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NU 302 Respiratory

Review of beta-2 agonists, anticholinergics, and corticosteroids for respiratory

Albuterol Drug Class Beta-2 agonist
Albuterol Mechanism of Action Stimulation of SNS beta-2 receptors Smooth muscle relaxation of bronchioles
Albuterol Adverse Effects Tachycardia, palpitations, restlessness H/A
Albuterol Contraindications Cardiac disease, hyperthyroidism
Albuterol Interactions Beta blockers
Albuterol Nursing Indications Monitor HR, respiratory status Teach regarding rescue inhaler use Use 30-60 minutes before exercise Avoid caffeine
Ipratropium Drug Class Anticholinergic
Ipratropium Mechanism of Action Increased PNS stimulation on CN X Antagonizes muscarinic receptors
Ipratropium Adverse Effects Dry mouth, blurry vision, tachycardia, urinary retention, constipation
Ipratropium Contraindications Narrow angle glaucoma Bladder neck obstruction/BPH Allergy to soy or peanuts (propellant sensitivity)
Ipratropium Interactions Other anticholinergics
Ipratropium Nursing Indications Monitor VS, respiratory status Monitor UOP Teach to void prior to drug administration Lozenges Fiber/fluids
Budesonide Drug Class Corticosteroid
Budesonide Mechanism of Action Inhibition of inflammatory response
Budesonide Adverse Effects Sore throat Xerostomia Oral candidiasis
Budesonide Contraindications Active infections Oral lesions increase systemic absorption
Budesonide Nursing Indications Monitor respiratory status, oral mucosa Taper the dose Rinse mouth after inhalation
Drug of choice for rescue inhaler SABA - albuterol
Theophylline Drug Class Methylxanthines
Theophylline Mechanism of Action Smooth muscle relaxation via mobilization of calcium and activation of prostaglandins Inhibition histamine
Theophylline Adverse Effects Typically only associated with toxicity 20-25 mcg/mL: N/V/D, insomnia, diaphoresis, H/A and irritability >30-35 mcg/mL: hyperglycemia, hypokalemia, hypotension, dysrhythmias, tachycardia, seizures, brain damage and death
Theophylline Interactions Multiple interactions – including caffeine Smoking increases metabolism of theophylline With smoking cessation – toxicity!
Theophylline Contraindications Caution with cardiac disease, hyperthyroidism
Theophylline Nursing Indications Monitor VS, lung sounds Serum drug level Decrease caffeine intake Toxicity treatment Activated charcoal, lidocaine, benzodiazepines
Montelukast Drug Class Leukotriene receptor antagonist
Montelukast Mechanism of Action Decreases: neutrophil, eosinophil migration, aggregation, leukocyte adhesion, capillary permeability, smooth muscle contraction
Montelukast Adverse Effects H/A, dizziness Elevated LFTs Suicidal ideation
Montelukast Interactions Increases toxicity of theophylline, warfarin
Montelukast Nursing Indications Monitor respiratory status Take on empty stomach Taper dose Avoid triggers
Created by: mlanpher
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