Unit 1 Ch. 31 Pharm

Front 1

The drugs used to treat the discomfort associated with an upper resp. disorder include:

Back 1

antihistamines

decongestants

antitussives

expectorants

Front 2

A substance produced by the amino acid histidine found in tissue of the body such as the heat, lungs, gastric mucosa, and skin

Back 2

Histamine

Front 3

an histamine is produced in response to ______

Back 3

injury

Front 4

A histamine produces _______ of the arterioles and _______ permeability of capillaries and venules thus promotes an escape of fluid from blood vessels into surrounding tissue causing localized swelling

Back 4

dialation

increased

Front 5

The release of a histamine produces and ________ response

Back 5

inflammatory

Front 6

A histamine is also released from _______ cells in allergic reactions or hypersensitivity reactions, such as anaphylactic shock

Back 6

mast

Front 7

________ block most, but not all, effects of histamines (called histamine type 1 (h1) receptor antagonists)

Back 7

anithistamines

Front 8

There are 2 types of antihistamines:

Back 8

1st generation

2nd generation

Front 9

This type of antihistamine binds NON selectively to central and peripheral H1 receptor and may result in CNS stimulation or depression

Back 9

First generation antihistamines

Front 10

Antipruritic

Back 10

anti inching

Front 11

antiemetic

Back 11

antinausea

Front 12

These types of antihistamines are SELECTIVE for peripheral H1 receptors, and as a group are less sedating.

Back 12

Second generation antihistamines

Front 13

examples of 1st generation antihistamines are:

Back 13

diphenhydramine HCL (Benedryl)

promethazine/ Phenergan (also antiemetic)

Front 14

Examples of 2ns generation antihistamines are:

Back 14

loratadine (Claritan, Zyrtec, or Allegra)

Front 15

The general uses for antihistamines include:

Back 15

relief of seasonal and perennial allergies

allergic and vasomotor rhinitis

Allergic Conjectivitis

Mild angioneurotic edema and uticaria

Allergic reaction to drugs, blood, or plasma

Relief of coughs cause by common cold

Adjective therapy in anaphylactic shock

Treatment of Parkinson sx

Relief NV

Relief Motion Sickness

Sedation

Adjucts to analgesia

Front 16

What are some CNS adverse reactions to antihistamines:

Back 16

Drowiness/ Sedation

disturbed coordination

Front 17

________ _______ of anithistamines affect the resp. system

Back 17

Anticholinergic actions

Front 18

Anticholinergic actions (effects) of an antihistamine may be:

Back 18

dryness of mouth, nose, and throat

thickening of brachial secretion

Front 19

____________ is relating to nerve cells or fibers that use acetylcholine as their neurotransmitter

Back 19

Cholinergic

Front 20

What are symptoms of allergy?

Back 20

urticarial or skin rash

Front 21

______ generation antihistamines may cause CNS stimulation or depression. Some of these drugs may have antipruritic or antiemetic effects

Back 21

1st generation

Front 22

_____ generations antihistamines may have less drowsiness and fewer anticholinergic effect

Back 22

2nd generation

Front 23

Assessment of the involved areas if pt. is receiving an antihistamine for relief of allergy symptoms include:

Back 23

eyes

nose

upper and lower resp. tract

Front 24

If promethazine or Phenergan (1st generation) is used with an _____ to enhance the effects and reduce the dosage of the opioid, the nurse should take the pt _____ _____ before giving the drugs.

Back 24

opioid

Vital signs

Front 25

Phenergan is often given with _______

Back 25

Codeine

Front 26

During the on going assessment the nurse should observe pt for expected effects of the ________ and for _____ ______

Back 26

anithistamines

adverse reactions

Front 27

If the antihistamine is given for a serious situation, the nurse assess the pt at ______ intervals until sx appear relieved and for about ____ hours after the incident

Back 27

frequent

24 hours

Front 28

While monitoring the pt. needs the 2 things to watch for are:

Back 28

impaired oral mucous membrain

risk of injury

Front 29

a pt that is experiencing ____ ____ _____ membrane is dryness of mouth, nose, and throat. it is important to offer pt sips of _____ or ice chips to relieve the sx.

