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Resp. Disorders
Pharmacology Exam 1
| Question | Answer | |
|---|---|---|
| Antihistamines (histamine antagonists) Indications: | Manage allergies; treatment of allergic reactions; motion sickness; Parksinson’s disease; vertigo | |
| Antihistamine Drugs: | Sedative: G: Diphenhydramine B: Benadryl Nonsedative: G: Loratadine B: Claritin | |
| Main adverse effect of antihistamine drugs? | Drowsiness | -Antihistamines have anticholinergic effects (ex. runny nose dried up) too |
| Antihistamine Contraindications: | Narrow-angle glaucoma, cardiac and kidney disease; hypertension, COPD, asthma, Peptic ulcer disease, benign prostatic hyperplasia, pregnancy, liver and kidney disease, children | -Women who are pregnant should not be taking antihistamines because it can harm the fetus |
| Antihistamine Interactions: | Drug/Drug: Erythromycin, cimetidine, ketoconazole, alcohol, MAOI, CNS depressants, St. John’s Wort Drug/Food: Apple, grapefruit and orange juice | -Antihistamines can cause cardiac and respiratory failure |
| Antihistamine Adverse Effects: | Cardiovascular: Dysrhtymias, hypotension, cardiac arrest, dizziness CNS: Sedation, muscular weakness, excitement, restlessness GI: Anorexia, diarrhea, constipation | -Stop antihistamines 4 days prior to allergy tests -Long term use will cause dysrhythmias -Especially will cause constipation because of its anticholinergic effects |
| Decongestants Indications: | Reduce nasal congestion and reduce nasal passage swelling; shrink engorged nasal mucous membranes; PO/Inhaled nasal | |
| Three Decongestant Groups: | -Adrenergic (sympathomimetics) -Anticholinergics (parasympatholytics) -Corticosteroids (intranasal steroids) | -Adrenergic-constrict the small arterioles that supply the upper respiratory tract -Anticholinergics-dry everything up -Corticosteroids-reduce inflammation and swelling -Many of these drugs are OTC>more likely to be abused |
| Decongestant Contraindications: | Narrow-angle glaucoma, cardiovascular disease, hypertension, diabetes | -Narrow-angle glaucoma>fluid in eye already decreased> do not want to dry up eye more |
| Decongestant Adverse Effects: | Nervousness, palpitations, hypertension | |
| Decongestant Interactions: | Drug/Drug: MAOI’s | -Interactions: MAOI’s-drugs used in psych; can cause high BP; stroke |
| Antitussive Indications: | Suppress the cough reflex | Opioid: -Codeine -Direct action on the cough center -Analgesic effects Nonopioid: -Dextromethorphan -Non sedative |
| Antitussive Drugs: | Opioid: G: Codeine B: Dimetane-DC Nonopioid: G:Destromethorphan | -Opioid>can be addictive; sedative -Dextromethorphan-abusive drug (methamphetamine); very addictive |
| Antitussive (Opioid) Contraindications: | Alcohol abuse, respiratory depression, increased intracranial pressure, liver and renal disease, COPD | -Alcohol can cause increased intracranial pressure> especially for people taking an opioid |
| Antitussive (Opioid) Adverse Effects: | Sedation, nausea, vomiting, constipations, lightheadness, addictive side effects | -Nausea and vomiting is the #1 side effect with people taking codeine |
| Antitussive (Opioid) Interactions: | CNS depressants, sedatives, tranquilizers, alcohol | |
| Antitussive (Nonopioid) Contraindications | Hyperthyroidism, advance cardiac and vessel disease, hypertension, glaucoma, MAOI’s | -Nonopioid affects cardiac and vessel disease |
| Antitussive (Nonopioid) Adverse Effects: | Dizziness, headache, nausea | |
| Expectorant Indications: | Aids in the expectoration of excessive mucus;loosening and thinning of secretions;direct stimulation of the secretory glands;relief of a productive cough | |
| Expectorant Drugs: | G: Guaifenesine B: Mucinex | -Nausea, vomiting, gastric irritation |
| Quick Relief Medications of Asthma and other Pulmonary Disorders: | -Short-acting beta2-adrenergic agonists (SABA) -Anticholinergics -Corticosteroids; systemic | |
| Long-Acting Medications of Asthma and other Pulmonary Disorders: | -Corticosteroids; inhaled -Mast Cell stabilizers -Long-acting beta2-adrenergic agonists (LABAs) -Immunomodulators | -Immunomodulators-not been out very long; very expensive |
