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Cardiopulm Final > Medications > Flashcards

Medications Flashcards

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1
Q

The overall goal of pulmonary medication is to:

Increase:

Decrease:

A

Sympathetic

Decrease parasympathetic

Therefore INCREASE Lumen size in lungs

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2
Q

What are side effects of most medications that enhance sympathetic output

A

Arrythmias

High HR

High BP

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3
Q

4 Mechanisms that Pulmonary meds can work?

A

Bronchodilation

Facilitation of mucociliary action

Increased alveolar ventilation/improved oxygen

Improved control of breathing pattern

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4
Q

What do sympathomimetics do

A

Immitate sympathetic NS

by stimulating Beta 2 Receptors

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5
Q

What is a SABA?

A

Short acting Beta 2 agonist

works in 3-5 mins, lasts 4-6 minutes

THIS IS FOR ACUTE ASTHMA ATTACKS

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6
Q

What is epinephrine used for?

A

Given to promote bronchodilation/increase BP

Used in emergent situations (also asthma attack)

This is not a SABA because it’s nonselective

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7
Q

What is a LABA?

A

Long acting Beta 2 Agonist

this is NOT for acute asthma attacks

-used to help patients breathe in their sleep or for maintence therapy

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8
Q

Albuterol is an example of a

A

SABA

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9
Q

LABA effects kick in how fast, and last for how long?

A

3-30 minutes after inhalation

last up to 12 hours

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10
Q

What is for chronic issues, SABA or LABA?

A

LABA

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11
Q

When a patient first starts taking SABA or LABA, what should we do?

A

Monitor for side effects

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12
Q

You should only take decongestants ____________

A

To get over the initial hump of the problem, do not use chronically!

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13
Q

What do decongestants do?

A

Stimulate alpha-adernergic receptor vasoconstriction of capillaries threfore sreducing fluid secretion in nose

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14
Q

What are side effects of decongestants

A

dizziness hypertension nausea, headache, insomnia, arrythmias

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15
Q

What is a parasympatholytic

A

Supressed parasymp nervous system

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16
Q

What nerve supplies parasympathetic input to lungs?

A

Vagus nerve

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17
Q

Parasympatholytics are used to stop ____________

A

Bronchoconstriction

They’re usually given for any kind of inflammatory lung disease

example: asbestos exposure

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18
Q

What is a S.A.M.A and a L.A.M.A

A

Short acting muscarinic antagonist or Long acting muscarinic antagonist

note: Used in outpatient

reduces secretions in mouth and airways, used to treat paralysis of respiratory system due to poisoning

Most common kind: atropine

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19
Q

Are muscarinic agents (SAMA and LAMA) used for asthma?

What are side effects of muscarinic agents?

A

NO

Dry mouth, headache, tachycardia, blurred vision

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20
Q

Caffine is an example of what

A

Methylxanthine

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21
Q

What does a Methylxanthine do?

A

-Positive inotrope

Increases sympathetic output

Blocks breakdown of cAMP

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22
Q

How do methylxanthines helpful to patients

A

Increases exercise tolerance w/ improved contractility and reduces fatigue of diaphram

note: These drugs can be preformance enhancing

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23
Q

How will a patient feel taking methylxanthines?

A

Theyll feel sick

Side effects: Chest pain, tremors, urination, insomnia, dizziness, nausea

CHECK THEIR VITALS

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24
Q

What is the good thing about corticosteroids

What is the bad thing?

