Lilley Chapter 38: Respiratory Drugs Flashcards
(11 cards)
A patient is taking aminophylline intravenously for a severe exacerbation of chronic obstructive pulmonary disease. Which effect does the nurse expect to note when evaluating for a therapeutic response to the medication?
a. Drowsiness
b. Increased HR
c. Increased respiratory rate
d. Increased ease of breathing
d. Increased ease of breathing
What is Aminophylline?
Aminophylline is a bronchodilator, and it’s basically the nerdy cousin of theophylline (they’re in the same drug family).
Its whole personality is based on one goal: opening up the airways to help people breathe easier—especially during a COPD flare-up or asthma attack.
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How does it work?
Aminophylline is part of the methylxanthine class (yes, that’s the same group as caffeine, which is why side effects feel like a triple espresso meltdown).
Here’s what it does:
1. Relaxes bronchial smooth muscle →
This means it tells the muscles around your airways to chill, so your air passages open up more easily.
2. Increases diaphragmatic contractility →
That means it helps your diaphragm (main breathing muscle) work better, like upgrading from a rusty old fan to one that actually blows air.
3. Reduces airway responsiveness to irritants →
So you’re less likely to spasm and wheeze when a breeze hits your lungs wrong.
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Why does it lead to “increased ease of breathing”?
Because it literally opens the pipes, allowing more air to get in and out.
Think of it like pulling a crumpled paper straw back into shape—air finally moves through again. That’s what aminophylline does to inflamed, tightened airways.
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So why aren’t we giving it to everyone all the time?
Because it also:
• Raises heart rate
• Can cause arrhythmias
• Has a super narrow therapeutic window (aka you go from “better” to “ICU” real fast if you screw up the dose)
It’s like using a flamethrower to light a candle. Effective, but risky if you’re not careful.
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TL;DR:
• Aminophylline = bronchodilator
• It opens airways + helps diaphragm function
• Therapeutic effect = easier breathing
• Side effects = caffeine vibes + cardiac chaos if not monitored
Which is an adverse effect associated with the use of xanthine derivatives?
a. Diarrhea
b. Palpitations
c. Bradycardia
d. Dowsiness
b. Palpitations
What are Xanthine Derivatives?
These are bronchodilators.
They’re used to open up the airways in conditions like asthma, COPD, and sometimes when the lungs are being especially dramatic.
The most well-known one is:
Theophylline (sounds like a Shakespeare character, but it’s a drug).
Also:
• Aminophylline (IV form, remember from earlier?)
• Caffeine is technically a xanthine, too, so if you’ve ever chugged an espresso and felt your heart tap-dancing—that’s the vibe.
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What do they do?
• Relax smooth muscle in the bronchi → easier to breathe
• Increase the force of contraction in the diaphragm
• Mild diuretic
• Stimulate the CNS and the heart
They’re kind of like lung Red Bull—they help you breathe better, but they can also make you twitchy, wired, and a little cardiac-y.
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Side Effects?
Oh buddy, the list is very “I drank too much coffee at 3 AM.”
• Palpitations – Your heart does the cha-cha out of rhythm
• Tachycardia
• Nausea/vomiting
• Restlessness, insomnia
• Toxicity risk if blood levels get too high (narrow therapeutic window)
So that’s why the correct answer is:
b. Palpitations
What is the rationale for using inhaled budesonide (Pulmicort)?
a. It causes bronchodilation
b. It this bronchial secretions
c. It inhibits the activity of B-agonists
d. It provides an anti-inflammatory response.
d. It provides an anti-inflammatory response.
What is Budesonide (Pulmicort)?
It’s an inhaled corticosteroid—aka an anti-inflammatory that lives in your lungs rent-free and tells your airways to calm down.
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What does it do?
