Pharmacology-Respiratory Drugs

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Pharmacology-Respiratory Drugs
2011-10-03 18:12:48
Pharmacology Respiratory Drugs

Pharmacology-Respiratory Drugs
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  1. CAL
    Chronic Airflow Limitation
  2. Loss of elasticity, increased secretions, narrowed airways and inflammation can result in?
    CAL (chronic airflow limitation)
  3. Mucolytics do what?
    Liquefy and remove secretions.
  4. CNS depressants and drugs that stimulate a parasympathetic response are referred to as?
    "unkind drugs"
  5. Drugs causing a parasympathetic response may cause what adverse reaction on the respiratory system?
  6. What are the five main categories of respiratory drugs?
    • 1-bronchodilators
    • 2-antihistamines
    • 3-anti-inflammatories
    • 4-mucolytics
    • 5-antitussives
  7. What are three common types of bronchodilators?
    • 1-beta-adrenergic agonists
    • 2-anticholinergics
    • 3-xanthines
  8. Beta-1 receptors are primarily found where?
    in the heart
  9. Beta-2 receptors are primarily found where?
    in the bronchi
  10. Epinepherine and Afrin are examples of what kind of drugs?
    non-selective adrenergic
  11. Caution: The use of serevent (Servent Diskus) has been associated with fatal ______ ______.
    asthma attacks
  12. What is a beta-adrenergic agonist?
    A respiratory drug that acts on beta receptors to produce a sympathetic response.
  13. Beta-2 agonists should be used with caution in the ______ and ______ women.
    elderly, pregnant
  14. Albuterol (Proventil) and Formoterol (Foradil) are approved for use in children __ and older.
  15. Metaproterenol (Alupent) and pirbuterol (Maxair) are approved for use in children __ and older.
  16. What is an MDI?
    Metered dose inhaler
  17. What are non-selective adrenergics?

    Give two examples.
    Beta-adrenergic agonists that act equally on beta-1 and beta-2 receptors.

