Respiratory Medications

Question 1

Bronchodilators

Answer 1

Albuterol *
Terbutaline *
Ipratropium (anticholinergic)
Theophylline
Levosalbutamol

Question 2

Albuterol

Answer 2

Therapeutic class: Bronchodilator; short acting beta 2 agonist

Indication: Asthma, COPD

Action: Binds to Beta2 adrenergic receptors in airway = relaxation of the smooth muscles in the airways

Nursing Considerations:
● Be very cautious when using in clients w/ ♡ disease, diabetes, glaucoma, or seizures
● Causes tachycardia (expected)

Question 3

Terbutaline

Answer 3

Therapeutic Class: Selective Beta 2 adrenergic agonist

Indication: rescue/relief + maintenance drug for wheezing, SOB, coughing caused by asthma

Action: Blocks Beta 2 receptors in resp. sys. = bronchodilation by inhibiting release of hypersensitivity reaction products from mast cells; ALSO works on beta 2 receptors that are in the uterus to slow/stop premature contractions

NC:
- SE: shakiness, jittery, tachycardia, drowsy, sleep disturbances, HA/N/V, ↑ BP + BS, CNS overstim.
- Assess HR, BP, EKG, BG
- Can be given PO, SC, inhaler 4-6 hr duration → more SE w/ PO d/t ↑ dosage
- Monitor HR of mom + baby when used in labor - monitor FHR strips closely
- Teach proper inhaler use

Question 4

Long-term/ Misc. Resp. Medications

Answer 4

Long-term:
*Montelukast → leukotriene modifier - blocks leukotrienes from over responding to triggers
Theophylline - must be used regularly, helps keep bronchioles open
Allergen control
Inhaled corticosteroids → budesonide, fluticasone (daily)

Misc.:
*Guaifenesin → expectorant
Acetylcysteine → mucolytic
Psuedoephedrine, phenylephrine → decongestant
Antitussives → dextromethorphan, codeine

Question 5

What’s often given to respiratory clients?

Answer 5

Corticosteroids + Antihistamines

Question 6

Methylprednisone

Answer 6

Therapeutic Class: Corticosteroids

Indication: Inflammation, allergy, autoimmune disorders

Action: Suppress inflammation + normal immune response

NC:
- Monitor for too much steroids - Cushing’s syndrome (buffalo hump, moon face, trunk obesity)
- SE
- Immunosuppression - delayed wound healing
- Hyperglycemia
- Osteoporosis

Question 7

Diphenhydramine

Answer 7

Therapeutic Class: Antihistamine

Indication: Allergy, anaphylaxis, sedation

Action: Antagonizes effects of histamine, CNS depression

NC:
- Monitor for drowsiness
- Anticholinergic effects (can’t see, can’t pee, can’t spit, can’t shit) [constipation, urinary retention, constipation, dry eyes + mouth]

Question 8

Pulmonary Embolism

Answer 8

Dx:
- Pulmonary angiography - most sensitive + specific test for PE ***
- Computerized tomography angiogram (CTA) - most freq. used test to dx PE! - uses a dye so check renal fx
- If pt has renal issues → (+) VQ scan - does NOT use dye, pt. needs to be able to follow instructions
- ↑ D-dimer - can tell if clot is located anywhere in the body

Anticoagulants Bleeding Precautions:
- Warfarin (vit. K antagonist)
- Heparin / Dabigatran / Enoxaparin (thrombolytic)
- Rivaroxaban or Fondaparinux (factor Xa inhib.)
- tPA or Alteplase (fibrinolytic agent [helps dissolve embolus])

• Pulm. embolectomy if pt. has embolus + not a candidate for fibrinolytics
• Inferior vena cava filtration device - prevents clots from getting into pulm. sys. (anticoagulation contraindicated)