respiratory drugs Flashcards
what medications are used for upper respiratory disorders?
antihistamines
medications to control bronchial secretions:
antitussives
expectorants
mucolytics
decongestants
what are the medication classes to control bronchial secretions?
antitussives
expectorants
mucolytics
decongestants
What is the method of action of antihistamines?
compete with histamine at receptor sites
What are the effects of antihistamines?
Bronchial smooth muscle relaxation
Prevent or alleviate pruritis (itching)
Reduce secretions (runny nose, scratchy throat, watery eyes…)
antihistamines work best when?
early in response cycle
What are the first generation antihistamines?
Diphenhydramine
Promethazine
Dimenhydrinate
what are the second generation antihistamines?
Loratadine
Cetirizine
are great at treating nasal allergies- hay fever and helping with the symptoms of a common cold
first and second generation antihistamines
Which drug class causes CNS depression?
1st generation antihistamines
which drugs have anticholinergic effects?
promethazine
dimenhydrinate
are antihistamines useful in extreme anaphylaxis?
no
are antihistamines useful as monotherapy in asthma attacks?
no
Blocking acetylcholine can cause?
which drugs do this?
temporary drowsiness, confusion, and memory loss
first generation antihistamines
this drug is used to prevent N/V and motion sickness
promethazine -bc of its anticholinergic effects
______ may be used for an allergic reaction causing itching, hives, but in a true anaphylactic emergency reaction, epinephrine (epi pen) needs to be used.
diphenhydramine
Airway: SOB, wheezing, chest pain or tightness, tightening of throat, difficulty swallowing
Skin: hives, swelling, itchiness, widespread redness, warmth
brain: anxiety, confusion, headache, feeling that something is about to happen
heart: faint, pale or blue color, dizziness, weak pulse, shock, loss of consciousness,
Stomach: N/V, diarrhea, stomach pain or cramps
S/S of anaphylaxis
What are the anticholinergic antihistamine drugs?
What are negative side effects of the drugs?
dimenhydrinate
promethazine
Cants: see, spit, piss, shit
Nasal allergies
hay fever
hives
mild blood transfusion reactions
What are the primary uses for antihistamines? (4)
What are the secondary uses for antihistamines? (5)
motion sickness
vertigo
Parkinson’s
anaphylactic reactions (with other drugs)
sleep aid
which drug is used to treat motion sickness and vertigo?
dimenhydrinate
_______ and _______ are often used before a blood transfusion to prevent possible reactions.
Benadryl and acetaminophen
_____ and _____ are first gen antihistamines that are not going to be used for nasal allergies.
promethazine and dimenhydrinate
When are maximal plasma concentrations reached for antihistamines?
epinephrine?
1-3 hours for antihistamines
<10 minutes for epi
Has both CNS depressant and Anticholinergic properties
diphenhydramine
does diphenhydramine cross the placenta and go into breast milk?
yes
Appears on BEERS list- geriatric more susceptible to drug reactions- dose should be decreased or other antihistamine recommended
diphenhydramine
what is diphenhydramine used for?
anaphylaxis
allergic rhinitis
parkinson’s symptoms
insomnia
pruritis
Decreases skin response to allergy testing. Stop 4 days before testing.
Can be given PO, IV, or topically.
Avoid use of alcohol with ______
diphenhydramine
Avoid when breast feeding.
CNS depressant- avoid driving or things that require alertness
antiCholinergic- sugarless gum, frequent liquids, good oral hygiene
education for diphenhydramine
what can diphenhydramine cause in young children?
paradoxical excitation
how long should you avoid diphenhydramine before an allergy test?
four days
how is promethazine administered?
PO
IM
IV (caution)
suppository
ointment
Used for nausea, vomiting, often used as an adjuvant with pain med postop. In some cough syrups
promethazine
is promethazine a BEERS drug?
yes
because promethazine is a high alert drug, what can happen if it is given incorectly or in the wrong dose? what age should it not be administered to?
respiratory depression
dont use under 2 years old
what happens if promethazine is not diluted or given too rapidly?
tissue damage and fall of BP
must be given slowly
is promethazine given subcutaneously?
no, can cause tissue necrosis
IV- Assess for pain and burning at IV site. Avoid IV administration if possible.
Risk of CNS depression/respiratory depression with other CNS depressants.
promethazine cautions and assessments
IV –if not properly diluted or given too fast it can actually be dangerous –resp depression, pain and burning at IV site. has to be diluted well and given slowly
not usually given when pregnant
promethazine
can alcohol be taken with promethazine?
no
Life threatening reaction to some medications
Altered Mental Status
Muscle rigidity
Fever (102-104)
Irregular, rapid pulse
May have high or low blood pressure
adverse effects of promethazine (6)
(Promethazine & some antipsychotics)
Anticholinergic Antihistamine (antiemetic)
PO/IM
dimenhydrinate
Used for nausea, vomiting, dizziness accompanying motion sickness
Decreased vestibular (inner ear) stimulation, which may prevent motion sickness
BEERS Drug
Causes CNS depression: drowsiness, dizziness
Can cause paradoxical excitation in children
Increased CNS depression with other CNS depressants
Pregnancy Risk B
dry mouth (anticholinergic)
dimenhydrinate
CNS depression- teach to avoid driving or other activities requiring alertness. Avoid use of other CNS depressants- alcohol, sedative/hypnotics, other antihistamines, opoids. pregnancy risk B
used for motion sickness, anticholinergic antihistamine
dimenhydrinate
do second generation antihistamines cause as much sedationas the first generation?
no, they do not
because second generation antihistamines do not cross the blood brain barrier, they do not cause which adverse effect as much?
respiratory depression
are the second generation antihistamines or the first generation histamines longer acting?
second generation are longer acting
these are often given more often daily because they can be taken during the day and don’t cause the drowsiness.
second generation antihistamines
which antihistamines typically have to be given every four hours?
promethazine
diphenhydramine
taken once a day and decrease symptom of allergies
second generation antihistamines
Decreased symptoms of allergic symptoms (nasal stuffiness, red swollen eyes, itching)
Daily dosing
Cautious use in children under 2.
Geri- Increased risk of adverse reactions
Dry mouth..
Avoid CNS depressants
loratadine
can cause photosensitivity, pregnancy risk B, and available in rapidly disintegrating tablet
loratadine
what is the only contraindication to the OTC drug loratadine?
allergy to the drug
PO/IV- most PO
Given for allergic/seasonal rhinitis and urticaria (hives)
Children: Contraindicated in children under 6 with renal/hepatic impairment
Geri: Lower dose
Caution in renal/hepatic impairment
Mouth dryness..
Pregnancy B; risk vs benefit (also breastfeeding)
Avoid CNS depressants with medication
Side effect of dizziness/drowsiness although not as significant as 1st generation
cetirizine
what do you need to assess for with first generation antihistamines?
drowsiness/dizziness
symptom resolution
toxicity
what do you need to increase you fluid intake to when taking a 1st generation antihistamine?
2-3 liters per day
t/f: you should administer an antihistamine prior to contact with allergens if possible?
true
t/f: antihistamines may cause a false negative on an allergy test?
true
what are the four drug classes used to control bronachial secretions?
anti-tussives
expectorants
mucolytics
decongestants
these medication shrink swollen nasal mucosa
nasal decongestants
what are decongestants used to treat?
rhinitis
common cold
sinusitis
hay fever
allergies
these medications are used for visualization of membranes prior to procedures
nasal decongestants
what are the three primary nasal decongestants?
phenylephrine
ephedrine
pseudoephedrine
Decrease the swollen nasal mucosa and decrease stuffiness
nasal decongestant
this drug is used to make meth and is controlled by pharmacists
pseudoephedrine
how do adrenergics or (sympathomimetic) nasal decongestants work?
