Pharmacology PDF Notes

Antitussives (Non-opioid) Dextromethorphan (Delsym; Robitussin) Action Depresses the cough center in the medulla to control cough spasms (CNS) Indications for nin-productive Relief of nonp...

Antitussives (Non-opioid) Dextromethorphan (Delsym; Robitussin) Action Depresses the cough center in the medulla to control cough spasms (CNS) Indications for nin-productive Relief of nonproductive cough Covan Side/Adverse Effects Mild Sedation (Sleepy), nausea, dizziness Client Education/Interventions Avoid administering with grapefruit juice (increases serum levels and can cause toxicity); not for chronic cough Antihistamines Diphenhydramine (Benadryl) Action Competes for histamine receptor sites leading to blocking of the sites Indications Rhinitis, allergies, idiopathic urticaria charco is reverse effect for theothline Side Effects Drowsiness, sedation, anorexia, dizziness, Anticholinergic: dry mouth, urinary hesitation Client Education/Interventions What can we teach our client? educate on Candies don't drive after taking , do humidifier , Caution w/ akchono Mucolytics Acetylcysteine (Mucomyst) Action Thins and enhances the flow of secretions in the respiratory tract Indications Increased mucous secretions, acute and chronic pulmonary disorders exacerbated by secretions, cystic fibrosis Side Effects Drowsiness, dizziness, constipation bronchospasm Client Education/Interventions Monitor cough frequency, effort, & ability to expectorant Promote fluid intake to facilitate the removal of secretions and create productive cough Smells like rotten eggs Can be Antidote for acetaminophen poisoning Expectorants Guaifenesin (Mucinex) Action Enhances the output of respiratory tract fluid by reducing the adhesiveness and surface tension of fluid -> facilitates removal of viscous mucus Indications Respiratory conditions with dry, nonproductive cough and in the presence of mucus in the respiratory tract Side Effects Drowsiness, dizziness, nausea, vomiting, headache Nursing Indications/Considerations Assessment for baseline - Is it effective Oo not take for more than week , alot of over counter made educate on druwsiness : dizziness , Can be used in upper and lower respiratory tract Drugs Acting on the Lower Respiratory Tract Pulmonary obstructive diseases include asthma and COPD (emphysema and chronic bronchitis) – Cause obstruction of major airways and may lead to complications – Obstruction can be related to inflammation that results in narrowing of the interior of the airway and to muscular constriction that results in narrowing of the conducting tube * 1st step of treatment – reduce environmental exposure to irritants *ON TET Then – treatment aimed at opening airways through muscular bronchodilation or decreasing the effects of inflammation on the lining of the airway Asthma Treatment Effective treatment of asthma includes: – Long-term treatment to prevent attacks and decrease inflammation – Short-term treatment when an attack occurs Inhalation treatment is effective with asthma – goes directly to the site of action in the respiratory tract ↑ Most affective COPD Treatment #1 Oxygenation – Monitor effectiveness of low-dose oxygen – RR and Pulse Ox – Encourage oral fluids – Stop smoking #2 Breath Sounds – Auscultate chest or lung sounds – Monitor Pulse Ox – Upright position #3 Medications – Inhaled fast-acting bronchodilators – open airways and remove CO2 – good for acute shortness of breath – Anticholinergics – reduce hypersensitivity – Steroids – reduce inflammation, increase diameter of passageways, improving ease of breathing Xanthines/Methylxanthines Theophylline - Smooth murcies relax diuretic effecto want between 5-15 levels Action Directly relaxes bronchial smooth muscle, causing bronchodilation and increasing vital capacity PO Medication Indications Symptomatic relief or prevention of bronchial asthma Side Effects Irritability, restlessness, dizziness, palpitations, loss of appetite, flushing Nursing Indications Caffeine increases CNS and cardiac ↓ adverse effects Monitor theophylline blood levels (5 to 15 Smokinolizes medication mcg/mL) Activated charcoal for adverse effects due to increased level (poisoning) Increase fluid intake to 2L/day Beta2 Adrenergic Albuterol Sulfate (Proventil, Ventolin) Agent/Sympathomimetics – Bronchodilators Action Mimic effects of the sympathetic nervous system to mimic flight or flight response to widen airways Acts at alpha and beta receptor sites to cause bronchodilation, increased HR, increased RR, and increased BP Inhalation Indications Asthma, COPD Side Effects Tachycardia, Nervousness, restlessness, tremors, palpitations, hypertension Client Education/Interventions Inhalation therapy – effective Education on side effects How to use an inhaler– 3-5 minutes between each puff of an inhaler Or by nebulizer Contraindications Pregnancy, dysrhythmias Sympathomimetics epinephrine Action Reacts at alpha and beta receptor sites in the SNS to cause bronchodilation, increased HR/RR/BP Inhaler or IV/IM Indications Anaphylactic reactions, acute asthma attacks Side Effects Fear, anxiety, restlessness, headache, nausea, tachycardia, rebound congestion with nasal inhalation Nursing Indications Monitor airway Anticholinergic/Bronchodilators Ipratropium (Atrovent) Action Inhalation – inhibits cholinergic receptors in bronchial smooth muscle (bronchodilation) Indications COPD bronchospasms Seasonal allergic rhinitis Asthma Side Effects Increase dry oropharyngeal membranes, blurred vision, nervousness, dizziness, cough, GI distress, hoarseness, bitter taste Client Education/Interventions Educate client that rinsing out mouth Wait 5 min between inhaled medications Dry mouth education Leukotriene Modifiers/Receptor Zafirlukast (Accolate) Antagonists montelukast (Singulair) Action Prevents effects of leukotrienes resulting in decreased inflammation, bronchoconstriction, airway edema, and mucus production PO Indications Long term management of asthma, prophylaxis of asthma symptoms Side Effects Increased liver enzymes, tremor, fatigue, anxiety, agitation, headache, dizziness Depression Precautions DO NOT use for acute asthma attacks Older adults >65 y/o & clients with hepatitis C or significant hepatic dysfunction Glucocorticoids (Inhalation) Beclomethasone (Beconase AQ) Action Prevents inflammatory response by suppression of airway mucus production, immune responses, and adrenal function Indications Asthma, COPD Side Effects Euphoria, insomnia, increased appetite, candidiasis Client Education/Interventions Administered with meals NEVER stop abruptly Inhalation therapy is effective Educate client to rinse mouth out after administration to prevent oral fungal infections Adrenal concerns May cause addisonian crisis Glucocorticoids (PO) Prednisone (Deltasone) - Oral Action Prevents inflammatory response by suppression of airway mucus production, immune responses, and adrenal function Indications Asthma Side/Adverse Effects Euphoria, insomnia, hyperglycemia, increased appetite, weight gain and fluid retention Bone loss – osteoporosis Precautions Never stop abruptly Client Education/Interventions Administered with meals Teach about gradual reduction of dose to prevent Addisonian crisis