Week 5 - Altered Oxygen/ Respiratory Function (12/8/16) Flashcards
Chapter 17: Airflow Disorders
Beta_2-adrenergic agonists Methylxanthines Inhaled Anticholinergic Glucocorticoids Leukotriene modifiers
most important medicine
oxygen
Oxygen toxicity
Can result form high concentrations of oxygen (typically greater than 50%), long durations of oxygen therapy (typically more than 24-48 hours), and the severity of lung disease
Oxygen devices
Nasal cannula Simple face mask Partial rebreather mask Nonrebreather mask Venturi mask Aerosol mask
what is FiO2
amount of air per breath per type of oxygen devices
Maximum oxygenation for Nasal Cannula
FiO2
24%-44%
flow rate
1-6 L/min
rebreather
40%-70%
6-10L/min
nonrebreather
60%-100%
10-15 L/min
ventori mask
24%-60%
4-12 L/min
Beta2-adrenergic agoinists
Prototype med: Albuterol Purpose: dilate bronchioles Therapeutic use: - prevention of asthma - treatment for bronchospasm - long-term control of asthma S/E: - tachycardia - tremors Contraindications: - Pregnancy Risk Category C - Do not give to patients with dysrhythmias Nursing Administration: - nurse can give breathing treatment - listen to lung sounds before / after - patient get oral care after treatment (oral thrush) --- Nystatin [antifungal] - check heart rate before - tachycardia
Beta2-adrenergic agonists
prototype medication
other medications
prototype: Albuterol
other; formoterol, levalbuterol, salmeterol, terbutaline
Beta2-adrenergic agonists
purpose
bronchodilation
Beta2-adrenergic agonists
therapeutic uses
Albuterol, levalbuterol
- prevention of asthma episode (exercise-induced)
- inhaled, short-acting, used for prevention of asthma
- treatment for bronchospasm
- long-term control of asthma
Formoterol, salmeterol
- long-term control of asthma
Terbutaline
- long-term control of asthma
Beta2-adrenergic agonists
S/E
- Tachycardia, can lead to angina (stop giving it)
- Tremors (transient)
Beta2-adrenergic agonists
Contraindications (pregnancy risk)
Category C
Beta2-adrenergic agonists
Nursing administration
- assess patient
- nurses can give breathing treatment
- listen to lung sounds before / after
- patient get oral care after treatment (oral thrush)
- –Nystatin [anti fungal]
- check heart rate after - tachycardia
Methyxanthines
prototype: Theophylline
therapeutic level: 10-20
purpose: bronchodilation
therapeutic use: oral theophylline is used for long-term control of chronic asthma or COPD
S/E:
- mild toxicity reaction can include GI distress and restlessness
- toxicity: cardiotoxicity and seizures
— mesaure serum levels
Contraindications:
- pregnancy risk category C
- clients who have heart disease, HTN, liver/kidney dysfxn, and diabetes mellitus
Interaction:
- caffeine
Nursing administration:
- advise client to take medication as prescribed
— if a dose is missed, the following dose should not be doubled
- instruct not to chew or crush sustained-release preparations
Methylxanthines
therapeutic level
10-20
Methylxanthines
prototype medication
theophylline
Methylxanthines
Purpose
bronchodilation
Methylxanthines
Therapeutic use
used for long term control for chronic asthma and COPD
Methylxanthines
S/E
S/E:
- mild toxicity reaction can include GI distress and restlessness
- toxicity: cardiotoxicity and seizures
— mesaure serum levels
Contraindications:
- pregnancy risk category C
- clients who have heart disease, HTN, liver/kidney dysfxn, and diabetes mellitus
Interaction:
- caffeine
Nursing administration:
- advise client to take medication as prescribed
— if a dose is missed, the following dose should not be doubled
- instruct not to chew or crush sustained-release preparations
MEthylxanthines
contraindications
Contraindications
- preg C
clients who have heart disease, HTN, liver/kidney dysfxn, and diabetes mellitus
Methylxanthines
interactions
caffeine
