Miscellaneous respiratory medications Flashcards
Old thoughts on smooth muscle and brochospasms
too smooth bronchiolar smooth muscle to experience bronchospasms
Mechanism of action of bronchodilators
decreased airway resistance, increases compliance as early as 28 weeks with BPD as well as 2 day old RDS
How/when are bronchodilators best used
Acute situations for short periods of time
Albuterol actions
selective beta-adrenergic agonist, relaxes smooth muscle, bronchodilates, drives K into cell.
Systemic effects of albuterol
Increase HR, arrhythmia, tremors, hypokalemia, irritability
Mechanism of action of albuterol
promotes production of intracellular cyclic-adenosine monophosphate which enhances binding of intracellular Ca. This decrease Ca concentration in cell leads to relaxation of smooth muscle and bronchodilation.
Albuterol and CLD
100 mg via inhaler showed improvement in resistance and compliance in 65%. Remaining required 200 mg. peak response 30 minutes
Racemic epinephrine acts on which receptors
alpha and beta adrenergic receptors
Racemic epi acts where in the body?
vasoconstriction which decreases blood flow to the capillary level causing shrinking of upper respiratory mucosa and reduces edema
When is racemic epi used the most
post extubation stridor, used as adjunct to pulmonary hemorrhage.
Side effects of racemic epi
tachycardia, arrhythmia, HTN, peripheral vasoconstriction, hyperglycemia, hyperchloremia, metabolic acidosis, leukocytosis
Ipatropium bromide
Bronchodilation in infants with BPD, decrease respiratory resistance.
IPB and albuterol
decrease in respiratory system resistance and increases in compliance in ventilated BPD patients
Rationale for use of IPB in neonates with CLD
presence of functional muscarinic receptors in premature infants
Inhaled steriods
studies show no effect with inhaled steroids
