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Ch. 76 Asthma
Pharmacology for Nurses
| Question | Answer |
|---|---|
| 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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