Methylxanthines
Nursing administration
- advise client to take medication as prescribed
- – if a dose is missed, the following dose should not be doubled
- instruct not to chew or crus sustained-release preparations
Leukotriene modifiers
S/E
contraindications
S/E
- depression, suicidal thoughts
- hepatotoxicity (zileuton and zafirlukast)
contraindications:
pregnancy category B (montelukast and zafirlukast)
pregnancy category C (zileuton)
Leukotriene modifiers
interactions
nursing administration
interactions
- zileuton and zafirlukast inhibit metabolism of warfarin and theophylline, leading to increased warfarin and theophylline levels
- montelukast used concurrently with phenytoin can inhibit effects of montelukast
nursing administration:
- food prevent absorption
- advise clients to take zileuton as prescribed, 1 hour before or 2 hours after meals
Leukotriene modifiers
interactions
nursing administration
interactions
- zileuton and zafirlukast inhibit metabolism of warfarin and theophylline, leading to increased warfarin and theophylline levels
- montelukast used concurrently with phenytoin can inhibit effects of montelukast
nursing administration:
- food prevent absorption
- advise clients to take zileuton as prescribed, 1 hour before or 2 hours after meals
Antitussives: Opioids
prototype
other
purpose
therapeutic use
prototype
Codeine
other: hydrocodone
purpose
suppresses cough through its action on the CNS
therapeutic use
used for chronic nonproductive cough to decrease the frequency and intensity
Antitussives: Opioids
S/E
- CNS effects (dizziness, lightheadedness, drowsiness, respiratory depression)
- GI distress (nausea, vomiting, constipation)
- Opioid use disorder
Antitussives: opioids
contraindication
nursing administration
contraindication
preg risk C
contraindicated in clients who have resp depression, acute asthma, head trauma, liver/renal dysfxn, acute alcohol use disorder
nursing administration
- advise to avoid activities that require alertness
- advise to change positions slowly
- avoid alcohol and other CNS depressants
Antitussives: nonopioids
prototype
other
purpose
therapeutic use
prototype Dextromethorphan (robutussin) other benzonatate diphenhydramine
purpose
suppresses cough
therapeutic use
cough suppression
ANtitussives: nonopioids
S/E
- mild nausea, dizziness, sedation can occur
- GI: nausea
- medicine does not work for kids
Antitussives: nonopioids
contraindication
nursing administration
contraindication
preg risk C
nursing administration
Expectorants
prototype
purpose
therapeutic use
prototype: Guaifenesin (Mucenix)
purpose
promotes increased cough production by increasing and thinning mucous secretions
(allow decrease chest congestion by coughing out secretions)
therapeutic use
Expectorants
S/E (are mild)
- GI upset
- drowsiness, dizziness
- allergic reaction (rash)
- doesn’t work for pediatrics
- – (kids just need fluids and rest)
Expectorants
contraindication
nursing administration
contraindication
preg risk C
nursing administration
advise to increase fluid intake when taking guaifenesin
Mucolytics
prototype
other
purpose
therapeutic use
prototype
acetylcysteine
other
hypertonic saline
purpose
thin and enhance the flow of secretions in the respiratory passages
therapeutic use
Mucolytics
S/E
nursing administration
liquify dry mucous
inhaler
IV - OD
antidote for tylenol
aspirate: causes bronchospasm
given: situp at least 30 min
need to be chilled (PO form) because of bad taste (on ice) smells like rotten eggs
IV dosing depend on amount of Tylenol taken
Tylenol and antidote causes hepatotoxicity
Mucolytics
contraindication
nursing administration
contraindication preg risk B not used in client shwo are hypersensitive to acetylcysteine - -
nursing adminstration
advise odor
administered by inhalation to liquefy nasal
oral IV
