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Pharm 201 > Chapter 39 > Flashcards

Chapter 39 Flashcards

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1
Q

Functions of the Respiratory System

A 
Gas exchange
Delivery of oxygen to tissues through Kreb cycle
Remove wastes
Acid-base balance
Protection
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2
Q

Respiratory pH range

A

7.34-7.45

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3
Q

Respiratory diffusion

A

O2 & CO2 between alveoli & pulmonary capillaries

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4
Q

Respiratory perfusion

A

O2 & CO2 between capillaries & body cells

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5
Q

bronchodilators stimulate?

A

beta2- adrenergic receptors

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6
Q

Sympathetic nervous system stimulation causes?

A

Bronchodilation

Increased rate & depth of respirations

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7
Q

Parasympathetic nervous stimulation causes?

A

Bronchconstriction

Decreases rate & depth of respirations

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8
Q

Aerosol Therapy effects

A

Immediate relief of bronchospasm

Loosens thick mucus

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9
Q

Disadvantages of Aerosol Therapy

A

Difficult to measure dose (only 10–50% of drug is placed)
side effects occur if client swallows drug
bitter taste
must rinse mouth

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10
Q

Small volume nebulizer (SVN)

A

Aerosol
Vaporizes liquid drug into fine mist
Uses small machine and face mask

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11
Q

Asthma

A

inflammation and constriction of airway

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12
Q

Status Asthmaticus

A

acute attack with severe bronchospasm

does not respond well to bronchodilator therapy

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13
Q

Rescue medication types

A

Short acting beta2-agonists

Anticholingerics

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14
Q

Controller medication types

A

Inhaled corticosteroids
Long acting beta2-agonists
Leukotriene modifiers
Mast cell stabilizers

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15
Q

Bronchodilators

A

Beta agonists
Albuterol (Proventil)
Salmeterol (Serevent)
Salmeterol + Fluticasone (Advair)

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16
Q

Bronchodilator mechanism of action

A

stimulates sympathetic receptors in bronchial smooth muscle to cause bronchodilation

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17
Q

Beta2-Adrenergic Agonists

A

Sympathomimetics

Most effective drugs for relieving acute bronchoconstriction

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18
Q

Beta2-Adrenergic Agonists action

A

activate beta2-receptors in bronchial smooth muscle to cause bronchodilation

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19
Q

Beta2-Adrenergic Agonist route

A

inhalation

orally

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20
Q

Beta2-Adrenergic Agonist oral therapy

A

Longer duration of action than oral

can cause systemic effects of tachycardia, dysrhythmias, hyperglycemia(because of steroid component)

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21
Q

Beta2-Adrenergic Agonist long term use

A

decreased duration of action
leads to increased dose or addition of glucocorticoid
beta 2 receptors may decrease as you age

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22
Q

salmeterol (Serevent) category

A

Beta2-Adrenergic Agonists

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23
Q

salmeterol (Serevent) mechanism of action

A

selectively binds to beta2-receptors in bronchial smooth muscle
causes bronchodilation

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24
Q

salmeterol (Serevent) use

A

prevention of exercise-induced bronchospasm

not for acute rescue, given hours before exercise

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25
salmeterol (Serevent) adverse effects
headaches, throat irritation nervousness, restlessness, tachycardia, dry mouth
26
Anticholinergics action
block parasympathetic nervous system causing bronchodilator effect possible alternative to beta agonists
27
Ipratropium (Atrovent) category
Anticholinergic
28
Ipratropium (Atrovent)
slower and less effective than beta 2 agonists | most effective when combined with beta 2 agonist or glucocorticoid
29
Tiotropium (Spiriva) category
Anticholinergic
30
Tiotropium (Spiriva) adverse effects
dry mouth, GI distress, HA, anxiety, rare systemic
31
Anticholinergic contraindications
narrow-angle glaucoma, benign prostatic hyperplasia, renal disorders, urinary bladder neck obstruction do not give under 12 years old
32
Albuterol (Proventil) length of action
short
33
Salmeterol (Serevent) length of action
moderate
34
Salmeterol + Fluticasone (Advair) length of action
moderate plus steroid for long action
35
Beta2-Adrenergic Agonist contraindications
soy or peanut allergy
36
Anticholinergics ending
tropium
37
Ipratropium (Atrovent) mechanism of action
bronchodilation by blocking cholinergic receptors in bronchial smooth muscle
38
Ipratropium (Atrovent) use
acute bronchospasm chronic bronchitis symptomatic relief of nasal congestion
39
Ipratropium (Atrovent) adverse effects
cough, drying of nasal mucosa, hoarseness, bitter taste
40
Methylxanthines category
bronchodilators related to caffiene
41
Methylxanthines ending
lline
42
theophylline (Theo-dur) category
Methylxanthines
43
theophylline (Theo-dur) cautions
narrow margin of safety & interacts with many drugs
44
why don't we use Methylxanthines
Less effective and produce more side effects than beta 2-agonists
45
Methylxanthines adverse effects
profound nervousness | nausea, vomiting, CNS stimulation, dysrhythmias, insomnia
46
Methylxanthines route
intravenous or oral
47
Methylxanthines use
long-term prophylaxis of asthma that is unresponsive to beta-agonists or glucocorticoids
48
theophylline (Theo-dur) use
given IV for an acute event
49
What to assess when giving Methylxanthines
Respiratory and pulse rate, cardiac rhythm, lung sounds | Respiratory effort, skin color, oxygen-saturation level
50
conditions contraindicated with Methylxanthines
Coronary artery disease, angina pectoris Severe renal or liver disorders, peptic ulcer Benign prostatic hyperplasia, diabetes mellitus
51
Glucocorticoids action
decrease activation of inflammatory cells and increase production of anti-inflammatory mediators Diminish mucus production Sensitize bronchial muscle to be more responsive to beta2-agonist Reduce bronchial hyper responsiveness to allergens
52
Glucocorticoids route
inhaled or oral
53
Glucocorticoids inhaled use
preventing an asthma attack
54
Glucocorticoids oral use
short-term therapy of severe, acute asthma
55
Oral Glucocorticoids time
Limit therapy to 5-7 days
56
Oral Glucocorticoids adverse effects
adrenal gland atrophy, peptic ulcers, osteoporosis, hyperglycemia more dangerous than inhailed
57
inhaled Glucocorticoids time
take 4-8 weeks for maximal effectiveness | taken daily for therapeutic effect
58
inhaled Glucocorticoids adverse effects
hoarseness, candidiasis
59
Glucocorticoids teaching
rinse mouth after use (all steroid inhalers)
60
Cautions when using Glucocorticoids
PT's with hypertension, GI disease, congestive heart failure, thromboembolic disease Closely monitor blood glucose levels
61
beclomethasone (Beclovent, Beconase, Vancenase, Vanceril) | category
Glucocorticoid
62
beclomethasone (Beclovent, Beconase, Vancenase, Vanceril) mechanism of action
reducing inflammation
63
beclomethasone (Beclovent, Beconase, Vancenase, Vanceril) use
decrease # of asthma attacks allergic rhinitis not for acute attack use 1-2 inhalations tid (max 20)
64
beclomethasone (Beclovent, Beconase, Vancenase, Vanceril) adverse effects
oropharyngeal candidiasis, dry mouth, cough, sore throat
65
Leukotrienes
occur naturally in the body mediators of immune response Promote edema, inflammation & bronchoconstriction Involved in allergic and asthmatic reactions
66
Leukotriene Modifiers use
oral medications used for asthma prophylaxis | not for acute tx
67
Leukotriene Modifiers mechanism of action
Reduce inflammation/edema
68
Zileuton (Zyflo) category
leukotriene modifier
69
Zafilukast (Accolate) & Montelukast (Singulair)
block leukotriene receptors May take up to 1 week for optimum therapeutic benefit take in AM to avoid insomnia
70
Zileuton (Zyflo) mechanism of action
blocks lipoxgenase, an enzyme that synthesizes leukotrienes
71
Zileuton (Zyflo) time
Must be taken QID | More rapid onset of action
72
What to monitor with Leukotriene Modifiers
Respiratory and pulse rates, respiratory effort, lung sounds Skin color, oxygen-saturation level Liver finction PT & INR when taking coumadin
73
zafirlukast (Accolate) category
Leukotriene Modifier
74
zafirlukast (Accolate) mechanism of action
prevents airway edema and inflammation by blocking leukotriene receptors in airways
75
zafirlukast (Accolate) use
for prophylaxis of persistent, chronic asthma
76
zafirlukast (Accolate) adverse effects
headache, nausea, diarrhea, rare hepatic failure, depression, insomnia, dark urine, clay colored stools (indicate hepatic involvement)
77
Mast-Cell Stabilizers action
inhibit mast cells from releasing histamine and other chemical mediators Reduce inflammation
78
Mast-Cell Stabilizers teaching
take daily takes weeks to reach therapeutic level not for acute attack less effective than glucocorticicoids
79
Cromolyn (Intal) category
mast cell stabilizers
80
Cromolyn (Intal) administration
through MDI of nebulizer | Inhaled 4-6x/day due to short half life
81
Cromolyn (Intal) adverse effects
stinging or burning of nasal passages, throat irritation, nasal congestion Uncommon: bronchospasm, anaphylaxis unplesent taste
82
Chronic Obstructive Pulmonary Disease (COPD)
characterized by airflow obstruction resulting from chronic bronchitis or emphysema
83
emphysema characteristics
loss of elastic recoil in the lungs so they are overly distended destruction of elastic lining trapping air in distal spaces
84
emphysema breathing pattern
Use of accessory muscles, tachypnea, pursed-lip breathing
85
Chronic Bronchitis
productive cough for 3 months in each of 2 successive years
86
Chronic Bronchitis characteristics
Potential cor pulmonale (collapse), atelectasis | Increased airway resistance
87
COPD Drug Therapy
Bronchodilators (maintenance) Corticosteroids (exacerbations) Mucolytics & expectorants Antibiotics
88
Parasympathetic
constriction
89
Sympathetic
dilation

Pharm 201 (24 decks)

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