| Beta2-Adrenergic-Agonists Indications: | Acute asthma attack;rescue agents;PRN agent | -Suppresses histamine release in the lung -Never stand alone when long acting>used with other meds |
| Beta2-Adrenergic-Agonists Drugs: | G: Albuterol B: Proventil | -Selectively binds to beta2-adrenergic receptors located in the bronchial smooth muscle. -Bronchodilation -PO, Inhaled -Albuterol> is a SABAs (short-acting beta 2-adrenergic agonists) |
| Beta2-Adrenergic Agonists Adverse Effects: | Palpitations,headaches,throat irritation (inhaled),tremor,nervousness,restlessness, tachycardia | |
| Beta2-Adrenergic Agonists Nursing Implications: | -Instruct patient on proper use of inhaler -Assess heart rate, respirations, O2 sat -Limit intake of caffeine -Rinse mouth after inhaled administration -No breast feeding while on medication | -Rinse mouth to avoid inhaling more medication than needed -Passes to baby through breast milk |
| Beta2-Adrenergic Agonists Interactions: | Drug/Drug: -Beta-Blockers -MAO Inhibitors -Thyroid Hormones -Food Interactions -Caffeine | -Beta-blockers, MAO inhibitors, Thyroid hormones>inhibited by inhaled beta adrenergic blockers |
| Anticholinergic Indications: | -Blocks the parasympathetic nervous system. -Prevent Bronchospasm -Causes Bronchodilation -May be combined with a beta-adrenergic -Available: PO, inhaled, and injection. | -Used for COPD ONLY! -Prevent bronchial spasms |
| Anticholinergic Drugs: | G: Ipratropium B: Atrovent G: Tiotropium B:Spiriva | |
| Anticholinergic Adverse Effects: | -Worsen glaucoma -Irritation of the upper respiratory tract. -Drying of the nasal mucosa -Hoarseness -Paradoxical acute bronchospasm -Urinary retention | Worsen glaucoma Irritation of the upper respiratory tract. Drying of the nasal mucosa Hoarseness Paradoxical acute Bronchospasm Urinary retention |
| Anticholinergic Nursing Implications: | -Do not use for acute asthma attacks -Take exactly as prescribed. -Assess for a history of glaucoma or urinary retention problems. -Assess for allergy to soy beans or peanut butter. -Use with caution with other Anticholinergics. | |
| Corticosteroid Indications (first and most effective treatment for Asthma): | -Reduces inflammation and immune responses -Used for long-term management -NOT to be used for acute asthma attack -Up to 4 weeks before full effects are seen. -Available: Inhalation (also nasal) | -Suppresses inflammation>decreases infiltration of inflammatory cells> decrease edema of airways> reduce bronchial hyperactivity>decrease airway mucus production -Increases beta cell receptors so they can help in the inflammatory airway responses |
| Corticosteroid Drugs: | G:Beclomethasone B:Beconase AQ, Qvar | |
| Corticosteroid Adverse Effects: | -Corticosteroid toxicity -Cataracts -Inhibit growth in children -Mask the signs/symptoms of an infection -Oral yeast infection -Varicella infection in children | -Corticosteroid toxicity-decrease of the adrenal glands |
| Corticosteroid Nursing Implications: | -CBC -Glucose levels -Monitor for signs/symptoms of an infection. -Not for an acute asthma attack -Assess for tarry stools, abdominal pain -Report worsening of condition | -Watch CBC-make sure no secondary infection is going on -Inhaled meds not for an acute asthma attack but PO and IV are |
| Mast Cell Stabilizer Indications: | -Prevents inflammation by stabilizing mast cells -Not used to terminate an asthma attack -Older drug used for mild to moderate asthma. -Available:Inhalation -OTC- Intranasal -Ophthalmic -PO (treatment for ulcerative colitis and food allergies | -Used for someone who has mild to moderate asthma -Used primarily in asthma not COPD-can decrease the attack |
| Mast Cell Stabilizer Drugs: | G: Cromolyn B: Intal | |
| Mast Cell Stabilizer Adverse Effects: | -Bronchospasm -Cough -Pharyngeal irritation | |
| Mast Cell Stabilizer Nursing Implications: | -Use bronchodilator first then wait 5 minutes before using Cromolyn -DO NOT use in acute attack -May take several weeks to achieve effects | |
