MS Ch.51 Respiratory Drugs Flashcards
Medication Inhalation Devices
Metered-dose inhaler (MDI)?
Dry powder inhaler (DPI)?
Nebulizer?
Key Point?
A. Metered-dose inhaler (MDI): Uses a chemical propellant to push the medication out of the inhaler (Fig. 51-1)
B. Dry powder inhaler (DPI): Delivers medication without using chemical propellants, but it requires strong and fast inhalation.
C. Nebulizer: Delivers fine liquid mists of medication through a tube or a mask that fits over the nose and mouth, or with a mouthpiece, using air or oxygen under pressure.
Key: If 2 different inhaled medications are prescribed and 1 of the medications contains a glucocorticoid (corticosteroid), administer the bronchodilator first and the corticosteroid second.
If 2 different inhaled medications are prescribed how should you instruct the patient to take them?
Instruct the client to wait 5 minutes following administration of the first before inhaling the second. If a second dose of the same medication is needed, instruct the client to wait 1 to 2 minutes before taking the second dose.
Bronchodilators
Description?
Sympathomimetic ?
Methylanthine?
Used to treat acute bronchospasm, acute and chronic asthma, bronchitis, restrictive airway diseases, and reactive airway diseases.
Sympathomimetic bronchodilators: relax the smooth muscle of the bronchi and dilate the airways of the respiratory tree, making air exchange and respiration easier for the client. Examples include β2-adrenergic agonists, such as albuterol.
Methylxanthine bronchodilators: stimulate the central nervous system (CNS) and respiration, dilate coronary and pulmonary vessels, cause diuresis, and relax smooth muscle. An example is theophylline.
Bronchodilators
Contraindications?
Use with caution with what kind of patinets?
Contraindicated in individuals with hypersensitivity, peptic ulcer disease, severe cardiac disease and cardiac dysrhythmias, hyperthyroidism, or uncontrolled seizure disorders.
Caution with: Used with caution in clients with hypertension, diabetes mellitus, or narrow-angle glaucoma.
Bronchodilators: Theophylline
What is it for?
Increaes risk for what?
What may happen if its admin. w/ β2-adrenergic ?
What drugs increase the effect of this drug?
What drugs decrease the effects of thsi drug?
Saftey?
It is used to treat lung problems like emphazema and chronic broncitis.
- Theophylline increases the risk of digoxin toxicity and decreases the effects of lithium and phenytoin. Theophylline should be a last-line medication.
- If theophylline and a β2-adrenergic agonist are administered together, cardiac dysrhythmias may result.
- Beta blockers, cimetidine, and erythromycin increase the effects of theophylline.
- Barbiturates and carbamazepine decrease the effects of theophylline.
Safety:
Theophylline toxicity is likely to occur when the serum level is higher than 20 mcg/mL (111 mcmol/L). Early signs of toxicity include restlessness, nervousness, tremors, palpitations, and tachycardia.
Bronchodilators: Side effects.
How does it affect your cardiovascualr system?
How does it affect you nervous system?
How does it affect your endocrine system?
how does it affect your respiratory system?
Cardiovascular: Palpitations and tachycardia, Dysrhythmias.
Nervous System: Restlessness, nervousness, tremors, headaches+ dizzy.
Endocrine: Hyperglycemia, anaorexia, nausea, vomiting, mouth/throat dry.
Respiratory:Tolerance and paradoxical bronchoconstriction with inhalers
Broncodialtors: Side effects and there interventions.
Go through all your body systems and thing what sould be done?
Cardiovascular: Monitor for cardiac dysrhythmias.
Respiratory: Asses lung sounds, Assess for cough, wheezing, decreased breath sounds, and sputum production.
- Monitor for a therapeutic serum theophylline level of 10 to 20 mcg/mL (55.5 to 111 mcmol/L).
- Intravenously administered theophylline preparations should be administered slowly and always via an infusion pump.
Gastrointestinal: Provide adequate hydration, Administer the medication at regular intervals around the clock to maintain a sustained therapeutic level, Administer oral medications with or after meals to decrease gastrointestinal irritation.
Bronchodilators: Patient Education
Agian go through your body systems.
a. Not to crush enteric-coated or sustained-release tablets or capsules
b. To avoid caffeine-containing products such as coffee, tea, cola, and chocolate, and over-the-counter medications
c. About the side and adverse effects of bronchodilators
d. How to monitor the pulse and to report any abnormalities to the primary health care provider (PHCP)
e. How to use an inhaler, spacer (see Fig. 51-1), or nebulizer and how to monitor the amount of medication remaining in an inhaler canister
f. The importance of smoking cessation and information regarding support resources
g. To monitor blood glucose levels if diabetes mellitus is a coexisting condition
h. To wear a MedicAlert bracelet, particularly if the client has asthma
ANTICHOLINGERGICS
What are they?
Treat what?
Side effects?
Syetemic effects?
Why cant penut alerrgy take ipratropium?
A. Inhaled medications that improve lung function by blocking muscarinic receptors in the bronchi, which prevents bronchoconstriction
B. Effective for treating chronic obstructive pulmonary disease, allergy-induced asthma, and exercise-induced bronchospasm
C. Side effects include dry mouth and irritation of the pharynx; sucking on sugarless candy will help relieve symptoms.
D. Systemic anticholinergic effects rarely occur but can include increased intraocular pressure, blurred vision, tachycardia, cardiovascular events, urinary retention, and constipation.
Glucocorticoids
What are they used for?
Glucocorticoids act as antiinflammatory agents and reduce edema of the airways; they are used to treat asthma and other inflammatory respiratory conditions.
Leukotriene Modifiers
Used for what?
How do they work?
Contraindicated in?
Be careful witn what kind of patinets?
What if given at the same time as inhaled glucocorticoids?
- Used in the prophylaxis and treatment of chronic bronchial asthma (not used for acute asthma episodes)
- Inhibit bronchoconstriction caused by specific antigens and reduce airway edema and smooth muscle constriction
- Contraindicated in clients with hypersensitivity and in breast-feeding mothers
- Should be used with caution in clients with impaired hepatic function
- Coadministration of inhaled glucocorticoids increases the risk of upper respiratory infection.
Leukotriene Modifiers : Side effects
Whata re they?
- Headache
- Nausea and vomiting
- Dyspepsia
- Diarrhea
- Generalized pain, myalgia
- Fever
- Dizziness
Leukotriene Modifiers: Interventions and Client Education?
C. Interventions
- Assess frequency of exacerbations.
- Assess changes in lung function.
- Assess liver function laboratory values.
- Monitor for cyanosis.
D. Client education
- To take medication 1 hour before or 2 hours after meals
- To increase fluid intake
- Not to discontinue the medication and to take it as prescribed, even during symptom-free periods
Inhaled Nonsteroidal Antiallergy Agent
How do they work?
Used to treat what?
Contraindciated in?
Orally administered cromolyn sodium is used with?
- Antiasthmatic, antiallergic, and mast cell stabilizers inhibit mast cell release after exposure to antigens.
- Used to treat allergic rhinitis, bronchial asthma, and exercise-induced bronchospasm
- Contraindicated in clients with known hypersensitivity
- Orally administered cromolyn sodium is used with caution in clients with impaired hepatic or renal function.
Inhaled Nonsteroidal Antiallergy Agent : Side effects?
What are they?
1. Cough, sneezing, nasal sting, or bronchospasm following inhalation
- Unpleasant taste in the mouth
