Pharmacology of Xanthines in Respiratory Treatment
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Questions and Answers

Which side effect is specifically associated with narcotic antitussives?

  • Nausea and vomiting
  • Constipation (correct)
  • Sedation and dizziness
  • Urinary retention (correct)

    • What is a potential interaction of dextromethorphan?

  • Monoamine oxidase inhibitors (MAOIs) (correct)
  • Ester-type anesthetics
  • Antihistamines
  • Antidepressants that are SSRIs (correct)

    • For coughs associated with upper respiratory infections (URI), what does the American College of Chest Physicians recommend?

  • Increased dosage of antitussives
  • Second-generation antihistamines
  • Using cough suppressants
  • First-generation antihistamines and decongestants (correct)

    • What is a caution for using antitussives in children?

    <p>CNS side effects and behavioral disturbances</p> Signup and view all the answers

    What class of drugs do first-generation antihistamines antagonize to reduce symptoms of allergies?

    <p>Histamine receptor sites</p> Signup and view all the answers

    Which of the following side effects is NOT typically associated with narcotic antitussives?

    <p>Skin rash</p> Signup and view all the answers

    What is a potential effect of antihistamines when used for the common cold?

    <p>Reduced bronchial secretions</p> Signup and view all the answers

    Which of the following is a known side effect of excessive use of narcotic antitussives?

    <p>Respiratory depression</p> Signup and view all the answers

    What is the benefit of using nicotine replacement therapy for smokers trying to quit?

    <p>It helps lessen withdrawal symptoms while allowing focus on behavioral change.</p> Signup and view all the answers

    Which of the following best describes the impact of e-cigarettes compared to traditional cigarettes?

    <p>E-cigarettes theoretically have fewer toxic effects but lack long-term safety data.</p> Signup and view all the answers

    What percentage of smokers typically succeed in quitting on their first attempt?

    <p>Most smokers fail to quit on their first attempt.</p> Signup and view all the answers

    What combination of nicotine replacement methods is considered most effective?

    <p>Combining one long-acting method with one short-acting method.</p> Signup and view all the answers

    What role does behavioral modification play in smoking cessation efforts?

    <p>It provides social support to enhance the chances of quitting.</p> Signup and view all the answers

    What is a common use for first-generation antihistamines?

    <p>Continued treatment of anaphylaxis</p> Signup and view all the answers

    Which of the following side effects is associated with first-generation antihistamines?

    <p>Urinary retention</p> Signup and view all the answers

    First-generation antihistamines are particularly cautioned against in which patient population?

    <p>Children under the age of 6</p> Signup and view all the answers

    Which of the following is a second-generation antihistamine?

    <p>Cetirizine</p> Signup and view all the answers

    What distinguishes second-generation antihistamines from first-generation antihistamines?

    <p>Greater specificity for histamine receptors</p> Signup and view all the answers

    What are some common side effects of nasal preparations?

    <p>Dryness and sneezing</p> Signup and view all the answers

    Which of the following is a potential interaction with first-generation antihistamines?

    <p>Potentiation of CNS depression</p> Signup and view all the answers

    Which group of patients should be approached with caution when prescribing decongestants?

    <p>Older adults with glaucoma</p> Signup and view all the answers

    What was one significant action taken by the FDA in 2011 regarding cough and cold products?

    <p>Removal of many unapproved products</p> Signup and view all the answers

    What is a noted difference in side effects between first and second-generation antihistamines?

    <p>Second-generation antihistamines have fewer anticholinergic effects</p> Signup and view all the answers

    What should patients be cautioned against when using combination cough and cold formulations?

    <p>Overdosing due to ingredient duplication</p> Signup and view all the answers

    Which of the following side effects is least likely to occur from second-generation antihistamines?

    <p>Sedation</p> Signup and view all the answers

    What interaction may occur with the use of decongestants?

    <p>Potentiation of side effects with other adrenergics</p> Signup and view all the answers

    Which age group faced warnings about cough and cold products being unsafe?

    <p>Children under 2 years old</p> Signup and view all the answers

    Which type of medical condition should decongestants be used cautiously with?

    <p>Cardiovascular disorders</p> Signup and view all the answers

    What feature was added to cough and cold products to enhance safety?

    <p>Child-resistant packaging</p> Signup and view all the answers

    What is a potential side effect of theophylline that can be fatal?