| Leukotriene Modifier Indications: | -Prevents inflammation and airway edema by blocking leukotriene receptors in the airways. -For chronic persistent asthma -Not considered a bronchodilator -Available: PO, inhaled | -Used for chronic persistent asthma -Can take weeks to show effect -Decreased inflammation and edema; decreased much production |
| Leukotriene Modifier Drugs: | G:Zafirlukast B:Accolate | |
| Leukotriene Modifier Adverse Effects: | -Headaches -Rhinitis (stuffy nose) -Nausea -Vomiting -Hepatic failure | -Causes injury to liver>stopping meds will cause liver to recuperate and function normally again |
| Leukotriene Modifier Nursing Implications: | -Assess for the presence of hepatic failure -History of alcoholism -Monitor lab for liver damage -Monitor PT/INR -DO NOT use for an acute asthma attack -Monitor for signs/symptoms of an infection | |
| Leukotriene Modifier Interactions: | -Warfarin -Erythromycin -Theophylline -ASA -Food/Drug interaction -TAKE on an empty stomach. | |
| Methylxanthine Indications: | -Relaxes bronchial smooth muscle -Approved for acute bronchospasm but not recommended. -With caffeine can be used in neonates to treat sleep apnea -Reduce neurotoxicity from methotrexate -Available: PO, Parental, Suppository | -Rarely given this drug anymore -Used long term for COPD not asthma |
| Methylxanthine Drugs: | G:Theophylline B:Slo-Phyllin | |
| Methylxanthine Adverse Effects: | -Narrow therapeutic index -10-15 mcg/ml -Irritability -Insomnia -Dysrhythmias -Hypotension -Seizures | -Therapeutic index (patients respond at 5 and can be toxic at 20) -Hypotension, seizure and dysrhythmias |
| Methylxanthine Nursing Implications: | Use in caution in patients with -Cardiac impairment -Severe renal disease -Liver disease -Peptic ulcers Monitor for common side effects -Tachycardia -Irritability -Restlessness -Insomnia -Palpitations -Heart burn | Monitor serum levels -Theophylline -Liver Limit caffeine |
| Methylxanthine Interactions: | Antibiotics -Ciprofloxacin, clarithromycin, erthromycin Antianxiety -Diazepam, flurazepam, lorazepam, midazolam Epinephrine Norepinephrine Isoproterenol Herbal/Food -Caffeine -St. John’s Wort | |
| Immunomodulator (Monoclonal Antibodies) Indications: | -Biologic therapy -Moderate to severe persistent asthma -Test positive for an allergen -Attaches to IgE preventing inflammation and dampens the body’s response to allergens | -Doses: 150-375 mg; patient’s weight determines how much medication we give the patient -Last resort medication>can cause up to $10,000 a year |
| Immunomodulator Drugs: | G:Omalizumab B: Xolair | |
| Immunomodulator Adverse Effects: | -Anaphylaxis (life-threatening allergic reaction) -Bleeding disorders -Severe dysmenorrhea -Rash -Headache -Viral infections | |
| Intradermal (Skills): | -Outer layer of the dermis -Allergy and TB testing -1 ml syringe -25-27 gauge 3/8-5/8 inch needle -Inject 5 to 15 degrees | |
| Subcutaneous (Skills): | -Loose connective tissue under the dermis -25 gauge ½-5/8 inch needle. -Give in abdomen at lest 2 inches away from umbilicus -DO NOT rub site after injection Rotate Sites and document what site used | Heparin -TB syringe -DO NOT ASPIRATE Lovenox -Comes with own syringe -Inject with air -DO NOT aspirate Insulin -U-100 insulin syringe -Rotate sites |
| Inhaled Drugs (Skills): | Nasal -Blow nose before to clear passages -Assess for nasal fractures/deviated septum -Hold the opposite nostril when giving the medication -Have patient hold position for 5 minutes | -Nasal Drops -Head tilted back -Nasal Spray -Patient sitting up |
| Oral (Skills): | MDI -Shake the inhaler -Grasp with thumb and two fingers -Tilt the patient's back slightly -Have patient exhale and press down gently on the inhaler then have the patient breath in slowly and deeply -Hold breath for 10 seconds exhale slowly | Small Volume Nebulizers -Nebulizer treatment -Inhale and press down on inhaler at the same time -Can’t mix chambers for inhalers |
Created by:
ayilim
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