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Nursing Pharmacology: Respiratory Drugs

Terms in this set (67)

NURSING PHARMACOLOGY: RESPIRATORY DRUGS 53 TEST QUESTIONS
by: Jaymee B. Quindara
http://bitesizenursing.blogspot.com
Q: Thses Drugs dilate the airways of the respiratory tree, making air exchange and respiration easier for the client, and relax the smooth muscle of the bronchi
A: Sympathomimetic bronchodilators
Q: These drugs increase levels of cyclic adenosine monophosphate by stimulating the beta2 -adrenergic receptors in the smooth muscle, resulting in bronchodilation.
A: Beta 2 -Adrenergic Agonists
Q: Give examples of short acting Beta-2 Adrenergic Agonist
A: albuterol (systemic, inhalation)
levalbuterol (inhalation)
metaproterenol (inhalation)
pirbuterol (inhalation)
terbutaline (systemic)
Q: Give examples of long acting Beta-2 Adrenergic Agonist
A: formoterol (inhalation)
salmeterol (inhalation).
Q: Give indications for Bronchodilators
A: Bronchodilators are used to treat allergic rhinitis and sinusitis, acute bronchospasm, acute and chronic asthma, bronchitis, chronic obstructive pulmonary disease, and emphysema.
Q: Give contraindications for Bronchodilators
A. Bronchodilators are contraindicated in individuals with hypersensitivity, peptic ulcer disease, severe cardiac disease and cardiac dysrhythmias, hyperthyroidism, or uncontrolled seizure disorders. Bronchodilators should be used with caution in clients with hypertension, diabetes mellitus, or narrow-angle glaucoma.
Q: Enumerate some adverse reactions to short -acting beta2 -adrenergic agonists
A: paradoxical bronchospasm
tachycardia
palpitations
tremors
dry mouth
Q: Enumerate some adverse reactions to long-acting beta2 -adrenergic agonists
A: bronchospasm
tachycardia
palpitations
hypertension
tremors
Q: Enumerate some nursing interventions for a patient receiving bronchodilators part1
A: 1. Assess vital signs.
2. Monitor for cardiac dysrhythmias.
3. Assess for cough, wheezing, decreased breath sounds, and sputum production.
4. Monitor for restlessness and confusion.
Q: Enumerate some nursing interventions for a patient receiving bronchodilators part2
5. Provide adequate hydration.
6. Administer the medication at regular intervals around the clock to maintain a sustained therapeutic level.
7. Administer oral medications with or after meals to decrease gastrointestinal irritation.
8. Instruct the client not to crush enteric-coated or sustained-release tablets or capsules.
Q: Enumerate some nursing interventions for a patient receiving bronchodilators part3
9. Instruct the client to avoid caffeine-containing products.
10. Instruct the client in the side effects of bronchodilators.
11. Instruct the client in how to monitor the pulse and to report any abnormalities to the physician.
12. Instruct the client in how to use an inhaler or nebulizer and how to monitor the amount of medication remaining in an inhaler canister; how to use a spacer .
Q: Enumerate some nursing interventions for a patient receiving bronchodilators part4
13. Instruct the client to avoid over-the-counter medications.
14. Instruct the client to stop smoking and provide information regarding support resources.
15. Instruct the client with diabetes mellitus to monitor blood glucose levels.
16. Instruct the client with asthma to wear a Medic-Alert bracelet.
Q: These drugs inhibits muscarinic receptors, which results in bronchodilation. This drug works by blocking the parasympathetic nervous system, rather than stimulating the sympathetic nervous system.
A: Anticholinergics (Ipratropium)
Q: This is the most commonly used anticholinergic drug for respiratory disorders.
A: Ipratropium
Q: Enumerate some adverse reactions to anticholinergic drugs.
nervousness
tachycardia
nausea and vomiting
paradoxical bronchospasm (with excessive use)
dry mouth.
Q: These drugs stimulate the central nervous system and respiration, dilate coronary and pulmonary vessels, cause diuresis, and relax smooth muscle.
A: Methylxanthines
Q: Enumerate the types of Methylxantines .
A: Methylxanthines include anhydrous theophylline and its derivative salt aminophylline.
Theophylline is the most commonly prescribed oral methylxanthine. Aminophylline is preferred when an I.V. methylxanthine is required. Caffeine is also a xanthine derivative.
