NUR 2474 Exam 2 Review Module 4: - Prototype Medication Class

NUR 2474 Exam 2 Review Module 4: Prototype Medication Name - Prototype Medication Class Beclomethasone - Glucocorticoids Prednisone - Glucocorticoids Cromolyn - mast cell stabilizers Zafirlukast - leukotriene modifiers Albuterol - Bronchodilators: Beta2 -Adrenergic Agonists Salmeterol - Bronchodilators: Beta2 -Adrenergic Agonists Theophylline - Bronchodilators: Methylxanthines Ipratropium - Anticholinergic Drugs Hydrocodone - Opioid Drugs for Cough Dextromethorphan - Nonopioid Drugs for Cough Cimetidine - H2-Receptor Antagonists Omeprazole - Proton Pump Inhibitors Sucralfate - Mucosal Protectants Aluminum hydroxide/magnesium hydroxide - Antacids Methylcellulose - Bulk -Forming Agents Docusate sodium - Surfactants Magnesium hydroxide - Osmotic Laxatives Ondansetron - Serotonin Antagonists Prochlorperazine - Dopamine Antagonists Dronabinol - Cannabinoids Glucocorticoids - Glucocorticoids are intended for long -term control. Inhalation is the primary route of administr ation, as it is associated with less adverse reactions than systemic administration via oral or IV routes. Glucocorticoids suppress inflammation by decreasing the synthesis and release of inflammatory mediators, decreasing the activity of the body's immune cells, and decreasing edema within the airway mucosa. - Most glucocorticoids are synthetic analogues of hormones secreted by the adrenal cortex. They exert anti-inflammatory, metabolic, and immunosuppressant effects. - Metabolized in the liver and excreted by the kidneys - Drugs used: Beclomethasone & Prednisone - Used for: o Asthma and COPD - Action: o Suppress hypersensitivity and immune responses o Suppress the redness, edema, heat, and tenderness associated with the inflammatory response. - Adverse effects: o Insomnia o Increased sodium and water retention o Increased potassium excretion o Suppressed immune and inflammatory responses osteoporosis o Intestinal perforation o Peptic ulcers o Impaired wound healing Beta2 Agonists - Short -acting beta2 agonists are intended for relieving acute symptoms and are most often administered via inhalation. By activating beta2 receptors in the lungs, the bronchi and bronchioles dilate, which relieves bronchospasm and allows more air to enter the lungs. - Used to treat symptoms associated with asthma and chronic obstructive pulmonary disease (COPD) - Short -acting Drug: o Albuterol (systemic, inhalation) ▪ fast relief of symptoms - Adverse reactions to short -acting beta2 -adrenergic agonists include: o paradoxical bronchospasm tachycardia o palpitations o tremors o dry mouth - Long -acting Drug: o Salmeterol (inhalation) ▪ Used with anti-inflammatory agents, namely inhaled corticosteroids, to help control asthma - Adverse reactions to long-acting beta2 -adrenergic agonists include: o bronchospasm o tachycardia o palpitations o hypertension o tremors - Action: o Increase levels of cyclic adenosine monophosphate by stimulating the beta2 - adrenergic receptors in the smooth muscle, resulting in bronchodilation - Risk for: o toxicity Mast cell stabilizers - Drug: Cromolyn o Used for: Asthma propylaxis, Bronchial Inflammation, and Allergic rhinitis o Prevents breakdown of mast cells and prevents the release inflammatory agents like histamine from entering the tissue o Side effects: ▪ Cough ▪ Bronchospasm ▪ Increase mucous secreations o Considerations: ▪ Give at a fixed schedule Leukotriene modifiers - Drug: Zafirlukast o Used to control and prevent symptoms (such as wheezing and shortness of breath) caused by asthma. o Benefits derive in part from reduced infiltration of inflammatory cells, resulting in decreased bronchoconstriction. o Administered at least 1 hour before meals or 2 hours after o Adverse effects: ▪ headache ▪ gastrointestinal (GI) disturbances ▪ Arthralgia ▪ Myalgia ▪ depression ▪ suicidal thinking ▪ hallucinations ▪ Churg -Strauss syndrome Bronchodilators: Methylxanthines - Drug: Theophylline - Level:5 -15 mcg/mL o Causes CNS stimulation and bronchial smooth muscle relaxion o Treatment for asthma o Side effects: ▪ Insomnia ▪ Restlessness ▪ Arrythmias ▪ Seizures o Avoid giving with caffeine o Considerations: ▪ Narrow therapeutic range ▪ Monitor plasma levels Anticholinergic Drugs - Drug: Ipratropium o Treat COPD and acute asthma/bronchospasm o Prevents bronchoconstriction/Promote bronchodilation o Adverse effects: ▪ Systemic effects ▪ Dry mouth/Irritation of the pharynx Drugs for Cough - Drug: Hydrocodone o Opioid o Taken orally to relieve pain and to suppress cough o Dosage is 5 mg o Is available alone or in combination with acetaminophen or ibuprofen o For cough suppression, the drug is combined with antihistamines and nasal decongestants. - Drug: Dextromethorphan o Nonopioid o Blocks receptors for N-methyl -D-aspartate (NMDA) in the brain and spinal cord o Adult dosage is 10 to 30 mg every 4 to 8 hours. o Low doses = psychologic effects o At doses 5 to 10 times higher = euphoria, disorientation, paranoia, altered sense of time, and visual/auditory/tactile hallucinations H2 (histamine) -Receptor Antagonists - Drug: Cimetidine o Action: decreases production of gastric acid o Risk of lactic acidosis o Side effects: ▪ Pneumonia ▪ Anti-androgen effect ▪ CNS changes • Hallucinations • Confusion • Depression/Excitation o Considerations: ▪ Elderly patients with liver/kidney dysfunction Proton Pump Inhibitors - Suffix: prazole - Drug: Omeprazole o Used for ulcers, gastric ulcers, erosive esophagitis, and GERD, and for long-term therapy of hypersecretory conditions o Action: decreases stomach acid o A single 30-mg oral dose o Side effects: ▪ Pneumonia ▪ Hip fractures ▪ Hypomagnesium o The dosage is 20 mg once daily for 14 days, taken before the first meal of the day. o To treat Zollinger -Ellison syndrome and other hypersecretory states, doses up to 120 mg 3 times a day Mucosal Protectants - Drug: Sucralfate o Creates a protective barrier in the stomach to protect ulcers from stomach acid and pepsin to allow ulcers to heal o Side effects: ▪ Constipation ▪ Metallic taste o Considerations: