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respiratory med usm
respiratory meds, nursing, pharmacology, usm
| Question | Answer |
|---|---|
| When giving patient Rimfampin teach them what | Tears, saliva, vaginal secretions—everything will be orange red .. Tell the patients this information, wear protective garments |
| Glucocorticoids – Action, | suppress histamine and other prostaglandins, inhibit COX-2, suppress phagocytosis & lymphocytes |
| suppress histamine and other prostaglandins, inhibit COX-2, suppress phagocytosis & lymphocytes | Glucocorticoids – Action |
| Hypersensitivity reaction give what | steroids to suppress the histamine |
| Glucocorticoid drugs | Ex: prednisone, decadron, celeston |
| prednisone, decadron, celeston are used for | severe inflammation; asthma, Ca, arthritis |
| if you have severe inflammation; asthma, Ca, arthritis what will you take | glucocorticoids |
| Side effects seen in Glucocorticoids | adrenal suppression, hyperglycemia, mood changes, cataracts, PUD, electrolyte changes, osteoporosis, wt gain ( cause the sugar) , bruising |
| Asthma patient who is taking glucocorticoids will have | bruising |
| Drugs of coice for long tierm prophylaxis of asthma | inhaled glucocorticoids |
| Inhaled glucocorticoids are taken | daily Systemic side effects rarely observed |
| Oral drugs Glucocorticoids are used for | short-term therapy of severe, acute asthma |
| Oral Glucocorticoid therapy should last | Limit therapy to under 10 days |
| When givien glucocorticoids | Take with food – gi upset ,Watch for infections-Reverse isolation |
| When givien glucocorticoids Monitor for | blood sugar & BP ( make sure its not going up) Cushing’s: moon face, etc |
| When taking glucocorticoids and discontinuing | Don’t abruptly discontinue |
| Glucocorticoids are Contraindicated in those | w/ impaired immune function (hiv – if it outweighs the risk or cancer patient) |
| May impair Growth & Development (short and typically get a pot-belly) | glucocorticoids |
| Intranasal Glucorticoids side effects | Less Ses – right into nasal instead of systemically |
| Intranasal glucorticoids | Flonase, Nasonex |
| allergic rhinitis use what drugs | intranasal glucorticoids |
| Action: decreases local inflammation in nasal passages, thus reducing nasal stuffiness | intranasal glucorticoids |
| Action of intranasal glucorticoids | decreases local inflammation in nasal passages, thus reducing nasal stuffiness |
| When using Intranasal Glucorticoids … | Make sure the nasal mucosa is intact ,Lay back , 1-2 sprays each nostril |
| Blocks H1 receptors | antihistamines |
| Used for allergies | antihistamines |
| First generation antihistamine… | usually have more sedation effects |
| Example of a first generation antihist. | Ex-Benadryl |
| Second generation sedation, side effect…. | usually have very little sedation, can make jittery if you take it too close together from last time that you took the meds. |
| Second generation antihistamine examples : | Ex-Zyrtec, Claritin |
| Antihistamines warn patients of side effects such as : | SEs: drowsiness; occasionally, paradoxical CNS stimulation and excitability ,May cause photosensitivity |
| drowsiness; occasionally, paradoxical CNS stimulation and excitability ,May cause photosensitivity are side effects of | antihistamines |
| Antihistamines have what other effects : | anticholinergic effects : dry mouth, tachycardia, mild hypotension |
| Tell your patient when taking anithistamines to avoid… | other CNS depressants |
| When should you use antihistamines ? | Adm prior to initiation of symptoms if possible – take when you know you might have allergic reactions. |
| Sympathomimetics are also known as | Decongestants |
| Sympathomimetics action is .. | Action: stimulates alpha-adrenergic receptors in sympathetic nervous system |
| Action: stimulates alpha-adrenergic receptors in sympathetic nervous system | sympathomimetics |
| Decongestants do what ? | Causes arterioles in nasal passages to constrict ; Dries mucous membranes |
