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Kol- Pharm 323 Spring > Oxygenation- Breathe Baby Breathe > Flashcards

Oxygenation- Breathe Baby Breathe Flashcards

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1
Q

4 ways to breathe in drugs

A
  1. MDI
  2. Respimat
  3. Dry Powder Inhaler
  4. Nebulizer
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2
Q

Which inhaled drug method uses a spacer and requires hand/breath coordination?

A

MDI

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3
Q

Which inhaled drug method is a fine mist and does not have a propellant?

A

Respimat

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4
Q

Which inhaled drug method is breath activated and does not require hand/breathe coordination?

A

Dry Powder inhaler

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5
Q

Which method of inhaled drug uses a machine to deliver aerosolized droplets?

A

Nebulizer

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6
Q

Order the drugs in terms of least to most amount of drug that reaches the lunglies

A

MDI (10%)
Respimat
Dry Powder Inhaler (20%)
Nebulizer

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7
Q

Which method of inhaled drug is a pressurized device?

A

MDI

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8
Q

Time b/w puffs with an inhaler, patient teaching….

A
  • -need to wait at least 1 minute b/w puffs to increase amt of drug into lung
  • -5 minutes with glucocorticoid + MDI
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9
Q

what are actuations

A

of puffs listed on the container

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10
Q

Patient teaching for inhaler usage

A
  • how to use
  • time b/w puffs
  • how long the inhaler is good for
  • cleaning the inhaler
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11
Q

what is GINA?

A

GINA = Global Initiative for Managing Asthma, guidelines for prescribing
-can help nurse determine where someone is in stage of asthma

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12
Q

Respiratory meds are divided into 2 broad categories what are they?

A

Bronchodilators (3) and Anti-Inflammatory (5)

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13
Q

Which 2 respiratory rescue drugs work on the ANS?

A
  1. Beta 2 Agonist = sympathomimetic

2. Anticholingeric (aka muscarinic antagonist–> blocks parasymp actions of Ach)

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14
Q

List 3 classes of bronchodilators

A
  1. Beta 2 Adrenergic Agonist (long and short acting)
  2. Anticholinergic
  3. Methylxanthines
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15
Q

List 5 classes of Anti-inflammatory respiratory meds

A
  1. Glucocorticoids
  2. Leukotriene modifiers
  3. Mast cell stabilizers
  4. Monoclonal Antibodies
  5. Phosphodiesterase Inhibitor
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16
Q

What is the difference b/w SABA and LABA?

A

short acting = albuterol = rescue

long acting = salmeterol = prevention

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17
Q

How does beta 2 adrenergic Agonists work?

A

-Sympathomimetics = emergency life-saving drugs

FXN: Act by relaxing bronchial smooth muscle; resulting in bronchodilation

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18
Q

What is the drug of choice for bronchoconstriction?

A

Beta2-Adrenergic Agonists

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19
Q

Beta2-Adrenergic Agonists end in what?

A

-terol!

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20
Q

Beta2-Adrenergic Agonists are divided based on what?

A
  • Divided based on onset and duration of action:
    • Short acting (SABA) (albuterol)
    • Long acting (LABA) (salmeterol)
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21
Q

Tell me about the duration and orders for Albuterol (proventil HFA)

A

Beta2-Adrenergic Agonists

  • Onset : immediate
  • Peak 30-60 min
  • order every 6 hours w/in hospital for maintenance
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22
Q

Tell me about orders and frequency of LABA Salmeterol

A

Beta2-Adrenergic Agonists

  • Used for PREVENTION
  • Never used as monotherapy–> increased risk of death
    • usually combined with glucocorticoid
  • Not PRN, fixed schedule taken daily
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23
Q

which respiratory drug when used alone can increase risk of death ?

A

Salmeterol (Servent Diskus)
(Beta2-Adrenergic Agonists- “terol”)

-use with glucocorticoid

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24
Q

SE of Beta2-Adrenergic Agonists

A

tachycardia, tremors, palpitations, angina (usually occurs with high doses)

