VEEB > Resp System(Pharm) > Flashcards

Resp System(Pharm) Flashcards

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1
Q

Dextromethorphan

A

Generic Name: Dextromethorphan
Trade Name: Romilar
-Antitussive(central acting)(non narcotic)
most commonly used for nonproductive, dry cough
-working in CNS(central acting non-narcotic)
-non narcotic
-cause hypotension, decrease resp.drowsiness(not as severe), increase risk of tolerance/abuse, euphora,misused by adolescents
-not for children under 4
-caustion 4-12
-adolescents can abuse

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2
Q

Guaifenesin

A 
Generic Name: Guaifenesin
Trade Name: Robitussin
-rarely has adv reaction
-is expectorant
-10ml/2tsp q4hr
    side effect:
-hypersensitvity
-gastrotoxivity
-drowsiness
          nursing implication:
-give meals(after meal), do not follow by water
-position in high fowlers
-teach deep breathing cough
-humidification
-increase fluids
-temp control
-suction as needed
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3
Q

Acetylcysteine

A 
Generic Name: Acetylcysteine
Trade Name: Mucomyst
-Mucolytic
-liquify thick tenacious secretion, breaks down mucous
-break down mucous
-antidote to tylenol
-indication-emphysema,copd,
-smells like rotten egg
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4
Q

Albuterol

A 
Generic Name: Albuterol
Trade Name: Proventil
Sympathomimetics(drug) 
bronchodilator(anti-asthmatic drug)
-short acting beta agonist(drug)
PO/Inhalation-q6h
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5
Q

Theophylline

A

Generic Name: Theophylline
Trade Name: Elixophyllin/Theo-Dur/Unipyhyl
Methyl-Xanthine
Xanthinal/Xanthine Derivatives-Theophylline(Theo-Dur/Uniphyl)
-300-800mg
-start of with theophylization
-10-20mcg per ml(therapeutic level)action: act directly to relax the smooth muscle of the bronchus to increase the size and lumen of the bronchioles
-they are mild diuretics(remove fluid)
-indicated for pulmonary edema=dilate bronchi,get rid of fluid

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6
Q

Diphenhydramine

A

Generic Name: Diphenhydramine
Trade Name: Benadryl
-25-50mg 3x day, po,im
indication:
-seasonal allergy
-Hypersensitivity=from medication,blood products,seasonal allergies
-N&V,motion sickness
-Parkinsons-have anticholegerin like effect=decrease in strength/muscle tone
-adjucts to anesthesia-drying,prevent nausea
-allergy to drugs and blood products

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7
Q

Phenylephrine

A 
Generic Name: Phenylephrine
Trade Name: Neosynephrine
-Nasal Decongestant
-Sympathomimetics/Ageneric
-Topical, Local
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8
Q

Beclomethasone

A

Generic Name: Beclomethasone
Trade Name: Beclovent/Vanceril
-Beconase/Vancenase
-Corticosteroid nasal decongesant

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9
Q

Dexamethasone

A

Generic Name: Dexamethasone
Trade Name: Decadron
-corticosteroid/antiinflammatory/antiasthmatic
–po, 3-5days, ac exacerbation

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10
Q

Ipratropium Bromide

A

Generic Name: Ipratropium Bromide
Trade Name: Atrovent
-Anticholinergic/Broncodilator
inhalation-short term relief of symptoms-last 4hrs

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11
Q

Triamcinolone

A

Generic Name: Triamcinolone
Trade Name: Azmacort, Nasocort
Corticosteroid nasal decongesant

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12
Q

Isoproterenol

A 
Generic Name: Isoproterenol
Trade Name: Isuprel
-bronchodilator
-sympathomimetic
-short acting beta 2 agonist
-subcut,inhal,iv
-cause pink coloration of mucus
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13
Q

Loratadine

A 
Generic Name: Loratadine
Trade Name: Claritin
-Anti histamine
-2ng gen
-10mg daily,Tab,liq,and peds dose
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14
Q

Zafirlukast

A

Generic Name: Zafirlukast
Trade Name: Accolate
-bronchodilator
-Leukotrine antagonist

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15
Q

Histamine

A
  • substance found in various body tissue
  • highest concentration in the mast cells and basophils
  • produced in response to injury and released in allergic and hypersensitivity reaction
  • forms in foundation for many cold remedies
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16
Q

Antihistamine/Driers

A

action: blocks the action of histamine at the H1 receptor site and prevent histamine from entering the receptor site
- H1 receptor blocker
- H1 receptor antagonist
- more effective in prevention
- best given at early sign and symptoms
- better at preventing than reversing effect
- pallitive treatment(makes feel better)

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17
Q

Antihistamine/Driers(Indication)

