Respiratory And Endocrine/diabetes Meds

Front 1

Epinephrine
what, action, use

Back 1

nonspecific adrenergic agonist
decrease mucosal edema, bronchodilation, decrease inflammatory response
acute allergic reaction, anaphylaxis, bronchospasm
teach caution w/ OTC inhalers, cardiac effects

Front 2

Beta adrenergic agonists
(Beta-2 selective better, fewer cardiac effects)
"-erol"
action, adverse, therapeutics, teach

Back 2

Bronchodilation, inhibits inflammation (release of inflammatory mediators)
Dose-dependent adverse effects
MDIs or nebulizers, a few PO agents for kids
Teach proper use of inhalers, don't over use

Front 3

Albuterol (Proventil, Ventolin)

Back 3

Short acting beta adrenergic agonist
Use up to 4x/day to prevent, use before aggravating activities, or as rescue inhaler

Front 4

Salmeterol (Serevent)

Back 4

Long-acting beta adrenergic agonist (LABA)
Dry powder inhalers, prevent exacerbation
12h action, not rescue inhalers

Front 5

Corticosteroids (Glucocorticoids)
action, goal, adverse, teach

Back 5

Inhibit airway inflamation, decrease hyper-reactivity
Goal is to reduce use/dependence on beta-agonists, prevention
Adverse: systemic absorption, thrush
Teach: take beta agonist first to open airway, wait, then take this. Proper use. Always follow corticosteroid inhalers with oral care!

Front 6

Triamcinolone (Azmacort)

Back 6

Corticosteroid (glucocorticoid)

Front 7

Fluticasone/Salmeterol (Advair)
Formoterol/Budesonide (Symbicort)

Back 7

combo corticosteroid/beta agonist
for chronic management
only recommended long term use of LABAs

Front 8

Anticholinergics
action, use, adverse

Back 8

Reduce cholinergic effect, enhances adrenergic effects, bronchodilation (no anti-inflammatory though)
Slow onset, use in combo w/ beta agonists, not a first line option
Adverse: few (less cardiac effects)
MDI or nebulizer

Front 9

Ipratropium (Atrovent)
Tiotropium (Spiriva)

Back 9

Anticholinergic agents
Slow onset, used in combo therapy w/ beta agonists
same teaching teaching as beta agonists

Front 10

Proper use of MDIs

Back 10

Inhale, exhale fully
discharge med (using spacer or holding inches away from mouth) while inhaling fully
hold breath 10 seconds
wait 1-2 minutes before another dose
don't overuse!

Front 11

Methylxanthines
action, adverse, therapeutics

Back 11

Bronchodilation, increase CO, inhibit inspiratory fatigue (great for COPD), enhance mucociliary clearance
Dose dependent adverse: CNS stim, tachy, tremor
Therapeutic range 10-20mcg/ml (but monitor pt, not #s!)
IV loading dose followed by infusion, monitor vitals, therapeutic blood levels

Front 12

Theophylline

Back 12

Methylxanthine
IV, few PO agents
other relative include aminophylline, caffeine, theobromine (chocolate)

Front 13

Leukotriene receptor antagonist
"-lukast"
action, use, adverse

Back 13

Block leukotriene receptor, block inflammatory response, prevent asthma, decrease exacerbations
Use: PO agents for every day prevention, seasonal allergies
Adverse: few, GI

Front 14

Zafirlukast (Accolate)
Montelukast (Singulair)

Back 14

Leukotriene receptor antagonist
Daily PO agents for prevention and seasonal allergies

Front 15

Mast cell stabilizers, anti IgE agents, systemic corticosteroids

Back 15

other bronchodilators, not first line

Front 16

Expectorants

Back 16

(May) stimulate flow of respiratory secretions, mucociliary clearance
In many cough meds (concern with kids)
Best/safest expectorant: WATER! Rehydrate and humidify

Front 17

Antihistamines
"-amines"
action, uses, adverse, other uses

Back 17

Antagonize effects at histamine receptors, H1 receptors for respiratory, inhibit vasodilation (runny nose), inhibit edema and itching, CNS effect depends on person (stim/depress)
use: reduce symptoms in allergic reactions, secondary agent in treating anaphylaxis (not for asthma)
adverse: sedation, drug interactions
other uses: antiemetics, motion sickness/vertigo

Front 18

Diphenhydramine (Benadryl)

Back 18

first generation antihistamine
more sedation, crosses BBB

Front 19

Insulin Lispro (Humalog)
Insulin Aspart (Novolog)
Insulin Glulisine (Apidra)

Back 19

Rapid-acting Insulins
Onset 10-20 min
Peaks 30-90 min
Duration 3-5 hours
must eat w/in 15 min of injection

Front 20

Regular Insulin IV

Back 20

Clear. Only type use for IV admin (emergency)
Onset 5 min
Peak 30 min
Duration 1 hour

Front 21

Regular Insulin (SQ)

Back 21

Onset 30 min
Peak 2-3 hours
Duration 5-7 hours

Front 22

NPH ("Lente" doesn't exist anymore)

Back 22

Cloudy solutions (precipitates to slow absorption)
SQ only, roll vial before use to re-suspend
Onset 1-2 hours
Peak 4-12 hours
Duration 18-24 hours

Front 23

Insulin Detemir (Levemir)

Back 23

Low dose - intermediate acting insulin (12h)
High dose - long acting insulin (24h)

Front 24

Insulin Glargine (Lantus)

Back 24

Long acting insulin, once daily dosing at bed time, clear
NO peak - even blood levels for 24hrs
Used in kids and elderly to prevent hypoglycemic incidents

Front 25

Teaching Proper Insulin Admin

Back 25

90 degree angle in fatty area (abd or back of arm)
Rotate sites to avoid scarring
Site choice (abd faster absorption, leg/arm affected by exercise)
Teach symptoms and sick day rules

Front 26

Pre-mixed and mixing

Back 26

Pre-mixed: larger % always loner acting (NPH)
70/30 and 50/50
Mixing: pull regular/faster acting up first, then longer acting. Why?
"Clear to cloudy"

Front 27

BG normal range?
Monitoring?

Back 27

80-120 mg/dL
Finger prick, blood draw, serum, or A1c (past 60-90 days)
Monitoring closely in ICU/surgeries. Why?