Respiratory Meds

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  1. 2 Short Acting Beta Adrenergic Agonist
    • Albuteral
    • Pirbuteral
  2. How do SABA's/LABA's work?

    Stimulate Beta Adrenergic receptors in bronchioles to produce bronchodilation and increase muccociliary clearance and inhibit release of histamine
  3. What are SABA's good for?
    • Rescue drug
    • Quick relief....can be used to prevent bronchospasm from exercise and other inflammatory mediators from mast cells
  4. Both SABA's and LABA's cause....
  5. Adverse Effects of SABA's and LABA's
    • Tremors
    • Anxiety
    • Tachy
    • Palpitations
    • Nausea
  6. Patient Teaching for SABA's
    • Used for relief only
    • Instruct patient how to check pulse....and report an increase greater than 20-30bpm
    • Tremors will usually resolve with continued use...if not reduce the dose
    • Avoid caffeine
  7. Name 2 LABA's
    • Salmeterol
    • Formoterol
  8. What are LABA's used for?
    Long term control of moderate to sever persistent asthma/COPD
  9. Patient Teaching for LABA's
    • Only use ONCE every 12 hrs
    • Instruct patient how to check pulse and report increase greater than 20-30bpm
    • Avoid caffeine
    • Tremors will stop after use
  10. Both SABA's and LABA's need to be taken before of after ICS?
  11. Examples of Combo therapy with LABA and ICS
    • Advair and Salmeterol
    • Symbicort and Formoterol
  12. What is ICS?
    Inhaled Corticosteroid
  13. Name a Methylxantine drug.....

    How does it work?

    It is a sustained release inhaler used as an alternative therapy for step 2 care in mild/persistent asthma/COPD
  14. Adverse Effects of Methylxanthine (theophylline)
    • Nausea
    • Headache
    • Insomnia
    • GI distress
    • Tachy
    • Dysrhythmia
    • Seizures
  15. Patient teaching for Methylxanthines (Theophylline)
    • Drug interactions
    • Don't double dose if missed
    • Don't drink caffeine
    • Report GI distress
  16. What are the specific drug interactions to know about with Methlxanthines (Theophylline)?
    • Antibiotic dosage may need to be decreased
    • Phenobarbital and Phenytoin may need to increase dosage
  17. Methylxanthine (Theophylline) has a narrow margin of safety...explain
    You will need to have serum blood levels checked to make sure it stays within therapeutic range

    5-15 mcg/ml
  18. Name Anticholinergic medication and why is it used?

    It is used for quick relief for patients that cant tolerate SABA's.
  19. How does Atrovent work?

    Blocks the bronchoconstricting influence of the parasympathetic nervous system
  20. When does Atrovent peak and how long does it last?
    Peaks at 30-60 min and lasts 4-6 hours
  21. Adverse effects of Atrovent
    • Dry mouth
    • Hoarseness

    *Doesn't get absorbed very well systemically so no many AE's
  22. Name 2 Corticosteroids (ICS)
    • Flovent
    • Pulmicort
  23. What do corticosteroids do? (ICS)
    They are anti inflammatories that reduce bronchial hyper-responsiveness.

    • Prevents inflammation¬†
    • suppresses airway mucous production¬†
    • Inhibits migration of inflammatory cells
  24. What are ICS used for?
    Acute exacerbation and maintenance of asthma and COPD. 

    No immediate effect, but decreases frequency and severity of attacks
  25. How long does it take for the therapeutic effect to occur with ICS meds?
    24 hours to 2 weeks
  26. Adverse effects of ICS
    • Bruising
    • Increased Bone Loss
    • Hoarseness
    • Dry Cough
  27. Long term effects of taking ICS
    • suppression of adrenal gland function
    • bone loss
    • hyperglycemia
    • glycosuria
    • myopathy
    • muscle weakness
    • Peptic Ulcer
    • Infection
    • Disruption of F&E
  28. Patient teaching for ICS
    • Use a spacer and rinse mouth after admin
    • If alternate day schedule
    • monitor Blood Glucose
    • Report muscle weakness
    • Report signs of infection
    • Report signs of F&E imbalance
  29. What medication do you need to avoid if on an ICS tarry stools
  30. Oral ICS are given to people .....
    for short term use following an attack
  31. Name 2 Leukotriene modifiers
    • Singulair
    • Accolate
  32. Name 1 Leukotriene Synthesis Inhibitor....what does it do?

    Inhibits the synthesis of leukotrienes
  33. What does Zileuton used for?

    How does it work?
    Long term oral therapy as a prophylactic and maintenance med

    • Prevents inflammation
    • Bronchoconstriction
    • Prevents Airway edema
    • Prevents mucous production
  34. Adverse effect of Zileuton
    Liver injury
  35. Patient teaching for Zileuton
    • Take 1x/day at bedtime
    • Get a baseline LFT and monitor it periodically
  36. Name an Anti-IgE medication
  37. What does Xolair do and what does it treat?
    Treats moderate to persistent allergic asthma and those requiring 5 or 6 care with persistent asthma that CANT be controlled with ICS

    It decreases circulating free IgE and prevents them from attaching to mast cells
  38. How do you take Xolair and how often?
    • Subcutaneously and q 2-4 weeks
    • In the Doctors office cuz of risk of anaphylaxis
  39. Adverse effects of Xolair
  40. Patient teaching for Xolair
    Have to go to Dr. office to subcutaneous injection
  41. What is the safest medication for asthma?
    Name them....2
    Mast cell stabilizers

    Intal and Tilade
  42. How do Intal and Tilade work?
    they are anti inflammatories
  43. When does a person take Intal and Tilade?
    15 min. prior to exercise or known exposure to an allergen
  44. Patient teaching for Intal and Tilade
    Long term prophylaxis may take several weeks for therapeutic effect to occur.
Card Set
Respiratory Meds
Respiratory, lecture and ATI
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