Exam 2 36 37 41 Flashcards
(179 cards)
1
Q
Two virus’ that cause the common cold
A
Rhinovirus
influenza virus
2
Q
How does virus’ cause upper Respiratory infection
A
by invading the tissues (mucosa) of the upper respiratory tract
3
Q
4 drug classifications that healthcare treat the common cold with
A
- antihistamines
- nasal decongestants
- antitussives
- expectorants
4
Q
T/F when treating the common cold the treatment is generally curative
A
False it is symptomatic
5
Q
Does symptomatic treatment eliminate the causative pathogen?
A
No it is symptomatic so it only treats the symptoms. Curative would treat the pathogen
6
Q
What are some things to watch out for (s/s) regarding antihistamines (4)
A
- drowsiness
- dysrhythmias
- dry mouth
- hypotension
7
Q
Antihistamines medications are (3)
A
Diphenhydramine ( Benadryl)
Hydroxyzine (Vistoril)
Cetirizine (zyrtec)
8
Q
Benadryl (diphenhydramine) gives the pt freedom from? (3)
A
- allergies
- Nausea
- vomiting
9
Q
Vistoril (Hydroxyzine) gives the pt. freedom from? (2)
A
Anxiety
pain
10
Q
___ antagonists are commonly referred to as antihistamines
A
H1
11
Q
2 examples of H1 antagonists antihistamine
A
- Diphenhydramine ( benadryl)
2. Loratadine (Claritin)
12
Q
The definition of Antihistaminic
A
counter acts the effect of the histamine
13
Q
A substance that blocks the neurotransmitter acetylcholine is
A
anticholinergic
14
Q
a substance that induces sedation by reducing irritability or excitement
A
sedative
15
Q
what percentage of the general population is sensitive to various environmental allergies
A
10 to 20%
16
Q
5 histamine-related disorders are
A
- allergic rhinitis
- anaphylaxis
- drug fever
- insect bite reactions
- Urticaria
17
Q
What is urticaria
A
itching
18
Q
3 triggers for an allergic rhinitis
A
- hay fever
- mold
- dust
19
Q
- block action of histamine at H1 receptor sites
- compete with histamine for binding at unoccupied receptors
- cannot push histamine off the receptor if already bound’
These 3 things are all what
A
mechanism of action for antihistamines
20
Q
what happens in the small blood vessels to histamine (think cardio)
A
Dilation and increase permeability
21
Q
dilation and increased permeability of the small blood vessels allows what?
A
substances to leak into tissues
22
Q
What happens to the blood vessels when an antihistamine is given?
A
dilation and increased permeability
this allows substances to leak into the tissues
23
Q
what happens if antihistamine is given (think cardiac)
A
reduced dilation of blood vessels
reduced increase permeability of blood vessels
24
Q
Histamine effects on smooth muscle (exocrine glands)
A
stimulate salivary, gastric, lacrimal, and bronchial secretions
25
Antihistamine effects on smooth muscle (exocrine glands)
reduce salivary, gastric, lacrimal and bronchial secretions
26
Mast cells releasing histamine and other substances result in ____ in the immune system
an allergic reaction
27
The immune system release ____ that binds to histamine receptors, thus preventing histamine from causing a response
antihistamine
28
Antihistamines also effects skin... How? (3)
reduce capillary permeability, wheal-and-flare formation, itching
29
What is the anticholinergic effects caused by antihistamines
drying effect that reduces nasal, salivary, and lacrimal gland secretions
30
What are the nasal, salivary, and lacrimal gland secretions
runny nose, tearing, and itching eyes
31
Some antihistamines can cause __
sedation
32
6 adverse effects of antihistamines
1. anticholinergic (drying effects)
2. dry mouth
3. difficulty urinating
4. constipation
5. changes in vision
6. drowsiness
33
what is the most common adverse effect of antihistamines
anticholinergic
34
What are the two types of antihitamines
1. traditional
| 2. nonsedating/peripherally acting
35
what is an important nursing implication when gathering data regarding antihistamines? (2)
gather data about the condition or allergic reaction that required treatment; also assess for drug allergies
36
what is a nursing implication regarding antihistamines where it is contraindicated (2 disease process)
1. acute asthma attacks
| 2. lower respiratory diseases IE pneumonia
37
A nursing implication, USE WITH CAUTION, for antihistamines is (9)
1. intraocular pressure (glaucoma)
2. cardiac disease
3. renal disease
4. HTN
5. asthma
6. COPD
7. peptic ulcer disease
8. BPH
9. pregnancy
38
a nursing implication for antihistamines that you would instruct your pt to report to you if these should occur are? (3)
1. report excessive sedation
2. report confusion
3. report hypotension
39
a nursing implication for antihistamines that you would instruct your pts to avoid are
1. avoid driving or operating heavy machinery
| 2. avoid alcohol or other CNS depressants
40
Should the pt. be allowed to take over the counter or other prescribed medications while taking antihistamines.