A
  • seasonal allergy
  • Hypersensitivity=from medication,blood products,seasonal allergies
  • N&V,motion sickness
  • Parkinsons-have anticholegerin like effect=decrease in strength/muscle tone
  • adjucts to anesthesia-drying,prevent nausea
  • allergy to drugs and blood products
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18
Q

Antihistamine/Driers(First Generation s/s)

A
  • works centrally at the brain
  • works periphally at the site
  • have anti-cholegernic effect(drying,decrease muscle tone,decreased mobility,dilated pupils,cause drowsiness(sedation)
  • fast onset(30min), short duration=taken more frequetly
  • decrease muscle strength, urinary retention,constipation,dilated pupils, blurry vision, hypotension, monitor BP
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19
Q

Antihistamine/Driers(First Generation Drugs)

A

Diphenhydramine(Benadryl)
-25-50mg 3x day, po,im
Hydroxyzine(Atarax Vistaril)
-25-50mg 3x day, po,im

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20
Q

Antihistamine/Driers(Second Generation s/s)

A
  • slower onset: 1hr or more
  • dont have to take as often
  • less effective in drying
  • less sedating/drowsiness
  • Anticholinergic like effect
  • sedation, hypotension
  • gastrotoxicity
  • hypersensitivity
  • photosensitivity
  • paradoxical excitement-some pt may have insomnia-elderly
  • tolerance-w/ prolonged use-less drowsy as continue to take medication
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21
Q

Antihistamine/Driers(Second generation drugs)

A
  • Loratadine(Claritin)-10mg daily,Tab,liq,and peds dose
  • Cetirizine(Zyrtec)
  • Fexofenadine(Allegra)- 2x day dose, 60mg cap, BID, po, not to be used by anyone under the age of 12,pt should not be drinking fruit juice, decrease absorbtion
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22
Q

Antihistamine/Driers(contraindication)

A
  • asthma,copd=b/c drying effect=mucous harde to expel
  • glaucoma=b/c dilates pupil
  • prostate=b/c decreae unrinary output/retention
  • pregnant and lactating women
  • interaction-MAOI
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23
Q

Antihistamine/Driers(Nursing implication)

A
  • take with meal, parental deep IM(exception allegra(fruit juice)
  • for motion sickness 30min to 1hr before traveling
  • stop 4 days before allergic testing: b/c can mask allergic response
  • watch for degree of drowsiness
  • provide safety: decrease bp: orthostatic hypotention-watch for hot showers
  • relieve drynes
  • alcohol and other CNS depressants increase drowsiness
  • can cause resp difficulty
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24
Q

Nasal Deocongestants(action/indication)

A

shrink engorged mucous membrane in the nose to relive stuffiness
-constrict blood vessels in the nose to decrease the formation of mucous and increase drainage to lessen swelling

