What color is the sputum for acute bronchitis?
Clear to yellow
Acute bronchitis is often __.
viral
What are the main types of influenza?
A, B, C
What are the notable symptoms of influenza?
Rapid onset of fever, chills, and body aches
What is the biggest problem with influenza?
The secondary infection of pneumonia
What helps get mucus out of the bronchioles?
Cilia
What is the tissue that sits on top of the vocal cords?
Epiglottis
What is the clinical diagnosis for epiglottitis?
Inspiratory stridor and retractions
What are respiratory retractions?
when the area between the ribs and in the neck sinks in when a person attempts to inhale
How is croup differentiated from epiglottitis?
Croup has the distinct barking cough and epiglottitis has the distinct drooling
Why does someone with epiglottitis drool?
They are unable to swallow the secretions in their mouth
What are other symptoms of epiglottitis?
Rapid onset of fever, pain, and difficulty swallowing
What is the steeple sign?
The steeple sign, also called the wine bottle sign, refers to the tapering of the upper trachea on a frontal chest radiograph reminiscent of a church steeple.
If someone has a steeple sign, what does that indicate?
Epiglottitis
What is the MOA of antihistamines?
Block histamine release from receptors
What are the indications for antihistamines?
Allergies, cold and flu symptoms, edema, itch, inflammation, rash, runny nose, etc.
What are first generation antihistamines used to treat?
Induce sleep, prevent motion sickness, reduce anxiety
What are the side effects of first generation antihistamines?
Sedation, dry mouth, dizziness, low BP
Why are second generation antihistamines much less sedating?
They don’t affect the receptors in the CNS
What generation is diphenhydramine?
First generation antihistamine
What is the brand name of diphenhydramine?
Benadryl
What ways can diphenhydramine be given?
IM, IV, or PO
What should you teach patients about taking Benadryl?
Avoid alcohol and use caution when driving
Why should a patient taking diphenhydramine avoid alcohol?
Compounds sedative effects
What are the 3 second generation antihistamines?
Cetirizine (Zytrec)
Loratadine (Claritin)
Fexofenadine (Allegra)
What type of drug is cetirizine?
a second generation antihistamine
What type of drug is loratadine?
a second generation antihistamine
What type of drug is fexofenadine?
a second generation antihistamine
What is the brand name for cetirizine?
Zytrec
What is the brand name for loratadine?
Claritin
What is the brand name for fexofenadine?
Allegra
What route is cetirizine, loratadine, and fexofenadine?
PO
What should you use for an acute exacerbation of allergies?
diphenhydramine to get symptoms under control and then second generation antihistamines to maintain control
What are sympathomimetics?
Decongestants
What are the indications for sympathomimetics?
reduce nasal congestion, allergic rhinitis, sinusitis, and the common cold
What is the MOA for sympathomimetics?
Mimics the action of the SNS, activates alpha1-adrenergic receptors
What do sympathomimetics do to our physiology?
Causes vasoconstriction, causing turbinates to shrink and open nasal passages
What are the side effects of sympathomimetics?
Agitation, insomnia, anxiety, tachycardia, heart palpitations (all related to CNS stimulation)
When should patients stop taking sympathomimetics?
After 4 days
What happens if a patients stops taking sympathomimetics after prolonged use?
Rebound nasal congestion
Why is pseudoephedrine kept behind the counter at pharmacies?
It is the primary ingredient in meth, and has high potential for abuse
What type of drug is pseudoephedrine?
sympathomimetic
What type of drug is phenylephrine?
sympathomimetic
What are cough suppressants?
Antitussives
What is the MOA for antitussives
Directly inhibits the cough reflex in the brain
What is the route for antitussives?
PO - syrups, sprays, lozenges
What two opioids are cough suppressants?
Codeine and hydrocodone
What type of drug is coedine?
Antitussive/opioid
What type of drug is dextromethorphan?
Antitussive
What type of drug is benzonatate?
Antitussive
What type of drugs should you not take with Benadryl and why?
Antitussives because they are both CNS depressants
What antitussive drugs are subject to abuse?
dextromethorphan and codeine
What happens if you abuse dextromethorphan?
Taken in high doses it have PCP like effects (hallucinations, psychosis)
What drug is an expectorant?
guaifenesin (mucinex)
What are the indications for expectorants?
decrease mucus in colds, bronchitis, etc.
What is the MOA for expectorants?
reduction in surface tension of secretion helping thin the mucus making it easier to expectorate
What are the side effects for guaifenesin?
Very few, some people experience mild GI distress
What teaching point for guaifenesin?
Encourage fluids to help thin those secretions
What should you be cautious of with guaifenesin?
Don’t use in patients with asthma or chronic cough because the medication is not meant for prolonged use
