Respiratory Drugs

  1. Short Acting Beta Agonist

    albuterol (Proventil, Ventolin)
    • *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
  2. Long Acting Beta Agonist

    salmeterol (Serevent)
    • *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

  3. Cholinergic Antagonist

    ipratopium (Atrovent), tiotropium (Spiriva)
    • *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
  4. Methylxanthines

    theophylline (Theo-Dur, Theolair)
    • *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.
  5. Corticosteroids

    fluticasone (Flovent, Pulmioncort)

    prednisone (Deltasone, Solu-Medrol, Decadron) -> Systemic IV; only used short-term for acute asthma exacerbation.
    • *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.
  6. Mast Cell Stabilizer

    cromolyn (Intal), nedocromil (Tilade)
    • *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.
    • Should be taken on scheduled basis.

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

    montelukast (Singulair), omalizumab (Xolair)
    • *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.
  8. Combination Inhalers

    Advair Diskus, Symbicort, Combivent, DuoNeb
    Advair; used daily with inhalation in am & pm

    DuoNeb; delivered via nebulzier

    Combivent; MDI, 2 puffs tid/qid
Card Set
Respiratory Drugs
Respiratory Medications