Drugs Acting on the Respiratory System

Question 1

H1 blockers or antagonists

Answer 1

Antihistamines

Question 2

• Decrease nasopharyngeal secretions by blocking the H1 receptors
• Commonly used to treat colds, allergic rhinitis but not useful in emergency situations like anaphylaxis

Answer 2

Antihistamines

Question 3

Antihistamines

Cause drowsiness, dry mouth, and other anticholinergic symptoms

Answer 3

1st Generation Antihistamines

Question 4

drug under 1st generation antihistamines

Answer 4

diphenhydramine (Benadryl)

Question 5

Antihistamines

• non-sedating antihistamines because they have little to no effect on sedation
• cause fewer anticholinergic symptoms

Answer 5

2nd Generation Antihistamines

Question 6

Drugs under 2nd generation antihistamines

Answer 6

cetirizine, fexofenadine, loratadine, azelastine

Question 7

MOA of diphenhydramine

Answer 7

Diphenhydramine blocks the effects of histamine by competing for and occupying H1 receptor sites.

Question 8

Side Effects:

• Drowsiness, dizziness, fatigue, and disturbed coordination
• Anticholinergic effects (dry mouth, urine retention, blurred vision)

Answer 8

1st Generation Antihistamines

Question 9

• suppress or inhibit coughing
• act on the cough control center in the medulla to suppress the cough reflex

Answer 9

Antitussives

Question 10

Antitussives are indicated if the cough is ________ and ________

Answer 10

nonproductive and irritating

Question 11

major antitussives (4)

Answer 11

• benzonatate
• codeine
• hydrocodone
• dextromethorphan

Question 12

MOA of dextromethorphan, codeine, and hydrocodone

Answer 12

Dextromethorphan suppresses the cough center in the medulla; however, it does not depress respiration.

Question 13

MOA of benzonatate

Answer 13

Benzonatate acts by anesthetizing stretch receptors throughout the bronchi, alveoli, and pleura.

Question 14

____________ relieves cough caused by pneumonia, bronchitis, the common cold, and COPD like emphysema.

Answer 14

Benzonatate

Question 15

Antitussives

Can be used during ____________ when the patient needs to avoid coughing.

Answer 15

bronchoscopy

Question 16

____________ are used to treat intractable cough usually associated with lung cancer.

Answer 16

Narcotic antitussives (codeine and hydrocodone)

Question 17

____________ may cause excitation, an extremely elevated temperature, hypertension or hypotension, and coma when taken with monoamine oxidase inhibitors (MAOI).

Answer 17

Codeine and hydrocodone

Question 18

Dextromethorphan used with ____________ may produce excitation, an elevated body temperature, hypotension, and coma.

Answer 18

MAOIs

Question 19

____________ may increase CNS depression when taken with other CNS depressants including alcohol, barbiturates, sedative-hypnotics, and phenothiazines.

Answer 19

Codeine

Question 20

drugs under asthma drugs

Answer 20

• methylxanthines
• pirbuterol
• cromolyn sodium

Question 21

xanthine derivatives

Answer 21

Methylxanthines

Question 22

Bronchodilators used in asthma

Answer 22

Methylxanthines

Question 23

Stimulate CNS and respiration, dilate coronary and pulmonary vessels, and cause diuresis

Answer 23

Methylxanthines

Question 24

Relaxes the smooth muscles of the bronchi, bronchioles, and pulmonary blood vessels by inhibiting the enzyme phosphodiesterase resulting in an increased cAMP which thereby promotes bronchodilation.

