Respiratory Drugs pt 2 (study alongside notes)

The generic name for Serevent is ____________________.

salmeterol

Long-acting beta-2 agonists work by relaxing ____________________ and reducing ____________________.

bronchospasms; airway resistance

These medications are used for the ____________________ treatment of ____________________ and ____________________.

maintenance; asthma; COPD

LABAs are used in conjunction with an ____________________ ____________________.

inhaled corticosteroid

They are considered ____________________ medications, used for ____________________ of acute bronchospasm.

controller; prophylaxis

They are not effective for ____________________ attacks due to their slower onset of up to __________ minutes.

acute; 20

Long -Acting Beta -2 Agonist: Common adverse effects include ____________________, ____________________, and ____________________.

headache, hypertension, neuromuscular & skeletal pain

LABAs should never be given more than ______ puff(s) every ______ hours.

one; 12

Advair is a combination inhaler that includes ____________________ and ____________________, and it is very popular for treating ____________________.

salmeterol; fluticasone; COPD

Two main examples of anticholinergic bronchodilators are ____________________ (trade name: Atrovent) and ____________________ (trade name: Spiriva).

ipratropium; tiotropium

Anticholinergic Bronchodilators work by blocking the action of ____________________ in ____________________ smooth muscles.

acetylcholine; bronchial

This action helps prevent ____________________.

bronchoconstriction

Anticholinergics are used ____________________ to decrease the ____________________ and ____________________ of asthma.

prophylactically; frequency; severity

They are also used for the prevention of ____________________ in patients with ____________________ and ____________________.

bronchospasm; emphysema; chronic bronchitis

When Anticholinergic Bronchodilators are used with beta-2 agonists (such as ____________________), they act ____________________ to improve lung function by up to ______%.

albuterol; synergistically; 15

Anticholinergic Bronchodilators: Common adverse effects include ____________________, ____________________, ____________________, ____________________, ____________________, and ____________________.

dry mouth, nasal congestion, urinary retention, palpitations, cough, GI distress, nervousness, headache

When using a HandiHaler, teach the patient to place the ____________________ in the device to pierce it and not ____________________ the capsule whole.

capsule; swallow

Spiriva is the trade name for ____________________.

tiotropium

It belongs to the drug class ____________________ ____________________.

anticholinergic bronchodilator

It is administered using a device called the ____________________.

HandiHaler

The HandiHaler uses a ____________________ containing the medication in powder form.

capsule

The patient must place the capsule into the device and ____________________ it to release the medication for inhalation.

pierce

The capsule should not be ____________________ whole.

swallowed

Spiriva works by blocking the action of ____________________ in the lungs, leading to ____________________ of the bronchial smooth muscle.

acetylcholine; relaxation

It is used for the long-term management and prevention of ____________________ in patients with ____________________ and ____________________.

bronchospasm; emphysema; chronic bronchitis

Spiriva: Common side effects include ____________________, ____________________, and ____________________.

dry mouth, constipation, urinary retention

Two examples of xanthine bronchodilators are ____________________ and ____________________.

Theophylline; Aminophylline

They stimulate the ____________________ much like caffeine.

central nervous system (CNS)

Xanthine Bronchodilators MOA: They directly ____________________ bronchial smooth muscles and stimulate the ____________________ center.

relax; respiratory

This helps strengthen ____________________ contractions and prevent fatigue in patients with ____________________.

diaphragmatic; COPD

These drugs are used for ____________________ that is not controlled by other medications and as an adjunct therapy in ____________________.

asthma; COPD

Xanthine Bronchodilators are contraindicated in patients with uncontrolled ____________________, ____________________ disorders, ____________________, and ____________________ ulcers.

cardiac dysrhythmias; seizure; hyperthyroidism; peptic

Xanthine Bronchodilators: Common adverse effects include ____________________, ____________________, ____________________, and ____________________.

tachycardia, palpitations, nausea/vomiting, restlessness (GI bleeding, anorexia also possible)

Nursing Measure: Check blood levels therapeutic range is ___ mcg/mL.

10 ; 20

Xanthine Bronchodilators have many interactions (e.g., ____________________, ____________________, ____________________, ____________________, ____________________), so obtaining a thorough ____________________ ____________________ is essential.

