Respiratory Medications
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| What is best med for Bacterial Pneumonia and Haemophilus influenza? | 3rd Generation Cephalosporin
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| 1st Line meds for TB | INH, Rifampin, Ethambutol, pyrazinamide
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| 2nd Line meds for TB | Capreomycin, ethionamide, cycloserine
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| How long should you take TB drug therapy? When is best time to take meds? | 6-12 months
on empty stomach or 1h b4 meals
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| Isoniazid(INH) side effects? What is administered with INH to prevent peripheral neuropathy? | peripheral neuritis,hepatitis
With INH: Vitamin B(pyridoxine)
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| Rifampin(Rifadin) SE? | hepatotoxicity, vision changes, orange urine/sweat/tears, fever, N/V
Increases metabolism of: beta blockers/anticoagulants/corticosteroids/oral contraceptives/theophylline/dig
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| Ethambutol(Myambutol) SE? | may lead to blindness, skin rash, use with caution with renal disease and monitor visual acuity
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| Pyrazinamide SE? | hyperuricemia(monitor uric acid), hepatotoxicity, skin rash, GI distress, arthralgias
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| IV antibiotics for lung abscess? Oral antibiotics taken when? | Penicillin -G or Cleocin for 3-5 days
oral: after IV for 4-8 weeks to prevent relapse
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| What irritating agent is aerosolized obliterate the pleural space to prevent fluid from accumulating in a pleural effusion | Talc or bleomycin
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| In Acute Respiratory Distress Syndrome(ARDS), if pt fights ventilator what meds should be given and in what order? | 1. Sedative: Propofol(Diprivan), midazolam(Versed), lorazepam (Ativan), haloperidol
2. Paralytic agent:Pavulon, Norcuron, Tracrium, Zemuron
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| What nsg mgmt should be given with a paralytic? | Reassure pt it is temporary, and given with sedative and pain meds, eye care, short duration
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| Flolan, Viagra, Tracleer, do what with Pulmonary Hypertension? | Flolan: given IV relaxes vascular smooth muscle and requires special training), Viagra(pulmonary vasodilation), Tracleer(oral vasodilator and antihypertensive), Remodulin Ventavis(inhaled)
Diuretics/anticoagulators
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| A pt has a PE, what will the nurse expect to give first? This is followed by what? | First, IV Heparin with PTT goal of 2-2.5xnorm then oral Coumadin(INR 2-2.5)followed: Lovenox(bubble last to go in)- **Heparin does not break up existing clots, prevents forming**
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| Sarcoidosis | Corticosteroids
Methotrexate (if steroids not effective)
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| A pt is dx with pulmonary fungal infections, what drug will need an exclusive IV line? What are alternative drugs? | Amphotericin B(4-12 wks)and give Benadryl 1h prior infusion
Nizoral, Diflucan, Ancobon
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| Name three short term beta2 adrenergic agonists used for COPD? | albuterol(Proventil, Ventolin): inhaler/nebulizer/oral/short
fenoterol(Alupent): i/n/o/s
terbutaline(Brethine): i/short
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| When are corticosteroids used with in a COPD pt? | for long term, not emergency
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| Name a smoking cessation drug? What antidepressants help with smoking cessation? What anti-HTN helps as well? | Varenicline(Chantix)
antidep: Wellbutrin, Zyban, Aventyl
anti-HTN: clonidine(Catapres)
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| For mild COPD what short acting bronchodilator might be prescribed? | albuterol(Proventil, Ventolin)
fenoterol(Alupent)
terbutaline(Brethine)
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| For severe COPD, what might be prescribed? | bronchodilator and inhaled corticosteroid or a combination drug like Symbicort or Advair diskus
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| What short acting anticholinergic agent is good for COPD? | Ipratropium bromide(Atrovent): inhaler or nebulizer
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| What methylxanthines are used for COPD and asthma? | Long term control and 2nd line:
theophylline(Theo-Dur, Slo-Bid) or aminophylline
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| Name two combination B2 agonist and anticholinergic agent for COPD | salbutamol/ipratropium(Combivent)
fenoterol/ipratropium(Duovent)
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| Name the quick relief short acting B2 agonists and anticholinergics for asthma | B2: albuterol(Proventil), levalbuterol (Xopenex), pirbuterol (Maxair), Alupent
antichol: iprotropium(Atrovent), Spiriva
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| what is most effective long term medication used in Asthma | Inhaled corticosteroids:
beclomethasone, fluticasone (Flovent), triamcinolone (Azmacort),
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| What sytemic IV corticosteroids help in asthma for short term "burst"? What long/short SE to watch for? | methylprednisolone(Medrol), prednisone
SE: BS and BP abnormalities, peptic ulcer.
