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RESPIRATORY-pharma > RESPIRATORY-pharma > Flashcards

RESPIRATORY-pharma Flashcards

1
Q

What are two types of Histamines?

A
  • H1 receptors mediate smooth muscle contraction(allergic symptoms) and dilate capillaries
  • H2 accelerate HR and gastric acid secretion
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2
Q

What is allergic reactions?

A
  • both H1 and H2 dilate vessels
  • causes fluid to move out of vessels and into tissue causing BP to drop
  • allergies are due to molds, mold spores, dust that causes hay, fever, itchy eyes, uticaria, sneezing, cough
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3
Q

How do allergens produce allergic reactions?

A
  • Histamine are released by mast cells, basophils due to reaction to circulating antigens in blood
  • binds and activates specific receptors in eyes, nose, skin, resp tract
  • histamine bind to receptors causing pruritis
  • H1 Blockers block histamine if receptors are not taken yet
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4
Q

What are non-sedating anti-histamine?

A
  • Fexofenadine ( allegra and Seldane)
  • Claritin
  • EES and Ketoconazole(antifungal) can lead to seldane buildup and cause cardiac dysrythmias
  • Allegra for seasonal allergic rhinitis-OTC and safe for 12 years old
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5
Q

CLARITIN

A
  • not used in lower resp tract diseases

-

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6
Q

DIPHENDRAMINE

A
  • Diphenhydramine-Benadryl
  • used for allergies and motion sickness and sleep aid( safety)
  • very safe -few S/E
  • anticholinergic effects
  • not used in neonates and nursing mothers
  • combo with calamine and camphor
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7
Q

MECLIZINE

A
  • for tx of vertigo
    for dizziness
    -use for motion sickness
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8
Q

PROMETHAZINE- phenergan

A
  • antihistamine for antiemetics
  • Rx only-Po,IV, IM, rectal
  • usually ordered q4-6 hrs prn for nausea
  • give in conjunction with DEMEROL
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9
Q

ASTELIN

A
  • only nasal
  • for adults and over 12 years old
  • rebound effects
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10
Q

ZYRTEC

A
  • used year round allergy med

- for chronic uticaria also

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11
Q

CHLOR-TRIMETON

A
  • OTC
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12
Q

DRAMAMINE

A
  • motion sickness
  • age 6 and over
  • causes sleepiness
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13
Q

Unisom

A
  • OTC for sleep aid

- take with full glass of water

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14
Q

ATARAX/VISTARIL

A
  • has sedative and mild antianxiety effects
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15
Q

ANTIVERT

A
  • for treating vertigo
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16
Q

What are adverse reactions of antihistamines?

A

-dysrhythmia/palpitations
-hypotension, syncope
-dizziness, blurred vision
-sedation
-paradoxical excitement, insomnia
-nervousness, HA
seizure
-N/V/D
- rarely-Leukopenia, pancytopenia

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17
Q

What are 3 types of decongestant?

A
  • adrenergics
  • anticholinergics
  • corticosteroids
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18
Q

NEO-SYNEPHRINE/ SUDAFED

A
  • longest effect b/c systemic
  • onset is delayed
  • caution with sudafed. WHY?
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19
Q

How do topical adrenergics work?

-ephedrine, afrin, neo-senephrine

A
  • vasoconstrict
  • shrink engorged M. mem
  • if it entered blood stream: causes: HTN, palpitations, HA, dizziness
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20
Q

Antitussive

A

-cough reflex
-stimulated in medulla
-

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21
Q

Non-opioid antitussives

A
  • less effective
  • no analgesic effects
  • safe for short term
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22
Q

Benzonate

A
  • non-opioid but anesthesize cough reflex by numbing of stretch receptors
  • tesselon perle’s
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23
Q

Codiene/hydrocodone

A
  • directly suppresses cough reflex
  • cause dizzy, drowsy, dry mouth, nausea and constipation
  • addictive properties( opioid)
  • in combo with cough med-robitussin AC
  • depress RR and CNS
  • controlled subs
  • not for severe resp DO, seizures, ICP
24
Q

expectorants

A
  • robitussin, guifenesin, guiatuss
  • thins secretions
  • can worsen hyperkalemia with K sparing diuretics
25
Q

Nursing process for all H1 blockers

A
  • assess s/s, allergic rxn
  • URI symptoms-many safe
  • LRI- not so safe
  • ICP, IOP{, asthma, cardiac problems, HTN
  • renal/liver
26
Q

Implementation for H1

A
  • take with food to avoid GI upset
    -makes mouth dry- gum/hard candy
    -frequent oral care
    -not other meds with antihistaminer. WHY?
    -increase PO flids
    -If liquid- no food/drink 30 min after
    -safety-drowsiness
    -avoid coffee
    -
27
Q

HISTAMINE 2 BLOCKERS

A
  • ACTS more on GI
    -reduce acid likke GERD
    -examples are tagamet, pepcid, zantac
    -
28
Q

Emphysema

A
  • enlarged air spaces in the lungs
  • destroyed alveolar walls
  • O2 and CO2 exchange becomes impaired
  • smoke and irritants exacerbate
29
Q

Types of bronchodilators

A
  • Xanthine deriv

- Beta-agonists

30
Q

Xanthine derivatives

A
  • plant alkaloids
    -caffeine
    -theophylline.. LEVELS? 10-20
    -theobromine
  • used primarily for asthma attacks
  • increase cardiac contractility increasing HR
    -Bioavailability? meaning
    -
31
Q

Side effects of Xanthine deriv?

