Respiratory Flashcards
(108 cards)
1
Q
Describe the pathophysiology of a cold (2)
A
- Inflammatory response –> increased mucus
- Mucous drips down the pharynx –> esophagus –> lower respiratory tract
2
Q
Release of inflammatory substances in the case of a cold causes …
A
Dilation - nasal congestion
3
Q
Describe the mechanism of action of antihistamines
A
Block histamine receptors
4
Q
Do NOT push off histamine that is …
A
Already bound to a receptor (compete for unoccupied receptors)
5
Q
Histamines are beneficial when …
A
Given early
6
Q
What are the functions of histamine 1? (2)
A
- Smooth muscle contraction
- Capillary dilation
7
Q
What are the functions of histamine 2? (2)
A
- Heart rate acceleration
- Gastric acid secretion
8
Q
Excessive release of histamine can lead to ______
A
Anaphylaxis
9
Q
What are the indications of antihistamines? (3)
A
- Allergies / urticaria
- Motion sickness
- Parkinson’s disease
10
Q
What are the contraindications of antihistamines? (5)
A
- BPH
- Bronchial asthma
- COPD
- Narrow angle glaucoma
- Seizure disorders
11
Q
What is the primary side effect of antihistamines?
A
Drowsiness
12
Q
What are the anticholinergic effects of antihistamines? (4)
A
- Dry mouth
- Visual changes
- Urinary retention
- Constipation
13
Q
Antihistamines require caution use in what population?
A
Elderly men (BPH)
14
Q
What type of antihistamine is diphenhydramine (Benadryl)?
A
1st generation
15
Q
Describe the characteristics of 1st generation antihistamines (2)
A
- High sedating effect
- High anticholinergic effect
16
Q
What type of antihistamine is loratadine (Claritin)?
A
2nd generation
17
Q
Describe the characteristics of 2nd generation antihistamines (2)
A
- Low sedating effect
- Low anticholinergic effect
18
Q
2nd generation antihistamines have ______
A
High antihistamine activity
19
Q
What are some examples of H1 blockers? (4)
A
- Allegra
- Benadryl
- Claritin
- Zyrtec
20
Q
What are some examples of H2 blockers? (4)
A
- Axid
- Pepcid
- Tagament
- Zantac
21
Q
What are the 3 subclasses of nasal decongestants?
A
- Adrenergics
- Anticholinergics
- Corticosteroids
22
Q
Describe the mechanism of action of adrenergics (2)
A
- Constriction –> nasal drainage
- Stimulation of sympathetic nervous system
23
Q
What is the primary indication of adrenergics?
A
Sinusitis
24
Q
What are the side effects of adrenergics? (4)
A
- Increased BP
- Insomnia
- Palpitations
- Tremors
25
What are some examples of adrenergics? (2)
- Sudafed
- Afrin
26
What side effect is associated with Afrin?
Rebound congestion
27
Afrin should be used for no more than ______
3 days
28
Describe the mechanism of action of anticholinergics
Dilation --> prevents nasal drainage
29
Anticholinergics block ______
Acetylcholine
30
What is the primary indication of anticholinergics?
Rhinorrhea
31
What is an example of an anticholinergic?
Atrovent
32
Describe the mechanism of action of corticosteroids
Control of inflammation
33
What is the primary indication of corticosteroids?
Rhinorrhea
34
What are some examples of corticosteroids? (3)
- Flonase
- Nasacort
- Rhinocort
35
What is a contraindication of corticosteroids?
Nasal infection
36
Describe the effects of oral nasal decongestants (3)
- Systemic
- Delayed onset
- No rebound congestion
37
Describe the effect of inhaled nasal decongestants
Risk of rebound congestion with adrenergics
38
Describe the effect of topical nasal decongestants
Risk of rebound congestion with adrenergics
39
What are the 2 types of antitussives?
- Opioid
- Non-opioid
40
Describe the mechanism of action of antitussives
Suppression of cough reflex
41
Opioid antitussives also function as ______
Analgesics
42
What are the only 2 opioids used as antitussives?
- Codeine
- Hydrocodone
43
What are the side effects of opioid antitussives? (3)
- Sedation
- Dizziness
- Constipation
44
What is a possible adverse effect from large amount of opioid antitussives?
Respiratory depression
45
Describe the teaching associated with opioid antitussives (3)
- Do not combine with other CNS depressants
- Avoid ethanol
- No driving
46
What are some examples of non-opioid antitussives? (2)
- Delsym
- Tessalon
47
______ may occur if the recommended dosage of Delsym is exceeded - commonly abused
Sedation
48
Describe the teaching associated with Tessalon
Do not chew capsules - causes numbness in mouth and throat (aspiration risk)
49
What is an example of an expectorant?
Mucinex
50
Describe the mechanism of action of expectorants (2)
- Respiratory tract hydration
- Decreases mucus viscosity
51
What is the primary indication of expectorants?
Productive cough
52
What are the side effects of expectorants? (3)
- Nausea
- Vomiting
- Gastric irritation
53
Describe the teaching associated with expectorants
Increase fluid intake
54
What is an example of a mucolytic?
