PHARM (nr293): WEEK 3 Questions and answers + rationales

Drugs That Affect the Respiratory System

what are all 3 possible actions of these drugs?

facilitate breathing through dilation of airways, clearance or reduction of secretions, reduction of inflammation

Which conditions are respiratory medications used to treat?

1. Congestive heart failure

2. Emphysema and chronic bronchitis

3. Chronic obstructive pulmonary disease (COPD)

4. Asthma

5. Allergies and hay fever

2, 3, 4, 5

Which drug classifications are respiratory drugs? Select all that apply.

1. Expectorants

2. Antibiotics

3. Decongestants

4. Antihistamines

5. Antitussives

6. Diuretics

7. Bronchodilators

1, 3, 4, 5, 7

Which drug class should be used as a rescue inhaler for an acute asthma attack?​

1. Mast cell stabilizers

2. Long-acting inhaled beta 2-agonists

3. Inhaled corticosteroids

4. Short-acting inhaled beta 2-agonists

4 (think of this like short/rapid acting insulin)

Use of Respiratory Medications

if a normal airway = open/dilated

then inflammation = ?

closing/constriction

Use of Respiratory Medications

what are all 6 treatments these can provide?

allergies, hay fever, asthma, chronic obstructive pulmonary disease, emphysema, chronic bronchitis

Use of Respiratory Medications

Some of these medications inhibit the ____ response produced from allergens

inflammatory

Use of Respiratory Medications

Others may ____ secretions and ___ or help with ___ of secretions [3 terms]

decrease, coughing, expectoration/expel

Use of Respiratory Medications

what medication is this?

can act rapidly and are used as “rescue” drugs

Bronchodilators

Use of Respiratory Medications

give one bronchodilator that is a rescue drug

beta 2 agonist

Use of Respiratory Medications

what is this?

rescue drugs as they stimulate the beta-2 cells, which causes rapid bronchodilation

beta 2 agonist

Use of Respiratory Medications

what drug is this?

dry up secretions

antihistamines

Use of Respiratory Medications

what drug is this?

decrease amount of secretions

decongestants

Use of Respiratory Medications

what drug is this?

suppress cough

antitussives

Use of Respiratory Medications

what drug is this?

move secretions out of body

Expectorants

Use of Respiratory Medications

what drug is this?

open airway through dilation

bronchodilators

Use of Respiratory Medications

what drug is this?

suppress underlying cause of illness

nonbronchodilators

Management of Asthma

what medication is used only for acute attacks?

short-acting inhaled beta 2 agonist

Management of Asthma

name a short acting beta 2 agonist

albuterol

Management of Asthma

name all 7 medications for this?

xanthine derivatives, corticosteroids, mast cell stabilizers, short acting beta 2 agonists, long acting beta 2 agonist, anticholinnergic

Antihistamines

During an allergic reaction, ___ is one substance that is released

histamine

Antihistamines

Histamine molecules activate cells in the __, ___, ____, _____ , and ___ , which produce allergic signs and symptoms

nose, eyes, respiratory tract, gastrointestinal tract, skin

what medication is this?

block the histamine receptors, preventing the release of histamine, creating relaxation of smooth muscle, and decreasing itching and secretions (such as tears and saliva

antihistamine

Antihistamines

what are all 4 treatments this is used for?

nasal allergies, seasonal allergic rhinnitis, uticaria, common cold symptoms

Antihistamines

what type can cause drowsiness?

diphenhydramine

Antihistamines

name all 5

loratadine, cetirizine, desoloratadine, fexofenadine, diphenydramine

Antihistamines

If the patient is scheduled for an allergy test, remind them to stop taking antihistamines ___ days prior to the exam

4

Antihistamines

when should these be taken?

before exposure and with food

Antihistamines

which one is old?

1. diphenhydramine

2. loratadine

3. cetirizine

4. desloratadine

5. fexofenadine

1

Decongestants

what are the 3 classifications

adrenergics, anticholinergics, topical corticosteroids

Decongestants​

sympathomimetics

which one?

