The Respiratory System- pharmacology quiz 3

what is the drug class of albuterol (Proventil HFA, Ventolin HFA)

Beta-2 adrenergic agonists

what is the mechanism of albuterol/beta-2 adrenergic agonists

stimulate beta2 adrenergic receptors of the SNS, causing bronchodilation- opening up the airway

provide relief of acute bronchospasm and prevention of exercise-induced bronchospasm

albuterol is quick relief/rescue inhaler

what are the ADRs of albuterol

Everything is moving faster:

• tachy

• heart palpitations

• chest pain

• tremors

how are beta2 adrenergic agonists administered

long term- oral

quick relief- inhalation

patient education for albuterol

avoid caffeine use

report tremors impacting ADLs

precautions for albuterol

• cardiovascular disease

• HTN

• diabetes

• patients taking antidepressants

what is the drug class of ipratropium (Atrovent)

anticholinergics

what is the mechanism of action for ipratropium/anticholinergics

inhibit acetylcholine which causes vasoconstriction of the bronchi/bronchioles

provide relief of bronchoconstriction and reduces secretions

ADRs of ipratropium/anticholinergics

can’t see, spit, poop, pee

• dry mouth

• constipation

• increased intraocular pressure (glaucoma risk)

patient education for ipratropium/anticholinergics

prevention of dry mouth

• lots of fluids and suck on something (hard candy)

have routine eye exams

how is ipratropium/anticholinergic administered

inhaler or nebulizer

precuation for ipratropium

patient with glaucoma

what are the three glucocorticoids for lower resp airflow disorders and what is it used for?

end in -SONE

oral- prednisone

• short-term and post exacerbation

inhaled- beclomethasone

• long term management

IV- methylprednisone

• emergency and acute

what is the mechanism of action of glucocorticoids (-end in SONE)

decreases inflammation by preventing the release of prostaglandins and histamines (cause inflammation)

ADRs of glucocorticoids/steroids

• increased infection (thrush)

• suppress adrenal function

• myopathy

• hyperglycemia

• GI distress/PUD

• F+E imbalances

• fat redistribution

• truncal obesity

• osteoporosis

• hypotension

administration for glucocorticoids

• inhalation med- use a spacer and rinse mouth after

• TAPER

precautions for glucocorticoids

• patients with PUD, diabetes, renal dysfunction, NSAID daily use (if ulcer, bleeding, increased bleeding risk)

contraindication for glucocorticoids

NOT WITH potassium sparing diuretic (Lasix)

• risk of hypokalemia

what drug class is montelukast (Singulair) in?

leukotrine modifiers

what is the mechanism of action of montelukast/leukotrine modifiers

work by suppressing effects of leukotrienes (work on WBCs) that cause inflammation

used in combo with other anti-inflammatory drugs to decrease bronchoconstriction and inflammation

ADRs for montelukast/leukotrine modifiers

liver damage (but not a risk of montelukast specifically)

suicidal thoughts

NI related to ADRs of montelukast/leukotrine modifiers

• liver damage

  • Monitor for jaundice, ascites, abdominal pain, confusion, LFTs

• suicidal thoughts

  • ask if having active suicidal thoughts

administration of montelukast/leukotrine modifiers

orally at night

may interact with other drugs—> need a higher dose

what are the benefits of inhalation route of admin

• fast onset

• fewer bad side effects

what are the 3 aerosol devices we use to administer medication?

• nebulizer

• metered dose inhaler

• dry powder inhaler

how do you use a dry powdered inhaler and what is it?

patient inhaled powder from crushed pill— activated by inhalation

how to use:

1. DO NOT SHAKE

2. make sure mouth is sealed tightly around mouthpiece before breathing in

3. breath in—> hold for 10 secs

4. rinse mouth or brush teeth after use to prevent thrush

what is a nebulizer and how do we use it?

vaporizes liquid into fine mist—> machine and face mask used to deliver drug

how to use:

1. wash hands and equipment before use to avoid infections

2. sit upright when administering and hold neb upright

3. breathe normally through your mouth until all medication is gone from the cup (5-15 mins)

what is a MDI and how do you use it?

standard inhaler—> delivers measured dose; patient inhales as puff of drug is expelled

how to use:

1. remove cap and shake before admin

2. take a deep breathe and exhale completely before administering meds

3. form a tight seal with lips around inhaler so doesn’t leak

4. breathe in while pressing button and hold breath for around 10 secs before slowly breathing out

what is the drug class for diphenhydramine (Benadryl)

first generation antihistamines (SEDATING)

what is the mechanism of action of diphenhydramine (Benadryl)/first gen antihistamines

Sedating antihistamines bind to H1 receptors and block the release of histamine

treat allergic and anaphylactic reactions

mild anticholinergic (drying out effects)

ADRs of diphenhydramine/ first gen antihistamines (sedating)

drowsiness and dizziness

anticholinergic effects—> can’t see, spit, poop, pee

administration of diphenhydramine (Benadryl)

orally

maybe IV

patient education for diphenhydramine (Benadryl)/first gen antihistamines

avoid ETOH and other CNS depressants

no driving or heavy machinery

what is the drug class for cetirizine (Zyrtec)

second gen antihistamines (NONSEDATING)

what is the mechanism of cetirizine (Zyrtec)/second gen antihistamines

used to treat allergic rhinitis and chronic idiopathic urticaria

nonsedating antihistamines block histamine effects at the H1 receptors without binding to or inactivating histamine

what are the ADRs of cetirizine (Zyrtec)/second gen antihistamines

mild drowsiness

admin of cetirizine (Zyrtec)/second gen antihistamines

oral

precautions for cetirizine (Zyrtec)/second gen antihistamines

patients with impaired kidney or liver function

what drug class are opiod (codeine) and nonopioid (dextromethorphan)

antitussives

what is the mechanism of action for opiod (codeine) and nonopioid (dextromethorphan)

suppress coughing related to allergies or URIs

they suppress the cough reflex in the brain

ADRs for opiod (codeine) and nonopioid (dextromethorphan)/antitussives

drowsiness

respiratory depression

patient education for opiod (codeine) and nonopioid (dextromethorphan)/antitussives

only use when necessary

monitor for abuse

contraindications for opiod (codeine) and nonopioid (dextromethorphan)/antitussives

MAO inhibitors or SSRIs— antidepressant meds

what is the drug class for guaifenesin (Mucinex)

expectorants

what is the mechanism of action for guaifenesin (Mucinex)/Expectorants

treats colds and other URIs that produce mucus; bronchitis to remove secretions

work by reducing surface tension of secretions therefore thinning them—> makes it easier to cough out/drain to the sinuses

ADRs for guaifenesin (Mucinex)/Expectorants

rare but drowsiness or headache

admin of guaifenesin (Mucinex)/Expectorants

oral

patient education for guaifenesin (Mucinex)/Expectorants

increase fluid intake

what is the drug class for acetylcysteine (acetadote)

mucolytics

what is the mechanism of action for acetylcysteine (acetadote)/Mucolytics

used to decrease viscosity of mucus secretions

work by breaking down proteins in mucus—> thin secretions so its easier cough out

ADRs of acetylcysteine (acetadote)/Mucolytics

bronchospasm or GI upset

administration of acetylcysteine (acetadote)/Mucolytics

through inhaler or nebulizer