What are our 5 respiratory drugs and their classes?
- 1) DMX: anti-tussive
- 2) guaifenesin: expectorant
- 3) albuterol: selective adrenergic bronchodilator
- 4) ipratropium: resp. anticholinergic
- 5) fluticasone: corticosteroid
What class is dextromethorphan (DMX)?
What is its action and use(s)?
Anti-tussive (OTC drug)
Acts in medulla oblongata to suppress cough reflex.
What is DMX and guaifenesin contraindicated for?
Contraindicated in children <4 yo.
What are the SFX to DMX?
What is its adverse reaction if used with MAOI? (think of the photo)
dizziness and sedation.
AFX: Seratonin-Syndrome: hypotn, HYPERPYREXIA (105-6 F), coma.
What must you monitor in Pts on DMX?
Monitor for liver functions (alt/ast), and decreased RR.
What class of drug is guifensesin?
What is its use?
Uses: decreases viscosity of secretions = easier to cough up.
What are SFX of guaifensesin?
N/V and anorexia.
What is a teaching for guaifenesin?
Limit or avoid alcohol.
What class is albuterol?
What is its action?
Selective adrenergic (beta2) bronchodilator.
Dilates airways and increases rate/depth of respiration.
Which respiratory drug would you use in an "emergency, quick relief" situation?
Which respiratory drugs are used for "maintenance" of airways?
ipratropium and fluticasone.
What are some SFX of alubuterol? (think of the inhaler)
Why do most SFX happen with the use of this drug?
tremors, N/V, chest pain, restlessness.
Most b/c of too many puffs.
What is an AFX of both alubuterol (selective adrenergic bronchodilator) and ipratropium (respiratory anticholinergic)?
*Usually due to overuse; how long should Pt wait for next puff?
What is its interaction (think of inhaler)
Do not take with caffeine.
Wait 2 minutes between puffs.
How should you have Pts teach you the proper use of inhalers?
Have Pts "teach back" by demonstrating in front of you.
Explain the steps in using inhaler.
- Prime/shake (spray 4x).
- Clear nasal and throat.
- Exhale deeply.
- Engage mouthpiece and seal lips.
- Inhale deeply as you press down on canister.
- Hold breath for several seconds, remove, exhale.
What class is ipratropium?
What is its action and use?
Action: blocks ACh; blocks vagal-mediated reflexes.
Uses: treats bronchospasm, asthma, bronchitis, ephysema.
What other drug may ipratropium be combined with?
What class of drug is fluticasone?
What is its action?
Uses: decreases frequency of asthma attacks; seasonal rhinitis
What are fluticasone's contraindications?
Active lung infections-->worsens.
Systemic fungal infections
What are fluticasone's AFXs? (think about the flute)
- Laryngeal edema
- *Chung-Strauss Syndrome: inflammation of arteries and veins effecting lungs, GI, nerves.
What is a food interaction with fluticasone?
No grapefruit juice.
What are some teachings for someone on fluticasone?
- Prime spacer before use.
- Rinse and spit after use.
- Add spacer for further effect.
What would someone with COPD begin with for treatment (order from less to severe COPD)?
- Self-mgmt edu. & smoking cessation
- Inhaled Corticosteroids
- Pulmonary Rehab.