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ventilation
moving air into and out of the lungs
profusion
allows gas exchange across the capillaries
what devices are used to deliver drugs via inhalation? (3)
nebulizers
metered dose inhalers
dry powder inhalers
what are the two components of asthma?
inflammatory and bronchospasm components
what medication class treats inflammation with asthma? (4)
glucocorticoids
mast cell stabilizers
leukotriene modifiers
monoclonal antibodies
what medication class treats bronchospasm with asthma? (3)
beta-adrenergic agonists
methlyxanthines
anticholinergics
what are beta receptors?
Beta receptors are responsible for signaling the sympathetic nervous system. They are present on various tissues throughout the body
what is the dominant receptor for the heart and kidneys?
beta 1
what is the dominant receptor for smooth muscle relaxation at the lungs, blood vessels, gi tract, and liver?
beta 2
what is the dominant receptor for adipose tissue and the bladder?
beta 3
what do beta-adrenergic agonists do for asthma?
relieves bronchospasms by opening the airway by relaxing the smooth muscle of the bronchi
why can beta-adrenergic agonists make you feel jittery and anxious?
it can act on some beta cells in the heart
what do glucocorticoids do for asthma?
supress airway inflammation
what form of glucocorticoid is used for long term prevention of asthma attacks?
inhaled glucocorticoids
what form of glucocorticoids is used for acute, severe attacks?
oral glucocorticoids
what is an important teaching for patients using glucocorticoid inhalers?
always rinse mouth after use, because it can cause infection of the mouth/nose
what is an important teaching for patients using oral glucocorticoids?
if taken for more than 10 days, do not discontinue abruptly, as it will cause side effects
what are the most common anticholinergics? (2)
ipratropium (Atrovent)
tiotropium (Spirivia)
what do anticholinergics treat?
COPD, asthma
how do anticholinergics work?
Anticholinergics block acetylcholine from binding to its receptors on certain nerve cells. They inhibit parasympathetic nerve impulses, which are responsible for involuntary muscle movements
what do methylxanthines treat?
asthma
what do methylxanthines do?
it is a bronchodialator, so it opens the airway
what drug is chemically related to caffeine?
methylxanthines
how do mast cell stabilizers work?
inhibit degranulation of mast cells by trigger stimuli by blocking calcium channels and inhibiting the release of histamines.
AKA
prevent the mast cells from releasing the substances that cause inflammation
prophylaxis
an action taken to prevent disease
ex. taking a drug to prevent an asthma attack
how are mast cell stabilizers administered?
administered as an areosol through a metered dose inhaler
what is a teaching point for mast cell stabilizers?
needs to be taken 4-6 times daily because of the short half-life
how do leukotriene modifiers work?
used to block the bronchoconstrictor / inflammatory activity of leukotrines
how and when are leukotriene modifiers administered?
orally, every 12 hours
how do monoclonal antibodies work?
they are laboratory made proteins that mimic the immune systems ability to fight antigens, and inhibits a person's immune response to certain triggers
how are monoclonal antibodies administered?
injection
what medication dampens the cough reflex?
antitussives
what is a medication used for severe coughs?
opioids, like codiene and hydrocodone
what medication is used for mild coughs?
dextromethorphan
antigen
any foreign substance that triggers an immune response
what is released in the body in response to antigens?
histamines
how do antihistamines work?
block / inhibit H1 receptors
what is another name for antihistamines?
H1-receptor antagonists
what are drugs that inhibit H1 (histamine) receptors used to treat?
allergic reactions
what are drugs that inhibit H2 (histamine) receptors used to treat?
gastric reflux disease
what are the 2 generations of antihistamines?
1st gen - central effect, also a sedative
2nd gen - less central effect, do not have a sedative effect
what conditions contraindicate the use of antihistamines? (3)
pregnancy
glaucoma
use of alcohol or other CNS depressants
anti-infective
general term describing any medication that is effective against a pathogen
what are the 2 classes of antibacterial medications?
narrow spectrum (targets few types)
broad spectrum (targets many types)
pathogen
any organism that can cause disease, includes:
viruses
bacteria
fungi
unicellular organisms (protozoans)
multicellular animals
pathogenicity
ability of an organism to cause disease
virulence
a quantitative measure of an organism’s pathogenicity (how harmful it is)
does a pathogen with high virulence have a high or low chance of transmission? why?
high virulence = less chance of transmission
why? because people who are very sick usually stay home
does a pathogen with low virulence have a high or low chance of transmission? why?
low virulence = more chance for transmission
why? because people who are less sick (ex. cold) will still go in public
what are 3 bacteria shapes
spheres (cocci)
rods (bacilli)
spirals
what is the difference between gram positive rods and gram negative rods?
gram positive rods have thicker plasma membrane with more layers
bacteriocidal
drugs that kill bacteria
bacteriostatic
drugs that inhibit bacterial reproduction
selective toxicity
drug is toxic to the bacteria, but not the host
sensitivity
the drug is toxic to the bacteria causing the infection
antibiotic resistance
the bacteria is no longer affected by a particular antibiotic that was once effective
antibiotic stewardship
the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients
what are common resistant microbes? (3)
MRSA
VRE
Multi-drug resistant tuberculosis
what type of antibiotics are patients usually started on?
broad spectrum -targets lots of bacteria
what cannot be taken with antibiotics?
aluminium or calcium containing antacids
why are antibiotics administered on a strict schedule?
because adequate levels of antibiotics must be maintained in the blood, or bacteria has a chance to grow
what are possible adverse effects of antibiotics? (3)
destruction of normal gut flora (causes diarrhea).
suprainfection - infection with a second, resistant organism.
allergy (most common with penicillins).
what are teaching points for patients taking antibiotics? (4)
complete full dose.
take missed dose asap.
signs + symptoms of hypersensitivity.
may need a backup method of birth control.
what is tuberculosis?
a chronic, recurrent, infectious disease caused by Mycobacterium tuberculosis
who is at higher risk of contracting tuberculosis? (4)
newcomers.
patients with HIV/AIDS.
racial + ethnic minorities.
individuals in dense / overcrowded places.
what is the vaccine for tuberculosis?
Bacille Clamette-Guerine (BCG) vaccine
direct observation therapy
patient takes medication while being observed by HCP for adherence
what is important to know about the drug isoniazid?
impacts vitamin B6, patient will need supplement
what is important to know about the drug rifampin?
turns body fluids orange
what is important to know about the drug pyrazinamide?
it is very hard on liver, sight, and hearing
what is important to know about the drug ethambutol?
can cause vision problems
how is tuberculosis treated? (4)
multidrug therapy of oral antituberculosis drugs:
isoniazid
rifampin
pyrazinamide
ethambutol