Question Answer
Beta Agonists Airway obstruction in asthmas and COPD
Albuterol, Levalbuterol, Metaproterenol Acute airflow obstruction
Salmeterol, Formoterol, Arformetorol Maintenance bronchodilation, control bronchospasm
Racemic Epi Reduce AW swelling after extubation or epiglottitis, croup, or control AW bleeding
What is the mode of action of adrenergic drugs? stimulation of Beta 2 receptors located in bronchial smooth muscle`
What are the effects of Alpha receptor stimulation? Vasoconstriction in upper AW, decongestion
What are the effects of Beta 1 receptor stimulation? Increased heart conductivity, heart rate, and contractile force
What are the effects of Beta 2 receptor stimulation? Relaxation of bronchial smooth muscle, mucociliary clearance, some inhibition of inflammation
What are the side effects of Beta adrenergic bronchodilators? Tachycardia, nervousness, tremors, nausea
Terbutaline stop contractions in premature labor
What is responsible for the breakdown of Beta agonist? COMT
What breaks down C3’5’AMP to 5 AMP? Phosphodiesterase
How does bronchodilation occur? Attachment to Beta 2 receptors – Gs protein – adenylyl cyclase – C3’5’AMP

Question Answer
Midazolam/ Versed Sedative
Diazepam/ Valium SEDATIVE
Lorazapam/ Ativan SEDATIVE
Propofol/ Diprovan SEDATIVE
What sedative is nicknamed Milk of Amnesia? Propofol
Dexmedetomide/ Precedex Sedative
Morphine Sulfate/ Roxanol, Duramorph, MS Contin Narcotic
Fentanyl/ Duragesic Narcotic
Meperidine/ Demerol NARCOTICS
Succinylcholine/ Anectine Depolarizing PARALYTICS (NMBA)
Pancuronium/ Pavulon PARALYTICS (NMBA)
Vecuronium/ Norcuron PARALYTICS (NMBA)
Rocuronium/ Zemuron PARALYTICS (NMBA)
Atracurium/ Tracrium PARALYTICS (NMBA)
Cisatracurium/ Nimbex PARALYTICS (NMBA)
Dopamine VASOPRESSORS
Norepinephrine VASOPRESSORS
Phenylephrine/ Neosynephrine VASOPRESSORS
What are the two groups of paralytics? Depolarizing and Nondepolarizing Agents
What kind of agent is succinlycholine? Depolarizing
What must you give along with paralytics? Sedatives
How do depolarizing agents work? Prolongs the depolarization phase by bonding to AcH receptors.
How do nondepolarizing agents work? Compete with AcH to bind with receptors.
Acidemia intensifies or diminishes effects of NMBA’s. Intensifies. Lower dosage of paralytic needed. Higher dose of reversal agent needed.
Alkalemia intensifies or diminishes effects of NMBA’s. Diminishes. Higher dosage of paralytic and lower dosage of reversal agent.
Question Answer
Proventil,Ventilin, and Proair HFA Generic Name: Albuterol Class Fast Acting Beta Agonist/Quick Relief/Relaxes smooth Muscle
Brovana aformoteral tartrate: Long acting beta agonist/long term control
Combivent: MDI & DuoNeb solution for SVN Albuterol and ipratropium bromide:
Foradil Aerolizer DPI & Perfomist Generic Name: formoteral fumarate: Long acting beta agonist/long term control/Relaxes the smooth airway muscles. Used with pre-exertion with exercise induced asthma
Maxair Genetic Name: pirbuterol acetate: Fast acting beta agonist/quick relief/ Relaxes smooth airway muscles
Serevent Genetic Name: Salmeterol: Long acting beta agonist/long term control: Relaxes smooth muscle
Xopenex, Xopenex HFA Generic Name: levalbuterol Fast acting beta agonist/Relaxes smooth airway muscles
Atrovent Generic Name: Ipratropium Bromide/ Anticholinergic/long term not quick relief /accentuates albuterol
Spiriva Generic Name: tiotropium bromide/Long acting anti-cholinergic/not for quick relief
Advair Diskus & Advair HFA MDI Generic Name: Saleterol&Fluticasone Combanation Agent/ Long Term Control
Aerobid Generic Name: Flunsolide/Glucocorticod/long term/Anti Inflamatory
Alvesco HFA MDI Generic Name: Ciclesonide/Glucocorticod/long term control/Anti-Inflamatory
Asmanex Generic Name:Mometasone Furoate:Glucocorticod/ long term control/ anti-inflamatory
Azmacort Generic Name:Triamcinolone/Glucocorticoid/Long Term control/Anti-Inflamatory
Beclovent Generic Name: Beclomethasone/Glucocorticoid/ Long term control/ Anti-Inflamatory
Flovent Generic Name:Fluicasone/Glucocorticoid/long term control/
Pulmicort Generic Name: Budesonide/Glucocorticoid/Long term acting/Anti-Inflamatory
QVAR HFA Generic Name: Belclomethasome/Glucocorticoid/Long Acting/Anti-Inflamatory
Pulmozyme Generic Name: Dorsa Alfa/mucolytic/Reduces sputum visco-elasticity
Mucomyst Generic Name: Acetylcysteine/Thining non-purulent&purulent secreations/Can Bronchocontrict,use with Albuterol
Intal Generic Name:Cromolyn Sodium/ Anti-Inflamatory Long term control/Mast Cell Stabilizer
Tilade Generic Name:Nedocromil Sodium/Anti-Inflamatory/Long term control/Mast Cell Stabilzer
Micro Nefrin Generic Name: Racemic Epinephrine/Fast-acting Beta agonist/decongestant/Relaxes the smooth airway muscles,decreases mucosal edema
Pentam GenericName:Pentamidine/antimicobial/ antiprotozoal
TOBI Generic Name:Tobramycin Inhale/antimicrobial/ Gram Negitive bacteria
Symbicort Generic:Formoteerol&Budesonide/Combination agent/Long term control/Refer to Indivisual agents.