1. adrenergics

2. anticholinergics

3. topical corticosteroids

1

Decongestants​

parasympatholytics

which one?

1. adrenergics

2. anticholinergics

3. topical corticosteroids

2

Decongestants​

intranasal steroids

which one?

1. adrenergics

2. anticholinergics

3. topical corticosteroids

3

Decongestants​

what do these do?

shrink mucous membranes to relieve stuffiness

Decongestants​

what do nasal steroids aim at?

inflammatory response

Decongestants​

name all 4

beclomethasone dipropionate, budesonide, fluticasone, riamcinolone

Decongestants​

do these raise blood pressure or lower?

raise

Decongestants​

name all 5 contraindications

glaucoma, cardiovascular disease, hypertension, diabetes, prostatitis

Decongestants​

is it okay to give this to someone with high blood pressure?

no

Decongestants​

is it okay to give this to someone with high heart rate?

no

Antitussives

where do these work to suppress cough?

medulla

Antitussives

name all 3

benzonate, codeine, dextromethorphan

Antitussives

what type of assessment is to be done for this?

respiratory

Antitussives

Assess for other ____ that may interact with opioid-based antitussives.

medications

Antitussives

Opioid antitussives like codeine may ___ the effects of other opioids, general anesthetics, tranquilizers, sedatives and hypnotics, tricyclic antidepressants, alcohol, and other central nervous system (CNS) depressants

enhance

what is this?

coughing up and spitting out) of excessive mucus in the respiratory tract.

Expectorants

what is this?

break down and thin secretions

Expectorants

Expectorants

give 1 example

guaifenesin

Expectorants

what are the 3 areas to assess for thick secretions?

lungs, sinuses, nasopharnyx

Expectorants

how many times a day for immediate release?

multiple

Expectorants

how many times a day for sustained release?

1-2

Contraindications

what are the main behavior is this contraindicated for codeine, hydrocodone?

alcohol

Contraindications

what med?

should be cautiously used in those with a productive cough, as should dextromethorphan in those with hyperthyroidism, advanced cardiac and vessel disease, hypertension, glaucoma, and use of monoamine oxidase inhibitors (MAOI) within the past 2 weeks

benzonatate antiussives

Contraindications

what med?

should be used with caution in those with central nervous system (CNS) depression, anoxia, hypercapnia and respiratory depression, increased intracranial pressure (ICP), impaired renal function, liver disease, benign prostatic hyperplasia (BPH), and chronic obstructive pulmonary disease (COPD

codeine, hydrocodone

Respiratory Drug Classes

Fexofenadine

Loratidine

which one?

1. antihistamine

2. decongestants

3. antitussives

4. expectorants

1

Respiratory Drug Classes

Fluticasone

Triamcinolone

which one?

1. antihistamine

2. decongestants

3. antitussives

4. expectorants

2

Respiratory Drug Classes

Codeine

Dextromethorphan

which one?

1. antihistamine

2. decongestants

3. antitussives

4. expectorants

3

Respiratory Drug Classes

Guaifenesin

which one?

1. antihistamine

2. decongestants

3. antitussives

4. expectorants

4

Beta Agonists and Anticholinergics

_____ are used for the treatment of asthma and chronic obstructive pulmonary disease (COPD

Bronchodilators

what are all 3 classes of bronchodilators?

beta agonist, anticholinergics, xanthine derivatives

Beta Agonists and Anticholinergics

what types of beta agonists are?

short acting, long acting

what med class?

the parasympathetic nervous system responses such as saliva stimulation and airway constriction

antichloinergics

Beta Agonists and Anticholinergics

airflow obstructions, such as in the case of an asthmatic attack

which one?

1. short

2. long

1

Beta Agonists and Anticholinergics

levalbuterol

which one?

1. short

2. long

1

Beta Agonists and Anticholinergics

metaproterenol

which one?

1. short

2. long

1

Beta Agonists and Anticholinergics

pirbuterol

which one?

1. short

2. long

1

Beta Agonists and Anticholinergics

bitolterol

which one?

1. short

2. long

1

Beta Agonists and Anticholinergics

terbutaline

which one?