*Intravenously administered aminophylline or theophylline preparations should be administered slowly and always via an infusion pump.
Q: Enumerate some inidications for Methylxantine use.
A: asthma
chronic bronchitis
emphysema.
Q: What is teh serum therapeutic level of Theophyline?
A: 10 to 20 mcg/mL.
*Note that toxicity is likely to occur when the serum level is higher than 20 mcg/mL.
Q: These drugs work by inhibiting the production of cytokines, leukotrienes, and prostaglandins; the recruitment of eosinophils; and the release of other inflammatory mediators.
A: Corticosteroids
Q: Enumerate some examples of inhaled Corticosteroids
A:
Beclomethasone dipropionate (Qvar)
Budesonide (Pulmicort Turbohaler, Pulmicort
Respules)
Flunisolide (AeroBid)
Fluticasone propionate (Flovent HFA, Flovent
Rotadisk, Flovent Diskus)
Mometasone furoate (Asmanex Twisthaler)
Triamcinolone (Azmacort)
Q: Enumerate some examples of oral Cortecosteroids.
A: Prednisone
Prednisolone
Q: Enumerate some adverse reactions to inhaled corticosteroid therapy
A:
mouth irritation
oral candidiasis
upper respiratory tract infection.
Q: These are substances released from mast cells, eosinophils, and basophils that can cause smooth -muscle contraction of the airways, increased permeability of the vasculature, increased secretions, and activation of other inflammatory mediators.
A: Leukotienes
Q: These drugs prevent the D4 and E4 leukotrienes from interacting with their receptors, thereby blocking their action.
A: Leukotriene receptor antagonists zafirlukast and montelukast.
Q: These drugs inhibits the production of 5 -lipoxygenase, thereby preventing the formation of leukotrienes.
A: leukotriene formation
inhibitor zileuton
Q: Enumerate some side effects of LEUKOTRIENE MODIFIER therapy.
1. Headache 2. Nausea and vomiting
3. Dyspepsia 4. Diarrhea
5. Generalized pain, myalgia 6. Fever
7. Dizziness
Q: Enumerate some nursing intervention to initiate if a patient is taking Leukotriene Modifiers 1
A:
1. Monitor vital signs and for cyanosis.
2. Assess lung sounds for rhonchi and wheezing andAssess liver function laboratory values.
3. Instruct the client to take medication 1 hour before or 2 hours after meals.
Q: Enumerate some nursing intervention to initiate if a patient is taking Leukotriene Modifiers 2
4. Instruct the client to increase fluid intake.
5. Instruct the client not to discontinue the medication and to take as prescribed, even during symptom-free periods.
Q: These drugs inhibit mast cell release after exposure to antigens possibly by inhibiting calcium channels, thus preventing the release of inflammatory mediators.
A: Mast cell stabilizers
Q: Enumerate some examples of Mast cell stabilizers.
A: Cromolyn sodium, inhaled (Intal)
Nedocromil, inhaled (Tilade)
Q: Enumerate some side effects of Mast Cell Stabilizers.
A:
1. Cough or bronchospasm following inhalation
2. Nasal sting or sneezing following inhalation
3. Unpleasant taste in the mouth
Q: Enumerate some adverse effect if taking Mast Cell Stabilizers.
A: pharyngeal and tracheal irritation
cough
wheezing
bronchospasm
headache.
Q: Enumerate some nursing interventions to initiate if a patient is taking Mast Cell Stabilizer drugs. 1
A:Interventions
1. Monitor vital signs and monitor respirations and assess lung sounds for rhonchi or wheezing.
2. Instruct the client to drink a few sips of water before and after inhalation to prevent a cough and an unpleasant taste in the mouth.
Q: Enumerate some nursing interventions to initiate if a patient is taking Mast Cell Stabilizer drugs. 2
3. Administer oral capsules (cromolyn sodium) at least 30 minutes before meals.
4. Instruct the client not to discontinue the medication abruptly because a rebound asthmatic attack can occur.
Q: These drugs inhibits the binding of IgE to its receptor on the mast cell and basophils.
This in turns inhibits the release of allergic substances which potentiate asthma
symptoms.