Question Answer
What are the two antiviral agents mentioned in class? Acyclovir, Valacyclovir
Valacyclovir is a prodrug of what? Acyclovir
What virus is Valacyclovir indicated for? Herpes simplex Virus
Where is the Herpes virus commom? ICU
What are the reasons for complications in treating viruses? Attacking virus could harm the host, No symptoms when virus replicates, Viruses are mutants
What other drugs can be used to treat RSV? RSV-IGIV, Palivizumab/Synagis
Who is indicated for Respigam? Children at risk of RSV: <24mos w/history of BPD and premature birth
What is the mode of action for Respigam? Passive immunity – exposure to antibody of RSV
What is the mode of action for Palivizumab/Synagis? Prevents viral replication
What does PCP stand for? Pneumocystis Carinii Pneumonia
Who is most at risk for PCP?
Question Answer
Anticholinergics Blocks the action of acetylcholine at parasympathetic sites in bronchial smooth muscle causing bronchodilation.
Anticholinergics Drugs tiotropium (Spiriva) ipratropium (Atrovent)
Atrovent Used Ipratropium is used to control and prevent symptoms (wheezing and shortness of breath) caused by ongoing lung disease (chronic obstructive pulmonary disease-COPD which includes bronchitis and emphysema).
Atrovent How it works It works by relaxing the muscles around the airways so that they open up and you can breathe more easily. Controlling symptoms of breathing problems can decrease time lost from work or school.
Beta2-agonists How It Works are bronchodilators. This means that they relax and enlarge (dilate) the airways in the lungs, making breathing easier.
Beta2-agonists Why It Is Used are considered first-line therapy for the treatment of stable chronic obstructive pulmonary disease (COPD) with symptoms that come and go (intermittent symptoms). They are used for both short- and long-term relief of symptoms.
Prescription short-acting beta2-agonists for asthma include: albuterol Proventil, Ventolin levalbuterol Xopenex metaproterenol pirbuterol Maxair terbutaline
How It Works Short-acting beta2-agonists They relax the muscles lining the airways that carry air to the lungs (bronchial tubes) within 5 minutes, increasing airflow and making it easier to breathe. They relieve asthma symptoms for 3 to 6 hours. They do not control the inflammation
Why It Is Used Short-acting beta2-agonists are used to: Provide quick relief of symptoms during asthma attacks. Prevent asthma symptoms before exercise. Treat symptoms in intermittent asthma.
Advair Generic Name: fluticasone and salmeterol (floo TIK a sone, sal ME te rol) Brand Names: Advair Diskus, Advair HFA
What is Advair? Advair contains fluticasone and salmeterol. Fluticasone is a steroid. Advair prevents the release of substances in the body that cause inflammation. Salmeterol is a bronchodilator. It works by relaxing muscles in the airways to improve breathing.
Advair uses Advair is used to prevent asthma attacks. It is also used to prevent flare-ups or worsening of chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis and/or emphysema.
Flovent Generic Name: fluticasone inhalation (floo TIK a zone) Brand Names: Flovent Diskus, Flovent HFA
What is Flovent? Flovent is a corticosteroid. It works by reducing inflammatory reactions in the airways in response to allergens and irritants in the air.
Flovent uses Flovent is used to prevent bronchial asthma attacks. It will not treat an asthma attack that has already begun.
GENERIC TRADE
BECLAMETHASONE VANVERIL, QVAR
DEXAMETHASONE DECADRON
METHYLPREDNISONE SOLU-MED(IV), MEDROL (PILL) DEPO-MEDROL (SHOT)
PREDNISONE PREDNISONE
HYDROCORTISONE SOLU-CORTEF (IV) CORTISOL (SHOT)
TRIAMCINOLONE AZMACORT
BUDESONIDE PULMICORT
FLUTICASONE FLOVENT (LUNG) FLONASE (HEART)
FLUNISOLIDE AEROBID
FLUTICASONE+ SALMETERAL ADVAIR
THEOPHYLLINE THEODUR (PILL) AMINOPHYLLINE (IV)
OXITRIPHYLLINES CHOLEDYL
DYPHYLLINE LUFYLLIN
RACEMIC EPINEPHERINE VAPONEFRINE: MICRONEFRINE
NOREPINEPHERINE LEVOPHED
ISOETHARINE BRONKSOL
ISOPROTERENOL ISOPREL
EPIMEPHERINE PRIMATINE MIST
IPATROPIUM BROMIDE ATROVENT
BITOLTEROL TORNALATE
SALMETEROL SEREVENT
METAPROTERNOL ALUPENT: METAPREL
FORMOTEROL FORADIL
ALBUTEROL+IPOTROPIUM MDI COMBOVENT SVN DUO NEB
FORADIL+BUDESONIDE SYMBECORT
