pulmonary medicines, nursing pharmacology
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| bronchodilators | beta-adrenergic agonists or sympathomimetics, Xanthine or Methylxanthenes,
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| action of beta adrenergic agonists | stimulates smoothe muscles to cause bronchodilation
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| beta 2 | receptors in lungs
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| beta 1 | receptors in heart
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| rescue inhalers | epinephrine (Primatene mist), terbutaline (Brethine), Albuterol (Provental, Ventolin), Salmeterol (Serevent)
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| Inhaled drugs | rapid onset, short duration
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| Oral bronchodilators | not effective in acute attacks
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| action of Xanthine or Methylxanthenes | smoothe muscle relaxant, inhibits phosphodiesterase
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| examples of xanthine bronchodilators | theophylline (Theodur or theolair), Aminophylline, caffeine
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| monitor for these with xanthine drugs | toxicity, blood levels
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| n/c for xanthines | toxicity, tachycardia, restlessness and insomnia, seizures, anorexia, give with meals
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| Action of Anticholinergics | blocks parasympathetic input, decreases bronchial constriction, not used for acute attacks!
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| Examples of Anticholinergics | Ipratropium bromide (Atrovent), and Combivent (albuterol and atrovent)
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| Anticholinergics | used before surgeries and broncoscopies to prevent vagal stimulation and decrease secretions
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| n/c of anticholinergics | dry secretions, urinary retention, NOT used in clients with glaucoma or urinary obstructions
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| Anti-inplammatory agents | corticosteroids
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| action of corticosteroids | decreases the inflammatory and immune responses
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| systemic corticosteroids | prednisone and methylprednisone
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| what to avoid with systemic corticosteroids | never ever stop abruptly, and taper when switching from systemic to inhaled steroids
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| s/e of corticosteroids | weight gain, electrolyte imbalances(decreased Potassium), hypertension, hyperglycemia from decreased effects of diabetic agents, thin skin, decreased healing, bone loss
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| inhaled steroids | flovent, aerobid, azmacort, pulmicort, vanceril, advair diskus
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| action of inhaled steroids | limited to respiratory system
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| important teaching for inhaled steroids | rinse mouth after use, and wash chamber and mouthpiece!
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| combo drug inhaled via dry powder | advair diskus (corticosteroid and beta2 receptor agonist)
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| Advair Diskus | not for children, not for acute attacks, never EXHALE into diskus
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| Mast cell stabilizers (antiinflammatory agent) | Intal - prevent histamine release Tilade - PREVENTS inflammation from occurring
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| Monoclonal antibodies (anti-inflammatory agent) | Xolair - prevents allergens from triggering asthmatic attack
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| Antileukotrinine Agents action | leukotriene modifiers, mast cell stabilizers, decreases airway edema
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| Antileukotrinine Agent drugs | PO- Accolate and Singulair
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| Antileukotrinine Agent n/c | not rescue drugs, instruct client to continue even when no symptoms, monitor LFT
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| S/e of antileukotrinines | n/v, (take one to two hours after meals), headaches, liver dysfunctions (LFT)
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| Antitussives | cough suppressants
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| Narcotic Antitussives | codeine, hydrocodone
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| non-narcotic antitussives | benzonatate (Tessalon), dextramethorphan (Benylin)
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| Do not use antitussives with.... | productive cough
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| n/c for antitussives | sedation, dry mouth, constipation, check for adequate hydration
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| Mucolytics and Expectorants action | thins out and loosens secretions, making them easier to expectorate
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| Mucolytics and Expectorant drugs | acetylcysteine (Mucomyst)nebulizer, Guaifenesin(Naldecon)oral.
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| mucolytics not used with | asthma d/t lack of secretions
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| nursinf diagnosis with impaired respiratory functions | *Impaired Gas exchange, *Activity Intolerance, *Imbalanced Nutrition, *Risk for Infection, *Home Maintenance Management
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