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2009-10-16 15:37:30
Pharmacology exam 2

Second pharmacology exam of ASU Junior 1 semester.
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  1. Lower Respiratory:

    Class of drugs:
    • •Mucolytics
    • •Bronchodilators
    • •Anti-Inflammatory Agents
  2. Mucolytics
    •Prototype: Acetylcysteine (mucomyst)

    •Indications: Mucolytics adjuvant therapy for abnormal or viscous mucous secretions in acute and chronic bronchopulmonary disease

    •Treatment of: cystic fibrosis, pneumonia, tuberculosis, COPD

    •Other uses: bronchoscopy, postoperatively, tracheostomies, acetaminophen overdose
  3. Mucolytics continued:

    • •Onset:
    • -Inhalation: 1 minute
    • -Instillation: 1 minute
    • •Duration: 2-3º
    • •Peak:5-10 minutes
    • •Metabolized: liver
    • •Excreted: kidneys
  4. Mucolytics cont.:

    Pharmacodynamics: acetylcysteine affects the mucoproteins in the respiratory secretions. It splits disulfide bonds that are responsible for holding the mucous material together. The result is a decrease in the tenacity of viscosity of the secretions.

    Notes: Sometimes patients need to have suctioning done to help pull out the secretions.
  5. Mucolytics:

    • • Hypersensitivity
    • • History of respiratory compromise: increased secretions can compromise the airway if it is not cleared.
    • • History of asthma: bronchospasm can occur
    • • Pregnancy category B
  6. Mucolytics:

    Adverse effects
    • Nausea and Vomiting*

    • Rhinorrhea*

    • Bronchospasm

    • Bronchoconstriction

    • • Chest tightness
    • “burning” feeling in upper airway

    * (most common)
  7. Mucolytics

    Nursing (indications):
    • Assessment:
    • -Respiratory baseline including ability to cough
    • -Abdominal assessment for hepatomegaly
    • -Temperature, skin evaluation

    • Environment-usually given under the direct supervision of respiratory therapist or RN

    • Notes: Temperature, skin evaluation might be because they have an infection.
    • Usually given in the hospital (if under supervision)
  8. Mucolytics:

    Nursing Diagnosis
    • Ineffective Airway Clearance related to:
    • (Thick mucus, bronchospasm, inhaled drug)

    Desired outcome: the patient’s airway will be maintained without increased difficulty breathing
  9. Mucolytics:
    Intervention and Planning
    • •Patient and family education
    • -Instruct patients to report all adverse effects, including difficulty breathing, severe nausea and dizziness
    • -Inform patients that the drug is administered with the assistance of Respiratory therapist or RN
    • -Medication has an odor-but transient
  10. Mucolytics:
    Ongoing assessment and evaluation
    secretions are loosening and the patient is having success coughing and moving secretions.
  11. Mucolytics: Critically thinking Nurse Know...
    • • Used to liquefy thick, tenacious secretions
    • • Major contraindication: hypersensitivity
    • • Most common adverse effects: N/V, rhinorrhea
    • • Most serious adverse effects: bronchospasm and bronchoconstriction
    • • Minimizing adverse effects: keep suction equipment close by
  12. Acetylcysteine (Mucomyst) is the drug of choice in treatment of:
    • a. Allergic rhinitis
    • b. Cystic fibrosis
    • c. Sinusitis
    • d. Viral upper respiratory disease

  13. The action of acetylcysteine (Mucomyst) is to:
    • A. Break down mucoproteins in the airways that block airflow
    • B. Decrease inflammation in the bronchioles
    • C. Dilate the bronchioles
    • D. Stop the breakdown of the mast cells

  14. Bronchodilators-Beta agonists:
    • •Indications: Sympathomimetic action:
    • -Dilate airways
    • -increased rate and depth of respirations
    • •Treatment of: asthma & COPD

    • Notes:Beta 2 agonists work on bronchodilation, but will also cause some side effects, I.e. jittery.
    • Release bronchospasm, reduce airway resistance, facilitates mucus drainage, and increases vital capacity of the lungs.
    • Causes glycogenolysis.