Respiratory Drugs Practice Questions with Answers and NCLEX® Review

The respiratory tract includes both the upper and lower airways, which are lined with ciliated epithelium. The cells that line the trachea and bronchi are cuboidal in shape and have few cilia; those lining the bronchi are taller than those lining the trachea and have many more cilia.

Respiratory disease is any disorder involving the lungs or airways. Respiratory disorders can be acute (short-term) or chronic (long-term). Allergies, asthma, and chronic obstructive pulmonary disease (COPD) are three of the most common conditions that affect people with lung disease.

Allergies and asthma are often caused by an overactive immune system, which is triggered by immunoglobulin E (IgE) antibodies. The immune system responds to these antibodies by releasing histamine and other inflammatory chemicals into the bloodstream, causing symptoms such as sneezing and coughing.

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COPD is a progressive lung disease that causes the airways to become narrow and stiff. The condition can be caused by smoking, vaping, second hand smoke, exposure to chemicals, or other pollutants.

Introduction to Respiratory Drugs

The most common respiratory drugs are aerosolized bronchodilators, which are inhaled directly into the lungs. These can help asthma and COPD clients. Aerosolized antibiotics may also be used when a client develops pneumonia. Antibiotics can be administered directly through an inhaler or nebulizer.

Clients may also receive oxygen therapy to increase the oxygen to the body. This involves breathing in pure oxygen from a tank or mask, which helps them breathe more easily and improves circulation.

Allergy Medications

Allergies are a response to encountering something new or previous exposure. The immune system reacts by releasing histamine, causing inflammation in the body. Histamines are chemical messengers used to transmit signals between cells. They’re part of the immune system.

Allergies can be caused by pollen, dust mites, pets, mold, food additives, insect bites and stings, latex, among many other things.

Antihistamines

Antihistamines are often used as an over-the-counter treatment for mild allergies, such as hay fever. They don’t treat the underlying cause of allergic reactions, but can help to alleviate symptoms like sneezing, itching, runny nose, and watery eyes.

Antihistamines are split into first and second generations. Both work by blocking histamine receptors, preventing the release of histamine. This means that they both have similar side effects: drowsiness, dry mouth, and blurred vision.

First generation antihistamines are great for treating itching, but are usually sedating and can also cause low blood pressure. Second generation antihistamines are less likely to cause drowsiness or low blood pressure, but they may cause headaches or dizziness in some people.

First generation antihistamines include:

• Brompheniramine
• Chlorpheniramine
• Clemastine
• Cyproheptadine
• Dexchlorpheniramine
• Dimenhydrinate
• Diphenhydramine
• Doxylamine
• Hydroxyzine
• Phenindamine

Second generation antihistamines include:

• Azelastine
• Loratadine
• Cetirizine
• Desloratadine
• Fexofenadine

Asthma Medications

Asthma is another respiratory condition that causes inflammation within the airways, making it difficult for clients to breathe normally.

There are two main classes of asthma drugs: beta agonists and anticholinergics. Beta agonists cause the muscles in the lungs to relax, which makes breathing easier. Anticholinergics prevent the muscles in the airways from tightening, which also makes it easier to breathe. These types of medications can be taken as pills or inhaled through an inhaler.

Beta Agonists:

• Salmeterol
• Albuterol
• Levalbuterol

Anticholinergics:

• Tiotropium
• Ipratropium
• Oxitropium

COPD Medications

COPD is a serious lung condition that causes wheezing, coughing, and shortness of breath. It can make it difficult for the client to perform activities of daily living (ADLs).

There are two types of COPD: chronic bronchitis and emphysema. Chronic bronchitis and emphysema are both lung conditions that can lead to shortness of breath but are quite distinct.

Chronic bronchitis is a recurring inflammation of the airway tubes (bronchi) that carry air in and out of the lungs. Chronic inflammation causes them to narrow and produce mucus, which makes them more susceptible to infection.

Emphysema can cause permanent damage to the lungs, making them less able to transfer oxygen from the air clients breathe into blood vessels that deliver it throughout the body. This can make breathing difficult.

Chronic Bronchitis Medications:

• Albuterol and Ipratropium (used together)
• Cefdinir
• Etofylline
• Gemifloxacin
• Mepolizumab
• Moxifloxacin
• Ozagrel
• Revefenacin

Emphysema Medications:

• Albuterol and Ipratropium (used together)
• Budesonide
• Fluticasone
• Formoterol
• Glycopyrrolate
• Indacaterol
• Revefenacin
• Roflumilast
• Salmeterol
• Theophylline
• Tiotropium

Respiratory Drugs Conclusion

Respiratory drugs can be used in any situation where a client needs assistance with their breathing – from COPD to asthma to congestive heart failure (CHF). Generally, they work by increasing the amount of air that enters and leaves the lungs. They do this by opening up the airways or reducing the resistance in the system.

Respiratory drugs are available in a variety of forms such as; inhalers, nebulizers, and oral medications.

As a nurse, you may administer medications for a chronic condition as well as in an emergent situation such as a client who is experiencing an asthma attack.

Sources

https://my.clevelandclinic.org/health/drugs/21223-antihistamines
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6640697/
https://www.medindia.net/drugs/medical-condition/chronic-bronchitis.htm
https://www.medindia.net/drugs/medical-condition/emphysema.htm