Transition Drug Cards

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Transition Drug Cards
2011-09-30 20:28:00
Lower Respiratory

Lower Respiratory
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  1. Xanthine Bronchodilators
    Aminophylline (Trophylline),
    Similar to Caffeine
    Symptomatic relief or prevention of broncial asthma and reversible bronchospasm. Directly relaxes bronchial smooth muscle. Narrow range for good effect. The parental drug should be switched to oral ASAP-oral med systemic effects are less acute.
  2. Sympathomimetic Bronchodilators
    epinephrine (Sus-Prine)
    • Powerful! Tiny dose for asthma & allergy-increases rate and depth of respiration. Acute asthma attack, bronchospasm in acute/chroni asthma. Systemic effects-increased BP, increased HR, Vasoconstriction, decreased renal & GI blood flow (all SNS system). Airway open or heart attack??
    • BETA2 (r/t lungs) selective Adrenergic Agonist
  3. Anticholinergic Bronchodilator
    Ipratropium (Atrovent)
    • Maintenance treatment of bronchospasm associated with COPD. Not a strong as sympathomimetics but work like them. Relaxes broncial smooth muscle. Can be used with older pts.
    • Blocks vagally mediated reflexes by antagonizing the action of acetylcholine.Spiriva is similar-rapid onset-1/2 life 5-6 days.
    • Effective within minutes and lasts about 4 hours. Caution with anticholinergic effects (glaucoma, bladder neck obstruction, BPH, SLUD.)
  4. Inhaled Steroids
    Budesonide (Pulmicort)
    • Decreases inflammatory response in airway. Smooth muscle relaxation.
    • Not for emergency use/not during an acute asthma attack.
    • They may take between 2-3 weeks to reach effective levels.
    • Rick of rebound congestion, irritability, Headache, epistaxis, local infection.
  5. Leukotriene Receptor Antagonists
    Zafirlukast (Accolate)
    Singulair more common
    • For Inflammation. Completely block or antagonize receptors for the production of leukotriene.
    • Everyday treatment of asthma.
    • Caution with cardiac meds.
    • Prevents inflammatory response because you take it all the time. Once daily med.
  6. Lung Surfactants
    Beractant (Survanta)
    • To produce surfactant you have to expand your lungs. (sign/deep breathe).
    • Rescue treatment of infants lungs who have developed RDS-Ususally premies.
    • Replaces the surfactant that is missing in infants with RDS-Surfactant can be administered via trachea-risks-Patent ducttus arteriousus (PDA), intraventricular hemmorrhage (IVH), hypotension, bradycardia, pneumothorax, pulmonary hemorrhage, apnea, sepsis, infection.
    • They do not put surfactant in adults!
  7. Mast Cell Stabilizers
    cromolyn (Intal)
    • Mast cells are part of inflammatory response.
    • Treatment of chronic bronchial asthma, exercise induced asthma, allergic rhinites.
    • Works on a cellular level to inhibit the release of histamine and SRSA.
    • Take prior to exposure that triggers allergy and asthma. Take 30 minutes prior.
    • Headache, dizziness, nausea, sore throat, dysuria, cough, nasal congestion.