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pharm resp 3314

Pharm 3314 Respiratory

Bronchodilators are used in the treatment of ___ and chronic ____. asthma bronchitis
List four types of bronchodilators: Beta2 Adrenergic Agonists Anticholinergic Bronchodilators Xantine Bronchodilators Leukotriene Antagonists
What are the two different types of Beta2 Adrenergic Agonists? Non-selective Beta2 Adrenergic Agonists Selective Beta2 Adrenergic Agonists
Beta2 Adrenergic Agonists bind to Beta2 receptors and cause ____. They can either be ____ or administered ___. They are most effective with acute ____. bronchodilation inhaled PO bronchospasms
What pregnancy category are Beta2 Adrenergic Agonists in? C
Beta2 Adrenergic Agonists are used in the treatment and prophylaxis of ____ diseases (asthma, chronic bronch, emph). Ctn should be taken with excessive ___ and ___ stim, ___, and ___ bc pts can suffer increased intraocular pressure. ____ are more at risk. bronchoconstrictive cardiac CNS anxiety glaucoma older adults
What are four examples of selective Beta2 Adrenergic Agonists? Albuterol (Proventil, Ventolin) Levalbuterol (Xopenex) Salmeterol (Serevent) Arformeterol (Brovan)
SBAA are relatively selective specifically for Beta2 Ad Receptors in the ___ and less likely to prod unwnt ___ effects. They relax ___ smooth muscles which in turn relieves ____ and dec airway ___. They also relax ___ smooth msc & bld vssls of ___ muscle. lungs cardiovascular bronchial bronchospasm resistance uterine skeletal
Albuterol (Ventolin, Proventil) is also produced for ____-induced bronchoconstriction. SE include nausea, incrd ___ or ___, palp, ___, dizziness, muscle ___ (mostly related to ____), hypokalemia, and ____. Cautn should be taken bc of the sevl ___ interact exercise anxiety sedation tremors cramping hypokalemia tachycardia drug
Salmeterol (Serevent) is used to PREVENT ____. SE & DI are similar to Albuteral (nausea, incrsd anxiety or sedation, palp, tremors, dizziness, muscle cramping, hypokalemia, tachycardia). Some ___ deaths are reported. ___ have a higher risk of morbidity. asthma attacks asthma-related African Americans
Non-selective Beta2 Adrenergic Agonists are prescribed less than Selective Beta2 Adrenergic Agonists because of their ___ effects with the excessive stimulation of ___ receptors. They also stimulate ___ receptors, relaxing bronchial smooth muscle. cardiac Beta1 Beta2
Give two examples of Non-Selective Beta2 Adrenergic Agonists epinephrine (Adrenalin, Primatene, Bronkaid) isoproterenol (Isuprel)
Anticholinergic Bronchodilators (Antimuscarinic) reverse ____ induced by parasympathetic activity by eliminating the ____. Caution should be taken in patients with ___, ___ women, and ___ patients. These medications are a pregnancy category ___. They can bronchoconstriction parasympathetic tone glaucoma pregnant elderly B inhaled intranasally 1.5-2 maintenance
What are two examples of Anticholinergic Bronchodilators? Ipratropium (Atrovent, Combivent) Tiotropium (Spiriva)
Ipratroprium (Atrovent) produces local ____ after inhalation; it has few systemic ___ effects. It is used for maintenance therapy in ____, not for __ episodes. It has a ___ onset of action and is used in combination with ____ to help with acute bronchodil bronchodilation anti-muscarinic COPD acute short Albuterol
Adverse effects of Ipratroprium (Atrovent) include dry ___ or ___, ___, headache, ___, and GI distress. Less often, ___ pain, ___ vision, tremors, ___, glaucoma, ____, skin rash, ___, and pharyngitis (changes in vocal tone) may occur. mouth throat coughing anxiety eye blurred tachycardia hives stomatitis
Patients on nebulizers in the hospital are on a combination drug of ___ and ___. These are given together because they ____ each other and you can give ___ of the drug to have __ systematic effects. They are ____ drugs. Albuteral Atrovent potentiate less less synergistic
