Respiratory Meds Flashcards
Guidelines for inhaled medication regimen
Take beta2 agonist before inhaled glucocorticoid to increase steroid absorption
Steps for taking inhaled medications (7)
- Remove cap on mouthpiece
- If needed shake medication
- Standup/sit upright and exhale deeply
- Place mouthpiece between teeth and close lips tightly around inhaler
- Breathe in while pressing down on inhaler to release medication continue breathing slow/long/steady breaths for several seconds
- Hold breath for 5-10 seconds
- Breathe in/out normally
Beta2 adrenergic agonists action
Promote bronchodilation by activating beta2 receptors in bronchial smooth muscle
Beta2 adrenergic agonists meds (4)
- Albuterol
- Formoterol
- Salmeterol
- Terbutaline
Albuterol route and onset
- Inhaled
- Short acting
- 5-10 minutes
Albuterol use
- Acute bronchospasm
Formoterol/salmeterol use
Long term control of asthma
Formoterol onset and duration
- Onset: 1-3 minutes
- Duration: 10 hours
Salmeterol onset and duration
- Onset: 10-20 minutes
- Duration: 12 hours
Formoterol/salmeterol route
- Inhaled
- Long acting
Beta2 adrenergic agonists precautions (4)
- Don’t use in patients with tachydysrhythmias
- Use caution in patients with diabetes, hyperthyroidism, heart disease, HTN, angina
- Beta blockers reduce effectiveness
- MAOIs increase effectiveness
Beta2 adrenergic agonists side/adverse effects (3)
- Tachycardia
- Palpitations
- Tremors
Beta2 adrenergic agonists precaution
- Don’t use salmeterol more frequently than every 12 hours
Methylxanthines action
Relaxes bronchial smooth muscle causing bronchodilation
Methylxanthines meds (2)
- Aminophylline
- Theophylline
Therapeutic uses of methylxanthines (2)
- Relieve bronchospasm
- Long term control of asthma
Precautions for methylxanthines (5)
- Don’t use in patients with active peptic ulcer disease
- Use caution in patients with diabetes, hyperthyroidism, heart disease, HTN, angina
- Don’t mix parenteral form with other medications
- Phenobarbital/phenytoin decrease theophylline levels
- Caffeine, furosemide, cimetidine, fluoroquinolone, acetaminophen, phenylbutazone cause false elevated levels
Side/adverse effects of methylxanthines (2)
- Irritability
- Restlessness
Toxic effects of methylxanthines (3)
- Tachycardia
- Tachypnea
- Seizures
Nursing interventions for methylxanthines (5)
- Monitor therapeutic levels
- Avoid caffeine
- Monitor for signs of toxicity
- Smoking decreases effects
- Alcohol abuse increases effects
How to treat methylxanthines toxicity (4)
- Stop infusion
- Give activated charcoal to decrease absorption in oral overdose
- Give lidocaine for dysrhythmias
- Give diazepam to control seizures
Inhaled anticholinergics action
Blocks muscarinic receptors causing bronchodilation
Inhaled anticholinergics meds (2)
- Ipratropium
- Tiotropium
Therapeutic uses for inhaled anticholinergics (3)
- Prevent bronchospasm
- Manage allergen/exercise induced asthma
- COPD
Precautions for inhaled anticholinergics (3)
- Don’t use in patients with peanut allergies (contains soy lecithin)
- Use caution in patients with narrow angle glaucoma, BPH
- Don’t use for treatment of acute bronchospasms
Side/adverse effects of inhaled anticholinergics (2)
- Dry mouth/eyes
- Urinary retention
Nursing interventions for inhaled anticholinergics (4)
- Maximum effects can take 2 weeks
- Shake inhaler well before giving
- When using 2 different inhaled medications wait 5 minutes between
- Use within 1 hour of reconstituting nebulized medication
Glucocorticoids action
Prevent inflammatory response by suppressing airway mucus production, immune responses, and adrenal function
Oral glucocorticoid medications (3)
- Prednisone
- Prednisolone
- Betamethosone
Inhaled glucocorticoid medications (4)
- Beclomethasone dipropionate
- Budesonide
- Fluticasone propionate
- Triamcinolone acetonide
IV glucocorticoid medications (3)
- Hydrocortisone sodium succinate
- Methylprednisolone sodium succinate
- Betamethasone sodium phosphate
IV short term respiratory use of glucocorticoids
- Status asthmaticus
Oral short term respiratory use of glucocorticoids
- Treat symptoms following acute asthma attacks