No,
the nursing implication is that we are to instruct pts to not take these medications without checking with thier HCP
41
A nursing implication, should be ..when do you take antihistamines?
with meals to reduce GI upset
42
A nursing implication should be ... if dry mouth occurs teach the pt. to (3)
1. perform frequent mouth care
2. chew gum
3. suck on hard sugar free candy
43
3 drug classifications for cough
1. antitussives
2. expectorants
3. mucolytics
44
what is the mechanism of action for antitussive
reduces coughing in nonproductive cough
45
what are some signs of caution for antitussive
drowsiness, GI upset and constipation
46
Mucus can be so think that ___ and ___ can grow in it
bacteria and virus
47
___ break the links that bind mucus together so it can be coughed up
Mucolytics
48
What is the mechanism of action for expectorants?
irritates mucous membranes to release the mucus
49
what are some signs of caution for expectorants?
GI upset, nausea and vomiting
50
What is the drug example for antitussive
dextromethorphan
51
what is the drug example for expectorant
guaifenesin (robitussin)
52
what is the drug example for mucolytics?
acetylcysteine (mucomyst)
53
what are some side effects of antitussive, mucolytics and expectorant (6)
1. dizziness
2. drowsiness
3. vomiting
4. bronchospasms
5. rhinorrhea
6. nausea
54
what are two primary causes of nasal congestion
1. allergies
| 2. upper respiratory infections ( common cold)
55
What is the common complaint for nasal congestion
excessive nasal secretions
56
3 main types of decongestants
1. adrenergics
2. anticholinergics
3. corticosteroids
57
2 key points about adrenergics
1. largest group of medications for decongestants
| 2. is a sympathomimetic
58
2 key points about anticholinergics
1. less commonly used medication for decongestant
| 2. is a parasympatholytic
59
2 key points about corticosteroids
1. they are topical
| 2. they are also intranasal steroids
60
How are decongestants given? (2)
1. oral
| 2. inhaled/topically applied to the nasal membranes
61
where is the site of action for nasal decongestants
blood vessels surrounding nasal sinuses
62
How do adrenergic (nasal decongestants) work
constrict the small blood vessels that supply URI structures
63
The result of nasal decongestants (adrenergic) are (not end result)
tissues shrink, and nasal secretions in the swollen mucous membranes are better able to drain
64
the end result of adrenergic a nasal decongestant is
nasal stuffiness is relieved
65
Nasal steroids have a ___ effect
antiinflammatory
66
How does nasal steroids work (mechanism of action)
work to turn off the immune system cells involved in the inflammatory response
67
if you decrease inflammation with nasal steroids you ___ congestion
decrease
| yup that easy
68
End result of nasal steroid
nasal stuffiness is relieved
69
what are the two drug effects of nasal decongestants
1. shrink engorged nasal mucous membranes
| 2. relieve nasal stuffiness
70
Adverse effects of adrenergics are (4) for nasal decongestant
1. nervousness
2. insomnia
3. palpitations
4. tremors
71
What systems can be affected by adrenergic stimulation (3) for nasal decongestant