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25
Special consideration for Beta2-Adrenergic Agonists
Tolerance may develop
26
Prototype for Anticholinergic Respiratory drugs?
Prototype: Ipratropium (Atrovent)
27
How does Ipratropium (Atrovent) work?
Anticholinergic Blocks the parasympathetic nervous system causing bronchodilation
28
Tell me about orders and onset for Ipratropium (Atrovent)
Anticholinergic -Typical order: ipratropium neb with albuterol neb Q 6 hrs - Onset: 30 seconds - Peak: in 3 min - Duration: 6 hours
29
Side effects of Ipratropium (Atrovent)
.Anticholinergics dry mouth, irritation of pharynx
30
Ipratropium (Atrovent) is contraindicated in which patient populations
Anticholinergic - Contraindicated if peanut allergy (10% affected) - Contraindicated with glaucoma as it can raise IOP
31
aminophylline (Somophyllin) is prototype for which respiratory class?
bronchodilator | Methylxanthines
32
how is aminophylline (Somophyllin) given?
-SLOW IV administration
33
Theophylline (Theodur) is prototype for which class of resp. drugs?
bronchodilator Methylxanthines
34
Route forTheophylline (Theodur)
oral (bronchodilator Methylxanthines)
35
2 special consideration for Theophylline (Theodur)
bronchodilator -Methylxanthines 1. Narrow window for therapeutic level 2. NO SMOKING on drug
36
List 5 classes of anti-inflamm resp drugs
1. Glucocorticoids 2. Leukotriene modifiers 3. Mast cell stabilizers 4. Monoclonal Antibodies 5. Phosphodiesterase Inhibitor
37
What class does beclomethasone fall under and what is its fxn?
Glucocorticoid- Anti-inflammatory -Suppress inflammation to treat Asthma and COPD
38
Route of administration for beclomethasone?
Glucocorticoid- Anti-inflammatory 1.Inhaled: used daily as prevention Effects: -Little to no systemic effects (inhaled) -May take 1-4 weeks to reach full effect 2. Oral/IV: given for acute bronchoconstriction - Prednisone (oral) - methylpredisone (Solumedrol) IV
39
Side effects of inhaled glucocorticoid?
(anti-inflammatory, prototype beclomethasone) SE: adrenal suppression, candidiasis, dysphonia
40
How do you transition from oral to inhaled glucocorticoids
(anti-inflammatory, prototype beclomethasone) - be on both drugs for a while, then taper off oral - risk adrenal crisis so must be done slowly
41
What class is Montelukast (Singulair) and wha is its fxn
Leukotriene Modifiers- Anti-Inflammatory Used to reduce inflammation -Act by modifying the action of leukotrienes (>important in the inflammatory response resulting in edema, inflammation and bronchoconstriction)
42
Is Montelukast (Singulair) used for prevention or rescue? route/onset?
prevention - PO Daily - Maximal effects develop within 24 hours of first dose
43
Side effect of Montelukast (Singulair)
Leukotriene Modifiers- Anti-Inflammatory neuropsychiatric effects
44
what class is Cromolyn (Intal) and what is its fxn?
Mast Cell Stabilizers- Anti-inflammatory Resp Med/ Allergic Rhinitis preventer Inhibits mast cells from releasing histamine and other chemical mediators of inflammation
45
is Cromolyn (Intal) used for rescue or prevention?
Mast Cell Stabilizers- Anti-inflammatory Resp Med/ Allergic Rhinitis preventer Prevention
46
Cromolyn (Intal) route and onset?
Mast Cell Stabilizers- Anti-inflammatory Resp Med/ Allergic Rhinitis preventer Route: Inhaler, nebulizer Onset: several weeks
47
What can happen if you stop Cromolyn (Intal) suddenly? what are the side effects?
Mast Cell Stabilizers- Anti-inflammatory Resp Med/ Allergic Rhinitis preventer - Rebound bronchospasm is stopped abruptly - SE: cough and bronchospasm
48
What class od drugs is Omalizumab (Xolair) and how does itt fxn?
Monoclonal Antibody- Antiinflammatory FXN: Binds to IgE in the body
49
What does Omalizumab (Xolair) treat?
Monoclonal Antibody- Antiinflammatory -Severe, persistent allergic asthma to dust mites/dander not controlled by high dose steroids
50
Which anti-inflammatory resp. drug is given by sub q injection every 2-4 weeks? Why does this med suck?
Omalizumab (Xolair) $10,000/ year cost! (Monoclonal Antibody- Antiinflammatory )
51
is Omalizumab (Xolair) for rescue or prevention?
prevention! | Monoclonal Antibody- Antiinflammatory
52
Omalizumab (Xolair) side effects?
(Monoclonal Antibody- Antiinflammatory ) SE: viral infections, URI, sinusitis, headache, injection site response *Serious SE: anaphylaxis (observe for 2 hours after first few doses then 30 minutes for following doses)
53
What class of drug is Roflumilast? How does it fxn?
Phosphodiesterase type 4 (PDE4) Inhibitor - Anti-Inflammatory -It blocks the action of an enzyme (PDE4) that breaks down cAMP resulting in decreased release of inflammatory mediators
54
Indication for using roflumilast?
Phosphodiesterase type 4 (PDE4) Inhibitor - Anti-Inflammatory Indication: Severe COPD with chronic bronchitis
55
Side effects of Roflumilast?
Phosphodiesterase type 4 (PDE4) Inhibitor - Anti-Inflammatory Common SE: loss of appetite, weight loss Serious SE: psychiatric effects (anxiety, depression, suicide)
56
Which two anti-inflammatory resp. drugs have psych effects?