long SE: growth suppression, Cushing's syndrome
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| These inhaled B2 agaonists are never used for acute asthma s/s or exacerbations, but good for preventing excercise-induced bronchospasms? | salmeterol(Serevent), formoterol (Foradil)
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| What are main side effects of inhaled corticosteroids for short term use? | cough, oral thrush, osteroporosis in high doses
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| What are main SE for short acting B2 agonists? | Tachy, muscle tremors, HA, hyperglycemia, dysrhythmias (esp in elderly)
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| 1. This long term Leukotriene Modifiers ________can only be given to pt >1yr? 2. _________ should not be given with Coumadin | 1. montelukast(Singulair)
2. zafirlukast(Accolate)
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| What is common tx for Status Asthmaticus | short B2 agonist +IV Systemic corticosteroid
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| What vitamins defends against free radicals with O2 toxicity? | Vitamins E, C, betacarotene
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| COPD: short acting: B2 agonist/anticholinergic combo | ipratropium bromide & albuterol sulfate (Combivent): inhale
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| What foods should be avoided with INH drugs? | Food containing tyramine and histamine(tuna, aged cheese, red winde, soy sauce, yeast extracts) and may cause HA, flushing, hypotension, palpitations, lightheadedness, diaphoresis
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| What is meant by primary resistance to TB drugs? | resistant to a first line agent with no previous tx
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| What is meant by secondary resistance to TB drugs? | resistant to one or more agents for pt undergoing therapy
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| If a pt is multidrug resistant to TB agents, which ones typically are included and what is recommended TB tx? | resistant to two agents: INH and rifampin, so begin TB tx with 4 or more meds
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| Indocin is classified as what type of drug? It is used for what lung condition? | NSAID for pain with pleurisy as pt takes deep breaths and coughs. Also used in newborns to close ductus arteriosus. Do you remember what keeps it patent? Prostaglandin E
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| Why is morphine given to a pt with pulmonary edema? | To reduce anxiety and pain and help the heart work less
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| How long should antibiotics be given with empyema? | 4-6wks to sterilize pleural cavity
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| When giving blood products to a pt with ARDS, what should the nurse look for? | fluid volume overload bc blood products have citrates which incr perfusion and causes body to take on more fluid.
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| What is main medical tx for Cor Pulmonale? | 24h O2 to improve gas exchange and reduce pulmonary hypertension
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| Name three thrombolytic drugs | urokinase, streptokinase, alteplase
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| Taxal is a toxic drug used to treat _______. Don't use if WBC is less than _______. _________ prevents Taxal from clearing body. | lung cancer, 1,000, Valium
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| Which type of cancer responds best to chemotherapy? | small cell ca
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| What is best tx for non-small cell ca? | pulmonary resection
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| Which is best med for nausea with Ca pts, Zofran or Phenergan? | Zofran, Phenergan best for pain
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| A pt with COPD is struggling to breathe what is a key medical management to give? | bronchodilators
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| When do you give more than 6L of O2 to a COPD pt? | Upon Dr. order and just til PaO2 is to at least 60mm Hg or sats are normal
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| How often is the flu vaccine given? How often is pneumovax given? | flu: every year
pneu: every 5 years
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