Week 9 Respiratory - Exam 2

albuterol class

SABA bronchodilator, beta agonist

albuterol, formoterol, salmeterol dynamics

selectively stimulates receptors of smooth muscle in lungs, uterus, and skeletal muscle vasculature

albuterol contraindications

hypersensitivity

albuterol interactions

sympathomimetics, beta blockers, digoxin, antidepressants, K - losing diuretics

formoterol/salmeterol class

LABA bronchodilator, beta agonist

formoterol/salmeterol nursing interventions

increased BP/pulse, give with steroid

ipratropium bromide class

SAMA anticholinergic bronchodilator

ipratropium bromide dynamics

muscarinic antagonist

ipratropium bromide contraindications

ipratropium and atropine sensitivity

ipratropium adverse effects

paradoxic acute bronchospasm, cough, hoarseness, dysgeusia, dryness

tiotropium class

LAMA antimuscarinic antagonist

theophylline, aminophylline, dyphylline, caffeine class

xanthine derivative bronchodilator

xanthine derivative nursing interventions

narrow therapeutic index - potentially toxic (monitor blood levels). hold if tachy, low BP, change in mental status, vomiting

theophylline toxicity symptoms

GI, CNS (disorientation, seizure), tremors, CV (arrhythmia, hTN, tachy)

acetylcysteine class

mucolytic

acetylcysteine indications

CF, acetaminophen OD, give after albuterol

acetylcysteine nursing interventions

kinda stinks, allergy, increased secretions

dornase alpha (Pulmozyme)

mucolytic for CF (it’s really expensive). made of hamster ovary cells. reduces exacerbations and increases lung function

dextromethorphan class

cough suppressant

dextromethorphan dynamics

affects cough center, may lead to resp dep if too much, NMDA antagonist (mimics glutamate)

dextromethorphan nursing interventions

don’t give to kids (ineffective + risky), cat C

dextromethorphan adverse effects

N+V, drowsy, dizzy, irritable, restless, seizure, elevated BP, abuse

dextromethorphan interactions

MAOIs (HTN crisis), fluoxetine, quinidine, sibutramine

codeine (cough suppressant) dynamics

suppress cough reflex in medulla, has drying effect on mucosa of resp tract, used in liquid combinations

what else is a cough suppressant (this is here as a reminder)

NSAIDS

guaifenesin class

expectorant

guaifenesin dynamics

reduce stickiness of respiratory tract fluids. not very effective, but also safe.

guaifenesin indications

older adults who need fluid restrictions and need to thin secretions

glucocorticoid, beclamethosone class

steroid anti-inflammatory

glucocorticoid dynamic

wide target, blocks inflammatory cascade by inhibiting leukotrienes and prostaglandins

glucocorticoid nursing interventions

taper if taken more than 10-14 days

beclomethasone nursing interventions

thrush, sore throat, cough, will not relieve acute attack

pseudoephedrine (Afrin) class

vasoconstrictor, bronchodilator decongestant

pseudoephedrine contraindications

HTN, pregnancy/lactation, CAD

pseudoephedrine drug interactions

MAOIs, guanethidine, methyldopa, furazolidone

phenylephrine (Sudafed) class

a1 agonist, vasoconstrictor

phenylephrine kinetics

metabolized by MAO in liver, lower availability

antihistamine dynamics

inactivate H1 (resp + CNS) and H2 (stomach)

diphenhydramine (Benadryl) class

first gen antihistamine

diphenhydramine dynamics

cross BBB, sedation, anticholinergic SE, caution BPH

loratadine (Claritin)

second gen antihistamine, less CNS SE

fexofenadine, cetirizine class

second gen antihistamine, H1 blocker

fexofenadine kinetics

peak 2-6 hr, T1/2 14.4

fexofenadine, cetirizine adverse effects

N+V, dysmenorrhea, drowsiness, dyspepsia, fatigue, constipation, dryness, caution w/pregnancy. minimal interactions w apple, grapefruit, OJ

cetirizine class

second gen antihistamine, H1 blocker

cetirizine kinetics

onset 30 min, peak 1 hr, T1/2 8 H, food blocks absorption

montelukast class

leukotriene receptor antagonist, anti-allergy

montelukast indications

asthma, allergic rhinitis, allergies

montelukast nursing interventions

SE - GI + CNS, suicide and depression in children