ATI section 4: respiratory meds Flashcards

1
Q

Inhalation therapies

A
  • tx for chronic respiratory disorders often includes multi drug therapies
  • take the beta2 agonist before the inhaled glucocorticoid to increase steroid absorption
  • Instruct on procedures for inhalation:
  • remove mouthpiece cap
  • if appropriate shake container
  • stand up or sit upright, exhale deeply
  • place mouthpiece between teeth, and close lips tightly around inhaler
  • while breathing deep press down and continue to breath deep for several seconds
  • hold breath for 5-10 seconds
  • breath out normally
  • examine mouth for irritation and perform frequent mouth care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Beta2 Adrenergic Agonist medication

Albuterol (Proventil, Ventolin)

A
  • Route/onset: Inhaled (short-acting), few min

- Use: Acute bronchospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Beta2 Adrenergic Agonist medication

Formoterol (Foradil), salmeterol (Serevent)

A

-Route/onset: Inhaled (long-acting), 15-20 min, lasts 12 hr

Use: Long-term control of asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Beta2 Adrenergic Agonist medication

terbutaline (Brethine)

A
  • Route/onset: oral (long-acting)

- Use: Long-term control of asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Beta2 Adrenergic Agonist medication

Precautions/interactions

A

Contraindication:
-clients with tachydysrhythmias

Caution:

  • DM, hyperthyroidism, heart disease, hypertension, angina
  • BBs will reduce effects
  • MAOIs will increase effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Beta2 Adrenergic Agonist medication

Side/adverse effects

A
  • Tachycardia
  • Palpitiations
  • Tremors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Beta2 Adrenergic Agonist medication

Nursing Interventions and client education

A

-Caution against using salmeterol more frequently than every 12 hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Mehtylxanthines

A

-Suffix: ophylline

Therapeutic use:

  • relief of bronchospasm
  • long-term control of Asthma

Precautions/Interactions:

  • peptic ulcer disease
  • do not mix parenteral med with other medications
  • phenobarbital and phenytoin decrease levels

Side/adverse effects:
-irritability and restlessness

toxic effects:
-tachycardia, tachypnea, seizures

Nursing interventions and client education:

  • monitor therapeutic levels of the medication
  • avoid caffeine, smoking , and alcohol abuse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Methylxanthines

A

Tx of toxicity:

  • stop infusion
  • activated charcoal to decrease absorption in oral overdose
  • lidocaine of dysrhythmias
  • diazepam for control seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Inhaled Anticholinergics

A
  • troplum

Therapeutic use:

  • prevent bronchospasm
  • manage allergen or exercise-induced asthma -COPD

Precautions/Interactions:

  • clients with peanut allergy
  • use extreme caution with narrow-angle bacteria and BPH
  • do not use for tx of acute bronchospasm

Side/adverse effects:

  • dry mouth and eyes
  • urinary retention

Nursing Interventions and client education:
-Instruct client that it may take up to 2 weeks for maximum effects to show

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Glucocorticoids

A

-Suffix: one

Short-term:

  • Respiratory therapeutic use: IV agents: status asthmaticus
  • Oral: tx of symptoms following and acute asthma attack

Long-term

  • Inhaled: prophylaxis of asthma
  • Oral: tx of chronic asthma

Precautions/Interactions:

  • Clients with DM may require higher doses
  • Never stop abruptly

Side/Adverse effects:

  • Euphoria, insomnia, psychotic behavior
  • Hyperglucemia
  • peptic ulcer
  • fluid retention
  • withdrawal symptoms

Nursing Interventions:

  • Administer with meals
  • Do not take with NSAIDs
  • Teach gradual reduction in dose to prevent addisonian crisis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Leukotriene Modifiers

A

-lukast, Zileuton

Therapeutic use:

  • Long-term mngt of asthma in adults and children
  • Prevention of exercise-induced bronchospasm

Precautions/Interventions:

  • Not for acute asthma attack
  • high risk for liver disease
  • phenobarbital will decrease circulating levels
  • chewable tabs contain phenylalanine

Side/Adverse effects:

  • elevated liver enzymes
  • Warfarin and theophylline toxicity

Nursing Interventions and client education:

  • Do not abruptly substitue for corticosteroid therapy
  • take daily
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Antitussives, Expectorants, Mucolytics

A

Antitussives : hydrocodone, codine
Exectorants: guaifenesin (Mucinex)
Mucolytics: acetylcysteine (Mucomyst, Acetadote) hypertonic saline

Precautions/Interventions:

  • children younger than 2 should only get saline
  • opioid antitussives have potential for abuse
  • caution with OTC meds

Side/Adverse effects:
-drowsiness, dizziness, aspiration and bronchospasm risk with mucolytics, constipation

Nursing Interventions and Client Education:

  • Monitor cough frequency, effort, and ability to expectorate
  • Auscultate fo radventitous lung sound
  • promote fluid intake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Antitussives (hydrocodone, codeine)

A
  • Actions: suppresses cough

- Therapeutic use: chronic nonproductive cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Expectorants gualfenesi (Mucinex)

A

Actions:
-promote increased mucous secretion to increase cough production

Therapeutic use:
-often combined with other agents to manage respiratory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mucolytics: acetylcysteine, hypertonic saline

A

Action:

  • acute and chronic pulmonary disorders with copious secretions
  • Cystic fibrosis

Therapeutic use: cystic fibrosis
-Antidote for Acetaminophen poisoning

17
Q

Decongestants, Antihistamines

A

Precautions/Interventions:

  • children may have symptoms of excitation, hallucinations, incoordination, and seizures
  • Avoid alcohol intake
  • products containing pseudo ephedrine should not be used longer than 7 days

Side/Adverse effects:

  • Anticholinergic effects
  • Drowsiness

Nursing Interventions and client educations

  • Assess for hypokalemia
  • Monitor BP
  • Advise to take at night