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Ch. 76 Asthma

Pharmacology for Nurses

Asthma: Chronic _________ disorder of the airways inflammation
Asthma: Usually occurs due to an immune response to _______________ known allergens
Asthma: Immune response causes airway to become ___________ and ___________ inflamed and bronchospasms (bronchoconstriction)
Asthma Drugs:mainly classified as anti- _______ agents and _______________ inflammatory and bronchodilators
Asthma Drugs:Principal __________ are beta 2 agonist bronchodilators
Asthma Drugs: Principal anti-inflammatory are _____ glucocorticoids
Asthma Drugs: drugs used for ________ are also commonly used in COPD asthma
Admin Inhalation- Advantages: therapeutic effects are ________ by drugs acting directly at the site needed enchances
Admin Inhalation- Advantages: _________ effects are minimized systemic
Admin Inhalation- Advantages: relief of acute asthma attacks is ______ rapid
Admin Inhalation- MDI: dosed usually with 1-2 puffs (wait one minute between puffs)
Admin Inhalation- MDI: Inhale _____ to activating the inhaler prior
Admin Inhalation- MDI: Provide _______ and _____ instructions prn written and verbal
Admin Inhalation- MDI: _____ of the drug stays in the oropharynx and about _____ actually reaches the lungs. 80% ; 10%
Admin Inhalation- MDI: May use ______ to increase delivery of drug to lungs and less loss to mucosa spacer
Admin Inhalation-DPI: Drug is ___ and inhaled dry
Admin Inhalation- DPI: ______ drug is delievered to the lungs more (20% of the total released vs. 10% of the MDI)
Admin Inhalation- Nebulizers: machine used to convert ______ into a ______ _____ through oxygen tubing, face mask, or ventilator tubing liquid; droplet mist
Admin Inhalation- Nebulizers: takes several minutes to administer the _______ _____ of drug same amount
Admin Inhalation- Nebulizers: are used at _____ or the _______ ________ setting home; doctor's office
Anti- Inflammatory Drugs- Glucocorticoids: inhaled beclomethasone diproionate (QVAR); budenoside (Pulmicort); flunisolide (Aerobid)
Anti- Inflammatory Drugs- Glucocorticoids: Oral prednisone; prednsiolone
Anti- Inflammatory Drugs- Glucocorticoids: Acts by suppressing ________ through decreasing synthesis of inflammatory mediators, decreasing inflammatory cells, and decreasing ____ of the airway mucosa inflammation; edema
Anti- Inflammatory Drugs- Glucocorticoids: can also act to crease airway ________ production mucus
Anti- Inflammatory Drugs- Glucocorticoids: can be used for __________ of chronic asthma and used on fixed schedule prophylaxis
Anti- Inflammatory Drugs- Glucocorticoids: inhaled GCs are used in patients with _______ to _______ severe asthma and are very safe moderate; severe
Anti- Inflammatory Drugs- Glucocorticoids: oral GCs are reserved for ________ asthmatics because of the rick of toxicity severe
Glucocorticoids: Adverse Effects-inhaled: teach to ______, use spacer, and report signs of ______ infections gargle; fungal
Glucocorticoids: Adverse Effects-inhaled: adrenal suppression (watch times of ______) stress
Glucocorticoids: Adverse Effects-inhaled: Can cause bone ___ in premenopausal women loss
Glucocorticoids: Adverse Effects-inhaled: can slow ______ in children growth
Glucocorticoids: Adverse Effects-inhaled: can increase risk of ______ and _________ cataracts; glaucoma
Glucocorticoids: Adverse Effects-oral: safe if used less than ___ days 10
Glucocorticoids: Adverse Effects-oral: watch foe adrenal suppression, osteoporosis, _______, peptic ulcer disease, and growth suppression hyperglycemia
Glucocorticoids: Adverse Effects-oral: increase GCs at times of ______ stress
Montelukast (Singulair): Acts to _______ leukotrienes block
Montelukast (Singulair): used to prevent _____, relieve exercised-induced ________, and to relieve allergic ________. asthma; bronchospam; rhinitis
Montelukast (Singulair): is not used ___ treatment of asthma, because drug takes at least ___ hours to take effect rapid; 24
Montelukast (Singulair): tablet is taken ___ a day to prevent asthma-related bronchospam once
Montelukast (Singulair): usually taken at _______ because it causes_______ bedtime; drowiness
Montelukast (Singulair): watch ______ closely during therapy liver