BAMBUTEROL PRODRUG CHANGES TERBUTALINE
TERBUTALINE BRETH-AIR (MDS) BRETHINE (SVN)
ALBUTEROL PROVENTIL: VENTOLIN: SALBUTOMOL: ATROVENT: COMBOVENT: DUONEB
LEVALBUTEROL XOPENEX
PIRBUTEROL MAX AIR
GLYCOPYRROLAYE ROBINUL
OXIVENT BROMIDE OXIVENT
TRIOTROPPIUM BROMIDE SPRIVA
ZAFIRLUKAST ACCOLATE
MONTELUKAST SINGULAIR
ZILEUTON ZYFLO
DORNASE ALFA DNASE: PULMOZYME
RIBAVIRIN VIRAZOLE
ACETYLCYSTEINE MUCOMYST: MUCOSIL
CRMOLYN ALFA INTAL: NASALCROM: OPTICROM
NEDACRMIL SODIUM TILADE
PENTAMIDINE PENTAM: NEBUPENT
ACETAMINOPHEN TYLENOL
MIDAZOLAM VERSED
DIAZEPAM VALIUM
LORAZEPAM ATIVAN
TUBOCURARINE CURARE
PANCRONIUM BROMIDE PAVULON
VECURANIUM NORCURON
SUCCINYLCHOLINE ANECTINE: QUELICIN
ATROPINE ATROPINE
PHENOBARBITOL LUMINAL
LIDOCANE XYLOCAINE
METHYLDOPA ALDOMET
METAPROLOL LOPRESSOOR
PROPANALOL INDERAL
TOBRAMYCIN NEBCIN (TOBI)
Question Answer
Racemic Epinephrine/MicroNefrin Nephron SVN
Salmeterol/Serevent MDI-DPI
Arformeterol/Brovana SVN
Formoterol/Foradil Perforomist DPI SVN
Albuterol/Proventil Ventolin SVN MDI
Levalbuterol HCL/Xopenex SVN
Dornase Alfa/Pulmozyme SVN
Acetylcysteine/Mucomyst SVN
Ipratropium Bromide/Atrovent MDI SVN
Tiotropium Bromide/ Spiriva DPI
Ipratropium Bromide and Albuterol/ Combivent DuoNeb SVN
Cromolyn Sodium/ Cromolyn Sodium SVN
Fluticasone Propionate/ Flovent Flovent Discus MDI DPI
Pentamidine Isethionate/ NebuPent SVN
Question Answer
Racemic Epinephrine .25-.5 ml QID
Salmeterol MDI 2 puffs DPI BID
Arformoterol 15 mcg/2 ml BID
Formoterol DPI BID SVN 20 mcg/2 ml
Albuterol SVN 2.5 mg QID MDI 2 puffs
Levalbuterol HCL (Xopenex)
Question Answer
Racemic Epinephrine (Microphen Nephron) Ultra short Adrenergic
Albuterol (Proventil Ventolin) Short Adrenergic
Levalbuterol HCL (Xopenex) Short Adrenergic
Salmeterol (Serevent) Long Lasting Adrenergic
Arformoterol (Brovana) Long Lasting Adrenergic
Formoterol (Foradil Perfomist) Long Lasting Adrenergic
Dornase Alfa (Pulmozyme) Mucoactive
Acetylcysteine (Mucomyst) Mucoactive
Ipratropium Bromide and Albuterol (combivent DuoNeb) Anticholinergic and Adrenergic
Cromolyn Sodium (Cromolyn Sodium) Nonsteriodal antiasthma
Beclomethoasone dipropionate (QVAR) Corticosteroid
Fluticasone propionate (Flovent/Flovent Discus) Corticosteroid
Flunisolide (aerospan) Corticosteroid
Pentamidine Isethionate (Nebupent) anti-infective
Question Answer
What do Bronchodilators do? Open narrow airways to allow better air circulation.
What do Anticholinergics do? Maintenance of open airways.
What do Steroids do? Reduce inflammation of airways.
What is the Brand name of Beclomethasone? QVAR
What is the Brand name of Budesonide? Pulmicort
What is the Brand name of Flunisolide? Aerobid
What is the Brand name of Fluticasone? Flovent
What is the Brand name of Triamcinolone? Amzacort
What is the Brand name of Mometasone? Asmanex
What is the Brand name of Budesonide and Formoterol? Symbicort
What is the Brand name of Fluticasone and Salmeterol? Advair
What is the Brand name of Mometasone and Formoterol? Dulera
Question Answer
Racemic Epinephrine SVN:0.25-0.5ml, 5.63-11.25mg (qid)
Metaproterenol SVN:0.3ml, 15mg (tid,qid)
Albuterol SVN:2.5,1.25,.63mgMDI:90ug/puff, 2 puffs (tid,qid)tabs, syrup
Levalbuterol SVN:1.25,0.63,0.31mgMDI:45ug
Salmeterol DPI:50ug
Formoterol DPI:12ug
Arformoterol SVN:15ug
Trade Name Info
Diamox Gen Nm: Acetazolamide Type: Diuretic Carbonic Anhydrase Inhibitor Uses: As Tx for metabolic alkalosis
Mannitol Gen Nm: Mannitol Type: Diuretic Osmotic Diuretic Uses: To decrease ICP
Diuril Gen Nm: Chlorothiazide Type: Diuretic Thiazide Diuretic Uses: CHF, Hypertension
Aldactone Gen Nm: Spironolactone Type: Diuretic K+ sparing Diuretic Uses:
Anectine (aka Succs) Gen Nm:Succinylcholine Chloride Type: Neuromuscular Blocking agent The ONLY Depolarizing Agent Uses: To fascilitate intubations ** Short action
Curare Gen Nm: Turbocurarine Type: NMBA Non-depolarizing
Pavulon Gen Nm: Pancuronium Type: NMBA Non-depolarizing
Norcuron Gen Nm: Vecuronium Type: NMBA Non-depolarizing
Tracrium Gen Nm: Atratracurium Type: NMBA Non-depolarizing
Nimbex Gen Nm: Cisatracurium Type: NMBA Non-depolarizing
Zemuron Gen Nm: Rocuronium Type: NMBA Non-depolarizing
Elavil Gen Nm: Amitriptyline Type: Antidepressant Tricyclic
