Oxygenation Pharm

pathology of oxygenation is often caused by

inflammation

Upper Respiratory disorders

cold, rhinitis, sinusitis, acute pharyngitis/laryngitis

LR disorders

atelectasis, pneumonia, bronchitis, COPD, asthma,

ABCD

alpha constricts, beta dilates

1 heart, 2 lungs

epinephrine aka

adernaline

drugs for asthma (LRAD)

inhaled sympathomimetics, inhaled anticholinergices, inhaled steroids, leukotriene modifiers

drugs for allergic rhinitis

both gen antihistamines, sudafed, decongestants

drugs for cough

antitussives, expectorants, mucolytics

respiratory therapy goals

keep airways open and improve gas exchange

(decrease histamine and prostaglandin, unblock obstructions, decrease swelling of membranes, loosen and mobilize secretions, dry secretions)

when to contact provider instead of continuing OTC

fever, green phlegm, over 2 wks, symptoms get worse

Drugs that work in upper airway

antitussives, decongestants, antihistamines, expectorants, mucolytics

drugs that work in the lower airway

expectorants, bronchodilators (sympathomimetics and antichol), antiinflammatory steroids

drugs for asthma and emphysema

bronchodilators, antiinflammatories

acute allergy/anaphylaxis drugs

bronchodilators, antihistamines, antiinflammatories

common cold drugs

decongestants, antitussives, 1st gen antihistamines

seasonal allergies/rhinitis drugs

2nd gen antishistamines

Beta 2 adrenergic agonist prototype

albuterol

Albuterol is for

acute bronchospasm, fast or long term management,

Albuterol pharmacokinetics

stimulate b2 adrenergic receptors, sympathetic, bronchodilation

increase ciliary motility and depress histamine

albuterol top 4

sympathetic, long and short, beta, caffeine or stimulants

Epinephrine is the ____ for _____

1st line, anaphylaxis

epinephrine pharmacokinetics/moa

beta for bronchodilation, alpha for vasoconstriction

prevent histamine release

epinephrine (adrenaline) top 3

sympathetic, fast everything, first line

Inhaled anticholinergics prototype

ipratropium

ipratroprium MOA

block Ach to stop bronchi vasoconstriction, blocks parasympathetic stimulation,

ipratroprium works at the

vagus nerve

ipratroprium top 5

not acute, antichol effects, bad taste, 5 minute intervals, glaucoma tests

vagal stimulation means

stimulate smooth muscle contraction = bronchooconstriction

Inhaled steroids/glucorticoids prototype

budesonide

budesonide therapeutic indication

suppress immune, decrease inflammation, asthma, copd

budesonide/glucorticoid MOA

decreases inflammation

promotes beta activity to relax smooth muscles and inhibit bronchodilation

budesonide/glucorticoid top 5

inhaled long oral short, steroid swish candidiasis, hyperglycemia, anticholinergic, weak immune

leukotriene modifiers prototype

montelukast

montelukast therapeutic indication

rhinitis, asthma, exercise spasm

prophylactic and asthma maintenance

montelukast moa

suppress leukotrienes, reduce inflammation and bronchoconstriction

montelukast top 3

suicide risk, no acute asthma, once in evening

1st gen sedating antihistamines prototype

diphenhydramine

diphenhydramine therapeutic indication

allergy, motion sickness

diphenhydramine moa

h1 receptor antagonists, block histamine

diphenhydramine is mild ______ blockers

cholinergic

diphenhydramine top 5

CNS depress, activated charcoal antidote, phenytoin IV for seizures, anticholinergic

2nd gen nonsedating antihistamines prototype

cetrizine

cetrizine therapeutic indication

peripheral, rhinitis, chronic idiopathic urticaria

cetrizine moa

antagonize histamine at H1 without binding or inactivating histamine completely

cetrizine is less ____ and lasts _____than 1st gen antihistamines

anticholinergic, longer

cetrizine top 3

less cns effect, anticholinergic, lasts longer

pseudoephedrine/sudafed therapeutic indication

nasal congestion, rhinitis, sinusitis, cold

sudafed is NOT for

allergies

sudafed moa

mimic sympathetic by activating alpha 1 receptors in nose to vasoconstrict and open nose passages

pseudoephedrine top 5

abuse, rebound congestion risk so only 3-5 days, cns stimulation, no allergy

antitussive prototype

opioid (codeine) or dextromethorphan

antitussive therapeutic indication

chronic nonproductive cough

allergies or URI

antitussive moa

depress cough reflex in medullary cough center

antitussive top 4

CNS depress, fluids and fiber, opioid abuse, prn only

expectorants prototype

guaifenesin/mucinex

guaifenesin therapeutic indication

thin mucus

guaifenesin moa

reduce viscosity of secretions to thin mucus

guaifenesin top 5

lots fluids, cns depress, aspartame allergy not good

mucolytics prototype

acetylcysteine

acetylcysteine therapeutic indication

decrease mucus viscosity, reverse acetaminophen

acetylcysteine moa

break down disulfide links in mucus proteins to reduce viscosity

acetylcysteine top 5

respiratory issues, clean nebs, bad smell, sugar syrups diabetes, APAP antidote

for expectorants, the pt needs to be able to

cough

nasal decongestant/fluticasone moa

antiinflammatory

not absorbed systemically