constrict small blood vessels in the nasal passage and sinuses
constrict small blood vessels in the nasal passage and sinuses
adrenergics
how do anticholinergic nasal decongestants work?
decrease secretions
these nasal decongestants decrease secretions
anticholinergics
how do corticosteroid nasal decongestants work?
reduce inflammatory response in nasal passage
reduce inflammatory response in nasal passage
corticosteroid nasal decongestants
oxymetazoline is an example
adrenergic decongestants
______ nasal decongestants are addictive and can cause ______ ______ if used over 3-5 days
adrenergic, rebound congestion
fluticasone propionate is a ?
corticosteroid nasal decongestant
takes longer to receive full benefit and can be used for longer periods of time without rebound congestion.
corticosteroid decongestant
is the only intranasal anticholinergic
ipatropium bromide
Most decongestants are OTC while many ______ are by prescription
corticosteroids
Causes dilated arterioles in the nose to constrict
Reduces congestion
adrenergic decongestants (oxymetazoline)
Use these drugs no more than 3 days at a time to prevent?
adrenergic (oxymetazoline)
rebound congestion
is an alpha adrenergic agonist
oxymetazoline
causes vasoconstriction of dilated arterioles and reduces blood flow.
oxymetazoline
Sympathomimetic drug
(Increase heart rate/blood pressure)
oxymetazoline
During a cold, the blood vessels that surround the nasal sinus are dilated and engorged with plasma, white blood cells, mast cells, histamines, and many other blood components that are involved in fighting infections of the respiratory tract. This swelling, or dilation, blocks the nasal passages, which results in nasal congestion. When these drugs are administered intranasally, they cause dilated arterioles to constrict, which reduces nasal blood flow and congestion. ______ should be used for no more than 3 days at a time.
Oxymetazoline
can cause you to be nervous –high heart rate, high bp,
(IMPORTANT)
oxymetazoline
this decongestant decreases secretions and must be primed y spraying before first use? what class is it in as well?
ipratropium, anticholinergic decongestant
good for treating runny nose in patients with both allergic and nonallergic rhinitis
ipratropium (anticholinergic decongestant)
These work by blocking acetylcholine which decreases secretions from the glands in the nasal passage. Common reactions include dry mouth and bad taste. It doesn’t have to be stopped after 3 days although there are differing opinions on length of time)
anticholinergics, ipratropium
what are the side effects of ipratropium ?
sore throat
nasal dryness/irritation
does not have to be stopped after three days, does not cause rebound congestion
anticholinergic decongestants
Corticosteroids
fluticasone propionate is a ?
corticosteroid nasal spray
treat allergic rhinitis caused by airborne allergens
Children: Less than 4 years safety not established
OB: Safety not established
Lactation: Risks vs benefits
corticosteroid nasal sprays (fluticasone propionate)
side effect of these drugs are decreased growth in long term use by children
corticosteroid nasal spray
what are some of the side effects of cortiocosteroid nasal sprays?
nasal burning and irritation
) takes longer to receive full benefit and can be used for longer periods of time without rebound congestion
Corticosteriod- (fluticasone propionate)
It works in your nose to block the effects of substances that cause allergies (such as pollen, pet dander, dust mites, mold) and to reduce swelling
Corticosteriod- (fluticasone propionate)
Don’t use adrenergic nasal sprays longer than ___ days
3
Avoid with
Hypertension; uncontrolled cardiovascular disease; dysrhythmias
Narrow angle glaucoma
Stroke
adrenergic
Increase fluids if not contraindicated
Report fever over 100.4 F or any other symptoms (indicate infection)
lasting longer than 3-4 days
Caution with caffeine (adrenergic)
Smoking = vasoconstriction
Adrenergic: longer than 3 days, take oral preparation
If rebound congestion, taper use
Drops preferred for children (rather than nasal spray)
nursing notes for nasal decongestants
usually use a saline drop rather than a nasal decongestant in?
