Adrenergic/Anticholinergic Vocabulary Review

Bronchodilation in COPD and Asthma:

• Agents that relax bronchial smooth muscle include:
• Corticosteroid
• Leukotriene
• Adrenergic
• Mucoactive

Bronchoconstriction Characterization:

• Defined as:
• Mucosal edema
• Bronchospasm
• Wheezing
• Reduced airway lumen

B2 Receptor Stimulation Effects:

• Activation by a "front door" medication leads to:
• Bronchodilation

Ultra-short Acting Bronchodilators:

• Includes:
• Racemic epinephrine
• Terbutaline
• Metaproterenol
• Ipratropium

B2-Adrenergic Synonym:

• Identified as:
• Sympathomimetic

Ventolin SVN Dose:

• Appropriate doses include:
• 2.5mg
• 2mg
• 3mg
• 5mg

B1-Adrenergic Effects:

• Effects include:
• Positive cardiac chronotropic effect
• Decreased myocardial contractility
• CNS depressant effects
• Bronchodilation not included

Tolerance to Beta-Adrenergic Inhaler:

• Addressed by using:
• Xanthine
• Corticosteroid
• Anticholinergic

Anticholinergic Use:

• May cause effects if used incorrectly in the eye, such as:
• Scarring of the cornea
• Blindness
• Pupil constriction
• Pupil dilation

Aerosolized Anticholinergic:

• Example:
• Ipratropium bromide

Patient Populations for Anticholinergic Use:

• Indicated for:
• Acute, severe asthma
• Psychogenic asthma
• Nocturnal asthma
• Pulmonary fibrosis

Generic Name for Spiriva:

• Tiotropium bromide

Drug Mechanism Definitions:

• Blocks a receptor site and stops action:
• Antagonist

Duoneb and Combivent Composition:

• Combination of:
• Albuterol and atrovent

SVN Treatment Monitoring:

• If heart rate increases:
• Continue and monitor or notify physician depending on severity

Brand Name for Formoterol:

• Foradil

Adverse Effects of Adrenergic Bronchodilators:

• Includes:
• Hyperkalemia not common
• Tachycardia
• Worsening V/Q mismatch
• Tremor

Ipratropium Nebulized Dose Precautions:

• Protect patient’s eyes and advise caution not to swallow

COPD Treatment Outcome:

• Greater FEV1 increase with combination therapy (albuterol + ipratropium) than alone

Common Side Effects of Aerosolized Ipratropium:

• Includes:
• Nasal congestion
• Dry mouth
• Cough
• Not excessive salivation