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Respiratory Drugs
Drugs for the Respiratory System
11
Pharmacology
Undergraduate 1
03/25/2016

Additional Pharmacology Flashcards

 


 

Cards

Term

Respiratory Disorders 

Definition

Asthma:a recurrent, reversible SOB when lung airways become narrowed

  • componenets:
    • bronchospasm
    • inflammation & edema
    • production of mucous 
  • NAEPP - provide guidelines for diagnosis & treatment 



Chronic Obstructive Pulmonary Disease (COPD):

- consists of chronic bronchitis & emphysema

- precipitated by prolonged exposure to bronchial irritations - such as smoke 

  • Chronic Bronchitis: inflammation of bronchi & has excessive secretion of mucous 
  • Emphysema: air spaces enlarge in response to obstruction of alveolar walls 

Drug Therapy: 
  • long term 
  • relief or rescue
  • 50% of COPD pts don't adhere to medication regime - must urge pt to adhere 
Term

Bronchodilators

Definition

Drug: 

  • albuterol (Proventil) - inhaled, 1st choice 
    • onlhy can be used as often as ordered - too much leads to increased HR, nervousness, shakiness
  • epinephrine (Adrenalin) - subQ 
    • usually only given in ER for resp. distress 
  • salmeterol (Serevent) - Long-Acting
    • used for COPD & asthma 
    • maintenance ONLY 



 


Action: stimulate Beta 2, causing bronchodilation by relaxing bronchial smooth muscle 


 


Use: asthma; salmeterol (COPD & asthma) 




Adverse: increased HR / increased force of contraction (these drugs can also stimulate Beta 1) 


 


Contraindications: cardiac tachyarrhythmias / severe CAD / HTN / DM 

 

 



Nursing Implications: 

  • teach prevention of attacks & to avoid triggers (cig smoke, perfumes, animals, etc) 
  • teach use of inhaler 
    • wait 3-5 minutes in between puffs 
    • rinse mouth to prevent fungal infections 
  • may use spacer
  • bronchodilator first, then other inhaler (opens airways then 2nd inhaler gets deep down in lung 
  • mark rescue inhaler for easy ID 
Term

Anticholingergics 

Definition

Drug: 

  • ipratropium (atrovert) - not for rescue 
  • tiotropium (spiriva) - not for rescue (24 hour) 


 


Action: block action of acetylcholine in bronchial smooth muscle/ prevents bronchoconstriction 


 


Use: maintenance therapy for bronchitis/emphysema - only used to prevent attacks from occuring 




Adverse: nervousness / headache / hypotension / GI distress 


 

 

Term

Corticosteroids 

Definition

Drug: 

  • afluticasone (Flonase)
  • beclomethasone (Beclovent)
  • budesonide (Pulmicort)
  • triamcinolone (Azmacort)
  • dexamethasone (Decadron)
  • methylprednisone (IV) 
  • prednisone (PO) 



 


Action: stabilize membrane of cells that release bronconstricting substances, suppresses inflammation, decreases mucous production, decreases edema 

 


Use: asthma, COPD, emphysema 



Adverse: inhaled avoids systemic problems / impaired growth in children / dry mouth / cough / plus addtl effects  


 


Nursing Implications: 

  • usually not given in acute attack - come into play if Beta 2 meds don't work 
  • May be given alone or w/ bronchodilator 
  • use conticosteroid inhaler last (use bronchodilator first) 
  • gargle after use for risk of fungal infections 
  • IV & PO used during acute probs when pt can't be controled with inhaled route 
Term

Mixed Inhalers 

Definition

Drug: 

  • ipratropium/albuterol (Combivent, DuoNeb) 
    • anticholingergic and short term beta-2
  • Fluticasone/salmeterol (Advair) 
    • inhaled steroid and long acting beta-2

 


Use: for maintenance only, NOT rescue



 

Term

Xanthines 

Definition

Drug: 

  • theophyline (Theo-dur, Aminophyline) 

 


Action: causes bronchodilation by dilating airways

 


Use: asthma / emphysema / chronic bronchitis 



Adverse: CNS stimulation / increased cardiac output / restlessness / convulsions / tachycardia 

  • Toxicity: 
    • siezures 
    • arrhythmias
    • if below 5, pt at risk for asthmatic attack
    • if above 15, toxicity occurs 

 



Nursing Implications: 

  • not first line agent ( due to narrow therapy range) 
  • therapeutic level 5 - 15 mcg/mL
  • frequent lab draws required
  • coming out of favor b/c hard to keep pt regulated on this drug 
Term

Leukotriene Modifiers 

Definition

Drug: 

  • zafirlukast (Accolate) 
  • montelukast (Singulair) 


 


Action: prevent leukotrienes from binding to receptors, leading to a reduction in bronchoconstriction, inflammation, mucus production, and airway edema 



Use: asthma along w/ bronchidilators and steroids (not a single use only drug) (PREVENTION ONLY) 




Adverse: N/V/ headache / infection


 


Contraindications: liver disease 

 

 



Nursing Implications: 

  • monitor liver enzymes
  • take 1 hour before or 2 hour after meals for best absorption 
Term

Anti-Histamines 

Definition

Drug: 

  • diphenhydramine (Benadryl) - 1st gen. 
    • binds with central & peripheal receptions, causing CNS depression
  • fexofenadrine (Allegra) - 2nd gen. 
  • loratadine (Claritan) - 2nd gen. 

 


Action: antagonize the action of histamine by occupying receptor sites, working against vasodilation & inflammation 

 


Use: seasonal allergic rhinitis 

 


Adverse: drowsiness problems w/ 1st. gen. 


 



Nursing Implications: 

  • teach safety about drowsiness 
  • give w/ food 
  • for seasonal allergies, take regularly 
Term

Nasal Decongestants 

Definition

Drug: 

  • pseudoephedrine (Sudafed)
  • oxymetazoline (Afrin) 
  • phenylephrine (NeoSynephrine) 

 


Action: shrinks engorged nasal mucosa 


 


Use: relief of nasal congestion 

 


Contraindications: severe HTN / CAD 

 

 



Nursing Implications: 

  • usually only used in kids ages 6+ 
Term

Anti-Tussives 

Definition

Drug: 

  • non-narcotic: dextromethorphan (Benylin) 
  • narcotic: codeine or hydrocodone added to syrup (aids w/ sleep trouble) 

 


Action: suppress cough center in the medulla 


 


Use: to relieve dry hacking cough 




Adverse: dizziness / sedation (opioid added) / nausea 


 


Nursing Implications: 

  • assess cough 
  • use @ night if using opioid 
  • no ETOH 
  • increase fluids 
  • if combined with opioid, don't operate machinery, don't drive 
Term

Expectorants 

Definition

Drug: 

  • guaifenesin (Mucinex, Robitussin) 

 


Action: relieves productive cough caused by thin respiratory secretions 


 


Use: to suppress reproductive cough 


 



Nursing Implications: 

  • take only as needed
  • can be combined in cold remedy formula 
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