Wk 1 Allergy & Respiratory Meds PPT Flashcards
(41 cards)
Respiratory defined
The upper respiratory system is a passageway for air to move through as it travels into lower structures of the system. It also filters and humidifies air that is inhaled.
The function of the lower respiratory system is to exchange oxygen and carbon dioxide between the alveoli and the blood.
The respiratory system is a primary regulator of the acid-base (pH) balance in the body.
Diseases such as asthma, chronic bronchitis, emphysema, lung cancer, or infections such as the common cold or pneumonia will directly affect the functioning of the respiratory system.
Histamine
Chemical released from mast cells & basophils after an injury or an allergic reaction
Chemical released from mast cells & basophils after an injury or an allergic reaction
Action
- causes inflammatory response
- produces capillary dilation with increased blood flow
- fluid escapes in tissues
- bronchi and other smooth muscle contracts
Symptoms
-Redness, edema, nasal drainage, bronchial constriction (may be severe).
Antihistamine Drugs Action Uses Adverse Reactions Over dosage Implementation
Action - Block receptors, Inhibit, Sedative
Uses- Allergic disorders
Adverse Reactions- Severe anticholinergic symptoms
Over dosage- Fatal in Children
Implementation- Drowsiness, Tolerance, Rebound effect, Elderly & Children
Antihistamine Drugs
Action for
-diphenhydramine HCL (Benadryl)
-fexofenadine (Allegra)
diphenhydramine HCL (Benadryl)
fexofenadine (Allegra)
Action
Block action of histamine by competing with it for the H1 receptor sites on the effector structures (such as respiratory mucosal glands and salivary glands)
Inhibit the release of acetylcholine which produce an anticholinergic (drying) effect.
Sedative effect on CNS
Antihistamines uses
Uses
- Season rhinitis (SAR), hay fever
- Perennial allergic rhinitis (PAR)
- Allergic disorders
- -urticaria (hives
- -serum sickness (motion sickness)
- -reactions to blood or plasma
- -anaphylactic shock
Antihistamines adverse reaction and overdose
Adverse Reactions
Hypertension, hypotension, tachycardia, drowsiness, excitation, restlessness, sedation, blurred vision, confusion, dizziness, tinnitus, anorexia
Overdosage
fatal in children
this occurs when the CNS is being stimulated and depressed at the same time
Antihistamines
implementation
Implementation
Take only as needed
Drowsiness (safety)
Oral dose with meals or milk
Tolerance develops, change to another med
Rebound effect (increased in symptoms) can occur with long term use of nasal preparations
Decrease dose in elderly and children due to an increase in sensitivity to anticholinergic effect
Leukotriene Receptor Inhibitorsor Leukotriene Modifiers
montelukast sodium (Singulair)
action
use
montelukast sodium (Singulair) Action- -Not a bronchodilator -Block receptors for leukotrienes (constrict bronchi, increase vascular permeability, & increase mucous secretion) bound to the amino acid, cysteine -Reduce symptoms of asthma
Use-
Used to treat chronic asthma but does not work on an asthma attack. Can also be used during acute attacks, although they will not reverse bronchospasm
Decongestants
ACTION
USE
ADVERSE REACTION
ACTION- Affect the alpha receptors of blood vessels in the nasal mucosa, causing vasoconstriction (< blood flow, < fluid exudation, < mucosal edema)
USE- Relieve nasal congestion in allergies, and upper respiratory tract infections (URTIs), and ear infections
ADVERSE REACTION- Rebound congestion (with long term use), tachycardia, dizziness, nausea
Decongestants
Contraindications
Use with Caution- Patients with hypertension, dysrhythmias, heart disease, angina, hyperthyroidism, glaucoma
Nursing Implications- Oral route is more effective
Watch for rebound congestion
If headache or nervousness occur stop medication and contact your health care provider
Corticosteriods
ACTION
USE
Action-
Block the reaction to allergens and reduce airway hyperresponsiveness. (anti-inflammatory effect). DO NOT CAUSE BRONCHO DILATION.
