Ch. 70 Flashcards Preview

Pharmacology > Ch. 70 > Flashcards

Flashcards in Ch. 70 Deck (16):
1

Zafirlukast: Adverse Effect

- headache, nausea, diarrhea, liver dysfunction
- depression, suicidal thoughts, hallucinattions
- arthralgia
* can prevent P450 enzymes which can prevent Warfarin metabolism= toxicity

2

Nursing Implications

- not acute asthma only chronic
- improvement in 1 week
- check any OTC meds
- liver function
- should be taken on continuous schedule even it symptoms improve

3

Bronchodilators

- but do not alter
the underlying disease process
(inflammation)
- should also be taking a
glucocorticoid for long-term suppression of
inflammation
- principal bronchodilators are the beta2-adrenergic agonists

4

B-Adrenergic Agonists

- Used during the acute phase of the attack
- Imitate norepinephrine & stimulate beta2-adrenergic receptors = immediate dilation of airways and airflow restoration
- short and long acting
- epinephrine, salbutamol

5

B-Adrenergic Agonists: Mechanism

– Stimulate specific beta2receptors = dilation of
airways & relief of spasms, no histamine effect
– Non-selective adrenergic agonists = reduction of edema & swelling of mucous membranes = decreased secretions of mucous

6

Inhaled short-acting beta2 agonists
(SABAs)

- EIB: Taken before exercise to prevent an attack
- Taken PRN to abort an ongoing attack
- MDI in outpatient setting may be equally effective

7

Inhaled long-acting beta2 agonists
(LABAs)

- Long-term control in patients who experience frequent attacks
- Dosing is on a fixed schedule, not PRN
- Effective in treating stable COPD
- When used to treat asthma, must always be combined with a glucocorticoid

8

β-Adrenergic Agonists: Contraindications

- allergy, uncontrolled cardiac dysrhythmias and high risk of strokes
adverse effects: insomnia, restlessnes, anoerxia, cardiac stimulation, hyperglycemia, HTN, hypotension, hypokalemia, tremor and vascular h/a

9

B-Agonist Derivaties: Nursing Implications

- get prompt treatment for flu or other illnesses and to get vaccinated against pneumonia or flu
- Salbutamol, if used too frequently, loses its β2 specific actions at larger doses = β1
receptor stimulation = nausea, increased anxiety & HR, palpitations & tremors

10

Methylxanthines: mechanism of Action

- increase cAMP levels
- Higher intracellular cAMP levels = smooth muscle relaxation, bronchodilation, and increased airflow (also less allergic reactions)
- Slow onset of action; used for PREVENTION rather than tx of acute attacks

11

Xanthine Derivatives: Drug
Effects

- Stimulate cardiovascular system (CVS), increasing force of contraction and heart
rate, resulting in increased cardiac output and increased blood flow to the kidneys
(diuretic effect)
- Cause bronchodilation by relaxing smooth muscles of the airways (bronchi)
- stimulate CNS (resp. response centre)

12

Xanthines: Contradications/Agents

- CV disorders and seizures disorders
- hyperthyrodism
- peptic ulcers

- Theophylline and Aminophylline (usually not answer on MC)

13

Xanthines: Adverse Effect

- more urine production
- CVS
- GI

14

Anticholinergics: Mechanism of Action

- Acetylcholine (ACh) causes bronchial constriction and narrowing of the airways
- preventing ACh from binding
- airways dilate

15

Anticholinergics: Indications

- slow and prolonged action
- prevent bronchoconstriction
- are NOT used for acute
examples:
- Atrovent and Spiriva (long acting)

16

Anticholinergics: Adverse Effects

- dry mouth, nasal congestion, heart palpitations, GI distress, headache, coughing, anxiety, glaucoma