Inhaled long term respiratory use of glucocorticoids
Asthma prophylaxis
Oral long term respiratory use of glucocorticoids
Treat chronic asthma
Glucocorticoids precautions (2)
- Diabetic patients might need higher doses
- Don’t stop abruptly
Side/adverse effects of glucocorticoids (8)
- Euphoria
- Insomnia
- Psychotic behavior
- Hyperglycemia
- Peptic ulcer
- Fluid retention
- Withdrawal symptoms
- Increased appetite
Nursing interventions for glucocorticoids (4)
- Assess activity and behavior
- Give with meals
- Don’t take NSAIDS
- Teach client to gradually reduce dose to prevent Addisonian crisis
Leukotriene modifiers action
Prevent effects of leukotriene resulting in decreased inflammation, bronchoconstriction, airway edema, and mucus production
Leukotriene modifiers medications (3)
- Montelukast
- Zileuton
- Zafirlukast
Therapeutic uses of leukotriene modifiers (2)
- Long term management of asthma in adults and kids
- Prevent exercise induced bronchospasm
Precautions for leukotriene modifiers (4)
- Don’t use for acute asthma attacks
- Zileuton/zafirlukast have high risk of liver disease, increased warfarin effects, theophylline toxicity
- Phenobarbital decrease circulating levels of montelukast
- Chewable tablets have phenylalanine
Side/adverse effects of leukotriene modifiers (3)
- Elevated liver enzymes
- Warfarin/theophylline toxicity
- Increased levels of beta blockers causing hypotension/bradycardia
Nursing interventions for leukotriene modifiers (5)
- Never abruptly substitute for corticosteroid therapy
- Take daily in the evening
- Don’t decrease/stop taking other medications for asthma
- Mix oral granules with cold soft foods or pour directly into mouth
- Use open packets within 15 minutes of taking medication
Antitussive medications (2)
- Hydrocodone
- Codeine
Antitussive action
- Suppress cough through action in CNS
Therapeutic use of antitussive medications
- Chronic non-productive cough
Expectorant medications (1)
- Guaifenesin
Expectorant medication action
- Promote increased mucus secretion to increase cough production
Therapeutic use of expectorant medications
- Combined with other medications to manage respiratory disorders
Mucolytic medications (2)
- Acetylcysteine
- Hypertonic saline
Mucolytics action
Enhance flow of secretions in respiratory tract
Therapeutic use of mucolytics (3)
- Acute/chronic pulmonary disorders with copious secretions
- Cystic fibrosis
- Antidote for acetaminophen poisoning
Antitussives, expectorants, mucolytics precautions (3)
- Saline solutions only used in kids younger than 2 years
- Opioid antitussives can lead to abuse
- Caution with OTC medications for potentiate effects
Side/adverse effects of antitussives, expectorants, mucolytics (4)
- Drowsiness
- Dizziness
- Aspiration/bronchospasm risk with mucolytics
- Constipation
Antitussives, excpectorants, mucolytics (5)
- Monitor cough frequency, effort, ability to expectorate
- Monitor character and tenacity of secretions
- Auscultate for adventitious breath sounds
- Educate on the importance of needing multiple therapies
- Promote fluid intake
Decongestant medications (3)
- Phenylephrine
- Pseudoephedrine
- Naphazoline
Decongestant medications action
Stimulate alpha1 adrenergic receptors causing reduced inflammation of nasal membranes
Therapeutic uses of decongestant medications (3)
- Allergic rhinitis
- Sinusitis
- Common cold
Antihistamine medications (5)
- Diphenhydramine
- Loratidine
- Cetirizine
- Fexofenadine
- Desloratidine
Antihistamine action
Decrease allergic response by competing for histamine receptor sites
Therapeutic use of antihistamines
- Relieve/prevent hypersensitivity reactions
Decongestants/antihistamines precautions (4)
- Use caution in patients with HTN, glaucoma, peptic ulcer disease, urinary retention
- Children could have hallucinations, incoordination, seizures
- No alcohol
- Products having pseudoephedrine shouldn’t be used longer than 7 days
Side/adverse effects of decongestants/antihistamines (2)
- Anticholinergic effects
- Drowsiness
Nursing interventions for decongestants/antihistamines (4)
- Assess for hypokalemia
- Monitor bp
- Teach how to manage anticholinergic effects
- Take at night