    Epinepherine and Afrin
  18. What do selective beta-adrenergic drugs primarily effect?
    bronchi (and they exert a lesser degree of influence on beta-1 receptors)
  19. _______ agonists can be used more safely than non-selective adrenergics in a variety of clients.
  20. Anticholinergenics do what?
    Block the parasympathetic neurotransmitter, acetylcholine.
  21. The most common anticholinergic bronchodilator is _________.
    Ipratroprium bromide (Atrovent)
  22. Ipratropium has the greatest theraputic effect if taken?
    consistently, rather than as needed.
  23. Ipratropium peaks in?
    1.5 hrs.
  24. Is Ipratropium effective in emergency situations? why or why not?
    no, b/c it take 1.5 hrs to peak.
  25. Ipratropium should be used with caution in patients with:
    • 1-glaucoma
    • 2-myasthenia gravis
    • 3-obstructive or infectious GI diseases
    • 4-prostatic hypertrophy
  26. _________ type side effects occur when a client uses anticholinergenics.
  27. Xanthines, anticholinergenics and beta-adrenergic agonists three common types of?
  28. Some common Xanthines are?
    aminophylline, theophylline
  29. The long half-life of xanthines can be dangerous because?
    the drug can build up in the body and cause toxicity.
  30. Effective client education for xanthines must include:
    • 1-Take the med at same time every day 2-take w/plenty of fluids to thin
    • secretions.
    • 3-limit caffeine and smoking
    • 4-Learn toxicity manifestations
    • 5-report toxicity manifestations to PCP
    • immediately.
  31. Manifestations of xanthene toxicity are:
    • 1-CNS stimulation (tremors, headache..)
    • 2-GI distress
    • 3-Cardiac stimulation (palpatations,
    • tachycardia, dysrhythmias)
    • 4-Hyperglycemia and hyperkalemia
  32. Xanthines are chemically related to _________.
  33. Some side effects of Xanthines are (xanthines are chemically related to caffeine):
    • 1-tachycardia
    • 2-insomnia
    • 3-diuresis
    • 4-restlessness
    • 5-epigastric pain
  34. Side effects of xanthines are increased by?
    • 1-caffeine
    • 2-beta-adrenergic bronchodilators
  35. Clients on _______ therapy require blood levels to be drawn periodically to make sure their therapy is in a safe, theraputic range.
  36. Severe xanthine toxicity can result in
    • 1-seizures
    • 2-ventricular fibrillation
  37. Glucocorticoids have these three important actions:
    • 1-anti-inmlammatory
    • 2-anti-allergic
    • 3-anti-stress
  38. Acetylcystine can cause bronchospasm and the concurrent use of ______________ is often recommneded.
  39. _________ smells and tastes like rotten eggs, often causing nausea in patients.
    Acetylcysteine (Mucomyst)
  40. Cromolyn sodium (intal) has a very _____ onset and is used __________.
    slow, prophylactically
  41. Paradoxial restlessness can occur in the elderly and children when administered ____________.
  42. The nurse is reviewing a client's medical history, which disease would contraindicate the use of antihistamines?
    B)parkinson's disease
    C)sinus headaches
    (this multiple choice question has been scrambled)
  43. (fatal arrythmeas with prolonged QT interval)
  44. Cromalyn sodium (Intal) is most effective when used ?
  45. Rebound congestion is?
  46. A patient newly prescribed theophylline will be instructed to have ______ levels checked regularly.
    blood (theophylline has a narrow theraputic range)
  47. Beclomethasone (Beclovent) is what type of bronchodillator?
  48. List 3 important instructions for a patient prescribed Beclomethasone (Beclovent) for long-term use.
    • 1-Use a spacer during admininstration by MDI.
    • 2-Rinse and gargle after inhaling to prevent candidiasis
    • 3-engage in weight bearing excercises and ensure adequate intake of calcium and vitamin D since steroids promote bone loss.
  49. When prescribed both Albuterol (Proventil) and beclomethasone dipropionate (QVAR) inhalers for asthma, when, how and why should the patient use these in a special sequence?
    Use the albuterol inhaler 5 min before using the beclomethasone inhaler because the beta-2 agonist (Albuterol) promotes bronchodillation and enhances the absorption of the glucocorticoid (beclamethasone).
  50. Albuterol is used for asthma treatment to?
    promote bronchodilation
  51. Glucocorticoids and cromolyn decrease?
  52. Montelukast (Singular) a leukotriene modifier decrease _______ _______ production and supress the effects of ________ _________.
    airway mucus, leukotriene compounds
  53. Glucocorticoids can result in weight _____ and fluid ______.
    gain, retention
  54. Subcutaneous needles are between ___ and ___ in. long.
    1/4 to 5/8 in. long
  55. Sites for subq injections are:
    • 1-upper arm
    • 2-upper back
    • 3-abdomen
    • 4-thighs
    • 5-top of buttocks
  56. A nurse is preparing to give an obese patient a subq injection. She knows which angle is best?
  57. The two angles for giving subcutaneous injections are?
    45 and 90
  58. Subcutaneous syringes are no more than __mL.
  59. IM deltoid needles are __in. long?
  60. IM Deltoid syringes are up to __mL?
  61. Where are four IM injection sites?
    • 1-Deltoid
    • 2-Ventrogluteal
    • 3-Dorsogluteal
    • 4-Vastus Lateralis
  62. Mucolytics work on the ______.
  63. Surfactants work in the _______?
  64. Antitussives ______ the cough reflex.
  65. The antitussive Benzonatate (Tessalon) acts like a _________ _________ for a _________ cough.
    numbing agent, non-productive.
  66. Dextromethorphan (Benylin) belongs to which class of drugs?
  67. Sally is walking through the perfume department at her favorite departments store as another customer sprays several perfumes. The correct antitussive for this kind of non-productive cough due to irritation of the throat would be? And why?
    Benzonotate (Tessalon) because it's a numbing agent.
  68. If a patient has a severe, non-productive cough that just won't go away and is causing irritation, the nurse would administer which antitussive and why?
    Either Dextromethorphan (Benylin) or Hydrocodone (Hycodan) because they supress the cough reflex in the brain.
  69. Adverse reactions associated with antitussives are (3):
    Dizziness (CNS), respiratory depression, dry mouth.
  70. Decongestants cause vasoconstriction or vasodilation of upper airway?
    vasoconstriction (to allow drainage)
  71. Topical decongestants are _____________, meaning that they imitate the effects of the sympathetic nervous system.
  72. Oxymetazoline (Afrin) and Ephedrine (Pretz-D) are examples of what class of respiratory drugs?
  73. _______ decongestants are not absorbed into the blood stream.
  74. Describe the rebound effect:
    After taking Afrin for several weeks you suddenly stop and the symptoms are worse than before. You have built up a tolerance for the drug and need more each time for it to work.
  75. Steroids should be avoided for patients that have vasoconstriction. Give some examples:
    Glaucoma, CV, thyroid, HTN
  76. Is the decongestant Ephedrine (Pretz-D) topical or oral?
  77. Is the decongestant pseudoephedrine (Sudafed) topical or oral?
  78. Beclomethasone (Beclovent) and flunisolide (Aerobid) are examples of what class of respiratory drugs?
    Topical steroid nasal decongestants (reduce inflammation)
  79. Topical steroids can cause an overgrowth of ______________.
  80. Diphenhydramine (Benadryl) and Promethazine (Phenergen) belong to which class of respiratory drugs?
  81. True or False:

    The nurse knows Benadryl can be used to treat, prophylactically or for it's sedation qualities.
  82. Promethazine (Phenergen) is used as (2 things)?
    antihistamine or nausea
  83. Antihistamines can cause a __________ _________.
    fatal interval.
  84. This classification can cause ______ ______ with prolonged QT interval.
    fatal arrythmeas
  85. A very serious drug interaction for antihistamines is?
    MSO inhibitors (anti-depressant)
  86. It's very important to assess the _____ and the ___ when administering an antihistamine.
    heart, GI
  87. A glaucoma patient complains of irritation to their eyes after taking a Sudafed for 3 days. What is this patient at risk for? and why shouldn't they be taking this?
    blindness, b/c decongestants are vasodilators.
  88. Guaifenesin (Mucinex) is?
    an expectorant
  89. Acetylcysteine (Mucomyst) is?
  90. Because mucolytics and expectorants liquify secretions, it is always important to teach the patient to?
    drink fluids
  91. What is the antidote for acetaminophen poisoning?
    Acetylcysteine (Mucomyst)
  92. Be aware of _______ when administering mucomyst via nebulizer.
    skin excoriation
  93. Antitussives and decongestants affect which part of the respiratory tract, upper or lower?
  94. ARDS & RDS stand for?
    Acute respiratory distress syndrome and Respiratory distress syndrome
  95. RDS refers to?
    any obstructrions at the alveoli
  96. The progressive loss of lung compliance and hypoxia refers to?
  97. The nurse has control over RDS or ASRDS?
  98. ARDS can happen within __ hours.
  99. RDS or ARDS is completely preventable?
  100. Xanthines, enzyme therapy, sympathomimetics and anticholinergenics are all examples of?
  101. Caffeine, aminophylline and theophylline are all examples of what group of bronchodilators?
  102. Common side effects of xanthines are:
    tachycardia, jitters
  103. The nurse is concerned because her smokes and is taking a __________.
  104. Alpha1-protease inhibitor treats a __________ deficiency?
  105. An emphysematic patient in their 30's or 40's is most likely to be prescribed this therapy.
    Alpha1-protease inhibitor (enzyme therapy)
  106. Alpha1-protease inhibitor is specifically for treatment of ________ deficiency.
  107. Smokers who have the protease deficiency are at risk for severe _____ destruction.
  108. Albuterol (Proventil), Epinepherine and Salmeterol (Serevent) are all?
  109. Sympathomimetics work by _______ the bronchi.
  110. Sympathomimetics work by _________ rate amd depth of respiration.
  111. Sympathomimetics act on ______ receptors.
  112. A patient taking a sympathomimetic may feel ________ or ________ because everything is speeding up.
    restless or anxious
  113. What is imperative to monitor on a patient taking a sympathomimetic?
  114. Epinepherine is the __________ drug of choice.
    anaphylactic shock
  115. Sympathomimetics can cause these two serious adverse reactions:
    bronchospasm, arrythmeas (tachycardia, dysrhythmias)
  116. Serevent, Albuterol and Epinepherine are all?
  117. Anticholinergenics block the vago stimulation, ________ smooth muscle.
  118. Ipratropium (Atrovent) & Tiotropium (Spiriva) are all?
  119. Enlarged prostate and bladder problems are important to assess when considering an ___________.
  120. With sympathomimetics and Anticholinergenics, it's important to assess __________ and ________ to make sure it's working. (why?)
    respirations and 02 stats; because they are bronchodilators.
  121. Anticholinergenics often cause ______ _______.
    dry mouth
  122. With anticholinergenics it's important to assess for these 2 conditions:
    glaucoma and BPH (enlarged prostrate)
  123. Steroids often cause?
  124. An important adverse reaction of Glucocorticoids is?
  125. Glucocorticoids take ____ to reach theraputic levels
    2-3 weeks
  126. True or False:
    The glucocorticoid Beclomethasone (Beclovent) is used to treat in an emergency situation?
    False-it takes 2-3 weeks for theraputic effect.
  127. Albuterol is a?
  128. Beclovent and Flovent are?
  129. Singulair and Accolate are?
    Leukotriene Receptor Antagonists
  130. Accolate interferes with?
    • 1-Theophylline/Amophylline
    • 2-Warfarin (blood thinner)
    • 3-beta blockers
  131. An older adult on blood thinners and beta blockers cannot take this leukotriene receptor antagonist.
    Accolate or Singulair
  132. Accolate is toxic to the ________.
  133. Accolate and Singulair should be taken with food or on an empty stomach?
    empty stomach.
  134. True or False:
    Beractant (Survanta) is commonly usef for treatment in the elderly.
    False-Neonates ONLY
  135. Mast cell Stabilizers prevent or promote the release of histamine?
  136. Cromolyn (Nasalcrom) is a?
    Mast Cell Stabilizer
  137. Cromolyn (Nasalcrom) works by ________ the allergen.
  138. Nasalcrom comes in what forms?
    Topical or inhaler
  139. Name a mast cell stabilizer?