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Pharm Test 2
Respiratory Study Guide
Question | Answer |
---|---|
Antihistamines, decongestants, antitussives, and expectorants are used to treat the ______? | common cold |
Manifestations of the common cold are due to triggering of ______ response. | the inflammatory response |
What herbal/supplemental products may be helpful in treating the common cold? | Echinacea and Vitamin C |
T/F Histamine is a substance that performs many functions; there are 3 types of histamine receptors? | FALSE: Histamine is a substance that performs may function and there are only TWO types of Histamine receptors. |
Histamine 1 (H1) anti-blockers receptors mediate:_____ | smooth muscle contraction and dilation of capillaries |
Histamine 1 anti-blockers are very drying. Name four drugs that are histamine 1 anti-blockers | 1. Diphenhydramine (benadryl). 2. Tylonal PM 3. Meclizine (antivert) 4. claritin |
Diphenhydramine (Benadryl), Tylonal PM cause ____ and used for_____. | They cause drowsyness and are used for motion sickness |
Does Claritin cause drowsyness? | NO |
Histamine 2 (H2) receptors mediate: ______. | Histamine 2 receptors mediate: the acceleration of the heart rate and gastric acid secretion |
H1 blockers are used for the ____ and _____ because of _______. Give examples. | H1 blockers are used for the common cold and allergies because of ability to block inflammatory effects, i.e. runny nose, due to histamine. |
What drug does the following: Dilation of capillaries; Increased capillary permeability; Contraction of smooth muscle; Stimulation of gastric secretions; Accelerates the heart rate? | Histamine 1 and 2 |
Antihistamines compete with histamines for unoccupied receptors. They do not unbind histamine that is already attached to receptors. Therefore, antihistamines are more effective when? | Antihistamines are more effective when given early in a histamine-mediated reaction, before all of the free histamine molecules bind to cell membrane receptors. |
Indications of Antihistamines: | nasal allergies, allergic rhinitis, and common cold |
What is the chief complaint of Antihistamines? | Drowsiness |
Adverse Effects of Antihistamines/Anticholinergic effects include.... | The anticholinergic (drying) effects of antihistamines can cause adverse effects such as dry mouth, changes in viion, difficulty urinating, and constipation. |
Your key drugs are loratidine (Claritin) and diphenhy dramine (Benadryl). What are the main differences between these two drugs? | Claritin is a non-sedative (non drowsy) and Benadryl is a sedative. |
The 3 groups of nasal decongestants are: | adrenergics (sympathomimetics:ANS albuterol; anticholinergics (parasympatholytics); and corticosteroids (intranasal steroids) |
Which is the largest group of nasal decongestants? | adrenergics (sympathomimetics: ANS albuterol |
Which nasal decongestant is a selected topical? | corticosteroids |
Name the 3 routes that nasal decongestants can be administered. | Orally to produce a systemic effect, inhalation, and topically to the nose. |
Adrenergics MOA is? | Adrenergics constrict nasal arterioles, which allow the nasal secretions in the swolen mucous membranes to drain. |
Adverse effects of decongestants are | Most common are: mucosal irritation and dryness. May have some sympathomimetic-related effects |
T/F Antitussives: used when coughing is not useful or may be harmful. | True |
Use Dextromethorphen (Vicks Formula 4, robitussin-DM) when a person has a _____ but no _____? | Use when a person has a cough but no mucus build up. It is a cough suppressant. |
Guaifenesin (Humabid, robitussin) is used when there is _______. | mucus build up and the person is coughing |
How do codeine, hydrocodone (the opiates) and dextromethorphan work? | They suppress the cough reflex through direct action on the cough center in the CNS (medulla). They also provide analgesia and have a drying effect on the mucosa on the respiratory tract, which increases viscosity of respiratory secretions. it reduce Sx |
Why is dextromethorphan different than the opiates? | Because it is not an opioid, however, it does not have analgesic properties, nor does it cause addiction or CNS depression |
Adverse Effects for dextromethorphan (Vicks Formula 44, Robitussin-DM) | dizziness, drowsiness, and nausea |
_____ Breaks down thick secretions so they can be 'expectorated' | Expectorants |
What is the 2 MOA's of Expectorants? | 1st is reflex stimulation, in which loosening & thinning of respiratory tract secretions (Guaifenesin is the only drug available). 2nd is direct stimualation of secretory glands in the respiratory tract (Iodine-containing pdts (iodinated glycerol & KI) |
Expectorants provide relief of _____, by ..... | Expectorants provide relief of productive cough, by loosening/thinning sputum, indirectly diminish tendency to cough |
The key expectorant drug is | Guaifensen (Humabid, Robitussin) |
A client with pneumonia is complaining of inability to sleep due to frequent coughing with thick sputum. What OTC would be the best? | Guaifenesin (Humabid, robitussing)-is for mucus build up |
Bronchodilators and other respiratory drugs are used to treat what diseases? | Chronic broncitis, asmas, emphesema and COPD |
What are the 3 key bronchodilators? | beta-adrenergic agonists, antic holinergics, xanthine derivatives) |
Beta 2-Adrenergic Agonists are used for what phase of an asthma attack? | Acute |
Beta 2-adrenergic agonists such as albuterol (Proventil, Ventolin) is used to treat asthma because? | it is selective and works on broncho dilators |