1. heart
2. blood vessels
3. CNS
72
Adverse effects of steroid for nasal decongestants
local mucosal dryness and irritation
73
____ may cause HTN, palpitations, and CNS stimulation.
Decongestants
74
Pts with ___, ___, and ___ stimulation should avoid decongestants
1. HTN,
2. Palpitations
3. CNS stimulation
75
Pts. on medication therapy for ___ should check with their PCP before taking over the counter decongestatnts
HTN
76
Main thing to check for as a nursing implication with regards to decongestants
Allergies
77
A nurse should teach pts. taking nasal decongestants to avoid___
caffeine
78
Nursing implications regarding nasal decongestants should include teaching the pt to report (3)
1 fever
2. cough
3. other symptoms lasting longer than a week
79
a commonly missed nursing implication for nasal decongestant is
monitor for intended therapeutic effects
80
Respiratory secretions and foreign objects are naturally removed by the ___ ___
cough reflex
81
Two mechanism of actions for the cough reflex
1. induces coughing and expectoration
| 2. initiated by irritation of sensory receptors in the respiratory tract
82
what are the two basic types of cough
1. Productive cough
| 2. nonproductive cough
83
___ has congestion, and removes excessive secretions
productive cough
84
___ is a dry cough that produces nothing
nonproductive cough
85
Most of the time, ___ is beneficial
coughing
86
Why is coughing beneficial? (2)
1. removes excessive secretions
| 2. removes potentially harmful foreign substances
87
Give an example of when it would be harmful to cough
after hernia repair surgery
88
Drugs used to stop or reduce coughing (this is the definition)
antitussive
89
Antitussives have two classifications, they are
1. opiod
| 2. nonopioid
90
Antitussives are used only for ___ coughs
nonproductive
91
what is the excepting to the rule for antitussives
may be used in cases where coughing is harmful
92
what is the adverse effects of the antitussive: Benzonatate (5)
1. dizziness
2. headache
3. sedation
4. nausea
5. (others) no freakin clue what she means by that
93
what is the adverse effects of antitussive: Dextromethorphan (3)
1. dizziness
2. drowsiness
3. nausea
94
What is the adverse effects of Antitussive: opioids (5)
1. sedation
2. nausea
3. vomiting
4. lightheadedness
5. constipation
95
what is an assessment nursing intervention for antitussives
perform respiratory and cough assessment, and assess for allergies
96
What teaching nursing implication should be instructed to pts. regarding antitussives
1. instruct pts. to avoid driving or operating heavy equipment because of possible sedation, drowsiness or dizziness
97
Pts. taking chewable antitussive tablets or lozenges should be cautioned about __
do not drink liquids for 30 to 35 minutes afterward
98
pts. taking antitussives should report what symptoms to their caregiver? (4)
1. cough that lasts more than a week
2. a persistent headache
3. fever
4. rash
99
Antitussives drugs are for ___ cough
nonproductive
100
what are the 3 mechanism of action for expectorants
1. drugs that aid in the expectoration of mucus
2. reduce the viscosity of secretions
3. disintegrate and thin secretions
101
what is expectoration mean
removal
102
What are the indications to use expectorants:
used for the relief of productive coughs
103
Productive coughs are associated with: (8)
1. common cold
2. bronchitis
3. laryngitis
4. pharyngitis
5. coughs caused by chronic paranasal sinusitis
6. pertussis
7. influenza
8. measles
104
Guaifenesin is an example of _
expectorant
105
adverse effects of guaifenesin (expectorant)
1. nausea
2. vomiting
3. gastric irritation
106
Iodinated glycerol is an example of ___
expectorants
107