children
need to avoid caffeine with ___ meds (fast heart beat, restlessness or fidgeting)
adrenergic
what are the two types of anti tussives?
opioids, non-opioids
Suppress cough reflex
Analgesic and drying effect
opioids
non-opoid medication that suppresses cough reflex?
dextromethorphan
non-opioid medication that numbs receptor cells that cause cough?
benzonatate
can you drive while taking an opioid cough medicine?
no
what opioid antitussive is used?
codeine
what are the nonopiod antitussives?
dextromethorphan
benzonatate
[diphenhydramine]
when is the ONLY time you want to use an antitussive to suppress a cough?
when it is NON productive that interferes with sleep health or healing
t/f: May give cough medicine after surgery if the patient has a major cough to prevent them from coughing and busting open those sutures.
true
what are antitussives contraindicated in?
individuals at high risk for respiratory depression/sedation
trail elderly
those on other CNS depressants
opoid antitussives, concern with opioid dependency
Mild nausea, dizziness, and sedation
Euphoria in high doses
nonopioid antitussive adverse effects
CNS effects (Sedation, dizzy, lightheaded, respiratory depression)
GI effects (N/V, constipation)
Abuse potential
opioid adverse effects
Avoid drinking liquids within half hour of taking _____ of this form of antitussive
lozenge
t/f: avoid smoking with antitissives?
true
take oral codeine with?
food
how much water should you drink in a day with antitussives?
2-3 liters (helps with dry mouth and nose)
how do expectorants work?
Stimulate glands in respiratory tract
Breakdown and thin secretions in respiratory tract
are used for secretions in the bronchi and NOT in the nose
expectorants
what is the prototype expectorant?
guaifenesin
what are the adverse effects of expectorants?
GI upset
drowsy/dizzy
rash
used for thick secretions that need to be thinned
expectorant
what are drugs that interact with guaifenesin ?
none are known
Minimal adverse effects (Yay!)
Fluid intake of 2-3 liters a day if not contraindicated
Check OTC expectorants for ingredients and combinations
Report fever or cough that lasts more than a week
Short half life; repeat dosing
nursing notes for expectorants
Sometimes acetaminophen may be mixed in with ______ and we want to make sure they aren’t taking a mixed medication and separate acetaminophen.
If they are coughing longer than a week then we need to check for a different dx.
expectorants
used for babies and little kids to help them absorb inhalant
spacer
s/s: inflammation
bronchoconstriction
mucosal edema
viscous mucus
asthma
constriction of airway, mucus becomes thick, drying of the mucosa
symptoms of asthma
is destruction of the respiratory wall characterized by one or both: chronic bronchitis and emphysema
COPD -chronic obstructive pulmonary disease
what are the two indications that someone has COPD?
chronic bronchitis
emphesema
what are three indications for acetylcstine?
Acute and/or chronic pulmonary disorders with large amounts of secretions (cystic fibrosis/COPD)
Acetylcysteine (Mucomyst) is antidote for acetaminophen (Tylenol) poisoning
Prevent renal dysfunction due to administration of radiocontrast
acetylcystine is a ?
mucolytic
what are the mucolytics?
acetylcystine
hypertonic saline (3-7%)
How does it work?
Thin and liquefy mucus
Uses enzymes to break down mucus (some)
Muscle relaxant properties for easier expectoration (some)
Enhance flow of secretions in respiratory tract
how mucolytics work
crackles in the lungs- thins and liquifies the mucous so they are able to cough up the mucous.
mucolytics
this mucolytic smells like rotten eggs
acetylcysteine
Hx of hypothyroidism, CNS depression, renal or liver disease, seizure disorders, asthma
caution with mucolytics
Bronchospasm and possible aspiration of the liquid, sore throat, cough, dizziness, drowsiness, hypotension, tachycardia, hepatoxicity
adverse effects associated with acetylcysteine
Increased coughing, sore throat, chest tightness are adverse effects associated with?
hypertonic saline
If they already have severe asthma- acetylcysteine could cause a _______
bronchospasm (airway goes into spasm)
Fluid intake 2-3L per day unless contraindicated
Mix with fruit juices, sodas, water
Usual dosage: q 4 hours for 3 days
Monitor Labs
Liver function tests, PT, BUN, creatinine, glucose, electrolytes and acetaminophen levels
administration and education for mucolytics
prothrombin (PT) is an enzyme produced by?
the liver
what are the kidney function labs?
