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What is a prostaglandin?
a local hormone that is in every tissue
What do prostaglandins do?
- mediate inflammation
- protect GI & renal
- regulate smooth muscle
- blood clotting
When taking NSAIDS, the pt should know to report a fever that does not diminish below _____.
100 F (37.8 C)
Pts taking NSAIDS should immediately report what?
- dizziness or vertigo
- eye pain or blurred vision
Pts taking NSAIDS should increase _______.
What type of wt changes should a pt report who is on NSAIDS?
- wt gain of more than 1kg in 24 hrs
- wt gain of more than 2kg in a week
- -also rpt increasing peripheral edema
When should NSAIDs not be given to children under 19?
- (aspirin or salicylates)
- within 203 weeks after the varicalla vaccination
Teaching points for pts taking antihistamines.
- Do not take OTC drugs in conjunction (could cause HTN)
- Do not drink apple, grapefuit, or OJ within one hour of taking them
- Increase fluid intake to liquify & mobilize mucus
- (monitor for dizziness & drowsiness)
When should antihistamines be used with caution and avoided?
- caution - pts with HF
- avoid - pts with glaucoma
Pt teaching with intranasal corticosteroids.
- avoid swallowing the med
- clear nose B4 using
- supplement w/ nasal saline for dryness
When should decongestants be avoided and used with caution?
- -with MAOIs
- -with nitrates
- -with cardiac drugs (Digoxin)
- -HTN (CNS Stim) &
- -BPH (decreases UOP)
Use for antitussive.
- raises cough threshold
Use of expectorants.
Reduces thickness or viscosity of bronchial secretions
Med used in pts with CF, chronic bronchitis, etc.
Two primary categories of drugs for asthma.
3 types of inhalers.
- Metered-dose inhaler
- Dry powder inhaler
Most frequently prescribed drugs for treatment of bronchoconstriction.
B-2 adrenergic agonists
What are B-2 adrenergic agonists used for?
- ACUTE ATTACKS (short-acting)
- can also be used as long-acting maintenance drug
Drug interactions with Albuterol??
Main thing to monitor for with Albuterol.
What two classes of bronchodilation (inhalation) meds can be combined to produce greater, more prolonged bronchodilation?
- B-adrenergic agonists
Ipratropium (anticholinergic) is almost always used in combo with what?
Albuterol (B-2 adrenergic agonist)
Use of anticholinergic inhalers can worsen what?
Do not use anticholinergic bronchodilators for what?
to stop an acute asthma attack
Methylxanthines are reserved for what?
- long-term management of persistent asthma that is
- unresponsive to B-agonists or inhaled corticosteroids
What is the risk with Methylxanthines (Theophylline)?
toxicity (narrow TI)
What drug is Methylxanthines related to?
How are Methylxanthines administered?
IV (not avail for inhalation)
________ are used to prevent bronchospasm.
Most effectice drugs for long-term control of asthma.
What are glucocorticoids used for in the treatment of asthma?
- reduce long-term adverse effects of disease
- suppress inflammation
why wouldn't you give oral steroids to a diabetic pt?
they increase BGL
Serious adverse effects of Beclomethasone (glucocorticoid asthma treatment)
- catactacts with long-term therapy
- growth inhibition in kiddos
Primary use of Leukotriene modifiers.
- asthma prophylaxis
- (reduce inflammation)
Drug interactions for leukotriene modifiers.
- P450 inhibitors
Most common side effect with lueukotriene modifiers.
When should you tell a pt to take Zafirlukast (luekotriene modifier)?
on an empty stomach
Prevents trigger of IgE mast cells.
Which class of resp drugs should you teach the pt to rinse their mouth out?
- B-2 adrenergic agonists
Resp drugs given for acute therapy?