If your patient's inhaler has a cortisone in it, which increases the risk for ____, you will always have your patient ___ their mouth after because it can cause ____ or ____. infection rinse thrush stomatocytis
When administering Anticholinergic Bronchodilators, assess for difficulty ____ and for worsening of ___. Also, assess to see if it's expiratory or inspiratory ____; ____ is more of a beginning airway problem (in the ____). Assess ___ and how many liters o breathing bronchospasm wheezing stridor trachea O2 sat COPD dry blurred tachycardia retention constipation
Xanthine Bronchodilators relax smooth muscle, produce ___ stimulation, increase ___, stimulate ____ muscle, and inhibit ___ and the release of ____ and other agents that cause bronchoconstriction. They can also act as agonists on ___ receptors and induce CNS diuresis cardiac mast cell degranulation histamine adenosine respiratory control ventilatory
Xanthine Bronchodilators do not have the ____ that the anticholinergic drugs do. urinary retention
Xanthine Bronchodilators are administered ___, ___, or ____. Caution should be taken in patients with ___ disorders, ___ disease (because bronchodilators increase___ secretion), ____ disease (tachycardia), and ___ insufficiency. IV oral suppository seizure peptic ulcer HCl cardiovascular renal
What are two Xanthine Bronchodilators? Aminiphylline (Aminophylline) Theophylline (Theodur, Bronkodyl, Elixophylline, Uniphyl)
Aminiphylline (Aminophylline) is given via ___. It is monitored with ___ levels. IV serum blood
Theophylline is used in the prevention and treatment of bronchial ___ and the treatment of ____, ___, and ___. It is administered slowly over ___ minutes (can cause fatal acute ____ failure). It has a ___ therapeutic index, which means that it has a ___ r asthma bronchitis emphysema COPD 20-30 circulatory low higher drug C
Theophylline Toxicity results in ___ and cardiac ___. There is no specific ___. The only way to relieve this is to treat the ___. It is important to check ___ levels. seizures dysrhythmias antidote symptoms drug
Leukotriene Antagonists inhibit the ___ receptors and block ____. Thus, they interfere with the formation of substances that cause ____ and ___ bronchial airways. They reduce ___, ___ secretion, and ____ associated with asthma. Leukotrienes normally provo leukotriene lopoxygenase mucus plugs constrict inflammation mucus bronchoconstriction bronchoconstriction
Leukotriene Antagonists are used more for ___-related asthma because of the inflammatory process that occurs. allergen
Leukotriene Antagonists are used for the treatment of ____ to ____ persistent asthma to improve response to treatment. They are also used for ____ and ____. They are often used in conjunction with ____. Caution should be taken with severe ___ disease and mild moderate bronchitis emphysema Beta2 agonists liver elderly upper respiratory
Give three examples of Leukotriene Antagonists: Montelukast (Singulair) Zafirlukast (Accolate) Zileuton (Zyflo)
Montelukast (Singulair) has fewer drug interactions. It is used for the treatment and prophylaxis of asthma in ___ and ___. It is also used for the treatment of seasonal allergic ____. Adverse effects include ___, GI distress, ___, cough, ___ pain, fever, adults children >1year old rhinitis headache weakness dental congestion rash B
What pregnancy category is Zafirlukast (Accolate)? B
What pregnancy category is Zileuton (Zyflo)? C
Nursing Process and Patient Teaching for Bronchodilators: -Monitor ____: ___ pulse, ___, respirations, ____, pulse ox, ___ sounds (especially if it's a Beta2) -Monitor ___ to look at acid-base balance; monitor ___, ___ cultures, ___ levels (also S&S o vital signs apical BP temperature breath ABGs electrolytes sputum theophylline liver drug respiratory GI dry blurred tachycardia retention constipation CNS sleep tremors I&O diuresis cardiovascular
Nursing Process and Patient Teaching for Bronchodilators: -Teach patient use of ___, dose metered ___, ___ and deep ____, __ therapy and precautions, and S&S of ____ distress.
