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Nurs301- week 9

by: Mary Eke

Nurs301- week 9 330

Mary Eke
GPA 3.83
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About this Document

This note covers the lecture on Medications affecting respiratory system, including drugs for asthma.
Dr. Amendolia
Class Notes
Respiratory, medication, Asthma, Drugs, system




Popular in Pharmacology

Popular in Nursing and Health Sciences

This 4 page Class Notes was uploaded by Mary Eke on Thursday August 4, 2016. The Class Notes belongs to 330 at Drexel University taught by Dr. Amendolia in Summer 2016. Since its upload, it has received 4 views. For similar materials see Pharmacology in Nursing and Health Sciences at Drexel University.


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Date Created: 08/04/16
Medication affecting respiratory system: Asthma Types of inhaled devices:  Metered dose inhaler (MDI): small, hand pressurized device, delivers a measured dose of drug upon activation. Patient inhales first before inhaling drug. Spacers increases delivery of drugs to lungs  Dry powder inhaler (DPI): delivers directly to lungs, breath activated, easier to use, no need for spacers  Nebulizers: Converts drug solution to mist, takes several minutes before activation, can be used anywhere. Advantages of Inhalation medications  Therapeutic effects are enhanced  Systemic side effects are minimized  Rapid relief of asthma acute attack Classification of medications Bronchodilators Anti- inflammatory  Adrenergic corticosteroids  Anticholinergic leukotriene modifiers  Xanthine mast cell stabilizers Other classifications: expectorants, antitussives, mucolytics, nasal decongestants, antihistamines Bronchodilators:  they provide acute symptomatic relief  they provide long term control, but they don’t alter inflammation 1. Beta 2-Adrenergic Agonist o Stimulate the beta 2 adrenergic receptors in smooth muscle of bronchi and bronchioles o Causes bronchodilation o Relieves bronchospasm o Suppresses histamine release in lung o Increases ciliary motility o Preferred drug for exercise induced bronchospasm o They are selective and not absolute o They result in tachycardia, monitor pulse before administration o Contraindicated on pts with angina, certain dysrhythmias. o Tremor is another side effect  Short acting beta 2 agonist (SABA): taken prn to relieve asthma attack. Albuterol (Proventil)  Long acting beta 2 agonist (LABA): taken on schedule for frequent attacks. Combined with glucocorticoids. Salmeterol (Serevent Diskus) 2. Anticholinergics o Improve lung function by blocking muscarinic receptors in the bronchi, causing bronchodilation. o Both classes are administered by inhalation o The principal difference between two classes is pharmacokinetics, tiotropium lasts longer and is administered less often o Most common adverse effect is dry mouth  Ipratropium (Atrovent) : is a muscarinic antagonist, used for bronchospasm associated with COPD, and can be combined with albuterol, avoid with patients with peanut allergy  Tiotropium (Spiriva): long acting, used for maintenance of bronchospasm associated with COPD, most effective and convenient but for long term purposes 3. Xanthines: o Bronchodilation o Inhibits pulmonary edema o Increases ciliary action o Decreases inflammation o Excitation, cardiac stimulation and diuresis  Theophyline: has a narrow therapeutic index, PO, for long term treatment and maintenance of chronic stable asthma. Toxicity can cause: nausea, vomit, diarrhea, insomnia, restlessness, lethal heart rhythms. Activated charcoal can decease absorption. Avoid caffeine.  Aminophylline: is available in oral and IV dosing. Administer slowly, rapid administration can cause hypotension and death. Anti-inflammatories:  Taken daily for long term control  foundation of asthma therapy 1. Corticosteroids (glucocorticoids) o First line treatment of asthma, most effective antiasthma drugs available o Reduce asthma symptoms by suppressing airway inflammation o Decrease mucous production o Restores or increases effectiveness of beta 2 receptors and agonists o Administered by inhalation (Fluticasone), PO (Prednisone), IV (Methylprednisone), or Nebulizer (Budesonide) o Adverse effects include: oropharyngeal candidiasis, dysphonia (rinse and gargle after, use spacer) 2. Leukotriene Modifiers (antagonists) o they suppress the effects of leukotrienes which are strong chemical mediators that cause bronchoconstriction, eosinophil infiltration, mucus production and airway edema o second line therapy, adjunct therapy  Singulair indication: prophylaxis and maintenance therapy in asthma, prevents EIB, relieves allergic rhinitis. Can’t be used for rapid relief because of slow development of effects. Adverse effects: depression and suicide thinking/behavior (neuropsychiatric)t 3. Mast Cell Stabilizers:  These drugs stabilize mast cells which release bronchoconstrictive and inflammatory substances when confronted with allergen or other stimuli.  Cromolyn: suppresses inflammation by preventing release of histamine and other mediators Other classifications  Expectorants: Liquefy respiratory secretions, and allow for easier removal. It increases respiratory tract flow by promoting secretion of mucous. [Mucinex/Guaifenesin]  Antitussive: cough suppresser. It depresses coudh center in the brain, trachea and lungs. Given for dry hacking cough. [Codeine (opioid), Dextromethorphan(nonopiod)]  Mucolytics: given inhalation or via nebulizers. They liquefy mucus for productive cough. Effective within 2 minute. [Acetylcysteine- PO form used for acetaminophen overdose antidote]  Nasal decongestant: sympathomimetic, relieve nasal congestion. Given PO or via nasal spray. Rebound nasal swelling can occur with excessive use. [Sudafed, Afrin]  Antihistamines: they block histamine 1 receptors; decreasing rhinorrhea, sneezing and nasal itching. They do not reduce congestion. Used for mild to allergic running nose, motion sickness, insomnia, and common cold. Administered regularly. Adverse effect: sedation, dizziness, incoordination, confusion, fatigue, GI, urinary hesitancy, palpitations. Excreted in breast milk and interacts with alcohol and CNS depressants  1 generation: produces much sedation and cholinergic endects; Benadryl, Phenergan, Dexchlorpheniramine  2 generation: produces little or no sedation, minimal anticholinegic effect, expensive; Zyrtec, Allegra, Claritin, Clarinex


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