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81 Cards in this Set

  • Front
  • Back
Which bronchodilators:

stimulate an enzyme (adenyl cyclase) to increase production of cyclic AMP -> bronchodilation
What are some side effects of Adrenergics? (try to name 5)
- angina
- tachycardia
- palpitations
- agitation
- anxiety
- insomnia
- seizures
- tremors
True or False:

Adrenergics are ok for use in all ages.
True (older clients may experience more cardiac stimulation)
For which receptors is Epinephrine an agonist?
- B1
- B2
What is the drug of choice for bronchospasm?
B2 agonist
Which bronchodilator:

- 1st choice for status asthmaticus, acute asthma
Short-acting B2 agonist
Concerning short-acting B2 agonist:

- when is the onset of action?
- how long is the duration?
- 5 min

- 3-8 hours
How are Short-acting B2 agonists administered?
metered dose inhalers (MDIs) or nebulizer
The examples below are from which bronchodilator class?

- albuterol (Proventil)
- levalbuterol (Xopenex)
Short-acting B2 agonist
What route can albuterol be given besides inhalation?
Which bronchodilator:

- used to prevent episodes of bronchoconstriction
- slower onset of action
- duration up to 12 hours
Long-acting B2 agonist
What rule applies to the frequency of taking long-acting B2 agonist
Never take more frequently than q12hr
The examples below are from which bronchodilator class?

- formoterol (Foradil)
- salmeterol (Serevent)
Long-acting B2 agonist
What long-acting B2 agonist is sometimes given to prevent preterm labor?
terubutaline (Brethine)
What bronchodilator:

blocks the action of aCH in bronchial smooth muscle when administered via inhalation
When are anticholinergics indicated?
- long-term management of COPD
- bronchoconstriction
When are Anticholinergics contraindicated?
- cautious use with narrow-angle glaucoma (increase intraocular pressure)

- BPH (causes urinary retention & anticholinergic prevents contraction of bladder :(
What are the side effects of Anticholinergics (try to name 5)
- dry mouth
- urinary retention
- cough
- nervousness
- nausea
- GI upset
- headache
- dizziness
The examples below are from which bronchodilator class?

- ipratropium (Atrovent)
- tiotropium (Spiriva)
Which bronchodilator?

- unknown method of action
- 2nd line drug in asthma & COPD
When are Xanthines contraindicated?
emergency tx of bronchospasm
When do side effects to Xanthines usually present?
with elevated serum levels
What are some side effects to Xanthines? (try to name 5)
- anorexia
- N/V
- agitation
- nervousness
- insomnia
- dysrhythmias
- tonic-clonic seizures
The example below are from
which bronchodilator class?

- theophylline (Aminophyilline, Theo-dur)
Which routes can Xanthine be administered?
IV and PO (sustained release far more common)
What is the therapeutic range for Xanthines?
serume theophylline 5-15 mcg/mL (narrow range)
When should blood be drawn after Xanthine administration?
- 1-2 hours after immediate release

- 4 hours after SR
How is the dosage for Xanthines calculated?
using lean body mass
What is the nursing implication concerning administration if GI upset occurs with Xanthine administration?
take with a glass of H2O or food
What respiratory drugs suppress the inflammatory process and decrease mucus secretion, mucosal edema, repair of damaged epithelium, reduced airway reactivity. Also increased B2 receptors, enhancing responsiveness to B2 agonist
When are corticosteroids indicated?
- Acute asthma (IV or PO in high/multiple doses)
- Chronic asthma (daily inhalation)
What are some contraindications for corticosteroid use?
- caution with PUD
- inflammatory bowel disease
- thromboembolic disorders
What are some side effects to corticosteroid use?
- fewer with short-term use
- chronic use in children may retard growth & bone mass, and decrease adrenal function
- avoid high doses in children
- oropharyngeal candidiasis, hoarseness (rinse mouth)
- adrenal insufficiency may occur with systemic use or high doses of inhalation
- high dose in elderly increases risk of osteoporosis
the following are example of which respiratory drugs:

- PO - prednisone (Deltasone)
- IV - hydrocortisone (Solucortef), methylprednisolone (Solu-medrol)
- Inhalation - fluticasone (Flonase), triamcinolone (Azmacort), beclomethasone (Beconase)
Advair is a mixture of corticosteroids and what B2 agonist?
Serevent (given q12 hours)
When are Leukotriene modifiers indicated?
- long-term management of asthma in adults and children
Which Leukotriene modifier is contraindicated in liver disease?
zileuton (Zyflo)

(increase LFT with Zyflo)
What are some side-effects of Leukotriene modifiers?
- HA
- nausea
- diarrhea
- infection
the following are examples of which respiratory drugs:

- montelukast (Singulair)
- zileuton (Zyflo)
Leukotriene Modifiers
Which respiratory drugs prophylactically stop the release of inflammatory mediators when mast cells come in contact with allergens and/or other stimuli
Mast Cell Stabilizers
When are Mast Cell Stabilizers indicated?
prophylaxis for acute asthma attacks
When are Mast Cell Stabilizers contraindicated?
- acute bronchospasm
- status asthmaticus
- caution in renal/hepatic impairment
What are some side effects of Mast Cell Stabilizers?
- dysrhythmias
- hypotension
- chest pain
- dizziness
- convulsions
- anorexia
- N/V
- CNS depression
the following are examples of which respiratory drugs:

- cromolyn (Intal)
- nedocromil (Tilade)
Mast Cell Stabilizers
What route are Mast Cell Stabilizers given?
Which respiratory drugs block receptors on mast cells and basophils by binding to IgE, ultimately preventing the release of inflammatory mediators
Immunosuppressant Monoclonal Antibodies
When are Immunosuppressant Monoclonal Antibodies indicated?
allergic asthma unrelieved with corticosteroids
What are some side effects of Immunosuppressant Monoclonal Antibodies?
- pharyngitis
- sinusitis
the following is from which respiratory drugs

- omalizumab (Xolair) [SC route]
Immunosuppressant Monoclonal Antibodies
How long should one wait between MDI puffs?
3-5 minutes
Which respiratory drugs is caffeine associated with?
Which two vaccines are recommended to clients with respiratory difficulties?
- flu vaccine
- pneumonia vaccine
What is the recommended fluid intake for clients with respiratory difficulty?
2-3 quarts/ day
At what times should montelukast (Singulair) be administered?
administer in the evening or HS to increase drug concentrations during the night and early morning
What is the first chemical mediator released from basophils & mast cells w/ immune & inflammatory disorders
Which histamine receptor is located in the smooth muscle in blood vessels, respiratory tract, and GI tract
Which respiratory drugs inhibit bronchoconstriction, decrease capillary permeability, decrease salivary & tear formation - block histamine from acting of target tissues
H1 receptor antagonists (Antihistamine)
When are H1 receptor antagonists indicated?
- allergic rhinitis
- anaphylaxis
- allergic conjunctivitis
- drug allergies & pseudoallergies
- transfusion premedication
- dermatologic conditions
- motion sickness
- N/V
When are H1 receptor antagonists contraindicated?
- pregnancy
- narrow-angle glaucoma
- prostatic hypertrophy
- stenosing peptic ulcer
- bladder neck obstruction
What is the side effect of First Generation (SEDATING/nonselective) Antihistamines?
CNS depression
the following are examples of which respiratory drugs?

- diphenhydramine (Benadryl)
- hydroxyzine (Vistaril)
- promethazine (Phenergan)
First Generation (SEDATING/nonselective) Antihistamines
In addition to PO, both Benadryl and Phenergan can be given IV. When giving Phenergan IV, what amount of saline is used to dilute the drug?
10mL saline
What property causes the second generation (Nonsedating / selective) antihistamines to produce less sedation than 1st generation?
Second Generation Antihistamines do not cross the BBB
the following are examples of which respiratory drugs:

- loratadine (Claritin)
- cetirizine (Zyrtec)
- fexofenadine (Allegra)
Second Generation Antihistamines
Though Second Generation Antihistamines are usually better, what is the downside?
they are more expensive
What is the MOA of Nasal Decongestants?
constricts arterioles and reduces blood flow to nasal mucosa thereby decreasing nasal congestion
What are some contraindications for Nasal Decongestant use?
- Narrow-angle glaucoma
the following are examples of which respiratory drugs:

- pseudoephedrine (Sudafed)
- oxymetazoline (Afrin - nasal spray
- phenylephrine (Neosynephrine)
Nasal Decongestants
What can occur with extended use of nasal spray (> 7 days)
Rebound nasal congestion
Which respiratory drugs depress the cough center in the medulla oblongata, cough receptors in throat, trachea, and lungs
When are antitussives indicated?
dry, hacking, Nonproductive cough
Which antitussive drug is centrally active (causes drowsiness)?
Which antitussive drug is Non-narcotic (non drowsy)?
dextromethorphan (Bentyl DM)
What common antitussive drug is given locally?
throat lozenges
Which respiratory drugs are given to liquefy secretions?
the following is an example for which respiratory drugs:

- guaifenesin (Robitussin, Mucinex)
Which respiratory drugs are given via inhalation therapy to liquefy secretions?
the following are examples of which respiratory drugs:

- sodium chloride & acetylcysteine (Mucomyst)
Which respiratory drug is used in the treatment of acetaminophen overdose and in small doses with dye administration?
acetylcysteine (Mucomyst)
Which herb and mineral supplements are used to combat colds?
- Echinacea
- Zinc gluconate
What dose of vitamin C is given to decrease incidence and severity of colds and flu?
doses > 100mg