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Which of these options are correct? (Select all that apply) Treatment of the common cold involves the use of:
Which of these options are correct? (Select all that apply) Treatment of the common cold involves the use of:
Over-the-counter cough and cold products can safely be given to children younger than 6 years of age.
Over-the-counter cough and cold products can safely be given to children younger than 6 years of age.
False
Which of the following is a common symptom associated with Rhinitis/influenza?
Which of the following is a common symptom associated with Rhinitis/influenza?
What is the main cause of inflammation, nasal congestion, and increased mucus production in the upper respiratory tract due to Rhinovirus/influenza?
What is the main cause of inflammation, nasal congestion, and increased mucus production in the upper respiratory tract due to Rhinovirus/influenza?
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Which of the following is NOT a common cause of nasal congestion?
Which of the following is NOT a common cause of nasal congestion?
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The treatment for Sinusitis depends on the cause of the infection. Which of the following is the correct treatment for bacterial sinusitis?
The treatment for Sinusitis depends on the cause of the infection. Which of the following is the correct treatment for bacterial sinusitis?
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What is the primary goal of antihistamines?
What is the primary goal of antihistamines?
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Antihistamines are ______ treatment, meaning they do not cure the underlying cause of the condition.
Antihistamines are ______ treatment, meaning they do not cure the underlying cause of the condition.
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Which of the following is NOT a typical adverse effect associated with antihistamines?
Which of the following is NOT a typical adverse effect associated with antihistamines?
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Which of the following is a common antihistamine that is often referred to as "non-drowsy"?
Which of the following is a common antihistamine that is often referred to as "non-drowsy"?
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What is the mechanism of action of antihistamines?
What is the mechanism of action of antihistamines?
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What is the nursing implication for antihistamines related to drowsiness?
What is the nursing implication for antihistamines related to drowsiness?
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What is the term used for excessive nasal secretions?
What is the term used for excessive nasal secretions?
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Which type of medication is MOST commonly used to address nasal congestion?
Which type of medication is MOST commonly used to address nasal congestion?
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Match the following drugs with their primary mechanism of action:
Match the following drugs with their primary mechanism of action:
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Which of the following decongestants is MOST likely to cause rebound congestion?
Which of the following decongestants is MOST likely to cause rebound congestion?
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Intranasal steroids are known to be effective in treating acute asthma exacerbations.
Intranasal steroids are known to be effective in treating acute asthma exacerbations.
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What is the primary function of expectorants?
What is the primary function of expectorants?
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What is the most common expectorant used in medications like Robitussin?
What is the most common expectorant used in medications like Robitussin?
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Expectorants should be used with caution in which patient group?
Expectorants should be used with caution in which patient group?
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Echinacea is scientifically proven to effectively prevent or reduce the duration of the common cold.
Echinacea is scientifically proven to effectively prevent or reduce the duration of the common cold.
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Which of the following medications is MOST likely to be used as a first-line treatment for acute asthma exacerbations?
Which of the following medications is MOST likely to be used as a first-line treatment for acute asthma exacerbations?
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Which of the following medications is classified as a long-acting Beta2 agonist?
Which of the following medications is classified as a long-acting Beta2 agonist?
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What is the term used to describe a prolonged asthma attack that does not respond to typical drug therapy?
What is the term used to describe a prolonged asthma attack that does not respond to typical drug therapy?
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Which of the following medications is used as a first-line treatment for status asthmaticus?
Which of the following medications is used as a first-line treatment for status asthmaticus?
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What is the primary way to assess if medications are working effectively for patients with asthma?
What is the primary way to assess if medications are working effectively for patients with asthma?
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Inhaled corticosteroids are typically used to manage acute asthma exacerbations.
Inhaled corticosteroids are typically used to manage acute asthma exacerbations.
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Which of the following medications is a long-acting beta agonist?
Which of the following medications is a long-acting beta agonist?
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What is the primary goal of using a combination inhaler like Symbicort or Advair for patients with asthma?
What is the primary goal of using a combination inhaler like Symbicort or Advair for patients with asthma?
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What is the most common side effect to monitor when a patient is using inhaled corticosteroids?
What is the most common side effect to monitor when a patient is using inhaled corticosteroids?
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Patients should take their inhaled beta agonist bronchodilator before using their inhaled corticosteroid.
Patients should take their inhaled beta agonist bronchodilator before using their inhaled corticosteroid.
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Which of the following is NOT a typical characteristic of COPD?
Which of the following is NOT a typical characteristic of COPD?
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Which of these is a commonly used long-acting bronchodilator for COPD?
Which of these is a commonly used long-acting bronchodilator for COPD?
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Which of these is a commonly used inhaled corticosteroid for COPD?
