respiratory flash cards

8/13/2019 respiratory flash cards

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Respiratory System(General Key Points)

N203 ATI (Unit 8)

Respiratory System


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Bronchodilators Anti-inflammatory

β2-adrenergic agonists Inhaled, short-acting

Albuterol (Proventil, Ventolin)

Inhaled, long-acting Formoterol, salmeterol

Oral, long-acting Albuterol, terbutaline

Glucocorticoids Inhaled medications

Beclomethasone (QVAR) Budesonide (Pulmicort) Fluticasone (Flovent) Triamcinolone (Azmacort)

Oral medications Prednisone, prednisolone

Methylxanthines Oral, long-acting

Theophylline

Cromolyn & nedocromil (inha Leukotriene modifiers (Oral)

Montelukast (Singulair) Zafirlukast (Accolate) Anti-cholinergics

Maintenance therapy Ipratropium, inhaled (Atrovent)

Bronchodilators are oral or inhaled, for acute relief, short-term prophylaxis andlong-term control. Anti-inflammatory are for long-acting prophylaxis.


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β 2-Adrenergic Agonists

N203 ATI (Unit 8)

Respiratory System


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Expected Action: Proto: albuterol (Proventil) — Others : formoterol (

salmeterol (Serevent), terbutaline (Bre

Selectively activate β2 receptors resulting in bronchodilation: bronchospasm irelieved, histamine release is inhibited, and ciliary motility is

Therapeutic Uses: Albuterol: Inhaled, short-acting and oral, long-acting Formoterol, salmeterol: Inhaled, long-acting Terbutaline : Oral, L-A

Adverse Effects: Inhaled: Minimal adverse effects Oral: Tachycardia/angina d/t β 1 in ♥ / tremors d/t β 2 in skeletal muscle

Contraindications/Precautions: ♀ (C) CI: tachydysrhythmiasInteractions:

β-blockers like propanolol negate effects of both TCAs and MAOIs risk of tachycardia and angina

Education: Inhale 3-5 sec, hold 10 sec, wait 60 sec for next dose Use inhaled β2-agonist before using inhaled glucocorticoid


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Methylxanthines

N203 ATI (Unit 8)

Respiratory System


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Expected Action: Proto: Theophylline (Th

Theophylline relaxes bronchial smooth muscle bronchodilation

Therapeutic Uses: Long-term control of asthmaAdverse Effects: Mild toxicity GI distress & restlessness. Severe reaction

Severe reactions can occur at therapeutic levels and include dysrhythmiasseizures. Effects unlikely @


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Inhaled Anticholinergics

N203 ATI (Unit 8)

Respiratory System


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Expected Action: Proto: ipratropium (Atrovent) — Others : tiotropium (S

Block muscarinic receptors on bronchi bronchodilation

Therapeutic Uses: Relief of bronchospasms associated with COPD

Relief of allergen-induced and exercise-induced asthma.

Adverse Effects: Local anticholinergic effects

Contraindications/Precautions: ♀ (B) CI: Peanut allergy Caution in narrow-angle glaucoma

Education: Usual adult dose is 2 puffs (1 minute apart)

If taking two inhaled medications, separate by at least 5 minutes.


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Glucocorticoids

N203 ATI (Unit 8)

Respiratory System


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ExpectedAction:

Proto: beclomethasone (QVAR) — Others : budesonide (Pulmfluticasone (Flovent), triamcinolone (Azmacort), prednisone (Deltason

Prevent inflammation, suppress airway mucous production, and promoteresponsiveness of β

2-receptors in bronchial tree.

Therapeutic Uses: Inhaled: Long-term asthma prophylaxis S-T, oral: Treat symptoms following acute asthma. L-T, oral: Treat chronic asthma 1º adrenocortical insufficiency Promote lung maturity and RDS in fetuses at risk for preterm birth.

Adverse Effects: Inhaled: Dysphasia, candidiasis, bone loss Oral (≥10d): adrenal gland function / bone loss / hyperglycemia / glucosuri

/ infection / peptic ulcer disease / myopathy / fluid & electrolyte disturbances.Contraindications/Precautions: ♀ (?) CI: Live virus / systemic fungal inInteractions: Diuretics: hypokalemia NSAIDs: GI ulceration

Glucocorticoids counteract effects of insulin and oral hypoglycemics.

Education: Oral are for short-term use, 3-10 days following acute attack


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Mast Cell Stabilizers

N203 ATI (Unit 8)

Respiratory System


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Expected Action: Proto: Cromolyn (Intal) — Others : nedocromil ( Anti-inflammatory: Stabilize mast cells, inhibiting histamine release. Suppress inflammatory cells (e.g. eosinophils, macrophages)

Therapeutic Uses: Management of chronic asthma Prophylaxis of exercise-induced and allergen-induced asthma attacks

Allergic rhinitis by intranasal route

Adverse Effects: Safest of all asthma meds / safe for kidsContraindications/Precautions: ♀ (B)

Propellant CI: CAD, dysrhythmias, and status asthmaticus

Education: Take 15 min before exercise Long-term prophylaxis may take several weeks


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Leukotriene Modifiers

N203 ATI (Unit 8)

Respiratory System


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Expected Action: Proto: montelukast (Singulair) — Others : zileuton

zafirlukast (Ac

Prevent effects of leukotrienes thus suppressing inflammation, airway edema, bronchoconstriction, and mucus production.

Therapeutic Uses: Long-term asthma therapy in folks ≥ 12 YO

Adverse Effects: Liver injury ĉ zileuton and zafirlukast . (nausea, anorexiabdominal pain)

Contraindications/Precautions:

♀ (?)

Interactions: Zileuton / zafirlukast inhibit warfarin metabolism [warfarin ]

Zileuton / zafirlukast inhibit theophylline metabolism theophylline

Education: Zileuton given without regard to food. Zafirlukast taken ŝ f


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Antitussive – Opioids

N203 ATI (Unit 8)

Respiratory System


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Mucolytics

N203 ATI (Unit 8)

Respiratory System


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Decongestants

N203 ATI (Unit 8)

Respiratory System


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