SPC Respiratory Pharm Final
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| What are the Diuretic Drugs? | Lasix, Mannitol, and Diamox
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| Lasix | Diuretic, Fast onset, Loss of Potassium resulting in excretion of hydrogen ions which results in a metabolic ALKALOSIS
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| Mannitol | Osmotic diuretic, slow, gentle, spares electrolytes, tx of head trauma to reduce intracranial pressure
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| Diamox | Diuretic promotes Metabolic ACIDOSIS by the loss of HCO3(BiCarb)
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| Sedative/Hypnotic/Narcotic drugs | Ativan, Diprivan, Narcan, Haldol, Demerol, Dilantin, Compazine, Morphine Sulfate, Versed, Valium
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| Haldol | Tx of Dt's & highly agitated states
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| Dilantin | Prevent seizures, makes pt sleepy
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| Compazine | Tx of nausea
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| Versed | Short acting sedative/hypnotic, used during short-term procedures.
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| Diprivan | Sedative/hypnotic, dose dependent, fast onset, quick recovery, IV drip for continuous sedation.
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| Ativan | Anti-anxiety, pre-op med
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| Valium | Tx of occurring seizure
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| Morphine Sulfate | Narcotic analgesic, reduces drive to breathe by lowering sensitivity to CO2, relaxes smooth muscle surrounding blood vessels which drops preload & may drop BP, reduces work of heart.
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| Demerol | Narcotic analgesic
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| Narcan | Antidote for narcotic & barbiturate overdose.
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| ASA(Asprin) | Non-narcotic analgesic, avoid w/viral symptoms (fever, side aches) may worsen asthma by dropping PGE levels & promoting airway spasms.
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| COX2 Inhibitors | Non-narcotic analgesic, given for pain
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| Atrovent(Ipratopium Bromide) | Anticholinergic, Neb dose is 0.5mg, MDI not for those with soy or peanut allergy.
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| Spiriva(Tiotropium Bromide) | Anticholinergic, DPI, long-lasting anticholinergic 24-36hrs
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| Anticholinergics | Promote bronchodilation in the LARGER airways. Prevent parasympathetic response (bronchoconstriction) by antagonist action of M3 receptor. Avoid mask therapy due to eye problems caused by dilation of pupils.
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| Combo Meds | Advair DPI, DuoNeb, Combivent
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| Advair DPI | Slow onset, mtce med, sympathomimetic w/ steroid
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| DuoNeb | Anticholinergic Atrovent(Ipratropium Bromide) w/ sympathomimetic Albuterol Sulfate, dilates upper & lower airways.
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| Combivent | MDI, anticholinergic ipratropium bromide & sympathomimetic albuterol sulfate, NOT for those with soy/peanut allergies.
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| Glucocorticoids | Stops all inflammation, takes hours for onset. Enhances and promotes Beta response. Problems: promotes metabolic ALKALOSIS, mood swings, fat deposits, hair growth, atrophy of adrenal glands.
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| Leukotrienes (LT) Inhibitors | Reduce/prevent inflammation response associated with asthma.
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| Anticholinesterase Meds | Act by promoting acetylcholine by inhibiting acetylcholinesterase which is the enzyme that breaks down acetylcholine.
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| Sympathomimetic Side-Effects | B1(cardiac): ^HR & contraction strength, B2(lungs): Tremors/Nausea
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| Sympathomimetics | Adrenergic bronchodilators that stim B2 receptor & promote dilation in smaller airways, inhibit prod of inflammatory mediators.
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| Racemic Epinephrine | Fast catecholamine, A1, B1 & 2 agonist. Dose 0.5ml, for tx of upper airway edema.
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| Albuterol Sulfate (Ventolin, Proventil) | 5mg/ml - onset up to 15 min.
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| Xopenex | Racemic albuterol, pure R isomer, 2 strengths, lower B1 activity which means lower incidence of tachycardia & less B2 effects which means a lower occurrence of tremors.
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| Brovana (arformoterol) | Long lasting 12hr sympathomimetic
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| Foradil(formoterol) | DPI, long-lasting sympathomimetic, 12hrs.
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| Mucomyst(n-acetylcysteine) | Mucolytic, disrupts mucus viscosity & elasticity, airway irritant, re-eval every 3-5 days, toss after 96hrs of opening.
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| Pulmozyme(Dornase Alpha) | Proteolytic, tx of infectious mucus(pneumonia), noted by purulent secretions, refrigerate after opening, toss if cloudy or discolored, HCW should avoid breathing this med, often used with CF pts.
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| Methylxanthines | Inhibits bronchoconstriction, reduces PVR/dilates pulmonary blood vessels, enhances diaphragm contraction & endurance. Side-effects: improvement of resp drive, anxiety, irritability, insomnia, twitching, tremors, seizure.
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| Lidocaine | Used during bronchoscopy to prevent spasm, tx PVC(cardia arrythmia), admin as an IV drip.
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| Dobutrex | +INO, improves stroke volume by B1 stimulation
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| Digitalis | +INO, improves stroke volume by promoting free Ca+ for contraction.
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| Nitrates | Vasodilators reduce pre & after loads while improving coronary perfusion by dilation of coronary arteries.
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| Dopamine | High dose: vasopressor for tx low BP(shock) Moderate dose: B1 effects, Low dose: dilates renal vessels which promotes urine output = diuretic.
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| Oxygen | Non-flammable, non-explosive, promotes rapid combustion, will reduce PVR when it is secondary to low PAO2.
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| SSKI (Potassium Iodide) | Reduces mucus elasticity.
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| Calcium Channel Blockers | Tx of atrial arrythmias.
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| Singulair(Montelukast) | LT receptor agonist.
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| Tensilon | Dx & Tx of Myasthenia Gravis.
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| Aminophylline | A methylxanthine
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| Lidocaine overdose | Causes methemoglobin which darkens the arterial blood which changes skin color to gray/dusky appearance due to the low O2 content, may also cause seizure.
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