Tagamet, Erythromycin, Cipro, oral birth control pills, allopurinol; medication history

Inhaled Corticosteroids are also called ____________________ drugs and work by reducing ____________________ in the airways.

glucocorticoids; inflammation

Examples of Inhaled Corticosteroids include ____________________ (Beclovent), ____________________ (Flovent), ____________________ (Pulmicort), ____________________ (Aerobid), and ____________________ (Azmacort).

beclomethasone; fluticasone; budesonide; flunisolide; triamcinolone

Inhaled Corticosteroids are used for the long-term ____________________ of asthma and COPD, not for ____________________ attacks.

maintenance; acute

Nursing Measure: Rinse mouth after use to prevent ____________________.

oral fungal infection (thrush)

Leukotriene Receptor Antagonists (LTRAs), such as ____________________ (Singulair), work by blocking ____________________ which cause airway inflammation and bronchoconstriction.

montelukast; leukotrienes

Montelukast is used for long-term control of ____________________ and allergy symptoms like ____________________.

asthma; allergic rhinitis

Nursing Teaching: Take daily in the ____________________, even if symptoms are not present.

evening

Phosphodiesterase-4 Inhibitor example: ____________________ (Daliresp) — decreases inflammation in the lungs and relaxes the airways but carries risk for ____________________ adverse effects such as depression or suicidal thoughts.

roflumilast; psychiatric

Monoclonal Antibody Anti-Asthmatic example: ____________________ (Xolair) — given by ____________________ injection for severe ____________________ asthma not controlled by inhaled corticosteroids.

omalizumab; subcutaneous; allergic

Must monitor for signs of ____________________ reaction after administration.

anaphylactic

Inhaled corticosteroids are preferred over the ____________________ or ____________________ routes because their action is limited to the ____________________ site in the lungs.

oral; IV; topical

Corticosteroids MOA: They reduce ____________________ by stabilizing the membranes of cells that release ____________________ substances.

inflammation; bronchoconstricting

Corticosteroids are often used concurrently with ____________________ drugs (like ____________________) because they restore or increase the ____________________ of bronchial smooth muscle to beta-2 stimulation.

beta-2 adrenergic agonist; albuterol; responsiveness

Long-term use of corticosteroids can cause many ____________________ effects.

adverse

Corticosteroids are used for ____________________ or ____________________ asthma, and are given ____________________ for acute exacerbations when a rapid anti-inflammatory effect is needed.

severe; persistent; IV

For chronic asthma or COPD, corticosteroids are given via ____________________.

inhaler

Adverse effects of inhaled corticosteroids include ____________, ____________ ____________, and ____________ infections.

cough; dry mouth; oral fungal

Systemic effects of high-dose IV or oral corticosteroids include increased susceptibility to ____________.

infections and hyperglycemia.

Corticosteroids can cause fluid and ____________ disturbances.

electrolyte

Corticosteroids can cause ____________ (difficulty sleeping) and ____________.

Insomnia; nervousness

Long-term corticosteroid use can lead to brittle skin, bone loss, and ____________.

osteoporosis

Corticosteroids may cause ____________ (swelling) and ____________ (high blood sugar).

Edema; hyperglycemia

Example of corticosteroid: ____________ (fluticasone)

flovent

Example of corticosteroid: ____________ (methylprednisolone)

Solu-Medrol

Example of corticosteroid: ____________ (budesonide)

Pulmicort

Example of corticosteroid: ____________ (triamcinolone)

Azmacort

Corticosteroids are contraindicated in patients with ____________________ infections.

fungal

For acute attacks, corticosteroids may be given for __ to __ days, and must be ____________________ if given for longer than a week.

7; 10; tapered

Advise the patient to take the corticosteroid exactly as ____________________, even if they are ____________________ ____________________.

ordered; feeling better

A(n) ____________________ ____________________ (bronchodilator) may be used before the inhaled corticosteroid to provide ____________________ ____________________ before administering the anti-inflammatory drug.

inhaled beta-2 agonist; bronchial relaxation/dilation

Teach the patient to take the bronchodilator drug ___ minutes before the corticosteroid drug.

2-5

Instruct the patient to ____________________ their mouth and then ____________________ after using an inhaled corticosteroid to prevent ____________________ ____________________.

rinse; spit; fungal infections

The inhaler casing should be cleaned weekly by removing the ____________________ and washing the casing with ____________________ ____________________ ____________________.

canister; warm soapy water

Teach patients to use their ____________________ ____________________ ____________________ to monitor improvement and response to therapy when using respiratory drugs for asthma or COPD.

peak flow meters

Patients should take their corticosteroid medication as ordered ____________, even if they are feeling better.

daily

An inhaled ____________ drug may be used before the inhaled corticosteroid to provide bronchial relaxation.

beta-2 agonist (bronchodilator)

The bronchodilator should be taken ____________ to ____________ minutes before the corticosteroid.

2–5

Patients should ____________ their mouth and ____________ after using inhaled corticosteroids to prevent fungal infections.

rinse; spit

The inhaler casing should be washed with ____________ ____________ water weekly.

warm soapy

Patients should use their ____________ ____________ meters to monitor improvement and response to therapy.

peak flow

The most common example of an LTRA is ____________.

montelukast (Singulair)

The mechanism of action involves blocking ____________ from binding to receptors, preventing inflammation and ____________ production.

leukotrienes; mucus

LTRAs are used for the ____________ and ____________ treatment of asthma.

prevention; long-term

They are not used for ____________ asthma attacks.

acute

LTRAs may decrease the need for ____________ agonists.

beta-2

Montelukast is approved for children aged ____________ years or older.

1

Dosing is usually ____________ mg daily in the ____________.

10; evening