• Reduces inflammation in the airways
• Prevents asthma and COPD flare-ups
• Keeps airway walls from swelling, which means fewer spasms, less mucus, and more air getting where it needs to go
It does not open up the airways immediately like a rescue inhaler (e.g., albuterol). It’s more of a slow and steady guardian that prevents problems from building up in the first place
A patient has been prescribed an respiratory corticosteroid medication. What should the nurse tell this patient about the proper method for taking this medication?
a. Rinsing of the mouth after using the inhaler is recommended.
b. The tubings and mouthpieces should be cleaned with only hot water.
c. The medications is to be inhaled deeply, with the head tipped backward to maximize opening of the airway.
d. After taking an inhaler medication, the patient should remove the inhaler and hold the breath for at least 20 seconds.
a. Rinsing of the mouth after using the inhaler is recommended.
Inhaled corticosteroids (like budesonide, fluticasone, etc.) are used to reduce inflammation in the airways—awesome for asthma, COPD, etc.
BUT—some of that medication sticks around in your mouth and throat. And guess what thrives in warm, moist, immunosuppressed environments?
Fungus. Specifically, Candida albicans.
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If you don’t rinse after using it, you’re asking for:
• Oral thrush
(White, patchy, gross coating on your tongue and cheeks. Feels like eating sandpaper dipped in regret.)
• Hoarseness
• Cough or irritation in the throat
• A lovely little antifungal prescription in your near future
The physician has prescribed fluticasone (Flovent) to treat a patient’s asthma. What important information should the nurse emphasize when teaching the patient about this medication?
a. The patient must use the proper techniques for inhalation.
b. The medication should be kept on the patient’s person at all times for treatment of an acute asthma attack.
c. The medication is to be taken every day on a continuous schedule, even if symptoms improve.
d. When the asthma symptoms improve, the dosage schedule can be tapered and eventually discontinued.
c. The medication is to be taken every day on a continuous schedule, even if symptoms improve.
Which drug is used in the treatment of acute attacks of bronchial asthma?
a. nedocromil
b. salbutamol (Ventolin)
c. zafirlukast (Accolate)
d. Triamcinolone
b. salbutamol (Ventolin)
A patient has a prescription for two inhalers. One inhaler is a bronchodilator; the other is a corticosteroid. Which instruction should the nurse give the patient regarding these inhalers?
a. The corticosteroid should be taken first.
b. The bronchodilator should be taken first.
c. The two drugs should be taken at least 2 hours apart.
d. The order of administration does not matter with these two drugs.
b. The bronchodilator should be taken first.
— because it’s the polite thing to do. You open the airways before throwing in the corticosteroid, otherwise the medication just awkwardly bounces off tight, angry bronchi like a bad party guest showing up before the door’s even open.
Bronchodilators (like albuterol) do the heavy lifting by relaxing the smooth muscle, letting the airways widen. Then the corticosteroid can sweep in, reduce inflammation, and get all up in there where it’s actually useful.
A patient has recently been placed on inhaled corticosteroids. Which common adverse effects should the nurse discuss with the patient?
a. Fatigue and depression
b. Anxiety and peripheral vasoconstriction
c. Headache and rapid heart rate
c. Oral candidiasis and dry mouth
c. Oral candidiasis and dry mouth
After receiving a nebulizer treatment with a β -agonist, the patient reports feeling slightly nervous and wonders whether the asthma is getting worse. What is the nurse’s best answer to the patient’s concern?
a. “Feeling a little nervous is an expected adverse effect. Let me take your pulse to check it”
b. “The next scheduled nebulizer treatment should be skipped”
c. “I will notify the physician about this adverse effect”
d. “We will hold the treatment for 24 hours”
a. “Feeling a little nervous is an expected adverse effect. Let me take your pulse to check it”
Yes, choice a is correct. Feeling slightly nervous is a common side effect of beta-agonists like albuterol due to their stimulant effect—kind of like the feeling you get when your coffee hits a little too hard, but medically sanctioned. Always good to assess vitals like pulse after the treatment, just in case the nervousness is code for “my heart is doing jazzercise.
For which condition would the nurse anticipate treatment with montelukast?
a. Acute bronchospasm
b. Exacerbation of chronic obstructive pulmonary disease
c. Long-term treatment of emphysema
d. Prophylaxis of asthma in children
d. Prophylaxis of asthma in children
Blue
Blue