| Sympathomimetic drugs are | Afrin, Primatene, Sudafed |
| Afrin, Primatene, Sudafed are what .. | decongestants , sympathomimetics |
| Side effect of Afrin | – rebound nasal congestion, |
| Primatene has led to | heart attacks |
| If you have nasal congestion need to use | sympathomimetic / decongestant |
| : rebound congestion is a side effect of | sympathomimetic/ decongestant |
| Mostvpeople like the decongest. Cause | it opens up right away. |
| Sympathomimetics Nursing Implications | Only use for 3-5 days |
| Don’t give sympathomimets to what patients | Don’t give with HTN pts, increase pressure |
| The patient has been prescribed oxymetazoline ( afrin) The nurse understands that … | The most serious side effect is rebound congestion |
| Which group of drugs mimic the SNS | beta agonist bronchodilators |
| Selective beta agonist bronchodilators are | Ex- Albuterol, Xopenex, Serevent, Advair |
| The action of Beta agonist bronchodilators | Action-Stimulates beta2 increasing cAMP causing bronchodilation |
| Action-Stimulates beta2 increasing cAMP causing bronchodilation | beta agonist bronchodilators |
| Which drug would you use for acute issue of asthma | Albuterol – acute issues, I need help now, may be included in maintenance, stimulates beta 2 |
| Which beta agonist bronchodilators comes only as a nebulizer | Xopenex – maintenance, only comes in a nebulizer |
| Beta agonist bronchodilators that are used for maintenance | servernt, advair |
| Nonselective Beta agonist bronchodilators drugs | Epinephrine (short half-life) |
| Beta agonist bronchodilators action | Action-Stimulates beta1 and 2 relaxing smooth muscle and dilates trachea w/t the release of cAMP; more cardiac SE |
| Action-Stimulates beta1 and 2 relaxing smooth muscle and dilates trachea w/t the release of cAMP; more cardiac SE | Beta agonist bronchodilators |
| When giving Beta agonist bronchodilators what effect will happen and what will you have to do | will have cardiac effect, may have to balance out tachycardia – such as injection of a beta blocker, lidocaine, |
| Beta agonist bronchodilators are Contraindicated in patients with | cardiac problems already |
| Beta Agonist Bronchodilators Most effective drugs for relieving | acute bronchospasm |
| bronchial asthma, bronchitis, bronchospasm, and pulmonary diseases you will need | Beta agonist bronchodilators |
| Can be used for both quick relief and long-term control | Beta agonist bronchodilators |
| The patient is using beta agonist for treatment of asthma. The nurse teaches that the action of this drug is : | relaxing bronchiole smooth muscle, thereby causing bronchiodilation |
| Beta Agonist Bronchodilators side effects are | SE-tachycardia, palpitations, HTN, anxiety |
| Do not give Beta agonist bronchodilators w/ … | MAO inhibitors-HTN crisis |
| Inhaled Corticosteroids drugs | EX-Beconase, Flovent |
| Action of inhaled corticosteroids | Stabilizes cells that release bronchoconstricting substance histamine; Neutrophil stab. preventing the inflamm. response (prevents broncocons. mucosal edema, secretions; Prevent the release of prostaglandins, leukotrienes, & interleukins Mobilizes cilia |
| Action Neutrophil membranes are stabilized preventing the inflamm. response (prevents broncoconstriction, mucosal edema, secretions) | inhaled corticosteroids |
| Action : Prevent the release of prostaglandins, leukotrienes, & interleukins | inhaled corticosteroids |
| Inhaled corticosteroids are used for- | chronic asthma (prophylactically and actute) bronchospasm disorders COPD bronchiis cystic fibrosis |
| If you have chronic asthma (prophylactically & acutely), bronchospasm disorders, COPD, bronchitis, cystic fibrosis you will use | inhaled cortico. |
| Side effects of inhaled corticosteriods | less likely : cushings, oral candidda, impaired growth and development and wait gain |
| Side effect of cushing’s | inhaled corticosteroids |
| Nursing Implications for inhaled corticosterioids | Teach proper use of inhaler, Rinse mouth after use |
