Resp drugs PPT Fall 23-1.ppt

Respiratory Drugs NSG 170 R. LONG, MSN, RN, CPNP  Used for bronchodilation Beta2- adrenergic Forms agonists  Inhalation (I) Examples  Systemic Albuterol (S,I)  Long-acting (L) Bitolterol (S,I)...

Respiratory Drugs NSG 170 R. LONG, MSN, RN, CPNP  Used for bronchodilation Beta2- adrenergic Forms agonists  Inhalation (I) Examples  Systemic Albuterol (S,I)  Long-acting (L) Bitolterol (S,I)  Short-acting (S) Levalbuterol (S,I) Beta-adrenergic blockers Metaproterenol (S,I) decrease the bronchodilating Pirbuterol (S,I) effects of these drugs Often used with inhaled Terbutaline(S,Sy) Formoterol (L,I) corticosteroids Treat symptoms of COPD and Salmeterol (L,I) asthma  Inhaled forms (neb or MDI) Anticholinergic Work locally s Bronchodilator Example: Relieve symptoms of COPD Ipratroprium bromide (Atrovent)… most commonly used and asthma Works in 15-20 minutes, lasts 3-5 hours  Forms Corticosteroid  Inhaled s  Systemic-IV Examples: Most effective treatment and Beclomethasone (inhaled) prevention of acute asthma Prednisone (po) attacks Prednisolone (po- Special considerations liquid)  Peds-growth Hydrocortisone- sodium succinate  Elderly-osteoporosis Methylprednisolone  Diabetics- more carefully monitor -IV sodium blood glucose levels succinate  Passed to infant through breast milk Leukotriene Stop the effects of leukotrienes. modifiers Decreases: Examples:  airway constriction Montelukast (Singulair)  increased permeability of the vasculature Zafirlukast  increased secretions Zileuton  activation of inflammatory response. Used in place of steroids for control of mild to moderate asthma Mast cell Stabilize mast cell membrane Stabilizers preventing the release of Cromolyn sodium (Intal) inflammatory mediators nedocromil Prevention and long- term control of asthma symptoms Drug of choice for children and patients with exercise induced asthma Inhaled or oral.   Theophylline toxicity  Diet- High fat meals can increase risk Methylxanthine s  Must monitor blood levels. Therapeutic serum levels 10- Aminophylline (IV) 20mcg/mL Theophylline (oral)  Decrease airway reactivity and Caffeine bronchospasm  Bronchodilation * Caution… S/S of toxicity include GI,  Decreased inflammatory response nervous system,  Non-reversible airway disease and cardiac arrhythmias  Increase brains sensitivity to CO2  Reduce diaphragm fatigue  ACE (Asthma, chronic bronchitis, emphysema)   Used when there is increased production of respiratory secretions  Reduces thickness, adhesiveness, and Expectorants surface tension of mucus; making it Guaifenesin most easier to clear airway. Makes it easier commonly used to cough up secretions. (Mucinex) PO  Relieves symptoms of non- productive cough associated with  Bronchitis  Colds  Emphysema  Influenza  Sinusitis  Bronchial asthma  Minor bronchial irritation  Treat serious non-productive cough Antitussives Drug interaction with *Dextromethorphan (Delsym, Robitussin, MAOI’s can lead to coma in Dayquil). PO-OTC. Codeine with other CNS depressants may increase Benzonatate (Tessalon) –RX only CNS depression (lethargy, Codeine-RX only drowsy, dizzy, respiratory Hydrocodone depression, coma, and death) bitartrate-Rx only Not advised to use with *most commonly used chronic conditions (asthma, COPD).   Break down sticky, thick secretions, thin it out and help it Mucolytics move easily from the lungs. Acetylcysteine (N-  Uses acetylcysteine)  Bronchitis Dornase Alpha (CF  Cystic fibrosis pts. Only)  COPD/asthma (Mucomyst and Pulmozyme..brand  Acetylcysteine also the antidote names). for Acetaminophen toxicity  Activated charcoal decreases the (Po, IV or nebulized) effectiveness  Not recommended for asthma patients due to risk of bronchospasm   Cause vasoconstriction which decreases inflammation and decreases capillary Decongestant permeability s  Topical decongestants have minimal Ephedrine (S, T) adverse reactions and act quickly Phenylephrine (Sudafed  Systemic decongestants PE) (S, T)  Cause jitteriness, trouble sleeping. Pseudoephedrine  combined with MAOIs may cause (Sudafed) (S,T) hypertensive crisis Oxymetazoline (Afrin nasal spray)  Combined with other sympathomimetic Naphazolone (T) drugs may cause greater CNS stimulation Tetrahydrozoline (T)  Pseudoephedrine sold behind the Xylometazoline (T) counter, due to it’s use in making (T- topical S-systemic- methamphetamines. po pills and liquid,  Phenyephrine no potential for misuse. nose gtts, nasal sprays).  Epogen Colony Epogen increases RBC production by acting Stimulating like the hormone erythropoietin (in kidneys). Factors Used to treat anemia by helping the body Epogen, Procrit create more RBC’s (thus more Hgb). (RBC’s) (epoetin Hgb allows the body to carry O2 to the cells, alfa) (injection-SQ or thus increasing function of the organs. IV)) Decreases need for blood transfusions. Neupogen (WBC’s) Not for acute anemia/blood loss. Give 1-3 (filgrastim) x/week. (injection-SQ) Improves ability to walk, move, and do self care. Neupogen Bone marrow stimulant Helps the body make white blood cells (neutrophils). May give daily for 2 weeks. Side effects: bone pain, rash, headache.