Term
| What is your goal of therapy for UPper Respiratory Disorders? |
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Definition
decrease inflammation
decrease upper airway secretions
vasoconstriction of nasal blood vessels |
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Term
| Common upper respiratory disorders |
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Definition
common cold
acute rhinitis
sinusitis
tonsillitis
laryngitis |
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Term
| what is your goal for Lower Respiratory tract disorders? |
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Definition
bronchodilation
decrease synthesis and release of endogenous substances that cause bronchoconstriction |
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Term
| List of Lower Respiratory Disorders |
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Definition
respiratory tract infections
COPD
asthma
chronic bronchitis
emphysema
bronchiestasis
infections (bronchitis, pneumonia, tb)
restrictive pulmonary disease (fibroids, tumors,deformities, thoracic muscle wall disorders) |
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Term
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Definition
H1 histamine antagonist- increase secretions in upper respiratory tract
compete for h1 receptor sites;
anticholinergic effects- decrease upper resp secretions |
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Term
| examples of antihistamine |
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Definition
| Benadryl, allegra, claritin |
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Term
| Side effects of antihistamine |
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Definition
drowsiness
dehydration
uti or urine retention
thicken secretions
bronchospasm |
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Term
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Definition
causes vasoconstriction of capillaries in nasal mucosa; sympathomimetic amines
forms: nasal sprays, drops, tablets, capsules, elixirs |
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Term
| Examples of decongestants |
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Definition
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Term
| Nursing considerations for decongestants |
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Definition
overuse- rebound vasodilation and irritation of nasal mucosa. **do not use more than 5 days**
may cause cns stimulation- nervousness, insomnia
increase heart rate and blood pressure |
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Term
| Intranasal Glucocorticoids |
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Definition
reduce inflammation of nasal mucosa
do not cause vasoconstriction
short term use only due to systemic absorption
long term use predisposes to infection
increase blood sugar and chance of osteoporosis |
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Term
| Examples of intranasal glucocorticoid |
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Definition
momestasone (nasonex)
flunisolide (aero-bid) |
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Term
| Antitussives and expectorants |
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Definition
antitussive- suppress cough
expectorants- loosen bronchial secretions |
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Term
Example of expectorant?
Example of antitussive |
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Definition
Robitussin(guaifenesin)
Tessalon, pherngan vc, benylin, hycodan, |
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Term
| Combination antitussive and expectorants |
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Definition
guaifenesin and codeine- robitussin ac
guaifenesin and dextromethorphan- robitussin dm |
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Term
| Sympathomimetics: alpha and beta adrenergic agonist |
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Definition
bronchodilation
Prefer drugs that affect beta 2 receptors because they have fewer side effects and adverse reactions
increase Heart rate, b/p, and nervousness
take without beta blockers because they decrease the effectiveness of the inhalant |
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Term
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Definition
bronchodilation- inhibit acetylcholine
chemically related to atropine; have a drying effect on secretions |
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Term
| examples of anticholinergic agents |
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Definition
atroven (ipratropium)
Spiriva (tiotropium) |
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Term
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Definition
relax the smooth muscle of bronchi, bronchioles and pulmonary blood vessesl
used to treat severe bronchoconstriction
stimulate cns, seizures
diuresis, nausea/vomiting, nervousness, palpitaitons
increase heart rate
can increase or decrease b/p |
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Term
| examples of methylxanthines |
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Definition
Aminophylline- treats severe or acute bronchoconstriction; also inhibits release of histamines; IV
Theophylline (theo-dur) po |
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Term
| Nursing consideratons for sympathomimetics, anthicholinergics, methylxanthines |
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Definition
monitor for:
increase in heart rate
increase in blood pressure
take orally with foods
watch for nervousness, irritability, insomnis, headache, seizures
periodic therapeutic blood levels must be drawn with theophylline
anticholinergic drugs can cause dry mouth, and blurry vision |
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Term
| Leukotriene receptor antagonist and leckotriene synthesis inhibitors |
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Definition
given daily as prophylactic for bronchial asthma
block certain leukotrienes receptors or inhibit synthesis of leukotrienes
decrease leukotrienes inhibit airway edema, smooth muscles constricition, and inflammatory process
abrupt d/c can cause bronchoconstriction
elevate liver enzymes |
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Term
| examples of leukotriene receptor antagonist and leukotriene synthesis inhibitors |
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Definition
montelukast(singulair)
zarfirlukast (accolade)- give on empty stomach/ increase warfarin
zeleutin (zyflo) |
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Term
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Definition
prevent releas of histamines and other bronchoconstricting substances when mast cells are stimulated by an antigen.
taken daily; not used for acute bronchoconstriction
do not d/c abruptly |
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Term
| examples of mast cell stabilizer |
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Definition
cromolyn sodium (intal)
nedocromil sodium (tilade) |
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Term
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Definition
anti-inflammatory
used if other drugs do not improve symptoms
***not intended to for long term use***
inhalants can be used for long term therapy
there are some systemic effects of all preparations |
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Term
| Examples of glucocorticoids |
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Definition
beclomethasone (vanceril, beclovent)
fluticasone (flovent)
hydrocortisone (solu-cortef)
methylprednisolone (solu-medrol) |
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Term
| Glucocortoids Combination prep |
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Definition
advair: combines flovent and serevent
combivent: combines atrovent and proventil |
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Term
| Nursing considerations with Glucocortoids |
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Definition
give with food
antacids or h2 receptors blockers should be ordered
taper doses to discontinue
monitor to weight gain, fluid retention, increased b/p, hypovolemia
monitor for adverse effects |
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Term
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Definition
used to liquefy very thick secretions so they can be experctorated
used for cystic fibrosis
bronchodilating agents used concurrently
cause a runny nose |
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Term
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Definition
acetylcysteine (mucomyst)
dornase alfa(pulmonzyme) |
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Term
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Definition
onset is more rapid than oral dose
if you have to give more than one; give 5 minutes apart
always give the bronchodilator first!*** |
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