BUN, creatinine
What are the three different classes of bronchodilators?
beta adrenergic agonists
anticholinergics
xanthines
what are the beta2 adrenergic agonists?
albuterol
levabuterol
formoterol
salmeterol
terbutaline
these drugs work by relaxing smooth muscle in the airway
beta2 adrenergic agonists
these drugs imitate norepinephrine and quickly open airway
beta 2 adrenergic agonists
t/f: beta 2 adrenergic agonists can be short or long acting?
true
beta-adrenergic agonists work by ______ beta 2 adrenergic receptors in lungs
stimulating
which drug type and specific drug should a patient take when they immediately need help breathing?
short acting beta 2 agonist bronchodilators , albulterol
Contraindicated
Client with tachydysrhythmia/severe artery disease
High risk for stroke
Using MAOIs
Other sympathomimetics (epinephrine, norepinephrine, and dopamine or cocaine and methamphetamines)
contraindications with beta 2 agonist bronchodilators
______ is the most commonly used short acting beta specific beta agonist
Albuterol
alternative for patient with tachycardia
Less Beta 1 (cardiac) effects
More expensive
levabuterol
Frequent, large doses
Increase in cardiac side effects
Palpitations, increased HR
Anxiety, tremors, nausea
albuterol
Assess for chest, jaw, or arm pain or palpitations and notify the provider if they occur (cardiovascular problem?)
Check pulse, report an increase of greater than 20-30 beats/min
Teach patient how to use inhalers, spacers, etc. and which medication is “rescue” and which one is “prevention”
nursing notes for albuterol
Albuterol inhaler works in _______ minute(s). Inhale as they push the button. Hold breath and then slowly let it out slowly.
1 minute
acetycholine causes broncho______
chronchoconstriction
_________ block acetylcholine receptors = indirect bronchodilation
Anticholinergics
t/f: inhaled anticholinergics reduce secretions in respiratory tract
true
Prevents bronchospasm
Not for acute symptom management
inhaled anticholinergics
Airway relaxation and dilation. Can indirectly reduce secretions.. Dry them up.
inhaled anticholinergics
what are the two inhaled anticholinergics?
ipratropium
tiotropium
Used for the prevention of bronchospasm and not for management of acute symptoms
anticholinergic bronchodilators
Peanuts, soy allergy (this would only be because of an inactive ingredient- shouldn’t be in new formulations)
contraindications for anticholinergic bronchodilators
Narrow-angle glaucoma and benign prostatic hypertrophy
Taking other _______
anticholinergic bronchodilators
Rinse mouth after administration due to unpleasant taste and to prevent oral yeast infection
Manage ______ effects
Wait____minutes between puffs for same inhaler
Wait _____ minutes between different types of inhaler
Not a rescue inhaler
anticholinergic
1-2
2-5
Increases cyclic adenosine monophosphate (cAMP) levels
Smooth muscle relaxation (bronchial dilation)
Decreases allergic reaction
Enhances respiratory drive
how xanthines work
Higher levels of ______ _____ _____ contribute to smooth muscle relaxation
cyclic adenosine monophosphate
relax smooth muscle and dilates bronchi, decreases allergic reaction, and enhances respiratory drive (opens up the airways)
xanthines
What are the two xanthine examples?
methylxanthines
theophylline
Increases the ease of breathing. These decrease seizure threshold so they can cause seizures should not be used in someone who already has seizures
xanthines
May be used for asthma (often allergy related) or COPD. Slow onset medication.
xanthines
what are the indications for xanthines?
mild to moderate asthma
COPD adjunct
are xanthines a rescue drug?
no, they are not
Contraindications
History of uncontrolled cardiac dysrhythmias
History of peptic ulcer disease or seizure disorders
History of hyperthyroidism
contraindications with xanthines
what is the therapeutic blood level of theophylline?
