respiratory 2

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respiratory 2
2010-05-03 10:47:52

respiratory 2
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  1. Selective beta2-adrenergic agonists - Bronchodilators
    • Terbutaline (Brethine)
    • Metaproterenol (Alupent)
  2. What is the MOA for Terbutaline (Brethine) & Metaproterenol (Alupent)?
    • relaxes smooth muscle of bronchi
    • keep from going into labor (Brethine)
  3. How is Terbutaline (Brethine) & Methaproterenol (Alupent) administered ?
    • Oral
    • Inhalation
    • subQ
  4. What are side effects of Terbutaline (Brethine) and Methaproterenol (Alupent)?
    tremors, restlessness, anxiety, headaches, nervousness, tachycardia, palpitations, dysrhythmias, hyperglycemia
  5. Anticholinergics – bronchodilator
    Is an Alternative bronchodilator but SABA first choice
  6. Names of anticholinergics
    • Ipratropium bromide (Atrovent)
    • ipratropium (Combivent)
    • tiotropium(Spiriva)
  7. Action of anticholinergics?
    dilates bronchioles
  8. How is anticholinergic bronchodilator administered?
    • aerosol inhaler
    • Caution : Narrow-angle glaucoma
  9. Methylxanthine (Xanthine) derivatives are:
    • Aminophylline (Somophyllin)
    • theophylline (Theo-Dur)
  10. Action of Methylxanthine (Xanthine) derivatives?
    • relaxes smooth muscle of bronchi
    • bronchioles increasing cAMP promoting bronchodilation
  11. What is the use for methylxanthine?
    maintenance therapy for chronic stable asthma
  12. What is the therapeutic range for methylxanthine (Xanthine)?
    • Therapeutic range: 10-20 mcg/ml
    • (toxicity greater than 20)
  13. Aminophylline (Somophyllin), theophylline (Theo-Dur) Contraindications
    seizure, cardiac, renal, or liver disorders
  14. Administration of Aminophylline (Somophyllin), theophylline (Theo-dur)
    oral, IV
  15. Side effects of Aminophylline (Somophyllin) & theophylline (Theo-Dur)
    dysrhythmias, nervousness, irritability, insomnia, dizziness, flushing, dizziness, hypotension, seizures, GI distress, intestinal bleeding, hyperglycemia, tachycardia, palpitations, cardiorespiratory collapse
  16. Leukotriene Receptor Antagonists
    Zafirlukast (Accolate), montelukast (Singulair)
  17. Action of Leukotriene Receptor Antagonists
    • reduce inflammatory process
    • decrease bronchoconstriction
  18. Use of Leukotriene Receptor Antagonists
    • Prophylactic
    • maintenance for chronic asthma
  19. Side effects of Leukotriene Receptor Antagonists
    dizziness, HA, GI distress, abnormal liver enzymes, nasal congestion, cough, pharyngitis
  20. Glucocorticoids
    • Beclomethasone (Beclovent, Vanceril)
    • dexamethasone (Decadron)
  21. Action of Glucocorticoids
    antiinflammatory effect
  22. how is the Glucocorticoids fluticasone (Flovent) administered?
    Aerosol inhaler
  23. How is the glucocorticoid triamcinolone (Aristocort) administered?
  24. How is dexamethasone (Decadron) (glucocorticoid) administered?
  25. Prednisone
  26. Cromolyn and Nedocromil is used as
    • Prophylactic treatment of bronchial asthma
    • Not to be used for acute asthmatic attack
  27. Action of Cromolyn and Nedocromil?
    antiinflammatory effect and suppresses the release of histamine
  28. Administration of cromolyn and nedocromil?
  29. Side effects of Cromolyn and Nedocromil?
    • Cough
    • bad taste
    • rebound bronchospasm
  30. Mucolytics drug?
    Acetylcysteine (Mucomyst)
  31. What is the MOA of acetylcysteine (Mucomyst)
    liquefies and loosens thick mucus secretions
  32. Administration of acetylcysteine (Mucomyst)?
    • Administer 5 minutes after a bronchodilator
    • Should not be mixed with other drugs
    • Also an antidote for acetaminophen overdose if within 12-24 hours
    • Give orally diluted in juice or soft drink
  33. A client with COPD is admitted to the hospital for exacerbation. The client has severe dyspnea.
    • A selective beta2-adrenergic agonist, albuterol (Proventil) is ordered to increase airway patency.
    • Critical Thinking
    • Compare the action and side effects of albuterol with isoproterenol and metaproterenol.
  34. Practice Question #1
    • When ipratropium, a bronchodilator, and a glucocorticoid inhaler are ordered together, the:
    • (Select all that apply.)
    • a. bronchodilator is given 5 minutes before a glucorticoid.
    • b. combination is more effective than when given alone.
    • c. glucocorticoid is administered 10 minutes before the bronchodilator.
    • d. glucocorticoid should be administered immediately after the bronchodilator.
  35. Answer: A, B. Rationale: When a bronchodilator and a glucocorticoid inhaler are given together, the bronchodilator is given first. The nurse should wait for 5 minutes before administering the
    glucocorticoid. This drug combination is more effective than when given alone.
  36. General Nursing Implications of Metered Dose Inhalers (MDI’s)
    Hand held pressurized devices that deliver a measured dose of drug with each “puff”
  37. When two “puffs” are needed, how much time should elapse between the two “puffs”
    • 1 minute
    • A spacer may be used to increase the delivery of the medication
  38. Aerosol inhaler
    • Metered-dose inhaler (MDI)
    • Dry powdered inhaler (DPI)
  39. Frequent dosing cause
    • Tremors, nervousness, tachycardia
    • Administration
    • Teach client to use inhaler correctly and take care of equipment correctly