Term
| Histamine is synthesized and stored in ____ and ____ |
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Definition
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Term
| What mechanism trigger a histamine reaction? |
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Definition
| allergic and non-allergic mechanisms |
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Term
| What are the names of the two major classes of histamine receptors? |
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Definition
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Term
| Acitvation of H1 receptors causes what? |
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Definition
| vasodilation, increased cap permeability, pain, itching, bronchoconstriction, and CNS effect |
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Term
| Acitivation of H2 receptors causes what? |
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Definition
| release of gastric acid from stomach parietal cells |
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Term
| What are the two major classes of histamine receptor agonist? |
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Definition
H1 antagonist- tx allergic reactions
H2 antagonist-tx gastric and duodenol ulcers |
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Term
| H1 antagonist relieve allergic symptoms by blocking histamine receptors on____,___, and____. |
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Definition
| small blood vessels, capillaries, and sensory nerves |
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Term
| H1 antagonist do not block the release of histamine from ____ and ___ |
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Definition
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Term
| first generation H1 antagonist cause___ and ____ |
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Definition
| sedation and anticholinergic effects |
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Term
| second generation H1 antagonist cause neither _________ or __________ |
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Definition
| sedation or antichoinergic effects |
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Term
| _____ is intensified in first generation H1 antagonist by _______ or _______- |
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Definition
| CNS depression, alcohol, and other drugs |
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Term
| What is often the underlying cause of asthma? |
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Definition
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Term
| Asthma is characterized by____,___, an___. |
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Definition
| inflammation of the airwys, bronchial hyperreactivity, and bronchospasm |
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Term
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Definition
| with anti-inflammatory drugs and bronchodialators |
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Term
| what route are most asthma drugs administered? |
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Definition
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Term
| administering asthma medication by inhalation _____,____, and ____. |
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Definition
| increases therapuetic effect, reduces systemic effects, and allows rapid releif of acute attacks |
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Term
| __________ are the most effective asthma drugs for reducing the risk of __________. |
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Definition
| glucocorticoids and asthma flares |
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Term
| Glucocorticoids reduce symptoms of asthma by |
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Definition
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Term
| Glucocorticoids promote synthesis of bronchial beta 2 receptors which |
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Definition
| increases their responsiveness to beta2 agonist |
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Term
| Inhaled glucocorticoids are used for long term _____ not for aborting __________ attacks |
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Definition
| prophylaxis of asthma and ongoing |
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Term
| Glucorticoids are administered on a ___ schedule. |
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Definition
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Term
| Unless asthma is severe, glucorticoids should be administered by |
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Definition
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Term
| The side effects of inhaled glucorticoids are ____ and ____ |
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Definition
| oropharyngeal candidiasis and dysphonia. |
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Term
| Side effects of inhaled glucorticoids can be minimized by ____ and ____. |
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Definition
| applying a spacer device during admin and gargling aferwars |
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Term
| Inhaled glucorticoids can cause |
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Definition
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Term
| To minimize bone loss from glucorticoids, dosages should be |
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Definition
| as low as possible, weight bearing exercise, adqueate intake of Vit D and Ca+ |
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Term
| Glucortocoids can slow the growth of |
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Definition
children
-may impact adult height;use lowest dose |
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Term
| Not txing asthma effectively can impact |
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Definition
| growth and lung volume as one ages |
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Term
| Prolonged glucorticoids can cause |
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Definition
| adrenal suppression, osteoporosis, hyperglycemia, PUD, and growth suppression |
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Term
| Because of adrenal suppression, pt taking oral glucorticoids must be given supplemental doses of oral or IV glucorticoids during |
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Definition
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Term
| Dx of asthma is based upon |
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Definition
| current impairment and future risk |
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Term
| what are the four classes of asthma? |
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Definition
| intermittent, mild persistent, mod persistent, and severe persistent |
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Term
| Asthma drugs can be classified as ______ and _____. |
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Definition
| long term control meds (inhaled glucorticoids) and quick releif (inhaled SABAs) |
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Term
| The stepwise approach to asthma therapy is to |
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Definition
| prevent symptoms, maintain normal pulmonary fx, maintain normal activity, prevent recurrent exacerbations, minimize ED visits, prevent progessive loss of lung fx, and meet pt and family expectations |
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Term
| Intermittant asthma is tx'd ____ using an inhaled ______ to abort acute episodes |
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Definition
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Term
| For persistent asthma, daily ____ is given. |
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Definition
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Term
| With severe asthma, an inhaled dose of ______ is added to the regimen. |
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Definition
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Term
| A short-acting ____ is added to the asthma regimen for break through attacks |
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Definition
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Term
| What is the tx for acute severe exacerbations of asthma? |
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Definition
| oxygen to reduce hypoxemia, systemic glucorcorticoids, nebulized SABA, and nebulized ipratropium. |
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Term
| What should pts do to prevent exercise induced/ asthma |
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Definition
| inhale SABA just prior to activity |
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Term
| Pt should avoid allergens that cause_____ and triggers that can provoke______ |
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Definition
| airway inflammation and exacerbations |
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Term
| List the important sources of allergens |
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Definition
| house dust mites, warm-blooded pets, cockroaches, and mold |
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Term
| List important triggers of allergens |
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Definition
| tobacco smoke, wood smoke, and household sprays |
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Term
| What are first line drugs for allergic rhinitis? |
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Definition
| antihistamines (h1 receptor antagonist |
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Term
| Antihistimines relieve____, ____, and ____ but not_____/ |
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Definition
| rhinorrhea, sneezing, itching, and congestion |
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Term
| First generation antihistamines cause |
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Definition
sedation and anticholinergic effects
-not as severe with second generagtion |
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Term
| ______ are the most effective drugs for allergic rhinitis. |
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Definition
| intranasal glucorcorticoids |
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Term
| First line agents for allergic rhinitis _____ allergy symptoms and provide modest relief of _____ |
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Definition
| prevent and nasal congestion |
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Term
| Medications that treat allergic rhinitis may take _____ days to see results. |
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Definition
5-7days
-pt may stop taking the medication bc they don't have immediate results. educate pt that medication is for prevention and it takes 5 days for the medication to coat the nasal membranes |
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Term
| How do sympathomimetics decrease nasal congestion? |
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Definition
| activates alpha1-adrenergic receptors on blood vessels;causes vasoconstriction and shrinks swollen nasal membranes |
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Term
| Topical sympathomimetics decrease nasal congestion rapidly with |
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Definition
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Term
| Topical sympathomimetics cause |
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Definition
| rebound congestion when used for more than a few days |
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Term
| Oral sympathomimetics decrease nasal congestion ______ and produce____ and _____ stimulation |
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Definition
slowly, CNS, and Cardiovascular
-do not cause rebound congestion |
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Term
| oral sympathomimetics should be used with caution in pts with |
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Definition
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Term
| What is the most effective cough suppressant? |
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Definition
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Term
| doses of codeine for cough suppressant is |
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Definition
| one tenth of those used for analgesia |
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Term
| what is the most effective none opiod cough suppressant? |
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Definition
|
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Term
| only use codeine or dextrohorphan if there is a |
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Definition
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Term
| There is no evidence that ANY cough suppressant can control a cough associated with |
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Definition
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Term
| OTC cough meds and remedies are not recommended for children less than |
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Definition
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