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72 Cards in this Set
- Front
- Back
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What drug class therapeutic intent is vasoconstriction causing reduction in blood flow to stuffy nasal areas reducing swelling
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decongestants
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Neosynephrine
ephedrine epinephrine pseudoephedrine are examples of |
decongestants
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Decongestants are used for
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symtomatic treatment of colds (congestion in allergy symptoms)
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decongestants are admined how
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orally
nasal sprays-drops-sprays |
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If nasal sprays/drops are used incorrectly (too much) what can develop
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nasal spray rhinitis medicamentosa/ tolerance reaction
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Decongestants are contraindicated in patients with
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cardiovascular disease
diabetes enlarged prostate (BPH) Patients should check with MD before using if have any of these conditions |
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Side effects to report of decongestants
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hypertension
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protein substance released in response to allergic rhinitis- that causes inflammatory response (stuffy, runny, itchy nose)
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histamine
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Indications for use of antihistamines
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allergies/seasonal rhinitis
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mechanism of action for histamines
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binds to histamine-1 receptor sites inhibiting the inflammatory (antigen/antibody) response
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Therapeutic action of antihistamines
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to reduce the symptoms of allergies (allergic rhinitis, conjunctivitis) reduces sneezing, rhinorhea, lacrimation, nasal and conjunctival pruritus
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Side effects of antihistamines
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anticholinergic side effects- drying, blurred vision, urinary retention
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Side effects of 1st generation antihistamines
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sedation
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Side effects of 2nd generation antihistamines
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not as sedating as 1st generation,
drugs exacerbate BPH used cautiously in patients with glaucoma |
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Examples of 1st generation antihistamine drugs
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diphenhydramine/Benadryl
chlorpheniramine/Chlor-Trimeton promethazine/Phenergan clemastine fumarate/ Tavist |
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Most 1st generation antihistamines cause side effects such as
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dry mouth
drowsiness other anticholinergic symptoms |
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Examples of 2nd generation antihistamines are
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Zyrtec/cetirizine
Claritin/ loratadine Clairitin D- decongestant added Clarinex/ desloratadine Allegra/ fexofenadine |
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Nursing interventions for the treatment of allergies
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assessment-symptoms, triggers-common cold, no fever
med history-both RX and OTC antihistamines best taken 45-60 min. before exposure Pt. to take meds as RX'd and avoid allergic triggers all antihistamines have anticholinergic side effects, especially when taken in larger doses-dry mouth, nose, eyes, constipation, blurred vision, and urinary retention |
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Patients with __________ or _________ should take antihistamines only with a health care providers supervision because it may exacerbate the condition
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prostatic enlargement (hypertrophy)
glaucoma |
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Intranasal corticosteroids indications for use are
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reduction of inflammation in nares, sinus (localized application) related to allergies (reduced rhinorhea, itching, sneezing etc)
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Side effects of intransal corticosteroids
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nasal burning-usually resolves with continued use
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examples of intransal corticosteroids are
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Beconase
Vancenase/ beclomethasone Rhinocort/ budesonide Flonase/ fluticasone Nasacort/ trimcinolone |
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the movement of air in and out of the lungs
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ventilation
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the process by which oxygen passes across the alveolar membranes to the blood in the capillaries and carbon dioxide passes from the blood to the alveolar sacs
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diffusion
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specialized mucous glands in the respiratory tract that produce gelatinous mucous that forms a thin layer over the interior surfaces of the respiratory tract
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goblet cells
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common lower airway pathologies
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asthma TB
COPD emphysema cystic fibrosis bronchitis allergies |
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bronchodilators indications for use are
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COPD
chronic lower respiratory diseases-asthma |
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Sympathomimetics (Adrenergics) examples are
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albuterol-Proventil, Ventolin
epinephrine (Primatene Mist) salmeterol (Serevent Diskus) levabuterol (Xopenex) |
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Beta2 agonist have ___________ and __________ significant side effects than non selective agonist
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fewer
less |
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Nursing interventions for sympathomimetics (adrenergics)
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Pt. education- may reduce the effects of antihypertensives (increase b/p)
Known as the rescue inhalers and should be taken before other types to rapidly bronchodilate |
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Side effects of sympathomimetics (adrenergics)
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hypertension anxiety
tachycardia palpitations HA tremors nervousness |
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Side effects to report of sympathomimetics (adrenergics)
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tremors
anxiety suspected dysrhythmias |
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Patients with which types of disorders should possibly not use sympathomimetics (adrenergics) (rescue inhalers group)
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Patients with: hypertension
CV disease diabetes |
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Side effects of beta2 agonist (epinephrine and albuterol)
