Respiratory Study guide 3

02=5
Home oxygen therapy
02 therapy via nasal cannula-Mixes oxygen with room air, Often used for clients who
require long term therapy at low concentrations ,May cause nasal mucosa drying
codeine an antitusive-Opioid antitussives:Codeine, hydrocodone
Use of codeine may result in dizziness, lightheadedness, drowsiness, euphoria, sedation,
nausea, vomiting, constipation, respiratory depression, and hypersensitivity Potential for
abuse, use short duration only
Phenergan with codeine- antiemetic with codeine
Fluticasone- flonase- USES: This medication is a corticosteroid that works directly on the
nasal passages to reduce swelling and inflammation. Fluticasone is used to relieve
seasonal and year-round, allergic and non-allergic nasal symptoms such as itching, runny
or stuffy nose, postnasal drip and sneezing in adults and children 4 years of age and older.
Mucomyst- Mucolytics - Acetylcysteine (Mucomyst) and dornase alfa (Pulmozyme) are
mucolytics-Acetylcysteine is primarily given by nebulization but maybe directly
instilled into a tracheostomy tube, mixed with juice, or IV-Acetylcysteine when given
into a tracheostomy tube requires a suction machine at the bedside for immediate removal
of secretions-Nurse needs to advise client that medication may smell like rotten eggs
Adverse reactions:StomatitisNausea and vomitingAspirationFeverDrowsiness
BronchospasmIrritation of the trachea and bronchi
Contraindications: known hypersensitivity, not recommended for clients with asthma
Suppresant dextromethorphan-Dextromethorphan (Robitussin) chemically related to
codeine; taken every 4-8 hours
Antitussive- drug used to relieve nonproductive coughing May be centrally acting or
peripherally actingCentrally acting depress the cough center in the medulla Codeine,
hydrocodone -GI adv reactions Constipation- Precautions: used with caution in
clients with persistent or chronic cough, cough with excessive secretions, high fever,
rash, persistent headache, or nausea or vomiting-Antitussives are given orallyDrink
plenty of fluids
d/h x q
tessalon- how does it work in the body- Nonopiod antitussives- Benzonatate (Tessalon
Perles -Peripherally acting anesthetize stretch receptors in the respiratory passages,
Benzonatate (Tessalon

hydrocodone-Opioid antitussives:Codeine, hydrocodone

epinephrine-Epinephrine (Adrenaline, Epinephrine Mist, Primatene Mist) asthma,

acute bronchospasmGiven inhalation, SC (use TB syringe), IM
ambu-bag- Manual Oxygen administration for apnea
bronchospasm- Adverse reaction to Mucolytics
bronchodilation-Use of a bronchodilating drug opens the bronchi by relaxing the smooth
muscles and allows more air to enter the lungs, which relieves respiratory distress-The
2-adrenergic drugs (mimic the sympathetic nervous system; stress hormones) are used
in the treatment of chronic respiratory problems due to bronchoconstriction, such as:
Acute, chronic bronchial asthma and exercise induced bronchospasm (EIB)Bronchitis
EmphysemaBronchiectasis reactions: nervousness, anxiety, insomnia When these
drugs are taken by inhalation, excessive use (more than the recommended dose times)
may result in paradoxical bronchospasm; oral drugs should be taken a few hours before
bedtime to prevent insomnia
Bronchodilators are administered before corticosteroid inhalers Wait one minute
between inhalations from the same inhaler Wait 2-3 minutes between inhalations from
different inhalers Wait 2 minutes between inhalations of Metaproterenol (Alupent)
qualfenesin Z-Expectorants: guaifenesin (Hytuss, Oranidin NR, Robitussin), potassium
iodide (Pima, SSKI) Instruct client to fluids to help thin and loosen secretions If
potassium iodide is given with postassium sparing diuretics, hyperkalemia, cardiac
arrhythmias and arrest may occur
clarinex-Desloratadine (Clarinex) allergic rhinitis (runny nose)
oxymetazoline-Oxymetazoline (Afrin, Dristan, Vicks Sinex) nasal congestionOveruse of the topical decongestants may cause rebound congestion; advise the client to
use topical decongests for 3-5 days only
albuterol-Albuterol (Proventil, Ventolin) acute bronchospasm, prevention of EIB
Given orally, inhalation, or nebulizer
flovent-Fluticasone (Flovent) inhaled Corticosteroids (ICSs)
serevent- Long Acting b2 Adrenergic Agonists- Salmeterol (Serevent Diskus) long
term treatment and prevention of bronchospasm; given by inhalation The long acting 2
Adrenergic Agonists may increase risk of asthma related death; the inhaled
corticosteroids should be considered 1st for long term control of asthma
cromolyn- Mast Cell Stabilizers-Mast cell stabilizers are gradually tapered
subcutaneously