Which of these is a commonly used inhaled corticosteroid for COPD?
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Which of these is a commonly used anticholinergic for COPD?
Which of these is a commonly used anticholinergic for COPD?
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Nonselective beta blockers are contraindicated for patients using beta agonists for asthma or COPD.
Nonselective beta blockers are contraindicated for patients using beta agonists for asthma or COPD.
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What is the primary mechanism of action related to leukotriene receptor antagonists for asthma?
What is the primary mechanism of action related to leukotriene receptor antagonists for asthma?
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Which of the following is a commonly used leukotriene receptor antagonist for asthma?
Which of the following is a commonly used leukotriene receptor antagonist for asthma?
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Which of these medications is a phosphodiesterase type 4 inhibitor, commonly used for COPD?
Which of these medications is a phosphodiesterase type 4 inhibitor, commonly used for COPD?
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Theophylline is a commonly used medication for long-term management of asthma.
Theophylline is a commonly used medication for long-term management of asthma.
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Which of the following medications is a monoclonal antibody used for severe asthma?
Which of the following medications is a monoclonal antibody used for severe asthma?
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Patients should take their inhaled bronchodilator first and then their inhaled corticosteroids.
Patients should take their inhaled bronchodilator first and then their inhaled corticosteroids.
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A patient with COPD and hypertension should avoid using beta blockers.
A patient with COPD and hypertension should avoid using beta blockers.
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The most common adverse effect associated with inhaled corticosteroids is oral fungal infections.
The most common adverse effect associated with inhaled corticosteroids is oral fungal infections.
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What is the name of the steroid that is commonly used for exacerbations of COPD?
What is the name of the steroid that is commonly used for exacerbations of COPD?
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Which of these are common adverse effects associated with theophylline?
Which of these are common adverse effects associated with theophylline?
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Which of these is a primary cause of COPD exacerbations?
Which of these is a primary cause of COPD exacerbations?
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Patients should be advised to avoid caffeine while taking theophylline.
Patients should be advised to avoid caffeine while taking theophylline.
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Study Notes
Respiratory Drugs
- Respiratory drugs are used to treat various respiratory conditions.
- The common cold is treated symptomatically with antihistamines, nasal decongestants, antitussives, and expectorants.
- Treatments are empirical, meaning they treat the most likely cause, which may not be easily identified.
- Over-the-counter cough and cold products should not be given to children under 6 years of age.
Upper Respiratory Tract Infections
- Symptoms of Upper Respiratory Tract Infections (URTIs) include sore throat, cough, lymphadenopathy, fever, runny nose, and sinus pressure.
- Treatment for URTIs depends on the cause: bacterial infections require antibiotics, while viral infections are treated symptomatically.
- Sinusitis involves inflammation of the sinus lining; treatment depends on the cause (bacterial: antibiotics, viral: symptomatic relief).
- Pharyngitis (sore throat) has viral (symptomatic) and bacterial (antibiotic) causes. Throat swabs help identify the specific cause.
Antihistamines
- Antihistamines block histamine receptors to treat allergic reactions and some common cold symptoms.
- Histamine is a major inflammatory mediator in allergic disorders (allergic rhinitis—e.g., hay fever, mould and dust allergies, anaphylaxis, angioedema, insect bite reactions, urticaria—pale red, raised, itchy bumps, drug fevers).
- Histamine is synthesized in mast cells in response to an allergen.
- Antihistamines are primarily used for symptomatic relief, not a cure.
- Traditional antihistamines (brompheniramine, chlorpheniramine, dimenhydrinate, diphenhydramine, promethazine) can cause drowsiness, while nonsedating antihistamines (loratadine, cetirizine, fexofenadine) have longer durations of action.
- They are best taken with meals.
Nasal Congestion
- Excessive nasal secretions and inflamed/swollen nasal mucosa cause nasal congestion.
- Common causes include allergies and upper respiratory infections (common cold).
Decongestants
- Decongestants reduce nasal congestion by reducing swelling and secretions in the nasal passages.
- Three types: Adrenergics (sympathomimetics), Anticholinergics (Parasympatholytics), and Corticosteroids (topical or intranasal).
- Adrenergics (e.g., pseudoephedrine, oxymetazoline) are widely used but can sometimes lead to rebound congestion.
- Inhaled intranasal steroids and anticholinergic drugs (e.g., mometasone furoate, ipratropium) are used for prophylactic treatment of nasal congestion for patients with chronic upper respiratory tract issues.
- Avoid caffeine with decongestants. Report symptoms lasting longer than a week.
Cough Physiology
- Coughing is a bodily reflex to eliminate mucus and foreign objects.
- A productive cough is associated with congestion (removal of excess secretions).
