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Pharmacotherapeutics > Lower Respiratory Tract Drugs > Flashcards

Lower Respiratory Tract Drugs Flashcards

1
Q

Bronchial Asthma

A

Recurrent and reversible shortness of breath

Airways narrow due to bronchospasms, inflammation of bronchial mucosa, edema of bronchial mucosa, production of viscous mucus

Symptoms include wheezing, difficulty breathing, tightening of the chest, cough

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2
Q

Asthma Categories

A

Intrinsic (occurring in patients with no history of allergies)

Extrinsic (occurring in patients exposed to a known allergen)

Exercise induced

Drug induced (less common)

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3
Q

Status Astmaticus

A

Prolonged asthma attack that does not respond to typical drug therapy

MEDICAL EMERGENCY

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4
Q

Chronic Bronchitis

A

Continuous inflammation and low-grade infection of bronchi

Excessive secretion of mucus due to a prolonged exposure to bronchial irritants

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5
Q

COPD

A

Chronic, progressive, largely irreversible disorder characterized by airflow restrictions and inflammation

Chronic cough, excessive sputum, wheezing, dyspnea, poor exercise tolerance

Most commonly caused by smoking cigarettes

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6
Q

Emphysema

A

DESTRUCTION OF ALVEOLAR WALLS

SURFACE AREA WHERE GAS EXCHANGE TAKES PLACE IS REDUCED

EFFECTIVE RESPIRATION IS IMPAIRED

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7
Q

Bronchodilators

A

RELAX BRONCHI SMOOTH MUSCLE

Beta-adrenergic agonists, anticholinergics, and xanthine derivatives

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8
Q

Short-Acting Beta Agonist Inhalers

A

ALBUTEROL (VENTOLIN) AND METAPROTERENOL (ALUPENT)

Rapid relief of acute asthma

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9
Q

Long-Acting Beta Agonist Inhalers

A

SALMETEROL (SEREVENT)

Used for prophylactic and maintenance measures

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10
Q

Glucocorticoid/LABA Combinations

A

FLUTICASONE/SALMETEROL (ADVAIR)

BUDESONIDE/FORMOTEROL (SYMBICORT)

Indicated for long-term maintenance in adults and children

Not recommended for initial therapy

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11
Q

Beta2 Adrenergic Agonists

A

Use in asthma and COPD

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12
Q

Contraindications of Beta-Adrenergic Agonists

A

Known drug allergy, uncontrolled hypertension, cardiac dysrhythmias, high risk of stroke (due to vasoconstrictive drug action)

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13
Q

Adverse Effects of Beta-Adrenergic Agonists

A

ALPHA AND BETA: RESTLESSNESS, TREMOR, CARDIAC STIMULATION-TACHYCARDIA

ANGINAL PAIN WITH BETA1 AND BETA2

TREMOR WITH BETA2 (ALBUTEROL)

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14
Q

Albuterol (Proventil)

A

MOST COMMONLY USED DRUG IN THE SHORT-ACTING BETA2 AGONISTS

Must not be used too frequently

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15
Q

Salmeterol (Serevent)

A

Long-acting Beta2 agonist bronchodilator

NEVER TO BE USED FOR ACUTE TREATMENT

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16
Q

Anticholinergics

A

IPRATROPIUM (ATROVENT) AND TIOTROPIUM (SPIRIVA)

Indirectly cause airway relaxation and dilation

Help reduce secretions in COPD patients

17
Q

Indications for Anticholinergics

A

PREVENTION OF BRONCHOSPASMS ASSOCIATED WITH CHRONIC BRONCHITIS OR EMPHYSEMA

Not used for management of acute symptoms

18
Q

Adverse Effects of Anticholinergics

A

DRY MOUTH OR THROAT, nasal congestion, heart palpitations, GI distress

19
Q

Xanthine Derivatives

A

ONLY THEOPHYLINE IS USED AS A BRONCHODILATOR

20
Q

Indications for Xanthine Derivatives

A

Dilation of airways in asthma, chronic bronchitis, and emphysema

Mild to moderate cases of acute asthma

NOT FOR MANAGEMENT OF ACUTE ASTHMA ATTACK

Not used as frequently because of potential for drug interactions and variables related to drug levels in the blood

21
Q

Theophyline

A

Most commonly used xanthine derivative

THERAPEUTIC RANGE FOR THEOPHYLINE BLOOD LEVEL IS 10-20 MCG/ML

22
Q

Nonbronchodilating Respiratory Drugs

A

CORTICOSTEROIDS, leukotriene receptor agonists

23
Q

Leukotriene Receptor Agonist Mechanism of Action

A

Leukotrienes cause inflammation, bronchoconstriction, and mucus production

LRTAs prevent leukotrienes from attaching to receptors on cells in the lungs and in circulation

Inflammation in the lungs is blocked, and asthma symptoms are relieved (prevent smooth muscle contraction, decrease mucus, prevent vascular permeability, decrease neutrophil and leukocyte infiltration)

MONTELUKAST (SINGULAIR)

24
Q

Indications for LTRAs

A

Prophylaxis and long-term treatment and prevention of asthma in adults and children 12 years old and older

NOT for management of acute asthmatic attacks

Approved for treatment of allergic rhinitis

25
Q

Corticosteroids

A

Anti-inflammatory properties

Used for CHRONIC ASTHMA, BRONCHITIS, EMPHYSEMA

May take several weeks before full effects are seen

BECLOMETHASONE (DIPROPIONATE)

26
Q

Indications for Inhaled Corticosteroids

A

Primary treatment of bronchospastic disorders to control the inflammatory responses that are believed to be the cause of these disorders

Persistent asthma

Often used concurrently with beta-adrenergic agonists

27
Q

Contraindications for Inhaled Corticosteroids

A

Hypersensitivity to glucocorticoids, patients with positive Candida sputum tests, patients with systemic fungal infection

28
Q

Adverse Effects of Inhaled Corticosteroids

A

Pharyngeal irritation, coughing, dry mouth, oral fungal infections

29
Q

Nursing Implications for Beta-Adrenergic Agonists

A

Ensure patients take medications exactly as prescribed

Frequent use of albuterol makes it lose its beta2-specific functions

Report insomnia, jitteriness, restlessness, palpitations, chest pain, or any change in symptoms

30
Q

Nursing Implications for LTRAs

A

TEACH PATIENT TO TAKE MEDICATIONS EVERY NIGHT ON A CONTINUOUS SCHEDULE, EVEN IF SYMPTOMS IMPROVE

Assess liver function before therapy and throughout

31
Q

Nursing Implications for Xanthine Derivatives

A

Be aware of drug interactions with cimetidine, oral contraceptives, allopurinol, certain antibiotics, influenza vaccine, and others

Cigarettes enhance xanthine metabolism

32
Q

Nursing Implications for Inhaled Corticosteroids

A

Teach patients to gargle and rinse the mouth with lukewarm water

Pharmacotherapeutics (37 decks)

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