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  • This is Chapter three respiratory or respiratory and I'm going to do the same

  • thing just for efficiency sake I've already written everything up on the

  • board so that I'm just going to highlight stems. I'm going to highlight

  • drug classes drug classifications and in the order in which I put them the first

  • section we're going talk about are antihistamines and you're dividing it to

  • histamines in first and second generation there's controversy over

  • whether there's a third generation drugs like fexofenadine which is Allegra is

  • one that might be in the third generation a third generation drug would

  • be something that's maybe a metabolite or one of the isomers of the racemic

  • mixture so I'm not going to go into a third generation, first and second is

  • enough for just our purposes right now so antihistamines H-1 first generation is

  • diphenhydramine and again we have this non-alphabetical order so I put an ABC

  • with a slash and then ABC with an arrow here to explain why so we begin with

  • first-generation diphenhydramine. Diphenhydramine is in that generation

  • that was first invented and these made people very drowsy you can see B E and D

  • in benadryl so you can think of bed and you can also see the D R Y because it's

  • drying helps with allergy symptoms okay but diphenhydramine that's first

  • generation that goes through the blood-brain barrier makes them on drowsy

  • second generation on the other cetirizine and loratadine so [brands] Zyrtec

  • and Claritin these don't cause the drowsiness because they can't get

  • through the blood-brain barrier or they can't stay through the blood-brain

  • barrier and loratadine has a stem it's -atadine and I know spelling has

  • been de-emphasized since I was a kid so I'm a gen X-er I was clapping erasers and

  • had chalkboards and things like that but in drug name spelling is incredibly

  • important because you pronounce loratadine the same as you pronounce

  • famotidine and the ta-da ine and the actual stem is

  • -atadine sounds just like the -tidine in the H-2 blockers but if you spell it

  • -tidine by accident you've just made this drug instead of for allergies for

  • acid and we don't want to do that so paying attention to spelling is very

  • important with these medications. So cetirizine, [brand] Zyrtec this -tir- in cetirizine

  • is pronounced "tear" so you can think of tearing from allergy eyes. Loratadine

  • has the -atadine stem and the Claritin Clear commercials have been very clear

  • about what it's for you see people outside having fun on the

  • picnic you even look at the box it's blue sky so Claritin Clear for allergies

  • but what I want to talk about also is this loratadine-D so what is that D? Well

  • D is for decongestant and that decongestant is pseudoephedrine so

  • pseudoephedrine is brand name Sudafed and you'll see it as loratadine-D or

  • Claritin-D and what's the rationale for that well if you have allergies and

  • nasal congestion if you just use loratadine or claritin it's not going to

  • help but if use loratadine with a

  • decongestant then it will take care of the allergy symptoms and the

  • congestion. This decongestant pseudoephedrine where Sudafed is

  • actually BTC it's behind the counter you have to show ID for it this -rin

  • or -drin I think is the is the stem and

  • because it's behind the counter there's a certain amount that any person can get

  • in a single day certain amount you can get in a month because the

  • pseudoephedrine can be used to make methamphetamine or meth but one of my

  • students said I'm so fed up with being congested and that's how you remember

  • pseudoephedrine or sudafed so what we're doing to remember these is we start

  • over-the-counter with these antihistamines in this decongestant and

  • what we're going to do is we're going to go into the nose so we're physically

  • thinking okay we're in the nose now and phenylephrine is the PE in many oral

  • liquids and it's very similar to pseudoephedrine

  • except this one is not regulated you can get as much of it as you want the brand

  • name for the nose one is Neo-Synephrine and then another one which can be used

  • in the nose another decongestant is oxymetazoline which is Afrin and this

  • nasal spray you should really only use for three days otherwise you might get

  • some kind of rebound congestion so we're staying in the nose and that's how we're

  • just like in the in the GI chapter we went from stomach down to intestines

  • we're staying in the nose and then we'll go down to the chest so we have

  • triamcinolone and this -lone some people use as a way to remember

  • that it's a steroid, it's not a proper stem. The brand name, the '-cort' stands for

  • cortical steroid and nasa- for nose again it's not a stem you can't have a stem

  • in a brand name but these are hints that let you know what it's for but

  • allergic rhinitis you have an -itis that means you have an inflammation so

  • informations we can use some kind of steroid so for the first group here

  • we're starting with anti-histamines then we go to the decongestant then allergic

  • rhinitis and we're being very mindful of where we are in the body. So we're

  • going to go from the nose to then cough which is going to be in the chest so

  • just as we've done before we're going to go from an OTC to a prescription and

  • this is where we make our jump. Everything before just now is

  • over-the-counter behind the counter. So guaifenesin is a mucolytic and some

  • people get that confused because they've seen robitussin for coughs so long but

  • the guaifenesin is actually just m-u-c-o-l-y-t-i-c a mucolytic is something that

  • breaks up mucus or breaks up chest congestion the stem is in

  • dextromethorphan but you may never see that word you might just see the DM

  • okay so guaifenasin with dextromethorphan is Robitussin DM

  • there's also Mucinex DM either one of those

  • but the -orphan stem is the one that tells you it's dextromethorphan if the

  • cough doesn't subsist and maybe you go to the prescriber and say you know I've had

