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28 Cards in this Set
- Front
- Back
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Rationale for Rx of pulmonary meds |
-Bronchodilation -Facilitation of mucociliary/secretion clearance -Inc Alveolar ventilation and/or improved oxygenation -Improved control of breathing pattern |
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What is Bronchomotor Tone |
Normal Tone is a result of a balance between adrenergic and cholinergic influences |
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Effects of disruption of balance of adrenergic and cholinergic influences? |
Disruption leads to bronchospasm --Smooth muscle constriction, mucus production, vascular engorgement, submucosal inflam edema |
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Primary purpose of Bronchodilators |
Influence autonomic nervous system receptors via two opposing nucleotides cAMP and cGMP |
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Describe purpose of cAMP
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Facilitates smooth muscle relaxation and inhibits mas cell degranulation Bronchodilation |
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Decribe purpose of cGMP |
Facilitates smooth muscle constriction and enhances mast cell release of histammine Bronchoconstriction |
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What are the common type of bronchodilators? |
1) Anticholingeric --Block Ach 2) Beta 2 Agonist --Stimulate Beta 2 receptors 3) Phosphodiestrase inhibitors --Phosphodiestrase Breaks down cAMP - block it and cAMP inc 4) Nonselective beta agonists |
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What are sympathomimetics |
Medications that stimulate the adrenergic receptors Relaxes smooth muscle bronchodilates Epipen |
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What are Sympatholytics |
Medications that inhibit adrenergic receptors Anti adrenergic |
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What are parasympathomimetics |
Medications that stimulate the cholinergic receptors Stimulate Parasympathetic ach |
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What are parasympatholytics |
Medications that inhibit cholinergic receptors Anti cholinergic Bronchodilate |
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Describe effects of sympathomimeticAgents or Adrenergic Agonists |
•Maybe selective or non selective •Alphareceptors- mostly in peripheral smooth muscle , some bronchial, cardiac, somemucosal •Beta1– Mostly Cardiac, some mucosal •Beta2– Mostly Lungs, smooth muscle,peripheral smooth muscle, skeletal muscle |
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How are pulmonary medications administrated? |
Oral - affects the whole body. Requires higher doses because it will be broken down more. Subcutaneous injection Inhaled - preferred - goes straight to lungs and faster acting |
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Describe Beta 2 agonists |
Advantage over other sympathomimetics:affect lungs without affecting peripheral or cardiac receptors. Relaxes smooth muscle by inc cAMP Long acting - 2x/day, kicks in 3-20 min Short acting - only lasts 4-6 hours; kicks in in 3-5 min |
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Side effects of Beta 2 agonists |
–Tremor –Palpitations –Headache –Nervousness –Dizziness –Nausea –Hypertension –Maycause inotropic and chronotropiceffects |
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Advantages and disadvantages to parasympatholytic |
Blocks Parasymp and prevents an inc in cGMP and causes an increase in cyclic AMP Advantages: Less side effects than B2 agonists. Not stimulating stymp receptors (important for cardiac patients) Disadvantages: Depression, Delirium, hallucinations |
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Describe steroids effect on pulmonary function |
Suppresses immune system/antiinflam therby improves airflow |
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Adverse effects of steroids |
•Immunosuppression •GI disturbance •Emotional lability •Insomnia •Osteoporosis •Growth retardation•Muscle weakness/atrophy •Hyperglycemia (steroid induced diabetes) •Na+ and H20 retention •Cushingoid syndrome - cortisolg |
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What are leukotriene inhibitors |
Leukotriene promote neutrophil-endotherlial interactions inducing bronchospasm and inc airway hyperresponsiveness Inhibits production and blocks receptor sutes |
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Side effects of leukotriene inhibitors |
Hepatic impairment Headaches Fatigue Nausea and vomitting |
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Describe how Anti IgE monoclonal antibodies work |
After Haptens enter the body and binds to bodies protein Bodies convert them to allergens and IgE antiodies are formed This causes histamine, leukotrienes and prostaglandin release --> Bronchoconstriction |
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Side effects of Anti IgE Monoclonal Antibodies |
Itching Headaches Injection site pain Anaphylaxis |
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What are Decongestants |
Bronchodilator to allow mucous to come up Treats upper airway mucosal edema and discharge |
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Side effects of Decongestants |
Headache, Dizziness Nausea Nervousness Insomnia Hypertension Cardiac irregularities |
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What are antihistamines |
Decrease mucosal congestion, irritation, and discharge caused by inhaled allergens |
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What is an antitussive? |
Primary purpose: sedation - cough suppression Used often at night |
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What are mucokinetics |
Promote mobilization and removal of secretions Mucolytics: decrease viscosity Expectorants: Increase production of respiratory secretions Wetting agents: Humidify and lubricate secretion Surface-active agents - stabilize aerosol droplets |
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Rehab concerns |
Schedule therapy when the drugs are reaching max effect --Inhaled bronchodialators - about 10 minutes --Mucolytic or expectorant - 30-60min to reach max effect Watch for signs of excessive use (HBP, arrythmias) |
