Drugs Affecting Oxygenation Respiratory System

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J1 semester only

Repiratory center is the ...

medulla oblongata

Process of gas exchange is called

respiration

Process of ventilation is..

mechanical

V/Q ratio is ...

the amount of air reaching the alveoli to the amount of blood reaching the alveoli; should be about .95-1

Airway is the size of your ...

pinky

Inadequate ventilation/Oxygen means ....

increased airway resistance(swelling/mucus/ decreased ciliary action/bronchospasms)
Loss of elastic recoil of lungs(emphysema, cystic fibrosis)

Emphysema causes your alveoli to...

puff up, and become destroyed due to air being trapped and lung size increase

Pink puffers is a condition of...

emphysema

Asthma is also called...

airway reactive disorder

Asthma is either ...

intrinsic- non-allergic; infection or exercised induced
Extrinsic- allergy/hypersensitive; Ab/allergen rxn; mucus, swelling, bronchoconstriction

In an extrinsic rxn, Ab attach to ... cells, which rupture and release ..., and slow reacting substance of anaphylaxis(SRS-A)

mast;histamine

Drug administration for lung problems can be..

oral, IV, nasal spray, inhalant(Metered Dose Inhaler), inhalation

Inhaled drugs were known by ancient civilizations, current smokers, and drug abusers to...

act quickly, min. dose required, non-invasive

Scientists discovered that inhalants...

goes directly into lungs, min. side effects, avoids hepatic first pass, systemic absorbed

Metered dose inhalers are...

advantages: portable, cheap
Disadvantages: don't take it right

How you use inhalers is ....

shake, take deep breath while inhaling, wait 30 seconds, then rinse mouth(thrush/bacterial/yeast infection if don't)

Spacer is used if can't...

hold breath

What are the disadvantages/advantages of dry powder?

Advantages= no propellant, just inhale
Disadvantages= bulky, limited doses, expensive, don't know when you are out

Nebulizer's advantages/disadvantages are?

Advantages= for children/elderly/emrgency; drug nebulized into a mist; breath normally
Disadvantages=bulky, inconvenient, expensive, long tx time(10-15min), drug packaging varies, need power source

Antitussive is a ..

cough suppressant

Cough center is in the ...

medulla

Antitussive medicines..

depress cough center in medulla; cause post nasal drip

Some antitussive drugs are...

narcotics: codeine, hydrocodone; in tablets or syrup; cause drowsiness
Non-narcotics: dextromethorphan, Robutussin-DM, Benylin

Benzonatate(Tessalon) is similar to...Side effects are...

local anesthetic, anesthetizing stretch receptors in lungs(if receptors aren't stretch, then can't cough; rash, increased secretion, sedation, nausea, paradoxical excitement

Some long acting antitussive medications are...

whiskey+lemon+honey and wild cherry

Halls menthalarem cause ... because cause post nasal drip...

cough

Expectorant is....

sputum

Antitussive agents ...

promote the cough, or smoothing action on mucosa by increasing amount if liquid in repiratory tract (i.e Robutussin-stimulate secretions)

Antihistimines ....

dry you up; blocks effects of histamine(runny nose, congestion, allergic reaction, itching, motion sickness; side effects are sedation, dry mouth, urinary hesitency(anticholinergic)

Antihistimines also can cause an ....... attack, increase ..., increase blood pressure, and may trigger ... storm, increase ... pressure and photosensitivity, increase risk for seizures (avoid driving).

asthma;HR;Thyroid(too much); intraocular

Mucolytic's do what...

lysis tenacious secretion; some side effects are bronchospasms, smells like rotton eggs

Some mucolytic drugs are...

acetylcysteine-liquefies

Some nursing considerations of antitussives are...

adequate fluid intake(except milk); liquid cough medicine; Head above body when sleep; note color, consistency of sputum, avoid caffeine

Inflammatory cell(mast cell) stabilizer's ....

work on mast/macrophage/neutrophils/eosinophils cell's to prevent release of histamines; not antihistamines; give before exercising, running

Some Inflammatory cell stabilizer medicines are...

cromolyn sodium(Ital); have short half life

Antiinflammatory leukotriene receptor antagonist drugs are...

zafir lukast(accolate) or monte lukast (Singular); promotes bronchorelaxation, improves wheezing, coughing, dyspnea, decrease inflammation; slow acting and po; side effects are headache, nausea/vomiting

Corticosteroids...

decrease inflammation and edema; side effects are hoarseness, oral candida infection(suppress normal flora of mouth); must observe mouth for thrush

Some corticosteroid medications are

beclomethasone(Beclovert) and fluticasone propionate(Flonase), and prednisone given typically via inhalation and intranasal

Singular with inhaled steroid provides...

better control of inflammation becuase inhaled steroid can't formation of cysteinyl leukotrienes

Non-selective Bronchodilators are..

sympathamimic; epinephrine(potent);Vaponephrine(racemic epinephrine); Medhale-Epi; Primatine mist(OTC);Pseudoephedrine(sudafed)

Selective bronchodilators(Beta2 agonists) are...

albutrol(ventolin) po inhalation; metroproternol(Alupent) po inhalation; terbutaline(Brethine) po injection, inhalation[preterm labor relaxes bronch]; side effects are palpitation, tachycardia, headache, flushing, nausea, hypertension, anxiety, tremor

Anticholinergic bronchodilators are...

ipothropiaum bromide(atrovent); stops bronchoconstriction; side effects are glaucoma, cough, hoarseness, irritation, dry mouth, constipation, urinary retention, blurred vision, paradoxical effect

Bronchodilator Xanthine(caffeine) acts directly on .. muscle of bronchus and inhibits release of ...

smooth; SRS-A; (i.e. Theophylline by IV and Thoedor(sustained release); has narrow margin of safety of 10-20 ug/ml

Nursing considerations of bronchodilators...

initial therapy, stay with patient,quiet environment, upright position; percuss side and back to expel mucus plug then give aerosol; metered dose requires 2 puffs(wait 1min b/w puffs)

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