Test 2 Respiratory Meds Flashcards
(51 cards)
1
Q
acetylcysteine: class
A
- antidote to acetaminophen
- mucolytic
2
Q
acetylcysteine: MOA
A
- substitutes for depleted glutathione in the rxn that converts the toxic metabolite of acetaminophen to its non toxic form
- as a mucolytic, it makes mucus more watery, so it’ll help make cough more productive
- lowers the viscosity of mucus
3
Q
acetylcysteine: indication
A
- liver injury from acetaminophen
- when ppl get certain tests done with contrast dye, they will give this prophylactically to protect the kidneys from the dye
4
Q
acetylcysteine: ADRs
A
- bronchospasm
5
Q
acetylcysteine: nursing implications
A
- IV: when given w/in 8-10 hours of acetaminophen overdose, it is 100% effective at preventing severe liver injury
- PO: can provide protection if given w/in 24 hours after poisoning
6
Q
albuterol: class
A
- beta 2 adrenergic agonist
- noncatecholamine
7
Q
albuterol: MOA
A
- causes beta 2 mediated bronchodilation–>reduces airway resistance
- albuterol is relatively selective for beta 2 receptors, and does not produce much activation of cardiac beta 1 receptors, but if take in large doses, then albuterol may lose selectively and bind to some beta 1 receptors
8
Q
albuterol: indications
A
- asthma
- taken PRN to abort an ongoing attack
- COPD
9
Q
albuterol: SEs
A
- SEs are minimal at therapeutic doses
- tremor is common
10
Q
albuterol: ADRs
A
- tachycardia
- if dosage is excessive and albuterol binds to and activates beta 1 receptrs in the heart
- paradoxical bronchospasms
11
Q
albuterol: nursing implications
A
- contraindicated in pts with tachydysrhythmias or tachycardia associated with digitalis toxicity
- teach pts to use the inhalers
- may need to use a spacer in pts with poor hand/breath coordination
- if need 2 inhalations, then need to wait at least 1 minute between inhalations
- take it with meals
12
Q
theophylline: class
A
- methylxanthine
13
Q
theophylline: MOA
A
- produces bronchodilation by relaxing smooth muscle of the bronchi
- most likely due to blockade of receptors for adenosine
14
Q
theophylline: indications
A
- maintenance of chronic stable asthma
- longer duration than beta 2 agonists
- can dec frequency and severity of asthma attacks
- most appropriate when pts have nocturnal attacks
- COPD
15
Q
theophylline: SEs
A
- nausea
- vomiting
- diarrhea
- insomnia
- restlessness
- same SEs as caffeine
16
Q
theophylline: ADRs
A
- severe dysrhythmias (ventricular fibrillation)
- convulsions
17
Q
theophylline: nursing implications
A
- contraindicated in pts with untreated seizure disorders or PUD, dysrhythmias
- should NOT consume caffeine b/c caffeine can intensify the effects
- tobacco and marijuana can inc clearance
- end of the line medication for COPD–last thing you would try
18
Q
fluticasone: class
A
- anti-inflammatory
- inhaled glucocorticoid
- anti-asthma
19
Q
fluticasone: MOA
A
- prevent major symptoms of allergic rhinitis: congestion, rhinorrhea, sneezing, nasal itching, erythema
- prevent asthma syptoms by suppressing inflammation:
- dec synthesis and secretion of inflammatory mediators
- dec infiltration and activity of inflammatory cells (ie. eosinophils, leukocytes)
- dec edema of airway mucosa
20
Q
fluticasone: indications
A
- prophylaxis of chronic asthma
- must be done on a fixed schedule, should be used daily
- prevention and tx of seasonal and perinneal rhinitis
21
Q
fluticasone: SEs
A
- drying of nasal mucosa
- burning, itching sensation
- sore throat
- epistaxis
- nosebleed
- oropharyngeal candidiasis
- dysphonia
- slowed growth in children
- cataracts/glaucoma
22
Q
fluticasone: ADRs
A
- adrenal suppression
- bone loss
- anaphylaxis
- angioedema
23
Q
inhaled glucocorticoids: nursing implications
A
- contraindicated for patients with persistently positive sputum cultures for Candida albicans
- make sure pts administer on an ongoing schedule
- teach pt how to use inhaler
- use spacer or else can cause medicine to sit in mouth and can cause oral thrush
- to prevent dysphonia and candidiasis, rinse mouth and gargle
- make sure taking Ca and vitamin D and doing weight bearing exercise
24
Q
mometasone: class
A
- anti-inflammatory
- inhaled glucocorticoid
- anti-asthma
25
mometasone: MOA
* prevent major symptoms of allergic rhinitis: congestion, rhinorrhea, sneezing, nasal itching, erythema
* prevent asthma syptoms by suppressing inflammation:
* dec synthesis and secretion of inflammatory mediators
* dec infiltration and activity of inflammatory cells (ie. eosinophils, leukocytes)
* dec edema of airway mucosa
26
mometasone: indications
* prophylaxis of chronic asthma
* must be done on a fixed schedule, should be used daily
* prevention and tx of seasonal and perinneal rhinitis
27
mometasone: SEs
* drying of nasal mucosa
