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
administration, 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:
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
administration, 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:
