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Pharmacology Mod5+6
| Question | Answer |
|---|---|
| What are preventers for Allergic Rhinitis? | Antihistamines, intranasal corticosteroids, mast cell stabilizers |
| What are relievers for Allergic Rhinitis? | oral and intranasal decongestants |
| What is the MOA of diphenhydramine (Benadryl)? | Histamine receptor blocker |
| What is the primary use of diphenhydramine (Benadryl)? | To treat minor symptoms of allergy and common cold |
| What are contraindications of diphenhydramine (Benadryl)? | BPH, narrow angle glaucoma, GI obstruction |
| What is the drug of choice in treating allergic rhinitis? | Intranasal corticosteroids |
| What is the MOA of intranasal corticosteroids? | Reduces tissue edema and causes mild vasoconstriction |
| What is the pharmacologic class for fluticasone (Flonase)? | Corticosteroid |
| What is the primary use of fluticasone (Flonase)? | To treat seasonal allergic rhinitis |
| What are adverse effects of fluticasone (Flonase)? | Nasal irritation, epistaxis, headache |
| What are contraindications of fluticasone (Flonase)? | Patients with known infections should not receive the medication. |
| What drug does fluticasone (Flonase) interact with? | Ritonavir |
| How long should you use intranasal preparations? | 3-5 days due to rebound congestion |
| What is the pharmacologic class for oxymetazoline (Afrin)? | sympathomimetic |
| How long should the patient take oxymetazoline (Afrin)? | 3-5 days |
| What are contraindications for oxymetazoline (Afrin)? | patients with thyroid disorders, HTN, diabetes, heart disease |
| What do antitussives do for a cough? | Inhibit cough |
| What do opioids do for a cough? | Inhibits severe cough |
| What do expectorants do for a cough? | Inhibit mucus production |
| What do mucolytics do for a cough? | Loosen thick bronchial secretions |
| What are examples of antitussives? | Benzonatate (tessalon) and Dextromethorphan (delsym, robitussin) |
| What is an example of an expectorant? | Guaifenesin (mucinex) |
| What are examples of mucolytics? | Acetylcysteine (mucomyst), Dornase Alfa |
| What are adverse effects of dextromethorphan (delsym)? | Dizziness, Drowsiness , GI Upset |
| What food does dextromethorphan (delsym) interact with? | grapefruit juice |
| What illness's are expectorants and mucolytics used for? | Cystic Fibrosis and Chronic Bronchitis |
| What is the purpose of drugs used for asthma? | Preventing asthma attacks and terminating attacks in progress. |
| What is the goal of drugs used for asthma? | Terminate acute bronchospasm in progress and reduce frequency of asthma attacks. |
| What are examples of quick relief asthma medications? | beta-adrenergic agonists, anticholinergics, systemic corticosteroids |
| What are examples of long acting asthma medications? | inhaled corticosteroids, mast cell stabilizers, leukotriene modifiers, long acting beta-adrenergic agonists, methylxanthines, immunomodulators |
| What is the most effective drug for relieving acute bronchospasm? | Beta-adrenergic agonists |
| What does beta-adrenergic agonists cause? | It causes bronchodilation |
| What is an example of a beta-adrenergic agonist? | Albuterol |
| What is the MOA of albuterol? | causes bronchodilation |
| What is the primary use for albuterol? | for the termination of acute bronchospasm |
| What are adverse effects of albuterol? | Headaches, throat irritation, nervousness, restlessness, tachycardia, chest pain, allergic reactions |
| Is albuterol short or long acting? | short acting |
| What is the therapeutic class for albuterol? | bronchodilator |
| What should the nurse assess for when treating a patient with anticholinergics? | Hx of narrow angle glaucoma, BPH, Renal disorders, urinary bladder neck obstruction |
| What is the pharmacologic class for ipratropium (atrovent)? | anticholinergic bronchodilator |