Antichollnergics drug such as ipratropium (Atrovent) is a _____ and MOA? | ipratropium (Atrovent)- is a nonselective, vasoconstriction, increases heart rate and increases cardio contractility. MOA they block Ach receptors that cause bronchoconstriction. |
The most commonly reported adverse effects of ipratropium and tiotropium therapy are related to.... | related to the drug's anticholinergic efects & include dry mouth/throat, nasal congestion, heart palpitations, GI distress, headache, coughing, & anxiety. |
Xanthine Derivatives Increases CAMP which is a chemical responsible for .... | bronco dilation and it is important in maintaining an open airway |
Theophylline (Slo-Bid, Theo-Dur) is a Xanthine Derivative that can cause ____ and is metabolized where? | Can cause cardiac disrthymias and is metabolized in the liver |
What drug causes bronchodilation by increasing levels of energy-producing substance cAMP, which is important in maintaining an open airway. | Xanthine Derivatives such as Theophylline (Slo-Bid, Theo-Dur) |
Theophylline is metabolized to ____, therefore it stimualtes the _____. | Theophylline is metabolized to caffeine in the body, therefore it stimulates the CNS |
Xanthines are used to dilate teh airways in patients with ..... | asthma, chronic bronchitis, or emphysema. |
Contraindications of ____ is mostly related to CNS stimulation, Nervous, irritability, cardiac disrhytmias. | Xanthines |
Therapeutic range is 10-20 mcg/ml for what drug | Xanthines |
The common adverse effects of the _____ derivatives include nausea, vomiting, and anorexia. GI reflux may occur during sleep. | Xanthine derivatives |
The use of xanthine derivatives with any of the following drugs causes the serum level of the xanthine derivative to be increased: | allopurinol, cimetidine, macrolide antibiotics (e.g., erythromycin), quinolones (e.g., ciprofloxacin), influenza vaccine, rifampin, and oral contraceptives. |
A reported herbal interaction of xanthine derivatives is the tendency of _____ to enhance the rate of xanthine drug metabolism. | St. John's Wort |
What is the key drug for xanthine deriviatives? | theophylline (Slo-Bid, Theo-Dur) |
What is the therapeutic blood level range for theophylline? | 10-20 mcg/ml |
What are the two nonbronchodilating respiratory drugs? | Antileukotriene drugs, corticosteroids |
What are leukotrienes? | family of molecules, prevention of asthma |
Nonbronchodilating respiratory drugs MOA is that they bind to leukotriene receptors in the lungs which prevents _____, decreases ____ and reduces ____. | bronchial smooth muscle contraction, decrease mucus secretion, and reduces vascular permeability (edema). |
Nonbronchodilating respiratory drugs are a Long or short term treatment of asthma? | LONG |
Which nonbronchodilationg respiratory drug is used for allergic rhinitis? | Montelukast |
When using nonbronchodilating respiratory drug when do you see improvement? | One week |
What drug is the adverse effect Churg-Strauss syndrome may occur. Systemic necrotizing vasculitis? | Montelukast (Singulair) |
Your key drug of nonbronchodilating respiatory drug is | Montelukast (Singulair) |
Corticosteroids Inhaled or nasal spray Key drug is | fluticasone (Flovent) -nasal spray and is used to prevent asthma |
Pt receiving both Flovent and albuterol. You should give ____ first to open up the airways and then ____. | Give albuterol first to open up the airways and then flovent |
When taking corticosteroids pt should rinse mouth out after so you don't get | thrush |
Why are Corticosteroids used in the treatment of the respiratory diseases? | Corticosteroids, also known as glucocorticoids, are either naturally occurring or synthetic drugs used in the treatment of COPDs for their antiinflammatory effects. |
Corticosteroids can be given in what possible routes? | Inhalation, PO or IV in severe cases of asthma when the drug cannot get to the airways because of the obstruction |
What is the advantage of inhaled over oral or intravenous corticosteroids? | Corticosteroids administered by inhalation have an advantage over orally administered corticosteroids in that their action is limited to the topical site in the lungs. |
MOA of ____ Dual effect of 1) reducing inflammation and 2) enhancing the activity of β-agonists | Corticosteroids such as Flovent |
T/F List the main undesirable effects associated with inhaled corticosteroids, include pharyngeal irritation, coughing, dry mouth, and oral fungal infections. | True |
Is there a problem with systemic effects with inhaled corticosteroids? | Most of the drug effects are limited to lungs and there is relatively little systemic absorption of the drugs. So YES if you need a systemic effect |
What is the difference between Flonase and Flovent? | Fluticasone is administered intranasally (Flonase) (1 inhalation in each nostril daily) and by oral inhalation (Flovent) (usually 1 inhalation by mouth twice daily). |
List 2 things you should assess with xanthine derivatives. | Cardiovascular and CNS stimulation may occur with these drugs, thus requiring astute cardiac and neurological assessment. |
Why is age important to assess with corticosteroids? | Age should be noted because corticosteroids are not recommended in pediatric patients in whom growth is still occurring |
T/F Quick-Relief: short acting inhaled beta 2 agonists-albuterol; Systemic cortosteroids are usually given IV then switched to inhaled form | true |
Long term treatment of asthma | Antileukotriene agents; mast cell stabalizers; inhaled steroids; anticholenergics; theophline |
Short term treatment of asthma | albuterol or beta 2 agonists |