Nursing Pharmacology: Respiratory drugs Flashcards

Terms Definitions
calfactant (Infasuf)
SURFACTANTS
ammodium chloride**
COUGH SUPRESSANTS
Expectorant
pseudoephedrine (Sudafed)
DECONGESTANTS
Oral (OTC)
class of
desloratadine (Clarinex)
H1 antihistamine
class of
fexofenadine (Allegra)
H1 antihistamine
cetirizine (Zertec)
ANTIHISTAMINE
H1 Receptor Antagonists
fexofenadine (Allegra)
ANTIHISTAMINE
H1 Receptor Antagonists
acetylcysteine (Mucomyst)
Mucolytic Drugs: Expectorant
beclomethasone (Beconase, Vancenase)
DECONGESTANTS
Intranasal Steroids
ephedrine (Pretz-D)
DECONGESTANTS
Adrenergic Nasal decongestant
Necromil (Tilade)
PROPHYLACTIC ANTIASTHMATIC Drugs
iodinated glycerol (Iophen)**
COUGH SUPRESSANTS
Expectorant
potassium iodine (SSKI)**
COUGH SUPRESSANTS
Expectorant
diphenhydramine (Benadryl)**
ANTIHISTAMINE
H1 Receptor Antagonists
iprotropium (Atrovent)**
BRONCHODILATOR Drugs
Anticholinergic Bronchodilator Agent
epinephrine (Adrenalin)
BRONCHODILATOR Drugs
Sympathomimetic Drug
Nonselective Adrenergic Drugs
Contraindications of
ipratropium bromide (Atrovent)
clients with glaucoma
albuterol (Proventil, Ventolin)
BRONCHODILATOR Drugs
Sympathomimetic Drug
Selective Beta2 Receptor Drugs
phenylephrine
(Neo-Synephrine, Sinex)**
DECONGESTANTS
Adrenergic Nasal decongestant
montelukast (Singular)
zafirlukast (Accolate)**
zileuton (Zyflo)
BRONCHODILATOR Drugs
Leukotriene Antagonists
Classificaion of
montelukast (singular)
leukotriene receptor antagonists: antileukotriene
tetrahydrozoline (Tyzine Pediatric Drops)
DECONGESTANTS
Adrenergic Nasal decongestant
Class, mechanism, effects of:
astemizole (Hismanal)
cetirizine HCl (Zyrtec)
loratadine (Claritin)
fexofenadine (Allegra)
-H1 antihistamine
-specific in blocking peripheral H1 histamine receptors.
-result in lower incident of sedation.
Name the commonly used nasal decongestant spray available OTC.
phenylephrine (Neo-Synephrine)
side effects of
benzonatate (Tessalon)
1. dizziness
2. headache
3. sedation
4. nausea
5. constipation
6. pruritus
7. nasal congestion
Systematic effects of nasal decongestants.
1. headache
2. nervousness
3. dizziness
Interactions for nasal decongestants.
1. sympathomimetic drugs and sympathomimetic nasal decongestants are more likely to cause toxicity when given together.
2. MAOIs may result in additive pressor effects (i.e. raising BP) when given with sympathomimetic nasal decongestion.
Name three leukotriene receptor antagonists.
1. zafirlukast (Acculate)
2. montelukast (Singular*)
3. zileuton
Give 3 classes of Xanthan.
1. caffeine
2. theophylline
3. theobromine
What class of drugs is the action antihistamine similar to?
Anticholinergic
dextromethorphan BR (Benylin DM, Robitussin DM)**
COUGH SUPRESSANTS
OTC Antitussive Drugs
Mechanism of
ipratropium bromide (Atrovent)
antagonize the action of acetylcholine, thereby resulting in bronchodilation.
Indications of Antihistamine
1. Skin: wheal, flare formation, and iching.
2. Sesonal or perennial allergic rhinitis
3. Some symptom of common cold
What is the only anticholinergic drug use as a brochodilators?
ipratropium bromide (Atrovent)
Drugs that may interact with Fexofenadine.
erythromycin or ketoconazole
-may increase the level of Fexofenadine-
Side effects of Histamine
1. drowsiness
2. dry mouth
3. change in vision
4. difficulty urinating
5. constipation
Drugs that may interact with antihistamine in general.
1. ketoconazole
2. cimetidine
3. erythromycin
4. loratadine
(may increase the concentration of loratadine there by increase the depressant effects)
What does H1 receptors mediate?
1. smooth muscle contraction
2. dilation of capillaries
Mechanism of leukotriene receptor antagonists
Act by bloking leukotriene-mediated bronchoconstriction.
Name 5 adrenergic nasal inhalation decongestants.
1. *naphazoline (Privine)* alpha-adrenergic vasoconstrictor
2. tetrahydrozoline (Tyzine Pediatric Drops)
3. oxymetazoline (Afrin)
4. phenylephrine (Neo-Synephrine, Sinex)
5. ephedrine (Pretz-D)
Name the commonly used oral decongestant available OTC.