Back 29

impaired oral mucous

water

Front 30

The prevent any risk of injury of a pt. who has taken an antihistamine, the following precautions are:

Back 30

assist with ambulation

place call light with in reach and instruct pt to use

do not drive or operate machinery

Front 31

What is the #1 cause of anaphylactic shock in a hospital

Back 31

PCN

Front 32

what is the #1 reason for anaphylactic shock outside the hospital?

Back 32

bee sting

Front 33

When implementing a nurse needs to _____ the dosage regimen and possible _____ drug reactions with the pt.

Back 33

review

adverse

Front 34

During evaluation of pt after administering anithistamines, nurse if looking for:

Back 34

mucous membranes are moist and intact

No injury reported

the pt and family understand the drug regiment

Front 35

A _____ is a drug that works directly on blood vessels to reduce swelling of the nasal passages, which opens clogged nasal passages and enhances drainage of the sinuses.

Back 35

Decongestants.

Front 36

The nasal decongestants are ______, in that they produce localized vasoconstriction of the small blood vessels of the nasal membranes like adrenergic drugs.

Back 36

sympathomimetic

Front 37

_______ reduces swelling in nasal passages (decongestive activity)

Back 37

Vasoconstriction

Front 38

Oxymetazoline or ______ is available as nasal spray or drop.

Back 38

Afrin

Front 39

pseudoephedrine or _____ is taken orally

Back 39

Sudefed

Front 40

Decongestants are used to treat _______

Back 40

congestion

Front 41

Common Conditions associated with congestion are:

Back 41

common cold

hay fever

sinusitis

allergic rhinitis

congestion associated with rhinitis

Front 42

When a pt has an adverse reaction to a _______ decongestant, they may experience burning, stinging, and dryness.

Back 42

Topical

Front 43

Use of oral decongestions may result in the following adverse reaction:

Back 43

Tachycardia (arrhythmias)

nervousness

restlessness

insomnia

blurred vision

NV

Front 44

Pt over the age of 60 using decongestants are at greater risk for ____, ____, and ____

Back 44

hallucinations

convulsions

CNS depression

Front 45

When using decongestants, always monitor the pt for any signs of ________

Back 45

hypertension

Front 46

While promoting an optimal response to therapy, what 2 implements will a nurse take:

Back 46

Watch for ineffective breathing pattern

education of pt and family

Front 47

If a pt over uses a topical decongestant it can lead to _____ nasal congestion

Back 47

rebound

Front 48

Pt should be taught to take drug exactly as _____ and discontinuing drug tx _______

Back 48

prescribed

gradually

Front 49

When educating a pt on decongestants, a nurse should inform them of:

Back 49

nasal burning or stinging with topical, and sniff hard a few minutes after administration.

use as directed

overuse of topical decongestant can make sx worse

do not share your container

Front 50

While evaluating a pt on decongestants, a nurse is observing:

Back 50

effective breathing pattern

therapeutic effect is acheived

pt demonstrates understanding and compliance with drug regimen

Front 51

_____ is a forceful explosion of air from the lungs

Back 51

Coughing

Front 52

a cough may be _____ or _____

Back 52

productive

non productive

Front 53

A _______ cough is a dry, hacking one that produces no secretions. A ________ drug is sued to relived this type of coughing

Back 53

non productive

antitussive

Front 54

with a ____ cough, secretions are made in the resp. track. An _______ is a drug that thins resp. secretions to remove them more easily from the resp. tract.

Back 54

productive

expectorant

Front 55

Most antitussives depress cough at center located in the _____ and are known as ____ acting drugs

Back 55

medulla

central

Front 56

_____ is a drug used to suppress a non productive cough

Back 56

codeine

Front 57

What are the 2 classes of antitussives:

Back 57

opioid antitussives

non opioid antitussives

Front 58

____ antitussives are the most affective such as codeine sulfate.

Back 58

opioid

Front 59

an example of non-opioid antitussives is:

Back 59

dextromethorphan or Robitussin

Front 60

What are 2 main adverse reactions that an antitussive can cause:

Back 60

CNS: sedation, dizz, lightheadedness

GI: NV and constipation

Front 61

What are some interactions that may cause additive depressant effects when administering antitussives with codeine?

