109: U4: Resp Meds Flashcards Preview

109: U4: Chronic Resp Disorders > 109: U4: Resp Meds > Flashcards

Flashcards in 109: U4: Resp Meds Deck (55):
1

Decongestants Action

Stimulate receptors in nose causing vaso-constriction.

2

Decongestants SE's

Insomnia.
Minimal: Jittery, nervousness, seizures in elderly, increased BP (in people prone to it).

3

Decongestants Drug Names

Pseudophedrine (Sudafed)
ephedrine (Ephedsol): systemic
oxymetazoline (Afrin): local (can only use nasal spray for 3 days max - rebound congestion can occur)

4

Decongestants Routes

PO
Nasal Inhaler

5

Decongestants NI's

Do not give to pts with HTN or pts with glaucoma. Don't use long term.

6

Antitussives Action

Suppresses cough center in medulla

7

Antitussives SE's

CNS and resp depression only with codeine.
N, V, A, Constipation, Rash, Urine retention

8

Antitussives Drugs

Codeine
Dextromethorphan (mainly used - not many SE's)

9

Antitussives Routs

PO

10

Antitussives NI'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).

11

Expectorants Action

Loosens secretions so they can be coughed up.

12

Expectorants SE's

Nausea/Vomiting, Drowsiness

13

Expectorants Drugs

Guaifenesin (Robitussin, Mucinex)
Robitussin is short acting, Mucinex is a 12 hour tablet.

14

Expectorants Route

PO

15

Expectorants NI's

Drugs do not work unless you are hydrated! Drink at least 2 liters a day.

16

Sympathomimetics Action.

Bronchodilators (beta adrenergic agonists). Cause dilation of the bronchi.

17

Sympathomimetics SE's

MDI: mouth dryness, throat irritation.
Systemic: tremor
headache
nervousness
increased HR
cough
insomnia
palpitations
increased blood sugar
angina
dysrhythmias

18

Sympathomimetics Drugs

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)

19

Sympathomimetics Route

Frequently administered by MDI (1-2 puffs)
Nebulizer
Combinations

20

Sympathomimetics NI's

Check HR, RR, breath sounds before and after.
Angina: monitor HR
Diabetics: monitor blood sugar
Can use albuterol before exercise

21

Methylxanthines Action

Bronchodilators. (Xanthine derivatives). Relaxes bronchial smooth muscle. Well absorbed PO - interacts with beta blockers and cimetidine.

22

Methylxanthines SE's

Many Drug Interactions!!
Anorexia, N/V, heartburn, cardiac dysrhythmias, increased BP, increased HR, nervousness, palpitations.

23

Methylxanthines Drugs

Aminophylline (IV)
Theophylline (PO) (Theodor)

24

Methylxanthines Routes

IV
PO

25

Methylxanthines NI's

Smoking will decrease effectiveness.
Narrow therapeutic range (10-20).
Caffeine intensifies SE's.
Check drugs for interactions.

26

Anti-Cholinergics Action

Bronchodilator. Results in bronchodilation by blocking the action of acetylcholine.

27

Anti-Cholinergics SE's

N/V, Cramps, dizziness, drying to oral mucosa, cough,, flushing of skin, bad taste, blurred vision, Anticholinergic SE's.

28

Anti-Cholinergics Drugs

ipratropium (Atrovent)
tiotropium (Spiriva)
ipratropium and albuterol (Combivent or Duoneb)

29

Anti-Cholinergics Routes

Discus
HHN
MDI
Nasal spray

30

Anti-Cholinergics NI's

Do not over use.
Assess for HTN and glaucoma.
Do NOT use with BPH (urinary retention, blurred vision).

31

Anti-Inflammatory Uses

Should be used for anyone with persistent asthma s/s. Inflammation symptoms of asthma triggered by allergic and environmental stimuli (release of eosinophils).

32

Glucocorticoids

Decrease inflammation and bronchoconstriction.
Used in combo with bronchodilators.
Decreases edema.
Blocks late phase response and decreases hyperresponsiveness.
Inhibits release of mediators

33

Anti-Inflammatory SE's

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.

34

Anti-Inflammatory Drugs

MDI's:
triamcinolone (Azmacort)
beclomethasone (Vanceril)
fluticasone (Flovent)
(Advair diskus is a combo of salmeterol and fluticasone)
PO: prednisone, prednisolone (Orapred)
IV: methylprednisolone (Solu-medrol) : rescue med only when used IV.

35

Anti-Inflammatory Routes

PO (chewable)
MDI
IV (rescue med)

36

Anti-Inflammatory NI's

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.

37

Leukotriene Action

Decreases inflammation and bronchoconstriction. Used for asthma, not COPD. Controller med.

38

Leukotriene SE's

Generally few:
Dizziness, fatigue, headache, GI, cough, nasal congestion.

39

Leukotriene Drugs

montelukast (Singulair)

40

Leukotriene Routes

PO and chewable PO

41

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.

42

Mast Cell Stabilizers SE's

Cough, bad taste, throat irritation, rash, headache, N/V

43

Mast Cell Stabilizers Drugs

cromolyn (Intal)
nedocromil (Tilade): Inhaled anti-inflammatory.
Not used often. Must give 4x a day = poor compliance.

44

Mast Cell Stabilizers Routes

MDI
Neb
Nasal (for allergies)

45

Mast Cell Stabilizers NI's

Water before and after (for bad taste)
Do NOT d/c abruptly.

46

Mucolytics Action

Liquify and loosen secretions.
Also increases hepatic glutathione, which is necessary for inactivation of toxic metabolites in Tylenol overdose.

47

Mucolytics SE's

N/V, oral sores, dizziness, drowsiness, rhinnorhea, bronchospasm.

48

Mucolytics Drugs

acetylcysteine (Mucomyst)

49

Mucolytics Routes

HHN

50

Mucolytics NI's

Smells like rotten eggs. Wash face after and provide gum/candy.

51

Anti-immunoglobulin E antibody Use

Allergic type moderate to persistent asthma

52

Anti-immunoglobulin E antibody SE's

Risk for anaphylaxis

53

Anti-immunoglobulin E antibody Drugs

omalizumab (Xolair) : long term usage

54

Anti-immunoglobulin E antibody Route

SQ every 2-3 weeks

55

Anti-immunoglobulin E antibody NI's

For kids >12 years old.
Dose is based on serum IgE levels.
Must sit for 2 hours after dose is given (d/t risk for anaphylaxis).