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80 Cards in this Set
- Front
- Back
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The Upper Respiratory System is also known as? |
conducting airway |
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What are the protective reflexes of the URS? |
coughing and sneezing |
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(part of the URS) Functions: -catches and filters foreign substances via cilia -warms and humidifies the air -secretes mucus via goblet cells -moves mucus and trapped substances toward the throat via epithelial cells -rich with mast cells and basophils (which release histamine) |
nasal cavity |
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air-filled passages that open into the nasal passage; mucus produced here will drain into the nasal cavity and into the throat to be swallowed and destroyed |
paranasal sinuses |
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passageway for air to move through |
pharynx |
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contains the vocal cords and epiglottis |
laryns |
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URS condition-inflammation/infection of the pharynx casued by bacteria or viruses |
pharyngitis |
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What is seen in bacterial pharyngitis? |
erthyema edematous purulent exudate sore throat enlarged tonsils lymphadenopathy mild fever |
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What is seen in viral pharyngitis? |
erthyema w/raised white/yellow lesions mild fever HA sore throat |
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URS condition-inflammation of the larynx due to chemical or mechanical irritation, bacteria or viruses |
laryngitis |
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What are the signs/symptoms of laryngitis? |
hoarseness aphonia (cannot speak) tickle in throat (subjective data) dry cough |
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What is a complication of laryngitis if left untreated? |
epilgottitis |
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What is seen in chronic laryngitis? |
dry mucous membrane and polyps in mucous membrane? |
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inflammation of the epithelial lining caused by either bacteria, viruses, or fungal; pain results from swollen tissue pushing against the bone because the sinus passages are blocked with junk |
sinusitis |
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What are the signs/symptoms of sinusitis? |
facial pain/pressure localized or diffused HA (think sinus HA) |
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(BROAD) What is the trt for sinusitis? |
antibiotics (if bacterial invasion), decongestants/analgesics |
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If sinusitis is left untreated, what can happen? |
pathogens can enter the brain |
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infected droplet transmission; virus gains entrance and selectively attacks/destroys the ciliated epithelial cells; has types A, B, & C |
influenza (the flu) |
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What are the sings/symptoms of the flu? |
sudden chills fever fatigue myalgia diffuse HA *abrupt onset* |
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Antivirals can only be used for what types of influenza? |
type A & B |
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What are two medications used for influenza and what are their forms? How do they BOTH work? |
Oseltamivir (oral) Zanamivir (inhaled) Both are neuraminidase inhibitors-only difference is form. Both reduce duration of symptoms. |
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enzyme that influenza uses to replicate |
neuraminidase |
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When should influenza meds be initiated? |
within 48 hrs of symptoms onset-if you wait too long, there will not be much of an effect |
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inflammation of the mucous membranes in the nose, throat, and airway due to exposure to antigen(s); can be seasonal or perennial |
allergic rhinitis |
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What are the signs/symptoms of allergic rhinitis? |
sneezing rhinorrhea itchy watery eyes nasal congestion |
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What are the two categories that drugs for allergic rhinitis can be grouped into? |
preventers and relievers |
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What are the preventer drugs for allergic rhinitis? |
H1RA, intranasal corticosteroids, and mast cell stabilizers |
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What are the relieving drugs for allergic rhinitis? |
oral/intranasal decongestants |
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What is the nurse's job/role in allergic rhinitis? (before giving meds) |
should help patients identify sources of the allergy ad recommend appropriate actions |
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H1RA 1st gen prototype: |
diphenhydramine |
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(diphenhydramine) H1RA 1st gen MOA: |
selectively block the effects of histamine at the H1 receptor sites blocks cholinergic receptors |
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(diphenhydramine) H1RA 1st gen therapeutic uses: |
allergic rhinitis vertigo and motion sickness insomnia mild forms of parkinson's urticaria (allergies) or hives |
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What H1RA drugs are used for vertigo and motion sickness? How do they work? |
1. (vertigo) meclizine-depressing the neurons of the vestibule apparatus in the inner ear 2. (motion sickness) scopolamine-supressing the VC in the medulla |
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(diphenhydramine) H1RA 1st gen contraindications: Why? |
glaucoma BPH/urinary/retention/fecal impaction due to its anticholinergic effects |
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(diphenhydramine) H1RA 1st gen precautions:
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asthma and seizures |
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(diphenhydramine) H1RA 1st gen ADR: Mnemonic: Some Super Extra Sleepy med |
sedation significant anticholinergic effects CNS excitation or seizures (paradoxical effect) |
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(diphenhydramine) H1RA 1st gen lab-drug interactions: |
stop drug 4 days prior to skin allergy testing |
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(diphenhydramine) H1RA 1st gen drug-drug interactions:
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CNS depressants/alcohol |
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H1RA 2nd gen prototype: |
fexofenadine |
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(fexofenadine) H1RA 2nd gen MOA: |
selectively block the effects of histamine at the H1 receptor sites
blocks cholinergic receptors *same as 1st gen* |
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(fexofenadine) H1RA 2nd gen therapeutic uses:
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seasonal/perennial allergic rhinitis allergic conjunctivitis uncomplicated urticaria and angioedema |
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(fexofenadine) H1RA 2nd gen ADR:
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flu-like symptoms |
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(fexofenadine) H1RA 2nd gen drug-drug interactions:
WHY? |
CNS depressants/alcohol orange, apple, and grapefruit juice-will decrease the absorption of drug |
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(fexofenadine) H1RA 2nd gen lab-drug interactions:
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stop drug 4 days prior to skin allergy testing *same as 1st gen* |
