Respiratory Medications

Using an inhaler with a spacer

§ 1. Before each use, remove the caps from the inhaler and the spacer.

§ 2. Insert the mouthpiece of the inhaler into the non-mouthpiece end of the spacer.

§ 3. Shake the whole unit vigorously three or four times.

§ 4. Fully exhale and then place the mouthpiece into your mouth, over your tongue, and seal your lips tightly around it.

§ 5. Press firmly down on the canister of the inhaler to release one dose of medication into the spacer.

§ 6. Breathe in slowly and deeply. If the spacer makes a whistling sound, you are breathing in too rapidly.

§ 7. Remove the mouthpiece from your mouth; and, keeping your lips closed, hold your breath for at least 10 seconds and then breathe out slowly.

§ 8. Wait at least 1 minute between puffs.

§ 9. Replace the caps on the inhaler and the spacer.

§ 10. At least once a day, clean the plastic case and cap of the inhaler by thoroughly rinsing in warm, running tap water; at least once a week, clean the spacer in the same manner

Using an Inhaler without a spacer

§ Shake the inhaler for 5-10 seconds, remove the cap, and breathe out fully.

§ Place the mouthpiece between your teeth, sealing your lips tightly.

§ Press the canister once while taking a slow, deep breath, then hold your breath for 10 seconds

Bronchodilators

Beta 2 Adrenergic Agonists

Cholinergic Antagonist

Combination Short-acting Beta 2 Adrenergic Agonist and Cholinergic Antagonist

Methylxanthines

Beta 2 Adrenergic Agonists medication names

§ Salbutamol, Albuterol (Proventil, Ventolin)

§ Fenterol (Alupent)

§ Terbutaline (Brethine)

§ Formoterol (Foradil)

§ Salmeterol (Serevent)

§ Levalbuterol (Xopenex)

§ Arformoterol (Brovana)

Cholinergic Antagonist medication names

§ Ipratropium Bromide (Atrovent)

§ Tiotropium bromide (Spiriva)

Combination Short-acting Beta 2 Adrenergic Agonist and Cholinergic Antagonist med

§ Salbutamol/Ipratropium (Combivent)

Methylxanthines medication names

§ Aminophylline

§ Theophylline (Theo Dur, Slo-Bid)

Cholinergic Antagonsists also decrease

pulmonary secretions

Cholinergic Antagonsists side effects

dry mouth

Cholinergic Antagonsists Systemic s/s of overdose-

§ blurred vision, eye pain, headache, nausea, palpitations, tremors, inability to sleep

Corticosteroids will

decrease inflammation, but does not bronchodilate

Corticosteroids need to

be used with a bronchodilator

Corticosteroids indications

Rinse mouth after inhaled steroid→ avoid thrush

Beta 2 adrenergic agonists Side effects:

§ Tremors, nervousness, tachycardia, hypo/hypertension, hypoglycemia, blurred vision, muscle cramps, N/V, dysrhythmias, flushing

Beta 2 adrenergic agonists avoid

§ excessive use of caffeine and certain OTC medications with caffeine

§ Increase fluids

Methylxanthenes have a

Narrow margin of safety

Methylxanthenes Side Effects

§ vomiting, dizziness, tachycardia, palpitations, arrhythmias, severe hypotension, diarrhea, seizures, and respiratory arrest

Methylxanthenes considerations

§ Avoid caffeine

§ Give with histamine blockers and food to prevent GI upset

§ May be given IV

Mast Cell Stablizers side effects

dry mouth, cough, bronchospasm, headache, and sneezing

Mast Cell Stablizers full effect in usually

6-8 weeks

Leukotriene Antagonists have a

Slow onset of action

Leukotriene Antagonists take

1 hr before a meal or 2 hrs after a meal

§ Take it even when symptom-free to be effective

with Leukotreine Antagonists, periodic

liver function tests need to be done

Do not take Leukotriene Antagonists with

§ theophylline

Leukotriene Antagonists side effects

headache, nausea, mild infections, and GI upset