  • this cough for a week and it's just not going away it's not productive

  • they might prescribe something like codeine now in the United States codeine

  • you can't just get it over the counter you used to be able to get a little bit

  • but now it's regulated and that Cheratussin the 'cher' is for cherry and then

  • AC some people just use anti cough but I think and codeine was probably what it

  • stood for okay and then -tussin an antitussive is something that's for

  • cough. So if that cough doesn't go away and you still have that chest

  • congestion if the prescriber is being very aggressive maybe they'll treat the

  • inflammation in the chest and they'll do that with a steroid with either

  • methylprednisolone or prednisone and again we're staying with our

  • alphabetical within the class of steroids and methylprednisolone this is

  • an infix so in English we can have something that's a prefix before we can

  • have a suffix which is at the end or we can have an infix and in fixes are

  • extremely rare in English but they're not rare when it comes to medications

  • so the -pred- not the -lone is what tells you it's a prednisone type steroid but

  • some people still use that -lone or -sone as their cue but really the stem is that

  • -pred- so maybe we go from the chest and we stay in the chest and stay

  • in the lungs and in the lungs we're going to talk about these asthmatic

  • medications and so we have budesonide and we pronounce this -son- not as sun

  • but as sone and I'm not going to underline it because it's not a proper

  • stem but some people still use it to recognize this is the steroid part and I

  • put fluticasone this -sone underneath it because these two drugs are doing the

  • same thing they're long-acting steroids that are going to be inhaled so we have

  • the steroid part of it for asthma and then we also have what's, I put beta-2 here

  • a beta-2 agonist is a bronchodilator it's going to open up your lungs and the stem

  • for that is -terol. t-e-r-o-l. t-e-r-o-l. You're probably most familiar with albuterol

  • but in these long-acting versions formoterol and budesonide come together

  • to make symbicort so they're symbiotic together working together with a

  • corticosteroid and then fluticasone is working together with salmeterol

  • to give you air or you're adding them together spelling add ad instead of a DD

  • to get air fluticasone can you can find it alone and what I did was where these

  • are combination medicines I just staggered this I put a hanging indent

  • where the fluticasone is on this side under the steroids and albuterol is on

  • this side just to show you that I'm just separating this out where these are

  • long-acting these are sure this is long-acting but this is a little bit

  • more short acting so if fluticasone comes as Flonase for the nose but also

  • it's Flovent if you're going to use it orally and then this albuterol is that

  • rescue inhaler that most people are familiar with what I did here was I put

  • prophylaxis before acute so our healthcare system is really treat once

  • you've something's happened but ideally you don't get asthma attacks because you

  • take these long-acting medications but sometimes you might have a breakthrough

  • asthma attack and you would want that rescue inhaler the beta-2 agonist

  • albuterol so I kept with that alignment so albuterol the -terol is under here and

  • another combination product but here we have -tropium and -tropium is an

  • anticholinergic the -chol c-h-o-l is about acetylcholine and acetylcholine is

  • a neurotransmitter we're talking about ipratropium does a really good job with

  • asthma as well and this comes in the medication DuoNeb literally two, a duo

  • that can be nebulized and so albuterol works

  • as a bronchodilator ipratropium as well and they work in concert together tiotropium

  • also has this -tropium stem to let you know there's an anticholinergic but this

  • one is a little bit more long-acting than this short acting one and

  • tiotropium is a long-acting anticholinergic and this brand name is

  • Spiriva and if you think of the word respire or respiration you see the s-p-i-r

  • and there but it's the -tropium stems that lets you know this is an

  • anticholinergic medication so again now we've gone from then just using some of

  • the cognitive tools to go from over-the-counter to Rx we're going from

  • a cough which is in the chest to the lungs which is in the chest and asthma

  • and then we're going to go on from these medications to three other medications

  • that can be used in asthma incidents and things like that

  • the leukotriene inhibitor montelukast the stem -lukast seems an awful lot like

  • leukotriene it's given once a day and that's where that single comes from in

  • Singular and then if you're asthmatic and it's helping your condition then the

  • air a-i-r is what helps. Anti IgE antibody so again one of these biologics

  • omalizumab so the -mab tells you it's a monoclonal antibody and then -li- and -zu-

  • also have meaning I won't go into it here but it's in the book and it's

  • important to understand what the biologics we're going to have these

  • complex stems telling us where it's from and that's Xolair and that to me that

  • just sounds like extra air so again a way to remember that it's for it asthma

  • but this is an injectable the one thing with omalizumab is that it can cause

  • anaphylaxis so you always have to have somebody around when it's being injected

  • an epinephrine or an EpiPen is what you would use okay so epi means above neph

  • means kidney so above the kidney what's above the kidney the adrenal gland

  • so epinephrine is an injectable that does something very similar to the

  • adrenal gland which is secrete epinephrine there's another word it's also

  • called that's very similar and I'll just put it here it's called adrenaline and

  • this is the Latin version so ad- means above or to towards and then -renal- means

  • kidney and then so this is the Roman or the Latin and then this is the

  • epinephrine is the Greek but that's the respiratory medications in a nutshell

This is Chapter three respiratory or respiratory and I'm going to do the same

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(CC) トップ200の薬 第3章 サフィックス別呼吸器看護薬理学 (暗記薬理学) ((CC) Top 200 Drugs Chapter 3 Respiratory Nursing Pharmacology by Suffix (Memorizing Pharmacology))

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    Mark Lu に公開 2021 年 01 月 14 日