Respiratory Meds Flashcards
Beta2 Adrenergic Agonists
-rol
albuterol, formoterol, salmeterol, terbutaline
Uses:
- albuterol: inhaled short acting for acute bronchospasm
- Formoterol, salmeterol: inhaled long acting; long term control of asthma
- F - onset 1-3 min; 10 hr
- S - onset 10-20 minutes; 12 hr
- Terbutaline: Oral (long-acting); long term control of asthma
Precautions/interactions:
- Contraindicated for clients with tachydysrhythmias
- Caution: DM, hyperthyroidism, heart disease, HTN, angina
- Beta blockers will reduce effects
- MAOIs will increase effects
side/adverse effects:
- tachycardia, palpations
- tremors
Nursing interventions/education:
-Caution against using salmeterol more frequently than every 12 hours
Methylxanthines
-lline
Aminophylline, theophylline
Uses:
- relief of bronchospasm
- long-term control of asthma
Precautions/interactions;
- contraindicated with active peptic ulcer disease
- caution: DM, hyperthyroidism, heart disease, hypertension, angina
- do not mix parenteral form with other medications
- phenobarbitol and phenytoin decrease theophylline levels
- Caffeine, lasix, cimetidine fluoroquinolones, acetaminophen, and phenylbutaone falsely elevate therapeutic levels
Side/adverse effects:
- irritability and restlessness
- toxic effects: tachycardia tachypnea, seizures
nursing interventions/education:
- monitor therapeutic levels for aminophylline and theophylline
- avoid caffeine intake
- monitor for signs of toxicity
- smoking will decrease effects
- alcohol abuse will increase effects
Treatment of toxicity:
- stop parenteral infusion
- activated charcoal to decrease absorption in oral overdose
- lidocaine for dysrhythmias
- diazepam to control seizures
Inhaled anticholenergics
-pium
Ipratrtopium, Tiotropium
Uses:
- prevent bronchospasm
- manage allergen or exercised induced asthma
- COPD
Precautions/interventions:
- contraindicated for clients with peanut allergy (contains soy)
- Use extreme caution with arrow-angle glaucoa and BPH
- do not use for treatment of acute bronchospasms
Side/adverse effects:
- dry mouth and eyes
- urinary retention
Nursing interventions/education
- instruct client that maximum effects may take up to 2 weeks
- shake inhaler well before administration
- when using two different inhaled meds, wait 5 mins
- if administered via nebulizer, use within 1 hr of reconstitution
Glucocorticoids
-sone
Oral: predisone, prednisolone, betamethasone
Inhalation: Beclomethasone dipropionate, Budesonide, fluticasone propionate, triamcinolone acetonide
Uses:
- short term;
- IV agents: status asthmaticus
- Oral: treatment of symptoms following an acute asthma attack
- long term:
- inhaled: prophylaxis of asthma
- Oral: treatment of chronic asthma
Precautions/interactions:
- clients who have DM may require higher doses
- never stop medication abbruptly
Side/adverse effects:
- euphoria, insomnia, psychotic behavior
- hyperglycemia
- peptic ulcer
- fluid retention
- withdrawal symptoms
- increased appetite
Nursing interventions/education:
- assess activity and behavior
- administer meds with meals
- teach symptoms to report
- do not take with NSAIDs
- teach client about gradual reduction of doose to prevent addisonian crisis
Leukotriene modifiers
-kast
Montelukast, Zileuton, Zafirlukast
Uses:
- long term managment of astha in adults and children
- Montelukast can be gven to clients over the age of 1
- Zileuton can be given to clients 12 years and older
- Zafirlukast can be given to clients 5 years and older
- prevention of exercises-induced bronchospasm
Precautions/interactions:
- do not use for acute asthma attack
- Zileuton or zafirlukast: high risk of liver diease, increased warfarin effects, and theophylline toxicity
- phenobarbital will decrese circulating levels of montelukast
- chewable tablets contain phenylalanine
side/adverse effects:
- elevated liver enzymes (zileuton or zafirlukast)
- warfarin and theophylline toxicity (zileuton or zafirlukast)
- may increase levels of beta blockers leading to hypotension and bradycardia (propranolol)
Nursing interventions/education:
- never abruptly substitute for corticosteroid therapy
- teach client to take daily in the evening
- do not decrease or stop taking other prescribed asthm drugs until instructed
- if using oral granules, pour directly into mouth or mix with cold soft foods (never liquids)
- use open packes within 15 min of taking medication
Antitussives, Expectorant, Mucolytics
antitussives: Hydrocodone, codeine
Expectorants: guaifenesin
Mucolytics: acetylcysteine, hypertonic saline
Use:
- antitussives: chronic nonproductive cough
- expectorants: often combined with other agents to manage respiratory disorders
- Mucolytics: acute and chonic pulmonary disordrs with copious secretions; cystic fibrosis; antidote for acetaminophen poisoning
Precautions/interactions:
- only saline solutions should be used in children younger than 2 years
- opiod antitussives have potential for abuse
- caution with OTC meds - potentiate effects
Side/adverse effects:
- drowsiness
- dizziness
- aspiration and bronchospasm risk with mucolytics
- constipation
Nursing interventinos/education:
- monitor cooough frequency, effort, and ability to expectorate
- monitor character and tenacity of secretions
- auscultate for adventitious lung sounds
- teach client why multiple therapies are needed
- promote fluid intake
Decongestants, antihistamines
Decongestants: phenylephrine, pseudoephedrine, naphazoline
Antihistamines: Diphenhydramine, loratadine, cetirizine, fexofenadine, desloratidine
Uses:
- Decongestants: allergic rhinitis, sinusitis, common cold
- antihistamines: relieve/prevent hypersensitivity reactions
Precautions/interactions:
- use cautiously in clents with HTN, glaucoma, peptic ulcer disease, and urinary retention
- children may have symptoms of exitation, hallucinations, incoordination, and seizures
- avoid alcohol intake
- products containing pseuoephedrine should not be used longer than 7 days
side/adverse effects:
- anticholinergic effects
- drowsiness
Nursing interventions/education:
- assess for hypokalemia
- monitor blood pressure
- teach client to manage anticholenergic effects
- advise to take at night
