Drugs Affecting the Respiratory System Flashcards Preview

Pharmacology Exam 2 > Drugs Affecting the Respiratory System > Flashcards

Flashcards in Drugs Affecting the Respiratory System Deck (57):
1

Bronchodilators

Beta-Adrenergic Agonists (albuterol & salmeterol)
Anticholinergics (ipratropium)
Xanthine Derivatives (theophylline)

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Nonbronchodilating

Leukotriene Receptor Antagonists (montelukast)
Corticosteroids (methylprednisolone)

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Antihistamines

diphenhydramine & loratadine

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Decongestants

phenylephrine

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Antitussives

Codeine & benzonatate

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Expectorants

guaifenesin

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MOA of Beta-Adrenergics

Beta-2 Agonists, can be selective or non-selective
short acting (albuterol- instantaneous, rescue inhalers)
long acting (salmeterol- onset 30 minutes, asthma control)

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Indications of Beta-Adrenergics

acute and chronic bronchospasms
(asthma attack or control of asthma)

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Contraindications of Beta-Adrenergics

Allergy
HTN (even with albuterol and salmeterol because of poorly controlled HTN)
dysrhythmias and increased risk of stroke (especially with nonselective that have cardiac implications

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Adverse Effects of Beta-Adrenergics

Very few with selective
Related to hyper (insomnia, restlessness, tremors, signs of cardiac stimulation)

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Interactions with Beta-Adrenergics

competitive with Beta-blockers
potential for hyperglycemia, because it promotes liver to release extra glucose

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MOA of Anticholinergics

Block acetylcholine from binding

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Indication for anticholinergics

PREVENTION of bronchospasm

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Contraindications of anticholinergics

Allergy to atropine
Glaucoma and BPH (anything that will be negatively effected by an increase in pressure)

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Adverse Effects of anticholinergics

dry mouth, anxiety, coughing

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Interactions of anticholinergics

additive effects with other anticholinergics

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Nursing considerations of anticholinergics

Teach patient to rinse their mouth- increase compliance
Should only be applied to lungs (inhale but don't swallow)
Monitor lung sounds, pulse ox, respiratory rate, then BP and anxiety/dizziness (HR especially with HTN and cardiac impairment)

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MOA of Xanthine Derivatives

theophylline is metabolized into caffeine!
Prevents Breakdown of cAMP (which normally promotes bronchodilation, so we want to keep in around longer)

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Indications for Xanthine Derivatives

Bronchospasms unrelieved by other medications- severe cases of status asthmaticus (constant bronchospasms- worried about airway patency, not about having a little buzz)

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Contraindications for Xanthine Derivatives

Dysrhythmias, seizures, liver impairment

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Adverse Effects of Xanthine Derivatives

buzzing around room, hyper, anxious, increased HR, insomnia

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Interactions with Xanthine Derivatives

Caffeine (additive), St. John's Wort (increases metabolism of theophylline- gets it out of the system really quick)
Antibiotics decrease metabolism of theophylline (will hang around longer

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Nursing Considerations for Xanthine Derivatives

Monitor HR, respirs, BP

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MOA for Leukotriene Receptor Antagonists

Block inflammatory response
Leukotrienes help gear up the inflammatory response of body, montelukast blocks this

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Indications for Leukotriene Receptor Antagonists

Prophylactic Seasonal Allergy
Should take this no matter what- it is a preventative

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Contraindications of Leukotriene Receptor Antagonists

Specific Allergy to drug or components of drug

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Adverse Effects of Leukotriene Receptor Antagonists

Liver dysfunction

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Interactions with Leukotriene Receptor Antagonists

Phenobarbital and Refampin- decrease concentration of drug in system (increase metabolism so it doesn't stay around as long)

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Nursing Considerations with Leukotriene Receptor Antagonists

Check liver enzymes and neuro status because it can cause liver dysfunction as well as headache, dizziness and insomnia.
Monitor other vital signs, but most importantly watch for respiratory distress.
It is given PO, so it takes longer to get into system, but sticks around longer.

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MOA for Corticosteroids

Stabilize cell wall and increase smooth muscle response to beta stimulation (make smooth muscle more receptive to beta stimulation by decreasing cell wall's irritation)

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Indications for Corticosteroids

Bronchospasm

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Contraindications to Corticosteroids

Fungal Infections (increased risk to develop fungal infections and if they already have one, you can make it worse) and hypersensitivity to corticosteroids (some people become CRAZY with steroids- steroid psychosis)

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Adverse Effects of Corticosteroids

oral infections, adrenal suppression, Cushing's syndrome (too much cortisol), CNS stimulation (steroid psychosis)

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Interactions with Corticosteroids

Systemic, hyperglycemia (corticosteroids promote the release of blood sugar- careful with diabetics), hypokalemia, immunosuppressants, antifungals, antidiabetics

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Nursing considerations for Corticosteroids

BP, glucose, CNS, respirations

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MOA of antihistamines

H1 Antagonists (compete for histamine receptors)
Histamine is part of body's natural immune response when something foreign is sensed-- it binds with H1 receptors which causes BV in nose to vasodilate and become more permeable to fluid (nasal congestion, mucous, red nose)

diphenhydramine is sometimes used as a sleep aid because it has a sedative quality
loratadine is nonsedative and it stops congestion and drainage

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Indications for antihistamines

allergies and colds

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Contraindications for antihistamines

allergy, glaucoma and HTN (nondrowsy)

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Adverse effects of antihistamines

Sedative (diphenhydramine)- drowsy, should not drive
Nonsedative (loratadine)- increased HR, HTN

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Interactions with antihistamines

additive- other antihistamines
competitive- vasodilators

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MOA of Decongestants

shrink mucosal membranes- vasoconstriction (adrenergic agonist)
Most frequently used is phenylephrine

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Indications of Decongestants

Nasal Congestion

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Contraindications of Decongestants

Glaucoma, HTN, CV issue (related to increase of pressure b/c of overall vasoconstriction)
Diabetes (liver effect to increase blood sugar)

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Adverse Effects of Decongestants

Alpha-Adrenergic- stimulating aspects

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Interactions of decongestants

Few mainly HTN effects- mainly OTC b/c of this potential for causing increase in BP

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Nursing Considerations for Decongestants

monitor CV status

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MOA for Antitussives

Suppress cough center in the CNS
Codeine is the most effective, but can cause opiate related side effects-- they are CNS depressants that target the cough center, but opioids effect pain center and can cause respiratory distress

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Indications for Antitussives

Non productive cough-- May have stuff in chest, but airway is so irritated that they can't get anything up-- the antitussive makes cough more productive.

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Contraindications for Antitussives

Decreased LOC, Respiratory Suppression, HTN

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Adverse Effects of Antitussives

CNS depression vs cardiac stimulation

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Interactions of Antitussives

CNS Depressants (additive with codeine)

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Nursing Considerations of Antitussives

possible effects on CNS-- assess LOC and respiratory status

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MOA of Expectorants

Loosen and thin secretions- thick secretions need to be thinned so it is easier to get out

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Indications of Expectorants

Relief of cough associated with non-chronic coughs

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Contraindications of Expectorants

Drug allergy

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Adverse Effects of Expectorants

nausea, vomiting, gastric irritation- if taken on an empty stomach

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Nursing Considerations of Expectorants

Don't give on an empty stomach!