Prozac Gen Nm: Fluoxetine Type: Antidepressant SSRI
Zoloft Gen Nm: Sertraline Type: Antidepressant SSRI
Lithium Gen Nm: Lithium Type: Mood Stabilizer Uses: BiPolar Disorder
Tegretol Gen Nm: Carbamazepine Type: Mood Stabilizer Uses: BiPolar Disorder
Haldol Gen Nm: Haloperidol Type: Antipsychotic
Thorazine Gen Nm: Chlorpromazine Type: Antipsychotic
Ativan Gen Nm: Lorazepam Type: Sedative Benzodiazepine
Xanax Gen Nm: Alprazolam Type: Sedative Benzodiazepine
Vlaium Gen Nm: Diazepam Type: Sedative Benzodiazepine
Versed Gen Nm: Midazolam Type: Sedative Benzodiazepine
Nembutal Gen Nm: Pentobarbital Type: Sedative Barbiturate
Seconal Sodium Gen Nm: Secobarbital Type: Sedative Barbiturate
Solarcaine Gen Nm: Benzocaine Type: Anesthetic Local
Xylocaine Gen Nm: Lidocaine Type: Anesthetic Local
Marcaine Gen Nm: Bupivacaine Type: Anesthetic Local
Pentothal Gen Nm: Thiopental Type: Anesthetic Barbiturate
Brevital Gen Nm: Methohexital Type: Anesthetic Barbiturate
Morphine Gen Nm: Morphine Type: Analgesic Narcotic
Codeine Gen Nm: Codeine Type: Analgesic Narcotic
Demerol Gen Nm: Meperidine Type: Analgesic Narcotic
Nubain Gen Nm: Nalbuphine Type: Analgesic Narcotic
ASA Gen Nm: Aspirin Type: Analgesic Non-Narcotic
Tylenol Gen Nm: Acetaminophen Type: Analgesic Non-Narcotic
Motrin Gen Nm: Ibuprofen Type: Analgesic Non-Narcotic
Aquachloral Supprettes Gen Nm: Chloral Hydrate Type: Sedative Hypnotic Uses:Conscious Sedation
Propofol Gen Nm: Diprivan Type: Sedative Hypnotic Uses:Conscious Sedation
Ketanest Gen Nm: Ketamine Type: Sedative Hypnotic Uses:Conscious Sedation
Narcan Gen Nm: Naloxone Type: Respiratory Stimulant Uses: Compensation for anesthetics or opiates
Tensilon Gen Nm: Edrophonium Type: Actylcholinesterase Inhibitor Uses: Reversal of drug-induced paralysis
Prostigmin Gen Nm: Neostigmine Type: Actylcholinesterase Inhibitor Uses: Reversal of drug-induced paralysis
Term Definition
Brand names for – Racemic Epinephrine -Vaponefrin -Asthmanefrin -Micronefrin
Dosage for Racemic Epinephrine 0.25-0.5mL
Formula to calculate mL mg / mg/mL= mL
Formula to calculate mg mL x mg/mL = mg
Brand name for – Albuterol Proventil Ventolin
Dosage for Albuterol 1.25-2.5 mg
Brand name for – Levalbuterol Xopenex
Dosage for Leavlbuterol 3mL
Brand name for – arFormoterol Tartrate Brovana
Dosage for arFormoterol Tartrate 15 mcg
Brand name for – Formoterol Fumarate Performist
Dosage for Formoterol Fumarate 20 mcg
Brand name for Albuterol & Ipratropium (combined) DuoNeb
Dosage for Albuterol and Ipratropium 3mL
Brand name for – Terbutaline -Brethine -Bricanyl
Dosage for Terbutaline 0.25 mL or 0.25 mg
Brand name for – Epinephrine Adrenaline
Short Acting Beta2 agonist – Albuterol -Lealbuterol
What is MDI Metered Dose Inhaler
What is DPI Dry Powered Inhaler
Albuterol HFA – MDI -Ventolin -Proventil -ProAir
Dosage for Albuterol, MDI 1-2 puffs 4-6 hours
Dosage for Levalbuterol, HFA 1-2 puffs 4-6 hours
Short Acting ABAB’s are -Short acting Beta Agonist -Bronchodilator -Sympathomimetic drugs -Adrenergic drugs
What is LABA? (MDI & DPI) Long acting Beta2 Agonists
What is SABA? Short Acting Beta2 agonist
What drugs are LABA? -Salmeterol -Farmoterol Fumorate
Dosage for Salmeterol, MDI 2 puffs every 12 hours (MDI) 1 capsule every 12 hours (DPI)
Dosage for Formoterol, DPI 1 capsule every 12 hours
Combined SABA and SAMA is Combivent-Respimat
What is SAMA? Short-Acting Muscarinic Antagonist
Brand name for – Combivent-Respimat -Advair -Symbicort -Dulera
Dosage for Combivent-Respimat 1 inhalation QID
What is ICS? Inhaled corticosteriods
Meds that are LABAs and ICS -Advair -Symbicort -Dulera
What is Advair Diskus? Salmeterol (LABA) and Fluticasone (ICS)
Advair dosing DPI- 1 inhalation MDI- 2 puffs every 12 hours
What is Symbicort made up of? Formoterol (LABA) and Budesonide (ICS)
Symbicort dosing 2 inhalations twice a day
What part of combined drugs are increased with dosage? ICS
Question Answer
Pediatric Dosage – Clarks Rule child dose = (Childs weight/150)x max adult dose
Pediatric Dosage – Frieds Rule Infant dose = (infants age in mths/150) x max adult dose
Solution Calculation percentage number of grams of solute dissolved in 100ml of solvent. Ex. 1gram/100ml or 1000mg/100 multiply Xmg/3ml.