Answer 24

Theophylline

Question 25

Prescribed for the maintenance therapy for clients with chronic stable asthma and COPDs

Answer 25

Theophylline

Question 26

MOA of theophylline

Answer 26

Increases the level of cAMP resulting in bronchodilation

Question 27

Decreases airway reactivity and relieves bronchospasm by relaxing bronchial smooth muscle

Answer 27

Theophylline

Question 28

# Side Effects Anorexia, nausea and vomiting, gastric pain caused by increased gastric acid secretion, intestinal bleeding, nervousness, dizziness, headache, irritability, cardiac dysrhythmias, tachycardia, palpitations, marked hypotension, hyperreflexia, and seizures

Answer 28

Methylxanthines

Question 29

Can cause hyperglycemia, decreased clotting time and rarely leukocytosis

Answer 29

Methylxanthines

Question 30

Methylxanthines should not be taken with caffeinated products because of its ___________

Answer 30

diuretic effect

Question 31

IV prep must be administered slowly as rapid administration causes dizziness, flushing, hypotension, severe bradycardia, and palpitations.

Answer 31

Methylxanthines

Question 32

An aerosolized bronchodilator

Answer 32

Pirbuterol

Question 33

MOA of pirbuterol

Answer 33

Acts as beta 2 adrenergic receptor agonist to relax the smooth muscle of the bronchi

Question 34

# Adverse Reactions Nervousness, Tremors, Headache, Palpitations, Rapid heart rate, Chest pain or tightness, Nausea, Diarrhea, Dry mouth

Answer 34

Pirbuterol

Question 35

Used primarily to prevent bronchial asthma

Answer 35

Cromolyn Sodium

Question 36

MOA of cromolyn sodium

Answer 36

Prevents the release of histamine and slow-reacting substances of anaphylaxis by stabilizing the mast cell membrane.

Question 37

Given by inhalation to improve breathing

Answer 37

Cromolyn Sodium

Question 38

# Adverse Reactions Bronchospasm, Sneezing, Wheezing, Cough, Nasal congestion and throat irritation, Dizziness, Pain, Nausea, Headache, Skin rash

Answer 38

Cromolyn Sodium

Question 39

Act directly on mucus, breaking down sticky, thick secretions so they are more easily eliminated

Answer 39

Mucolytics

Question 40

MOA of mucolytics

Answer 40

Liquefy and loosen thick mucus secretions so that they can be expectorated.

Question 41

drug under mucolytics

Answer 41

Acetylcysteine

Question 42

* Administered by nebulization * May be administered with bronchodilator for patients with asthma or hyperactive airway disease because increased secretions may obstruct the bronchial airways

Answer 42

Acetylcysteine

Question 43

# Side Effects nausea, vomiting, stomatitis (oral ulcers), and “runny nose”

Answer 43

Acetylcysteine

Question 44

Acetylcysteine can be used as an antidote for ____________ if given within 12-24 hours after the overdose ingestion.

Answer 44

acetaminophen overdose

Question 45

MOA of acetylcysteine

Answer 45

Decreases the thickness of the respiratory tract secretions by altering the molecular composition of mucus.

Question 46

* An enzyme that digests the DNA in thick sputum secretions of clients with cystic fibrosis (CF) * Helps reduce respiratory infections and improves pulmonary functions

Answer 46

Dornase Alfa

Question 47

# Side Effects chest pain, sore throat, laryngitis, hoarseness

Answer 47

Dornase Alfa

Question 48

Thins mucus so it’s cleared more easily out of airways

Answer 48

Expectorants

Question 49

* Soothe membranes in the respiratory tract * Loosen bronchial secretions so that can be eliminated by coughing

Answer 49

Expectorants

Question 50

drug under expectorants

Answer 50

guaifenesin

Question 51

____________ is the best expectorant

Answer 51

hydration

Question 52

# Indications * For the relief of cough from minor bronchial irritation * Bronchitis, sinusitis, influenza * Bronchial asthma and emphysema * Other respiratory disorders

Answer 52

Expectorants

Question 53

MOA of expectorants

Answer 53

By increasing the production of respiratory tract fluids, expectorants reduce the thickness, adhesiveness, and surface tension of mucus making it easier to clear from the airways .

Question 54

Provide a soothing effect on the mucus membranes of the respiratory tract

Answer 54

Expectorants