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  1. during acute asthma exacerbation broncoconstriction worsens. the increase resistance in the airways increases shortness of breath.

    drugs that stimulate which receptors are ket to the tx because that is the only part of the pathology that can be reversed.
    Beta 2 receptors
  2. what method of adminstratin is a common route for pulmonary drugs:

    because the drugs are delivered to the site where they are needed, theres no problems created by distribution, metabolism or excretion and the systemic side effects
  3. a machine that creates a vapor from liquid is called:
    a nebulizer
  4. nebulizer tx are primarily done for which class of drugs:

    what is the benefit?
    nebulizer tx are primarily done for which class of drugs: beta 2 agonist

    why: it gives rapid delivery of the drug to the constricted muscles
  5. a device that changes a solid drug into a fine power thats inhaled is called:

    how is this device activated:
    dry particle inhaler (DPI)

    activited: by the patient inhaling device
  6. a device that releases powered drugs when the pt activates the device, taking a deep breath right after the device is triggered is called:
    metered dose inhaler

    successfully using the device requires proper technique and is not easy
  7. sympathomimetics that stimulate the adrenergic beta 2 receptors for the tx of asthma are the:

    where are the beta 2 receptors found:
    beta agonists

    beta 2 receptors: found on bronchial smooth muscle
  8. beta 2 agonists are used to lessen acute bronchoconstriction.

    how does this affect the diameter of the lumen on the bronchi:
    beta agonists increase the lumen diameter of the bronchi
  9. name the beta agonist that is NOT beta 2 specific:

    which receptors do they stimulate:

    what is the effect of the receptors they stimulate:
    name the beta agonist that is NOT beta 2 specific: epinephrine

    which receptors do they stimulate: beta 1 receptors

    what is the effect of the receptors they stimulate: increase the hearts work load, causing increased HR
  10. beta agonist do not reverse any of the underlying pathology that causes asthma because:
    beta agonists have no anti-inflammatory effects
  11. how are beta agonists classified:
    by their duration of action
  12. what is the onset of action  and duration for ultra short acting bronchdilators (beta agonists):

    what is the most commonly used drug from this class:
    onset of action: rapid onset, but only lasts a few hours

    common drug: isoproterenol (Isuprel)
  13. what is the onset of action and duration of short acting bronchodilators (beta agonists):

    what is a commonly used drug from this class:
    onset of action: rapid, but it lasts 2x as long as ultra short acting

    common drug: terbutaline (brethine)
  14. how long do intermediate acting bronchodilators (beta agonists):

    list 2 commonly used drugs from this class:
    duration: 4-8 hours

    • common drugs
    • albuterol (proventil)
    • levalbuterol (xopenex)
  15. list the 3 classes of bronchodilators (beta agonists) that are used for acute asthma attacks:
    • ultra short acting
    • short acting
    • intermediate acting
  16. what is the duration of action for long acting bronchodilators (beta agonists):

    name the commonly used drug from this class:
    duration: up to 12 hours

    common drug: salmeterol (serevent)
  17. what is the 2 indications of use for long acting bronchodilators (beta agonists):
    • to prevent attacks
    • frequent night attacks
  18. name the beta agonists that contains a rapid acting and a long acting bronchodilator:
    formoterol (Foradil)
  19. oral bronchodilators last longer but cause more side effects, list 3 of the side effects
    • increase HR
    • dysrhthmias
    • increased blood sugar
  20. what is the disadvantage of oral beta agonists:
    with long term use tolerance can develop and the duration of the action can decrease, necessitating increased dosing
  21. list 10 side effects of beta agonists:
    • rebound bronchospasm
    • chest pain
    • respiratory distress
    • heart palpitations
    • increased HR
    • dry mouth
    • nervousness
    • hypokalemia
    • cough
    • increased blood sugar
  22. the use of beta agonists and which other drug class can prevent bronchodilation:
    beta blockers
  23. overuse of a resuce inhaler such as, ventoline can indicate:

    how is excess use defined:
    poor asthma control

    (associated with increased mortatily)

    excess use: using more than 1 canister a month
  24. pt. care for the use of beta agonists should include which 5 things:
    • checking VSs
    • lung sounds
    • respiratory effort
    • sking color
    • o2 saturation

    ... before and after giving the tx
  25. pt. education for beta agonists should include limiting the use of:
  26. how long should the pt. hold their breath for after inhaling the drug:

    how long should the pt. wait before the 2nd inhalation:
    how long should the pt. hold their breath for after inhaling the drug: 10 seconds

    how long should the pt. wait before the 2nd inhalation: 2 minutes

    rinse mouth after use
  27. what color may the sputum and saliva be after inhaler use:
  28. how are anti cholinergics similar to beta agonists for the tx of asthma:
    because they block the parasympathetic nervous systems's bronchoconstrction they have essentially the same effect as beta agonits
  29. how are anti cholinergic different from beta agonists for the tx of asthma:

    what is the benefit of this difference:
    they work on different receptors

    if theres a beta blocker affecting beta 1 receptors being taken, beta agonists may not help, but an anti cholinergic will
  30. excess drying the copious secretions that occur with chronic bronchitis and possibily thickened secretions so much that they have to be removed by bronchoscopy is the result of what class of bronchodilators:
    anti cholinergics
  31. name the most commonly used anti cholinergic used for COPD:
  32. how long dose the anti cholinergic ipratropium last:

    how is the onset of action of this drug different from beta agonists
    lasts: 6 hours

    onset of action: slower than with most beta agonists

    the bronchodilation that it produces is less than that with a beta agonists, it is NOT the 1st line of tx
  33. what type of effect does the anti cholinergic ipratropium, have when it is used with a beta agonist:

    what is the result:
    effect: synergistic effect

    reult: prolonged bronchodilation
  34. name the drug that combines an anti-cholinergic and a beta agonist:
  35. name a newer inhaled anti cholinergic with a longer 1/2 life than ipratropium:
    tiotropium (spiriva)
  36. describe the reason few pts. develop typical anti cholinergic side effects with their use for the tx of pulmonary:
    the drugs are inhaled
  37. are anti cholinergic used as rescue drugs:
    no, they are used for mainenance
  38. list the (3) side effect for the use of anti cholinergics:
    • cough
    • nasal mucosal dryness
    • hoarseness
  39. decribe the after tast for the use of anti cholinergic inhalents:
    it leaves a bitter taste
  40. describe why people with a soy or nut allergy should not use anti cholinergic inhaler:
    soy lecithin is used as a propellant for the inhaler
  41. list the (5) things that should be chekced before and after adminstering a anti cholinergic:
    • check VSs
    • breath sounds
    • respiratory effort
    • skin color
    • o2 saturation
  42. how long should a pt. wait before taking a 2nd inhalation of an anti cholinergic:
    5 minutes
  43. should the pt. rinse their mouth after the use of an anti cholinergic inhalent:
  44. why are methylxanthines rarly used any longer:
    due to the narrow safety margin, drug interactions and toxicity
  45. which drug class is chemically similar to caffeine:
  46. how are methylxanthines adminstered:
    PO or IV
  47. list the side effects of methylxathines
    • seizures
    • HF
    • respiratory arrest
    • increased HR
    • irritability
    • insomnia
    • restlessness
    • dizziness
    • headache
    • heart palpitations
    • vomiting
    • abdomial pain
  48. what are the (2) contraindications for the use of methylxathines:

    what is the (1) precaution for the use of methylxathines:
    • contraindications
    • CAD
    • breast feeding

    precautions: elderly and kids
Card Set
pulmonary meds
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