1. Montelukast (Singulair) Leukotriene Modifiers 2.roflumilast Phosphodiesterase type 4 (PDE4) Inhibitor
57
Which drug falls into 2 categories- Anti-inflammatory Resp Med/ Allergic Rhinitis preventer
Cromolyn (Intal)- Mast Cell Stabilizer
58
Drugs for allergic rhinitis are divided into what 2 categories?
Preventers (3) and Relievers
59
What are the 3 kinds of allergic rhinitis preventers
1. Antihistamines 2. Intranasal glucocorticoids 3. Mast Cell Stabilizers
60
Antihistamines are divided into what 2 categories
1st gen and 2nd gen
61
How do antihistamines work?
Allergic Rhinitis Preventer Work to block the actions of histamine at the H1 receptor
62
What are Antihistamines indicated for?
1st line therapy for mild/mod seasonal allergies | -Most effective when taken prophylactically
63
What class is diphenhydramine (Benadryl) and what is its side effect?
Prototype 1st generation Antihistamine -Allergic Rhinitis Preventer SE: sedation anticholinergic effects
64
What class is loratadine and what are its side effects?
Prototype 2nd generation Antihistamine -Allergic Rhinitis Preventer SE: sedation can occur
65
What class is fluticasone (flonase) and what is it used for?
Intranasal glucocorticoids -Allergic Rhinitis Preventer -MOST effective for seasonal allergies
66
What is are most effective treatment for seasonal allergies?
fluticasone (flonase) Intranasal glucocorticoids -Allergic Rhinitis Preventer
67
fluticasone (flonase) route?
Intranasal glucocorticoids -Allergic Rhinitis Preventer Route: Administered with a metered dose spray device
68
Patient education for fluticasone (flonase)
Intranasal glucocorticoids -Allergic Rhinitis Preventer Education for using intranasal: opposite hand for nostril, point nose to toes, try to keep spray off of septum, gently sniff in
69
Side effects of fluticasone (Flonase)
Intranasal glucocorticoids -Allergic Rhinitis Preventer SE: drying/burning sensation, epistaxis
70
fluticasone (Flonase)- does it have systemic or localized effects?
Intranasal glucocorticoids -Allergic Rhinitis Preventer Action and SE limited to nasal passages
71
What are the two prototype for Allergic Rhinitis Relievers? What class do they fall under
pseudoephedrine (Sudafed) oxymetazoline (Afrin) --Sympathomimetics (Decongestants)
72
What class pseudoephedrine (Sudafed) and how does it fxn?
Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever Fxn: Stimulate the sympathetic nervous system to relieve nasal congestion -Alpha 1 agonist , causes vasoconstriction
73
What route can pseudoephedrine (Sudafed) be given?
Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever Route: oral or intranasal -Oral: slower onset of action
74
Side effects of pseudoephedrine (Sudafed)?
Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever HTN, CNS stimulation (insomnia)
75
Which patient population should avoid pseudoephedrine (Sudafed)?
Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever -Should not be used in cardiac patients
76
What class of drug is oxymetazoline (Afrin) and what is its route?
Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever
77
What can happen with prolonged use of oxymetazoline (Afrin) and what we gonna do about it?
Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever -->Rebound congestion: prolonged use causes escalating congestion requiring more drug to get the same results (build up tolerance) Ways to come off of it: 1. cold turkey 2. use in 1 nostril at a time 3. use nasal glucocorticoid for 2-6 weeks, start it 1 week before coming off of Afrin
78
What is recommended duration of use for oxymetazoline (Afrin)
Sympathomimetics (Decongestants) - Allergic Rhinitis Reliever use no longer than 3-5 days lest ye end up with a case of the Rebound Congestion
79
Antitussives are divided into what 2 categories?
Opioid - Codeine | Non-Opioid - dextromethorphan (robitussin)
80
What is Codeine the prototype for?
Opioid antitussive
81
What schedule of drug is Codeine?
(Opioid antitussive) - Usually combination drugs - Schedule II if alone or Schedule IV if combined
82
How big of a dose do ya need to suppress a cough with codeine?
(Opioid antitussive) low dose!
83
What class of drug is dextromethorphan (robitussin) ?
Nonopioid antitussive
84
High doses of dextromethorphan (robitussin) can lead to what?
(Nonopioid antitussive) | -High doses can lead to euphoria and can be abused
85
What is the most frequently used OTD formulation?
dextromethorphan (robitussin) | Nonopioid antitussive
86
When do we want to use cough medicine?
Stopping a cough is NOT always beneficial - can be good to expectorate mucus - use if interrupting daily life/sleep --> give at bed
87
What the heck is guaifenesin (mucinex)? what does it do?
- Fxn: Drugs that increase bronchial secretions | - Expectorant-->Stimulate flow of secretions
88
What in the hairy hell is acetylcysteine (Mucomyst) and how does it work?
Mucolytic --> makes mucus more watery; cough more productive
89
hat route do we give acetylcysteine (Mucomyst) for its mucolytic properties?
Nebulizer

Kol- Pharm 323 Spring (41 decks)

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