COPD Study Guide PDF

Bronchodilators Adrenergics Anticholinergics Methylxanthines Glucocorticoids Can be given oral or Inhalation Anti-inflammatory Agents Inhaled corticosteroids Leukotriene Mast Cells Inhaled Corticosteroid (pulmicort, Flunisolide-AeroBid prototype) Clients making the transition from oral to inhaled...

Bronchodilators Adrenergics Anticholinergics Methylxanthines Glucocorticoids Can be given oral or Inhalation Anti-inflammatory Agents Inhaled corticosteroids Leukotriene Mast Cells Inhaled Corticosteroid (pulmicort, Flunisolide-AeroBid prototype) Clients making the transition from oral to inhaled have increased risk of adrenal insufficiency if they experience trauma, surgery, or infections(especially gastroenteritis) Leukotriene Zafirlukat Accolate prototype Singular Prophylactic Anti-inflammatory Should not be used during acute asthma attack Used for chronic asthma Interacts with Theophylline increase its drug level LABA Long acting Beta Agoinst Salmeterol Not used in abortive therapy as long acting Antihistamines 1st gen Benadryl used for sleep, motion sickness, and antimetic Do not use if you have gluacoma Anticholonirgic 2nd gen Loratadine once a day on an empty stomach apple , grapefruit and orange juice interferes with drug Rifampin decreases absorption Allergra SABA Short acting beta agonist Albuterol Used in acute asthma attacks If used more than 2-3 times per week poorly controlled asthma Overuse may cause rebound bronchoconstriction Methylxanthines (theophylline) Range 5-15 Have a narrow therapeutic range closely monitor There is no antidote for toxicity Toxicity 20mcg at 30mcg seizures, hyperglycemia, hypotension, brain damage If levels decrease screen diet, OTC drugs, smoking habits, adherence to medication Tobacco with increase half life by 50%. If smoking increase theophylline dose. Caffeine including otc drugs with caffeine can increase theophylline dose. Theophylline decreases the effects of lithium Stages of COPD Treatment and Guidelines 1.​ SABA PRN to manage acute episodes 2.​ SABA plus long acting anticholinergic (ipratropium) Bronchodilator. Consider theophylline for breakthrough symptoms 3.​ Add inhaled steroid Palmocort 4.​ Add oxygen Inhaled steroids decrease frequency of exacerbation Mast Cell Chromlin prophylactic anti-inflammatory agent not bronchodilator Bitter taste in mouth after administration Salmeterol Long acting bronchodilator Do not use with a beta blocker Servant Diskus Used in chronic maintenance of asthma and COPD Do not use PRN Do not take more than twice daily Ipratropium Anticholinergic Long Acting anticholinergic Atrovent First line treatment for COPD Prescribed in oral and nasal Give last after other inhalers Give 5 min before steroid Not a first choice in acute situations because long acting Can produce a paradoxical bronchospasm with newly opened MDI MDI 2 sprays before use Antidepressants SSRI Indication depression First line treatment Fluoxetine, sertraline, paroxetine, citalopram, escitalopram, fluvoxamine Adverse effects Sexual function, mania Serotonin syndrome presents in 6-8 hrs of initiation or increasing dose Contraindicated for clients taking MAOI- need to wait five weeks after discontinuation before starting SSRI Administer with caution for clients taking anticoagulants- protein bound Avoid breastfeeding Tricyclic Antidepressants Once daily Imipramine tofrail Desipramine norpramine Amitriptyline Doxipine Nortiptyline Pamelor Indication eating disorder and Insomnia Adverse effects Cardiac conduction disorders Monitor drug level