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Pharmacology chapter 41
Lower Respiratory
45
Nursing
Undergraduate 3
04/01/2014

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Term
Chronic obstructive pulmonary disease (COPD)
Definition
COPD is caused by airway obstruction with increased airway resistance of airflow to lung tissues. Four major pulmonary disorders cause COPD: chronic
Term
Restrictive lung disease
Definition
is a decrease in total lung capacity as a result of fluid accumulation or loss of elasticity of the lung.
Term
Restrictive lung disease examples
Definition
Pulmonary edema, pulmonary fibrosis, pneumonitis, lung tumors, thoracic deformities (scoliosis), and disorders affecting the thoracic muscular wall (e.g., myasthenia gravis)
Term
COPD Examples
Definition
bronchitis, bronchiectasis, emphysema, and asthma.
Term
Asthma
Definition
is an inflammatory disorder of the airway walls associated with a varying amount of airway obstruction. This disorder is triggered by stimuli such as stress, allergens, and pollutants
Term
asthma symptoms
Definition
bronchospasm (constricted bronchioles), wheezing, mucus secretions, and dyspnea.
Term
Chronic bronchitis
Definition
progressive lung disease caused by smoking or chronic lung infections. Bronchial inflammation and excessive mucous secretion result in airway obstruction.
Term
bronchiectasis
Definition
abnormal dilation of the bronchi and bronchioles secondary to frequent infection and inflammation. The bronchioles become obstructed by the breakdown of the epithelium of the bronchial mucosa. Tissue fibrosis may result
Term
Emphysema
Definition
progressive lung disease caused by cigarette smoking, atmospheric contaminants, or lack of the alpha1-antitrypsin protein that inhibits proteolytic enzymes that destroy alveoli (air sacs)
Term
most common risk factor for COPD
Definition
Cigarette smoking
Term
Medications frequently prescribed for COPD
Definition
Bronchodilators, Glucocorticoids, Leukotriene modifiers, Expectorants, Antibiotics
Term
Bronchospasm
Definition
bronchoconstriction, results when the lung tissue is exposed to extrinsic or intrinsic factors that stimulate a bronchoconstrictive response.
Term
Bronchial asthma
Definition
is a COPD characterized by periods of bronchospasm resulting in wheezing and difficulty breathing.
Term
Factors that can trigger an asthmatic attack (bronchospasm)
Definition
humidity; air pressure changes; temperature changes; smoke; fumes (exhaust, perfume); stress; emotional upset; exercise; and allergies to animal dander, dust mites, food, and drugs (e.g., aspirin, ibuprofen, beta-adrenergic blockers).
Term
Reactive airway disease (RAD)
Definition
a cause of asthma resulting from sensitivity stimulation from allergens, dust, temperature changes, and cigarette smoking.
Term
Exposure to an allergen results in
Definition
bronchial hyperresponsiveness, epithelial shedding of the bronchial wall, mucous gland hyperplasia and hypersecretion, leakage of plasma leading to swelling, and bronchoconstriction.
Term
, bronchoconstriction results from:
Definition
When histamine, ECF-A, and leukotrienes inhibit the action of cAMP
Term
Epinephrine is administered in
Definition
emergency situations to restore circulation and increase airway patency
Term
Albuterol (Proventil, Ventolin) is
Definition
a selective beta2 drug that is effective for treatment and control of asthma by causing bronchodilation with long duration of action.
Term
beta2-adrenergic agonists are frequently administered
Definition
for long term asthma treatment
Term
Metaproterenol reverses bronchospasm by
Definition
by relaxing bronchial smooth muscle. The drug acts on the beta2 receptor, promoting bronchodilation, and increases cAMP.
Term
isoproterenol is concidered to be:
Definition
a nonselective beta agonist because it stimulates both beta1 and beta2 receptors.
Term
Metaproterenol Contraindications
Definition
Hypersensitivity, cardiac dysrhythmias

