Pharm > Respiratory > Flashcards

Respiratory Flashcards

(44 cards)

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1
Q

H1 Antagonists Uses

A

Relieve sneezing, rhinorrhea, itching
- Most effective when taking prophylactically

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2
Q
A
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3
Q

H1 Antagonists MOA

A

Selectively bind to H1-histamine receptors, blocking their action

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4
Q

H1 Antagonists contradications

A

-new borns, children under 2, and women who are breastfeeding or pregnant
-contraindicated in clients who have narrow-angle glaucoma, prostatic hypertrophy, acute exacerbation of asthma

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5
Q

H1 Antagonists Nusring Considerations

A
  • Monitor ambulation
  • Monitor for excessive sedation
  • Avoid alcohol
  • Supportive care for anticholinergic effects
  • Monitor urinary retention
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6
Q

H1 Antagonists Patient Education

A

 Administer with food
 Administration for motion sickness
 Take at bedtime

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7
Q

H1 Antagonists first generation

A
  • Mildly sedating
  • CNS: dizziness, incoordination,
  • confusion
  • GI discomfort
  • Respiratory depression
  • Can cause anticholinergic effects
  • Paradoxical excitation in some
  • (insomnia, tremors, nervousness)
  • Examples:
    diphenhydramine (Benadryl)
    promethazine (Phenergan)
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8
Q

H1 Antagonists second generation

A

-Not sedating (usually)
-No anticholinergic effects
Examples:
*cetirizine (Zyrtec)
loratadine (Claritin)
fexofenadine (Allegra)

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9
Q

fluticasones (Flonase)

A

Intranasal Glucocorticoids

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10
Q

Intranasal Glucocorticoids/fluticasones (Flonase) uses

A

The most effective medications for allergic rhinitis d/t anti-inflammatory action

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11
Q

Intranasal Glucocorticoids/fluticasones (Flonase) adverse effects

A

dry mucosa, epistaxis, headache, sore thoat, nasal irritation

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12
Q

Azelastine (Astelin)

A

Intranasal Antihistamines

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13
Q

Intranasal Antihistamines/Azelastine (Astelin)

A

-Second generation
-Benefits are equal to oral antihistamines
-In theory, should have less systemic adverse effects
-Adverse Effects: nasal dryness, epistaxis, headaches

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14
Q

Nasal oxymetazoline (Afrin)

A

Decongestants

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15
Q

Decongestants examples

A

-nasal phenylephrine (neo-synephrine)
-oral pseudoephedrine (Sudafed)

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16
Q

Decongestants/Nasal oxymetazoline (Afrin) MOA

A

-reduces swelling of nasal mucosas (aka sympathomimetics, alpha 1 agonists) 0 only relieves nasal congestion

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17
Q

Decongestants/Nasal oxymetazoline (Afrin) adverse effects

A

 Oral: restlessness, anxiety, insomnia, vasoconstriction (HTN)
 Nasal: Rebound congestion (wean with nasal glucocorticoid)
 Potential for abuse – purchase limitations on oral tabs

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18
Q

Inhaled Corticosteriods (ICS): Glucocorticoids MOA

Study These Flashcards
A
  • Decreases bronchial hyperactivity
  • Decreases airway edema
  • Decreases synthesis of inflammatory mediators
  • Increases the number of beta 2 receptors
  • Increases responsiveness to beta 2 agonists
19
Q

Inhaled Corticosteriods (ICS): Glucocorticoids Adverse Effects

Study These Flashcards
A
  • Oropharyngeal candidiasis
  • Dysphonia
  • Increase in glucose level
  • Adrenal suppression
  • Bone loss possible
  • Slowing of growth possible in children
  • Peptic ulcer disease
20
Q

Glucocorticoids-inhaled protypes

Study These Flashcards
A

Beclomethasone
dipropionate
(QVAR)
fluticasone
(Flovent)

21
Q

Glucocorticoids-inhaled Nursing considerations

Study These Flashcards
A

-effects develop slowly
-attach a spacer
-antifungal therapy
-oral hygeines
-give routinely, rather than PRN
-Inhaled beta 2 agonist first

22
Q

Glucocorticoids-inhaled contradictions and precautions

Study These Flashcards
A
  • Cautious in clients who have peptic ulcer disease, DM, hypertension, renal dysfunction or taking NSAIDS regularly
  • Don’t give with Lasix, such as Furosemide
  • Avoid giving a client who has systemic fungal infection
  • Avoid giving a client who recently received a live virus immunization
23
Q

