Upper Respiratory Drugs

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  1. What are the drugs categories for Lower Respiratory Disorders?
    • Alpha & Beta2 Adrenergic Agonsits
    • Anticholinergics
    • Corticosteroids
    • Xanthines
    • Leukotriene Receptor Agonsits
    • Cromolyn/Nedocromil
    • Mucolytics
  2. What is COPD caused by?
    Airway obstruction with ^airway resistance of airflow to lung tissues.
  3. What are the four major pulmonary disorders that cause COPD?
    • Chronic Bronchitis
    • Bronchiectasis
    • Emphysema
    • Asthma
  4. Why do issues such as Chronic Bronchitis, Bronchiectasis, Emphasema & Asthma cause COPD?
    They frequently cause irreversible lung tissue damage.
  5. What is the etiology of Chronic Bronchitis?
    Progressive lung disease caused by smoking or chronic lung infections.
  6. What is the etiology of Bronchiectasis?
    An abnormal dilation of the bronchi & bronchioles secondary to frequent infection & inflammation.
  7. What is the etiology of Emphysema?
    A progressive lung disease caused by cigarette smoking, atmospheric contaminants, or lack of the alpha1-antitrypsin protein that inhibits proteolytic enzymes that destroy alveoli (air sacs)
  8. What is the etiology of Asthma?
    Inflammatory disorder of the airway walls associated w/a varying amount of airway obstruction.  Triggered by stimuli such as stress, allergens & pollutants.
  9. What is the action of Bronchodilators?
    • Stimulate the SNS receptors
    • Relaxes bronchial smooth muscles
    • Dilates bronchioles
    • Imitates the effects of Norepinephrine
  10. What are the other names for Bronchodialtors?
    • Beta Agonists
    • Adrenergics
  11. What are bronchodilators indicated for?
    • Asthma
    • Bronchitis
    • COPD
  12. What forms can Bronchodilators come in?
    • Injection
    • Inhalant
    • Aerosol
  13. Name the Bronchodilators (Beta-Agonists).
    • Epinephrine: alpha & beta
    • Isopreterenol (Isuprel): Beta1 & 2
    • Albuterol (Proventil): selective beta 2
    • Pirbuterol (Maxair): selective beta 2
    • Slameterol (Serevent): Selective beta 2
    • Advair= Salmeterol + Fluticasone (corticosteroid)
  14. What are the effects of the adrenergic Alpha 1 receptor sites?
    • ^cardiac contractility
    • Vasoconstriction
    • Dilate pupils (midriosis)
    • <salivary gland secretion
    • ^bladder & prostate contraction
  15. What are the effects of the adrenergic Alpha 2 receptor sites?
    • Inhibit norepinephrine release - promotes vasodilation
    • <GI motility & tone
  16. What are the effects of the adrenergic Beta1 receptor sites?
    • ^cardiac contractility: ^Pulse
    • ^renin secretion: ^BP
  17. What are the effects of the adrenergic Beta2 receptor sites?
    • <GI tone & motility
    • Bronchodilation
    • ^blood flow in skeletal muscles
    • Activates liver glycogenolysis= ^blood glucose
  18. What are the s/e of the Beta-Agonist Bronchodilators?
    • Rapid HR
    • Tremors
    • Arrhythmias
    • Palpitations
    • Restlessness, Agitation
    • Insomnia
  19. Bronchodilators are Beta-Agonsitst, & need to be given with caution in clients with what other disease processes?
    • Cardiac problems
    • HTN
    • DM
    • Seizure disorders
    • Hyperthyroidism
  20. What should a client starting on Bronchodilators be taught?
    • s/e
    • Proper use of MDI
    • Should have <dyspnea in 1-2min
    • Albuterol is a RESCUE inhaler
    • Salmeterol for prophylaxis only
    • How to know if canister is empty
  21. What should a client be taught about PDI (powdered dose inhalers)?
    • need Rapid deep inhalation
    • Mouth tightly closed around mouth piece
    • Dose can be greater than w/MDI
    • Can be used for children <4yrs
    • Salmeterol + Fluticasone = Advair diskus
    • Tiotropium Bromide = Spiriva (Handihaler Powdered capsules)