Solution Calculation ratio ratio 1:1000 1gr/1000ml or 1000mg/1000ml multiply Xmg/3ml
Theraputic Index equation Toxic dose/effective dose ex 500/100 = 5 TI=5 5 x the dose to be toxic
Equipotent dosage 1 Aspirin dosage is 50mg 1 ibuprofen dosage is 200mg These equal the same.
Ceiling effect after a certain amount of drug there is no additional effect.
Efficacy the maximum effect a drug can provide
Potency the amount of drug required to produce an effect. the least amount is the most potent.
Drug Indications For which a drug is to improve -speed up heart rate on a brady patient. -effect-increase heart rate -indication-low heart rate
Antagonist -attaches on to receptors and has not response. “Blocker” -no effect at the site but has a patient effect.
Agonist attaches onto the receptor and has a response.
Pharmacodynamics How the drug effects the body
Parent Drug the molecules structure at the time it was given whatever form it was given, it has been metabolized.
Absorption process by which a drug enters circulation.
5 primary ways of drug administration -enteral-along the GI tract -parenteral-outside of GI tract -transdermal-patch -inhalation-aerosol -topical-ointment
Pharmacokinetics -what your body does to the drug -How quickly it absorbs, changes, distributes and eliminates
Bioavailability amount of drug in serum in its active form available for distribution to intended site of action.
Cholinergic Indications -tachycardia -constrict pupils -increase GI and urinary motility -to diagnose asthma by broncho constricting.
What are the drugs that inhibit AchE which allow ACH to accumulate and produce greater effect? “gets rid of AchE” Physostigmine (Neostigmine) Endrophonium (Tensilon) -indirect acting -not an agonist so it does NOT attach to the receptor.
What drugs act as an agonist on muscarinic receptors -Bethanechol -Pilocarpine -Methacholine
Acetycholine (Ach) is terminated by? ACH is made in the body Acetylcholinesterase (AchE)
Norepinephrine (NE) is terminated by? MAO, COMT, reuptake
Cholinergic receptor drugs Nicotinic and Muscarinic
Cholinergic receptors interact with? ACH
Adrenergic receptors interact with? Norepi (NE)
Neurotransmitter Chemicals that transmit signals from a neuron to a target cell.
What do Sympathetics do increase heart rate
What do parasympathetics do decrease heart rate
Where can drugs be stored? fat cells and calcium
What are prodrugs? Inactive parent drug
What are the 2 routes of drug clearance? Kidney (renal) and Liver (hepatic)
receptors chemical components of cells with which drugs interact to product their effect.
What are the drug effects? changes we see clinically after administrating a drug. “physiological changes the drug produces”
What are drug indications? the conditions for which the drug is intended to improve.
Strength Expressed the amount of solute that is dissolved in a specific amount of solvent.
Solution percent the number of grams of solute dissolved in 100ml of solvent.
Clinical drop scale or gtts 20gtts = 1cc 10gtts = 0.5cc 8gtts = 0.4cc 6gtts = 0.3cc 4gtts = 0.2cc 2gtts = 0.1cc 1gtts = 0.05cc
Solution ratio Expressed as the number of grams of solute dissolved in the number of ml of solvent.
Autonomic involuntary structures. Smooth muscle (lungs), cardiac muscle and glands.
Cholinergic drugs drugs which produce effects similar to those produced by acetycholine.
Cholinergic effects any produced by parasympathetic nerves.
Anticholinergic drugs act as an antagonist on muscarinic receptors blocking ACH or cholinergic drugs.
Anticholinergic effects blocking parasympathetic so sympathetic effects are permitted to dominate.
Anticholinergic do not effect? blood vessels are not effected since there is no paraympathetic innervation to block.
Anticholinergic Indications -pre-operative to dry secretions -bradycardia -broncho dilate in asthma -counteract diarrhea -counteract urinary incontinence -dilate pupils for an eye exam
muscarinic sites Gland, GI, heart, eye
Cholinergic synapse Acetylcholine. Synthesis-within axonal ending from choline and acetate.
Adrenergic synapse Norepinephrine. synthesis-within axonal ending from tyrosine.
What are the adrenergic receptors Alpha, Beta1, Beta2
What do the Alpha receptors do mediate contraction of smooth muscle.
What are the Alpha receptors 1.Vascular smooth muscle – vasoconstriction 2.Radial muscle fibers of iris – mydriasis.
What do the Beta2 receptors do mediate relaxation of smooth muscles
What are the Beta2 receptors 1.Vascular smooth muscle – vasodilation. 2.Bronchial smooth muscle – bronchodilation.
What do the Beta1 receptors do mediate cardiac stimulation
What are the Beta1 receptors 1.Heart – increase rate and contract
What are adrenergic drugs Act as an agonist with sympathetic effects.
