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pharm resp 3314
Pharm 3314 Respiratory
| Term | Definition |
|---|---|
| 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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