Week 6: Lower Respiratory Drugs Flashcards
Intrinsic asthma?
Extrinsic asthma?
no hx of allergies
clients with known allergy exposed to the allergen
Status asthmaticus
What is it?
Last how long?
What is used to treat status asthmaticus?
Prolonged asthma attack that does not respond to typical drug therapy
May last several minutes to hours
MEDICAL EMERGENCY!!!!
AIM:
Albuterol
Ipratropium
methelynespresilone
Drugs to Treat Asthma
Quick Relief
3
Short-acting inhaled beta2 agonists
Anticholinergic agents
IV systemic corticosteroids
Drugs to Treat Asthma
Long-Term Control/Maintenance
4
Long acting beta2 agonists (LABAs)
LABAs combined with inhaled corticosteroids
Inhaled corticosteroids
Leukotriene receptor agonists
Anticholinergic agents
Mast cell stabilizers
Drugs to Treat the LRT: Beta-
Adrenergic Agonists
SHORT ACTING?
albuterol
Albuterol (SABA)
What may negate therapeutic effect?
Don’t give with what? and why?
Short acting beta agonist
Must not be used too frequently
**Beta-blockers may negate therapeutic effect!!!!!
DON’T give with caffeine-containing herbs (cola nut, guarana, mate, tea, coffee) can increase stimulant effect
SABAs
Nursing Implications
How are inhalers used?
same inhaler?
2nd inhaler?
For ANY inhaler:
if 2 puffs from the same inhaler, wait 1-2 minutes in between puffs;
if using a 2nd inhaler wait 2-5 minutes or the Rx’d amount of time after the first inhaler
Beta-Adrenergic Agonists- LABAs
LONG ACTING?
Salmeterol
Salmeterol
Never use for what?
Don’t give more than?
What may negate therapeutic effect?
Don’t give with what? and why?
Never to be used for acute tx
Should never be given more than twice daily, nor should the maximum daily dose (one puff BID) be exceeded
**Beta-blockers may negate therapeutic effect!!!!!
DON’T give with caffeine-containing herbs (cola nut, guarana, mate, tea, coffee) can increase stimulant effect
Beta-Adrenergic Agonists- LABAs
Nursing Implications
never use as?
dont use to treat what symptoms?
These drugs should be used alongside an inhaled corticosteroid, NOT AS MONOTHERAPY!!!
DO NOT USE LABA TO TREAT ACUTE SYMPTOMS
Anticholinergics
Ipratropium (Maintenance therapy for COPD)
used with what?
Asses for what?
Side effects?
DuoNebs (albuterol + ipratropium)
Bronchodilator
Assess for allergies to other anticholinergics such as atropine
Cant see
Cant pee
Cant spit
Cant shit
Xanthine Derivatives
Natural xanthines? 2
Synthetic xanthines? 1
Theophylline
caffeine
aminophylline
Xanthine Derivatives
Therapeutic range for theophylline?
What assessment should u do?
What should you avoid? and why?
Therapeutic range for theophylline blood level is 10 to 20 mcg/mL
Make sure you do a thorough cardiac assessment
Avoid charcoal broiled
High protein
Low-carb food
(will reduce serum levels of xanthines)
theophylline adverse effects for cv?
Note what?
Sinus tachycardia
Extrasystole
Palpitations
Ventricular dysrhythmias
*note intake of caffeine
What happens if theophylline is infused too quickly?
hypotension w/ possible syncope tachycardia
seizures
cardiac arrest
Leukotriene Receptor Antagonists
Montelukast (CHRONIC)
Can be used in who and cause what?
Dont use with what drug?
Why might some clients need to avoid this drug?
Can be used in children 1 year old and older
Can cause suicidal thoughts/behaviors
do not use with rifampin
chewable tablets contain aspartame,
assess for allergies as some clients may need to avoid it
Corticosteroids (Glucocorticoids)
Used for acute or chronic?
Used for chronic respiratory symptoms
Corticosteroids (Glucocorticoids)
fluticasone propionate (long acting)
dont give if? two
CONTRAINDICATION:
hypersensitivity to glucocorticoids
Clients with Candida (yeast) organisms (Thrush)
Inhaled
Corticosteroids (Glucocorticoids)
fluticasone propionate
Do what after taking it?
What do u use first? bronchodilator or cortecosteroid?
Gargle and rinse the mouth with lukewarm water afterward to prevent oral fungal infections
If a beta agonist bronchodilator and corticosteroid inhaler are both ordered
bronchodilator should be used several minutes before the corticosteroid to provide bronchodilation before
administration of the corticosteroid
Corticosteroids (Glucocorticoids)
aiM
methylprednisolone
What is it used for?
May increase requirement for what?
Monitor what?
avoid what?
acute exacerbation of asthma or COPD
May increase requirement for insulins or oral hypoglycemic
agents
Monitor serum glucose levels
Avoid live vaccines
PDE4 Inhibitor
roflumilast (COPD)
What is it used for?
adverse effetcs?
prevent cough and excess mucous from worsening and decrease the frequency of life-threatening COPD exacerbations
suicidal thoughts/behavior
weight loss
