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Questions and Answers
What is the primary function of mepolizumab and reslizumab?
What is the primary function of mepolizumab and reslizumab?
Which drug is known for preventing the release of inflammatory substances from mast cells?
Which drug is known for preventing the release of inflammatory substances from mast cells?
In what scenario is cromolyn primarily used?
In what scenario is cromolyn primarily used?
What is the role of lung surfactants in the treatment of neonates with respiratory distress syndrome?
What is the role of lung surfactants in the treatment of neonates with respiratory distress syndrome?
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Which cytokines does dupilumab target by binding to their shared receptor?
Which cytokines does dupilumab target by binding to their shared receptor?
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What is a common symptom of mastocytosis?
What is a common symptom of mastocytosis?
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What is the mechanism of action of lung surfactants?
What is the mechanism of action of lung surfactants?
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Why is cromolyn no longer part of standard treatment protocols?
Why is cromolyn no longer part of standard treatment protocols?
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What is a primary mechanism of action for antitussives?
What is a primary mechanism of action for antitussives?
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What adverse effect is most commonly associated with the use of decongestants?
What adverse effect is most commonly associated with the use of decongestants?
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Which class of drugs acts by blocking the action of histamine?
Which class of drugs acts by blocking the action of histamine?
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What is the primary purpose of expectorants?
What is the primary purpose of expectorants?
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What is a significant side effect of mucolytics like Acetylcysteine?
What is a significant side effect of mucolytics like Acetylcysteine?
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Which type of bronchodilator acts by blocking acetylcholine at receptor sites?
Which type of bronchodilator acts by blocking acetylcholine at receptor sites?
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What is a common adverse effect of inhaled steroids used for respiratory conditions?
What is a common adverse effect of inhaled steroids used for respiratory conditions?
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What is a common contraindication for the use of antitussives?
What is a common contraindication for the use of antitussives?
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Which mechanism do leukotriene receptor antagonists use to manage asthma symptoms?
Which mechanism do leukotriene receptor antagonists use to manage asthma symptoms?
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What is the main action of sympathomimetics as bronchodilators?
What is the main action of sympathomimetics as bronchodilators?
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Which statement is true regarding the absorption of antihistamines?
Which statement is true regarding the absorption of antihistamines?
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What classification do drugs like codeine and hydrocodone fall under?
What classification do drugs like codeine and hydrocodone fall under?
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What is a potential outcome of prolonged use of topical nasal decongestants?
What is a potential outcome of prolonged use of topical nasal decongestants?
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What is the role of expectorants in airway management?
What is the role of expectorants in airway management?
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Study Notes
Oxygenation Drugs
- This cluster will cover drugs used to manage oxygenation issues, including those affecting the respiratory, cardiovascular and central nervous systems.
- This cluster will classify respiratory, cardiovascular and central nervous system drugs according to their pharmacologic and therapeutic effects.
- Specific mechanisms of action will be discussed alongside appropriate indications, contraindications, side-effects, adverse effects, other effects, and nursing responsibilities.
- Health education and evaluation criteria to assess the client's response will also be covered.
Drugs Acting on the Upper Respiratory Tract
- Antitussives are used to suppress the cough reflex, particularly for uncomfortable, non-productive coughs.
- Antitussives act directly on the medullary cough center.
- Antitussives are rapidly absorbed, metabolized in the liver, and excreted in the urine.
- Codeine and hydrocodone are examples of narcotic antitussives.
- Antitussives are contraindicated (C/I) for individuals who need a cough to maintain their airway, and during pregnancy and lactation.
- Some common adverse effects (A/E) of antitussives include central nervous system (CNS) adverse effects, such as drowsiness and sedation.
- Antitussives can also interact with MAO inhibitors leading to hypotension, fever and nausea.
- Decongestants decrease the overproduction of secretions by causing local vasoconstriction in the upper respiratory tract.
- Frequent or prolonged use of decongestants can lead to rebound congestion (Rhinitis medicamentosa).
- Decongestants are typically adrenergics or sympathomimetics.
- Topical nasal decongestants are used for nasal congestion, providing almost immediate onset with fewer systemic effects.
- A/E of topical nasal decongestants include local stinging and burning.
- Topical steroid decongestants are indicated for allergic rhinitis.
- Oral decongestants shrink the nasal mucous membrane by stimulating alpha-adrenergic receptors in the nasal mucous membranes.
- This results in increased airway dilation.
- Oral decongestants are generally well absorbed within approximately 20-45 minutes.
- Potential A/E of oral decongestants include anxiety, tenseness, restlessness, tremors, hypertension, arrhythmias, sweating, and pallor.
- Antihistamines work by blocking the release or action of histamine, which contributes to inflammation, increased secretions, and narrowed airways.
- Antihistamines have antipruritic (anti-itch) effects.
