pharm respiratory drugs

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pharm respiratory drugs
2014-04-17 19:26:22

resp drugs
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  1. H-1 Receptor Antagonists

    Mech of action
    Histamine is released from mast cells and basophils when an allergen enters the body.  This causes itching, increased mucous secretion and nasal congestion.  H1 receptor antagonists block histamine from reaching the H1 Receptors so histamine cannot be produced
  2. H-1 receptor antagonists

    Routes of admin
    • PO
    • IV
    • IM
  3. H-1 receptor antagonists

    Adverse effects
    • Drowsiness
    • Paradoxical excitation
    • Anticholinergic effects -slow things down
  4. H-1 receptor antagonists

    • Prostatic Hypertrophy - BPH
    • GI Obstruction- because it slows things down
    • Narrow Angle Glaucoma-increased pressure in the eye
  5. H-1 receptor antagonists

    • Alcohol
    • Opiates
    • Other OTC cold Med
  6. H-1 receptor antagonists

    overdose (what happens?)
    • Anticholinergic effects
    • QRS widening
  7. what are some other uses for antihistamines?
    • Motion sickness
    • Insomnia
    • Parkinson's disease
    • Skin Rashes
  8. 2nd Generation Antihistamines have the same side effects and adverse effects same contraindications and interactions as H-1 receptor antagonists which are the first generation antihistamines
    only work better because they are newer and people have not developed a tolerance to them as much as the older ones
  9. Intranasal Corticosteroids

    Mech of Action
    • sprayed directly into the nose to decrease the secretion of inflammatory mediators, reduce edema, and cause mild vasoconstriction
    • Decreases the inflammation in the nose and helps the person feel less congested
  10. Intranasal Corticosteroids

    Route of Admin

    usually a metered spray device that limits the amount per spray and makes the dose consistent
  11. Intranasal Corticosteroids

    Adverse Effects
    no serious adverse effects when given intranasally, but may give systemic effect if large amounts are swallowed
  12. Intranasal Corticosteroids

    • Sensitivity
    • Know bacterial, fungal, viral or parasitic infection
  13. do not give intranasal corticosteroids if ___
    • patient has infection
    • Steroids will increase the infection
  14. Intranasal Corticosteroids

    Nasal Decongestants
  15. Nasal Decongestants

    Mech of action

    Activate alpha adrenergic receptors in the autonomic nervous system

    used only for nasal congestion, sometime combined with antihistamine for sneezing, tearing eyes
  16. Nasal Decongestants

    route of admin
    • PO
    • Intranasal
  17. Nasal Decongestants

    Adverse effects
    • intranasal = rebound congestion (can occur within 3 days of regular use of Afrin)
    • stinging or dryness

    • PO = no rebound congestion but it is slower onset to work
    • can cause HTN, CNS Stimulation, tachycardia, nervousness
  18. Nasal Decongestants

    • HTN
    • Heart Disease
  19. Nasal Decongestants

    limited for nasal

    PO - CNS Stimulants
  20. what is Antitussives?
  21. What are expectorants?
    reduces the thickness of secretions so that they can be removed by coughing
  22. what are mucolytics?
    breaks down the chemical structure of mucous to loosen it
  23. antitussives can come in ___ or ____
    opiate or non-opiate
  24. antitussives

    mech of action
    suppress the cough reflex

    used for dry hacking cough
  25. Route of admin for antitussives
  26. adverse effects for antitussives
    • Opiate based = Drowsiness, Dizziness
    • Non-Opiate Based = GI upset
  27. antitussives

    • asthma
    • excessive bronchial secretions
  28. Anitussives

    • MAOIs
    • CNS Depressants
  29. Benzonatate is different than other Antitussives

    How does it work?
    Works like local anesthetic by anesthetizing stretch receptors in the lungs

    Cannot be chewed or crushed, it will numb whatever it touches
  30. Expectorants

    Mach of action
    Makes the bronchial secretions thinner and increase mucous flow
  31. Expectorants
    Route of Admin
  32. Expectorant

    Adverse Effects
  33. Mucolytics

    Mech of action
    Breaks down the chemical structure of mucus to loosen it up and make it easier to remove by coughing

