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24 Cards in this Set
- Front
- Back
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What are antitussives used for
what is the most effective class of antitussive? |
dry, hacking, non productive coughs
narcotic analgesics are most effective (codeine) |
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What is the most popular antitussive?
What are its side effects? |
dextromethorphan (Robitussin)
side effects are rare, no risk dependence |
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what are expectorants used for?
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increasing bronchial secretions, reduce thickness of secretions, remove more easily by coughing
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what is the most effect OTC expectorant
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guaifenesin
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what are mucolytics used for- what is their MOA
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directly loosen thick vscouse bronchial secreitons- dissolve or digest mucus
enzyme acetylcysterine |
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What is the most used mucolytic?
what is its ROA? What disorder is it commonly used for? |
dornase alfa (pulmozyme)
inhalation- rx only cystic fibrosis |
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what are the symptoms of an asthma attack
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pt upright leaning forward, fighting for air
anxious and frightened wheezing (severe attack this may be absent) nasal flaring awareness decreased diaphoresis- sweating excessively cyanosis- turning a blue tint chest tightness |
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what are the vital signs of someone having an asthma attack
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tachypnea- 20-40 breaths
rise in bp and pulse- >120 bpm dyspnea- shortness of breath |
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what are the goals of drug therapy for:
asthma copd overall |
asthma- reduce frequency of asthma attack, control cough and bronchospasm
COPD- treat infection, control cough and bronchospasm overall*-directed at reducing inflammation and reversing airway obstruction |
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what are the characteristics of sympathomimetics
nonselective/selective adrenergic/cholinergic |
sympathomimetics are nonselective adrenergic agents
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what are some sympathomimetic nonselective adrenergic agents
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epinephrine and isporternol
(A and B agonists) |
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what are the side effects of sympathomimetics (epinephrine and isporternol)
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tachycardia, insomnia
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name 3 selective beta2 agonists
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salmeterol (serevent)
albuterol (proventil) terbutaline (brethine) |
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characteristics of selective beta2 agonsits:
bronchodilator? ROA- used for- side effects- other* |
selective beta2 agonists:
bronchodilators ROA- inhalation used for- prevnt attacks and ones in progress side effects- few cardiac side effects other*- synergistic effect with other sympathomimetics |
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characteristics of selective methylxanthines:
ROA- used for- side effects- MOA- other*- drugs- |
roa- tablets
used for- mgmt of bronchospasms in chronic asthma and bronchitis side effects- stimulates cns, cardiac stimulation moa- long acting bronchodilator other*- erythromycin: raises theyohylline levles- toxicity drugs- theophylline (theo-dur) |
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characteristics of anticholinergics:
ROA- used for side effects moa- drugs- |
roa- inhalation/nasal
used for- asthamtics, COPD side effects- dry mouth/throat MOA- blocks ach from binding to receptors on bronchial tree/ dilates alveoli drugs- ipratropium(Atrovent) |
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characteristics of corticosteroids:
ROA used for side effects moa other* drugs |
roa- inhalation/nasal
used for- anti inflammatory side effects- candidiasis, sore throat, hoarseness, cough moa- inhibits release of prostaglandin and leukotriene other*- rinse inhalers to avoid candidiasis drugs- beclomethasone (beclovent), fluticasone (flovent) triamcinoline (asmacort) |
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characteristics of drug ADVAIR
generic name? preventetive combo therapy with which drugs? what are their modes of action |
generic name- fluticasone and salmeterol
preventive combo therapy salmeterol- long acting beta2 adrenergic receptor agonist 0 bronchodilator fluticasone- prevents release of substances that cause inflammation- corticosteroid |
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selective leukotriene receptor antagonist characteristics:
drug? roa- used for- other* |
drug- montelukast sodium (singulair)
roa- tablet/chewable pill used for- relief of seasonal allergies/ chronic tx of asthma *newest anti inflammatory agent |
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mast cell stabilizers characteristics-
roa- used for moa- other drug |
roa- metered dose inhaler
used for- anti inflammatory, prophylactic only moa- messes up IgE antibody/antigen interaxn in mast cells of submucosal resp. passages. prevents histamine, leukotrienes from sensitizing mast cells other* least toxic of all asthma meds drug- cromolyn (intal) |
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dental considerations:
what drugs are contraindicated? what drugs are sensitive? what drugs are ok? |
barbiturates and opioids contraindicated- can lead to bronchospasms
sensitivity to aspirin and NSAIDS, sulfites (contained in local anesthetics with vasopressors ex. epinephrine) ok- conscious sedation, NO2, oral sedation (benzos) |
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dental considerations:
what is the long term goal? what are some oral manifestations? what are some questions that should be asked during the medical history? |
long term goal to maintain normal pulmonary status and prevent acute episodes
oral manifestation- mouth breathers, increased caries with powdered inhaler use medical hx- what causes your attacks? how often? how do you manage attacks? asa status (2-well controlled, 3-fearful, 4-chronic/incapacitating) |
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COPD emergency mgmt:
when is oxygen recommended vs not recommended? |
o2 recommended in severe cases of emphysema
severely afflicted (asa4) pts SHOULD NOT receive o2 OVER 3liters/min (minimizes risk of eliminating pts hypoxic drive-stimulus for breathing) *never withold oxygen in the even of emergency- low o2 flow if needed |
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asthma emergency mgmt
R.E.P.A.I.R what is I? |
implement protocol:
pt administer own bronchodilator albuterol (ventolin) up to 3 times, loosen clothing, oxygen via nasal cannula, pt may need secondary drug epinephrine |
