Flashcards in 109: U4: Resp Meds Deck (55):
Stimulate receptors in nose causing vaso-constriction.
Minimal: Jittery, nervousness, seizures in elderly, increased BP (in people prone to it).
Decongestants Drug Names
ephedrine (Ephedsol): systemic
oxymetazoline (Afrin): local (can only use nasal spray for 3 days max - rebound congestion can occur)
Do not give to pts with HTN or pts with glaucoma. Don't use long term.
Suppresses cough center in medulla
CNS and resp depression only with codeine.
N, V, A, Constipation, Rash, Urine retention
Dextromethorphan (mainly used - not many SE's)
Use for a non-productive cough. Increase fluids for constipation and to loosen secretions. Use at HS so people can sleep (suppressing a cough also suppresses the mechanism getting stuff out of the lungs).
Loosens secretions so they can be coughed up.
Guaifenesin (Robitussin, Mucinex)
Robitussin is short acting, Mucinex is a 12 hour tablet.
Drugs do not work unless you are hydrated! Drink at least 2 liters a day.
Bronchodilators (beta adrenergic agonists). Cause dilation of the bronchi.
MDI: mouth dryness, throat irritation.
increased blood sugar
metaproterenol (Alupent) - acute S/S
albuterol (Proventil) - rescue med
levalbuterol (Xopenex) - Less SE's, short acting
salmeterol (Serevent) - preventative, long acting (starts working after 1 hour)
Frequently administered by MDI (1-2 puffs)
Check HR, RR, breath sounds before and after.
Angina: monitor HR
Diabetics: monitor blood sugar
Can use albuterol before exercise
Bronchodilators. (Xanthine derivatives). Relaxes bronchial smooth muscle. Well absorbed PO - interacts with beta blockers and cimetidine.
Many Drug Interactions!!
Anorexia, N/V, heartburn, cardiac dysrhythmias, increased BP, increased HR, nervousness, palpitations.
Theophylline (PO) (Theodor)
Smoking will decrease effectiveness.
Narrow therapeutic range (10-20).
Caffeine intensifies SE's.
Check drugs for interactions.
Bronchodilator. Results in bronchodilation by blocking the action of acetylcholine.
N/V, Cramps, dizziness, drying to oral mucosa, cough,, flushing of skin, bad taste, blurred vision, Anticholinergic SE's.
ipratropium and albuterol (Combivent or Duoneb)
Do not over use.
Assess for HTN and glaucoma.
Do NOT use with BPH (urinary retention, blurred vision).
Should be used for anyone with persistent asthma s/s. Inflammation symptoms of asthma triggered by allergic and environmental stimuli (release of eosinophils).
Decrease inflammation and bronchoconstriction.
Used in combo with bronchodilators.
Blocks late phase response and decreases hyperresponsiveness.
Inhibits release of mediators
MDI: oral fungal infections, hoarseness, dry cough.
PO or IV: many SE's. Osteoporosis, immunosuppression, GI distress, increased blood sugar, weight gain, skin and muscle breakdown, edema. Especially with long term use. Thrush is the main SE.
(Advair diskus is a combo of salmeterol and fluticasone)
PO: prednisone, prednisolone (Orapred)
IV: methylprednisolone (Solu-medrol) : rescue med only when used IV.
IV (rescue med)
Wash mouth after use.
PO: Take with food/milk (d/t GI upset).
Watch blood sugar, BP, immune system.
Watch for s/s of Cushings.
Wean off if on >1 week d/t acute adrenal insufficiency (No BP, No BS).
Inhaled takes up to three weeks to get effect.
Decreases inflammation and bronchoconstriction. Used for asthma, not COPD. Controller med.
Dizziness, fatigue, headache, GI, cough, nasal congestion.
PO and chewable PO
Mast Cell Stabilizers Action
Non-steroidal anti-inflammatory. Used prophylactically. Can be used wlong with bronchodilators. Inhibits the release of histamine and other mediators. Decrease inflammation and irritation: inhibits immediate response and prevents late response.
Mast Cell Stabilizers SE's
Cough, bad taste, throat irritation, rash, headache, N/V
Mast Cell Stabilizers Drugs
nedocromil (Tilade): Inhaled anti-inflammatory.
Not used often. Must give 4x a day = poor compliance.
Mast Cell Stabilizers Routes
Nasal (for allergies)
Mast Cell Stabilizers NI's
Water before and after (for bad taste)
Do NOT d/c abruptly.
Liquify and loosen secretions.
Also increases hepatic glutathione, which is necessary for inactivation of toxic metabolites in Tylenol overdose.
N/V, oral sores, dizziness, drowsiness, rhinnorhea, bronchospasm.
Smells like rotten eggs. Wash face after and provide gum/candy.
Anti-immunoglobulin E antibody Use
Allergic type moderate to persistent asthma
Anti-immunoglobulin E antibody SE's
Risk for anaphylaxis
Anti-immunoglobulin E antibody Drugs
omalizumab (Xolair) : long term usage
Anti-immunoglobulin E antibody Route
SQ every 2-3 weeks