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Respiratory Meds
Respiratory Medications
| Question | Answer |
|---|---|
| What is best med for Bacterial Pneumonia and Haemophilus influenza? | 3rd Generation Cephalosporin |
| 1st Line meds for TB | INH, Rifampin, Ethambutol, pyrazinamide |
| 2nd Line meds for TB | Capreomycin, ethionamide, cycloserine |
| How long should you take TB drug therapy? When is best time to take meds? | 6-12 months on empty stomach or 1h b4 meals |
| Isoniazid(INH) side effects? What is administered with INH to prevent peripheral neuropathy? | peripheral neuritis,hepatitis With INH: Vitamin B(pyridoxine) |
| Rifampin(Rifadin) SE? | hepatotoxicity, vision changes, orange urine/sweat/tears, fever, N/V Increases metabolism of: beta blockers/anticoagulants/corticosteroids/oral contraceptives/theophylline/dig |
| Ethambutol(Myambutol) SE? | may lead to blindness, skin rash, use with caution with renal disease and monitor visual acuity |
| Pyrazinamide SE? | hyperuricemia(monitor uric acid), hepatotoxicity, skin rash, GI distress, arthralgias |
| IV antibiotics for lung abscess? Oral antibiotics taken when? | Penicillin -G or Cleocin for 3-5 days oral: after IV for 4-8 weeks to prevent relapse |
| What irritating agent is aerosolized obliterate the pleural space to prevent fluid from accumulating in a pleural effusion | Talc or bleomycin |
| In Acute Respiratory Distress Syndrome(ARDS), if pt fights ventilator what meds should be given and in what order? | 1. Sedative: Propofol(Diprivan), midazolam(Versed), lorazepam (Ativan), haloperidol 2. Paralytic agent:Pavulon, Norcuron, Tracrium, Zemuron |
| What nsg mgmt should be given with a paralytic? | Reassure pt it is temporary, and given with sedative and pain meds, eye care, short duration |
| Flolan, Viagra, Tracleer, do what with Pulmonary Hypertension? | Flolan: given IV relaxes vascular smooth muscle and requires special training), Viagra(pulmonary vasodilation), Tracleer(oral vasodilator and antihypertensive), Remodulin Ventavis(inhaled) Diuretics/anticoagulators |
| A pt has a PE, what will the nurse expect to give first? This is followed by what? | First, IV Heparin with PTT goal of 2-2.5xnorm then oral Coumadin(INR 2-2.5)followed: Lovenox(bubble last to go in)- **Heparin does not break up existing clots, prevents forming** |
| Sarcoidosis | Corticosteroids Methotrexate (if steroids not effective) |
| A pt is dx with pulmonary fungal infections, what drug will need an exclusive IV line? What are alternative drugs? | Amphotericin B(4-12 wks)and give Benadryl 1h prior infusion Nizoral, Diflucan, Ancobon |
| Name three short term beta2 adrenergic agonists used for COPD? | albuterol(Proventil, Ventolin): inhaler/nebulizer/oral/short fenoterol(Alupent): i/n/o/s terbutaline(Brethine): i/short |
| When are corticosteroids used with in a COPD pt? | for long term, not emergency |
| Name a smoking cessation drug? What antidepressants help with smoking cessation? What anti-HTN helps as well? | Varenicline(Chantix) antidep: Wellbutrin, Zyban, Aventyl anti-HTN: clonidine(Catapres) |
| For mild COPD what short acting bronchodilator might be prescribed? | albuterol(Proventil, Ventolin) fenoterol(Alupent) terbutaline(Brethine) |
| For severe COPD, what might be prescribed? | bronchodilator and inhaled corticosteroid or a combination drug like Symbicort or Advair diskus |
| What short acting anticholinergic agent is good for COPD? | Ipratropium bromide(Atrovent): inhaler or nebulizer |
| What methylxanthines are used for COPD and asthma? | Long term control and 2nd line: theophylline(Theo-Dur, Slo-Bid) or aminophylline |
| Name two combination B2 agonist and anticholinergic agent for COPD | salbutamol/ipratropium(Combivent) fenoterol/ipratropium(Duovent) |