Back 61

CNS depressants and alcohol

Front 62

When assessing a pt., document type of ______ and amt of any _____ that is present. Also record VS, pt. with productive cough may have an ____.

Back 62

cough

sputum

infection

Front 63

During the ongoing assessment, what are some things a nurse should observe:

Back 63

observe therapeutic effect

auscultate lung sounds, VS

describe and record type and frequency of coughing

record other things that interrupt sleep or pain in chest and body

Front 64

What are some expected outcomes to set for pt taking antitussives?

Back 64

optimal response to therapy

Support of pt needs for managing drug reactions

pt understands and is compliant

Front 65

Ways to promote optimal response to therapy for a pt:

Back 65

administer antitussives orally

monitor lungs for secretions pooling

Front 66

depression of cough reflex can cause secretions to ___ in the lungs

Back 66

pool

Front 67

indiscriminate ise of antitussives by general public may prevent early _____ and ____ of serious disorders, such as lung cancer or emphysema

Back 67

Diagnosis

treatment

Front 68

How can a nurse minimize a pt risk of injury while taking an antitussive drug?

Back 68

in hospital: orient with surroundings and closely supervise

encourage pt to as for assistance if dizzy or unsteady

Front 69

When educating the pt about the use of antitussive drugs, a nurse should:

Back 69

discourage use of OTC drugs

for lozenge, avoid drinking for 30 min (loss of effectiveness)

increase fluid intake (at least 1.5 to 2 L /d)

Advise pt to carefully ready, follow dosage recommendations and consult MD if cough persists (also fever and chest pains)

Front 70

What should a nurse evaluate when a pt is taking antitussives?

Back 70

Observe effectiveness

pt reports no injury or adverse reactions

Pt understands drug regimen

Front 71

Drugs with _____ activity appears to reduce viscosity of the resp. secretions by direct action on mucus.

Back 71

mucolytic

Front 72

And example of a mucolytic drugs is:

Back 72

acetylcysteine (Muscomyst)

Front 73

______ increase production of secretions which in turn appears to decrease viscosity of mucus and helps to raise secretions from resp. passage.

Back 73

Expectorants

Front 74

examples of an expectorant drug:

Back 74

gauifenesin (Robitussin or Mucinex)

Front 75

Reasons a mucolytic or expectorant might be used is:

Back 75

Acute brocho pulmonary disease

pulmonary complications of Cystic Fibrosis

Pulmonary complications assoc. with surgery

post Traumatic chest conditions

Atelectasis brochial studies

Front 76

Mucolytics and expectorants can be used for _________ overdose if caught within 24 hours

Back 76

acetaminophen

Front 77

What are some adverse reactions when using a mucolytic drug:

Back 77

GI : stomatitis, NV

Fever

Drowsiness

bronchospasms

Front 78

What are some adverse reactions when using an expectorant drug?

Back 78

GI: NV

HA

Dizz

Rash

Front 79

Before administering a mucolytic or expectorant drug, a nurse should always assess the pt ________ status and docum. ______ _______, amt of dyspnea, and consistency of ______

Back 79

respiratory

lung sounds

sputum

Front 80

During an on going assessment of a pt taking mucolytics or expectorants, nurse should:

Back 80

note increase or change in sputum

auscultation lungs

eval. pt resp. status and record

Front 81

What are some expected outcomes for a pt taking mucolytic or expectorant drugs:

Back 81

outcome of therapy

support needs if adverse reaction

understanding and compliance

Front 82

What can a nurse do to promote optimal response to therapy?

Back 82

explain tx and demonstrate nebulizer (RT)

warn acetylcysteine may small rotten eggs

remain with pt during tx

make sure suction equipment is reachable if aspiration occurs

Front 83

During ineffective airway clearance, a nurse should encourange pt. to take ____ _____ _____. and monitor amt and ______ on sputum

Back 83

Deep diaphragmatic breathes

consistency

Front 84

When educating pt. provide instructions on how to ____ and _____ nebulizer equipment. Take drugs as directed, and is tx is ineffective to contact ______

Back 84

use and clean

Doctor

Front 85

When a nurse evaluates a pt taking mucolytics or expectorants, you would look for:

Back 85

effect is achieved

easy, unlabored breathing

any reactions are identified, reported, and treated

pt has understanding and compliance on how to use equipment and meds