Question | Answer |
Hydrocodone | Antitussive
Narcotic
Control dry, non-productive cough |
Another antitussive aside from hydrocodone | Dextromethorphan |
AE of antitussives | respiratory depression
dizziness
dry mouth |
Flunisolide (AeroBid) | Topical Nasal Steroid Decongestant- decreases inflammatory response, reduces edema |
AE of topical nasal steroid decongestants | Inc risk for infection
local burning, stinging, dryness, rebound congestion!
Topical doesn't cause ^BP, but systemic does |
Diphenhydramine (Bendadryl) | Antihistamine
Used for allergies, seasonal rhinitis, upper respiratory congestion, sleep aid |
AE of diphenhydramine | Anticholinergic SE: dry mouth, urinary retention, drowsiness, sedation, bradycardia, constipation
Caution with arrythmias, cardiac pt |
PT teaching for diphenhydramine | Drowsiness may occur, caution in driving and using machinery. Fall risk, esp in elderly pt. |
Guaifenesin (Mucinex) | Expectorant
For: increasing productive cough
irritates gut muscles
Reduces adehesiveness of mucus by reducing surface tension |
AE of expectorants | GI effects, N/V |
Acetylcystine (Mucomyst) | Mucolytic
Liquify secretions to increase productive cough
Reduce viscosity of mucus to make it easier to bring up
Usually only used in hospital with impaired fxn pt (stroke, elderly) |
Six lower respiratory problems | COPD
Asthma
ARDS
Atelectasis
Pneumonia
Bronchitis |
Xanthines | (-phylline)
bronchial smooth muscle dilators
Do not use with liver dsyfxn
Used for COPD |
Epinephrine (Sus-Phrine) | (-rine) (-terol)
Sympathomimetic
Used for acute anaphylaxis, acute asthma attack, acute bronchospasm from COPD/asthma/allergy |
AE of epinephrine | Sympathomimetic effects: increased HR, BP, RR, tachycardia, restlessness
Decreased effect of beta-blockers |
Beta 2 Agonist Inhaler | Albuterol
Used for long acting treatment and prevention of bronchospasm
(doesn't work to treat bronchospasm caused by non-specific beta blockers!) |
AE of Albuterol | Sympathomimetic effects
If taken in combo with long acting Beta 2 agonist like Foradil could cause tachycardia) |
Budesonide (Pulmicort) | Inhaled Steroid (also Beclomethasone)
Decrease inflammatory response in airway so cause to open more |
AE of inhaled steroids | Increased risk for infection
Possible fungal infection in mouth and larynx
Local effects from inhalation like sore throat, coughing, dry mouth |
Pt teaching for inhaled steroids | Always wash with alcohol based mouthwash immediately after inhaling-prevent fungal infections |
Predosone | Systemic steroid used also for Asthma
Decrease inflammatory response
AE: inhibits prostoglandin, which inhibits mucus formation so possible ulcer! Often put on prophylactic proton pump inhibitors |
Zafirlukast | Leukotriene Receptor Antagonist (-lukast)
Decreases inflammatory response
Used for asthma and allergy in adults and CHILDREN OVER 5
Blocks SRSA |
AE of leukotriene receptor antagonists | Increased risk for infection
increased liver enzymes
headache, dizziness, nausea, myalgia, diarrhea, abd. pain |
Drug-drug interactions with leukotriene receptor antagonists | Warfarin (anticoagulant)
Ca+ channel blockers (BP meds)
propanalol (Beta blocker!)
Theophylline (Xanthene!)
cyclosporine (Immune suppressant)
Asprin (Salicylate) |
Cromolyn | Mast Cell Stablizer
Used for asthma and allergy
Prevents release of inflammatory and broncho-constricting substances
Can be used prophylactically |
AE of cromolyn | swollen eyes, nausea, dry mouth, tachycardia, headache |
(-tropium) | Anticholinergics
Block vagal nerve mediated response
causes bronchodilation
Causes anticholinergic SE (so like sympathomimetic effects) |
What is a normal potassium level? | 3.5-5 |
What is a normal sodium level? | 35-45 |
What are the five classes of diuretics? | 1.Thiazide and thiazide-like
2. loop diuretics
3.Osmotic diuretics
4.Potassium-sparing diuretics
5.carbonic anhydrase inhibitors |
Hydrochlorothiazide | Thiazide diuretic (all end in (-thiazide)
Inhibits reabsorption of Na+ and CL- at distal tubule. Leads to increased secretion of Na and Cl and H2O
Used for hypertension |
AE of thiazide diuretics | nocturia
muscle cramps/spasms
possible electrolyte imbalance-esp. hypokalemia!
