Pharmachology Respiratory System

Question 1

What is the classification of drugs affecting the respiratory system?

Answer 1

1- bronchodilators
2- anti-inflammatory agents
3- antihistamines
4- medications for Colds and Coughs and Nasal congestion

Question 2

What are contributing factors to having an efficient respiratory system?

Answer 2

Quality and quantity of air
Patency of airway
Expansion and contraction of the lungs
Exchange of O2 and CO2 at the alveoli level

Question 3

What is another name for Bronchodilators?

Answer 3

Anti-Asthmatic

Question 4

What do COPD, asthma, chronic bronchitis and emphysema have in common?

Answer 4

They are respiratory disorders characterized by bronchoconstriction or bronchospasm with potential triggers of:
Respiratory infection, odors, smoke, chemical fumes, cold air, exercise, emotional upset and some drugs.

Question 5

What are some physiological factors that aggravate bronchoconstriction?

Answer 5

Inflammation
Mucosal edema
Excessive mucus production

Question 6

What is the therapeutic action of bronchodilators and Anti-asthmatics?

Answer 6

Dilate airways
Reduce inflammation
Stabilize mast cells (they release histamine when not stable)

Question 7

What are the three (3) bronchodilators?

Answer 7

Adrenergics
Anticholinergics
Xanthine or “oophyllines”

Question 8

What are some of the characteristics of Adrenergic as a bronchodilator?

Answer 8

Prototype is Epinephrine (Adrenaline). Treatment in the ER. B1 and B2 effects so must monitor for B2: HTN, tachycardia, palpitations. There are B2 selective ones like Albuterol (Proventil) short acting for treatment or a rescue inhaler.

Question 9

Why must we use adrenergics cautiously with patients with DM?

Answer 9

Because it can increase blood sugar

Question 10

What are some ADE of Adrenergics?

Answer 10

Serious: bronchospasm (paradoxical side effect)
Common: palpitations, tachycardia, HTN, anxiety tremors.

Question 11

What are some characteristics of Anticholinergics in treating the respiratory system?

Answer 11

Prototype: Atropine
Think DRY so it decrease secretions. Not used for acute treatment. Used for daily maintenance.
ADE: cough
Serious: bronchospasm and arrhythmias

Question 12

What are some characteristics of Xanthines or “oophyllines” in treating the respiratory system?

Answer 12

Prototype: aminophylline
It relaxes smooth muscle in the bronchus. 
CNS stimulation:
Insomnia 
Headaches
Increase reflexes
Increase RR
Increase HR + chronotropic 
Increase Myocardial contraction + inotropic 
Increase risk of ulcers

Question 13

What are some of the ADE of Xanthines?

Answer 13

Serious: arrhythmias, seizures
Common: n/v, headache, insomnia
Respiratory distress: tachycardia, dyspnea, use of accessory muscles, hypoxia

Question 14

What are the three (3) classification of Anti-inflammatory agents?

Answer 14

1- corticosteroids
2- mast cells stabilizers
3- leukotriene inhibitors

Question 15

What are some of the characteristics of the Corticosteroids?

Answer 15

The therapeutic action is that they suppress airway inflammation. They are commonly referred to as steroids and are very good anti-flammatories. Decrease mucosa, airway reactivity, mucus secretions.

Question 16

What are some of the ADE of Corticosteroids?

Answer 16

Serious: oral candidiasis
Common: dry mouth
Contraindication: systemic fungal infection, TB, or any active infection.
Use cautiously with peptic ulcer disease, HTN, DM

Question 17

Anti- inflammatory nursing intervention related to Corticosteroids:

Answer 17

Give bronchodilators first. THEN Corticosteroids

Question 18

Anti-inflammatory: 2- Mast Cells Stabilizers?

Answer 18

Prototype: Cromolyn sodium (Intal)
Prevent release of histamine an related mediators. Prevents attack and exercise induced asthma. Blocks mast cell de granulation and stabilize cell. NOT for acute treatment.

Question 19

What are some of the ADE of Mast Cell Stabilizers?

Answer 19

Prototype: Cromolyn sodium (Intal)
Common: dry throat, cough, wheezing.
Serious: bronchospasm

Question 20

Anti-inflammatory: 3- Leukotriene Inhibitors?

Answer 20

Prototype: zarfirlukast (Accolate)
Prevents asthma attacks - NOT for acute attacks.
Common ADE: headache, gastritis
Serious: hepatic failure

Question 21

What is Anti-Histamines?

Answer 21

They block the action of histamine that is being released. H1 for respiratory

Question 22

What are the causes of Histamine release?

Answer 22

Bronchoconstriction
Cough 
Increase capillary permeability
Increase mucus production
Stimulation of sensory peripheral nerve endings 
Dilation of capillaries

Question 23

What is the main purpose of drugs affecting the respiratory system?

Answer 23

Relief symptoms as they do not have the ability to cure the disease

Question 24

What are the types of allergic reactions?

Answer 24

Type I to Type IV
Most concern with this class:
type I - immediate hypersensitivity
Ex: rhinitis to anaphylactic schock

Question 25

What do Anti-Histamines do?

Answer 25

They bind to central and peripheral H1 receptors 
CNS: depression : sedation 
Anticholinergic effect:
Dry mouth, nose and throat
Blurred vision
UA retention 
Anorexia, N/V, Constipation

Question 26

What are the two generations of Anti-histamines?

Answer 26

1st Generation: Non-selective
Benadryl
2nd generation: more selective for peripheral H1 receptors rather than CNS
Zyrtec, Allegra, Claritin

Question 27

What are the function of Colds and Coughs Medicines?

Answer 27

Work as a nasal decongestant (most often adrenergics.
Antitussives - prevent cough (design for the non-productive cough)
Expectorants - liquify secretions
Mucolytic- liquifies mucous
Cold remedies- combination of antihistamine, nasal decongestant and mild analgesic. E.g: NYQuil