Use- Inhaled meds --fluticasone (Flovent) --Long-term control of asthma --To decrease the need for oral corticosteriods --not to be used as a rescue inhaler
Systemic meds
- -Prednisone
- -To gain control when initiating long-term therapy
- -Treat moderate-severe exacerbation of asthma
Corticosteriods
Adverse reactions
Adverse reactions Cough Dysphonia (hoarseness) Oral thrush High doses can have systemic effects such as slowing of growth in children and osteoporosis in adults Impaired glucose metabolism Increased appetite Weight gain Mood swings Peptic ulcer Fluid retention
Topical Intranasal Steroids
fluticasone (Flonase)
ACTION
USE
fluticasone (Flonase)
Action
-Anti-inflammatory effect which decreases local congestion (not immediate, takes time to work)
Use
-Allergic , mechanical, or chemically induced local nasal inflammation or nasal polyps when the more usual treatment has been tried and found to not work
Topical Intranasal Steroids
Adverse Reactions
Adverse Reactions- Headache Light-headedness Loss of sense of smell Nasal irritation and dryness Nosebleeds --These drugs may decrease resistance to infection, as well as mask some common signs of infection
Topical Intranasal Steroids
Nursing implications
Nursing implications-
Monitor dosage
Use smallest effective dose
When stopping this drug, the dose needs to be slowly tapered
Watch for reduction in nasal stuffiness, obstruction, and discharge
Watch for cracked or bleeding nasal mucosa
Watch for adverse reactions such as signs of systemic absorption and fluid retention (↑ blood pressure, weight gain, ankle edema, or evidence of local infection
Asthma
Overview
Condition in which there is increased inflammation and mucus production leading to bronchiolar collapse
airway narrows and air becomes trapped in the lung
Wheezes occurs when air is forced out through narrow passages
caused by a variety of factors
stepwise plan for using asthma drugs is utilized
early use of inhaled antiinflammatory drugs
Asthma Medications
Prophylaxis
Prophylaxis- Mast cell stabilizers Cromolyn sodium Prevent allergy symptoms Not for an acute attack as they have no antihistamine, antiinflammaroty or bronchodilator activity Prevention of reoccurring episodes
Asthma Medications
Acute Treatment
Acute Treatment- Bronchodilators SABAs (short acting beta 2 agonist) LABAs (long acting beta 2 agonist) Cholinergic antagonists Anti-inflammatory meds Leukotriene receptor inhibitors Corticosteroids
Bronchodilators
SABAs?
LABAs?
Cholinergic Antagonists?
SABAs
albuterol
- caused bronchodilation. Binds B2 adrenergic receptors
-used for acute attack
LABAs
salmaterol (Serevent)
- causes bronchodilation. Binds B2 adrenegic receptors. Smooth muscle relaxation to bronchioles. Prevention NOT RESCUE
Cholinergic Antagonists
ipratropium (Atrovent)
tiotropium (Spiriva)
- Causes bronchodilation. Prevents nervous system from releasing acetylcholine, allowing boy’s adrenaline to activate beta 2 receptors in bronchial smooth muscle. controller drug
Bronchodilators
Sympathomimetics
Sympathomimetics
==albuterol (Ventolin, Proventil)
==epinephrine (Adrenalin)
-Relax smooth muscle cells of the bronchi by simulating the beta 2- adrenergic receptors
-Stimulate the alpha-adrenergic receptors which produces vasoconstriction resulting in less mucosal and submucosal edema
-Some stimulate the beta 1 receptors (which ↑ heart rate) those that only act on the beta 2 receptors have fewer side effects
Bronchodilators
Xanthine Derivatives
Xanthine Derivatives
==aminophylline
==theophylline
-Relax smooth muscle in the bronchi and blood vessels in the lungs
–Act directly on the kidneys
–Produce diuresis
–Increase heart rate and respiratory rate
–CNS effects
–monitor blood levels to make sure it is theraputic
–therapy for acute or chronic asthma
Bronchodilators
Interventions
Interventions
- Measure blood levels of theophylline (monitor for s/s of toxicity tachycardia, N/V, dizziness, seizures
- Children under 9 yrs of age require a larger dose
- Absorption rates is dependent upon form of medication used (liquid/uncoated tablets/enteric-coated)
- Take with meals or large glass of water to ↓ GI upset
- Avoid caffeinated beverages (these will ↑ CNS stimulation)
- Teach use of inhalers
Mucolytics or Expectorants guaifenesin (Robitussin, Mucinex) action use intervention
guaifenesin (Robitussin, Mucinex)
-Action
Decrease the thickness of respiratory secretions and aid in their removal by increasing the amount of fluid in the respiratory tract
-Use
Treat symptoms of productive cough
Chronic respiratory disease
-Interventions
Increase fluid intake
Provide humidified air
Antitussives
ACTION
USE
Action-
- Act centrally on the cough center in the brain OR
- Act peripherally by anesthetizing stretch receptors in the respiratory tract OR
- Act locally, primarily by soothing irritated areas in the throat
Use -
-Relief of overactive or nonproductive coughs
