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24 Cards in this Set

  • Front
  • Back

Ventolin: use and action

binds to beta2- adrenergic receptors in smooth airway muscle;


leads to activation of adenylcyclase and > levels of cAMP


inhibits phosporylation of myosin& intracellular Ca+


relaxes smooth airway muscles--- bronchodilation

Ventolin: side effects and interactionxs

nervousness, restlessness, tremor, PARADOXICAL BRONCHOSPASM, chest pain, palpitations



other adrenergic agents, MAO inhibitors, beta blockers, < serum digozxin, tricyclic antidepressants, K+ losing diuretics

Ventolin: Implications

lung sounds, BP, pulse before giving& during peak


pulmonary function tests & sputum colour


paradoxical bronchospasm (wheezing)


can cause < in serum K+

Ipatropium: uses and action

allergy, cold, cough remedies, bronchodilators--- anticholinergic



Inhibits cholinergic receptors in bronchial smooth muscle; < cGMP= local bronchodilation

Ipatropium: side effects and interactions

dizziness, headache, nervousness, blurred vision, sore throat, bronchospasm, cough, hypotension, palpitations, GI irritation, nausea, rash, allergic rx.



other drugs with anticholinergic properties (histamines, etc.)

Ipatropium: Implications

allergies to ipatropin& belladona alkaloids


respiratory status


when used with other bronchodialtors, give adrenergic bronchodialators first, then ipatropium, then corticosteroids

Albuterol: use and action

bronchodilators--- adrenergics


binds to beta 2 adrenergic receptors in airway smooth muscle--- adenyl cyclase--- > levels of cAMP


relaxes smooth muscle airways

Albuterol: side effects and interactions

nervousness, restlessness, tremor, PARADOXICAL BRONCHOSPASM, chest pain, palpitations



other adrenergic agents, MAO inhibitors, beta blockers, < serum digoxin, tricyclic antidepressants, K+ losing diuretics, caffeine

Albuterol: Implications

lung sounds, BP, pulse, before & during peak


sputum, pulmonary function tests


bronchospasm


< serum K+


unsual/ bad taste


take first before other bronchodilators


mouth care

Flucticasone (Flovent): use and action

anti- inflammatory--- corticosteiroid



potent, locally acting anti- inflammatory and immune modifier



< frequency and severity of asthma attacks

Flucticasone: side effects and interactions

headache, ANAPHYLAXIS, LARYNGEAL EDEMA, URTICARIA, BRONCHOSPASM, CHURG- STRUSS SYNDROME


CYP3A4 inhibitors

Flucticasone: side effects and interactions

respiratory status& lung sounds, pulmonary function tests


< bone mineral density


hypersensitivity


adrenal function test


give bronchodilator first & then corticosteiroid

Salmetrol: use and action

bronchodilator--- adrenergic


accumulation of CAMP at beta 2 adrenergic receptors

Salmetrol: side effects and interactions

headache, ASTHMA RELATED DEATH


beta blockers, MAO inhibitors &tricyclic antidepresssants, CYPS4A and caffeine > levels and risk of cardio effects

Salmetrol: Implications

lungs sounds, pulse, blood pressure


pulmonary function tests


paradoxical bronchospasm (wheezing)


> serum glucose


not used as a monotherapy


not used for acute symptoms of asthma

Montelukast: use and action

allergy, cold, cough remedies--- leukotriene antagonists


antagonizes the effects of leukotrienes which mediate: airway edema, smooth muscle constriction, altered cellular activity


< severity of allergic rhinitis and exercise induced asthma attacks

Montelukast: side effects and interactions

SUICIDAL THOUGHTS, SJS, TOXIC EPIDERMAL NECROLYSIS, EOSINOPHILIC CONDITIONS


drugs that induce CYP450 enzyme system may decrease its effect

Montekulast: Implications

respiratory status


allergic rx.


changes in behaviour


rash


AST/ALT values


take in evening/ at least 2 hrs before exercise


be alert for anxiety, agitation, panic attacks/ behavioral changes

Prednisone: use and action

anti- inflammatories (steiroidal) immune modifiers



suppress inflammation& immune response, intense metabolic effects, supress adrenal function at chronic doses of 5mg a day, replaces endogenous cortisol in deficiency states

Prednisone: side effects & interactions

depression, euphoria, hypertension, PEPTIC ULCER, anorexia, nausea, vomitting, acne, < wound healing, ecchymoses, fragility, adrenal suppression, THROMBOEMBOLISM, muscle wasting, osteoporosis, cushingoid appearance



thiazide& loop diuretics, amphotericin B, digoxin, oral contraceptives, phenytoin, NSAIDS, live virus vaccines, fluroquinolones

Prednisone: implications

assess involved systems, signs of adrenal insufficiency


fluid status


serum electrolytes & glucose, cholesterol, lipid, thyroid


give in AM to coincide with cortisol release


with food


DO NOT STOP SUDDENLY


contact physician if abd. pain/ tarry stools occur

Moxifloxacin: use and action

anti- infective--- fluoroquinolones



inhibits bacterial DNA synthesis by inhibiting DNA gyrase enzyme

Moxifloxacin: side effects and interactions

> INTRACRANIAL PRESSURE, TORSADE DE POINTS, PSEUDOMEMBRANOUS COLITIS, SJS, HYPERSENSITIVITY RX. including ANAPHYLAXIS



erythromycin, antipsychotics, tricyclic antidepressants, antineoplastics, cyclosporine, corticosteiroid therapy

Moxifloxacin: implications

signs and symptoms of anaphylaxis (rash, pruritis, laryngeal edema)


bowel movements (bloody stool, cramping, diarrhea)


rash (SJS)


peripheral neuropathy (pain, burning, tingling, etc.)


give over 60 mins