1. pseudoephedrine (Sudafed)
2. guaifenesin (Robintussin)
Class and mechainism of
acetylcysteine (Mucomyst)
mucolytic agent
it breaks down chemical bond resposible for the high viscosity of mucus.
Class & Mechanism of cromolyn sodium
-Antiallergic Agent & Antiasthmatic drug (prophylactic)
-inhibits histamine release and other chemical agents liberated as a result of allergic response by stabilizing mast cells.
adverse effects of fexofeadine/psuedoepedrine
may stimulate the nervous system causing cardiac collapse.
Name two adrenergic inhalation decongestion used orally.
1. desoxyephedrine (Vicks inhaler)
2. propylhexedrine (Benzedrex inhaler)
Side effets/Adverse reaction of corticosteroids inhalers.
1. GI distress
2. cough
3. dizziness
4. headache
5. bad taste in your mouth
6. oral fugal infection (candidiasis)
Usage of:
cromolyn sodium and nedicromil sodium
1. prophylactic treatment of bronchial asthma in client who require long-term therapy to control their disease.
2. those whose asthma attacks follow a predictable pattern.
What does H2 receptors mediate?
1. exceleration of heart rate
2. exceleration of gastric secretions
What is the H1 antihistamines (H1 blockers) use for?
the treatment of allergies
What the two example of mast cell stablizers?
1. cromolyn
2. nedocromil
Class and Mechanism of Ipecac syrup.
Expectorant;
stimulate the flow of gastric and respiratory tract secretions.
Name two main indications of
expectorants
1. relief of productive cough.
2. Supression of coughs caused by chronic paranasal sinusitis.
What is a mucolytic agent?
agent that reduces the thickness and the stickiness of pulmonary secretions so that removal by ciliary action and cough is facilitated and pulmonary ventilation can be improved.
Mechanism of:
cromolyn sodium and nedicromil sodium
inhibits the release of histamine and other substances from sensitized mast cells.
what are the side effects of expectorant?
1. nausea
2. vomiting
3. GI upset
Iodine= above + rash hypersensitivity
When is corticosteroid use in the respiratory system?
prophylactic treatment of bronchial asthma.
How do you treat an overdose of Xanthine bronchodilator drugs.
with syrup of ipecac
Give 2 examples of commonly used sympathomimetic bronchodilators:
1. albuterol (Proventil, Ventolin)
2. terbutaline sulfate (Brethaire, Brethene, Bricanyl)
List the pros and cons of oral decongestant.
Pros:
1. pro-longed decongestant effect.
2. no rebound congestion
Cons:
1. delayed onset activities.
2. less potent than topical decongestant.
3. may affects vascular beds other than those in the nasal mucosa.
4. may also precipitate or agrravate high BP, cardiac arrhythmias, ischemic heart disease, DM, and hyperthyroidism.
What are the three group of nasal decongestants?
1. adrenergic (sympathomimetic)
2. anticholinergic (parasympatolytic)
3. topical corticosteroids (intranasal steroids)
List the pros and cons of topical decongestant.
Pros:
1. produces potent decongestion effect.
2. prompt onset of action.
Cons:
1. rebound congestion
2. adverse systemic effects such as elevation of BP and CNS stimulation may occurs if the decongestant drains through the nasal passage and swollowed by the client.
What are some nursing implication for:
cromolyn sodium and nedicromil sodium?
1. properly instruct client on the method of administration
2. impressed the client with the need for adhering to the prescribed regiment.
Describe the MOA of narcotic antitussive agents.
supress the cough reflex through a direct action on the cough center in the CNS.
What is the therapeutic range for theophylline and when should it be taken?
10-20 mcg/mL
1-2 hours after immediate acting
about 4 hours after sustained-release
What is the indications for inhaled intranasal steroids and anticholinergic agents?
used prophylactically to prevent nasal congestion in patient with chronic upper respiratory symptoms.
**do not cause rebound congestion**
What is the mechanism of nasal steroids decongestant agents?
nasal steroid are aimed at the inflammatory response elicited by the invading organisms (viruses and bacteria) or antigens. Steroids exert their antiinflammatory effect by causing these cells to be turned off rendered unresponsive.
What is the use for
cromolyn and nedocromil?
used as adjuncts to the overall management of Pt. with asthma and are used solely for prophylaxis, not for acute asthma attacks.
List interaction that may occurs with narcotic antitussive:
Codine & Hydrocodone
potentiate the effects of:
1. other opiods
2. general anesthetics
3. tranquilizers
4. sedative or hypnotics
5. tricyclic antidepressants (TCAs)
6. MAOIs
7. alcohol
8. other CNS depressants
List 2 drugs interations that may occur with the use of expectorant.
1. Iodinated product + lithium or antithyroid drugs = hypothyroidism
2. Iodinated product + potassium-sparing diuretics = hyperkalemia
what is the rate of administration for aminophylline?
not exceed 25mg/min using a contiuous IV infusion pump.
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