Questions and Answers
Which of the following actions is performed by beta 2 adrenergic agonists?
What is a common side effect of methylxanthines that nurses should monitor for?
Which of the following patient conditions would contraindicate the use of beta 2 adrenergic agonists?
What type of medication is ipratropium?
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Which patient teaching point should be emphasized for a patient using inhaled beta 2 agonists?
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What is a notable effect of anticholinergic medications like ipratropium?
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What is a key monitoring parameter for patients on methylxanthines?
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Which condition is a contraindication for using glucocorticoids?
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What teaching point should be provided for a patient using montelukast?
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What is a potential side effect of anticholinergic inhaled medications?
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Which of the following symptoms could indicate toxicity in a patient taking theophylline?
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Which of the following effects should be monitored for in a patient taking glucocorticoids?
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What is the primary action of beta 2 adrenergic agonists?
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Which medication class is recommended for long-term control of asthma in patients?
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Study Notes
Bronchodilators
- Relax bronchial muscles, leading to expanded bronchial airways.
- Types include beta-2 adrenergic agonists, methylxanthines, and anticholinergics (inhaled).
Beta-2 Adrenergic Agonists
- Usage: Effective in treating asthma and COPD; targets bronchospasm and bronchoconstriction.
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Key drugs:
- Albuterol (short-acting)
- Salmeterol (long-acting)
- Mechanism: Activate beta-2 receptors to induce bronchodilation.
- Contraindications: Not recommended for pregnant patients, those with tachydysrhythmias, diabetes, hyperthyroidism, heart disease, or hypertension.
- Side Effects: Noted as the 3T's – tachycardia, tremors, and difficulty sleeping.
- Monitoring: Keep an eye on cardiac dysrhythmias and respiratory status.
- Patient Education: Instruct to take inhaled beta-2 agonist before inhaled glucocorticoid and to avoid caffeine.
Methylxanthines
- Usage: Primarily used for chronic asthma and COPD management.
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Key drugs:
- Theophylline
- Phenytoin/rifampicin (may decrease theophylline levels)
- Fluoroquinolones (may increase theophylline levels)
- Mechanism: Relaxation of bronchi smooth muscle, aiding in bronchodilation.
- Contraindications: Caution in pregnant individuals, children, and those with heart/renal disease, diabetes, or hypertension.
- Side Effects: Observed as SARG – seizures, arrhythmias, restlessness, and gastrointestinal upset.
- Monitoring: Continuous cardiac monitoring for dysrhythmias, respiratory status checks, and blood levels to avoid toxicity.
- Patient Education: Advise against caffeine consumption to minimize side effects.
Anticholinergics (Inhaled)
- Usage: Mainly prescribed for COPD management and occasionally for asthma.
- Key drug: Ipratropium.
- Mechanism: Blocks muscarinic receptors in the bronchi, leading to bronchodilation.
- Contraindications: Not suitable for pregnant patients, those with a peanut allergy, narrow-angle glaucoma, or benign prostatic hyperplasia (BPH).
- Side Effects: Results in severe dryness in various bodily functions (mouth, urination, sight, defecation).
- Monitoring: Watch for dry mouth symptoms and assess respiratory status.
- Patient Education: Encourage hydration and recommend sugar-free candy to relieve dry mouth.
Bronchodilators
- Function: Relax bronchial muscles to expand airways.
- Types: Include beta-2 adrenergic agonists, methylxanthines, and inhaled anticholinergics.
Beta-2 Adrenergic Agonists
- Usage: Treatment for asthma and COPD, specifically for bronchospasm and exacerbations.
- Examples: Albuterol (short-acting), Salmeterol (long-acting).
- Mechanism: Activates beta-2 receptors leading to bronchodilation.
- Contraindications: Not recommended during pregnancy or for patients with tachydysrhythmias, diabetes, hyperthyroid conditions, heart disease, or hypertension.
- Side Effects: Tachycardia, tremors, and insomnia (3T’s).
- Monitoring: Cardiac dysrhythmias and respiratory status should be monitored.
- Patient Education: Take inhaled beta-2 agonist before inhaled glucocorticoid; avoid caffeine.
Methylxanthines
- Usage: Used for chronic asthma and COPD.
- Examples: Theophylline; interactions with phenytoin/rifamp (reduce theophylline) and fluoroquinolones (increase theophylline).
- Mechanism: Relaxes bronchial smooth muscle, resulting in bronchodilation.
- Contraindications: Avoid in pregnancy, children, and patients with heart or renal diseases, diabetes, or hypertension.
- Side Effects: Seizures, arrhythmias, restlessness, gastrointestinal upset (SARG).
- Monitoring: Requires cardiac monitoring for dysrhythmias, respiratory status, and blood levels due to risk of toxicity.
- Patient Education: Avoid caffeine.
Anticholinergics (Inhaled)
- Usage: Primarily for COPD, sometimes for asthma (bronchospasm).
- Example: Ipratropium.
- Mechanism: Blocks muscarinic receptors in the bronchi, leading to bronchodilation.
- Contraindications: Not suitable for patients with pregnancy, peanut allergies, narrow-angle glaucoma, or benign prostatic hyperplasia (BPH).
- Side Effects: Causes dryness – affecting mouth, urination, vision, and gastrointestinal function.
- Monitoring: Observe for signs of dry mouth and respiratory status.
- Patient Education: Maintain hydration; use sugar-free candy for dry mouth relief.
Anti-inflammatories
- Purpose: Reduce airway inflammation.
- Classes: Include glucocorticoids and leukotriene modifiers.
Glucocorticoids
- Usage: Long-term and short-term management of asthma.
- Examples: Prednisone, Beclomethasone.
- Mechanism: Prevents inflammation and mucus production; reduces edema.
- Contraindications: Avoid in pregnancy, live vaccines, systemic infections, diabetes, renal diseases, and hypertension.
- Side Effects: Potential for speech issues, hoarseness, mood changes, sleep disturbances, candidiasis, osteoporosis, hyperglycemia, and increased infection risk.
- Monitoring: Track blood glucose levels, daily weight, and signs of infection.
- Patient Education: Rinse mouth after use; do not stop abruptly; take after inhaled beta-2 agonists; use nystatin for candidiasis.
Leukotriene Modifiers
- Usage: Long-term treatment for asthma.
- Example: Montelukast.
- Mechanism: Suppresses leukotrienes to reduce inflammation, bronchoconstriction, airway edema, and mucus production.
- Contraindications: Avoid in pregnancy and renal disease.
- Side Effects: May cause depression, suicidal ideation, and liver injury.
- Monitoring: Assess mental and respiratory status.
- Patient Education: Take at bedtime on an empty stomach, as food may decrease absorption.
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Description
Test your knowledge on bronchodilators and their effects on the respiratory system. This quiz covers key drug classes, such as beta-2 adrenergic agonists and their applications in treating bronchospasm and bronchoconstriction. Understand contraindications and mechanisms of action to enhance your pharmacology expertise.