Chapter 30/39: Lower respiratory drugs

flashcard set 4/4 for exam 2 pharm

what is in the lower respiratory tract?

trachea, bronchi, bronchioles, alveoli, and alveolar-capillary membrane

all of these lower respiratory meds do what to the lungs?

bronchodilation

what do beta2 adrenergic agonists (SABA) do?

these stimulate the beta 2 receptors in the lungs → relax smooth muscle in bronchi → bronchodilation

side effects of SABA’s

• jitters

• tachycardia

• anxiety

• palpitations

patients who take SABAs routinely…

may not have these side effects

what should not be used with patient’s taking the terols?

beta blockers (these block the receptors)

SABA admin

• oral

• MDI and aerosol **

Beta 2 agonist end in

-terol

short acting beta 2 agonists medication name

• albuterol

• levalbuterol

short acting beta 2 agonists are used for

RESCUE (acute distress) maybe maintenance if needed

long acting beta 2 medication names

• formoterol

• salmeterol

what are long acting beta 2 agonists used for?

MAINTENANCE (long acting)

what do anticholinergics do?

block acetylcholine receptors → relax bronchi → bronchodilate

what do anticholinergics end in?

-tropium

medication names for anticholinergics

• ipratropium

• tiotropium

what do we use anticholinergics for?

maintenence (routinely taken)

route for anticholinergics

• MDI

• nebulizer

• DPI

Side effects of anticholinergics

• drying effects

what do inhaled corticosteroids do?

block acetylcholine receptors → relax bronchi → decrease inflammation and open airway → bronchodilation

what do we take inhaled corticosteroids for?

maintenance

mediation names for inhaled corticosteroids

• budesonside

• fluticasone

• beclomethasome

how long for inhaled corticosteroids to see full effect?

a few weeks

side effects of inhaled corticosteroids

• throat irritation

• hoarseness

• dry mouth

• coughing

• oral thrush

what may help prevent infection on mouth?

spacer

what should we do after inhaling corticosteroids?

RINSE mouth with water after use, maybe even full oral care

nursing with inhaled corticosteroids/ SABA

• know how to use inhalers correctly

• clean/change equipment

• clean mouthpiece (do not submerge)

• educate side effects

instructions for DPI

• quick inhale (suck)

MDI instructions

slow and purposeful inhale

aerosols considerations

a wet environment is a breeding ground for bacteria, need clean and dry equipment

which do I give first - albuterol or fluticasone?

ALBUTEROL (quick hit bronchodilation)

what do xanthine derivatives end in?

-phylline

what do xanthine derivatives do?

talk to central nervous system to tell the lining of our bonchi to relax, open → bronchodilate

theophylline therapeutic range

5-15 mcg/mL

greater than 20 mcg/mL

toxicity

what will happen when you have theophylline toxicity

• cardiac issues → tachycardia

• CNS issues → seizures

• bleeding

___ increases half life of theophylline

smoking (increases risk for toxicity)

theophylline route

PO and IV slow infusion

when might theophylline be used?

someone with asthma or COPD (not very used)

what do leukotriene modifiers end in?

-lukast

what do leukotriene modifiers do?

antagonize leukotriene receptors → decrease inflammation → open airway → bronchodilation

is this for acute treatment or maintenance?

maintenance only

leukotriene modifiers are used for a patient with

asthma or allergy maintenance

route for leukotriene modifiers

PO in the evening

risk for taking leukotriene modifiers

behavior changes, neuropsychiatric changes

what do we give for tuberculosis?

antitubercular drugs

treatment for TB

extremely long (6-9 months) on many meds, on it so long your body may start to resist meds

what is latent TB?

they do not actively have TB, they can take TB meds prophylactically to prevent it from becoming active

medications for antitubercular drugs

• isoniazid

• rifampin

• ethambutol

• pyrazinamide

what is the first line medication for TB?

Isoniazid (INH) like a guarantee

how many drugs are prescribed for TB?

at least 3

organ of concern for TB drugs

liver

what does INH do?

blocks benefits of vitamin B6 (pyridoxine)

what does lack of vitamin B6 cause?

peripheral neuropathy

what should we administer when taking INH

pyridoxine

people who take pyrazinamide can develop what?

GOUT

ethambutol can cause?

optic neuritis (eye issues)

rifampin can cause?

orange colored body fluids

considerations for TB meds with the pregnant patient

benefits outweigh the risk

what is directly observed therapy?

tracking numbers, treatment, take home visits, watch patient take medications to decrease numbers of TB

why is medication adherance to TB meds important

if these are not taken correctly, bacteria can become resistant