| Inhaled Corticosteroids are contraindicated in who | Do not give to immune compromised pts (unless benefits outweigh the risk |
| When giving corticosteroids you will Monitor.. | glucose levels & for bleeding |
| When stopping Inhaled corticosteroids .. | Do not abruptly stop |
| Mast Cell Stabilizers drugs are | EX-Cromolyn |
| Cromolyn is | Mast cell Stabliizers |
| The action of Mast Cell Stabilizers | Action-inhibits mast cells from releasing histamine thereby reducing inflammation |
| Action-inhibits mast cells from releasing histamine thereby reducing inflammation | mast cell stabilizers |
| Mast cell stabilizers are use for | asthma |
| SE-bronchospasm (not ideal for someone with problems already), anaphylaxis are side effects of | mast cell stabilizers |
| What group of drugs is administered 4-6 times daily d/t short half life | mast cell stabilizers |
| Leukotriene Modifiers are | Ex-Singulair, Accolate |
| Singulair and Accolate are | leukotriene modifiers |
| Action-Blocks leukotriene-mediated bronchoconstriction that decrease bronchial edema & inflammation | leukotriene modifiers |
| leukotriene modifiers | Action-Blocks leukotriene-mediated bronchoconstriction that decrease bronchial edema & inflammation |
| Leukotrienes are released in.. cause ? | an allergic reaction & cause inflammation, bronchoconstriction, & mucus production |
| Leukotriene Drug’s effects are only seen | in the lungs ; Inflammation blocking is only seen in the lungs, and not systemically like in the steroids so the sideeffects and immunosupression isnt seen as much |
| Leukotriene ModifiersUses- | Decrease severity & frequency of asthma attacks (prophylaxis, not acute episodes) |
| How quick should you see improvements after using leukotriene modifiers | one week |
| Leukotriene Modifiers such as Acculate take | 1 hour ac or 2 hours pc (after meals) |
| Leukotriene modifiers is given how and how often | Give PO; Only have to take once a day! |
| Anticholinergics drugs | EX-Atrovent, Spriva (pill crushed, powder inhaled) |
| Spriva and atrovent are | Anticholinergics |
| Anticholinergics action is | Action-inhibit bronchoconstriction mediated by the PNS (parasympatetic nervous system) |
| Action-inhibit bronchoconstriction mediated by the PNS (parasympatetic nervous system) | anticholinergics |
| Anticholinergics are used for | asthma and other obstructive pulmonary diseases |
| SE-palpitations, anxiety, urinary retention are side effects seen in what kind of drugs | anticholinergics |
| When taking anticholinergics constipation may occur so | increase fiber before |
| When teaching pt taking anticholinergics tell them to report | Understand to what to report urinary retention and constipation |
| anticholinergics dry things up which cause | (dry mouth, constipation, urinary retention) |
| When taking anitcholinergics to help with Dry mouth, | gum or hard candy can help |
| Anticholinergics are Most effective when used in | combination with beta-agonist Ex: Combivent (albulterol, atrovent) |
| A 65 year old male is prescribed ipratropium (atrovent) for the treatment of asthma. An appropriate nursing intervention includes: | Teach patient to report an inability to urinate |
| Xanthines drugs are | Theophylline (Theobid, Theo-dur), amiophylline |
| Ex-Theophylline (Theobid, Theo-dur), amiophylline are | Xanthines |
| The use of Xanthines is for | Uses-COPD, apnea in infants, Cheyne-Stokes respiration, pulmonary edema, prevention of asthma attacks, status asthmaticus |
| COPD, apnea in infants, Cheyne-Stokes respiration, pulmonary edema, prevention of asthma attacks, status asthmaticus need to take | Xanthines (theobid, Theo-dur) |
| Xanthines Action | Inhibits phosphodiesterase (PDE) that breaks down cAMP increasing cAMP amts |
| Xanthines result in | bronchodilation d/t smooth muscle relaxation; increases catecholamine levels, inhibits Ca movement into smooth muscle, inhibits prostaglandin synthesis, & inhibits bronchoconstrictive substances from leukocytes & mast cells |
| Xanthines therapeutic index is | *(10-20mcg/ml)-monitor levels |