Adrenergic Indications for Alpha agonist. -hypotension – constricts vessels for blood to flow -respiratory congestion – upper resp -hemostasis – mucous membrane
Adrenergic Indications for Beta agonist. Beta1 – bradycardia, hypotension Beta2 – bronchospasms
Adrenergic Blockers act as antagonist. parasympathetic effects.
Adrenergic blockers Indications -angina pectoris – heart pain -tachycardia -hypertension
What happens automatically when giving an adrenergic beta blocker? Blood pressure will automatically come down.
What are the chemical structures of adrenergic drugs? Catechol, Resorcinol, Amine
Catechol a phenyl (benzene) ring with twho drydroxl groups in the 3 & 4 positions.
Resorcinol a phenyl (benzene) ring with two hydroxyl groups in the 3 & 5 positions.
Amine a compound containing nitrogen
catechol drugs -not used for bronchodilator, too much effect on the heart -can not take oraly -short acting drug -all are amines -destroyed by COMT
Resorcinol drugs -destroyed by MAO -medium acting drugs
Saligenins -long acting drugs
catechols are terminated quickly by COMT
Resorciinol are termimated by MAO
catecholmines are terminated by COMT and MAO
Saligenins are terminated by MAO
What drugs are more Beta2 specific and have greater duration. Resorcinol and Saligenins
What makes a drug more Beta2 specific and increases duration the longer the additive on the nitrogen or carbon.
What has the ability to decrease a patients serum potassium albuterol
Heart rate should not go above how many beats? 20
Beta2 side effects -CNS stimulation -skeletal tremors -hypotension -interference with physiological shunts.
Optical Isomerism same molecular formula but different molecular structure.
Racemic mixtures contain 50:50 mixture of Levo (R) and Dextro (L)
What isomer is the most active? Levo (R)
What isomer is the least active Dextro (L)
Question Answer
Adrenalin (Epinephrine) -catecholemine -short acting -alpha -beta1 -adrenergic
Vaponephrin, Micronephrin (racemic epinephrine) -catecholemine -short acting -alpha -beta1 -adrenergic
Isuprel (isoproterenol) -catecholemine -short acting -beta 1&2 -adrenergic
Isoetharine HCL (isoetharine) -catecholemine -short acting -adrenergic
Brethaire (Terbutaline) -resorcinol -medium acting -beta -adrenergic
Alupent (metaproterenol) -resorcinol -medium acting -beta2 -adrenergic
Proventil, Ventolin (albuterol) -saligenin -medium acting -beta 2 -adrenergic
Maxair (pirbuterol) -saligenin -medium acting -beta2 -adrenergic
Xopenex (levalbuterol) -saligenin -medium acting -beta2 -adrenergic
Serevent (salmeterol) -saligenin -long acting -beta2 -adrenergic
Foradil (formoterol) -long acting catecholamines -long acting -beta2 -adrenergic
Brovana (arformoterol) -long acting catecholamines -long acting -beta2 -adrenergic
Question
Answer
Class: Antituberculin Used to treat Tuberculosis Ethambutol
Class: Antibiotic Used to treat Gram Negative Infections Also with Tuberculosis. Streptomycin
Class: Non-steroid anti-inflammatory Used to treat General Inflammation. Aspirin Ibuprofen (motrin, Advil) Naproxen (Naprosyn, Aleve)
Class: Antibiotic Uesd to treat Gram neg. infections (Pseudomonas, E, Coli) Tobramycin
Class: Antituberculin Use to treat Tuberculosis **used with Isoniazid Rifampin
Class: Antibiotic Use to treat Gram Neg. Infections. (Pseudomonas, E. Coli) Gentamycin
Class: Antituberculin 1yr. use Used to treat Tuberculosis       **used with Rifampin Isoniazid (INH)
Class: Broad-spectrum Antibiotic Use to treat Rocky Mountian Spotted Fever Mycoplasma PneumoniaChronic Bronchitis Tetracycline
Class: Non-penicillin-type Antibiotic Treats Gram Positive Bacterial infections For patients ALLERGIC to Penicillin Caphalotihin (Keflin)Cephaloridine (Loridine)Caphalexin (Keflex)
Class:Stop-smoking Assistence Curbs addiction to Nicotine (Transdermal Patch) NicoDerm
Class: Non-Penicillin-type Antibiotic For patients ALLERGIC to Penicillin Or Mycoplasma Pneumonia Erythromycin
Class: Stop-smoking Assistance Curbs addiction to Nicotine Nocotrol NS
Class: Penicillin RESISTANT-Type Antibiotic Treats Gram + Bact. Infection that are RESISTANT to normal Penicillin. MethacillinOxacillineNafacillin
Class: Stop-smoking Assistance Curbs addiction to Nicotine (Gum) Nicorette
Class: Penicillin-Type Antibiotic Treats Fram positive Bacterial infections(staphylococcus, streptococcus, etc) CarbenicillinAmoxicillinAmpicilline
Class: Respiratory Stimulant Treats Central Sleep Apnea for NEONATES Aminophylline for Neonates(also called Theophylline)
Class: Respiratory Stimulant Treats Central Sleep Apnea Dopram(Doxapram)
Class: Artificial Surfactant Treats Immuature neonatal lungs Exosurf
Class: Respiratory Stimulant treats Central Sleep Apnea Medroxyprogesterone(Hormone)
Class: Artificial Surfactant Treats Immature neonatal lungs Survanta
Class: Artificial Surfactant Treats Immature neonatal lungs Curosurf
Class: Antipneumocystis Agent Treats Pneumocystis carinii(mostly in AIDS) Pentamadine(Nebupent)
Class: Artificial Surfactant Treats Immature neonatal lungs infasurf