  22. What is the action of Anticholinergic bronchodilators?
    • Block the effects of acetylcholine at the PSMS receptors of the bronchial tree
    • Prevents/reduces bronchoconstriction of smooth muscles of bronchus
  23. What diseases are the Anticholinergic Bronchodilator Inhalers indicated for?
    • Chronic Bronchitis
    • COPD
  24. What are the s/e of Anticholinergic Bronchodilators?
    • cough
    • nervousness
    • nausea
    • GI upset
    • HA
    • dizziness
    • **caution in pt's w/narrow angle glaucoma**
  25. Name the Anticholinergic Bronchodialtors.
    • Ipratropium bromide (Atrovent)
    • Tiotropium bromide (Spiriva Handihaler)
    • Combo drug: Ipratropium/Albuterol (Combivent)
  26. What teaching is done for a client starting on Tiotropium (Spiriva)?
    • Do NOT swallow capsule
    • Keep casule in blistercard until ready to use
    • Peel foil back only to the "stop" line in blistercard
    • Place capsule in center chamber of Handihaler
    • Pierce capsule by pressing & releasing button on side of device
    • Inhale one deep breath while mouth is tightly around mouth piece
  27. What is the action of Methylxanthine (Xanthine) derivatives?
    • Relaxes smooth muscle of bronchi, bronchioles
    • ^cAMP promoting bronchodialation
    • Stimulate the CNS
    • Stimulate respirations
    • Dilate coronary & pulmonary vessels
    • Cause diuresis
  28. What are the Methylxanthine (Xanthine) derivatives?
    • Aminophylline (Somophyllin)
    • Theophylline (Theo-Dur)
    • Caffeine
  29. What disease processes are the Xanthines indicated for?
    • Maintenance therapy for chronic stable:
    • Asthma
    • COPD
  30. What is the therapeutic range for Xanthines?
  31. What disease processes or disorders are Xanthines contraindicated in?
    • Seizures
    • Cardiac
    • Renal
    • Liver disorders
  32. How can Xanthines be administered?
    • Oral
    • IV
  33. What are the s/e of Xanthine derivatives?
    • Dysrhythmias
    • Nervousness
    • Irritability
    • Insomnia
    • Dizziness
    • Flushing
    • Hypotension
    • Seizures
    • GI distress
    • Tachycardia
    • Palpitations
    • Cardiorespiratory collapse
  34. What should a client starting on the Xanthine derivative Theo-Dur be taught?
    • Take w/food
    • Theophylline blood levels
    • NO OTC meds w/o dr approval
    • Sustained Release: do NOT crush
    • Avoid Caffeine products
  35. What is Leukotriene (LT)?
    • A chemical mediator that can cause inflammatory changes in the lung.
    •     ^eosinophil migration
    •     ^mucus production
    •     airway wall edema
  36. Leukotriene Receptor Antagonists are effective in doing what?
    • Reducing the inflammatory symptoms of asthma triggered by allergic & environmental stimuli
    • <bronchoconstriction
  37. Name the Leukotriene Receptor Antagonists.
    • Montelukast (Singulair)
    • Zafirlukast (Accolate)
    • Zileuton (Zyflo)
  38. Leukotrien Receptor Antagonists like Singulair are used how?
    As prophylactic & maintenance for chronic Asthma
  39. What are the s/e of Luekotriene Receptor Antagonists?
    • dizziness
    • HA
    • GI distress
    • abnormal liver enzymes
    • nasal congestion
    • cough
    • pharyngitis
  40. What should a client starting on an LT Receptor Antagonist be taught?
    • Singulair can be w/or w/o food
    • Accolate 1hr before or 2hrs after meals
    • Monitor liver enzymes
    • typically well tolerated drugs
    • Accolate interacts w/theophylline
  41. The drugs Cromolyn & Nedocromil are used for what?
    • Phrophylactic tx of Bronchial Asthma
    • **NOT to be used for acute asthmatic attacks**
  42. What is the action of the drugs Cromolyn & Nedocromil?
    Anti-inflammatory effect & suppresses the release of histamine
  43. Cromolyn does NOT have bronchodilator properties, so how does it act on the lungs?
    Inhibiting the release of histamine to prevent an asthma reaction
  44. How are Nedocromil & Cromolyn administered?
  45. What are the s/e of Cromolyn & Nedocomil?
    • Cough
    • Bad taste
  46. Cromolyn needs to be taken daily and should NOT be discontinued abruptly because of what possible s/e?
    Rebound bronchospasms (asthma attack)
  47. What is the action of Nedocromil?
    • Has an anti-inflammatory effect
    • Suppresses the release of histamine, leukotrienes & other mediators from the mast cells.
  48. List the Anti-inflammatory drugs used for COPD.
    • LT Receptor Antagonists
    • LT Synthesis Inhibitors
    • Glucocorticoids
    • Cromolyn
    • Nedocromil
  49. What is the action of Mucolytics like Mucomyst?
    Liquefies & loosens thick mucus secretions so they can be expectorated
  50. How is Acetylcysteine (Mucomyst) administered?
  51. When should Mucomyst (Acetylcysteine) be administered?
    • 5min after a bronchodilator
    • NOT to be mixed w/other drugs
  52. What is the other use for Acetylcysteine (Mucomyst)?
    • Antidote for Acetaminophen OD if w/in 12-24hrs
    •  **given orally diluted in Juice or soft drink
Card Set:
Upper Respiratory Drugs
2013-10-23 15:42:40
Upper respiratory drugs

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