A: Monoclonal Antibodies (Omalizumab (Xolair))
Q: Enumerate some side effects to Monoclonal Antibodies
A: Side effects
Injection site reactions. Viral infections. Upper respiratory infections . Sinusitis. Headache . Pharyngitis. Anaphylaxis . Malignancies
Q: Enumerate some Adverse reactions to Monoclonal Antibodies.
A: Adverse Effects:
injection site reactions, upper respiratory tract infections
sinusitis, headache, pharyngitis, allergic reaction.
Q: Enumerate some Nursing Interventions to Monocolonal Antibody therapy part 1.
A: Interventions
1. Assess respiratory rate, rhythm, and depth and auscultate lung fields bilaterally and assess for allergies and/or allergic reaction symptoms such as rash or urticaria.
3. Instruct the client that respiratory improvement will not be immediate.
Q: Enumerate some Nursing Interventions to Monocolonal Antibody therapy part 2.
4. Instruct the client not to stop taking or decrease the currently prescribed asthma medications unless instructed.
5. Avoid live virus vaccines for the duration of treatment.
6. Have medications for the treatment of severe hypersensitivity reactions available during initial administration in case anaphylaxis occurs.
Q: These medications compete with histamine for
receptor sites, thus preventing a histamine response.These drugs also decrease nasopharyngeal, gastrointestinal, and bronchial secretions by blocking the H1 receptor.
A: Antihistamine
Q: Enumerate some examples of antihistamines part 1
A:
Acrivastine/pseudoephedrine (Semprex-D)
Azelastine hydrochloride (Astelin Ready-Spray)
Brompheniramine (BrōveX)
Cetirizine hydrochloride (Zyrtec)
Chlorpheniramine maleate (Aller-Chlor; Chlor-Trimeton
Allergy 8 Hour, 12 Hour)
Q: Enumerate some examples of antihistamines part 2
A:
Doxylamine succinate (Unisom Nighttime Sleep-Aid)
Fexofenadine (Allegra)
Fexofenadine; pseudoephedrine (Allegra-D)
Loratadine (Claritin)
Loratadine; pseudoephedrine (Claritin-D 12 Hour, 24 Hour)
Triprolidine; pseudoephedrine (Actifed Cold & Allergy)
Q: Enumerate some examples of antihistamines part 3
A: hlorpheniramine; pseudoephedrine (Allerest)
Clemastine fumarate (Tavist)
Desloratidine (Clarinex)
Dexchlorpheniramine maleate
Dimenhydrinate (Dramamine)
Diphenhydramine (Benadryl)
Q: Enumerate some side effects of taking antihistamines.
A: Side effects
Drowsiness and fatigue Dizziness Urinary retention Blurred vision Wheezing Constipation Dry mouth Gastrointestinal irritation Hypotension Hearing disturbances Photosensitivity Nervousness and irritability Confusion Nightmares
Q: Enumerate some Nursing Interventions to initiate if a patient is taking antihistamines part 1.
A: Interventions
1. Monitor vital signs.
2. Monitor for signs of urinary dysfunction.
3. Administer with food or milk.
4. Avoid subcutaneous injection, and administer by intramuscular injection in a large muscle if the intramuscular route is prescribed.
Q: Enumerate some Nursing Interventions to initiate if a patient is taking antihistamines part 2.
A: 5. Instruct the client to avoid hazardous activities, alcohol, and other CNS depressants.
6. Instruct the client taking the medication for motion sickness to take it 30 minutes before the event and then before meals and at bedtime during the event.
7. Instruct the client to suck on hard candy or ice chips for dry mouth.
Q: These medications shrink nasal mucosal membranes and reduce fluid secretion.
A: Nasal Decongestants
Q: Enumerate some examples of Nasal Decongestants. (Intranasal Nonglucocortecosteriods)
A: INTRANASAL NONGLUCOCORTICOSTEROIDS
Naphazoline (Privine)
Oxymetazoline hydrochloride (Afrin 12-Hour Original)
Phenylephrine hydrochloride (Neo-Synephrine)
Pseudoephedrine hydrochloride (Sudafed)
Tetrahydrozoline (Tyzine)
Xylometazoline (Natru-Vent, Otrivin)
Q: Enumerate some examples of Nasal Decongestants. (Intranasal Glucocortecosteriods)
A: INTRANASAL GLUCOSTEROIDS
Beclomethasone dipropionate (Beconase AQ)
Budesonide (Rhinocort Aqua)
Flunisolide (Nasarel)
Fluticasone (Flonase)
Mometasone (Nasonex)
Triamcinolone (Nasacort AQ)
Q: Enumerate some side effects of Nasal Decongestants.
