Nursing Pharmacology: Respiratory, Antimicrobial, and Dermatologic Drugs

Vocabulary practice flashcards covering upper and lower respiratory medications, antibiotics, dermatologic agents, antivirals, antituberculars, and antifungals from the nursing pharmacology lecture notes.

Empiric Therapy (Cold Treatment)

Symptomatic treatment directed at the most likely cause of illness to manage manifestations without curing the infection or eliminating the virus.

Pediatric Cough and Cold Warning

Safety restriction stating over-the-counter (OTC) cough and cold products must not be given to children younger than $2$ years of age due to risks of oversedation, seizures, tachycardia, death, and proven ineffectiveness.

Antihistamines (H₁ Blockers)

Drugs that competitively block $H_1$ receptor sites; they must be administered early in an allergic response because they cannot dislodge histamine that is already bound.

Traditional Antihistamines

First-generation $H_1$ blockers (e.g., diphenhydramine, chlorpheniramine, promethazine) that act both peripherally and centrally, producing strong anticholinergic effects and marked sedation.

Nonsedating / Peripherally Acting Antihistamines

Second-generation $H_1$ blockers (e.g., loratadine, cetirizine, fexofenadine) that act solely in the periphery, resulting in minimal to no sedation, fewer CNS adverse effects, and a longer duration of action.

Rebound Congestion

Severe, worsening nasal congestion induced by the sustained use of topical nasal adrenergic sprays (such as ephedrine, oxymetazoline, or phenylephrine) for more than several consecutive days.

Dextromethorphan

A nonopioid antitussive that acts centrally in the brain like an opioid to suppress the cough reflex, but lacks analgesic effects and does not cause CNS depression.

Benzonatate

A nonopioid antitussive that numbs stretch receptors within the respiratory tract to prevent stimulation of the cough reflex.

Guaifenesin

An expectorant that loosens, thins, and disintegrates thick respiratory secretions by irritating the gastric mucosa reflexively or stimulating respiratory secretory glands directly.

Short-Acting Beta-Agonists (SABAs)

Fast-acting bronchodilators (e.g., albuterol, levalbuterol) that stimulate cyclic adenosine monophosphate ($\text{cAMP}$) to relax airway smooth muscle, serving as rescue inhalers during acute asthma attacks.

Long-Acting Beta-Agonists (LABAs)

Maintenance bronchodilators (e.g., salmeterol, arformoterol) intended solely for prevention; they must never be used for an acute attack or administered more frequently than twice daily.

Albuterol Overuse Effect

The loss of $\beta_2$-receptor specificity occurring with excessive frequency of use, resulting in $\beta_1$-receptor stimulation characterized by tachycardia, palpitations, tremors, nausea, and anxiety.

Theophylline

An oral xanthine derivative bronchodilator that inhibits phosphodiesterase to elevate $\text{cAMP}$ levels; its metabolism is substantially increased by cigarette smoking and altered by specific dietary factors.

Montelukast

A leukotriene receptor antagonist (LTRA) taken nightly for chronic asthma prophylaxis in patients aged $\ge 12$ years; carries a Black Box Warning for serious neuropsychiatric and mood-related changes.

Inhaler Combination Sequence

The clinical procedure of administering a beta-agonist bronchodilator first, waiting several minutes, and then administering a corticosteroid inhaler so that airways are open for deep drug penetration.

Inhaler Spacing Rule

The dosing interval requiring a nurse or patient to wait $1\text{ minute}$ between two puffs of the same medication, or $5\text{ minutes}$ between puffs of two different inhaled medications.

Sulfamethoxazole-Trimethoprim (SMX-TMP)

A bacteriostatic sulfonamide combination that inhibits bacterial folic acid synthesis; adverse effects include photosensitivity, Stevens-Johnson syndrome, and crystalluria, necessitating $2000\text{–}3000\text{ mL/24 hours}$ of fluid intake.

