BNPH700 Respiratory & antimicrobial

Question 1

What are the effects of the sympathetic nervous system on Lungs and heart

Answer 1

Lungs - bronchodilation
Heart - Increased rate and force of contractions

Question 2

What are the effects of the parasympathetic NS on heart and lungs

Answer 2

Lungs - bronchoconstriction
Heart - decreased rate and force of contractions

Question 3

What is the neurotransmitter for the SNS

Answer 3

adrenaline

Question 4

Neurotransmitter for PNS?

Answer 4

Acetylcholine

Question 5

MOA of Beta-2 agonist medications

Answer 5

Engage beta-2 receptors resulting in Bronchodilation
Vasodilation
Uterine relaxation
Glucose release

Question 6

Two types of beta-2 agonist medications?

Answer 6

SABA - Short acting beta agonists for acute onset (salbutamol)
LABA - Long acting beta agonists for regular use to control symptoms (Salmeterol)

Question 7

ADR’s of B2 agonists

Answer 7

Tachycardia
Palpitations
Headaches
Restlessness and anxiety
Tremor
Hypokalaemia and hyperglycemia in high doses

Question 8

Cautions for use of SABAs

Answer 8

Frequent use can result in a decrease in beta 2 receptor response leading to decreased bronchodilation
Increase of B1 stimulation causing increased HR, tremors and anxiety

Question 9

Cautions for use of LABAs

Answer 9

Not for acute symptoms
Should be used in conjunction with an inhaled corticosteroid (prophylactic)

Question 10

Anticholinergics MOA and ADR’s (think rest & digest)

Answer 10

Muscarinic antagonists - block the PNS response resulting in smooth muscle relaxation and bronchodilation
ADR’s - Dry mouth, metallic taste, nausea, constipation, headache, tachycardia, glaucoma (with nebs and face mask)

Question 11

Preventers - (Inhaled corticosteroids) MOA and ADR’s (suffix - sone)

Answer 11

MOA - Mimic the action of glucocorticoids secreted from adrenal glands by:
Decreasing inflammatory response in lungs, Decreasing bronchial mucus, decreasing bronchial hyper-reactivity and increasing B2 agonist responsiveness.

ADR’s
Dysphonia (hoarse voice)
Oral thrush
(Use spacer and rinse mouth to minimise these)

Question 12

ADR’s of systemic steroids

Answer 12

Moon face
Hyperglycaemia
Muscle wasting and weakness
Osteoporosis
Increased susceptibility to infection
Slow healing
Peptic ulceration
Ocular changes
Psychosis
Adrenal suppression
… and many more

Question 13

Important patient education for corticosteriods

Answer 13

• Can take weeks to reach full effect.
• Must be taken continuously.
• Do not stop taking without Dr consultation
• When used with a spacer it can greatly reduce systemic adverse effects
• May reduce exacerbations in severe COPD

Question 14

Patient education for Bronchodilators and corticosteriods

Answer 14

Inhaler technique
Use of spacer
Action plan for symptom management
ADR’s
For LABA and corticosteriods - Use regularly as prescribed and do not stop taking.

Question 15

Definition of antibiotics

Answer 15

Chemicals used to kill or slow growth of infection causing micro-organisms

Question 16

Bactericidal

Answer 16

Kill bacteria

Question 17

Bacteriostatic

Answer 17

Inhibit growth of bacteria allowing the host defenses to eventually kill bacteria

Question 18

What is a superinfection?

Answer 18

A secondary infection occuring during antibiotic therapy. AB’s destroy normal flora and opportunistic bacteria grow e.g vaginal thrush

Question 19

MOA of penicillins and cephalosporins

Answer 19

Inhibit bacterial cell wall synthesis by disrupting the cross-link structure causing lysis and cell death. (Bactericidal)

Question 20

What is the purpose of adding clavulanic acid to penicillin?

Answer 20

Bacteria produce enzymes called beta-lactamases that destroy penicillin. Clavulanic acid is a beta-lactamase inhibitor that prevents this. (amoxycillin + clavulanic acid)

Question 21

Penicillin ADR’s

Answer 21

Nausea, vomiting, diarrhea, abdo pain
Candidiasis
Allergic reactions

Question 22

Cephalosporins

Answer 22

Similar to penicillin
Pt with allergy to penicillin may also be allergic to cephalosporins
Broad spectrum
Similar side effects

Question 23

What is antibiotic resistance and how can nurses help to minimise this

Answer 23

Bacteria are becoming more sophisticated and are able to overcome the effects of AB’s. (E.g. beta-lactamase)
Educate patient on how and when to take antibiotics, stress the importance of finishing the whole course, don’t take anything that is not prescribed

Question 24

Nursing role for antibiotics

Answer 24

Educate on how and when to take the antibiotics
What it is for
Possible side effects
Red flags and when to call or come back in.