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(fexofenadine) H1RA 2nd gen special notes:
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longer half-life causes less sedation/anticholinergic effects most effective if used prior to onset of symptoms |
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Why do H1RA 2nd gen drugs (fexofenadine) cause less sedation/anticholinergic effects? |
2nd gen binds to lung receptors, NOT cerebellar receptors |
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What is the nurse's role in educating the pt. when taking H1RA 2nd gen drugs (fexofenadine)? |
institute measures to prevent dangers associated with thickening of resp secretions |
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Intranasal glucocorticoids prototype: |
fluticasone |
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(fluticasone) Intranasal glucocorticoids MOA: |
decreases the secretion of inflammatory mediators, reduces tissue edema, and causes a MILD vasoconstriction |
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(fluticasone) Intranasal glucocorticoids ADR:
Mnemonic: Normally dry |
-nasal irritation -drying of the nasal mucosa which can lead to epistaxis or nosebleed |
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(fluticasone) Intranasal glucocorticoids therapeutic uses:
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1st line drugs in trt of allergic rhinitis-BOTH preventer and reliever |
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(fluticasone) Intranasal glucocorticoids special notes:
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*IF NARES ARE BLOCKED, A TOPICAL DECONGESTANT SHOULD BE ADMINISTERED PRIOR TO GLUCOCORTICOID* -monitor growth status in children -full doses are administered initially, then lowest effective amount once symptoms are under control |
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How is flucticasone (intranasal glucocorticoid) administered? |
metered-dose nasal inhaler |
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Mast cell stabilizers prototypes: What route? |
cromolyn sodium (NasalCrom)-intranasal cromolyn sodium (Opticrom)-ophthalmic |
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(cromolyn sodium) mast cell stabilizers MOA: *this is for intranasal route* |
inhibits release of histamine, shields the mast cells that line nasal passages, and prevents degradation of mast cells |
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(cromolyn sodium) mast cell stabilizers therapeutic use:
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prophylactic agent (acting to defend against or present something, especially disease)- should be given prior to start of symptoms |
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(cromolyn sodium) mast cell stabilizers special notes:
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-prolonged onset of action (full week until full therapeutic effect is seen) -bitter taste -needs to be given a couple times a day -OTC -"proactive drug" |
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What is the nurse's role in education regarding mast cell stabilizers? |
tell pt. how to correctly deliver the medication |
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Nasal/Oral decongestants prototype: route? |
Nasal: phenylephrine Oral: pseudoephedrine |
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(Phenylephrine/Pseudoephedrine) Nasal/Oral Decongestants MOA: |
stimulates alpha 1 adrenergic receptors (sympathomimetic) |
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(Phenylephrine/Pseudoephedrine) Nasal/Oral Decongestants therapeutic use/goal:
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nasal congestion/sinusitis relieves pressure from otitis media |
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(Phenylephrine/Pseudoephedrine) Nasal/Oral Decongestants drug-drug interaction:
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MOA inhibitor |
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(Phenylephrine/Pseudoephedrine) Nasal/Oral Decongestants contraindications/precautions:
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hyperthyroidism CAD and HTN DM glaucoma BPH |
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(Phenylephrine/Pseudoephedrine) Nasal/Oral Decongestants ADR:
Intranasal and Oral |
Intranasal: rebound congestion minor nasal irritation and dryness Oral: CNS-hallucinations, delusions, and convulsants CV-palpitation, tachycardia, and arrhythmias |
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federal legislation enacted in theUnited States on March 9, 2006, to regulate, among other things, retailover-the-counter sales of following products because of their use in themanufacture of illegal drugs: ephedrine. pseudoephedrine |
combat methamphetamine epidemic act (2006) |
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(Phenylephrine/Pseudoephedrine) Nasal/Oral Decongestants special notes:
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-intranasal route quicker onset -oral route longer duration -available as eyedrops -often combined with H1RAs to control sneezing, rhinorrhea, and itchy watery eyes |
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viral infection of the URS in which there is usually no fever and secretions are generally watery and clear; self-limiting disorder in which there is no cure and trt is purely symptomatic |
common cold/cough |
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Cough is a reflex involving the ______, ______, & ________ muscles |
CNS, PNS, and respiratory |
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antitussives prototype: Opioid and nonopioid |
Opioid- codeine and hydrocodone Nonopioid- dextromethorphan |
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antitussives MOA: |
raise the cough threshold in the CNS |
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(codeine and hydrocodone) antitussives special notes: |
-reserved for more serious cough conditions (not for moist coughs) -low doses required to suppress cough reflex -codeine is most effective but schedule V |
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Nonopioid antitussives prototype: |
dextromethorphan |
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(dextromethorphan) Nonopioid antitussives contraindications:
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-chronic cough seen in emphysema, chronic bronchitis, or asthma -aspiration -bacterial infection -smokers |
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(dextromethorphan) Nonopioid antitussives interactions:
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MAO inhibitors-serotonin syndrome CNS depressants/alcohol-sedation grapefruit or orange juice ingestion |
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Expectorants prototype: |
guaifenesin |
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(guaifenesin) Expectorants MOA: |
reduces adhesiveness and surface tension of secretions to facilitate removal by increasing mucus flow *promotes productive cough* |
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(guaifenesin) Expectorants therapeutic uses/goals:
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common cold acute bronchitis influenza |
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(guaifenesin) Expectorants contraindications/precautions:
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-not used to control cough in smokers or those with chronic cough -do not use in those with a HIGHLY productive cough |
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(guaifenesin) Expectorants ADR:
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GI symptoms |
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(guaifenesin) Expectorants special notes:
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-prolonged use cold mask important symptoms of an underlying disorder; seek trt after 1 week -teach adequate pulmonary hygiene |
