Anti-Inflammatory Medications: Bronchodilators Flashcards
Beta2-Adrenergic Agonists: medications
1) prototype = albuterol (Proventil, Ventolin)
-inhaled, short-acting
-oral, long-acting
2) other medications =
-formoterol (Foradil Aerolizer)
inhaled, long-acting
-salmeterol (Serevent)
inhaled, long-acting
-terbutaline (Brethine)
oral, long-acting
Beta2-Adrenergic Agonists: expected actions
- bronchospasm relieved
- histamine release inhibited
- ciliary motility increased
Beta2-Adrenergic Agonists: therapeutic uses
- prevention of asthma attack
- treatment of ongoing asthma attack
- long-term control of asthma
Beta2-Adrenergic Agonists: adverse effects and nursing interventions/client education
1) inhaled agents (short-and long-acting)
- minimal adverse effects
2) oral agents
- tachycardia
- angina
- tremors
i. take pulse. report increases of 20-30/min
ii. notify provider of manifestations
iii. avoid caffeine
iv. tremors usually resolve w/ continued use
Methylxanthines: medications
1) prototype = theophylline (Theolair, Theo-24)
Methylxanthines: expected action and therapeutic use
1) bronchodilation
2) chronic asthma
Methylxanthines: adverse effects and severe reactions
1) -mild toxicity
- GI distress
2) -dysrhythmias
- seizures
Methylxanthines: nursing interventions/client education
1) monitor theophylline serum levels
2) if severe reaction occurs stop medication. notify provider.
3) avoid caffeine
4) increase theophylline dosage if used w/ these medications
5) caffeine increases CNS and cardiac effects of theophylline
6) phenobarbital and phenytoin decrease level
Methylxanthines: nursing administration
1) take as directed
2) if dose is missed, following dose should not be doubled
3) do not chew or crush sustained-released preparations
Inhaled Anticholinergics: medications
1) prototype = ipratropium (Atrovent)
2) other medication = tiotropium (Spiriva)
Inhaled Anticholinergics: expected action and therapeutic uses
1) bronchodilation
2) -COPD
- allergen-induced and exercise-induced asthma
- route: inhalation
Anticholinergics: adverse effects and nursing interventions/client education
1) -dry mouth
- hoarseness
2) -sip on water and suck on hard candy
- rinse mouth after inhalation
- usual dosage is 2 puffs
- wait between puffs
- wait at least 5 min between medications
Glucocorticoids: medications
1) prototype =
- inhalation: beclomethasone dipropionate (QVAR)
- oral: prednisone (Deltasone)
2) other medications =
- inhalation:
a. budesonide (Pulmicort)
b. fluticasone propionate (Advair, Flovent)
c. triamcinolone acetonide (Azmacort)
- oral: prednisolone (Prelone)
- IV: hydrocortisone sodium succinate (Solu-Cortef, Solu-Medrol)
Glucocorticoids: expected action
1) prevent inflammation
2) suppress airway mucus production
3) promote decreased frequency and severity of exacerbations and acute attacks
Glucocorticoids: therapeutic uses
1) short-term IV agents for status asthmaticus
2) inhaled agents for long-term prophylaxis of asthma
3) short-term therapy following acute asthma attack
4) replacement therapy for primary adrenocortical insufficiency
5) promote lung maturity and decrease respiratory distress in fetuses at risk for preterm birth
Beclomethasone Dipropionate (QVAR): adverse effects
1) difficulty speaking
2) hoarseness
3) candidiasis
Beclomethasone Dipropionate (QVAR): nursing interventions/client education
1) use spacer
2) rinse mouth w/ water or salt water
3) monitor for redness, sores, or white patches. Report to provider.
Prednisone Adverse Effects: 10 days or more
1) suppression of adrenal glands
2) bone loss
3) hyperglycemia and glycosuria
4) myopathy (muscle weakness)
5) peptic ulcer disease
6) infection
7) fluid and electrolytes
- weight gain
- edema
- hypokalemia
Prednisone: nursing interventions/client teaching
1) administer oral on alternate-day schedule
2) monitor blood glucose levels. Insulin may need to be increased
3) taper client dose
4) perform weight-bearing exercises
5) consume diet w/ sufficient calcium and vitamin D
6) report muscle weakness
7) avoid NSAIDS
8) report black, tarry stools
9) administer w/ food or meals
10) report weight gain, edema
Mast Cell Stabilizers: medications
1) prototype = cromolyn sodium (Intal)
2) other medication = nedocromil sodium (Tilade)
Mast Cell Stabilizers: expected action and therapeutic uses
1) anti-inflammatory
2) -chronic asthma
- exercise-induced asthma
- prevent allergen-induced attack
- allergic rhinitis by intranasal route
- inhalation
Mast Cell Stabilizers: nursing administration
1) very safe
2) take medication 15 min before exercise or exposure to allergen
3) long-term prophylaxis may take several weeks
Leukotriene Modifiers: medications
1) prototype = montelukast (Singulair)
2) other medications =
- zileuton (Zyflo)
- zafirlukast (Accolate)
Leukotriene Modifiers: expected actions
1) suppresses inflammation
2) bronchoconstriction
3) airway edema
4) mucus production
Leukotriene Modifiers: therapeutic uses
1) long-term asthma
2) prevent exercise-induced bronchospasm
Leukotriene Modifiers: adverse effects and nursing interventions/client education
1) liver injury
2) -obtain baseline liver function tests. monitor often
- monitor for liver damage:
i. nausea
ii. anorexia
iii. abdominal pain
3) notify providers if this occurs
Leukotriene Modifiers: nursing administration
1) take as prescribed
2) give zileuton w/ or w/o food
3) do not give zafirlukast w/ food. administer 1 hr before or 2 hr after
4) take montelukast once daily at bedtime
