Ch 37 Bronchodilators and Other Respiratory Drugs Flashcards
What are Bronchodilators used for?
Bronchodilators are used w/ COPD patients because of their ability to relax bronchial smooth muscle bands to dilate the bronchi and bronchioles.
What is the primary use of the beta agonists?
- For acute phase of asthmatic attack to quickly reduce airway constriction and restore airflow to normal.
What is another name for beta-adrenergic agonists?
Sympathomimetic bronchodilators
What are some examples of beta-adrenergic agonists?
- Albuterol
- Bitolterol
- Ephedrine
- Epinephrine
What are the main indications for the use of beta-adrenergic agonists?
- Relief of bronchospasm related to asthma, bronchitis and other COPD
- Treatment of ACUTE asthma attack as well as prevention
- Hypotension and shock
- Produce uterine relaxation to prevent premature labor
- Hyperkalemia = stimulates K + to shift into cells
What are the main adverse effects of beta-adrenergic agonists?
Ex: Epinephrine
- Insomnia
- Restlessness
- Anorexia
- Vascular headache
- Hyperglycemia
- Tremor
- ❤ stimulation
Ex: Albuterol
- Hypotension or Hypertension
- Vascular headache
- Tremor
What is a contraindication w/ beta-adrenergic agonists?
Risk of stroke (because of vasoconstrictive drug actions)
What are the nursing implications in concerns to beta-adrenergic agonists?
- Excess of Albuterol use will results in nausea, ⬆ anxiety, palpitations, tremors and ⬆ HR
- Patients should take medications EXACTLY as prescribed w/ no omission or double dose
- Instruct patient to REPORT insomnia, jitteriness, restlessness, palpitation and chest pain
What is an interaction the nurse needs to be concerned about w/ beta-adrenergic agonists?
Interaction w/ MAOIs –> ⬆ risk of hypertension
What are some patient teaching tips the nurse can share in regards to Beta-adrenergic agonists?
- Educate about healthy habits
- Instruct about potential drug interactions (or OD can be lethal)
- Pts w/ asthma, chronic bronchitis and emphysema should avoid allergens, smoke, stress and pollutants
- MDIs use: wait 1 or 2 min between puffs
What is the mechanism of action of Anticholinergics?
Anticholinergic drugs block ACh receptors to prevent bronchoconstriction and indirectly cause airway dilation.
What are is the main indication for Anticholinergic?
To prevent bronchospasm associated w/ Chronic Bronchitis or Emphysema
- Not used for the management of acute symptoms.
What are the 2 known Anticholinergic drugs?
- Ipratropium bromide = Atrovent
- Tiotropium = Spiriva
What are the adverse effects of Anticholinergics?
- Dry mouth or throat
- Nasal congestion
- ❤ palpitations
- GI distress
- Headache
- Coughing
- Anxiety
- Dizziness
- Fatigue
- Nervousness
- Urinary retention
What are the nursing implications in concerns to Anticholinergics?
- Provide lozenges for dry mouth
- Review use of inhaler w/ patient (1 to 2 min btw doses)
- Ensure patient knows to wait 2 to 5 min before use of additional inhaled medication
- Ensure adequate hydration (helps w/ secretions)
What are some contraindications with Anticholinergics?
- Allergy to Atropine or to soy lecithin
- Allergy related to food products such as peanut oil, peanuts, soybeans, and other legumes (beans)
What are some patient teaching tips the nurse can share in regards to Anticholinergics?
- Educate patient that Ipratropium is used prophylactically to ⬇ the frequency and severity of asthma and is taken YEAR round for effectiveness.
- ⬆ fluids to decrease viscosity of secretions and increase expectoration of sputum
- Teach patient to wait 2 to 5 min if taking another inhaled medication
What is the mechanism of action of Xanthines?
Xanthines cause bronchodilation by increasing the levels of the energy-producing substance cAMP.
What are the actions of Xanthines?
- Stimulate the CNS (less than caffeine)
- Act directly on medullary respiratory center to enhance respiratory drive
- In high dosage = ⬆ ❤contraction
⬆ HR
–> Result = ⬆ CO and GFR –> Diuretic effect
What are the indications for Xanthines?
Dilate the airways in patients w/:
- Asthma
- Chronic Bronchitis
- Emphysema
- Slow onset so used more for prevention than for acute asthma attacks
What are the contraindications of Xanthines?
- Uncontrolled ❤ dysrhythmias
- Seizure disorders
- Hyperthyroidism
- Peptic ulcers
What are the adverse effects of Xanthines?
- Nausea, vomiting, anorexia
- GI reflux
- Sinus tachy❤, extrasystole, palpitations + ventricular dysrhythmias
- Transient ⬆ urination + hyperglycemia
- In case of overdose = Activated Charcoal
What drug and food interactions are known w/ Xanthines?
- Sympathomimetics (or even caffeine) can produce an additive cardiac and CNS stimulation
- Charcoal-broiled, high protein and low carb foods can reduce serum levels of Xanthines
What are some patient teaching tips the nurse can share in regards to Xanthines?
- Educate about interactions such as smoking ⬇ blood concentration of drug as well as charcoal-broiled foods
- Avoid caffeine-containing beverages or foods
- Encourage patient to be accurate w/ time of administration (DO NOT CRUSH or chew extended-release forms)
