respiratory meds part 1

Albuterol drug class

(Beta 2-Adrenergic Agonist)

albuterol mechanism of action

- activates beta 2 receptors in the bronchus

- results in bronchodilation through relaxation of bronchial smooth muscle

albuterol leads to relief of

- bronchospasm

- inhibition of histamine release

- inc ciliary motility

- facilitates mucus drainage

albuterol routes of administration

- inhalation: short acting, acute attacks

- oral: long acting, not for acute attack

albuterol uses

- prevention of exercised induced asthma

- long term control of asthma

- bronchospasm

- acute asthma attack

albuterol adverse reactions/complications

- tachycardia, angina

- tremors

- chest pain

- palpations

- nervousness

albuterol drug interactions

- beta blockers: negate each other

- MAOIs: tachycardia + angina

- Caffeine: inc nervousness, tremors, palpations

albuterol precautions/contraindications

- pregnancy

- monitor pulse rate

- advice pt to avoid caffeine

albuterol nursing responsibilities

monitor pt pulse for inc of >20-30 bpm

albuterol patient education needs

- proper inhaler use (hold breathe for 10 sec after inhaling)

- wait 1 min before second puff

- for exercise induced 30 min prior to exercise

- know if schedules or PRN

- notify provider if asthma↑

If using with an inhaled glucocorticoid:

use bronchodilator (albuterol) first, wait 5 minutes, then use glucocorticoid (B before G).

common triggers of asthma

- air pollutants

- smoke

- allergens

- chemicals

- certain foods

- respiratory infections

- stress

- exercise in dry/cold climates

Beclomethasone drug class

inhaled glucocorticoid

Beclomethasone mechanism of action

- prevents inflammation

- reduces airway edema

- dec mucus production

- promotes beta 2 receptors

Beclomethasone routes of administration

inhaled

Beclomethasone uses

- short term IVs for asthma

- inhalation: preventative (long term)

- dec frequency of asthma aattack

- does not terminate attack in progress

Beclomethasone adverse reactions/complications

- cadidiasis

- difficulty speaking

- hoarseness

- headache

- sorethroat

candidiasis

- oral fungal infections

- redness, sore, thick white patches, occurs if mouth not rinsed

Beclomethasone precautions/contraindications

fungal patients

Beclomethasone nursing education

- instruct client to rinse mouth after using

- avoid known triggers

Beclomethasone patient education

- rinse mouth thoroughly after each use

- avoid known asthma triggers

- use albuterol before beclomethasone

prednisone drug class

Glucocorticoid

prednisone routes of administration

oral and IV

prednisone adverse reactions

- suppression of adrenal gland function

- bone loss

- peptic ulcer disease

- hyperglycemia

- myopathy

- infection

- inc appetite & weight gain

- trouble sleeping/insomnia

- fluid & electrolyte disturbance

prednisone drug interactions

- NSAIDs

- potassium wasting diuretics

- insulin

prednisone precautions/contraindications

- diabetics

- osteoporosis

- kidney issues

- GI bleed

prednisone nursing responsibilities

- Monitor blood glucose levels.

- Monitor for muscle weakness (myopathy); notify PCP.

- Encourage taking with food to reduce peptic ulcer risk.

prednisone patient education

- Do not stop medication abruptly

- Take vitamin D and calcium supplements

- weight bearing exercises

- Take with food to prevent peptic ulcers

- avoid kids & crowds

- Expect potential weight gain and difficulty sleeping

codeine drug class

opioid Antitussive (cough suppressant)

codeine mechanism of action

suppresses cough by working on the CNS

codeine routes of administration

Po (XR or syrup)

codeine uses

chronic nonproductive cough to decrease the frequency and intensity

Codeine adverse reactions/complications

- CNS effects: sedation, hypotension, respiratory depression

- GI upset: nausea, vomiting, constipation

- dizziness

Codeine drug interactions

- alcohol: inc cns effects

- other cns depressants

codeine nursing precautions/contraindications

- cautions w pregnancy

- caution w children (must be 18+)

- caution w older adults

codeine nursing responsibilities

- hold med if RR <12 breaths/minute

- obtain and monitor baseline vital signs, especially RR

- Ensure patient safety: bed low, side rails up, call light reachable, clear pathways

codeine Patient Education

- Prevent constipation: Increase fluids, fiber, ambulation.

- Change positions slowly (due to hypotension/dizziness).

- Avoid hazardous activities

- no alcohol

- Potential for abuse.

Dextromethorphan drug class

non opioid Antitussive

Dextromethorphan mechanism of action

suppress cough through its action on the cns

Dextromethorphan routes of administrations

- capsules

- lozenges

- syrup

Dextromethorphan uses

cough suppression

Dextromethorphan adverse reactions/complications

- Mild nausea and

dizziness

- sedations

- Drowsiness

- in high doses can produce euphoria

Dextromethorphan drug interactions

- High fever if used within 2 weeks of MAOI antidepressants.

- Alcohol, opioids, other CNS depressants

- Grapefruit juice.

Dextromethorphan precautions/contraindications

- post operative pt who have undergone thoracic surgery

- cough reflex should not be suppressed

- Some formulations may contain alcohol or sucrose.

Dextromethorphan nursing responsibilities

monitoring for increased sedation if used with other CNS depressants.

Dextromethorphan patient education

- Do not use longer than 2 weeks without medical advice.

- safe to use during pregnancy.

- Avoid hazardous activiites

- Seek physician if cough persists > 2 week