Respiratory concepts

Question 1

57. What are some medications used in the treatment of COPD?

Answer 1

glucocorticoids (PO, IV) “cort”, “onide” and “one” family. SEE MUST KNOW PAGE!
- prednisone (PO, IV)
- beclomethasone (inhaled)
- fluticasone (intranasal)
- budesonide (PO, inhaled)
- mometasone (inhaled)

Inhaled Beta 2 Agonist – DIRECT Bronchodilators
Examples: “eterol” family are short acting (albuterol) and the “metorol” and “motorol” are
the long acting or maintenance drugs for COPD
NO LAB2 for acute asthma- Black Box = can equal death.
Inhaled Anticholinergic medications – INDIRECT bronchodilation by relaxing the bronchial
tree and drying up secretions.
Examples: Tiotropium, ipratropium

Question 2

58. What is the therapeutic drug level of theophylline?

Answer 2

10-20mcg/mL

Question 3

59. What would indicate toxicity?

Answer 3

tachycardia, tremor, behavioral disturbances, epileptic seizures

• if too low, then the patient will continue with respiratory distress/symptoms
• Drug to food interactions: caffeine, charcoal broiled foods, high protein, low carb

Question 4

60. What is a leukotriene antagonist? List examples.

Answer 4

Exposure to antigen causes release of leukotrienes which result in inflammation,
bronchoconstriction, and mucus production.

• Medications which antagonize leukotrienes will block this process
• Good for allergy induces asthma
• zafirlukast, montelukast (blocks receptors for leukotrienes)
• zileuton (blocks synthesis of leukotrienes)

Question 5

61. What is the benefit of using glucocorticosteroids for clients with respiratory conditions?

Answer 5

• Anti-inflammatory, reducing mucosal edema, secretions, thereby reducing bronchospasm
• Also increase responsiveness to bronchial dilation from beta drugs

Question 6

62. What are some important things as a nurse that must be considered for any client taking steroids for any reason, not just respiratory issues? (This was covered in multiple lectures)

Answer 6

• If PO or IV systemic effects associated with all glucocorticoids, including risk of infection,
  ulcers, and hyperglycemia
• Suppression of normal adrenal function
• Minimal if any systemic effect with inhaler or intranasal unless high dose
  *NEVER stop abruptly as this can cause adrenal insufficiency or Addison’s Crisis

Question 7

63. What is an additional consideration for a client who takes inhaled corticosteroids?

Answer 7

Make sure they rinse their mouth/throat after each use to avoid thrush.