sympathomimetic bronchodilator (b2 adrenergic) Quick relief medications: used to treat

acute air flow obstructionShort acting beta-2 (2-adrenergic) agonists (helper) Oral
steroids The 2-adrenergic drugs (mimic the sympathetic nervous system; stress
hormones) are used in the treatment of chronic respiratory problems due to
bronchoconstriction, such as: Acute, chronic bronchial asthma and exercise induced
bronchospasm (EIB)BronchitisEmphysemaBronchiectasis
metaproterenol (alupent)- Short Acting b2 Adrenergic Agonists Metaproterenol
(Alupent) asthma, bronchospasm, Given orally, or inhalation
aminopylline-reactions: nervousness, anxiety, insomnia When these drugs are taken by
inhalation, excessive use (more than the recommended dose times) may result in
paradoxical bronchospasm; oral drugs should be taken a few hours before bedtime to
prevent insomnia
theophylline (slo-phyllin)-(Theo-Dur, Theolair, Slo-bid, Uniphyl) same uses and
adverse reactions as aminophylline; given orally
Theophylline (bronkodyl)-This medication is used to treat and prevent wheezing and
trouble breathing caused by ongoing lung disease (e.g., asthma, emphysema, chronic
bronchitis). Theophylline belongs to a class of drugs known as xanthines. It works in the
airways by relaxing muscles, opening air passages to improve breathing, and decreasing
the lungs' response to irritants. Controlling symptoms of breathing problems can decrease
time lost from work or school.
Theophylline (normal value) (Xanthine Derivative Bronchodilators) Theophylline dose
is determined by blood level (10-20 mcg); elevated levels stop the drug- Do not take
medication after 5 P.M. (insomnia)
Glucocoticoid (corticosteroid)
Methylprednisolone-s.q. injection: Decreases inflammation, mainly by stabilizing
leukocyte lysosomal membranes; suppresses immune response; stimulates bone marrow;
and influences protein, fat, and carbohydrate metabolism
is used to treat conditions such as arthritis, blood disorders, severe allergic reactions,
certain cancers, eye conditions, skin/kidney/intestinal/lung diseases, and immune system
disorders. It decreases your immune system's response to various diseases to reduce
symptoms such as swelling, pain, and allergic-type reactions. This medication is a
corticosteroid hormone.
Corticosteroid prednisolone
Cromolyn inhaler-Cromolyn (Intal, NasalCrom, Gastrocrom) bronchial asthma,
prevention of EIB, prevention of bronchospasm, nasal preparations for prevention and
treatment of allergic rhinitis; given by nebulizer, inhalation, nasal solution-When
Cromolyn is used to prevent exercise induced asthma it must be given 15 minutes to 1
hour prior to activity