Class: Antiviral(Deliver with a SPAG unit or a particle scavenger device) Treats RSV(Respiratory syncytial virus) Ribavirin(Virazole)
Class: Benzodiazepine Reduce Anxiety Restoril
Class: Narcotic Analgesic Provides Sedation and Pain Relief(Do not use on COPD patients) Codeine
Class: Benzodiazepine Reduces Anxiety Ativan
Class: Narcotic Agent Reverses Narcotic Influence Narcan(Naloxone)
Class: Benzodiazepine Reduces Anxiety Xanax
Class: Narcotic Agent Provides Sedation and Pain Relief (Do Not Use on COPD Patients!) Demoral(Meperidine)
Class: Bronchodilator BACK DOOR Treats Wheezing Especially good for emphysema Atrovent(Ipratropium Bromide)
Class: Brochodilator SIDE DOOR Therapeutic Blood Level: 10-20 ug/ml for Long Term Bronchodilation Theophylline(Aminophylline & Theo-Dur)
Class: Bronchodilator BACK DOOR Adult dose: DPI Inhaler – Q day for Long Term Bronchodilation Sprivia(Tiotropium Bromide)
Class: Bronchodilator SIDE DOOR for Long Term Bronchodilation Choledyl(Oxytriphylline)
Class: Bronchodilator BACK DOOR MDI Only for Long Term Bronchodilation Oxivent(Oxitropium)
Class: Mucolytic Agent Adult dose: 2.5 mg or 2.5 ml Prevents infection in CF Pulmozyme(Dornase Alpha)
Class: Bronchodilator BACK DOOR Long Term Bronchodilation & Drying Agent Robinul(Glycopyrrolate)
Class: Mucolytic Agent – Adult Dose: 2-4 cc of 10 – 20% strength – treats Thick Secrections Mucomyst ( Acetylcysteine)
Class: Bronchodilator Front Door – Adult Dose: 0.63 mg TID – Treats Wheezing Xopenex (Levalbuterol)
Class: Bronchodilator Front Door – Adult dose: 1.25 md QID – Treats Weezing Bitolterol (Tornalate)
Class: Bronchodilator Front Door – Adult dose: 0.5 mL – Main side effect: TREMORS – Treats Wheezing Albuterol
Class: Bronchodilator Front Door – Adult dose: MDI (2 Puffs q6 hr) – Treats Wheezing Pirbuterol (Maxair)
Class: Bronchodilator Front Door – Adult dose: 0.5 mL – Tablet – Treats Wheezing Terbutaline (Brethine)
Class: Bronchodilator BACK DOOR – Cardiac Stimulant – Treats Wheezing, Bradycardia, or Reverse cholinergic Crisis (as seen in Myasthenia Gravis) Atropine (Sch 1000)
Class: Bronchodilator Front Door – Adult dose: 0.3 mL – Main side effect : TACHYCARDIA – treats Wheezing Alupent (Metaproterenol)
Class:: Bronchodilator Front Door – Adult dose: MDI (2 puffs BID) Salmeterol (Serevent)
Class: Surface Active Agent – Treats Thick Secretions – also LOWERS pH Sodium Bicarbonate
Class: Asthma Prophilaxis – Do not give when wheezing present. – Dose: MDI 2 puffs QID Nedocromil (Tilade)
Class: Wetting Agent – May cause irritation and bronchospasm for thick SHyecretions Hypotonic Saline (0.45% saline)
Class: Corticosteriod – For Anti-inflammatory of Airways Prednisone
Class: Wetting Agent – May cause irritation and bronchospasm – For Sputum Induction Hypertonic Saline (1.8-15% Saline
Class: Corticosteroid For Anti-inflammatory of Airways Solu-Medrol (Methylprednisolone)
Class: Asthma Prophylaxis – Do not give when wheezing present – Not a rescue medication- For Inhibit histamine release (prevent bronchoconstriction) Intal (Cromolyn Sodium)
Class: Corticosteroid – For Anti-inflammatory of Airways Decadron (Dexamethasone)
Class: Corticosteroid – For Anti-inflammtory tiof Airways Beclamethasone (Beclovent or Vanceril)
Class: Corticosteroid – For Anti-inflammatory of Airways Pulmocort (Budesonide)
Class: Corticosteroid – For Anti-inflammatory of Airway Azmacort (Triamcinolone)
Class: Decongestant – Mucosal vasoconstrictor – For Acute epiglottitis Stridor following extubation Racemic Epinephrine (S2 or Vaponephrine)
Class: Corticosteroid – For Anti-inflammatory of Airways Flovent (Fluticasone)
Class: Leukotriene Modifier – Not a rescue medication – For Alternative to corticosteroids Zyflo (Zileuton)
Class: Corticosteroid – For Anti-inflammatory of Airways Aerobid (Flunisolide)
Class: Leukotriene Modifier – Not a rescue medication – For Alternative to corticosteroids Accolate (Zafirlukast)
Class: Leukotriene Modifier – For Alternative to corticosteroids Singulair (Montelukast)
Class: Cardiac Glycoside – For Atrial Arrhythmias Quindine or Propranolol (Inderal)
Class: Bronchodilator (Combined long and short term) – For Bronchoconstriction Advair (Fluticasone and Salmeterol)
Class: Anti-arrhythmic agent – For Atrial Arrhythmias & Ventricular tachycardia Pronestyl (Procainamide)
Class: Cardiac Glycoside – For Increase Cardiac Contractility (CHF, Left heart failure Digoxin (Lanoxin)
Class: Anti-arrhythmic agent – For Pulseless V-tach and V-fib (non responsive to defibrillation) Amioderone
Class: Cardiac Glycoside – For Increase Cardiac Contractility (CHF, Left heart failure) Digitalis (Crystogdigin)
Class: Anti-arrhythmic agent – Controls Ventricular rate (supraventricular tachycardia) Verpamil
Class: Anti-arrhythmic agent – For PVCs Pulseless V-tach V-fib Lidocaine
Class: Vasopressor – Use to Increase blood pressure Dopamine
Class: Anti-angina – For Angina pectoris (Chest pain) Nitroglycerine
Class: Diuretic – For Cerebral edema, Drug Overdose Osmitrol (Mannitol)
