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MSII Medication Review > Lewis 31 - Obstructive Pulmonary Disease > Flashcards

Lewis 31 - Obstructive Pulmonary Disease Flashcards

1
Q

MOA/Class

albuterol

A

Stimulates beta-2 receptors causing bronchodilation.
Short-acting beta-agonist (SABA)

Adrenergic agonist (B2)

Tucker 30, 55

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2
Q

Side Effects

albuterol

A

Tachycardia, palpitations, anxiety, insomnia, tremors
Paradoxical bronchospasms, hypokalemia

Tucker 30, 55

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3
Q

Nursing Considerations

albuterol

A

Take beta-agonist inhaler before other inhaled medications for maximum effect
Monitor for paradoxical bronchospasms
Monitor for dysrhythmias, tachycardia

Tucker 30, 55

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4
Q

Indications

albuterol

A

Acute respiratory distress caused by bronchoconstriction (asthma, COPD, etc.)

Tucker 30, 55

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5
Q

MOA/Class

salmeterol, formoterol

A

Stimulates beta-2 receptors causing bronchodilation.
Long-acting beta-agonist (LABA)

Adrenergic agonist (B2)

Tucker 30, 55

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6
Q

Side Effects

salmeterol, formoterol

A

Tachycardia, palpitations, anxiety, insomnia, tremors
Paradoxical bronchospasms, hypokalemia
*Generally has fewer side effects than SABA medications

Tucker 30, 55

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7
Q

Nursing Considerations

salmeterol, formoterol

A

May be combined with other inhaled medications as a combination inhaler
Prophylactic use

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8
Q

Indications

salmeterol, formoterol

A

Prevention of respiratory distress caused by bronchoconstriction (asthma, COPD, etc.)

Tucker 30, 55

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9
Q

MOA/Class

ipratropium, tiotropium

Inhaled

A

Blocks acetylcholine (ACh) from binding to ACh receptors.
Decreased secretions due to anti-SLUDGE effects and bronchodilation.

Anticholinergic

Tucker 33, 55

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10
Q

Side Effects

ipratropium, tiotropium

Inhaled

A

Localized dryness; headache, dizziness, palpitations. blurred vision

Tucker 33, 55

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11
Q

Nursing Considerations

ipratropium, tiotropium

Inhaled

A

Primarily maintenance therapy; Duo-Neb (ipratropium/albuterol) nebulizer may be used for acute symptoms

Tucker 33, 55

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12
Q

Indications

ipratropium, tiotropium

Inhaled

A

Maintenance therapy for asthma/COPD

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13
Q

MOA/Class

Prednisone, methylprednisolone

A

Steroids stabilize leukocytes (WBCs) preventing the release of intracellular chemical/inflammatory mediators
Restore/increase bronchial responsiveness to beta-adrenergic receptor stimulation

Systemic glucocorticoid/corticosteroid

Tucker 36

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14
Q

Side Effects

Prednisone, methylprednisolone

A

Growth suppression, elevated blood glucose, weight gain
GI upset (tolerated best in AM with food/milk)
Osteoporosis (long-term use)

Tucker 36

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15
Q

Nursing Considerations

Prednisone, methylprednisolone

A

Taper dose when stopping to prevent adrenal insufficiency

Tucker 36

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16
Q

Indications

Prednisone, methylprednisolone

A

Used to gain control of severe asthma or COPD exacerbations. Not a rescue medication, but systemically decreases inflammatory response in severe disease.

Tucker 36

17
Q

MOA/Class

fluticasone, budesonide

Inhaled

A

Steroids stabilize leukocytes (WBCs) preventing the release of intracellular chemical/inflammatory mediators
Restore/increase bronchial responsiveness to beta-adrenergic receptor stimulation

Inhaled corticosteroid (ICS)

Tucker 36, 55

18
Q

Side Effects

fluticasone, budesonide

A

Thrush/candidiasis

Tucker 36, 55

19
Q

Nursing Considerations

fluticasone, budesonide

A

Often given as combination inhaler or nebulizer with beta-adrenergic
Rinse mouth after using
Spacer use decreases risk of oral candidiasis

Tucker 36, 55

20
Q

Indications

fluticasone, budesonide

A

Maintenance therapy for asthma or COPD

Tucker 36, 55

21
Q

MOA/Class

omalizumab (Xolair)

A

Binds to IgE receptors on mast cells and basophils decreasing release of inflammatory mediators

Tucker 55

22
Q

Side Effects

omalizumab (Xolair)

A

Myalgia, fatigue, rash, headache, back pain

Tucker 55

23
Q

Nursing Considerations

omalizumab (Xolair)

A

Given subcutaneously every 4 weeks; First dose administered with healthcare monitoring. Subsequent doses may be administered at home.

Tucker 55

24
Q

Indications

omalizumab (Xolair)

A

Maintenance treatment for moderate to severe persistent asthma or allergic symptoms

Tucker 55

25
Q

MOA/Class

montelukast

A

Leukotrienes are produced in leukocytes such as mast cells. Once released from the mast cell during an inflammatory response, leukotrienes mediate additional responses such as bronchial constriction
LTRAs prevent leukotrienes from attaching to receptors on lymphocytes and alveolar macrophages thus reducing the inflammatory response thus preventing smooth muscle contraction (bronchi), decreasing mucus secretion, decreasing vascular permeability

Leukotriene Receptor Antagonist (LTRA)

Tucker 55

26
Q

Side Effects

montelukast

A

Headache, nausea, diarrhea, cough, elevated LFTs, myalgia, neuropsychiatric events

Tucker 55

27
Q

Nursing Considerations

montelukast

A

Tablets contain lactose (monitor patients for lactose intolerance)
Maintenance therapy
Safe for young children (used in ages 2 years and older)

Tucker 55

28
Q

Indications

montelukast

A

Asthma, seasonal allergic rhinitis

Tucker 55

29
Q

MOA/Class

theophylline, aminophylline

A

Relaxes the smooth muscles located in the bronchial airways and pulmonary blood vessels. Also reduces the airway responsiveness to histamine, adenosine, methacholine, and allergens.

Methylxanthine

Tucker 55

30
Q

Side Effects

theophylline, aminophylline

A

CNS stimulation

Tucker 55

31
Q

Nursing Considerations

theophylline, aminophylline

A

Many drug interactions; Narrow therapeutic range

Tucker 55

32
Q

indications

theophylline, aminophylline

A

Asthma and COPD maintenance
*May also be used to manage respiratory issues in premature infants.

Tucker 55

MSII Medication Review (13 decks)

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