Mucomyst
55
What are the possible routes of mucomyst? (2)
- PO
- Inhalation
56
Describe the mechanism of action of mucolytics
Decreases mucus viscosity
57
What are the side effects of mucolytics? (3)
- Headache
- Confusion
- Depression
58
Describe the treatment of asthma (2)
- Decrease inflammation
- Bonchodilation
59
Describe COPD
Emphysema and chronic bronchitis
60
What is the primary function of beta adrenergic agonist inhalers?
Bronchodilation
61
Describe the mechanism of action of a beta adrenergic agonist inhalers (2)
- Stimulation of beta 2 receptors in the lungs
- Relaxation of smooth muscle - bronchodilation / increased airflow
62
What are the side effects of beta-adrenergic agonists? (4)
- Bronchospasm
- Dry mouth
- Tachycardia
- Palpitations
63
What are the 2 types of beta adrenergic agonist inhalers?
- Short-acting (rescue)
- Long-acting (prevention / control)
64
When are short-acting beta-adrenergic agonists used?
During the acute phase of an asthma attack
65
______ is more common with albuterol than xopenex
Tachycardia
66
What is the maximum dose of short-acting beta-adrenergic agonists?
12 puffs / day
67
What occurs if albuterol is used too frequently? (2)
- Loses its beta 2 specific actions
- Stimulates beta 1 receptors
68
What is an example of a short-acting beta-adrenergic agonist?
Albuterol
69
When are long-acting beta-adrenergic agonists used?
Prophylactically to prevent asthma attacks
70
Long-acting beta-adrenergic agonists are often combined with ______
Anti-inflammatory drugs (steroids)
71
What are the side effects of long-acting beta-adrenergic agonists? (3)
- Hypertension
- Hyperglycemia
- Hypokalemia
72
What are the contraindications of long-acting beta-adrenergic agonists? (2)
- Acute asthma
- COPD events
73
What is an example of a long-acting beta-adrenergic agonist?
Salmeterol
74
Anticholinergic inhalers are used more in ______ than asthma
COPD
75
What is an example of an anticholinergic inhaler?
Ipratropium bromide
76
Anticholinergic inhalers are used as a controller medication with ______ effects
Slow and prolonged
77
Anticholinergic inhalers are used as an adjunctive therapy to prevent ______
Wheezing and dyspnea
78
Anticholinergic inhalers require caution in patients with what conditions? (2)
- Acute narrow angle glaucoma
- Prostate enlargement
79
What are the side effects of anticholinergic inhalers? (2)
- Intraocular pressure
- Urinary retention
80
Describe the mechanism of action of xanthine derivatives
Increases cAMP --> bronchodilation
81
High levels of cAMP contribute to ______
Smooth muscle relaxation
82
Large doses of xanthine derivatives stimulate the cerebrovascular system causing ...
Increased blood flow to kidneys --> dilation of renal blood vessels and increased GFR (diuretic effect)
83
What are the possible routes of xanthine derivatives? (2)
- PO
- IV
84
What is an example of a xanthine derivative?
Theophylline
85
Xanthine derivatives are metabolized similarly to ______
Caffeine
86
What are the primary risks associated with xanthine derivatives? (2)
- Drug interactions
- Narrow therapeutic range
87
Xanthine derivatives must be closely monitored with ______
Blood draws
88
What is the normal level of theophylline?
5 - 15 mcg / mL
89
What are the 2 types of leukotriene modifiers?
- Direct
- Indirect
90
Describe the mechanism of action of leukotriene modifiers
Smooth muscle relaxation --> airway dilation
91
What is the route of leukotriene modifiers?
PO
92
Leukotriene modifiers are a ______
Controller medication
93
Describe the teaching associated with leukotriene modifiers
Take before bed
94
What are the possible routes of corticosteroids? (3)
- Inhalation
- PO
- IV
95
______ corticosteroids have systemic absorption
Oral / IV
96
Oral / IV corticosteroids should be in the ______ for the shortest time possible
Lowest dose
97
What are the side effects of inhaled corticosteroids? (2)
- Oral candidiasis
- Oropharyngeal irritation
98
What are the side effects of oral / IV corticosteroids? (2)
- Hyperglycemia
- Immunosuppression
99
Describe the teaching associated with corticosteroids
Rinse mouth after using inhaler
100
What are the primary first lines drug used to treat TB? (2)
- Isoniazid (INH)
- Rifampin
101
Describe the mechanism of action of isoniazid (INH) / rifampin
Inhibits mycobacteria synthesis
102
What is the primary indication of isoniazid (INH) / rifampin?
Treatment of active / latent TB
103
Isoniazid (INH) can also be used for ______
Prophylaxis
104
What is the primary contraindication of isoniazid (INH) / rifampin?
Liver disease
105
What are the side effects of isoniazid (INH)? (2)
- Peripheral neuropathy
- Optic neuritis
106
What is the adverse effect of isoniazid (INH) / rifampin?
Hepatotoxicity
107
What is the primary drug interaction risk associated with rifampin?
Highly protein bound drugs
108
What unique characteristic of rifampin is important in patient teaching?
Colors all body fluid reddish orange