Glucocoriticoids oral prototype

24
Q

Glucocoriticoids oral/prednisone Nursing considerations

Study These Flashcards
A
  • short-term management of post-exacerbation symptomes
  • Monitor plasma drug levels
  • Cannot stop abruptly!
  • Implement gastric protective measures
  • Monitor blood glucose levels
  • Observe for signs or symptoms of infection
  • Monitor labs and s/sx of electrolyte imbalance
  • Osteoporosis prevention
25
Glucocoriticoids oral/prednisone Contradictions and Precautions
* Cautious in clients who have peptic ulcer disease, DM, hypertension, renal dysfunction or taking NSAIDS regularly * Don’t give with Lasix, such as Furosemide * Avoid giving a client who has systemic fungal infection * Avoid giving a client who recently received a live virus immunization
26
Glucocorticoids Nasal prototype
fluticasone (Flonase)
27
Glucocorticoids Nasal/fluticasone (Flonase) nursing considerations
-initial does is higher -taper to lowest effective does -therapeutic effects take 2-3 weeks -comfor measures for dry mucus membranes -non-NSAID for pain -monitor for s/sx infections
28
Glucocorticoids Nasal/fluticasone (Flonase) adverse effects
* Headache * Epistaxis * Sore throat
29
Beta 2 adrenergic agonists: short-acting (SABAs)
* Rescue inhaler * Used PRN for sx or before exercise (EIB) * Adverse effects: tachycardia, angina, tremor – temporary, minimal * Examples: - albuterol (Proventil, Ventolin), - levalbuterol (Xopenex)
30
Beta 2 adrenergic agonists: long-acting (LABAs)
* Not a rescue! It’s a Controller * Fixed-schedule dosing * May be needed to decrease freq of SABA use * Must be combined with ICS (in asthma) * Examples: - salmeterol (Serevent Diskus) - Arformoterol (Brovana)
31
Oral B2 agonists
* Only for long-term control – Not for acute attack! * Because they are absorbed systemically, have more adverse effects such as tachycardia, angina, tremors * Short T 1/2 * Examples: albuterol, terbutaline
32
Methylxanthine
Theophylline
33
Methylxanthine/Theophylline uses
treat asthma -causes CNS stimulation, cardiac stimulation, and bronchial dilations
34
Methylxanthine/Theophylline pharmacokinetics
* Only available as sustainedrelease PO * Wide variation in T1/2 requires individual dosing * NTI: Levels between 10 - 20 mcg/mL are therapeutic
35
Methylxanthine/Theophylline adverse effects
* At slight toxicity, see n/v/d, insomnia, restlessness * Even higher levels: dysrhythmias, angina, tremors, convulsions * Interaction: Caffeine!
36
montelukast (singulair)
Leukotriene modifier
37
montelukast (singulair)/Leukotriene modifier MOA
-decreased bronchoconstriction -decreased inflammatory response (less edema and mucus secretion)
38
montelukast (singulair)/Leukotriene modifier uses
ashtma, EIB, allergic rhinitis
39
montelukast (singulair)/Leukotriene modifier Nursing condiserations
-administration is PO -not first line of treatment -used in combo with glucocorticoids to lower steroid does
40
montelukast (singulair)/Leukotriene modifier contraindications
No serious drug interactions * Potential for liver damage * Slight risk of neuropsychiatric symptoms
41
ipratroprium (Atrovent) & tiotropium (Spiriva)
Anticholinergics (aka Muscarinic Antagonists)
42
Anticholinergics (aka Muscarinic Antagonists): ipratroprium (Atrovent) & tiotropium (Spiriva) MOA
block muscarinic receptors in the bronchi, prevents bronchoconstriction
43
Anticholinergics (aka Muscarinic Antagonists): ipratroprium (Atrovent) & tiotropium (Spiriva) Uses
COPD, off-label for asthma
44
Anticholinergics (aka Muscarinic Antagonists): ipratroprium (Atrovent) & tiotropium (Spiriva) nursing considerations/drug intereations
-inhaled administration * Works well in combo * Anticholinergic -> prevents bronchoconstriction * Beta 2 agonist -> promotes bronchodilation
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