respiratory and endocrine drugs
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| Dextromethorphan (Robitussin, PediaCare) Antitussive | Drug Action: related chemically to opiate agonists. Affects cough center in medulla. C/P: chronic coughs like emphysema or asthma. Used with caution in patients with hepatic impairment or pregnant.
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| Dextromethorphan Adverse Effects | NV, drowsiness, dizziness, irritability, and restlessness. In excess causes symptoms similar to PCP.
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| Dextromethorphan and other drugs | with MAOIs-serotonin syndrome-nausea, hypotension, excitation, hyperpyrexia, possible comma. Can cause sedation with other CNS depressants.
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| Pseudoephedrine (Sudafed) decongestant | mimics SNS and causes vasconstriction of nasal mucous membranes. C/p: hypertension and coronary artery disease
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| Pseudoephedrine Adverse Effects | tension, anxiety, restlessness, tremor, insomnia, and weakness. palpitations, tachycardia, hypertension, and arrhythmias. Severe CNS reactions are hallucinations, delusion, and convulsions.
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| Pseudoephedrine and rebound congestion | drug effects wear off and nasal passages become congested. The body compensates by vasodilating.
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| Fexofenadine (Allegra) Second Gen Antihistamines | Blocks effects of histamine at H1 receptor sites. C/P: hypersensitive to drug. Children younger than 12. Pregnant or have renal impairment. Don't take with fruit juices like apple, orange, or grapefruit
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| Fexofenadine Adverse Effects | viral infection, nausea and vomiting, dysmenorrhea, drowsiness, dyspepsia, and fatigue. QT interval prolongation and tachycardias (rare)
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| Diphenhydramine (Benadryl) | first gen antihistamine so more sedative than Second Gen. blocks histamine.
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| Guaifenesin (robitussin) Expectorant | reduces adhesiveness and surface tension of fluids, thus making it easier to move less viscous secretions. C/P=hypersensitivity.
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| Guaifensin Adverse Effects and patient education | NV, anorexia, headaches or dizziness. Do not take longer than 1 week. Don't drink alcohol while taking this drug. Drink lots of water and use humidifier. Take small meals to prevent GI upset.
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| Acetylcysteine (Mucomyst) Mucolytic | Inhaled and liquefies thick tenacious secretions. splits disulfide bonds in mucous material. Protects liver cells from acetaminophen toxicity. C/P=hypersensitivity, asthma, peptic ulcers of esophageal varices
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| Acetylcystein adverse effects | bronchospasm, bronchoconstriction, chest tightness, burning feeling in upper airway, and rhinorrhea. less common-fevers, chills, drowsiness, and clammy skin.
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| Albuterol Beta Agonists-Bronchodilators | oral, liquid, or inhaler. 5-15 minutes inhaled 30 minutes orally. stimulates beta-2 receptors of smooth muscle in lungs, uterus, and vasculature which reduces bronchospasms. C/P=hypersensitivity, hypertension, cardiac disease, cardiac arrhythmias.
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| Albuterol Adverse Effects | RESCUE DRUG throat irritation, palpations, sinus tachycardia, anxiety, tremor, and increased blood pressure. Rare-bronchospasm, urticaria, angioedema.
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| Ipratopum Bromide (Atrovent) Anticholinergic | Decreases contractility of smooth muscle and thereby reduces bronchospasm.
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| Theophylline (Elixophyllin, Theo24) Xanthine Derivatives | direct effect on smooth muscles of resp tract. Natural occurring bronchodilators like caffeine. Inhibits release of histamine
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| Theophylline Patient Education | Don't take if allergic, reacts to caffeine, or breast feeding. Diet, OTC drugs and smoking can interfere with drug. Never chew or crush time release capsules. Take on empty stomach and AVOID CAFFEINE!
report headaches, insomnia, restlessness
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| theophylline patient education cont | report severe GI pain, vomiting, palpitations and convulsions. Can become toxic!-over 20mcg used in stress test
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| Flunisolide (AeroBid, AeroSpan) Inhaled Glucocorticoid Steroid, Anti-Inflammatory Agent | maintenance drug for asthma. inhibit production of leukotrienes and prostoglandins enhance responsiveness of beta receptors in airway smooth muscles, and decrease the production of mucous.
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| Flunisolide Adverse Effects | sore throat, hoarseness, coughing, dry mouth, and pharyngeal and laryngeal fungal infections. Dysphonia, orophanryngeal candida albicans infections common with daily use. may delay growth pattern in children.
