Nursing 201: Oxygenation Medications Overview

Beta²-Adrenergic Agonists

Medications that relax smooth muscle and decrease bronchospasm/constriction.

Short-Acting Beta Agonist (SABA)

Used for acute asthma attack as a rescue inhaler with an onset within minutes.

albuterol/Proventil

A SABA used for bronchodilation.

levalbuterol/Xopenex

A SABA used for bronchodilation.

Long-Acting Beta Agonist (LABA)

Used for long-term control of asthma, typically administered twice a day.

formoterol/Perforomist

A LABA used for bronchodilation.

salmeterol/Serevent

A LABA used for bronchodilation.

Combination Products

Medications that combine LABA and corticosteroid to prevent asthma attacks by causing bronchodilation and decreasing inflammation.

salmeterol (LABA) & fluticasone (Corticosteroid)/Advair

A combination product used for the prevention of bronchospasms, not for acute attacks.

Anticholinergics

Medications that decrease secretions, reduce dyspnea/cough, and improve functional lung capacity.

atropine

An anticholinergic medication used for bronchodilation.

ipratropium bromide/Atrovent

An anticholinergic medication used for bronchodilation.

tiotropium bromide/Spiriva

An anticholinergic medication used for bronchodilation.

Methylxanthines

Medications that strengthen diaphragmatic contractions to decrease trapped air and are stimulants similar to caffeine.

theophylline/Theo-dur

A methylxanthine used for bronchodilation.

aminophylline/Somophyllin

A methylxanthine used for bronchodilation.

Corticosteroids/Glucocorticoids

Medications that suppress inflammation and decrease mucus production, reducing airway edema and bronchial hyperactivity.

mometasone/Asmanex

A corticosteroid available in MDI/DPI form.

beclomethasone/Vanceril

A corticosteroid available in MDI/DPI form.

prednisone

An oral corticosteroid.

methylprednisolone/Solu-Medrol

An intravenous corticosteroid.

budesonide (Pulmicort)

A corticosteroid used to suppress inflammation.

fluticasone (Flovent)

A corticosteroid used to suppress inflammation.

Notify PCP

If weight gain, fluid retention, muscle weakness, redistribution of fat or mood changes occur.

Candidiasis infection

A risk associated with long-term use of steroids.

Long-term steroid use

Causes increased risk of osteoporosis and vertebral fractures.

Blood glucose levels

Often elevated with steroid use.

Steroid inhalers

Should be used after bronchodilators.

Oral hygiene after inhaler use

Rinse mouth to reduce the risk of fungal infections and Dysphonia (hoarseness).

Antifungal medication

Administer nystatin or gargles as ordered.

Steroid use in acute attacks

Do not use these medications to alleviate the symptoms of an acute attack.

Steroid tapering method

Use the prescribed tapering method to avoid complications when stopping steroids.

Weight-bearing activity

Teach importance of weight-bearing activity and consuming a diet with calcium and vitamin D.

Systemic steroids and DM

Use caution in patients who have diabetes mellitus (DM).

Monitor blood glucose

May need increased insulin doses.

Adrenal suppression

Monitor for signs of adrenal suppression.

Mast Cell Stabilizers

Cromolyn sodium/Intal creates an anti-inflammatory effect by inhibiting inflammatory cells in the airway.

Mast Cell Stabilizers mechanism

Prevent bronchoconstriction in response to inhaling cold air.

Mast Cell Stabilizers side effects

Unpleasant taste; throat irritation.

Mast Cell Stabilizers administration

Administer 15 minutes prior to exertion; or take daily to prevent an asthma attack.

Monoclonal Antibodies

Dupilumab/Dupixent, mepolizumab/Nucala, reslizumab/Cinqair inhibit interleukins to decrease inflammatory response.

Monoclonal Antibodies side effects

Rash, fever, chills, shortness of breath (SOB), sweating, changes in BP/HR due to infusion.

Leukotriene Modifiers

Montelukast/Singulair creates an anti-inflammatory effect by suppressing the effects of leukotrienes.

Leukotriene Modifiers side effects

Depression & suicidal ideation; headache, nausea, dizziness, insomnia.

Leukotriene Modifiers administration

Must be taken every day on a continuous schedule.