Respiratory Meds Flashcards
Beta Agonists
Short acting:
- Albuterol (inhaled, short-acting, lasts 5 to 15 mins, treats acute bronchospasm)
- Cromolyn (10 - 15 mins before exercise)
Long acting:
- Formoterol (inhaled, long-acting, lasts 10 hours, starts working in 1-3 mins., treats long-term control of asthma)
- Salmeterol (inhaled, long-acting, lasts 12 hours, starts working in 10-20 mins., treats long-term control of asthma)
- Terbutaline (oral, lomg-acting, treats long-term control of asthma)
Facts:
- work on bronchial smooth muscle and promote bronchodilation
- do not give to patients with tachydysrythmias, hyperthyroidism, hypertension, angina, or heart disease
- beta blockers will reduce effects (do the opposite, especially nonselective that work on muscles and organs)
- MAOIs will increase effects
- do not use salmeterol more than once every 12 hours
- tachycardia, tremors, palpitations may occur
Methylxanthines
- Aminophylline
- Theophylline
Facts:
- bronchodilators
- long-term control of asthma
- do not give to patients with peptic ulcer disease
- phenobarital and phenytoin decrease theophylline
- caffeine, furosemide, cimetidine, fluorquinolones, acetaminophen, and phenylbutazone falsely elevate therapeutic levels
- toxicity can cause tachycardia, tachypnea, and seizures
- toxicity: stop parental infusion, activated charcoal to decrease absorption in oral overdose, lidocaine for dysrhythmias, diazepam to control seizures
Anticholinergics
- Ipratropium
- Tiotropium
Facts:
- Cause bronchodilation
- PREVENT acute bronchospasms, not treat
- manage allergen or exercise induced asthma
- treats COPD
- do not give to patients with peanut allergy or soy
- caution with patients who have BPH and narrow-angle glaucoma
- ANTI-cholinergic = DRY (can’t spit, can’t shit, can’t see, can’t pee)
- maximum effects may take up to 2 weeks
- shake inhaler well before
- wait 5 min when using different inhaled medications
Glucocorticoids
Oral:
- prednisone
- betamethasone
Inhalation:
- beclamethasone
- budesonide
- Fluticasone
- propionate
Intravenous:
- hydrocortisone sodium succinate
Facts:
- short term IV agents for status asthmaticus
- short term oral agents for symptoms following an acute attack
- long term oral agents for chronic asthma
- long term inhalation use for prophylaxis of asthma
- patients with diabetes may need higher doses
- don’t stop abruptly
- can cause hyperglycemia, peptic ulcers, insomnia, fluid retention, inceased appetite
- give with meals
- do not take with NSAIDs
- addesonian crisis may occur with long term oral use (hypotension, hypoglycemia, fatigue, weakness)
Leukotriene Modifiers
- Montelukast (for ages 1+)
- Zafirlukast (for ages 5+)
- Zileutron (for ages 12+)
Facts:
- used for long-term management of asthma
- montelukast only available as tablet or granules
- Zs: high risk for liver disease, increased warfarin effects, theophylline toxicity
- Montelukast: phenobarbital will decrease effects, take directly in mouth or mix with cold soft foods (not liquids)
- take daily in the evening
Antitussives, Expectorants, Mucolytics
Antitussives: suppress cough
- hydrocodone
- codeine
Expectorants: promote mucus secretion to increase cough production
- guaifenesin
Mucolytics: enhance flow of secretions in respiratory tract
- acetylcysteine
- hypertonic saline
Facts:
- only saline solutions should be used for children less than 2 years old
- aspiration and bronchospasm risk with mucolytics
- promote fluid intake
- constipation and drowsiness