A

Good: Can help open up airway indirectly

Bad: RIP Immune system

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25
What are other side effects of corticosteroids
Myopathy Edema Osteopenia Hyperglycemia HYPOKALEMIA THROMBUS FORMATION
26
Is a corticosteroid a bronchodilator?
No, but it indirectly helps
27
Can we do aggressive manual manipulations for patients on corticosteroids long term
No because their bones are wittle bitty toothpicks
28
How are patients divided when deciding what drugs to administer?
By amount of moderate exacerbations leading to hospitalization and by dyspnea ranked on a scale of 1-10
29
What is a meter dosed inhaler?
Delivers specific amount of meds per short burst from device drug in aresol form must coordinate inhalation with puff from inhaler
30
What are spacers used for w/ inhalers?
Used to reduce speed of meds into mouth so you dont have to time it perfectly
31
What is the most common breathing treatment method of delivery
Jet Nebulizer Tubing connected to compressed air soruce connected to patient w/ nose piece or face mask
32
What is bad about Respiratory stimulant drugs?
These medications can reduce the natural drive to breathe by the CNS note: too much oxygen can damage lungs These drugs are usually used to combat excessive use of drugs like narcotics that depress respiratory center
33
Can a PT put someone on oxygen if they feel the patient needs it what about turn up their current level of oxygen
NO, oxygen is a medication given in a specific amount by the doctor no touchy touchy you dumb PTs!
34
Respiratory depressants like Morphine, Midazoam, Propofol, and Diazepram are often used as a mild sedative for surgical procedures, are these appropriate for patients w/ respiratory disease?
NO AVOID THESE
35
What is the typical path that a DVT follows?
Lower extremity -> RA -> RV -> Pulmonary Trunk -> gets stuck in lung somewhere
36
Whats more dangerous, a DVT in the thigh or in the calf?
Thigh Proximal DVTs are more dangerous
37
38
What should a PT do during a patient interview
Screen for risk of DVT
39
Is screening for risk the same thing as screening for DVTs
NO!
40
What can PTs recommend to individuals at high risk of DVT
Mechanical compression Example: Compression stockings
41
What criteria is used to establish the likihood of a DVT
Wells Criteria
42
Is Wells criteria diagnostic for a DVT?
no
43
Physical therapist should verify patients with a DVT are ___________ and initiate mobilization when _____________________
Patient is on anticoagulant Therapeutic levels of anticoagulant have been reached
44
Can we mobilize patients with an IVC? (inferior vena cava filter)
Yes, when hemodynamically stable talk to physician first
45
What are 4 ways a PT can decrease risk of DVT
Encourage mobility use mechanical compession consult physican about medication provide education about prevention
46
What is the Padua Prediction score
Assesses RISK of DVT, not SYMPTOMS
47
What should you use if you want to establish the likelihood a patient has a DVT
Wells Criteria
48
What are classic signs of a DVT
Localized pain, swelling, discoloraton, warmth Symptoms cannot diagnose a DVT! Physical Exam findings are not sensitive or specific and in 50% of DVTs there are none of these symptoms
49
Wells Criteria and other scoring algorthms are HIGHLY SENSITIVE, what does this mean?
Very sensitive to what theyre suppose to pick up, but can produce many false positives
50
What is Homan's sign
USELESS
51
How is a DVT usually diagnosed
With a D-dimer test followed by a Doppler Ultrasound
52
What is prothrombin time?
The average time it takes for a clot to form
53
A D Dimer test will typically show what?
Under 500 ng/ML firinogen in blood. If there is OVER 500, this is positive for potential clots
54
What is normal pro-thrombin time? If this time is increased what happens?
Normal 11-13 Helps prevent clots, however too much of an increase puts you at risk of bleeding
55
What is INR
International Normalized Ratio Used to monitor affectiveness of warfarin for blood thinning
56
Too low INR means what? Too high INR means what?
too low: risk of clots too high: risk of bleeding
57
58
INR helps you determine if it's safe to get a patient up when they're taking anti-coagulants, but before this you should...
check w/ medical team
59
What is diagnostic test is used first for patients w/ high chance of DVT For patients w/ low chance?
High chance: Bedside ultrasound (doppler) Low chance: D-Dimer
60
If a patient took anticoagulants less than _____ hours ago do not get them up
2 hours However all meds are different, check w/ physician before mobilizing The algorthm seems to go: Under 2: NO mobility 3-5: check w/ physician Over 5: Mobilize
61
Will an IVC help w/ a DVT in your arm?
No
62
left off on slide 54

Cardiopulm Final (8 decks)

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