Lower Resp Drugs

Question 1

Albuterol

class
MOA
indications
route
contra
d-d
AEs
nursing

Answer 1

• Class: Beta2-Adrenergic Agonists (SABA)
• MOA: beta2 selective adrenergic agonst; bronchodilation
• Indications: acute bronchospasm (asthma attack, COPD exacerbation, pneumonia); prevention of exercise-induced asthma
• Route: inhaler, nebulizer; onset: 5-15mins
• Contra: conditions exacerbated by sympathomimetic effects
• D-D: beta-adrenergic antagonists
• AEs: sympathomimetic stimulation; cardiac arrythmias, HTN, sweating, tremors; worsened bronchospasm
• Nursing: admin for symps or schedule; overuse incrs AE; use 30-60min prior to exercise

Question 2

Fluticasone (Flovent)

class
actions
indications
route
AEs
nursing

Answer 2

• Class: Inhaled Corticosteroid
• Actions: dcr inflammatory response in airways
• Indications: prevention & treatment of asthma (maintenance)
• Route: inhaler
• AEs:
  > sore throat
  > hoarseness
  > coughing
  > dry mouth
  > pharyngeal & laryngeal fungal infections
  > systemic rare
• Nursing: assess mucous membranes; fungal infection, educate pt to rinse mouth after inhalation, NOT a rescue inhaler

Question 3

Fluticasone (Flonase)

class
actions
indication
route
contra
AEs
nruisng

Answer 3

• Class: Topical Nasal Steroid Decongestants
• Actions: localized anti-inflamm action
• Indications: seasonal allergic rhinitis
• Route: intranasal
• Contra: lesion or erosion in mucous membs
• AEs:
  > local burning & irritation
  > dry mucous membs
  > long term: break down nasal mucosa
• Nursing: assess nasal mucosa, takes 1 week to note change; stop if no effect after 3 weeks

Question 4

Inhaler Education

Answer 4

• Correct admin procedure & return demostration
• Clean delivery devices weekly
• Rinse mouth after inhaler use
  > esp w/ inhaled corticosteroids
• Timing of admin
  > prior to exercise, acute attack, daily
• AEs of inhaled med

Question 5

Sequencing of Multiple Inhalers

Answer 5

1. Bronchodilators
   - Beta agonist agents
   > wait 1 min btwn puffs for multiple inhalations of same med
   > wait 2-5 mins before admining next med
   - Anticholinergic agents
   > scheduled admin only (not a rescue inhaler)
2. Corticosteroids
   - admin after bronchodilators
   - wait 1 min btwn puffs for multiple inhalations of the same med
   - rinse mouth following use (do not swallow water) to prevent oropharyngeal fungal infection