Class: Vassopressor – For Increase blood pressure (cardiogenic shock) Levophed (Norepinephrine)
Class: Diuretic – For CHF, pulmonary edema, Fluid overload Lasix (furosemide)
Class: Vasodilator – For Lower blood pressure – Decrease ventricular preload Nipride (Sodium Nitroprusside)
Class: Diuretic – For Peripheral Edema, Cerebral Edema Diamox (acetazolamide)
Class: Seditive Minor Tranquilizers – Use to Provide Sedation Valium (Diazepam)
Class: Sedative Barbiturate – Use to Provide Sedation Seconal (Secobarbital)
Class: Sedative Minor Tranquilizers – Use to Provide Sedation Versed (Midazolam)
Class: Sedative NON-Barbiturate – Use to Provide Sedation Dalmane (Flurazepam)
Class: Sedative Barbiturate – Use to Provide Sedation Pentabarbital (Nembutal)
Class: Sedative NON-Barbiturate – use to Provide Sedation Quaalude (Methaqualone)
Class: Sedative Barbiturate – Use to Provide Sedation Phenobarbital (Luminal)
Class: Sedative NON-Barbiturate – Use to Provide Sedation Noctec (Chloral Hydrate)
Class: Narcotic Analgesic – Use to Provide Sedation and Pain Relief (Do not use on COPD Patients!) Morphine
Class: Benzodiazepine – Use to Reduce Anxiety Halcinon
Question Answer
what are the three primary conditions that leaad to nasal obstruction? Deviated septum,nasal plyps, and hypertrophied turbinates
What is the inflammation of the nasal mucous membranes, also referred to as the common cold? Rhinitis
What symptoms are associated with rhinitis? It includes sneezing, nasal congestion, rhinorrhea(clear nasal discharge), sore throat, watery eyes, cough, low-grade fever.
How long could the symptoms last for the common cold? Could last up to 5 to 14 days
What should you tell your clients with these diseases who are taking prescription drugs? To consult a physician befor using nonprescription drugs to treat a cold
What do Antitussives do? Act on the central nervous system to raise the cough threshold and dampen cough reflex.
What are side effects of Antitussives? Drowsiness, constipation, GI upset, and headache
What are Decongestant used for? Affect the autonomic nervous system to relieve nasal congestion
What are the side effects of decongestants? Nervousness, insomnia, headache, and dry mouth
What teaching considerations should you take for clients on decongestants? Encourage increased fluid intake and follow the proper manufacturer’s directions for administration.
What nursing considerations for antitussives? For use with nonproductive coughs.
What are Antihistamines used for? Block the actions of histamine at the h1 receptor.
What are side effects on antihistamines? Dry mouth, drowsiness, dizziness, urinary retention, hypotension.
What should nurses take into consideration when teaching a patient taking antihistamines? Contraindicated in slients with certain heart conditions, Encourage clients to increase fluid intake, may cause drowsiness:advise caution when driving if unaware of individual reactions.
What is the purpose of an Anti-Inflammatory? When sprayed on local tissures in the nasal mucosa, decrease the secretions of inflammatory mediators and reduce tissue edema.
What are the side effects of Anti-Inflammatory? Transient nasal irritation,burning,sneezing, or dryness
Nursing Considerations for Anti-Inflammatories? Avoid swallowing medication, and instruct to rinse mouth after use. May take 2 to 4 weeks to reach therapuetic effect.
The common cold may be potentially serious for older adults, especially when they have other diseases such as a chronic respiratory disorder or heart diseas. Advise older clients to see a healthcare provider if cold symptoms are sever or breathing is difficult.
What is inflammation of the sinuses? Sinusitis, which is mainly caused by the spread of an infection from the nasal passage to the sinuses.
Client and family teaching for treating Rhinitis. Rest as much as possible, Increase fluid intake, Wash hands frequently
What are signs and symptoms of sinusitis? pain over the affected sinus, nasal congestion and discharge, pain and pressure around the eyes.
What are the things a nurse can teach a client with sinusitis? If receiving medical treatment, the nurse informs them that use of mouthwashes and humidification, as well as increased fluid intake, may loosen secretions and increase comfort.
what are the s/s of pharyngitis? sore throat, dysphagia, some clients exhibit a white or exudate patch over the tonsillar area and swollen glands.
what is a nursing diagnosis for a client having a tonsillectomy and adenoidectomy? Risk for Aspiration r/t impaired swallowing secondary to throat surgery and reduced gag reflex secondary to anesthesia.
risk for impaired tissue integrity cause of tonsillectomy? instruct patient not to cough,clear throat,blow nose, or use a straw in the first few postop days.
If a patient has epistaxis, or nosebleed the nurse teaches them to… apply continuous pressure to the nare for 5-10 min with the head tilted slightly forward
Epistaxis can be treated by… applying ice packs to the nose