orthostatic hypotension
dry mouth |
Furosimide (Lasix) | Loop Diuretic
Inhibits reabsorption of Na and Cl from Loop of Henle and distal tubule
Leads to Na excretion and H2O excretion |
Caution with Lasix: | Sensitivity to sulfa drugs may have rx with lasix |
AE of loop diuretics (Lasix) | Possible HYPERglycemia
Orthostatic hypotension
rash
glycosuria |
Mannitol | Osmotic diuretic
Elevates osmolarity of glomerular filtrate, leads to loss of H2O, Na and Cl |
AE of osmotic diuretics | thirst
fluid and electrolyte imbalance, HYPOtension, risk for tachycardia, arrythmias |
Spironolactone (Aldactone) | Potassium-Sparing Diuretic
blocks effects of aldosterone in renal tubule, causes loss of Na and retention of K+ |
AE of potassium sparing diuretics | HYPERkalemia, irregular menses, gynocomastia, hirsutism & deepening of voice (in women), menstrual disturabances |
Acetazolamide (Diamox) | Carbonic Anhydrase Inhibitors
used for mt. sickness and glaucoma
Not used often cause of SE |
AE of carbonic anhydrase inhibitors | Bone marrow suppression, renal calculi, weakness, fatigue, rash, urinary frequency |
SE of all diuretics | Urinary frequency, possible fluid and electrolyte imbalance |
Oxybutynin (Ditropan) | Urinary tract antispasmodic: used for severe UTI with spasms |
AE of urinary tract antispasmodics | Similar to anticholinergic-drowsiness, dizziness, dry mouth, urinary retention, blurred vision |
Doxazosin (Cardura) | Treatment for BPH (alpha 1 selective adrenergic blocking agent-also used for hypertension)
Causes dilation of arterioles, decreased sympathetic effects on bladder |
AE of Doxazosin | SIGNIFICANT orthostatic HYPOtension!
CHF, edema, arrythmia
Do not give with other vasodilators! |
Dopamine | Alpha and Beta Adrenergic Agonist
Also norepinephrine
Used for SHOCK, bronchospasm, severe acute asthma
titrated to cardiac output
Caution: do not allow extravasation |
Contraindications for dopamine | pheochromocytoma, PVD, hypovolemia, tachyrythmias, OTC cold and allergy meds |
What to monitor when giving dopamine | Renal, liver, serum electrolytes, I&O, VS, ECG, light exposure (optical prep)
void prior to admin to avoid urinary retention |
AE of dopamine | CNS effects: dizziness, confusion, headac
Bradycardia, arrythmia, severe orthostatic hypotension
Bronchospasm, respiratory distress |
Phentolalamine | Non-specific alpha adrenergic blocker
Use to minimize tissue damage from extravasation |
SE of phentolalamine | prolonged and acute hypotensive episodes
tachycardia
arrythmias |
Propalanlol (Inderol) | Beta-Adrenergic Blocker
Used for HYPERtension, angina, migraines
(anxiety in public speaking) |
SE of Nonselective beta blockers | bradycardia, arrythmia, bronchospasm |
Drug -drug interactions of Propanalol | Insulin/antidiabetic meds
Clonadine
NSAIDs |
Contraindications for nonselective beta blockers | Do not give to diabetics, people baseline bradycardia (athletes), COPD, asthma (causes bronchospasm) |
Beta-1 SElective Blockers | Metapropalol, Atenalol
Used for HYPERtension, angina, glaucoma |
Contraindiactions for Beta-1 selective blockers | COPD, thyroid disease, sinus bradycardia, CHF, hypotension |
Dr-dr interactions with beta1 blockers | NSAIDs
injectible lidocaine |