| Xanthines *Toxicity s/s | -seizures, dysrhythmias, restlessness, N/V |
| Smokers and children may need higher doses of | xanthenes |
| Increase hydration in patients taking and why | xathines ; Help the meds work faster, increase renal excretion and prevent side effects in the kidneys |
| Combivent combo of | Atrovent+Albuterol |
| Solumedrol is a | Corticosteroid |
| Solumedrol is Given | IV-sort of like IV prednisone |
| When giving Solumedrol | Stop all other corticosteroid during therapy; Don’t stop aburptly |
| Which of the following agents is most immediately helpful in treating a severe asthma attack: | Albuterol (proventil, ventolin) |
| Expectorants drugs | Ex-guaifenesin (Robitussin, Mucinex) |
| Mucinex, robitussin, guaifenesin are | expectrants |
| Expectorants action is | Action-increase fluid flow in the resp tract & reduce viscosity of secretions to aid in removal of secretions through coughing & ciliary action |
| Action-increase fluid flow in the resp tract & reduce viscosity of secretions to aid in removal of secretions through coughing & ciliary action | expectrorants |
| What drug is Used - nonproductive cough associated w/ colds, bronchitis, laryngitis, flu | expectorant |
| 30 in after taking expectorant | Avoid drinking liquids for 30 min after adm |
| Antitussives drugs | Opioids-codiene, hycodan ; Nonopioids-tessalon perles (dry hacky cough) |
| Antitussive Action- | suppress cough reflex by directly suppressing the cough center in the medulla |
| suppress cough reflex by directly suppressing the cough center in the medulla | antitussive |
| What med is used to treat a nonproductive cough | Uses-nonproductive cough |
| Should not operate machines when taking which drug | (opioid antitussive ) |
| Do not drink for 30 min after taking | antitussive |
| If your going to give a kid antitussive give them when | this give it to them at night to let them sleep; because they need to cough |
| When taking antitussives don’t take with | other CNS depressants with, |
| Mucolytic Drugs | EX-Mucomyst (acetylcysteine) |
| Mucomyst | mucolytic |
| Mucolytic drugs action | liquefies mucus in respiratory tract; also increases renal excretion |
| liquefies mucus in respiratory tract; also increases renal excretion | mucolytic |
| mucolytic are used for | resp tract infections; Tylenol OD; post IVP dye adm (protects the kidneys) |
| PO or inhalation (smells terrible – rotten eggs) | mucolytic |
| Rinse out mouth after inhalation to decrease irritation | mucolytic |
| What drug Binds with tylenol and helps you excrete it | mucolytic |
| TB Drugs | EX-isoniazid (INH) |
| Isoniazid Action- | inhibitor of mycolic acids involved in cell wall synthesis and also block pyridoxine (vit b6) use in intracellular enzymes |
| Cant drink alcohol cause it will make you sick to your stomach when taking this med | TB drug - isoniazid |
| TB Drugs Isoniazid used for | Uses-tx or prophylaxis |
| Side effects of Isoniazid | SE-peripheral neuropathy(numb,tingling-report this explain what it is to the patient) make sure that they are taking the b6 vitamins for this reason, low B6 levels –explain why they are taking |
| Hepatotoxic – jaudice, bloating in belly is a side effect of .. | isoniazid |
| When giving tb drugs | Give with B6 |
| Teach patient when taking tb drug – isoniazid | take every dose without missing a dose important , report peripheral neuropathy, take b6 |
| Rifamycins-rifampin is not only given for tb also for | pneumonia of some form. |
| Rifampin Action- | inhibits DNA-dependent RNA polymerase stopping gene transcription and protein synthesis |
| inhibits DNA-dependent RNA polymerase stopping gene transcription and protein synthesis | rimfampin |
| RimfampinUses- | TB and Neisseria meningitdis |
| SE-turns body fluids orange-red which drug ? | Rimfampin |
| When giving patient Rimfampin teach them what | Tears, saliva, vaginal secretions—everything will be orange red .. Tell the patients this information, wear protective garments |
Created by:
ameliarae
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