pharm exam 1
rhinitis
inflammation and irritation in the mucous membrane of the nose
UR- mucolytics adverse effects
nausea (smells like rotten eggs), increase secretions difficult to mobilize unless has strong cough
what would a pt show signs of hyperglycemia
nausea, polydipsia,
UR- expectorants teachings
no eating, drink 30 mins after taking, hydrate
Define euglycemia.
normal blood sugar
structures of the upper respiratory tract
nose, nasal cavity, pharynx, paranasal sinuses
UR- antiasthmatics teachings
not to be used as a rescue med, may take several weeks to feel full effects, do not use during pregnancy, eliminates asthma triggers
when should a medical reconciliation be completed
on admission to the hospital and before transporting to another facility
UR/LR - corticosteroids (systemic) adverse effects- route IH/IN
oral thrush, throat irritation, hoarseness
UR-decongestant generic prototype
oxymetazoline (Afrin), pseudoephedrine (Sudafed)
UR/LR - corticosteroids (systemic) generic prototype- route PO/IV
prednisone (deltasone), methylprednisolone (soul-medrol)
LR- bronchodilators teachings
proper use, take as directed, limit caffeine, no OTC meds, no smoking
for which condition is an oral hypoglycemic agent indicated
reduced insulin production
LR- parasympathetics (anticholinergic) moa
relaxes airways by blocking action of Ach in bronchial smooth muscle
LR-bronchodilators (sympathomimetics or adrenergic) moa
relaxes airways by stimulating beta 1 receptors in the smooth muscle of bronchi and bronchioles
LR- methylxanthines teachings
report persistent GI, check blood level (can easily OD), watch for signs of toxicity due to narrow therapeutic window
define insulin aspart
reverse rapid acting insulin (within 10-20 minutes) for ketoacidosis
LR- parasympathetics teachings
same as bronchodilators
UR- mucolytics therapeutic effects
secretions thinner, increase in mobilizing secretions, treats acetaminophen overdose, increase renal clearance of contrast dye
UR-antitussives adverse effect: non-opioids
sedation, dizziness, mild GI effects
UR-antihistamine adverse effect- central nervous system
sedation, dizziness, muscular weakness, seizures, restlessness, nervousness
Define thyroid storm
severe hyperthyroidism where the temp increases, heart rate increases, fever develops, and tachycardia occurs (can lead to congestive heart failure)
albuterol is what type of beta?
short acting beta agent that relax the smooth muscle
define glyburide
stimulates insulin production by the beta cells of the pancreas
pt teachings for levothyroxine
take dose same time each day, check blood levels often, refrain from switching brands
what happens when the body serum glucose drops below normal levels
the liver releases stored glycogen
LR- methylxanthines generic prototype
theophylline (easily OD), aminophylline
structures of the lower respiratory tract
trachea, bronchi, lungs
adverse effect of albuterol
tremors, palpitations, tachycardia
UR-antitussives teachings
use caution with pt with respiratory disease, no alcohol, take with meals
UR/LR- corticosteroids teachings
use properly IN, may take several wks to feel full effects
purpose of the lower respiratory tract
ventilation and gas exchange
when should a pt stop taking medication?
when the pt doctor who prescribe those meds tells them to stop
UR-1st generation antihistamine
works inside the CNS, dose 4-6 hours
UR-2nd generation antihistamine
works outside the CNS and takes longer duration of action, dose one a day, non-sedating
LR- methylxanthines moa
inhibits endogenous catecholamines (similar to caffeine), inhibits calcium movement into the smooth muscle, inhibits release of bronchoconstrictive substances
which insulin would a nurse prepare for emergency treatment of ketoacidosis
insulin aspart
which insulin has the slowest onset
insulin glargine
which insulin has the fastest onset
insulin lispro
why does insulin need to be stored in a room temperature room
insulin that is close to body constriction prevents vasocontraction at the site and decreases irritation of tissue
define prophylactic
intended to prevent disease
define NPH insulin
intermediate acting insulin (within 1-2 hrs) for ketoacidosis, safe for when mixing insulin
LR- parasympathetics generic prototype
ipratropium (atrovent)
UR/LR - corticosteroids (systemic) generic prototype- route IH/IN
beclomethasone (QVAR, beconase) ,budesonide (pulmicort)
what could be a predisposing factor of type 2 diabetes
being overweight
UR-antihistamine moa
blocks effects of histamines , blocks constrictions of bronchial, Suppresses exocrine gland secretions, suppresses cough
UR- antiasthmatics (leukotriene modifiers- antileukotriene) moa
blocks leukotriene receptors to decrease inflammation
what is used for isotonic solution?
lactate ringers and ringers
define glargine
long acting insulin (within 1.5 hrs) for ketoacidosis
define detemir insulin
long acting insulin for ketoacidosis
salmeterol is what type of beta?