indication: drain sinuses/adjunct in middle ea infectino, cold

  • increase drainage
  • decrease swelling
  • decrease formation of mucous
  • adjunct for common cold/ear infection/pre op med for balance anesthesia
  • systemic last longer
  • topical works faster
  • locally/systemic
  • topical/ by mouth
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25
Nasal Deocongestants(Drugs)
- Sympathomimetics/Ageneric - Phenylephrine Hcl(Neo synephrine) Corticosteriods - Flucticasone - Tramcinolone - Beclomethasone
26
Nasal Deocongestants(side effects)
- local-use topically - cns stimulation - cardiac stimulation - gastrotoxicity - rebound congestion-no more than 3-5days-overuse of medication, more frequently than they should - contrainfication: MAOI(hypertensive crisis), pregancy,lactating women - caution HTN, Heart disease,diabetes(hyperglycemia) - systemic-cns stimulation,cardiac,gastrotoxity - local: burning, rebound congestion
27
Nasal Deocongestants(Nursing implications)
- caution in htn, heart disease and diabetes - burning or stinging discontinue - do not giver for more than 4 days can cause rebound congestiion - monitor bp and heart rate/apical pulse - assess nasal mucosa - d/c if burning/stinging occur
28
Antitussive
- action: suppress cough reflex center located in the medulla in the brain - there are two types central and peripheral(affecting receptor sites) acting - central acting directly on the cough reflex center in the medulla. There are two types of central acting(narcotics and non-narcotics) - suppresses cough reflex center in medullar - drowsiness - decrease resp. decrease bp
29
Antitussive
1) Narcotics: - Morphine - Codeine-most effective antitussive - Hydrocodone-most effective antiitussive 2) Non-Narcotics: - Dextromethorphan(Romilar)
30
Dextromethorphan(Romilar)
-Antitussive most commonly used for nonproductive, dry cough -working in CNS(central acting non-narcotic) -non narcotic -cause hypotension, decrease resp.drowsiness(not as severe), increase risk of tolerance/abuse, euphora,misused by adolescents -not for children under 4 -caution 4-12 -adolescents can abuse
31
Peripheral Acting
- works at receptor site - peripheral acting act directly on the cough receptor in the trachea,pharynx,and lung for a demulcent(soothing) or local anesthetic effect(dulling irritation)
31
Peripheral Acting
- works at receptor site - peripheral acting act directly on the cough receptor in the trachea,pharynx,and lung for a demulcent(soothing) or local anesthetic effect(dulling irritation)
32
Antitussive(indication)
-relieve dry hacking cough non productive cough side effects: -all antitussive can cause some drowsiness -central active have more degree drowsiness -opiate like -cns depression central side effect: -resp depression -euphora -dependency -n/v -constipation peripheral side effect: -cardiovasuclar collapse
32
Peripheral Acting(Drug)
Benzonatete(Tessalon): - has cain substance, - anesthetic like effect, - must swallow whole, - can cause arrhythmia, - spasm in bronchi - cardiovascular collapse, - allergy to cain products, - teach pt to swallow whole(gel like substance) Diphenhydramine(Benylin) - related to benadryl - drowsiness,dizziness
33
Antitussive(indication)
-relieve dry hacking cough
33
Antitussive(indication)
``` -relieve dry hacking cough non productive cough side effects: -opiate like -cns depression central side effect: -resp depression -euphora -dependency -n/v -constipation peripheral side effect: -cardiovasuclar collapse ```
34
Mucolytic(action)
- action:liquify thick tenacious secretion, breaks down mucous indication: emhysema-copd-part of treatment for pulmonary diseases
35
Expectorants
- reduce the viscosity and help raise thick tenacious secretions making expulsion of the sputum easier. act directly on the bronchial glands - loosen and thin the sputum
36
Expectorants(drug)
-Guaifenesin(Robitussin) -rarely has adv reaction -is expectorant -10ml-2tsp q4hr side effect: -hypersensitvity -gastrotoxivity -drowsiness nursing implication: -give meals(after meal), do not follow by water -position in high fowlers -teach deep breathing cough -humidification -increase fluids -temp control -suction as needed
37
Mucolytic
- action:liquify thick tenacious secretion, breaks down mucous indication: emhysema-copd-pulmonary diseases
38
Mucolytic(drug)
- acetylcystein(mucomyst)-antidote/tylenol | - tyloxapol(alevaire)
39
Mucolytic(side effect)
- N/V - smells like rotten egg - stomatitis,bronchospasm - interaction: tetracycline,erythromycin H202
40
Mucolytic(Nurising Implication)
- given instilled or by nebulizer - assess mucus membrane in mouth - cough patient or suction before and after - store in fridge discard after 96hrs
41
Asthma
- inflammatory respiratory condition characterized by recurrent attack of dysnea, wheezing and bronchospasm - various combination of drugs are used to treat asthma - the objective is to give the smallest dose and to decrease the number and frequency
42
Bronchodilator(Antiasthmatic drug)(indication)
``` -relieve bronchospasms associated with respiratory disorders such as asthma,emphysema,and chronic bronchiits Four types: -Sympathomimietics -Methyl Xanthine compounds -Anticholinergics -Leukotrience Receptors Antagonist ```
43
Sympathomimetics
- Broncodilator/Antiasthmatic drug - dilate the bronchus by stimulating the sympathetic nervous system - most stimulate beta 2 receptor site - drugs divided into short acting and long acting
44
Sympathomimetics(drug) bronchodilator(anti-asthmatic drug) -short acting beta agonist(drug)