* burning, itching sensation
* sore throat
* epistaxis
* nosebleed
* oropharyngeal candidiasis
* dysphonia
* slowed growth in children
* cataracts/glaucoma
28
mometasone: ADRs
* adrenal suppression
* bone loss
* anaphylaxis
29
prednisone: class
* oral glucocorticoids
* anti-asthmatics
* anti-inflammatory
30
prednisone: MOA
* prevent asthma syptoms by suppressing inflammation:
* dec synthesis and secretion of inflammatory mediators
* dec infiltration and activity of inflammatory cells (ie. eosinophils, leukocytes)
* dec edema of airway mucosa
31
prednisone: indications
* COPD
* asthma
32
prednisone: SEs
* osteoporosis
* infection: especially Pneumocystic pneumonia
* glucose intolerance
* myopathy, muscle weakness
* fluid and electrolyte disturbance--\>HTN, edema
* growth delay (in children)
* psychological disturbances: insomnia, anxiety
* cataracts, glaucomas
33
prednisone: ADRs
* **adrenal insuffiency**
* psychological disturbances: hallucinations, suicide
* peptic ulcer dz
* b/c inhibits PG synthesis
* Cushing's
* moon face, buffalo hump, potbelly, hyperglycemia, osteoporosis, muscle wasting
* thromboembolism
34
prednisone: nursing implications
* contraindicated in pts with fungal infections and receiving live vaccines
* DO NOT drink with grapefruit juice
* avoid taking aspirin with it
* should be taken with food to prevent gastritis
* do not stop abruptly
* inform pts about early signs of infection: fever, sore throat
* educate pt about S/S of fluid retention (weight gain, swelling of extremities) and hypokalemia (muscle weakness, irregular pulse, cramping)
* notify doc if vision becomes cloudy, blurred
* notify doc if black, tarry stool
* notify pt about possible psychologic rxns
* watch for signs of compression fractures and fractures of other bones
* take w/ Ca and vitamin D to prevent osteoporosis
* also should have bone scans
* evaluate growth of children
* pt should receive eye exams
* watch for signs of hyperglycemia
* watch for thinning of the skin, especially in older pts
35
guaifenesin: class
* allergy, cold, cough remedy
* **expectorant**
36
guaifenesin: MOA
* renders cough more productive by stimulating the flow of respiratory tract secretions
* **so thins mucus and causes you to cough it out--causes the productive cough**
37
guaifenesin: indications
* **Coughs associated with viral upper respiratory tract infections.**
38
guaifenesin: SEs
* dizziness
* headache
* nausea
* diarrhea
* rash
39
guaifenesin: nursing implications
* contraindicated in pts with PKU if drug contains aspartame or in pts with alcohol intolerance if drug contains alcohol
* Administer each dose of guaifenesin followed by a full glass of water to decrease viscosity of secretions.
* do not give if breast feeding or to children under 4 yo
40
montelukast: class
* leukotriene modifier (receptor blocker)
* allergy, cough, cold
* bronchodilators
41
montelukast: MOA
* high affinity for leukotriene receptors in the airway and on proinflammatory cells such as eosinophils
* drug occupies these receptors so drug blocks receptor activation by the body's leukotrienes
42
montelukast: indications
* prophylaxis and maintenance therapy of **asthma** in patients at least 1 yo
* prevention of exercise induced bronchospasm (EIB) in pts at least 15 yo
* relief of **allergic rhinitis**
* \*\*cannot be used for quick relief of asthma b/c effects develop too slowly
43
montelukast: SEs
* mood changes
* nausea
* diarrhea
44
montelukast: ADRs
* Churg Strauss syndrome
* **suicidal thoughts**
* Stevens Johnson syndrome
* toxic epidermal necrolysis
45
montelukast: nursing implications
* **watch for suicidal thoughts, depression, irritability**
* take daily in the evening or at least 2 hours before exercise even not experiencing asthma
* cannot use to treat acute asthma attacks
* pt should carry rapid acting bronchodilator
46
benzonatate: class
* antitussive
* allergy, cough, and cold
* "Tesslon Pearls"
47
benzonatate: MOA
* decreases sensitivity of respiratory tract stretch receptors
* Anesthetizes cough or stretch receptors in vagal nerve afferent fibers found in lungs, pleura, and respiratory passages
48
benzonatate: indications
* Relief of nonproductive cough due to minor throat or bronchial irritation from inhaled irritants or colds.
49
benzonatate: SEs
* sedation
* dizziness
* constipation
* confusion
* chest numbness
* hallucinations
50
benzonatate: ADRs
* overdose can cause seizures, dysrhythmia, and death
51
benzonatate: nursing implications
* do not chew capsules: can cause bronchospasm, laryngospasm, circulatory collapse
* in children under 2, accidental ingestion of 1-2 capsules can be fatal
* avoid irritants like cigarette smoke
* avoid alcohol
* **DO NOT give to COPD pts, b/c it suppresses your cough, and you want these pts to cough**