long-acting beta agent that prevents/ maintenance
define hypoglycemia
low blood sugar
UR-antihistamine 2nd generation generic prototype
cetirizine (zyrtec)
what is the type of nursing intervention needed when there is a blood transfusion
check pt vital signs, check typing and crossmatching of blood, use Y type infusion set to initiate 0.9% saline
UR-decongestants moa
mimics the sympathetic system, constricts arterioles, decreases blood flow, decreases edema to nasal mucosa
UR- antiasthmatics generic prototype
monelukast (singulair)
adverse signs of steroid therapy
mood changes, increased appetite, weight gain
UR/LR - corticosteroids (systemic) adverse effects- route PO/IV
cushing syndrome, becomes dependent
UR-expectorants (help secretions exit) moa
decrease mucous adhesiveness and surface tension
UR/LR- corticosteroids adverse effects
nasal burning, nasal bleeding
UR- mucolytics (lysis mucous) moa
decrease viscosity of resp. secretions by altering molecular composition of mucous
LR/UR- corticosteroids (systemic) moa
decreases airway swelling, decrease mucous secretion, increases sensitivity to beta adrenergic receptors
UR- antiasthmatics therapeutic effect
decreases frequency of asthma attacks
UR-antihistamine teachings
0 alcohol uses, a CNS depressant, hydrate,
what are signs that a pt has diabetes insipidus
dehydration, dry mucous membranes, decrease urine specific gravity, poor skin turgor
signs a pt would have when they have a hyperfunctioning thyroid gland
diarrhea and weight loss
when should you obtain a blood sample to determine the peak level when administering meds by intravenous piggybacking
30-60 mins after
Define dyspnea
difficulty breathing
UR-antihistamine 1st generation generic prototype
diphenhydramine (benadryl)
UR/LR - corticosteroids (systemic) teachings- route PO/IV
do not abruptly stop taking, if do you can damage adrenals
UR/LR - corticosteroids (systemic) teachings- route IH/IN
do not overuse, rinse mouth after
UR-antihistamines adverse effect
dryness of mouth, nose, throat, urinary retention, vertigo, visual disturbances, tinnitus, headache
UR-antitussives (cough suppressants) moa
CA- suppresses cough PA- suppresses cough receptors in the throat, trachea, lungs
lethargy has what type of adverse effect
CNS depression
UR-antitussives adverse effect: opioids
CNS depression, N, V, C
LR- bronchodilators adverse effects
CNS stimulation, CV stimulation
LR- parasympathetics adverse effects
Cough, limits systemic absorption
what are signs of hyperthyroidism in pts
fatigue, dry skin, and progressive weight gain
what would a pt show signs of hypoglycemia
fatigue, weakness, nervousness, increased perspiration
UR- antiasthmatics adverse effect
HA, cough, nasal congestion, N, hepatotoxicity
UR-antihistamine adverse effect- cardiovascular system
HT, palpations, synacope
UR/LR- corticosteroids generic prototype
fluticasone (flonase, sensimist)
UR-expectorants generic prototype
guaifenesin (musinex)
insulin must be kept away from
heat and sunlight because it decrease its stability
define hyperglycemia
high blood sugar
LR- methylxanthines adverse effects
N, V, CNS stimulation, CV stimulation
UR-antihistamines adverse effect- GI system
N, V, D, constipation
Define hypotonic solution
higher osmolarity than body fluids, 5% dextrose in normal saline
purpose of the upper respiratory tract
humidify and filter air before it enters the lower respiratory tract
UR-antitussives generic prototype
Opioid: codeine, non-opioid: dextromethorphan (delsym, robitussin DM)
What does potassium chloride serve for pts with diabetic keto acidosis
Prevents hypokalemia
UR- mucolytics teachings
hydrate, often given with bronchodilator, active
what are the therapeutic effects of LR drugs
improve resp. status, increase O2 levels, lungs sound clear, decrease in anxiety, decreases bronchospasms
UR-decongestant adverse effect
increase blood flow of vital organs, decrease blood flow of non-vital organs, rebound congestion with IN route
T/F- Albuterol is used for acute asthma attack
T
T/F- avoid crowded areas when taking steroids
T
T/F- steroids can depress your immune system
T
T/F- steroids should be taken with foods or antacid to prevent ulcer formation
T
UR- expectorants adverse effects
increase drowsiness in large doses, N, V, D
UR- mucolytics generic prototype
acetylcysteine (mucomyst, acetadote)
LR- bronchodilators generic prototype
albuterol, salmeterol, epinephrine (epipen)
signs a pt would have when they have a hypofunction thyroid gland
anemia, decreased heart sounds and distant heart sounds
UR/LR- corticosteroids moa
anti-inflammatory- decreases nasal mucosal swelling, decreases nasal secretions
UR-decongestant teachings
avoid using more than 7 days, use with caution if have CVR disease, stay hydrated
