1
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- Pat Edwards
- Professor of Nursing
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2
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- Anticholinergics (Atrovent)
- Antileukotriene (Accolate)
- Corticosteroids (Vanceril, Medrol)
- Mast Cell Stabilizers (Cromolyn)
- Antihistamines (Benedryl)
- Decongestants (Sudafed)
- Antitussives (Codeine, Benylin DM)
- Expectorants (Robitussin)
- Mucolytic (Mucomyst)
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3
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- Prevents bronchoconstriction= airway dilates
- Blends- Combivent
- Slow action and prolong
- Don’t use for acute exacerbation
- Prevents bronchospasm- COPD
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4
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- Dry mouth
- GI Distress
- H/A
- Coughing
- Anxiety
- Don’t give if hypersensitivity to atropine deriviatives
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5
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- New class of drug for Asthma
- Leukotrienes cause inflammation, bronchoconstriction, and mucus
- Coughing, wheezing, and SOB
- 3 sub-categories
- Zilauton (Zyflo)
- Montelukast (Singulair) and Zafirlukast (Accolate)
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6
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- Anti-inflammatory drug
- Don’t use for acute exacerbation
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7
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- Limited to lung
- Prevent smooth muscle contraction of bronchial airways
- Decrease mucus secretion
- Decrease inflammation
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8
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- Chronic treatment of Asthma
- Improvement in 1 week
- Primarily oral
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9
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- H/A
- Nausea
- Dizziness
- Insomnia
- Diarrhea
- Leads to liver dysfunction
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10
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- Montelukast (Singulair)
- Theophylline
- Warfain
- Digoxin
- Prednisone
- Oral Contraceptives
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11
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- Zafirlukast (Accolate)
- Aspirin (increase levels)
- Erythromycin (decrease levels)
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12
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- Used for chronic asthma
- Anti-inflammatory effect
- Decreases airway obstruction
- Helps to prevent attack
- Inhalation or oral route
- Inhalation only effects the lungs
- Vanceril and Medrol
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13
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- Beclomethasone Diproionate (Vanceril)
- Berdesonide (Rhinocort)
- Fluticasone (Flonase)
- Triamcinolone (Azmacort)
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14
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- Reduce inflammation
- Enhance activity of beta2-agonists
- Prevent release of WBC
- Restore or increase responsiveness of bronchial smooth muscle to
beta-adrenergic receptor stimulation
- Pronounced stimulation of beta2-agonist
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15
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- Inhalation prevents systemic absorption
- Can effect organs if systemic
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16
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- Inhaled for treatment of bronchospastic disorders
- Use if not controlled by bronchodilators
- Not 1st line med for acute or status asthmaticus
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17
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- Pharyngeal irritation
- Coughing
- Dry Mouth
- Oral fungal infections
- Systemic effects are rare
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18
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- Antiinflammatory action
- Methylprednisone (Medrol)
- Maintain normal B/P, fat metabolism, stress effects, and metabolism of
carbs and protein
- Watch for weight gain of >5 lbs.
- Oral, IM, IV
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19
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- Don’t take off abruptly
- Once a day dosing should be taken between 6-9am
- Contraindications- active untreated infections, hypersensitivity,
alcohol abuse
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20
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- Cromolyn
- Used in all 3 diseases
- Prevents release of chemical substance that causes bronchospasms
- Used only prophylactically
- Prevent asthma caused by allergens and exercise
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21
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22
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- Limited to lungs
- Primary drug effect is on surface of cell membrane
- Prevents inflammation
- Oral, inhaled, and in eye
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23
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- Adjunct to other drugs
- Solely for prophylaxis- COPD
- No value in acute asthma attack
- Used when exercise and allergens trigger
- Allergic eye disorders
- Chohn’s disease, food allergies
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24
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- Coughing
- Sore throat
- Rhinitis
- Bronchospasm
- Taste changes
- Dizziness
- H/A
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25
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- Drugs which compete with histamines
- H1 Blockers
- Treat nasal allergies, hay fever, common cold symptoms
- Palliative not curative
- Alleviates symptoms not virus
- Sedative effects
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26
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- Fexofenadine (Allegra)
- Diphenydramine (Benadryl)
- Ioratadine (Claritin)
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27
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- Block histamines
- Need to give early in reaction
- Prevent vasodilatation, increased GI and Respiratory secretions
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28
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- Prevent allergic response
- Antihistamines causes smooth muscle to relax
- Prevent secretions
- Prevent itching
- Decreases vascular effects
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29
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- Prevent histamine actions
- Help with nasal allergies, allergic rhinitis, and symptoms of common
cold
- Motion sickness, Parkinson's Disease, and vertigo
- Sleep aids
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30
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- Drowsiness
- Dry mouth, change in vision, difficulty urinating and constipation
- Alcohol, MAO inhibitors, and CNS depressants may increase side effects
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31
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- 3 groups of nasal decongestants
- Adrenergics (largest group)
- Antiocholinergics (rarely used)
- Corticosteroids (intranasal)
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32
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- Shrink nasal mucosa and relieve nasal stuffiness
- Constrict small blood vessels
- Mucus membranes can drain
- Pseudoephedrine (Sudafed)
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33
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- Relieves nasal congestion
- Reduces swelling of nasal passage before surgery
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34
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- Usually well tolerated
- Rare
- If topical is absorbed into the bloodstream then he following could
occur:
- Hypertension
- Palpitations
- Nervousness and dizziness
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35
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36
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- 2 categories- opioid, nonopioid
- Stops coughing
- Opioid-Codeine
- Most OTC
- Dextromethorpan- Benylin-DM
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37
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- Opioids- suppress cough relex
- Nonopioids- same effect, but not analgesic or addictive
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38
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- Codeine- dry mouth, analgesia, increase viscosity of bronchial
secretions
- Suppress cough reflex
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39
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- Codeine- sedation, nausea, vomiting, constipation, itching
- Benylin DM- dizziness, drowsiness, nausea
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40
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- Thins out and disintegrates secretions
- Oral
- OTC
- Guaifenesin (Robitussin)
- Questionable effectiveness
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41
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- Reflex stimulation
- Increase respiratory secretions
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42
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- GI Tract
- Respiratory Tract
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43
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- Relief of nonproductive cough
- Indirectly diminish the need to cough
- Minimal side effects
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44
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- Acetylcysteine (Mucomyst)
- Used to liquefy thick viscid mucous
- Inhalation
- Causes: drowsiness, rhinorrhea, bronchial/tracheal irritation,
bronchoconstriction, chest tightnesss, increased secretions, nausea,
vomiting
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45
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