A:Side effects
1. Frequent use of decongestants, especially nasal sprays or drops, can result in tolerance and rebound nasal congestion (vasodilation) caused by irritation of the nasal mucosa.
2. Nervousness
3. Restlessness, insomnia
4. Hypertension
5. Hyperglycemia
Q: Enumerate some nursing interventions to initiate if a patient is taking nasal decongestants. 1
A: Interventions
1. Assess the client for existing medical disorders.
2. Monitor for cardiac dysrhythmias.
3. Monitor blood glucose levels.
Q: Enumerate some nursing interventions to initiate if a patient is taking nasal decongestants. 2
4. Instruct the client to avoid consuming caffeine in large amounts because it can increase restlessness and palpitations.
5. Instruct the client in the importance of limiting the use of nasal spray and drops.
Q: These drugs loosen bronchial secretions so that they can be eliminated with coughing; they are used for dry unproductive cough and to stimulate bronchial secretions.
A: Expectorants such as Dornase alfa (Pulmozyme) and Guaifenesin (Humibid, Robitussin)
Q: These drugs agents thin mucous secretions to help make the cough more productive
A: MUCOLYTIC
Acetylcysteine (Mucomyst)
Q: Enumerate some side effects of Expectorants
A: Side effects
1. Gastrointestinal irritation
2. Skin rash
3. Oropharyngeal irritation
Q: Enumerate some nursing interventions to initiate if a patient is taking expectorants part 1
A: Interventions
1. Instruct the client to take the medication with a full glass of water to loosen mucus.
2. Instruct the client to maintain an adequate fluid intake.
3. Encourage the client to cough and deep breathe.
Q: Enumerate some nursing interventions to initiate if a patient is taking expectorants part 2
A:
4. Acetylcysteine (Mucomyst), administered by nebulization, should not be mixed with another medication.
5. If acetylcysteine is administered with a bronchodilator, the bronchodilator should be administered 5 minutes before the acetylcysteine.
6. Monitor for side effects of acetylcysteine such as nausea and vomiting, stomatitis, and runny nose.
Q: These drugs act on the cough control center in the medulla to suppress the cough reflex; used for a cough that is nonproductive and irritating.
A: Antitussives such as:
OPIOIDS
Codeine, codeine phosphate, codeine sulfate
Hydrocodone; homatotropine (Hycodan)
NONOPIOIDS
Diphenhydramine hydrochloride (Benadryl)
Q: Enumerate some adverse effects to atititussives.
A: Side effects
1. Dizziness, drowsiness, sedation
2. Gastrointestinal irritation, nausea
3. Dry mouth
4. Constipation
5. Respiratory depression
Q: Enumerate some nursing interventions to initiate if a patient is taking antitussives part1.
Interventions
1. Instruct the client that if the cough lasts longer than 1 week and a fever or rash occurs to notify the physician.
2. Encourage the client to take adequate fluids with the medication.
3. Encourage the client to sleep with the head of the bed elevated.
4. Instruct the client to avoid hazardous activities.
Q: Enumerate some nursing interventions to initiate if a patient is taking antitussives part2.
A:
5. Note that drug dependency can occur.
6. Avoid administration to the client with a head injury or a postoperative cranial surgery client.
7. Avoid administration to the client using opioids, sedative-hypnotics, barbiturates, or antidepressants because CNS depression can occur.
8. Instruct the client to avoid the use of alcohol.
Q: These medications reverse respiratory depression in opioid overdose.
A: Opiod or Narcotic Antagonists such as:
Nalmefene (Revex)
Naloxone hydrochloride (Narcan)
Naltrexone (ReVia)
Q: Enumerate some side effects of Opioid Antagonists.
A: Side effects
1. CNS depression 2. Nausea, vomiting
3. Tremors 4. Sweating
5. Increased blood pressure 6. Tachycardia
Q: Eunumerate some nursing interventions to initiate if a patient is taking Opioid antagonists.
Interventions
1. Assess vital signs, especially respirations.
2. For intravenous administration, the dose is titrated every 2 to 5 minutes as prescribed.
3. Have oxygen and resuscitative equipment available during administration.
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