- First-generation antihistamines have greater anticholinergic effects (drowsiness), while second-generation antihistamines are typically less sedating, although individual variations are common.
- Antihistamines are well absorbed orally (1-3 hours) and generally metabolized in the liver, with excretion in the feces and urine.
- A/E of antihistamines include drying of respiratory and GI mucous membranes, GI upset and nausea, arrhythmias, dysuria, urinary hesitancy, skin eruptions, and itching associated with dryness.
- Expectorants increase productive cough to clear the airways.
- Expectorants liquefy lower respiratory tract secretions by decreasing their viscosity, adhesiveness and surface tension, making it easier to cough up.
- Expectorants are rapidly absorbed within 30 minutes.
- A/E of expectorants include GI symptoms such as nausea, vomiting, anorexia, headache, dizziness, and ocassionally a mild rash.
- Expectorants should not be taken for more than a week.
- Mucolytics increase the volume and liquefy respiratory secretions to assist in clearing the airways for high-risk respiratory patients.
- Acetylcysteine is a mucolytic that splits disulfide bonds responsible for holding mucus material together, decreasing the viscosity of secretions.
- Dornase Alfa is another mucolytic that separates extracellular DNA from proteins, selectively breaking down respiratory tract mucus.
- A/E of mucolytics include GI upset, stomatitis, rhinorrhea, bronchospasm, and occasionally a rash.
Drugs Acting on the Lower Respiratory Tract
- Bronchodilators facilitate respiration by dilating the airways (acting as antiasthmatics).
- Bronchodilators are used for bronchial asthma or bronchospasm, such as seen in chronic obstructive pulmonary disease (COPD).
- Xanthines (e.g. theophylline) have a direct effect on smooth muscles of the respiratory tract, both in the bronchi and blood vessels.
- Xanthines have a narrow margin of safety.
- Sympathomimetics dilate the bronchi and increase the rate and depth of respiration.
- Epinephrine is the drug of choice in cases of acute bronchospasm.
- Anticholinergics (e.g. ipratropium) block the action of the neurotransmitter acetylcholine at vagal-mediated receptor sites, relaxing smooth muscles. Anticholinergics are commonly used for COPD.
Antiinflammatory Drugs
- Inhaled steroids are effective for bronchospasm, reducing swelling and promoting beta-adrenergic activity.
- A/E of inhaled steroids include sore throat, hoarseness, coughing, dry mouth, and pharyngeal and laryngeal fungal infections.
- Leukotriene receptor antagonists selectively and competitively block or antagonize receptors for the production of leukotrienes, thus blocking the symptoms (S/Sx) of asthma by reducing inflammation.
- These drugs are rapidly absorbed from the gastrointestinal tract (GIT).
- Leukotriene receptor antagonists should be used cautiously in patients with hepatic or renal impairment.
Immune Modulators
- Immune modulators are antibodies used as add-on maintenance therapy for moderate to severe asthma.
- Immune modulators end in “-mab” and do not have immediate effects.
- Benralizumab binds to the interleukin-5 receptor expressed on eosinophils and basophils, inducing apoptosis (cell death).
- Omalizumab binds to IgE receptors on mast cells, basophils and dendritic cells, reducing IgE-mediated inflammation.
- Mepolizumab and reslizumab bind to inhibit interleukin-5, a cytokine that facilitates growth and activation of eosinophils.
- Dupilumab binds to cells that have a receptor shared by interleukin-4 and interleukin-13.
Mast Cell Stabilizers
- Cromolyn is a mast cell stabilizer that prevents the release of inflammatory and bronchoconstricting substances (like histamine) when mast cells are stimulated to release these substances upon irritation or exposure to an antigen.
- Cromolyn is no longer part of the treatment standards due to the availability of more specific and safer drugs.
- It is still sometimes used to treat the symptoms of mastocytosis, a rare condition caused by an overproduction of mast cells in the body.
- Mastocytosis can cause S/Sx such as abdominal pain, nausea, vomiting, diarrhea, headache, flushing or itching of the skin, and hives.
Lung Surfactants
- Lung surfactants are naturally occurring compounds or lipoproteins containing lipids and apoproteins that reduce surface tension within the alveoli.
- Lung surfactants have the suffix ‘-tant’.
- Lung surfactants are used to replace surfactant in the lungs of neonates with Respiratory Distress Syndrome (RDS).
- Lung surfactants are instilled directly into the trachea and begin acting immediately after instillation.
- There are no contraindications for the use of lung surfactants.
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Description
This quiz covers essential drugs used to manage oxygenation issues, focusing on their pharmacologic and therapeutic effects. Learn about drugs affecting the respiratory, cardiovascular, and central nervous systems, including mechanisms of action, indications, contraindications, and nursing responsibilities. Special attention is given to antitussives and their effects on the cough reflex.