adverse effects of Iodinated glycerol(expectorants)
1. GI irritation
2. rash
3. enlarged thyroid gland
108
An example of herbal products that reduces symptoms of the common cold and recovery time
echinacea
109
adverse effects of echinacea (herbal products) (4)
1. dermatitis
2. GI disturbance
3. dizziness
4. headache
110
expectorants should be used with caution in the ___ or those with ___ or ___ ____. This would be a nursing implication
elderly or those with asthma or respiratory insufficiency
111
Nursing implication for expectorants should include ___ ___ if permitted to help loosen and liquefy secretions
more fluids
112
what teaching nursing implication should you teach your pt. to report to you in regards to expectant
report fever, cough, or other symptoms lasting longer than a week
113
3 methods of giving medications
1. oral
3. Topicals
4. Parenteral
114
6 examples of topical administration of drugs
1. rectal
2. Sublingual
3. nasal
4. eyes
5. ears
6. on the skin
115
two assessments needed to give oral medications
1. can they follow directions
| 2. ability to swallow
116
4 ways to give parenteral medications
1. IV
2. intradermal
3. subcutaneous
4. IM
117
two types of drugs used to treat asthma
1. long-term control
| 2. quick relief
118
3 examples of long-term control of asthma
1. leukotriene receptor antagonists
2. inhaled steroids
3. long-acting beta2-agonists
119
2 examples of quick relief drugs used to treat asthma
1. intravenous systemic corticosteroids
| 2. short-acting inhaled beta2-agonists
120
4 types of respiratory drugs (categories)
1. bronchodilators
2. anticholinergics
3. leukotriene receptor antagonists
4. corticosteroids
121
2 types of bronchodilators used to treat respiratory issues
1. beta-adrenergic agonists
| 2. xanthine derivatives
122
This drug is:
1. sympathomimetic, large group
2. used during acute phase of asthmatic attacks
3. quickly reduce airway constriction and restore normal airflow
4. stimulate beta 2-adrenergic receptors throughout the lungs
bronchodilators: beta-agonists
123
3 beta2-adrenergic agonist drugs
1. albuterol (proventil)
2. Terbutaline sulfate (brethine)
3. Salmeterol (serevent)
124
For Beta2-adrenergic agonist drugs what are some side effects
1. tachycardia
2. headache
3. irritability
4. anginal pain
5. Tremors
125
3 types of nonselective adrenergic (bronchodilator: beta agonists)
1. stimulate alpha
2. beta1 (cardiac)
3. Beta2 (respiratory) receptors
126
What does nonselective beta adrenergic (bronchodilator: beta-agonists) stimulate
stimulates both beta1 and beta2 receptors
127
Example of nonselective beta-adrenergic drugs
epi
128
3 types of bronchodilators: Beta agonists are
1. non selective adrenergic
2. nonselective beta adrenergics
3. selective beta 2 drugs
129
example of selective beta2 drug:
albuterol (proventil)
130
what does selective beta2 drug (bronchodilator beta-agonist) stimulate?
only beta 2 receptors
131
What are 7 adverse effects of beta-agonists both alpha and beta (clown)
1. insomnia
2. restlessness
3. anorexia
4. vascular headache
5. hyperglycemia
6. tremor
7. cardiac stimulation
132
5 beta agonist side effects of beta1 and beta2 (metaproterenol/ alupent)
1. cardiac stimulation
2. tremor
3. anginal pain
4. vascular headache
5. hypotension
133
example of beta1 and beta2 beta-agonists
metaproterenol (alupent)
134
3 adverse effects of beta agonist on beta2
1. hypotension or hypertension
2. vascular headache
3. tremor
135
example of beta 2 beta-agonist
albuterol
136
2 examples of anticholinergic
1. ipratropium bromide (atrovent)
| 2. tiotropium (spiriva)
137
anticholinergics are ___ and have ____ action
slow and prolonged action
138
do you use anticholinergics for acute asthma exacerbation?