| Name the quick relief short acting B2 agonists and anticholinergics for asthma | B2: albuterol(Proventil), levalbuterol (Xopenex), pirbuterol (Maxair), Alupent antichol: iprotropium(Atrovent), Spiriva |
| what is most effective long term medication used in Asthma | Inhaled corticosteroids: beclomethasone, fluticasone (Flovent), triamcinolone (Azmacort), |
| What sytemic IV corticosteroids help in asthma for short term "burst"? What long/short SE to watch for? | methylprednisolone(Medrol), prednisone SE: BS and BP abnormalities, peptic ulcer. long SE: growth suppression, Cushing's syndrome |
| These inhaled B2 agaonists are never used for acute asthma s/s or exacerbations, but good for preventing excercise-induced bronchospasms? | salmeterol(Serevent), formoterol (Foradil) |
| What are main side effects of inhaled corticosteroids for short term use? | cough, oral thrush, osteroporosis in high doses |
| What are main SE for short acting B2 agonists? | Tachy, muscle tremors, HA, hyperglycemia, dysrhythmias (esp in elderly) |
| 1. This long term Leukotriene Modifiers ________can only be given to pt >1yr? 2. _________ should not be given with Coumadin | 1. montelukast(Singulair) 2. zafirlukast(Accolate) |
| What is common tx for Status Asthmaticus | short B2 agonist +IV Systemic corticosteroid |
| What vitamins defends against free radicals with O2 toxicity? | Vitamins E, C, betacarotene |
| COPD: short acting: B2 agonist/anticholinergic combo | ipratropium bromide & albuterol sulfate (Combivent): inhale |
| What foods should be avoided with INH drugs? | Food containing tyramine and histamine(tuna, aged cheese, red winde, soy sauce, yeast extracts) and may cause HA, flushing, hypotension, palpitations, lightheadedness, diaphoresis |
| What is meant by primary resistance to TB drugs? | resistant to a first line agent with no previous tx |
| What is meant by secondary resistance to TB drugs? | resistant to one or more agents for pt undergoing therapy |
| If a pt is multidrug resistant to TB agents, which ones typically are included and what is recommended TB tx? | resistant to two agents: INH and rifampin, so begin TB tx with 4 or more meds |
| Indocin is classified as what type of drug? It is used for what lung condition? | NSAID for pain with pleurisy as pt takes deep breaths and coughs. Also used in newborns to close ductus arteriosus. Do you remember what keeps it patent? Prostaglandin E |
| Why is morphine given to a pt with pulmonary edema? | To reduce anxiety and pain and help the heart work less |
| How long should antibiotics be given with empyema? | 4-6wks to sterilize pleural cavity |
| When giving blood products to a pt with ARDS, what should the nurse look for? | fluid volume overload bc blood products have citrates which incr perfusion and causes body to take on more fluid. |
| What is main medical tx for Cor Pulmonale? | 24h O2 to improve gas exchange and reduce pulmonary hypertension |
| Name three thrombolytic drugs | urokinase, streptokinase, alteplase |
| Taxal is a toxic drug used to treat _______. Don't use if WBC is less than _______. _________ prevents Taxal from clearing body. | lung cancer, 1,000, Valium |
| Which type of cancer responds best to chemotherapy? | small cell ca |
| What is best tx for non-small cell ca? | pulmonary resection |
| Which is best med for nausea with Ca pts, Zofran or Phenergan? | Zofran, Phenergan best for pain |
| A pt with COPD is struggling to breathe what is a key medical management to give? | bronchodilators |
| When do you give more than 6L of O2 to a COPD pt? | Upon Dr. order and just til PaO2 is to at least 60mm Hg or sats are normal |
| How often is the flu vaccine given? How often is pneumovax given? | flu: every year pneu: every 5 years |
Created by:
palmerag
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