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Sympathomimetics:
promote bronchodilation and so relieve bronchospasm.
Useful in the treatment of bronchospasm in reversible obstructive airway diseases such as asthma and bronchitis.
Used to releave acute attack but not for prophlaxis.
albuterol (Proventil)
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Nursing responsibilities (albuterol (Proventil))?
Monitor the client's respiratory statues while administering sympathomimetics. This includes respiratory rate, lung sounds, oxygen saturation, and subjective symptoms.
These medications should be used with coution in clients with conditions such as cardiac disease, vascular disease, hypertension, hyperthroidism, and pregnancy.
Monitor the client for common side effects including increased heart rate(due to sympathetic stimulation of the heart) and tremors.
Monitor for other side effects that occur with excessive dosing, wich may include central nervous system stimulation, gastrointestinal upset, hypertension, and sweating.
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Client and Family teaching (albuterol (Proventil))?
Caution the client to use the least amount of medication needed to get relief for the shortest time period necessary. This willhelp prevent adverse effects.
Counsel the client ot report immediately any chest pain and/or changes in heart rate or rhythm
Teach the client and/or family how to use the delivery system. This will most be a metered-dose inhaler (MDI) or dry powder inhaler (DPI) or nebulizer.
Teach the client ot record the freqency and intensity of symptoms.
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Glucocorticosteriods: Steriods (medications that suppress infammation)
Administered to clients with oxygenation problems to suppress inflammation.
Well absorbed from the respiratory tract so giving them by inhalation is often effective
Decrease synthesis and release of inflammatory mediates, decreasing activity of inflammatory cells, adn decreasing edema.
fluticasone (Flovent)
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Nursing responsibilities (fluticasone (Flovent))
Glucocorticosteriods are intended for preventive therapy. They will not be useful in an acute attack.
If the client is also taking a sympathomimetic medication, delivery of inhaled corticosteriods (ICS) to the respiratory tract may be nehanced by administering the sympathomimetic first (and waiting 3 to 5 minutes).
It is important to monitor the client's respiratory status while administering steriods. This includes respiratory rate, lung sounds, oxygen saturation, and subjective symptoms.
These medications should be used with caution or not at all inc lients with conditions such as allergy, pregnancy, lactation, and stystemic infections.
Monitor the client for side effects of the medications. Most commonly this coudl be an increase in heart rate (due to sympathetic stimulation of the heart) and tremors.
The client should be monitored for other side effects, which will usually only occur with excessive dosing and may incldue central nervous system stimualtion, gastrointestinal upset, hypertension, and sweating.
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Client and Family Teaching (fluticasone (Flovent))
Caution the client to use the least amount needed to get relief for the shortest time period necessary. This will help revent adverse effects. Alternate day therapy may be recommended to decrease adrenal suppression.
Make sure the client understands that these drugs are not for acute attacks. They are intended for preventive therapy.
Teach the client and/or family how to use the delivery system. This will most often be a metered-dose inhaler 9MDI) or dry powder inhaler (DPI) or nebulizer.
Counsel the client to rinse the mouth after using ICS to decrease the risk of oropharyngeal or esophageal fungal infections (thrush)
Counsel the client ot report adverse effects such as sore throat, hoarseness, and pharyngeal and laryngeal fungal infections.
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Anticoagulant used to prevent deep venous thrombosis after hip, knee, or abdominal surgery.
Used for clients at risk for thromboemoblus secondary to prolonged bed rest due to acute illness.
Thse heparisn are given subcutaneously either once a day or every 12 hours.
They have a predictable dose response and do not require daily lab test monitoring.
Enoxaprin (Lovenox)
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Nursing Responsibilities (Enoxaprin (Lovenox))
- Administration:
- Administer deep subcutaneous. Do not give IM.
- Client should be lying down during administration.
- Do not expel the air bubble from the prefilled syringe. This avoids loss of the drug.
- The manufacturer recommends injection into the right or left anterior lateral or posterior lateral aspect of hte abdominal wall for best absorption.
- Alternate between right and left abdomen sites.
- Insert the entire lenght of the needle into a skinfold created by the thumb and forefinger; hold the skinfold unitl the needle is withdrawn.
- Do not massage the injection site to minimize bruising.
Do not mix with the injections
Lovenox and regular heparin cannot be used interchangeably
Assess baseline lab data (e.g., CBC, liver function, coagulation) and monitor periodically
Observe for early signs/symptoms of bleeding
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Client & Family Teaching (Enoxaprin (Lovenox))
Review how to administer
Administer at the same time each day
Report any unusual bleeding or bruising
Avoid aspirin or NSAIDS
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Anti-tubercular Drugs
isoniazid
rifampin,
pyrazinamide
ethambutol or
streptomycin
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Side Effects of Isoniazid (INH) (also used for prophylaxis
w/ exposure)
Peripheral neuropathy & hepatotoxicity, visual problems
Food↓ absorption rate
May need vitamin B6 supplements
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Side Effects of Rifampin (RIF)
Hepatotoxicity
Turns body fluids orange colored!
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Pyrazinamide (PZH)
Pyrazinamide tablets are so large that some patients find them impossible to swallow: pyrazinamide syrup is an option for these patients.
Pyrazinamide is only used in combination with other drugs such as isoniazid and rifampicin in the treatment of Mycobacterium tuberculosis. It is never used on its own. It has no other indicated medical uses. In particular, it is not used to treat other mycobacteria; Mycobacterium bovis and Mycobacterium leprae are innately resistant to pyrazinamide.
Pyrazinamide is used in the first two months of treatment to reduce the duration of treatment required. Regimens not containing pyrazinamide must be taken for nine months or more.
Pyrazinamide in conjunction with rifampin is a preferred treatment for latent tuberculosis.
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Side Effects of Ethambutol
Visual problems
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Side Effects of Streptomycin (possibly used, not always used)
hepatotoxicity
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Most are sympathomimetic
May contain pseudoephedrine, analgesic, antihistamine
Generally safe for children
Call Dr. before taking if:
Heart disease
HTN
Thyroid disease
OTC Cough & Cold Medicine
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Side Effects of Sympathomimetic
Headache
Nervousness
Increased blood pressure
Insomnia
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Side Effects of antihistamine
Drowsiness
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Antitussives & Expectorants
Cough medications
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What does an antitussive do?
Act on medulla to suppress cough
Increased effect with other CNS depressants
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What do expectorants do?
Loosen bronchial secretions
Found in combination with antitussives, analgesics
Can cause nausea/vomiting
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“Non-sedating antihistimines”
Zyrtec, Claritin
2nd generation Antihistamines
Little to no effect on sedation
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