- A nonproductive cough is a dry, unproductive cough.
Antitussives
- Antitussives suppress the cough reflex, useful for nonproductive or harmful coughs.
- Antitussives come in opioid and non-opioid forms. Codeine (an opioid) is an antitussive.
- Dextromethorphan is a non-opioid antitussive option.
Expectorants
- Expectorants loosen and thin respiratory secretions, aiding in expectoration (removal of mucus).
- Guaifenesin is an example.
- They are used for productive coughs.
Alternative Treatments
- Alternative treatments like Vitamin C, echinacea, honey, and zinc are discussed alongside conventional approaches.
Chronic Obstructive Pulmonary Disease (COPD)
- COPD is a progressive respiratory disorder characterized by chronic airflow limitation and comorbidities.
- Presence of cough and sputum for at least 3 months in each of 2 consecutive years helps categorize patients' COPD severity.
- Symptoms range from mild breathlessness with strenuous exercise to inability to leave house due to breathlessness when dressing.
- Drug therapy for COPD includes bronchodilators to relax the airway muscles, improve ventilation, and decrease dyspnea.
Inhalers
- Inhalers deliver medications directly into the lungs.
- Teaching patients to use inhalers properly is crucial.
- Always shake inhalers before use.
- Educate patients on inhaler types (beta-adrenergic agonists, anticholinergics, inhaled corticosteroids).
COPD Exacerbations
- Frequent exacerbations and severe exacerbations requiring hospitalization define high-risk COPD patients.
- These events are often associated with poor outcomes, including pneumonia and similar infections.
- Causes typically include infections and environmental factors (e.g., air pollution).
- Prednisone is often used to treat exacerbations.
Corticosteroids
- Corticosteroids (glucocorticoids) are used as anti-inflammatory drugs for various conditions, including COPD, and are used frequently in pulmonary conditions due to their anti-inflammatory properties.
- They can be administered intravenously and in oral and inhaled forms. Inhaled forms reduce systemic effects.
- Patients may need to wait multiple weeks for full effects to be visible.
- Inhaled corticosteroids may cause oral fungal infections, so patients should gargle with water afterwards.
- If a bronchodilator and corticosteroid are prescribed together, the bronchodilator should be used before the corticosteroid to allow for bronchodilation first.
Combination Inhalers
- Combination inhalers combine medications (like inhaled corticosteroid and a long-acting bronchodilator) to manage respiratory conditions.
- They improve compliance and reduce adverse effects potentially.
Leukotriene Receptor Antagonists
- These drugs prevent asthma symptoms/worsening/infections in adults and children.
- Improvement is typically seen within a week.
- They can cause liver problems (dysfunction), including headaches and nausea, and are generally safer than steroids for preventative use or other inflammatory conditions.
Phosphodiesterase Type 4 Inhibitor
- This medication reduces the worsening/hospitalization/frequency of exacerbations.
- Patients may exhibit side effects like an increase in nausea, diarrhea, headache, and insomnia.
Monoclonal Antibody Antiasthmatic
- This drug (omalizumab) limits allergic responses, often administered via injection.
- Potential for anaphylaxis.
NCLEX Review Questions (Examples)
- Review NCLEX practice questions to reinforce learning.
Asthma
- The symptoms may include recurrent breathing issues (shortness of breath), bronchospasm, edema of the bronchial mucosa, and production of viscous mucus within the lungs.
- Airways become narrow when these symptoms arise, obstructing airflow.
- Assessment/management tools include spirometry to measure air flow.
- Asthma attacks are sudden/severe symptoms; status asthmaticus refers to prolonged/resistant symptoms.
Medications for Acute Asthma Attacks
- Inhalers (salbutamol, albuterol) are first-line treatment.
- Epinephrine (intramuscular/intravenous) injections may be considered in severe cases, especially for allergen-triggered attacks where inhaler response is not sufficient.
- Intravenous corticosteroid use (methylprednisolone) is part of emergency room approaches/management for severe attacks.
Other Contraindications and Interactions
- Be aware of possible interactions between respiratory drugs and other medications (e.g., non-selective beta-blockers, monoamine oxidase inhibitors, and antidiabetic drugs).
- Consider concurrent conditions such as chronic obstructive pulmonary disease (COPD) and hypertension, which may affect the choice of antihypertensive medications.
- Be aware of possible side effects resulting from drug use (including drowsiness, palpitations, skin rash, difficulty in sleep) and patient teaching needs accordingly.
Patient Teaching
- Patients must fully understand how to take and use their respiratory drugs properly.
- Important to educate on potential adverse effects and necessary reporting parameters.
- Emphasize the importance of regular monitoring with healthcare professionals for patients with chronic respiratory conditions.
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