Respiratory Flashcards

Question

Short Acting Beta2 Agonist (SABA)

Answer 1

``` • Use o Abort asthma attack o Prevention of exercise induced bronchospasm (EIB) -Can be used in long term control, but taken frequently Inc frequency of drug intake in # of attacks go up -Short half-life • Route o Nebulized if severe attack o MDI o DPI • Adverse Effects o Tachycardia, angina, tremor • Contraindications/ Warnings o Step up therapy if using > 2x/week o Avoid in stable COPD (use LABA) ```

Answer 2

Use o Long term control in patients who have frequent asthma attacks, must be combination therapy in asthma o Stable COPD - ALL COPD -long acting=long half-life=long-term control -long half-life so you'll take them less frequently • Route o Inhalation o PO • Adverse Effects o Inhaled: increased risk of death in asthma if monotherapy o PO: angina, tachydysrhythmias, tremor • Contraindications/ Warnings o Can’t stop an acute attack o Avoid as monotherapy

Answer 3

PO beta2-adrenergic agonist Can cause tremors, insomnia, and tachycardia- Watch HR Can be used for long or short term control Dosing may be 3-4 times daily Often inhaled, but can be PO Selective for beta2 in recommended doses- nebulizers

Answer 4

``` Inhaled SABA Usually a MDI/nebulizer PRN for acute attacks Take before exercise to prevent exercise induced bronchospasm (EIB) short-acting drug ```

Answer 5

Inhaled LABA Fixed schedule Use with glucocorticoid, in same inhaler if possible (ideally) May need to increase frequency of dosing with continued use Frequently combined with fluticasone

Answer 6

Cause CNS excitation, bronchodilation Used to prevent asthma attacks at night and stable asthma COPD: use beta2-adrenergic agonists and glucocorticoids first Check drug levels, LFTs Interacts with caffeine, tobacco and marijuana smoke

Answer 7

Inhaled LABA Fixed schedule Use with glucocorticoid, in same inhaler if possible May need to increase frequency of dosing with continued use Frequently combined with fluticasone

Answer 8

Cause CNS excitation, bronchodilation Used to prevent asthma attacks at night and stable asthma COPD: use beta2-adrenergic agonists and glucocorticoids first Check drug levels, LFTs Interacts with caffeine, tobacco and marijuana smoke

Answer 9

Improve lung function by blocking muscarinic receptors in the bronchi, leading to bronchoconstriction FDA approval for COPD, but used off-label for asthma Inhaled, so minimal systemic effects Adverse effects are dry mouth, pharynx irritation

Answer 10

Reducing impairment Preventing chronic and troublesome symptoms Reducing use of SABAs for symptom relief to 2 or less days/ week Maintaining as normal of lung function as is possible Maintaining normal activity levels Meeting patient and family expectations regarding asthma care Reducing risk Preventing recurrent exacerbations Minimizing need for ER visits or hospitalizations Preventing progressive loss of lung function Providing maximum benefits with minimum adverse effects

Answer 11

Improve the patient’s health status and exercise tolerance | Reduce risks and mortality by preventing progression of COPD and preventing and managing exacerbations

Answer 12

``` Sympathomimetics Available nasally and PO Fast and effective when used topically Not as effective when used PO Not associated with abuse Used IV to treat hypotension ```

Answer 13

Stimulates respiratory secretions, making coughs more productive May need higher than recommended doses to be effective Often combined with dextromethorphan

Answer 14

``` Antihistamine/sympathomimetic combos Antihistamine/glucocorticoid combos Ipratropium Montelukast Omalizumab ```

Answer 15

``` Opioids Dextromethorphan Other Non-opioids Most effective Abuse potential is low Most effective OTC Diphenhydramine Benzonatate ```

Answer 16

``` Treat symptoms Usually a combination of: Nasal decongestant Antitussive Analgesic Antihistamine Caffeine ```

Answer 17

No proof of efficacy or safety in children Known potential for harm (including death) FDA does not recommend OTC cold remedies in children under 2 years FDA is reviewing the safety of these drugs in children 2-11 years American Academy of Pediatrics recommends avoiding until 6 years Measure carefully and accurately Do not use to sedate children

Answer 18

``` Sympathomimetics Only administered PO Higher incidence of CNS stimulation Can be converted to methamphetamine Restrictions of amount purchased More effective than phenylephrine ```

Answer 19

``` Sympathomimetics Only administered PO Cns stimulation is lower Can be converted to methamphetamine Restrictions of amount purchased More effective than phenylephrine ```

Answer 20

is drug of choice for severe allergies not an antihistamine in emergency you can give Benadryl if epi not available

Answer 21

``` Advantages Enhanced therapeutic effects Fewer systemic effects- b/c it's contained within the lungs Rapid relief of acute attacks Types Metered-dose inhalers (MDIs) Respimats Dry-powder inhalers (DPIs) Nebulizers ```

Answer 22

metered dose w/ each activation or inhalation | problem: the entire dose isn't absorbed.

Answer 23

reduces the need for the hand-breath coordination | reduced bronchospasm that occurs with sudden intake of inhaled drugs

Answer 24

fine mist activated by no propellent most of the drug reaches site b/c particles are so small BUT not all drugs come like this

Answer 25

Dry Powder Inhalers; breath activated = no hand-breath coordination needed. 20% makes it the lungs which is a fair amount

Answer 26

``` First Generation 5 major categories Alkylamines Ethanolamines-Diphenhydramine Phenothiazines Piperazines piperidines ``` ``` Second Generation 5 PO drugs Cetirizine- Zyertec Fexofenadine** - Allegra Loratadine- Claritin Levocetirizine- Xyzal Desloratadine- prescription - not often used ``` 2 intranasal drugs Azelastine - Astelin/Astepro Olopatadine

Answer 27

``` 1st gen Sedation is common Significant anticholinergic properties Generally less expensive 2nd gen Less sedating Fewer anticholinergic effects Usually more expensive ```

Answer 28

Take all you medications as prescribed Ask about medications for before you exercise Have you rescue medication handy Perform a 15 minute warm-up and cool-down Postpone exercise if symptoms are not well controlled or you have a cold or respiratory infection Check the air quality index- stay inside if pollution or allergen levels are high Breathe through the nose as much as possible When outdoors, avoid areas with a lot of allergens or irritants When indoors, keep windows and doors closed to reduce allergen exposure Promoting physical activity and exercise in patients with asthma and chronic obstructive pulmonary disease.

Answer 29

Asthma is the most chronic condition seen in pregnancy Pregnant asthmatics have increased risk of preterm birth, intrauterine growth restriction, pregnancy-induced hypertension, preeclampsia. Their babies have an increased risk of congenital malformations of nervous, respiratory and digestive systems at birth and respiratory disease later These women need to continue to take their asthma medications and should work to control symptoms The pregnant patient with asthma: Assessment and management.

Respiratory Flashcards

(53 cards)