ATI section 4: respiratory meds Flashcards
Inhalation therapies
- tx for chronic respiratory disorders often includes multi drug therapies
- take the beta2 agonist before the inhaled glucocorticoid to increase steroid absorption
- Instruct on procedures for inhalation:
- remove mouthpiece cap
- if appropriate shake container
- stand up or sit upright, exhale deeply
- place mouthpiece between teeth, and close lips tightly around inhaler
- while breathing deep press down and continue to breath deep for several seconds
- hold breath for 5-10 seconds
- breath out normally
- examine mouth for irritation and perform frequent mouth care
Beta2 Adrenergic Agonist medication
Albuterol (Proventil, Ventolin)
- Route/onset: Inhaled (short-acting), few min
- Use: Acute bronchospasm
Beta2 Adrenergic Agonist medication
Formoterol (Foradil), salmeterol (Serevent)
-Route/onset: Inhaled (long-acting), 15-20 min, lasts 12 hr
Use: Long-term control of asthma
Beta2 Adrenergic Agonist medication
terbutaline (Brethine)
- Route/onset: oral (long-acting)
- Use: Long-term control of asthma
Beta2 Adrenergic Agonist medication
Precautions/interactions
Contraindication:
-clients with tachydysrhythmias
Caution:
- DM, hyperthyroidism, heart disease, hypertension, angina
- BBs will reduce effects
- MAOIs will increase effects
Beta2 Adrenergic Agonist medication
Side/adverse effects
- Tachycardia
- Palpitiations
- Tremors
Beta2 Adrenergic Agonist medication
Nursing Interventions and client education
-Caution against using salmeterol more frequently than every 12 hr
Mehtylxanthines
-Suffix: ophylline
Therapeutic use:
- relief of bronchospasm
- long-term control of Asthma
Precautions/Interactions:
- peptic ulcer disease
- do not mix parenteral med with other medications
- phenobarbital and phenytoin decrease levels
Side/adverse effects:
-irritability and restlessness
toxic effects:
-tachycardia, tachypnea, seizures
Nursing interventions and client education:
- monitor therapeutic levels of the medication
- avoid caffeine, smoking , and alcohol abuse
Methylxanthines
Tx of toxicity:
- stop infusion
- activated charcoal to decrease absorption in oral overdose
- lidocaine of dysrhythmias
- diazepam for control seizures
Inhaled Anticholinergics
- troplum
Therapeutic use:
- prevent bronchospasm
- manage allergen or exercise-induced asthma -COPD
Precautions/Interactions:
- clients with peanut allergy
- use extreme caution with narrow-angle bacteria and BPH
- do not use for tx of acute bronchospasm
Side/adverse effects:
- dry mouth and eyes
- urinary retention
Nursing Interventions and client education:
-Instruct client that it may take up to 2 weeks for maximum effects to show
Glucocorticoids
-Suffix: one
Short-term:
- Respiratory therapeutic use: IV agents: status asthmaticus
- Oral: tx of symptoms following and acute asthma attack
Long-term
- Inhaled: prophylaxis of asthma
- Oral: tx of chronic asthma
Precautions/Interactions:
- Clients with DM may require higher doses
- Never stop abruptly
Side/Adverse effects:
- Euphoria, insomnia, psychotic behavior
- Hyperglucemia
- peptic ulcer
- fluid retention
- withdrawal symptoms
Nursing Interventions:
- Administer with meals
- Do not take with NSAIDs
- Teach gradual reduction in dose to prevent addisonian crisis
Leukotriene Modifiers
-lukast, Zileuton
Therapeutic use:
- Long-term mngt of asthma in adults and children
- Prevention of exercise-induced bronchospasm
Precautions/Interventions:
- Not for acute asthma attack
- high risk for liver disease
- phenobarbital will decrease circulating levels
- chewable tabs contain phenylalanine
Side/Adverse effects:
- elevated liver enzymes
- Warfarin and theophylline toxicity
Nursing Interventions and client education:
- Do not abruptly substitue for corticosteroid therapy
- take daily
Antitussives, Expectorants, Mucolytics
Antitussives : hydrocodone, codine
Exectorants: guaifenesin (Mucinex)
Mucolytics: acetylcysteine (Mucomyst, Acetadote) hypertonic saline
Precautions/Interventions:
- children younger than 2 should only get saline
- opioid antitussives have potential for abuse
- caution with OTC meds
Side/Adverse effects:
-drowsiness, dizziness, aspiration and bronchospasm risk with mucolytics, constipation
Nursing Interventions and Client Education:
- Monitor cough frequency, effort, and ability to expectorate
- Auscultate fo radventitous lung sound
- promote fluid intake
Antitussives (hydrocodone, codeine)
- Actions: suppresses cough
- Therapeutic use: chronic nonproductive cough
Expectorants gualfenesi (Mucinex)
Actions:
-promote increased mucous secretion to increase cough production
Therapeutic use:
-often combined with other agents to manage respiratory