Caution: Narrow-angle glaucoma, cardiac disease, hypertension
Term
Aerosol Inhalers
Definition
a metered-dose inhaler (MDI) or dry powdered inhaler (DPI),
Term
ide effects and adverse reactions of epinephrine
Definition
tremors, dizziness, hypertension, tachycardia, heart palpitations, cardiac dysrhythmias, and angina
Term
The side effects associated with beta2-adrenergic drugs (e.g., albuterol, terbutaline)
Definition
include tremors, headaches, nervousness, increased pulse rate, and palpitations (high doses). The beta2 agonists may increase blood glucose levels,
Term
methylxanthine (xanthine) derivatives
Definition
which include aminophylline, theophylline, and caffeine.
Term
Methylxanthine (Xanthine) Derivatives etiology
Definition
stimulate the central nervous system (CNS) and respiration, dilate coronary and pulmonary vessels, and cause diuresis. Because of their effect on respiration and pulmonary vessels, xanthines are used in the treatment of asthma.
Term
Theophylline
Definition
elaxes the smooth muscles of the bronchi, bronchioles, and pulmonary blood vessels by inhibiting the enzyme phosphodiesterase, resulting in an increase in cAMP, which promotes bronchodilation.
Term
Theophylline's theraputic index
Definition
low therapeutic index and a narrow therapeutic range (10 to 20 mcg/mL).
Term
Theophylline adverse effects
Definition
dysrhythmias, convulsions, cardiorespiratory collapse
Term
Side effects and adverse reactions to theophylline include
Definition
anorexia, nausea and vomiting, gastric pain caused by increased gastric acid secretion, intestinal bleeding, nervousness, dizziness, headache, irritability, cardiac dysrhythmias, tachycardia, palpitations, marked hypotension, hyperreflexia, and seizures. Adverse CNS reactions (e.g., headaches, irritability, restlessness, nervousness, insomnia, dizziness, seizures)
Term
Theophylline toxicity is most likely to occur when
Definition
serum concentrations exceed 20 mcg/mL
Term
Leukotriene (LT) is
Definition
a chemical mediator that can cause inflammatory changes in the lung. The cysteinyl leukotrienes promote an increase in eosinophil migration, mucus productio
Term
leukotriene modifier examples
Definition
zafirlukast (Accolate), zileuton (Zyflo CR), and montelukast sodium (Singulair)
Term
Glucocorticoids eitiology
Definition
hese drugs have an antiinflammatory action and are indicated if asthma is unresponsive to bronchodilator therapy or if the client has an asthma attack while on maximum doses of theophylline or an adrenergic drug. It is thought that glucocorticoids have a synergistic effect when given with a beta2 agonist.
Term
it can take up to how long for inhaled steroids to have full effect?
Definition
1 to 4 weeks for an inhaled steroid to reach its full effect.
Term
Side effects associated with orally inhaled glucocorticoid
Definition
generally local (e.g., throat irritation, hoarseness, dry mouth, coughing) rather than systemic. Oral, laryngeal, and pharyngeal fungal infections have occurred but can be reversed with discontinuation and antifungal treatment.
Term
oral and injectable glucocorticoids have many side effects--- long-term,
Definition
headache, euphoria, confusion, sweating, insomnia, nausea, vomiting, weakness, and menstrual irregularities. Adverse effects may include depression, peptic ulcer, loss of bone density and development of osteoporosis, and psychosis.
Term
Mucolytics etiology
Definition
act like detergents to liquefy and loosen thick mucous secretions so they can be expectorated.
Term
1. A client is diagnosed with a pulmonary disorder that causes COPD. Lung tissue changes are normally reversible with this condition. The nurse understands that which is the client's most likely diagnosis?

a. Asthma

b. Emphysema

c. Bronchiectasis

d. Chronic bronchitis
Definition
A
Term
A client with COPD has an acute bronchospasm. The nurse knows that which is the best medication for this emergency situation?

a. zafirlukast (Accolate)

b. epinephrine (Adrenalin)

c. dexamethasone (Decadron)

d. oxtriphylline-theophyllinate (Choledyl)
Definition
B
Term
A client is taking aminophylline–theophylline ethylenediamine (Somophyllin). For what should the nurse monitor the client?

a. Drowsiness

b. Hypoglycemia

c. Increased heart rate

d. Decreased white blood cell count
Definition
C
Term
A client is prescribed theophylline to relax the smooth muscles of the bronchi. The nurse monitors the client's theophylline serum levels to maintain which therapeutic range?

a. 1 to 10 mcg/mL

b. 10 to 20 mcg/mL

c. 20 to 30 mcg/mL

d. 30 to 40 mcg/mL
Definition
B
Term
A client with COPD is taking a leukotriene antagonist, montelukast (Singulair). The nurse is aware that this medication is given for which purpose?

a. Maintenance treatment of asthma

b. Treatment of an acute asthma attack

c. Reversing bronchospasm associated with COPD

d. Treatment of inflammation in chronic bronchitis
Definition
A
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