Beta-Lactamase Inhibitors

Non-antibiotic compounds (such as clavulanic acid, tazobactam, and sulbactam) that bind bacterial enzymes to prevent enzymatic inactivation of co-administered penicillin molecules.

Ceftaroline

A fifth-generation cephalosporin recognized as the only cephalosporin agent possessing antimicrobial activity against methicillin-resistant Staphylococcus aureus (MRSA).

Carbapenems

Broad-spectrum beta-lactam antibiotics (e.g., imipenem/cilastatin, meropenem) reserved for complicated cavity or connective tissue infections, carrying a potential toxicity risk of drug-induced seizures.

Tetracyclines

Bacteriostatic antibiotics that chelate calcium, rendering them contraindicated in children younger than $8$ years and pregnant or nursing mothers due to irreversible tooth mottling and impaired fetal skeletal bone development.

Mupirocin (Bactroban)

A prescription topical antibacterial agent indicated for the treatment of Staphylococcus impetigo and eradication of nasal colonization of MRSA.

Isotretinoin (Amnesteem)

A severe cystic acne therapy carrying a Black Box Warning for severe teratogenicity, requiring strict compliance with the iPLEDGE program, monthly pregnancy testing, and two forms of contraception.

Collagenase (Santyl)

An enzymatic wound-debriding ointment that selectively digests necrotic tissue while sparing granulation tissue, safe for use in patients receiving concurrent oral anticoagulation therapy.

Aminoglycosides

Bactericidal antibiotics targeting gram-negative organisms, requiring therapeutic peak and trough drug monitoring due to Black Box Warnings for nephrotoxicity and irreversible ototoxicity.

Neomycin Exception

The oral or rectal (enema) administration of neomycin utilized explicitly for local GI tract decontamination prior to surgery or in hepatic encephalopathy, bypassing the class's otherwise poor oral absorption.

Quinolones (Fluoroquinolones)

Bactericidal antimicrobials ending in '-floxacin' that inhibit bacterial DNA; they carry Black Box Warnings for tendonitis, tendon rupture, and QT prolongation, and form insoluble chelates with polyvalent cations.

Vancomycin

The drug of choice for systemic MRSA (given IV) and C. difficile colitis (given orally); rapid IV infusion induces Red Man Syndrome and severe hypotension, requiring an infusion duration of at least $60\text{ minutes}$.

Linezolid

An oxazolidinone antibiotic indicated for VRE and MRSA that can trigger fatal serotonin syndrome when combined with SSRIs and hypertensive crises when co-ingested with tyramine-containing foods.

Oseltamivir (Tamiflu)

An oral neuraminidase inhibitor active against Influenza A and B that must be initiated within $2\text{ days}$ of clinical symptom onset to shorten disease duration.

Zidovudine (AZT)

A nucleoside reverse transcriptase inhibitor (NRTI) safe for use during pregnancy and neonatal periods to prevent mother-to-child HIV transmission, known to induce severe bone marrow suppression.

Isoniazid (INH)

The primary antitubercular agent metabolized via hepatic acetylation; it causes hepatotoxicity and peripheral neuropathy, the latter of which is countered by co-administering pyridoxine (vitamin B6).

Rifampin

A first-line antitubercular drug that turns all body secretions (urine, sweat, tears, saliva) a red-orange color and renders oral contraceptive pills completely ineffective.

Ethambutol

A first-line antitubercular drug that suppresses RNA synthesis, contraindicated in children under $13$ years of age due to the risk of irreversible retrobulbar optic neuritis and blindness.

Amphotericin B

A systemic antifungal reserved for life-threatening mycotic infections; carries severe risks of nephrotoxicity and neurotoxicity, routinely requiring slow infusion over $2\text{ to }6\text{ hours}$ and premedication.

Antimalarial Prophylaxis Timeline

The prophylactic dosing schedule requiring antimalarial drugs to be initiated $1\text{ to }2\text{ weeks}$ prior to travel and sustained for $4\text{ to }8\text{ weeks}$ following departure from an endemic region.