Leukotriene receptor inhibitor montelukast sodium- Montelukast (Singulair)

prophylaxis and treatment of chronic asthma in adults and children 12 months or >,
seasonal allergic rhinitis; may cause headache, influenza-like symptoms; contraindicated
in pregnancy; given orally, or chewable in the evening
Omalizumab-(Xolair) S.q. injection: This medication is used to treat moderate to severe
asthma in adults and children over 12 years of age. It works by blocking your immune
system's natural response to allergic triggers that can lead to an acute asthma attack. This
action on your immune system (specifically immunoglobulin E-IgE), helps keep your air
passages open and, over time, it keeps your asthma in better control.
Ventolin-Albuterol (Proventil, Ventolin) acute bronchospasm, prevention of EIB
Given orally, inhalation, or nebulizer
What should you do before collecting giving an antibiotic drug
Prophylactic drug therapy for TB
Isoniazid-First line drug for active TB and for prophylaxis of TB; only drug that may be
prescribed alone May cause peripheral neuropathy, nausea, vomiting, epigastric distress,
jaundice, hepatitis (severe and sometimes fatal), pyridoxine (vitamin B6) deficiency, skin
eruptions, and hypersensitivity Contraindications: known hypersensitivity and acute
liver disease Used cautiously in pregnancy, lactation, alcoholism, or renal impairment
Do not administer isoniazid with foods containing tyramine, such as aged cheese,
processed meats and fish, bananas, dried fruits, yeast products (bread), soy sauce, and red
wine exaggerated sympathetic type response HTN, tachycardia, and palpitations
Advise client to take INH on an empty stomach unless gastric discomfort occurs, then
take with food; monitor liver function tests Administer pyridoxine (vitamin B6) as
prescribed to reduce the risk of neurotoxicity

Pyrazinamide-May cause hepatotoxicity, photosensitivity, thrombocytopenia, nausea,

vomiting, diarrhea, arthralgia, myalgia, and rashes Hepatotoxicity is principle adverse
reaction: monitor liver function tests Contraindications: known hypersensitivity, acute
gout (may cause levels of uric acid), and acute liver disease Used cautiously during
pregnancy, lactation, renal impairment, HIV infection, and diabetes Evaluate CBC
(thrombocytopenia), liver function tests (hepatotoxicity), and uric acid levels Evaluate
blood glucose levels because diabetes mellitus may be difficult to control during drug
therapy Instruct client to take medication with food Instruct client to avoid sunlight or
ultraviolet light, use sunscreen, wear long sleeves and hat
Ethambutol-May cause hypersensitivity (including anaphylaxis), anorexia, nausea,
vomiting, dizziness, malaise, mental confusion, depression, arthralgia, dermatitis, optic
neuritis (reversible color blindness), peripheral neuritis, thrombocytopenia, uric acid
levels Monitor for visual changes: altered color perception and visual acuity; hold
drug if changes occur-Monitor joint pain, I&O, mental status, numbness, tingling;
initiate safety precautions

Truphylline- Xanthine Derivative Brochodilators - Aminophylline (Truphilline, rectal

suppository) symptomatic relief or prevention of bronchial asthma and reversible
bronchospasm of chronic bronchitis and emphysema; Adv reactions: Central nervous
system reactions: restlessness, irritability, headache, nervousness, tremors, Cardiac and
respiratory reactions: tachycardia, palpitations
Peripheral neuritis
Exfoliative dermatitis
Diet for pts on isoniazin
Pyridoxine
Rifadin-Rifampin (Rifadin, Rimactane May cause urine, feces, saliva, sputum, sweat,
and tears to be colored reddish orange-Avoid soft contact lenses, may become stained
Streptomycin-Streptomycin for TB, infections due to susceptible microorganisms; may
cause nephrotoxicity, ototoxicity, numbness, tingling, paresthesia of the face, tinnitus,
nausea, dizziness; given IM
Antitubercular-TB responds well to long-term treatment with a combination of 3 or
more antitubercular drugs Initial phaseLasts approximately 2 monthsCDC
recommends administration of rifampin, isoniazid, pyrazinamide, and ethambutol
Continuing phaseLasts approximately 4 months or up to 7 months in special
populationsCDC recommends administration of rifampin and isoniazid only Treatment
is individualized and based on cultures and sensitivity studies that identify the drugs to
which the organism is susceptible CDC recommends using 3 or more drugs with initial
therapy, as well as in retreatment, because a combination of drugs slows the development
of drug resistance

46 questions
Make sure you know for each drug?
-Adv Reactions
-Nurse teachings
-Actions