midterm meds

Short-Acting Beta Agonists (SABAs)

Quick-relief agents used to treat acute asthma attacks.

Examples of SABAs

Albuterol (Proventil, Ventolin), Levalbuterol (Xopenex).Terbutaline (Brethine)

Action of SABAs

Relax the bronchiole smooth muscles.

Key side effects of SABAs

Skeletal muscle tremors, tachycardia, palpitations, hypokalemia.

Short-Acting Anticholinergics

Used for acute exacerbation; an example is Ipratropium (Atrovent).

Action of Short-Acting Anticholinergics

Prevents bronchoconstriction and bronchospasms, decreases pulmonary secretions. Moa short

Key warning for Short-Acting Anticholinergics

Report headache, blurred vision, or palpitations as they may indicate toxicity.

Systemic Corticosteroids

Short-term anti-inflammatory agents for exacerbations.

Examples of Systemic Corticosteroids

Methylprednisolone (IV), Prednisone (PO).

Key side effects of Systemic Corticosteroids

Hyperglycemia, fluid retention, weight gain, GI bleed, decreased immunity, decreased bone density.

Long-Acting Beta Agonists (LABAs) combined with??

Used as maintenance therapy, often in combination with inhaled corticosteroids.

Examples of LABAs

Formoterol (Symbicort), Salmeterol (Serevent Diskus).

Key side effects of LABAs

Skeletal muscle tremors, tachycardia, palpitations, hypokalemia.

Inhaled Corticosteroids (ICS)

Anti-inflammatory medications used for long-term control.

Examples of Inhaled Corticosteroids

Beclomethasone (Qvar), Budesonide nebulas (Pulmicort), Fluticasone (Flovent), mometasone (Nasonex).

Key nursing point for ICS

Client must rinse mouth after use to prevent oral thrush.

Long-Acting Anticholinergics

Used for maintenance therapy.

Examples of Long-Acting Anticholinergics

Tiotropium (Spiriva), Glycopyrronium, umeclidinium

Key actions of Long-Acting Anticholinergics

Prevents bronchoconstriction and decreases pulmonary secretions.

Side effects of Long-Acting Anticholinergics

Dry mouth, cough, urinary retention, UTIs, constipation, nausea, dizziness, dyspepsia.

Theophylline

A long-acting agent primarily for COPD and considered a last resort.

Action of Theophylline

Relaxes smooth muscle in the airways and creates mild bronchodilation.

Key nursing point for Theophylline

Requires routine monitoring of blood levels.

Side effects of Theophylline

Tachycardia, tremors, hyperglycemia, hypokalemia, vomiting.

Mucolytic Agents moa

Help thin secretions for COPD symptom management.

Examples of Mucolytic Agents

Acetylcysteine, Guaifenesin, dornase alfa, dextromethophan

IV Magnesium Sulfate

Used as part of treatment for status asthmaticus.

IV Epinephrine infusion

for status asthmaticus if hypotensive.

carbidopa/Levadopa (dopamine precursors)

Primarytreatment for parkinsons

levodopa

chemical precursor to dopamine,

once it passess the BBB -> turns to a active form of dopaminers.

carbidopa

protects the levodopa from being broken down by other enzymes until itgets to the BBB then it releases dopamine

pt teaching for carbidopa and levodopa

Take the 2 medications on schedule e take it on time. To maintaina therapeutic level helps lessen the symptoms of dopamine.

levodopa/carvidopa interactions

don’t take any supplements, herbs, OTC meds, Don't take the med with protein at the same time the protein it inhibits absorption

levadopa/cavidopa report

report uncontrolled movements, mental changes, palpitations, N & V, dysuria

(pramipexole) dopamine receptor agonist

directly stimulates dopamine receptors

pramipexole monitor

hypotension, dyskinesia, hallucinations

Trihexyphenidyl (Cogentin) <anticolinergics>

lower acetylcholine activity —> blocks cholinergic effect

trihexyphenidyl MOA & SE

helps muscle rigidity. SE. dry mouth, urinary retention, constipation

Monoamine Oxidase Type B (MAO-B) Inhibitors → Selegiline (Eldepryl)

Therapeutic effect : increase dopamine levels by blocking the breakdown of

it also reduces the wearing off of levadopa/carbidopa means that you will get the full affect during those 6 hours.

iv monoclonal antibodies: Natalizumab, Rituximab 

Natalizumab & Rituximab binds to your WBC prevents from crossing the BBB

Natalizumab SE

immunosuppresan, hepatotoxic , thrombocytopenia, dizzy, multi-focal leukoencephalopathy ( rare- attacks brain tissue)

• Immunomodulators: im injections

  • Interferon Beta-1a and Beta-1b (Avonex)

  • Glatiramer acetate (Copaxone) (Subq)

  • Fingolimod (Gilenya)

helps reduce Multiple sclerosis exacerbations don’t take while pregnant

interferon Beta-1a and Beta-1b (Avonex)

helps reduce exacerbations, SE: flu-like symptoms (Tylenol) . depression and suicidal ideation, hepatoxicity, mylosuppression ( bone marrow—> leukopenia, thrombocytopenia, anemia) 

pt teaching: rotate sites, deposit needles, redness/rash infection-phlebitis

Glatiramer acetate (copaxone)(subd)

it modifies the immune function responsible to multiple sclerosis

se:vasodilation, chest pain, tachycardia, palpitation, hepatotoxic, immune suppresses (Increase risk of infections)

patient teaching: don’t take live vaccines

fingolimod ( Gilenya )

educes the movement of your lymphocytes to WBS across the BBB.

Bradycardia,heart block asystole, hepatotoxic, causes leukopenia (WBC ↑risk for infections)

PT: no live vaccine .

antinoplastic- Mitoxantrone (IV)

inhibits DNA synthesis which slows progression ↓ disability that is seen in MS.

Se: Cardiotoxic thrombocytopenia, leukopenia,hepatotoxic, it can also cause leukemia.

drug therapy for MS

• Spasticity (baclofen, dantrolene)

• Fatigue (amantadine, pemoline)

• Tremor, vertigo, depression

• Pain (NSAIDs, acetaminophen),

• Bowel problems (docusate, polyethylene glycol)

• Bladder problems (oxybutynin, tamsulosin)

• Parasthesia (carbamazepine),

• Sexual problems, congitive changes

• Ataxia (propranolol & clonazepam)

cholinesterase inhibitors - donepezil, rivastigmine

stops breakdown of acetylcholine to help memory

1-4 weeks to work, full benefit after 6 months

may cause nausea, vomitting, diarrhea, sweating, slow heart rate, urinary urgency

NMDA antagonist memantine

blocks nerve cell damage caused by excessive glutamate.