5-15 mcg/mL
adverse effects associated with theophylline occur with drug levels of ?
20-25 mc/mL
adverse cardiac effects are more frequent with levels above ______ with theophylline
30mcg/mL
______ can be seen with theophylline levels above 40 mcg/mL
seizures
what do you do with an overdose of theophylline?
stop med
administer activated charcoal
monitor vitals
seizure precautions
______ are now deemphasized because of their potential for drug interactions and the interpatient variability in therapeutic drug levels in the blood.
Xanthines
CNS - confusion, tremors, dizziness, hallucinations, restlessness, agitation, headache, insomnia
GI - N/V, anorexia, stomach cramps, diarrhea, increased urination
CV - palpitations, tachycardia, arrhythmias, chest pain, flushing
toxicity/overdose to theophylline
GI
N/V, anorexia, gastroesophageal reflux during sleep
Cardiovascular
Tachycardia, palpitations, dysrhythmias
Others
Temporary hyperglycemia and increase in urination
side effects of theophylline
Dosages usually started low and titrated up to relieve symptoms
Aminophylline IV occasionally used for Status Asthmaticus
If used with oral contraceptives or some antibiotics can increase blood levels
xanthines
Aminophylline IV occasionally used for ______ _____
Status Asthmaticus
Drink 2-3 liters to decrease viscosity of secretions
Minimize intake of xanthine containing foods (colas, coffee, chocolate).
Notify prescriber of any signs/symptoms of toxicity
patient education for xanthines
what are the non broncho dilating respiratory medication classes?
leukotriene receptor antagonists
mast cell stabilizers
corticosteroids/glucocorticosteroids
are leukotriene modifiers bronchodilators?
no
what are the three leukotriene modifiers?
montelukast
zafirlukast
zileuton
Allergen -> _________ are released - >inflammation + bronchoconstriction + mucus production = ->Coughing, sneezing, wheezing, and shortness of breath!
Inhibits an enzyme or blocks receptor sites
Also prevents migration of neutrophils and lymphocytes (keep from going to lungs)
how leukotriene modifiers work
Prevent asthma attacks, NOT for current acute attacks
Chronic treatment of asthma in adults and teens
Drug effects primarily limited to lungs:
Prevent smooth muscle contraction of bronchial airways
Decrease mucus secretions
Reduce vascular permeability = decreases edema
improvement is usually seen in ~a week
leukotriene modifier indication
Allergy to povidone, lactose, titanium dioxide, cellulose derivatives (inactive ingredients in drug)
contraindications for leukotriene modifiers
Liver injury with use of zileuton (zyflo) and zafirlukast (accolate)
Normal AST is 0-45 IU/liter, Normal ALT is 0-40 IU/liter
Hold the medication if AST/ALT levels 3x higher
Check PT/INR
contraindications for leukotriene modifiers
IT IS MAINLY _______ THAT CAUSES LIVER INJURY WHEN GIVEN WITH a leukotriene
WATCH LIVER ENZYMES
ZILEUTON
PT/INR
measures how long it take your blood to clot
Liver Dysfunction is associated with which leukoriene modifier?
zafirlukast
this leukotriene modfier causes dizzines, insomnia, liver dysfunction
zileuton
this leukotriene modfier causes heartburn
montelukast
what are adverse side effects of all leukotriene modifiers?
headache, nausea, eiarrhea, sucicdal ideation, depression
Zileuton 1 hr before or after a meal
Avoid taking Zafirlukast with food
Take Montelukast once daily at bedtime
For exercise‑induced bronchospasm, take 2 hr before exercise
Monitor liver function tests, PT, and INR
DARK URINE, ITCHING, JAUNDICE, ABDOMINAL PAIN & SWELLING, CLOTTING ISSUES,
Monitor for signs of liver damage
How would you know?
leukotriene modifier nursingg notes
what are s/s of liver damage?