NO because they are slow to act
139
5 adverse effects of anticholinergics
1. dry mouth
2. constipation
3. urinary retention
4. blurred vision
5. tachycardia
140
3 examples of plant alkaloid (bronchodilators: xanthine derivatives)
1. caffeine
2. theobromine
3. theophylline
141
The only plant alkaloid that is actually used as a bronchodilator
theophylline
142
2 synthetic xanthine (bronchodilators)
1. aminophylline
| 2. dyphilline
143
xanthine derivatives have a ___ ___ on the kidneys
diuretic effect
144
xanthine derivatives cause ____ stimulation
cardiovascular
145
increasing cardiovascular stimulation is the increase force of ___ and increased __ ___, resulting in increased ___ output and increased ___ flow to the ___
contraction, heart rate, cardiac output, blood flow to the kidneys
146
xanthine derivatives cause bronchodilation by ___ smooth muscle in the airways
relaxing
147
what is the result of xanthine derivatives
relief of bronchospasm and greater airflow into and out of the lungs
148
what is the additional effect of xanthine deriatives
cns stimulation
149
xanthine derivatives adverse effects: (9)
1. nausea
2. vomiting
3. anorexia
4. gastroesophageal reflux during sleep
5. sinus tachycardia
6. extrasystole,
7. palpitations
8. ventricular dysrhythmias
9. transient increased urination
150
what is leukotriene modifiers
newer class of asthma medications
151
examples of asthma medications (3)
1, montelukast (singulair)
2. zafirlukast (accolate)
3. zileuton (zyflo)
152
define leukotrienes
substances released when a trigger, such as cat hair or dust, starts a series of chemical reactions in the body
153
leukotriene can cause 3 things. They are?
inflammation, bronchoconstriction and mucus production
154
what assessment findings would you find with a leukotriene reaction
coughing wheezing and sob
155
what prevents leukotrienes from attaching to receptors on cells in the lungs and in circulation
LRTA
156
LRTAs ____ inflammation in the lungs during an asthma episode
blocks
157
an example of a leukotriene is
an allergen
158
LRTAs drug effects block leukotrienes that does 4 things:
1. prevent smooth muscle contraction of the bronchial airways
2. decrease mucus secretion
3. prevent vascular permeability
4. decrease neutrophil and leukocyte infiltration to the lungs, preventing inflammation
159
3 examples of LRTA
1. zileuton (zyflo)
2. Zafirlukast (accolate)
3. Montelukast (singulair)
160
What are the adverse effects of zileuton (zyflo) (6)
1. headache
2. dyspepsia
3. nausea
4. dizziness
5. insomnia
6. liver dysfunction
161
What are the adverse effects of zafirlukast (accolate) (4)
1. headache
2. nausea
3. diarrhea
4. liver dysfunction
162
what are the adverse effects of montelukast (singulair)
1. nausea
2. liver dysfunction
*key is fewer than zyflo and accolate
163
corticosteroids have what type of properties
antiinflammatory
164
what is corticosteroids used for
chronic asthma
165
do you take corticosteroids to relieve acute asthmatic attack
NO to slow takes many weeks before full effects are seen
166
type of forms that corticosteroids can be administered
oral or inhaled forms
167
in corticosteroids which form reduces systemic effects
inhaled
168
stabilize membranes of cells that release harmful bronchoconstriction substances is the mechanism of action for what drug
corticosteroids
169
what are the cells that corticosteroids stabilize?
leukocytes
170
corticosteroids increase responsiveness of bronchial smooth muscle to __-__ __
beta-adrenergic stimulation
171
3 inhaled corticosteroids are
1. beclomethasone dipropionate (QAR)
2. fluticasone (Flovent)
3. budesonide (plumicort)
172
2 oral corticosteroids are
1. prednisolone
| 2. prednisone
173
indications to use inhaled corticosteroids:
1. treatments of bronchospastic disorders that are not controlled by conventional bronchodilators.
174
what is a bronchospastic disorder
asthma
175
is an inhaled corticosteroids is not indicated as
a first line drug for acute asthmatic attacks or status asthmaticus
176
what is status asthmaticus
uncontrolled asthma attack not treatable by the normal drugs
177
adverse effects of inhaled corticosteroids are (5)
1. pharyngeal irritation
2. coughing
3. dry mouth
4. oral fungal infections
5. systemic effects are rare because low doses are used for inhalation therapy
178
2 freedoms that zyrtec (cetirizine) can give the pt.
1. sneezing
| 2. running nose
179
3 properties of antihistamines:
1. antihistaminic
2. anticholinergic
3. sedative