Antiasthmatic drugs are used as ____ antiasthmatic treatment. They are not used for ____. prophylactic acute attacks
List three examples of Antiasthmatic drugs: Mast cell stabilizers (bc of the inflammatory process) Anti IgE monoclonal antibody Respiratory glucocorticoids
Mast Cell Stabilizers are anti-inflammatory agents that inhibit the release of ___ (which usually causes swelling), ____, and other intermediaries of ____ from the mast cells, macrophages, and other cells related with asthma. They have no ____ effect, so histamine leukotrienes inflammation bronchodilating
Give an example of a mast cell stabilizer: cromolyn sodium (Intal)
Cromolyn Sodium (Intal) is used for the prevention of ____ and bronchial ____. It is contraindicated in ___ attacks, ____, and ____. Its onset of action is within ____; it is not prescribed for PRN use. bronchospasm asthmatic attacks acute pregnancy lactation 4 weeks
Adverse effects of Cromolyn Sodium (Intal) include ___, hoarseness, dry ___ or ___, nasal ___, diarrhea, ___, worsening of bronchospasm, ___ and ___, ___ taste in mouth after using the inhaler (have patient rinse mouth), and ___ pain. cough mouth throat congestion myalgia hypoxia hypoxemia bad gastric
What is the difference between hypoxia and hypoxemia, and how do you monitor each? hypoxia is low oxygen in the tissues; it is monitored with O2 sat hypoxemia is low oxygen in the blood; it is monitored with ABGs
What is an example of an Anti IgE Monoclonal Antibody? Omalizumab (Xolair)
Omalizumab (Xolair) is an ___ antibody derived from DNA technology that binds IgE receptor sites to the ___ cells. It is administered via regular ___ injections every ___ weeks, based on IgE levels. It is not effective in treating ____. It is used for pat IgG mast SQ 2-4 acute asthma attacks severe allergic
Omalizumab (Xolair) is used for the treatment of ___ to ___ asthma not responding to high doses of inhaled ____ and other drugs. Adverse effects include local ____ at the injection site, headache, ____ pain, fatigue, and increased risk for ___ or ___ infe moderate severe corticosteroids irritation joint viral respiratory
The Black Box Warning for Omalizumab (Xolair) is ___. This occurs typically when first initiated. If the patient has been on it, the risk ____. You will see the greatest allergic reaction when giving the ___ dose because the patient's body has made ___ ag anaphylaxis decreases second antibodies
The mechanism of Respiratory Glucocorticoids is only partially understood; it involves the suppression of ___ formation responsible for triggering the asthma attack. It also inhibits the synthesis of ___, which in turn decreases ____ and ___ production. I antibody leukotriene bronchoconstriction mucus adverse
Respiratory Glucocorticoids are used for ___ treatment, or whenever feasible in an alternate-day schedule of ___ treatment doses. Any time you have a patient on corticosteroids, you typically have to ___ them off of them because when you give a patient co short-term tapering titrate cortisol adrenal crisis
Respiratory Glucocorticoids are used for the treatment and prophylaxis of severe, persistent _____. They are not used as the sole treatment for acute ____. ____ corticosteroids produce fewer systemic effects because they go to the lungs. Teach the patient bronchial asthma bronchospasms Inhaled rinse absorption candidiasis
Respiratory Glucocorticoids -Beclomethasone (Vanceril, Beclovent) -Prednisone (Deltasone) -Inhaled Corticosteroids -Budesonide (Pulmicort) -Flunisolide (Aerobid) -Fluticasone (Flovent) -Triamcinolone (Azmacort) ...
Your patient is taking a long-acting anticholinergic inhaler in addition to an inhaled corticosteroid; which one do you administer first? The anticholinergic inhaler should be administered first to dilate so that there will be more surface area for the corticosteroid to penetrate; they are usually given 15-20 minutes apart
Nursing Process and Patient Teaching for Antiasthmatic Drugs: -Monitor vital signs including ___ sounds, ___ effort, ___, and ___ -Monitor ___ results (mast cell stabilizers) and appropriate ___ data if patient is on high doses of corticosteroids -Mo breath respiratory pulse ox temperature ABG lab CBGs drug
Nursing Process and Patient Teaching for Antiasthmatic Drugs: -Teach adverse effects of ____, appropriate ___, and prevention of ___ -If chronic use of corticosteroids, the patient needs to wear a ___ device -Teach the patient how to prevent ___ insu corticosteroids care complications medical alert adrenal osteoporosis asthma attack
Patients on antiasthmatics have a higher risk for ____ because corticosteroids decrease bone density osteoporosis
Created by: hkrawietz



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