The Respiratory System MEeds STUDY GUIDE

DRUG THERAPY FOR NONINFECTIOUS LOWER RESPIRATORY AIRFLOW DISORDERS BETA2-ADRENERGIC AGONISTS: ALBUTEROL (PROVENTIL, VENTOLIN) ● THERAPEUTIC USE: ○ Long term treatment of asthma ○ Prevention of exercise-induced broncho ...

DRUG THERAPY FOR NONINFECTIOUS LOWER RESPIRATORY AIRFLOW DISORDERS BETA2-ADRENERGIC AGONISTS: ALBUTEROL (PROVENTIL, VENTOLIN) ● THERAPEUTIC USE: ○ Long term treatment of asthma ○ Prevention of exercise-induced bronchospasm ○ Treatment of ongoing asthma exacerbations ● PHARMACOLOGIC ACTION: ○ Adrenergic drugs stimulates the beta2-adrenergic receptors of the sympathetic nervous system, resulting in bronchodilation. ○ The primary pharmacologic action is to relieve bronchospasm of the bronchi and bronchioles of the lung ○ Valuable in the treatment of asthma because they help the airways of the lungs stay open. ○ Long acting beta2-adrenergic agonists are used in the treatment of client with stable COPD ● CONTRAINDICATIONS: Allergy to albuterol or levalbuterol ● PRECAUTIONS: ○ Diabetes mellitus, hypothyroidism ○ Cardiovascular disease, hypertension, angina pectoris, tachydysrhythmias, tachycardia due to digitalis toxicity ● ADVERSE DRUG REACTIONS: ○ Hypotension or hypertension, vascular headache ○ Chest pain, palpitations ○ Nervousness, restlessness, tremors ● INTERACTIONS: ○ Beta-adrenergic blockers reduce the effectiveness of beta2-adrenergic agonists ○ MAOIs and tricyclic antidepressants increase the risk of hypertension, tachycardia and angina ○ Hypoglycemic (antidiabetic) drugs require increased dosing because of hyperglycemic effects ● INTERVENTIONS: ○ Monitor and report dizziness, heart palpitations, chest pain, and shortness of breath ○ Monitor and report tremors ● ADMINISTRATION: ○ Follow manufacturer’s instructions for using delivery devices ○ Use short-acting preparations for acute exacerbations ○ Use long-acting preparations for long term control ○ Inhale beta2-adrenergic agonists before inhaling glucocorticoids ○ Follow dosage limits and schedules ○ Watch for signs and triggers of impending exacerbations of asthma ○ Keep a log of frequency and intensity of exacerbations ○ Notify the provider of changes in patterns of exacerbations ● CLIENT INSTRUCTION: ○ Take as prescribed – avoid overuse of rescue inhalers ○ Report chest pain and heart palpitations ○ Avoid caffeine ○ Notify provider if tremors interfere with activities of daily living INHALED ANTICHOLINERGICS: IPRATROPIUM (ATROVENT, ATROVENT HFA) ● THERAPEUTIC USE: ○ Relief of bronchoconstriction in clients with COPD ○ Decreases secretions in clients with COPD ● PHARMACOLOGIC ACTION: ○ Inhaled anticholinergics work by inhibiting the action of acetylcholine ○ Acetylcholine causes vasoconstriction of the bronchi and bronchioles, blocking stimulation of the parasympathetic receptors results in bronchodilation ● CONTRAINDICATIONS: Hypersensitivity to ipratropium, atropine, belladonna alkaloids or bromide ● PRECAUTIONS: ○ Glaucoma ○ Prostatic hypertrophy, bladder neck obstruction ● ADVERSE DRUG REACTIONS: ○ Dry mouth, irritation of the pharynx ○ Increased intraocular pressure ○ Urinary retention ● INTERACTIONS: Beta2-adrenergic agonists enhance bronchodilation ● INTERVENTIONS: ○ Provide water and hard candy to client ○ Schedule routine testings for glaucoma ○ Monitor urinary elimination patterns, especially in older adults ● ADMINISTRATION: ○ Follow manufacturer’s instructions for using delivery devices ○ Follow dosage limits and schedules ○ Allow the prescribed time between puffs ○ Delay use of other inhalants for 5 minutes ○ Do not use as an emergency rescue medication ○ Rinse the mouth after taste to reduce unpleasant taste ● CLIENT INSTRUCTION: ○ Suck on hard candy ○ Sip water frequently ○ Have regular eye examinations to test for glaucoma ○ Report any changes in urinary elimination