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NURS 251 (Pharmacology 1) > Respiratory Drugs > Flashcards

Respiratory Drugs Flashcards

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1
Q

What is bronchial asthma

A

Recurrent and reversible SOB.
Occurs when the airways of the lungs become narrow/obstructed

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2
Q

What are the diseases of the Lower respiratory tract

A

COPD, Asthma

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3
Q

With bronchial asthma, the alveolar ducts and alveoli are ________, but airflow to them is ________.

A

Open; obstructed

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4
Q

What are 2 symptoms of bronchial asthma

A

Wheezing
Difficulty breathing

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5
Q

List the 4 ways the airways of the lungs can narrow

A

Bronchospasms
Inflammation of the bronchial mucosa
Edema of the bronchial mucosa
Production of viscous mucus

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6
Q

What is the difference between and asthma attack and status asthmaticus

A

An asthma attack is a sudden onset of SOB
Status asthmaticus is a prolonged (several minutes to hours) asthma attack that does not respond to typical drug therapy

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7
Q

T/F: Status asthmaticus is not a medical emergency

A

False; it is a medical emergency

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8
Q

What is COPD and what is it characterized by?

A

It’s a progressive respiratory disorder
It is characterized by chronic airflow limitation, systematic manifestations and significant comorbidities

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9
Q

What is chronic bronchitis

A

Presence of cough and sputum for at least 3 months within a span of 2 years

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10
Q

What are the 3 classes of bronchodilators?

A

B-adrenergic agonists
anticholinergics
Xanthine derivatives

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11
Q

Name a short and long acting B-adrenergic agonist

A

SABA: Salbutamol
LABA: Salmeterol

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12
Q

Name a long acting B-agonist and glucocorticoid steroid combo inhaler and when is it used

A

Budesonide and formoterol fumarate dihydrate (Symbicort)
Used as a reliever or rescue treatment for moderate to severe asthma when symptoms worsen

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13
Q

when are b-adrenergic agonists indicated and what are they also referred to as

A

During acute asthma attacks because they quickly reduce airway constriction
Relief of bronchospasm resulting from COPD or asthma
Also used for hypotension and shock
AKA sympathomimetics

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14
Q

What are the 3 subtypes of B-adrenergics

A

Non-selective adrenergics
Non-selective B-adrenergics
Selective B2 drugs

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15
Q

What do non-selective adrenergics target and name one

A

Stimulate B, B1 (cardiac) and B2 (resp) receptors
Epinephrine

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16
Q

What do non-selective B-adrenergics target

A

Stimulate B1 and B2 receptors

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17
Q

What do selective B2 drugs target and name one

A

Only stimulate B2 receptors
Salbutamol

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18
Q

What is the MOA of B-adrenergic agonists

A

They begin at the specific receptor that is stimulated, smooth muscle is relaxed in the airway which results in bronchodilation

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19
Q

What are the contraindications of B-adrenergic agonists

A

Uncontrolled cardiac dysrhythmias
High risk of strokes (because of vasoconstrictive drug action)

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20
Q

What are the adverse effects of b-adrenergic agonists

A

Insomnia
Restlessness
Anorexia
Vascular headache
Hyperglycemia
Tremor
Cardiac stimulation
Anginal pain

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21
Q

What are the interactions with B-adrenergic agonists

A

Less bronchodilation when used with B-blockers
MAOIs
Diabetic therapy (increases BG)

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22
Q

What is the most commonly used B-adrenergic agonists

A

Salbutamol

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23
Q

T/F: Salmeterol (LABA) should always be used alone

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A

False; It should never be used alone but in combo with an inhaled glucocorticoid steroid

