resp. pharmacology

  1. Air is made up of:
    • 78% Nitrogen
    • 21% Oxygen
    • 1% CO2 and inert gases
  2. pO2 @ 50
    @32 or less
    Impaired mental and functional abilities and impaired muscular coordination and impaired emotional stability

    Impaired judgement and decreased pain perception

  3. Antihistamines aka histamine antagonists
    reduces the severity of the histamine release, but does not suppress the release--provides symptomatic relief
  4. Antihistamines
    1st gen
    2nd gen
    • 1st--sedating-- Benadryl, Chlor Trimeton
    • 2nd--non sedating-- Zyrtec, Allegra, Claritin
  5. Side effects of Antihistamines

    Nursing considerations
    drowsiness and sedation, dry mouth, disturbed coordination

    • Shouldn't drive til after a few doses
    • When in an emergency, not 1st choice
    • small amts in breast milk
    • kids can take but there's more problems
  6. Decongestents
    • po and sprays
    • Nasal congestion is a result of the dialation of the nasal blood vessels due to infection, inflammation, or allergy which moves interstitial fluid to the nose causing swelling of the nasal passages
  7. Decongestants drugs

    Nursing considerations
    Allerest, Afrin, NeoSynephrin, Sinex, Actifed, Sudafed

    • topical side effects lower than po form
    • can cause jitters, nervousness, restlessness
    • no more than 5 days
    • **caffine products increase jitters, restlessness, etc.
    • **rebound pneumonia-nasal congestion- when you have too much of the drug, swelling stays and BP goes high (stroke)
  8. Intranasal Glucocorticoids
    Effective in treating allergic rhinitis; topical anti-inflammatory agents; systemic effects are rare
  9. Intranasal Glucocorticoids drugs

    key point
    Beconase, Vancenase, Vanceril, Rhinocort, Decadron, Nasalide, Flonase, Nasacort

    Designed for short term use
  10. Cough med-- Antitussives

    Side effects
    Act on the cough control center in the medulla to suppress the cough

    nausea, drowsiness, dizziness
  11. Antitussive drugs

    key points
    • narcotic-- Codeine (II), Hycodan (III)
    • non narcotic-- Dextromethorphan (DM), Benylin, Romilar, Tessalon

    • increase fluid for cough meds
    • avoid drinking for 10-15 min after taking
    • avoid during 1st trimester
  12. Cough meds-- Expectorants

    modify and loosen bronchial secretions; decrease thickness

    guaifenesin (robutussin)(sp??)
  13. Cough meds--Demulcents

    Protective, relieve irritation, soothing; usually in the form of gargles, lozenges, syrups

  15. Bronchodilators
    Sympathomimetic Bronchdilators
    Stimulate the adrenergic receptors in the smooth muscle of the tracheobronchial tree to relax causing bronchodilation
  16. Bronchodilators
    Adrenergic Stimulation (three kinds)
    • Alpha stimulation--vasoconstriction
    • Beta 1 stimulation--cardiac stimulation (tremors, nervousness, heart palpitations, increased HR, HTN, angina)
    • Beta 2 stimulation--some cardiac stimulation, primarily bronchodilation
  17. Adrenergic stimulation drugs
    • First gen-- Isuprel (beta 1 and 2)
    • second gen-- Alupent (some beta 1, and beta 2)
    • Later drugs-- Proventil, Ventolin (beta 2)
  18. uses for adrenergic stimulation drugs
    • severe bronchospasm/Anaphylaxis: Epinephrine (Adrenalin)--has alpha, beta 1, and beta 2 effects
    • chronic asthma of COPD--beta 2 by aeroson or tablet
  19. Bronchodilators
    Anticholinergic bronchodilators

    inhibits cholinergic receptors; used for prophylaxis, used to dilate bronchioles--effects not immediate

    • atrovent (aeroson/MDI)
    • combivent= Atrovent + Proventil
    • (prophylaxis) (treats)
  20. When giving MDI meds:
    give sympathomimetic med 5 min before Anticholinergic med. Use the anticholinergic 5 min before an inhaled Glucocorticoid.
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resp. pharmacology
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