1. short

2. long

1

Beta Agonists and Anticholinergics

albuterol

which one?

1. short

2. long

1

Beta Agonists and Anticholinergics

name all 6 short acting beta

albuterol, levalbuterol, metaproterenol, pirbuterol, bitolterol, terbutaline

Beta Agonists and Anticholinergics

not used for acute treatment of bronchoconstriction. utilized as twice-daily administration for maintenance pharmacotherapy in the treatment of asthma and COPD

which one?

1. short

2. long

2

Beta Agonists and Anticholinergics

salmeterol

which one?

1. short

2. long

2

Beta Agonists and Anticholinergics

formoterol

which one?

1. short

2. long

2

Beta Agonists and Anticholinergics

arformoterol

which one?

1. short

2. long

2

Beta Agonists and Anticholinergics

Long-acting beta-agonists are prescribed either in conjunction with an inhaled ____ or in combination products that have a ____ combined with the long-acting ___

steroid, corticosteroid, bronchodilator

Beta Agonists and Anticholinergics

The medication actions and side effects of beta-adrenergic agonists will mimic the sympathetic nervous system. give 3 side effects

dilate pupils, increase heartbeat, dilation airways

Beta Agonists and Anticholinergics

name 2 anticholinergics

ipratropium, tiotropium

Beta Agonists and Anticholinergics

for anticholinergics what neurotransmitter is blocked, which causes constriction of airways?

acetylcholine

Beta Agonists and Anticholinergics

besides opening the airway what else do anticholinergics do?

reduce secretions

Beta Agonists and Anticholinergics

Because the action of anticholingeric drugs is slower and prolonged, they are predominately used for the prevention of ____ associated with COPD

bronchospasms

Beta Agonists and Anticholinergics

Side effects of anticholinergics can be identified based on the blocking of the parasympathetic nervous system. name 3

urinary retention, dry mouth, heart palpitations

Human Nervous System

Constrict pupils

Stimulate salvia

which system?

1. parasympathetic

2. sympathetic

1

Human Nervous System

Dilate pupils

Inhibit salivation

which system?

1. parasympathetic

2. sympathetic

2

Human Nervous System

Constrict airways

slow heartbeat

which system?

1. parasympathetic

2. sympathetic

1

Human Nervous System

Relax airways

Increase heartbeat

which system?

1. parasympathetic

2. sympathetic

2

Human Nervous System

Stimulate activity of stomach

Inhibit release of glucose

which system?

1. parasympathetic

2. sympathetic

1

Human Nervous System

Inhibit activity of stomach

Stimulate release of glucose

which system?

1. parasympathetic

2. sympathetic

2

what med is this?

cause bronchodilation of the airways by increasing levels of a substance called cAMP

Xanthine Derivatives

Xanthine Derivatives

what is this?

contributes to smooth muscle relaxation and inhibits chemical mediators that produce allergic reactions

cAMP

Xanthine Derivatives

name 1

theophylline

Xanthine Derivatives

what 3 people get this?

asthma, COPD, bronchitis

Xanthine Derivatives

creates ____ effects and increase ____ levels [2 terms]

bronchodilation, cAMP

Xanthine Derivatives

used to treat symptoms or prevent?

prevent

The nurse is caring for a client newly diagnosed with asthma. Which drug should the nurse educate the client to use as a rescue inhaler?

1. Albuterol

2. Salmeterol

3. Diphenhydramine

4. Fluticasone

1

The medication actions and side effects of beta-adrenergic agonists will mimic the ____ nervous system.

sympathetic

Inhaled Corticosteroids

what type of med is this?

nonnbronchodilator

Inhaled Corticosteroids

are these used for rescue?

no

Inhaled Corticosteroids

what are 2 examples?

mast cell stabilizer, leokotriene receptor antagonist

Inhaled Corticosteroids

how are these prescribed? routes/forms

inhaler, nebulizer, intravenously, orally

Inhaled Corticosteroids

They ___ the immune response and decrease inflammation. Corticosteroids also increase the responsiveness of bronchial ____ muscle [2 terms]

inhibit, smooth