Cromolyn (Intal): used for _________ of asthma prophylaxis (not quick relief)
Cromolyn (Intal): suppresses inflammation by acting to suppress _____ cells mast
Cromolyn (Intal): administered via _________ route and produces no systemic effects inhalation
Cromolyn (Intal): especially effective in preventing ______ allergy-related asthma attacks seasonal
Cromolyn (Intal): should take at least ____ minutes prior ro known allergen exposure 15
Beta 2- Adrenergic Agonist Inhaled: short-acting Albuterol - AccuNeb, ProAir, Proventil
Beta 2- Adrenergic Agonist Inhaled: long-acting Arfometerol (Brovana); Formoterol (Foradil); Salmeteral (Serevent)
Beta 2- Adrenergic Agonist Oral Albuterol (Vospire): Terbutaline (Brethine)
Beta 2- Adrenergic Agonist: most ____ drugs available to relieve acute bronchospasm and prevention exercise-induced bronchospasm (EIB) effective
Beta 2- Adrenergic Agonist: Acts by activating beta2 receptors in smooth muscle in lungs promoting _______ and relieving _____ bronchodilation; bronchospasm
Beta 2- Adrenergic Agonist: Short-Acting- effects are immediate and last 3-5 hours; taken ___ for attacks; taken 15 mins prophylacticalllly for ___; for severe attacks, _______ treatments are preferred PRN; EIB; nebulizer
Beta 2- Adrenergic Agonist: Long-acting drugs are used for prophylaxis and not usually immediate relief of acute attack; dosing is on a fixed ______ to provide adequate prophylaxis; usually not used ____, but added to a regimen including GCs schedule; alone
Beta 2- Adrenergic Agonist: __________ can be used best treat an attack short acting
Beta 2- Adrenergic Agonist: Oral beta2 agonist are used for __________ and usually added to GCs in treatment plan long-term control
Beta 2- Adrenergic Agonist: adverse effects: ________, angina, _________, feelings of tachycardia; tremors; anixety
Theophylline: Acts to produce bronchodilation by relaxing smooth ______ in the _______ muscle; bronchi
Theophylline: used in asthma and administered PO for _________ therapy of chronic stable asthma maintenance
Theophylline: has a ______ therapeutic range and doses must be watched carefully narrow
Theophylline: watch for _______ (want levels less than __ mcg/mL) toxicity occurs if above 30 mcg/mL toxicity; 20
Theophylline: mild toxicity can cause _______, diarrhea, _______, insomnia, and restlessness nausea; vomiting
Theophylline: severe toxicity can cause deadly __________ and convulsion dysrhythmias
Theophylline: if symptoms occur, anticipate activated charcoal, ________ for dysrhythmias, and ________ to control seizures lidocaine; diazepam
Theophylline-Drug interactions: ______ can increase level and potentiate adverse effects on CNS and cardiac systems (teach to avoid ________) caffeine; caffeine-containing beverages
Theophylline-Drug interactions: Phenobarbital and phenyotin can _______ level of drug decrease
Theophylline-Drug interactions: Cimetidine and ciprofloxacin can ________ level of drug increase
Theophylline: initial doses are ____ and gradually increase low
Theophylline-Drug interactions: if a doses is missed, do not __________, can cause toxicity double up
Theophylline-Drug interactions: do not ____ sustained release preparations....can cause toxicity chew
Theophylline-Drug interactions: IV theophylline may be used in emergencies, but watch for ___________ toxicity
Anticholinergic Drugs- Ipratropium (Atrovent)
Ipratropium (Atrovent): administered by INH and relieves _________ bronchospasms
Ipratropium (Atrovent): acts as muscarinic antagonist and promotes __________ bronchodilation
Ipratropium (Atrovent): effects begin within __ seconds and last about ___ hours 30; 6
Ipratropium (Atrovent): often combined with ____________ beta2 agonist
Ipratropium (Atrovent): side effects include dry mouth and ____ throat (sip _____ and have ____candy) soar; water; hard
Ipratropium (Atrovent): Patients with _______ allergy should avoid Atrovent HFA and Combivent due to production with _______ protein peanut; soya
Ipratropium (Atrovent): rinse ______ after inhaling mouth
Ipratropium (Atrovent) wait at least ___ minute between puffs 1
Ipratropium (Atrovent) wait ____ minutes between two different inhaled medications 5
Created by: emv2435
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