| What are adverse effects of ipratropium (atrovent)? | Cough, drying of nasal mucosa, hoarseness, bitter taste |
| How long should you wait between dosages when giving ipratropium (atrovent)? | 2-3 minutes |
| What are methylxanthines? | a group of bronchodilators related to caffeine |
| What are methylxanthines used for? | for long term prophylaxis of asthma that is unresponsive to beta agonists or corticosteroids |
| What are methylxanthines contraindicated with? | Contraindicated with CAD, angina pectoris, severe renal/liver disorders, peptic ulcer, BPH, DM |
| What is the most potent natural anti-inflammatory drugs? | corticosteroids |
| Are corticosteroids used for prevention or rescue? | prevention |
| How long should you limit oral corticosteroids to? | Under 10 days |
| What is the pharmacologic class for beclomethasone (QVAR)? | inhaled corticosteroid |
| When should you NOT use beclomethasone (QVAR)? | Do not use if the pt is experiencing an asthma attack |
| What are leukotriene modifiers? | Mediators of immune response that are involved in allergic and asthmatic rxns |
| What are leukotriene modifiers used for? | Used for asthma prophylaxis to reduce inflammatory component of asthma |
| What is the pharmacologic class for montelukast (Singulair)? | Leukotriene modifier |
| How long before exercise/activity should you take montelukast (Singulair)? | 2 hours before |
| What can montelukast (Singulair) increase? | ALT values |
| What do mast cell stabilizers do? | They inhibit mast cells from releasing histamine and other chemical mediators |
| Are mast cell stabilizers safe or unsafe for prophylaxis of asthma? | Safe for prophylaxis of asthma |
| Are mast cell stabilizers more or less effective than inhaled corticosteroids? | Less effective than inhaled corticosteroids |
| Are mast cell stabilizers effective or ineffective at relieving acute bronchospasm? | ineffective at relieving acute bronchospasm |
| What to Monoclonal Antibodies for asthma prophylaxis do? | Attach to specific receptor on a target cell or molecule |
| What is an example of a monoclonal antibody for asthma prophylaxis? | Omalizumab (Xolair) |
| What medication was the first biologic therapy approved to treat asthma? | Omalizumab (Xolair) |
| What drugs classes are used for COPD? | Bronchodilators, mucolytics, expectorants, oxygen therapy, antibiotics, roflumilast |
| What is the normal value for osmolality/tonicity? | 275-296 mOSm/kg |
| How are excess fluid balance disorders treated? | Treated with diuretics |
| What are crystalloids? | IV solutions with electrolytes |
| What are crystalloids used for? | Used to replace fluids and promote urine output |
| What are examples of selected crystalloid IV solutions? | NS, LR, plasma-lyte 148, dextrose in water, dextrose in LR |
| What do colloids do? | Increase osmotic pressure and expand plasma volume |
| What are examples of selected colloid solutions? | 5% albumin, dextran 40 in NS, dextran 40 in dextrose, dextran 70 in NS, hetastarch 6% in NS, plasma protein fraction |
| What pharmacologic class is dextran 40? | colloid |
| What is the primary use of dextran 40? | Fluid replacement with hypovolemic shock from hemorrhage, surgery, severe burns |
| What are adverse effects of dextran 40? | hypersensitivity rx, fluid overload, HTN |
| What s/sx may we see with fluid overload? | tachycardia, edema, distended neck veins, dyspnea, cough |
| What are contraindications for dextran 40? | pt with acute kidney injury, severe dehydration, severe HF, hypervolemic disorders |
| What are electrolytes essential for? | nerve conduction, membrane permeability, water balance |
| What is the pharmacologic class for Sodium Chloride (NaCl)? | electrolyte, sodium replacement |
| What is NaCl used for? | drug from hyponatremia |
| What are contraindications for NaCl? | No if the pt has hypernatremia, HF, or impaired kidney fx |
| What is the primary use of NaCl? | to treat hyponatremia when serum levels fall below 130 mEq/L |