Yellow skin and eyes
Itching
Dark urine
Abdominal pain and swelling
Elevated liver enzymes (AST and ALT)
Prolonged PT and increased INR (time required to form a clot)
Yellow skin and eyes
Itching
Dark urine
Abdominal pain and swelling
Elevated liver enzymes (AST and ALT)
Prolonged PT and increased INR (time required to form a clot)
signs of liver damage
do inhaled corticosteroids bronchodilate?
no, they do not
Anti-inflammatory effects
Stabilizes cell membranes that release bronchoconstricting substances
Less inflammatory mediators released from Leukocytes
Restores responsiveness of bronchial smooth muscle to beta adrenergic receptor stimulation
Better stimulation of Beta 2 receptors by Beta agonist drugs
how inhaled corticosteroids work
what are the inhaled glucocorticoid steroids?
fluticaseone and salmeterol
methyl prednisone IV
what are oral glucocorticoid steroids?
prednisone
prednisolone
what are IV glucocorticoid drugs?
hydrocortisone
methylprednisolone
how is methylprednisolone usually administered?
it is usually given IV
what are the indications for inhaled corticosteroids?
status asthmaticus
long term prophylaxis of asthma
bronchitis
COPD
Cystic fibrosis
severe asthma
It may take several ______ of inhaled corticosteroid for real effects to be seen.
weeks
contraindicated in client with infections or suppressed immune systems:
Systemic fungal infections, AIDS, tuberculosis (TB)
Positive sputum test for Candida organisms
Those who have received a live virus vaccine
contraindications for corticosteroids
Common Inhaled Effects:
Pharyngeal irritation/sore throat
Coughing
Dry mouth
Oral fungal infections such as thrush (candidiasis)
common INHALED corticosteroid effects
Suppression of adrenal gland function
Bone loss FOR CHILDREN
Hyperglycemia and glycosuria
Infection
adverse effects associated with corticosteroids
Oral doses may need to be increased during times of stress (long term treatment)
Oral ________ are used short‑term, 3 to 10 days
Rinse mouth after using inhaled ________
Take bronchodilator inhaler 2-5 minutes before ________ inhaler
Use as a maintenance drug, not a rescue drug
corticosteroid
stabilize ______ cell membranes to prevent release of inflammatory mediators such as histamine
mast
are mast cell stabilizers rescue ihalers or for long term control?
for long term control
3-5 minutes after rescue inhaler
OB/breastfeeding: Safety not established
Pedi- Children under 2: safety not established
More often used for mild persistent asthma
medication is not used a lot anymore
do not work as well as inhaled corticosteroids
mast cell stabilizers
Desired effect is Improved airflow in the air passages
Increased oxygen supply
Perform a thorough assessment of respiratory status-
Skin color, temperature
Respiratory rate, depth, rhythm
Breath sounds
Blood pressure, pulse
Signs and symptoms of respiratory distress
Pulse ox
assessment with any respiratory drugs
______ REACTS WITH MANY MEDS AND CAN CAUSE VASO CONSTRICTION AND EXASERBATES RESPIRATORY ISSUES
NICOTINE
May take longer to deliver than MDI
May be more effective in some patients
nebulizer
Less portable
Can be easier to get doses for small children (under 8) who are unable to use inhaler correctly.
More expensive (DME)
They require more cleaning.
nebulizer
Used to monitor a patient’s ability to breathe out air
peak flow meter
red zone for peak flow meter
50% or less
yellow zone for peak flow meter
50-80%
green zone for peak flow meter
> 80%
