Respiratory medications

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Respiratory medications

  1. 1. RESPIRATORYMEDICATIONSMedical Surgical Nursing
  2. 2. Bronchodilators• Sympathomimetic dilate the airways of the respiratory tree & relax smooth muscle• Methylxanthinie stimulate the CNS and respiration, dilate coronary and pulmonary vessels causes diuresis & relax smooth muscle• Bronchodilators treat allergic rhinitis, sinusitis, acute bronchospasm, acute & chronic asthma, COPD, emphysema• Contraindicated w/hypersensitivity, peptic ulcer, severe cardiac disease & dysrhythmias, hyperthyroidism, uncontrolled seizures• ***Use caution in hypertension, diabetes mellitus or narrow angle glaucoma• ***Theophylline increase risk of digoxin toxicity & decrease the effects of lithium and phenytoin (Dilantin)• Theophylline and a B2-adrenergic agonist together may result in cardiac dysrhythmias• B-blockers, cimetidine (Tagamet), & erythromycin increase effects of Theophylline• Barbiturates and carbamazepine (Tegretol) decrease the effects of Theophylline
  3. 3. Bronchodilators Side Effects• Palpitations• Tachycardia• Dysrhythmias• Restlessness – may mean hypoxia• Nervousness & tremors• Anorexia, nausea & vomiting• Headaches & dizziness• Hyperglycemia• Decreased clotting time• Mouth dryness• Tolerance & paradoxical bronchoconstriction w/inhalers
  4. 4. Bronchodilators Interventions• Assess vital signs• Monitor for cardiac dysrhythmias• Assess for cough, wheezing, decreased breath sounds & sputum production• Monitor for restlessness and confusion• Provide adequate hydration• Give meds at regular interval around the clock• Give oral meds with or after meals to decrease GI irritation• Instruct client not to crush enteric-coated or sustained release tab or capsules• Instruct on side effects• Instruct how to monitor pulse and report abnormalities• Instruct how to use inhaler or nebulizer & how to monitor amounts of med remaining in inhaler• Instruct how to use spacer• Instruct to avoid over the counter meds, to stop smoking• Instruct client w/diabetes to monitor blood glucose levels• Instruct client w/asthma to wear a Medic-Alert bracelet• ***Monitor serum theophylline of 10-20 mcg/mL >20 toxicity• IV aminophylline or theophylline should be administered slowly and Always via an infusion pump
  5. 5. Glucocorticoids• Beclomethasone dipropionate (Qvar)• Budesonide (Pulmicort Turbohaler, Pulmicort Respules)• Flunisolide (AeroBid)• Fluticasone propionate (Flovent HFA, Flovent Rotadisk, Flovent Diskus)• Mometasone furoate (Asmanex Twisthaler)• Triamcinolone (Azmacort)• Prednisone• Prednisolone
  6. 6. Inhaled Non-steroidal Anti-allergy agents• Mast Cell Stabilizers, antiasthmatic, antiallergic inhibit mast cell release after exposure to antigens• Used to treat allergic rhinitis, bronchial asthma, exercise- induced bronchospasm• Contraindicated in known hypersensitivity• Orally administered Cromolyn sodium (Intal)• Nedocromil (Tilade)• Side Effects • Cough • Bronchospasm • Nasal sting • Sneezing • Unpleasant taste
  7. 7. Leukotriene modifiers• Receptor Antagonists • Montelukast (Singulair) • Zafirlukast (Accolate)• Inhibitor • Zileuton (Zyflo)• Side Effects • Headache • Nausea & vomiting • Dyspepsia • Diarrhea • Generalized pain • Fever dizziness• Interventions • Monitor vital signs, lung sounds for rhonchi & wheezing • Assess liver function, cyanosis • Instruct to take meds 1 hour before or 2 hours after meals, increase fluid intake • Instruct not to discontinue med take as prescribed, even during symptoms free periods

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