| What is the pharmacologic class for potassium chloride (KCl)? | electrolyte, sodium supplement |
| What is the primary use of KCl? | to treat hypokalemia |
| What is the main administration alert for KCl? | never administer IV push |
| What are adverse effects for KCl? | GI irritation, hyperkalemia |
| What are the serum levels for hypernatremia? | Sodium level above 145 mEq/L |
| What is hypernatremia commonly caused by? | Kidney disease |
| What are s/sx of hypernatremia? | Christ, fatigue, weakness, muscle twitching, convulsions, altered muscle status, decreased LOC |
| What are treatments for hypernatremia? | low-salt diet, hypotonic IV (if hypovolemic), diuretics (if hypervolemic) |
| What are the serum levels for hyponatremia? | Sodium level below 135 mEq/L |
| What can hyponatremia be caused by? | excessive dilution of plasma, v/d, GI suctioning, diuretic use |
| What are early symptoms of hyponatremia? | n/v, anorexia, abd cramping |
| What are later signs of hyponatremia? | altered neuro fx (confusion, lethargy, convulsions, coma, muscle twitching, tremors |
| If the hyponatremia is caused by excessive dilution what can it be treated with? | Loop diuretics |
| If the hyponatremia is caused by sodium loss, what can it be treated with? | Oral sodium chloride or IV fluids containing salt (NS or lactated ringers) |
| What are the serum levels for hyperkalemia? | Potassium level above 5 mEq/L |
| What is hyperkalemia caused by? | By high consumption of potassium rich food, dietary supplements |
| What are symptoms of hyperkalemia? | muscle twitching, fatigue, paresthesia, dyspnea, cramping, diarrhea, dysrhythmias, heart block |
| What are treatments for hyperkalemia? | restrict dietary sources, decrease dose of potassium-sparing diuretics, administer glucose/insulin, administer calcium, administer polystyrene sulfonate and sorbitol to decrease potassium levels |
| What are the serum values for hypokalemia? | Potassium level below 3.5 mEqL |
| What is hypokalemia caused by? | By high doses of loop diuretics, strenuous muscle activity, severe vomiting or diarrhea |
| What are symptoms of hypokalemia? | muscle weakness, lethargy, anorexia, dysrhythmias, cardiac arrest |
| What are treatments for hypokalemia? | Increase dietary intake, give oral/parenteral potassium supplements |
| What is acidosis? | Excess acid |
| What is alkalosis? | excess base` |
| What are respiratory origins of acidosis? | Hypoventilation/shallow breathing, airway constriction, damage to respiratory center in medulla |
| What are metabolic origins of acidosis? | Severe diarrhea, kidney failure, DM, excess alcohol ingestion, starvation |
| What are respiratory origins of alkalosis? | hyperventilation due to asthma, anxiety or high altitude |
| What are metabolic origins of alkalosis? | constipation for prolonger periods, ingestion of excess sodium bicarbonate, diuretics, severe vomiting |
| What are symptoms of acidosis? | lethargy, confusion, coma, deep/rapid respirations |
| What is the goal for acidosis? | Goal is to quickly reverse effects of excess acid in blood |
| What is given for acidosis? | Sodium bicarbonate |
| What is the MOA of sodium bicarbonate? | to decrease pH of body fluids |
| What are adverse effects of sodium bicarbonate? | metabolic alkalosis caused by receiving too much Picard and hypokalemia |
| What are administration alerts for sodium bicarb? | Give oral 2-3 hours before or after meals and other medications |
| What is the primary use for sodium bicarb? | Treatment of acidosis |
| What are contraindications for sodium bicarb? | vomiting, pt who has continuous GI suctioning, HTN, peptic ulcers |
| What are symptoms caused by for alkalosis? | Sx due to CNS stimulation |
| What are treatments for alkalosis? | Administration of ammonium chloride, administration of sodium chloride with potassium chloride |
Created by:
mpnmurphy
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