  34. Mucolytics

    Adverse Effects
    • Vomiting
    • Bronchosparm
  35. Mucolytics

    Inhaled Insulin
  36. Mucolytics

    Asthma (because the bronchospasms)
  37. Nursing Process include
    • Breath Sounds
    • Respiratory Status
    • Vitals
    • Allergies
  38. Nursing Diagnoses
    • Ineffective airway
    • ineffective breathing pattern
    • disturbed sleep process
    • risk for injury
    • risk for falls
  39. nursing interventions
    • increased fluid intake (help thin secretions)
    • monitor fever
    • monitor dizziness, drowsiness
    • report changes in severity or frequency of cough
    • changes in mucus
    • educate-limit the use of nasal sprays
    • educate-blow nose...nasal spray...spit out spray that drains in mouth
  40. Lower Respiratory Tract jobs
    brings in O2 removes CO2
  41. what is asthma??
    chronic pulmonary disease with inflammatory and bronchospasm components

    effect 20 million people

    intense breathlessness, coughing and gasping for air

    (wheezing caused by inflammation, air trying to be forced through airways)
  42. drugs for Asthma therapy
    • Quick Relief: short immediate acting beta 2 adrenergic agonists, anticholinergic or systemic corticosteroids
    • Long Acting: long acting beta 2 adrenergic agonists, methylxanthines and immunomodulators (more SE because large amount inhaled at one time)
  43. Beta Adrenergic Agonists

    Mech of action
    activates beta 2 receptors found on the smooth muscles of the lung, which relaxes bronchial smooth muscles resulting in bronchodilation
  44. beta adrenergic agonists

    route of admin
    PO, Inhaled, IV
  45. Beta Adrenergic Agonists

    Adverse Effects
    • Headache
    • Tremor
    • Nervousness
    • Tachycardia
    • Dysrhythmias
    • Tolerance
  46. Beta Adrenergic Agonists

    • Cardiac History
    • HTN
    • Black Box Warning: LABAs
  47. Beta Adrenergic Agonists

    • Beta Blockers (counter act each other)
    • MAOI (increases BP when given together)
    • CNS Stimulants
  48. Anticholinergic

    Mech of action
    Blocks sympathetic nervous system and causes bronchodilator

  49. Methylxanthines

    Mech of action
    bronchodilators that act similar to caffeine

    can be given PO, IV

    Rarely used anymore becaused safer drugs are available
  50. Methylxanthines

    Adverse Effects
    • Nervousness
    • Insomnia
    • CNS Stimulation
    • Dysrhythmias
  51. Methylxanthines

    Cardiac History
  52. Inhaled Corticosteroids

    Mech Of Action
    • Dampen the activation of inflammatory cells and increases production of anti-inflammatory mediators
    • Reduce bronchial hyperresponse to allergens
    • Mostly used for prevention
  53. Inhaled corticosteroids

    Administer after bronchodilator (to open airway)

    Should Not be used during asthma attack (it will not work)
  54. Inhaled corticosteroids

    Adverse Effects
    • Thrush (because the steroid sits in the mouth)
    • Hoarseness
    • Dry Mouth
    • Systemic effects are rare unless it is swallowed
  55. Important Education for Inhaled Corticosteroids
    educate patient to brush teeth or rinse mouth after to prevent the steroid for sitting in the mouth
  56. Inhaled Corticosteroids are contraindicated ...
    Growth in Pediatric Patients (must measure frequently)
  57. Inhaled corticosteroids

    There are no known interactions when inhaled
  58. Leukotriene Modifiers (oral medication)
    leukotriene is mediator of immune response it promotes edema, inflammation, and bronchoconstriction

    Blocks leukotriene receptors

    LONG ACTING and can take 1 week to start working
  59. Leukotriene Modifiers

    route of admin
    PO, Inhalation
  60. Leukotriene modifirs

    adverse effects
    • minimal
    • headache
    • cough
    • nasal congestion
  61. leukotriene modifiers

    • patients older than 65
    • patients with Liver damage
  62. Mast Cell Stabilizers

    Mech of action
    • inhibit mast cells from releasing histamine
    • reduces inflammation
  63. Mast Cell Stabilizers have a short 1/2 life must be given QID
  64. Mast Cell Stabilizers

    Adverse Effects
    • Nasal Congestion
    • Throat Irritation
    • Bitter unpleasant taste
  65. Nursing Assessment Asthma
    • Health history
    • Asthma triggers
    • Vitals
    • Pulmonary function
  66. Nursing Diagnoses for patients taking asthma medications
    • impaired gas exchange
    • ineffective tissue perfusion
    • anxiety
    • activity intolerance
  67. nursing interventions for patients taking asthma medications
    • provide instruction regarding immediate acting vs long acting
    • increase fluids
    • reduce allergens
    • rinse mouth to prevent thrush
    • teach to use spacers if needed
    • always use bronchodilator before steroid
    • rinse inhaler and spacer daily