drugs affecting respiratory system Flashcards
long acting beta 2 agonist
salmeterol
salmeterol black box warning
should not be used by itself bc inv risk for asthma related intubation and death; either use albuterolor use long acting with steroid!
beta agonists drug interactions with which other drugs:
digitalis–> can cause dysrythmias
beta blockers-> both compete for sites, this includes beta blocker eye drops
TCAs and MAOIs: causes beta agonists to have more of a vascular effect
albuterol meter dosed inhaler amount dose frequency, how often can be repeated
2 puffs every 4 to 6 hours.
Dose via nebulizer is 2.5 mg/dose
May be repeated twice after 5 to 10 minutes
May be combined with ipratropium
what can be given for exercise induced bronchospasm?
albuterol puff : 2 puffs 15 min before exercise
or salmeterol : 2 puffs 30 min to an hour before exercise.
which 2 responses drugs are approved for use in children younger than 4 years of age.
albuterol and metaproteronol; albuterol safest on infants and cheapest
meter dosed inhaler education
return demonstration
spacer with all patients
Second- or third-line drug for asthma and COPD
theophylline; absorbed in GI tract completely
theophylline warnings
monitor in patients who have heart issues; preg category c; monitor for theophylline toxicity
theophylline toxicity:
occurs over 20
cns irritablity, palps, tachycardia, hypotension
things that increase clearance of theophylline and dec its half life:
phenobarbital use, dilantin, smoking cigs, being less than 12
things that increase half life, decrease clearance in theophyline
inc age, liver and kidney disease, chf
theophylline pt teaching
clearance is affected by diet
- monitor for toxicity
- avoid large amount of caffeine containing products
what drugs can be given for apnea of maturity
theophylline and caffeine citrate
theophylline:Loading dose of 4 mg/kg per dose
Maintenance dose of 4 mg/kg per day in the premature infant or newborn up to age 6 weeks
caffeine citrate:10 to 20 mg/kg is given in the treatment apnea of prematurity.
Maintenance dose of 5 mg/kg per day
this drug Blocks muscarinic cholinergic receptors
inhaled anticholinergic: ipratropium bromide (atrovent)
Inhibits muscarinic M3 receptors in lungs
Tiotropium and aclidinium bromide
what do inhaled anticholinergics cause and what do they primary treat
cause brachial smooth muscle relaxation
and treat cops
inhaled anticholinergics ADRs
cough and dry mouth mostly
leukotriene modifier antagonists (-lukast) singulair
when mast cells are broken down, luekotriene and histamine are released, causing the constriction, these meds in turn block the contraction from happening
precautions of leukotriene antagonists
do not suddenly stop and use oral or inhaled steroids; do not give to lactating women
-zafirlukast: don’t give to someone with hepatic insufficiency
rare side effect of leukotriene inhibitor
new onset neuro condition: adhd
most common singulair side effect
headache
this drug class:Inhibit the release of arachidonic acid through phospholipase A2 inhibition, thereby producing direct anti-inflammatory properties in the airways.
inhaled corticosteroids
ics precautions
don’t give to someone for acute bronchospasm
don’t give to immunocompromised pts
corticosteroids can also be used to manage
allergic rhinitis
ics adrs
altered taste: dysgeusia
tongue and mouth irritation
flushing
pt teaching with ics use
use spacer with each use; rinse mouth with water with each use
first generation vs second generation antihistamines
1st: diphenhydramine (Benadryl)–> causes drowsiness
2nd: non sedating antihistamines: loratadine, allegra, zyrtec
mast cell stabilizers
prevent breakdown of mast cells; cromolyn and nedocromil
decongestants examples
pseudoephedrine and phenyl ephedrine (pseudo more effective)
decongestants do what
promote vasoconstriction; not used for kids under 6 yrs
contraindications for decongestant use
its using MAOIs or those with severe HTN
afrin nasal spray
rebound nasal congestion if used more than 2-3 days
agent that is in all antitussives
dextramethorphan
the only expectorant/mucolytic approved by fda
guafenisin: not more effective than fluids