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HA
nervousness palpitations increased glucose levels |
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Examples of xanthine products ( PO, IV)
available parenterally, orally-tabs, liquids |
Aminophylline
Theophylline Theodur theophylline SR Theolair Theobid |
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NI for xanthine products
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monitor serum levels (10-20mcg/mL)
symptoms of toxicity- cardiac arrhythmias, nausea & vomiting Interactions- Lithium, char-broiled foods, caffeine- can increase levels Smoking-requires increased level to maintain therapeutic levels |
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Anticholinergic bronchodilator examples
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Atrovent-ipratropium bromide
Spiriva- tiotropium bromide |
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Atrovent-ipratropium bromide
Spiriva- tiotropium bromide are what type of dosing |
once daily capsule that is punctured and inhaled
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Aerosol inhalation produces
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bronchodilation by competitive inhibition of cholinergic receptors on bronchial SMOOTH muscle
less cardiovascular side effects |
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Side effects of anticholinergic bronchodilators
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dry mouth & throat
HA tachycardia urinary retention |
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Anticholinergic bronchdilators should NOT be used in patients with
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glaucoma
BPH (enlarged prostate) |
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Antitussives are used to
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suppress irritating nonproductive coughs, seen with post-nasal drips, sinusitis, pharyngitis, and other hacky conditions
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Antitussives can be combines with __________ to treat productive hacky coughs
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expectorants
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Examples of antitussives
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codeine
hydrocodone Promethazine dextromethorphan Tessalon Pearles |
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therapeutic action of antitussives
examples |
inhibits the cough center in the CNS-in the medulla-reducing the frequency of nonproductive coughs
examples: dextromethorphan, codeine, hydrocodone |
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Side effects of antitussives
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constipation
sedation-respiratory depression |
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Expectorant uses
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decreases mucous viscosity increasing secretion exit from the lower airways
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Indications for expectorants
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to stimulate the flow of bronchial secretions
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Examples of expectorants
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guafenesin-Robitussin
saline |
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SSKI means
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saturated solution of potassium iodine
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SSKI uses
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chronic pulmonary diseases
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SSKI stimulates
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increased secretions to decrease the viscosity of mucous
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SSKI pt. education
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give it through a straw as it stains the teeth
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NI for expectorants
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drink lots of fluids
humidify air quit smoking |
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Leukotriene receptor antagonists
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inhibit leukotriene production/release thereby reducing inflammation, mucous prophylactically
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Examples of leukotrienes
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Zyflo
Accolate Singulair (PO) |
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indications for use of leukotrienes
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for use in conjunction with other meds in the prophylaxis /chronic tx of asthma
Singulair is also approved for seasonal allergy use-PO daily |
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Inhaled corticosteroid meds are used
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for obstructive airway disease
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hormones -adrenal cortex naturally that have potent anti-inflammatory effects
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corticosteroids
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Corticosteroids for respiratory conditions can be admined
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inhalation
parenterally PO |
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Examples of inhaled corticosteroids
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Pulmicort-budesonide phosphate
Flovent-flunisolide Aerobid Azmacort-trimcinolone |
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NI for corticosteroids
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rinse mouth well after use to prevent thrush
use of spacing device helps pt. to utilize med better five min. space should be allowed between inhaled meds |
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Mucolytics mechanism of action
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dissolve the chemical bonds within muous itself (liquifies secretions)
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Acetaminophen overdose antidote
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acetylcysteine/Mucomyst
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Mucolytic example
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acetylcysteine/Mucomyst
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Immunomodulators
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monoclonal antibody
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Immunomodulator examples
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Xolair>12yrs-used for moderate to severe asthma-inhibits the release of chemicals in body that can exacerbate asthma-sub q injection-expensive
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Phosphodiesterase Type 4 (PDE-R) inhibitor
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useful in the treatment of exacerbation or worsening of COPD linked to bronchitis
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Phosphodiesterase Type 4 (PDE-R) inhibitor example
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Diliresp/ roflumilast
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used to treat neonatal respiratory distress syndrome that is related to pre-term delivery-lack of surfactant (hyaline membrane disease-old name)
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Lung surfactants
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Lung surfactant examples
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Survanta/beractant
colfosceril palmitate/Exosurf Neonatal |
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med that is specific to the treatment of cystic fibrosis-inhalation treatment-DNA recombinant
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Pulmozyme
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