Exam II review

Respiratory System Overview

• Unit covers respiratory and gastrointestinal (GI) systems.

• Key structures of the respiratory system: sinuses, nasal cavity, oral cavity, pharynx (upper airways) and lungs (lower airways).

• Epithelial tissue lines both upper and lower airways, explaining the connection between allergies and asthma.

Allergic Rhinitis and Common Cold

• Allergic Rhinitis: caused by allergens (e.g., grass, trees, animal dander).

• Common Cold: caused by viral infection.

• Symptoms overlap: sneezing, itching, watery eyes, increased mucus production, congestion.

• Allergies typically do not cause systemic illness, while colds may.

Autonomic Nervous System Role

• Sympathetic Activation: Vasoconstriction (reducing congestion) in the nose.

• Parasympathetic Activation: Vasodilation (increasing mucus production).

• Mucus contains immunoglobulins and mast cells (contain histamine).

Medications for Allergic Rhinitis

Antihistamines

• First Generation: Diphenhydramine, promethazine, cause sedation and anticholinergic effects.

• Second Generation: Cetirizine (Zyrtec), loratadine (Claritin), fexofenadine (Allegra), less sedating, suitable for daytime use.

• Paradoxical reactions can occur, especially in children (e.g., agitation instead of sedation).

Other Medications

• Cromolyn: Mast cell stabilizer, minimal side effects, used as a maintenance spray, must be used regularly.

• Leukotriene Inhibitors: Montelukast, taken in the evening, helpful for seasonal allergies.

• Intranasal Corticosteroids: Fluticasone, mometasone (RX), triamcinolone; effective for maintenance but may cause nasal irritation.

• Nasal Decongestants: Phenylephrine, pseudoephedrine, can raise blood pressure, recommended for short-term use only due to rebound congestion risk.

• Ipratropium: Anticholinergic agent, used to treat runny nose, blocks vasodilation in the nose.

Cough Medications

• Cough is a reflex to remove irritants or infections.

• Opioids: E.g., codeine suppresses cough, may cause respiratory depression.

• Non-opioids: Dextromethorphan (Robitussin, Delsym), benzonatate; caution in children due to psychoactive properties.

• Expectorants: Guaifenesin (Mucinex) helps thin mucus.

• Mucolytics: Acetylcysteine helps with severe mucus plugging (e.g., cystic fibrosis).

Asthma and Pulmonary Disorders

• Asthma vs. COPD:

  • Asthma: reversible airway obstruction, often triggered by allergens, exercise, or infections.

  • COPD: irreversible damage, typically due to smoking.

• Bronchodilators: Short-acting (albuterol), long-acting (formoterol, salmeterol), and anticholinergic (ipratropium).

• Inhaled Corticosteroids: Fluticasone, budesonide for maintenance therapy.

• Combination Inhalers: Contain corticosteroids and long-acting bronchodilators (e.g., Advair).

• Monitor cardiovascular effects, especially in patients with preexisting conditions.

Gastrointestinal System Overview

“Upper GI Disorders and Medications for Peptic Ulcer Disease”

• Upper GI includes the mouth, esophagus, stomach, liver, and gallbladder.

• Peptic Ulcer Disease (PUD): Ulcers in stomach or duodenum, caused by NSAIDs, H. pylori, or stress.

  • Symptoms: burning pain, nausea, possible GI bleeding.

  • Treatment: Proton Pump Inhibitors (PPIs) like omeprazole, antibiotics for H. pylori.

  • Risk factors include NSAID use and smoking.

• GERD: Acid reflux causing heartburn and other symptoms; treated with PPIs and lifestyle modifications.

Key Medications for GI Disorders

• PPIs: Omeprazole, pantoprazole - reduce stomach acid production.

• H2 Antagonists: Cimetidine, famotidine - reduce acid secretion (caution with cimetidine due to side effects).

• Antacids: Tums, milk of magnesia - neutralize stomach acid; can cause constipation or diarrhea.

• Antibiotics for H. pylori: Clarithromycin combined with amoxicillin or others for eradication.

• Stool Softener: Docusate sodium for preventing constipation.

Common GI Complaints and Management

• Constipation: Often caused by medications (opioids, anticholinergics), inadequate fiber or water.

  • Lifestyle changes (diet/high fiber and hydration) first line; laxatives as needed (bulk-forming laxatives, osmotic laxatives).

• Diarrhea: Can result from infection, food intolerances, or medications (e.g., antibiotics).

  • Treatment often focuses on fluid management; loperamide (Imodium) for symptomatic relief.

• Nausea and Vomiting: Manage with clear fluids, BRAT diet; medications like ondansetron for severe cases (e.g., chemotherapy-induced nausea).

Nutritional Considerations

• Vitamins: Water-soluble (C, Bs) versus fat-soluble (A, D, E, K) vitamins; monitor for deficiencies especially in vulnerable populations (e.g., elderly).

• Pharmacologic Nutrition: Enteral (tube feeding) and parenteral (IV feeding) for severe malnutrition.

• Obesity Management: Focus on diet, exercise; medical treatments available (semaglutide, bupropion/naltrexone).

• Surgical options: sleeve gastrectomy, gastric banding; monitor for nutritional deficiencies post-surgery.

Exam Information

• 71 multiple-choice questions including "select all that apply" and matching; partial credit available.

• Questions based on ATI respiratory and GI modules, course materials, and chapter review questions from Pearson textbook (Chapters 39–43).

• Prepare using supplemental resources available in the course folder.