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| Mast cell stabilizers cromolyn sodium (Intal) | Inhibits mass cell rupture and degranulation. So decreases histamine and symptoms associated with histamine. NOT a bronchodilator. caution patients who have known intolerance to lactose.
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| Leukotriene receptor antagonists zafirlukast (Accolate) | Used in maintenance therapy. Encourage to take non narcotic analgesics like Tylenol. Block leukatriene Give 1 hr before 2 hrs. after eating. Don't take under 5 years of age or if you have hepatic disease. no grapefruit juice.
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| prednisone (Deltasone, Prednicot) | anti-inflammatory effects suppress tissue repair and granulation. immunosuppressant. increases metabolism
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| Prednisone short and long term | Short-weight gain, hyperglycemia, GI effects, CNS effects, infection suceptibility.
Long-Cushings, obesity, osteoperosis, fluid retension, hiriutism (more hair growth), electrolyte imbalance.
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| Prednisone teaching | Can give with milk or food, dont stop immediately-acute adrenal insufficiency! Avoid infection. take in the morning because it increases energy
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| Insulin | Promotes absorption of glucose by the cells. ONLY regular can be give IV. short, intermediate, long acting
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| NPH intermediate insulin | onset-1-1.5 hrs
Peak 4-12 hrs
Duration-18-24 hrs
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| Regular Insulin | Only insulin that can be given IV. Must be drawn up first, dosage may need to be reduced with renal impairment, change sites. onset 30-60 minutes. Duration 8-12 Peak 2-3 hrs. Risk for hypoglycemia 3-4 hrs after injection
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| Long acting insulin | CAN NOT MIX!!! duration 24 hrs. no peak.
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| Non-insulin Antidiabetics Sulfonylureas | Increases insulin secretion. Linked to cardiovascular deaths. Stimulates pancreatic Beta cells to produce insulin. Stimulates breakdown of glucagon stored in the liver.
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| Sulfonylureas side effects | hypoglycemia, comes from sulfa drugs so don't take if allergic to sulfa drugs. Side effects-heartburn, metallic taste in mouth, NVA epigastric fullness
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| Sulfonylureas diet | Administer before breakfast or first meal. Avoid alcohol
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| Nonsulfonylureas Biguanides metformin | lower blood glucose in type II suppresses hepatic glucose production. Decreases intestinal absorption of glucose. Improves insulin sensitivity and reduces triglycerides
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| metformin side effects | lactic acidosis, hypoglycemia,weight loss
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| Alpha-glucosidase inhibitors acarbose (Precose) | Delays digestion of carbs. take it with first bite of meals. Take glucose tablets or milk to treat hypoglycemia.
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| Glucose-elevating Agents glucagon (GlucaGen) | Given IM. Naturally occurring in the body and counteracts insulin. Stimulates glycogenolysis
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| Glucose-elevating Agents glucagon (GlucaGen) | Give carbs as soon as possible. 15 grams within 15 minutes.
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| Thyroid Hormone levothyroxine (Synthroid) | Thyroid hormone replacement. Metabolized by liver excreted by bile. Influences every organ in the body. Must have life long treatment for hypothyroidism.
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| Thyroid Hormones levothyroxine (Synthroid) Adverse Effects | Symptoms of hyperthyroidism-tachycardia, blood pressure goes up, anxiety, weight loss, intolerance to heat.
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| Thyroid Hormones levothyroxine (Synthroid)teaching | Teach to report weight changes, nervousness, insomnia, and lesions, alopecia can occur, wear safety bracelet, teach purpose, don't take OTC drugs without doctor's permission
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| Thyroid Hormones levothyroxine (Synthroid) minimizing adverse effects | Monitor serum thyroid levels periodically, monitor heart rate and vitals relating to the heart.
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| Androgens testosterone Adverse Effects | gynecomastia, longer lasting erections, edema, jaundice and decreased liver functions. Women experience masculation
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| Androgens testosterone minimize adverse effects | radiographs to assess bones for prepubescent bones to make sure growth plates don't close too early.
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| Drugs to Treat Erectile Dysfunction sildenafil (Viagra) | Increases blood flow to the penis promotes vasodilation
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| Drugs to Treat Erectile Dysfunction sildenafil (Viagra) minimizing adverse effects | DO NOT TAKE NITRO!!!
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| Estrogens estrogen actions | Stimulates development of female sex organs and female characteristics.
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| Estrogens estrogen adverse effects | Blood clots and embolism. NV common.
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| Estrogens estrogen monitor for... | Watch for growth in girls.
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| Progestins progesterone | serious-thromboembolism and blood clots
common-changes in menstrual cycle, nausea, headache, bloating, fluid retention, breast tenderness, photsensitivity
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