-rescue inhaler/meds -Albuterol(Proventil)-PO/Inhalation-q6h -Epinephrine(Adrenalin)-via inhalation- 1-1000(0.5mg-1mg)-tuberculin syringe-side effect: tremors
45
Sympathomimetics(drug) bronchodilator(anti-asthmatic drug) -long acting beta agonist
- symptom control - Salmeterol - Formoterol fumarate - sustained released albuterol
46
Side effect(Sympathomimetic)
- CNS stimulation - cardiac stimulation - gastrotoxicity - endrocrine - prolonged used lead to tolerance
47
Methyl-Xanthine Xanthinal/Xanthine Derivatives (Action/Indication)
action: act directly to relax the smooth muscle of the bronchus to increase the size and lumen of the bronchioles - they are mild diuretics(remove fluid) - indicated for pulmonary edema=dilate bronchi,get rid of fluid
48
Methyl-Xanthine Xanthinal/Xanthine Derivatives (Drugs)
- Theophylline(Theo-Dur/Uniphyl) - 300-800mg - start of with theophylization - 10-20mcg per ml(therapeutic level)
49
Methyl-Xanthine Xanthinal/Xanthine Derivatives (interaction)
-beta blocker,erythromycin and cimetidine: cause increase theophylline toxicity, decrease effect allupurinol, anticonvulsant, oral contraceptive
50
Methyl-Xanthine Xanthinal/Xanthine Derivatives (Nursing implication)
- Xanthine products increase toxicity like chocolate and soda - given with food if nausea - monitor site/peri care - educate to protect from UV light(photosensitivity) - monitor for theophyline toxicity: N/V, anorexia, arrthymia, seizure
51
Anticholinergic(action) | bronchodilator
- most useful longterm treatment with COPD | - or for asthma not able to tolerate beta 2 agonist
52
Methyl-Xanthine Xanthinal/Xanthine Derivatives (side effects)
- similar to beta 2 agonist(review A part of map) - increase hypotension and N/V - iv: bp drop(hyp0tension), pump mlxhr
53
Anticholinergic(drug) | bronchodilator
- Inpratropium Bromide(Atrovent)-inhalation-short term relief of symptoms-last 4hrs - Tiotropium Bromide(Spiriva)-long term, last about 24hrs-maintain airway, not as drying
54
Anticholinergic(side effect)
- atropine like, cough, nervousness, headache, and dizziness - dilation of pupils=glaucoma(blurry vision) - tachycardia, N/V, headache, dizzy, cough, - best taken when they wake in the morning
55
Leukotriene Antagonist(Action)
- action: antagonize leukotriene which is a bronchoconstrictor to dilate the bronchus and decrease mucus secretion indication: prophylactic long-term - good for asthma patient,prophalatic,long term management
56
Leukotriene Antagonist(Drug)(Only PO routes)
Zafirlukast(Accolate)-5yrs and older Montelukast-1yr and above, tab,chewable,granules Zileuton-12 yrs and older
57
Leukotriene Antagonist(side effect)
- drowsiness, headache, dizziness, dyspepsia, abdominal pain, myalgia, hepatoxicity, and increased incidence of resp tract infection - monitor liver enzymes and s/s of infection - interaction-potentiate: NSAIDS, ASA, Theophyline and erythromycin decrease levels infection - contraindicated in pregnancy and lactation and an acute asthmatic attack - used to prevent not to treat acute attack
58
Bronchodilators(Nursing Implication)
- dose by number of puffs - vital signs - auscultate lungs - give oral with food - space dose at equal interval - if symptoms increase do not increase dose - IV rate monitor closely - wait one min to recharge - in more that one drug inhaled wait 5min - rinse mouth and spit out - check dose counter or indicator - check empty full if no indicator - if more than one drug inhaled wait 5 min - avoid smoking, OTDC, caffeine and beta blockers - increase fluids - sympathomimetic-epinephringe drug of choice for an acute attack asthma - isuprel and epinephrine should never be given together - methylxanthine: bp: hypotension - watch for theophylline toxicity - monitor blood levels - watch for seizures - inhalation puffs equally spaced - mdi wait 1 min to recharge - hold breathe for long as possible 10 seconds - use bronco dilator first than steroids to decrease inflammation - avoid smoking no OTC,caffeine - increase fluids
59
Anti-Inflammatory | Corticosteroids
- used prophylactic treatment of bronchial asthma - decrease inflammatory process - least amount of drug small dose
60
Anti-Inflammatory | Corticosteroids(Drugs)
Beclomethasone: - Beclovent-inhalation - Beconase-decongestion - maintanece Dexamethasone(Decadron): -po, 3-5days, ac exacerbation Triamcinolone(Azmacort/Nasort): Azmacort=for asthma Nasocort=nasal decongestion -maintenance
61
Corticosteroids(side effect)
- require tappering, give body time to release own steroids - can cause addison crisis - throat irritation-rinse mouth/throat - hoarsenss - cough - oral fungal infection - vertigo - headache - steroids effect calcium levels decrease(hypocalcemia)-take calcium supplements - increase Blood sugar - stunt growth in child - increase BP(hypertension)
62
Mast Cell Stabilizer(action)
-decrease secretion of histamine by the mast cells
63
Mast Cell Stabilizer(indication)
- prophylatic treatment of mild bronchial asthma especially in children when growth retardation is concern - exercise induced bronchospasm - need 2 to 4 weeks for optimal
64
Mast Cell Stabilizer(Drugs)(side effect)
``` -cromolyn and nedocromil side effect: -N/V/D -headache -fatigue -hypotension -joint swelling -dysuria -rash -sneezing -cough,hoarseness,burning,stinging, bad taste in mouth -rinse after use and spit out ``` Nursing implication: - teach mdi - teach spacer - humdifier - teach peak flow
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