Respiratory Drugs

• *Action
• Bronchodilation; relaxes bronchial smooth muscle
• Fast acting RESCUE DRUG during asthma attack or before activity that triggers attack.

• *Assessments
• When used with other inhaled drugs, use 5 mins. before other drugs.

• *Interventions
• Teach pt. to carry at all times.
• Shake inhaler well & allow 1 min between inhalations.
• Prime inhaler first before use.

• *SE
• nervousness, restlessness, tremor, insomnia, chest pain, palpitations

• *Action
• Bronchodilation; relaxing bronchial smooth muscle by binding to the pulmonary beta 2 receptors
• Slow onset with long duration.
• Used to PREVENT asthma attack.

• *Assessments
• Monitor for hypersensitivity reaction (rash, face, swelling).

• *Interventions
• Teach pt. how to use powder inhaler (never exhale into diskus, keep mouthpiece dry).
• Once opened, use within 6 weeks or discard.

• *SE
• H/A, nervousness, palpitations, tachycardia

NOT USED FOR ACUTE ATTACK!

• *Action
• Bronchodilation; inhibiting parasympathetic nervous system, allowing SNS to dominate.
• Resuce & asthma attack prevention.

• *Assessments
• Assess degree of dyspnea before administering & at peak (1-2hr).
• Assess for allergy to atropine.

• *Interventions
• Pt. to drink at least 4L of fluid/day.
• Shake MDI well & monitor use of MDI.

• *SE
• dizziness, H/A, nervousness, blurred vision (systemic symptoms), mouth dryness

• *Action
• CNS stimulant causing bronchodilation.
• Used for long-term asthma prevention.

• *Assessments
• Monitor chest pain & ECG changes if hx of CVD.
• Monitor drug levels routinely.
• Watch for S/S of toxicity (anorexia, N/V/D, confusion).

• *Interventions
• Administer around the clock to maintain blood levels.
• Administer oral dose with food or full glass of water.
• Higher doses are required at start of therapy.
• Avoid caffeine.

• *SE
• seizures, anxiety, tachycardia, arrhythmias, N/W, narrow margin of safety with many drug-drug interactions.

• *Action
• Inhaled steriods disrupt inflammatory mediators preventing asthma attacks caused by inflammation or allergies.
• Decrease inflammatory & immune responses.
• Preventing manifestations of asthma.

• *Assessments
• S/S of local infections especially yeast infections.

• *Interventions
• Slow onset of action, use drug daily even when no symptoms.
• Good mouth care & check for lesions.
• Use bronchodilator 1st wait 5 mins before corticosteriod.
• Oropharyngeal fungal infections can be prevented by using a space with inhaler.

• *SE
• local throat irritation, hoarseness, dry mouth, coughing, oropharyngeal fungal infections (Candida albicans), nasal stuffiness/sinusitis.

• *SE of systemic steriods
• hyperglycemia, GI ulcer, wt. gain, increased R/F infection.

• *Action
• Stabilizes membranes of mast cells and prevents release of inflammatory mediators (histamine).
• Preventing asthma attack triggered by inflammation or allergies.

• *Assessments
• Assess lung sounds, respiratory status

• *Interventions
• Taken daily by inhalation.
• NOT USED DURING ASTHAM ATTTACK
• Should be taken on scheduled basis.

• *SE
• H/A, sore throat, unpleasant taste, cough, anaphylaxis.

• *Action
• Blocks the luekotriene receptor, preventing inflammatory mediators from stimulating inflammation.
• Prevents asthma attack triggered by inflammation or allergens.

• *Assessments
• Assess allergy symptoms (rash, urticarial).
• May cause increased liver enzymes.
• Xolair associated with anaphylaxis (assess for allergic reactions - tongue, throat edema, urticaria within 2 hrs of administration).

• *Interventions
• Use daily even when no symptoms.
• Slow onset of action for long-term asthma control.
• Provide adequate hydration.
• Xolair administered SQ q2-4weeks.

• *SE
• fatigue, fever, H/A, cough
• Injection site; bruising, redness, warmth, burning.

Advair; used daily with inhalation in am & pm

DuoNeb; delivered via nebulzier

Combivent; MDI, 2 puffs tid/qid