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Pharm Week 5

front 1

H1 Receptor Antagonist (Antihistamine)

Diphenhydramine (Benadryl)

back 1

Treats minor symptoms of allergy and common cold

front 2

What are some Adverse effects for H1 Receptor Antagonists?

back 2

drowsiness: occasionally paradoxical CNS stimulation and excitability.

Dry mouth, tachycardia, mild hypotension

May cause photosensitivity

front 3

What should pts avoid when taking Antihistamines?

back 3

Alcohol

front 4

Who shouldn't take antihistamines?

back 4

Third trimester of pregnancy, nursing mothers, newborn infants,

front 5

Intranasal Glucocorticoids

Fluticasone (Flonase)

back 5

This is the 1st choice for prevention of rhinitis

it decreases local inflammation in nasal passages, thus reducing nasal stuffiness.

front 6

What are some adverse effects of fluticasone (Flonase)?

back 6

Drying of nasal mucosa or sore throat, Epistaxis (nosebleed), Headache,

front 7

Can a pregnant client take Mometasone and Triamcinolone?

back 7

No, this is a class C drug so the effects on pregnancy is unknown.

front 8

Oxymetazoline (Afrin)

back 8

causes arterioles in nasal passages to constrict, dries mucous membranes,

Only use for 3-5 days due to rebound congestion.

front 9

Antitussives

Dextromethorphan (Benylin)

back 9

Moa: acts in medulla to inhibit cough reflex

Adverse effects: Dizziness, drowsiness, GI upset

front 10

Inhaler Education

back 10

1. Remove cap and hold Inhaler upright, shake it, tilt your head back slightly and breath out slowly, press down on the inhaler to release medication as you start to breath in slowly for (3-5 seconds), Hold your breath for 10 seconds.

Wait 1 minute between puffs.

front 11

2 main classificationS of drug for Asthma and/or COPD

back 11

Bronchodilators and Anti-inflammatory agents

Bronchodilators

- Beta2-Adrenergic Agonists (Albuterol)

- Methylxanthines (Theophylline)

- Anticholinergics (Ipratropium)

Anti-inflammatory Agents

- Steroidal: Glucocorticoids (Prednisone)

- Non-steroidal: Cromolyn

- Leukotriene Modifiers

- Anti-IgE

front 12

Beta 2 adrenergic Agonists

back 12

Most effective drugs for relieving acute bronchospasm

front 13

What are some Short Acting "Rescue Inhalers"?

back 13

Albuterol, Salbutamol, Levalbuterol (Xopenex)

onset of action: 5min or less.

Duration: 4-6hrs

front 14

What is the off label use for Terbutaline?

back 14

Fetal distress, pre-term labor (Given SQ/IV)

front 15

What are some long acting bronchodilators?

back 15

These are commonly administered in conjunction with inhaled steroids.

Serevent (Salmeterol), Foradil (Formoterol),

front 16

Bronchodilators-Beta-Adrenergic Agonists

Albuterol (Proventil, Ventolin, Vospire)

back 16

Moa: Selectively binds to beta2-adrenergic receptors in bronchial smooth muscle to cause bronchodilation

Primary use: for the termination of acute bronchospasm/ It can also be used before exercise to prevent exercise induced asthma

front 17

Who can not get Beta-Adrenergic Agonsits?

back 17

Hx of Dysrhythmias or MI

Not rec. to women who are breastfeeding

front 18

Bronchodilators- Anticholinergic

Ipratropium (Atrovent), Combivent

back 18

Moa: Causes bronchodilation by blocking cholinergic receptors in bronchial smooth muscle

Primary use: Relief of acute bronchospasm

front 19

What are some Adverse effects when taking anticholinergics?

back 19

Cough, hoarseness, bitter taste

front 20

Methylxanthines

back 20

Theophylline, Aminophylline

They have a narrow margin of safety (5-15)

front 21

What are some side effects for Methyxanthines?

back 21

N/V, CNA Stimulation

They are primarily used for long-term prophylaxis of asthma that is unresponsive to beta agonists or corticosteroids

front 22

Who should not take Methylxanthine?

back 22

Pts with CAD, angina pectoris, severe renal or liver disorders, PUD, BPH, DM

Not rec. for women who are breastfeeding

front 23

Anti-inflammatory agents- Corticosteroids

Beclomethasone (Beclovent, Beconase, Vancenase, Vanceril)

back 23

Moa: Reduces inflammation

Primary use: to decrease the frequency of asthma attacks,

Adverse effects: Oropharyngeal, Candidiasis

Limit use to under 10 days

front 24

What should you teach the pt to do after taking a steroid inhaler?

back 24

Rinse mouth after using, closely monitor blood glucose levels

front 25

Omalizumab (Xolair)

back 25

Attach to receptor on Immunoglobin E (IgE)

front 26

Leukotriene Modifiers

Zafirlukast (Accolate)

back 26

Moa: Prevents airway edema and inflammation by blocking leukotriene receptors in airways

Primary use: for prophylaxis of persistent, chronic asthma

AE: Headache. nausea, diarrhea

front 27

Mast Cell Stabilizers

back 27

Are safe for Prophylaxis of asthma

Less effective than inhaled corticosteroid

Ineffective at relieving acute bronchospasm