    <p>CNS stimulation</p> Signup and view all the answers

    Which of the following conditions is NOT a caution when administering theophylline?

    <p>Hypotension</p> Signup and view all the answers

    How should theophylline be administered via IV to minimize the risk of cardiac side effects?

    <p>Slowly, over an extended period</p> Signup and view all the answers

    Which substance is known to decrease the effectiveness of theophylline?

    <p>Smoking</p> Signup and view all the answers

    When are inhaled corticosteroids primarily used in asthma treatment?

    <p>As a chronic prophylactic therapy</p> Signup and view all the answers

    What is a typical purpose of bronchodilators when used alongside xanthines?

    <p>To enhance respiratory effect</p> Signup and view all the answers

    Which drug category is most often combined with theophylline for better respiratory function?

    <p>Adrenergics</p> Signup and view all the answers

    Which of the following symptoms is NOT associated with the side effects of theophylline?

    <p>Hair loss</p> Signup and view all the answers

    Study Notes

    Xanthines

    • Administered as sustained-release formulations alongside adrenergics and anticholinergics to enhance symptom relief and improve breathing.
    • Theophylline side effects range from mild to severe, including:
      • GI distress: nausea, vomiting, abdominal pain, anorexia, diarrhea; best taken with meals to minimize irritation.
      • CNS stimulation: nervousness, insomnia, headaches, tremors, seizures which can be fatal.
      • Cardiac issues: palpitations, tachycardia, arrhythmias, particularly with rapid IV administration.
      • Increased urinary frequency and mild diuresis.
      • Hyperglycemia.

    Cautions and Contraindications for Theophylline

    • Increased serum levels due to sudden cessation of tobacco smoking.
    • Not recommended for patients with cardiovascular, kidney, pulmonary, or liver dysfunction.
    • Use with caution in diabetes, peptic ulcer, glaucoma, children, and older adults.
    • Slow IV injection is necessary to avoid cardiac side effects.
    • Careful in patients receiving influenza immunizations or during pregnancy and lactation.

    Drug Interactions with Theophylline

    • Increased levels due to cimetidine, allopurinol, certain antibiotics, oral contraceptives, and others.
    • Reduced effectiveness with smoking, barbiturates, phenytoin, rifampin, PDE-4 inhibitors.

    Bronchodilator Corticosteroids

    • Used to reduce inflammation, bronchial hyper-responsiveness, and control acute symptoms.
    • Inhaled corticosteroids are preferred for long-term asthma management and are not for acute treatment.
    • Regular use improves asthma control and reduces hospitalization and mortality.

    Antitussives

    • Side effects include respiratory depression, constipation, urinary retention, sedation, dizziness, and nausea.
    • Caution advised for addiction-prone individuals and patients with asthma or COPD.

    Antihistamines

    • Block histamine action to reduce symptoms from allergies (e.g., rhinitis, conjunctivitis).
    • First-generation antihistamines (e.g., diphenhydramine) may cause more side effects (sedation, dry mouth, urinary retention).
    • Second-generation antihistamines (e.g., loratadine) are less sedating and suited for treating seasonal allergic rhinitis.

    Cautions for Antihistamines

    • Contraindicated in COPD, asthma, closed-angle glaucoma, cardiovascular disorders, and older adults due to sedation risks.

    Decongestants

    • Used to relieve nasal congestion with side effects including palpitations, anxiety, and nausea.
    • Caution in patients with cardiovascular issues, hyperthyroidism, diabetes, and pregnant or lactating women.

    Cough–Cold-Allergy Products

    • Combination formulations must match symptoms, and caution is necessary to avoid overdosing from overlapping ingredients.
    • In 2011, the FDA removed many unapproved cough and cold products, particularly those for children due to safety concerns.

    Smoking Cessation Aids

    • Cigarette smoking is a leading cause of preventable disease and death.
    • Nicotine Replacement Therapies (e.g., gum, patches) double effectiveness compared to cold turkey methods.
    • E-cigarettes provide a less toxic alternative to traditional smoking but lack long-term safety data.

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    Description

    This quiz covers the use of xanthines in respiratory therapy, focusing on their administration, potential side effects, and the interactions with other respiratory medications. Test your knowledge on the toxicity and management of xanthine-based treatments for respiratory conditions.

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