A
  • N/V/anorexia
  • GI reflux during sleep
  • Tachy, palpitations, V dysrrhytmia
  • increased urination
  • hyperglycemia
  • nervousness/ tremors
32
Q

Interactions of XD?

A
  • oral contraceptives
  • EES-
  • allipurinol
  • flu vaccine
  • cimetadine
33
Q

THEOPHYLLINE

A
  • 10-20 mcg/ml is the safe levels
  • slo-bid, theodur, uniphyl
  • for chronic resp. disorders
  • monitor level
34
Q

Toxicity of theophylline?

A
  • increased restlessness, irritability, N/V, tremors
  • restlessness and anxiety
  • dont omit or double-up doses
35
Q

BETA AGONISTS?

A 
- smooth muscle relaxants
for acute asthma attack
- stimulate SNS( beta and alpha adrenergic)
-imitate effects of epi/norepi
-dilate smooth m and airway
-vasoconstrict
36
Q

terbutaline(brethine)

A

-relaxes uterus in preterm labor

37
Q

Beta agonists drugs?

A
  • albuterol, adrenalin, bronchaid
  • causes bronchodilation
  • causes tachy
  • Epi is used for first line drug in CODE
38
Q

COMBO drugs?

A

-albuterol and atrovent(combivent)
- COPD management
- not for acute attacks
SIDE -EFFECTS:anticholinergic, cough, HA, anxiety
- not use with hypersensitive to atrophine

39
Q

What is leukotreine agents

A
  • subs in body causing inflamm, bronchial constriction and mucous
  • ## causes wheeze, cough, SOB
40
Q

Anti-leukotreine drugs?

A
  • Singulair ( safe for 2 years and older and few S/E
    ACCOLADE- asthma prophlaxis for 12 years and older, interacts with ASA, EES, dilantin, theophylline
    ZYFLO- 12 years and older, not with LIVER disease and interacts with inderal, coumadin, theophylline
41
Q

contraindication of antileukotreine?

A

Cause N/V, dyspepsia, insomnia, dizziness. ACCOLADE can cause liver dysfunction

42
Q

CORTICOSTEROIDS?

A

Commonly used for chronic asthma, potent anti-inlamm, not for acute asthma attacks, prophylaxis for asthma prevention,, systemic can cause fluid and elect imbalance, nervous, and dermatology. can cause pharyngeal irritation, cough, dry mouth, oral fungal , not for candida already, can exacerbate phycosis

43
Q

Assessment for corticosteroids

A

baseline VS and lung sounds, skin color and cap refill, cough, dyspnea, SOB, orthopnea, distress, cardiac signs, restlessness, O2 sat,

44
Q

EDUCATION for corticosteroids

A

stop smoking, avoid kwn allergies, OTC, ID band, wean most drugs over 1-2 weeks, cause cushinoid symptoms, weight gain, 3-5 /week mean trouble, oral care,

45
Q

PREDNISONE

A

immunosuppresant can be used for inflamm diseases, lupus, arthritis, chron’s disease,

46
Q

hydrocortisone

A

skin conditions

47
Q

bexamethasone

A

skin conditions

48
Q

dexamethasone

A

bacterial meningitis

49
Q

Mast cells stabilizers

A

chromolyn and tilade
-for COPD
chromylyn used for rhinitic and allergic eye disordres, chron’s and ulcerative colitis

50
Q

Chromolyn

A

less potent than tilade

takes 4 weeks to start working

51
Q

PEDI and resp drugs

A

one spray per nostrils, no more than 6 doses/24 hours

clean tubing, mouth pieces with H20 and vinegar soln

52
Q

scopalamine

A 
anticholinergic 
works on inner ear for balance
NOT USED with glaucoma
72 hour patch behind the ear
4 hours to start working
not with antidepressant
53
Q

Meclazine/antivert

A

H1 blockers
inhibits Ach
for motion sickness or vertigo
safe antiemetic

54
Q

Compazine

A

dopamine blocking
neuroleptic drug NOT FOR bone marrow suppression
NOT FOR parkinson’s
not for seizure/ encepalopathy

55
Q

Zofran

A

serotonin blockers
safe for adults
increase chemo tolerance

56
Q

THC/Marinol (marijuana)

A

cause hypotensive effects
n/v for how long?
alters mood and relieves anxiety

57
Q

TEST

A

TEST

RESPIRATORY-pharma (3 decks)

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