Respiratory Meds

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

Bronchodialators

Stimulate Beta Adrenergic receptors in bronchioles to produce bronchodilation and increase muccociliary clearance and inhibit release of histamine
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
Both SABA's and LABA's cause....

Bronchodilation
Adverse Effects of SABA's and LABA's
- Tremors
- Anxiety
- Tachy
- Palpitations
- Nausea
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
Name 2 LABA's
- Salmeterol
- Formoterol
What are LABA's used for?

Long term control of moderate to sever persistent asthma/COPD
Patient Teaching for LABA's
- NOT A RESCUE MED
- 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
Both SABA's and LABA's need to be taken before of after ICS?

Before
Examples of Combo therapy with LABA and ICS
- Advair and Salmeterol
- Symbicort and Formoterol
What is ICS?

Inhaled Corticosteroid
Name a Methylxantine drug.....

How does it work?

Theophylline

It is a sustained release inhaler used as an alternative therapy for step 2 care in mild/persistent asthma/COPD
Adverse Effects of Methylxanthine (theophylline)
- Nausea
- Headache
- Insomnia
- GI distress
- Tachy
- Dysrhythmia
- Seizures
Patient teaching for Methylxanthines (Theophylline)
- Drug interactions
- Don't double dose if missed
- Don't drink caffeine
- Report GI distress
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
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
Name Anticholinergic medication and why is it used?

Atrovent

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

Bronchodilation

Blocks the bronchoconstricting influence of the parasympathetic nervous system
When does Atrovent peak and how long does it last?

Peaks at 30-60 min and lasts 4-6 hours
Adverse effects of Atrovent
- Dry mouth
- Hoarseness
*Doesn't get absorbed very well systemically so no many AE's
Name 2 Corticosteroids (ICS)
- Flovent
- Pulmicort
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
What are ICS used for?

Acute exacerbation and maintenance of asthma and COPD.

No immediate effect, but decreases frequency and severity of attacks
How long does it take for the therapeutic effect to occur with ICS meds?

24 hours to 2 weeks
Adverse effects of ICS
- Bruising
- Increased Bone Loss
- OROPHARYNGEAL CANDIDIASIS
- Hoarseness
- Dry Cough
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
Patient teaching for ICS
- Use a spacer and rinse mouth after admin
- If oral....do alternate day schedule
- monitor Blood Glucose
- Report muscle weakness
- Report signs of infection
- Report signs of F&E imbalance
What medication do you need to avoid if on an ICS

NSAID....report tarry stools
Oral ICS are given to people .....

for short term use following an attack
Name 2 Leukotriene modifiers
- Singulair
- Accolate
Name 1 Leukotriene Synthesis Inhibitor....what does it do?

Zileuton

Inhibits the synthesis of leukotrienes
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
Adverse effect of Zileuton

Liver injury
Patient teaching for Zileuton
- Take 1x/day at bedtime
- Get a baseline LFT and monitor it periodically
Name an Anti-IgE medication

Xolair
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
How do you take Xolair and how often?
Where?
- Subcutaneously and q 2-4 weeks
- In the Doctors office cuz of risk of anaphylaxis
Adverse effects of Xolair

anaphylaxis
Patient teaching for Xolair

Have to go to Dr. office to subcutaneous injection
What is the safest medication for asthma?
Name them....2

Mast cell stabilizers

Intal and Tilade
How do Intal and Tilade work?

they are anti inflammatories
When does a person take Intal and Tilade?

15 min. prior to exercise or known exposure to an allergen
Patient teaching for Intal and Tilade

Long term prophylaxis may take several weeks for therapeutic effect to occur.

Author

foxyt14

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Card Set

Respiratory Meds

Description

Respiratory, lecture and ATI

Updated

2013-08-28T03:16:01Z

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