24
Q

What is the maximum daily dose of salmeterol

25
What is the MOA of anticholinergics
Ach causes bronchial constriction and narrowing of airways Anticholinergics bind to the ACh receptors, preventing ACh from binding
26
Name 2 anticholinergics
Ipratropium, tiotropium bromide monohydrate
27
What are the indications for anticholinergics
Prevention of the bronchospasm associated with COPD; not used to manage acute symptoms
28
What are the adverse effects of anticholinergics
Dry mouth/throat Nasal congestion Heart palpitations GI distress Urinary retention Increased intraocular pressure Headache Coughing Anxiety
29
What is the most commonly used anticholinergic
Ipratropium
30
Name 2 xanthine derivates and the general name for them
Caffeine and theophylline Plant alkaloids
31
What is the MOA of xanthine derivatives
Increase levels of cyclic adenosine monophosphate (cAMP) by inhibiting the enzyme that breaks it down (phosphodiesterase) Increased cAMP levels cause smooth muscle relaxation, bronchodilation and increased airflow
32
How do xanthine derivatives cause cardiovascular stimulation
Increases force of contraction and HR, resulting in increased Cardiac output and increased blood flow to kidneys (diuretic effect)
33
What are the indications for xanthine derivatives
Mild to moderate asthma Adjunctively to treat COPD
34
T/F: Xanthine derivatives are not used for management of acute asthma
True
35
What are the contraindications for xanthine derivatives
Uncontrolled cardiac dysrhythmias Seizure disorders Hyperthyroidism Peptic ulcers Oral contraceptives
36
What are the adverse effects of xanthine derivatives
Gastro reflux during sleep Sinus tachycardia Extrasystole Palpitations Ventricular dysrhythmias Increased urination Hyperglycemia
37
What are other uses for caffeine
CNS stimulant or analeptic Cardiac stimulant in infants with bradycardia Increase respiratory drive in infants in the NICU
38
What is the most common xanthine derivative
Theophylline
39
When is injectable/IV theophylline used
Patients with status asthmaticus who have not responded to B-adrenergics such as epinephrine
40
What are 2 types of nonbronchodilating respiratory drugs
Leukotriene receptor antagonists (montelukast) Corticosteroids
41
What is the MOA for leukotriene antagonists
Leukotrienes cause inflammation, bronchoconstriction and mucus production when triggered Leukotrienes antagonists prevent leukotrienes from attaching to receptors in the lungs
42
What are the indications of Leukotriene receptor antagonists
Prophylaxis and long term treatment of asthma Treatment of allergic rhinitis
43
When should improvements be seen when using montelukast
Symptoms should improve in about a week
44
What are the contraindications of leukotriene receptor antagonists
Previous adverse drug reaction Allergy to povidone, lactose, titanium dioxide or cellulose derivatives (all inactive ingredients in these drugs)
45
What are the adverse effects of leukotriene receptor antagonists
Liver dysfunction Nausea Diarrhea Headache
46
What is the MOA of corticosteroids
Stabilization of membranes of cells that release broncho constricting substances (leukocytes) Increase responsiveness of bronchi smooth muscle to b-adrenergic agonists Reduces inflammation and enhances the activity of b-adrenergics
47
Name 3 inhaled corticosteroids
Beclomethasone dipropionate Budesonide Fluticasone propionate
48
What are the indications for inhaled corticosteroids
Persistent asthma Concurrently with B-adrenergic agonists
49
What are the contraindications of inhaled corticosteroids
Patients with sputum positive for candida bacteria Patients with systemic fungal infection
50
What are the adverse effects of inhaled corticosteroids
Pharyngeal irritation Coughing Dry mouth Oral fungal infections Systemic effects (rare)
51
What are some interactions with inhaled corticosteroids
Antidiabetics (increases BG) Raises blood levels of immunosuppressants Risk of hypokalemia with diuretics
52
What happens when salbutamol is used too frequently
Loses its B2 specific actions and causes B1 receptor stimulation resulting in nausea, anxiety, palpitations, tremors and increased HR
53
What are some foods that interact with xanthine derivatives
Charcoal-broiled, high-protein and low-carb food They reduce serum levels of xanthines
54
T/F: Smoking does not affect xanthine derivatives
F: It enhances xanthine metabolism
55
What does the patient need to do after using an inhaled corticosteroid and what does it prevent
Patients must gargle and rinse mouth after using to prevent oral fungal infections
56
What is a nursing consideration when administering a corticosteroid and a B-agonist bronchodilator
Use the bronchodilator several minutes before the corticosteroid so it has time to dilate the bronchi to receive the steroid

NURS 251 (Pharmacology 1) (20 decks)

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