Medications for PNA and PE

Medications for Pneumonia (PNA) and Pulmonary Embolism (PE)

Medications for Pneumonia (PNA)

1. Bronchodilators

• Purpose: Reduce bronchospasm and irritation in the lungs.

• Types of Bronchodilators:

  • SABAs (Short-Acting Beta Agonists): Used for quick relief.

  • Examples:

    • Albuterol

    • Levalbuterol

  • Cholinergic Agonists:

  • Example: Ipatropium

• Mechanism: Increases bronchodilation and decreases pulmonary secretions.

• Combination Therapy: Often combined with SABA (referred to as "duoneb").

• Considerations: Patient education on administration techniques.

2. Mucolytics and Antitussives

• Mucolytics:

  • Purpose: For productive cough; helps thin secretions for easier expectoration.

  • Commonly Used: Guaifenesin (Mucinex).

• Antitussives:

  • Purpose: Cough medications that suppress the cough reflex; can be beneficial for dry cough.

  • Examples:

  • Codeine/Hydrocodone

  • Dextromethorphan

  • Benzonatate (Tessalon Perles)

• Nursing Considerations:

  • Monitor patient's cough and level of consciousness (LOC) and respiratory status when using opioids.

3. Antibiotics for Bacterial Pneumonia

• Common Classifications:

  • Penicillins

  • Cephalosporins

• Others: Macrolides and fluoroquinolones are used for patients with co-morbidities or previous antibiotic therapy failure.

• Severe Cases: May require broad-spectrum antibiotics such as:

  • Piperacillin/tazobactam

  • Vancomycin (for drug-resistant strains)

• Nursing Protocols:

  • It's essential to obtain cultures before starting antibiotic therapy.

  • Transition patients from IV to oral antibiotics as soon as feasible.

  • Educate patients about potential side effects and the importance of completing the prescribed full course of antibiotics.

  • If no improvement is noted, patients should contact their healthcare provider.

4. Anti-Inflammatories

• Purpose: Glucocorticoids used to reduce inflammation associated with pneumonia.

• Examples:

  • Fluticasone

  • Prednisone

• Administration Protocol: Start with IV and transition to oral as the patient's condition stabilizes.

• Patient Education: Important details about the administration of these medications to ensure effectiveness.

Medications for Pulmonary Embolism (PE)

1. Anticoagulants

• Critical Need for Immediate Anticoagulation: Required unless there are contraindications.

• Types:

  • Unfractionated Heparin: Administered as a continuous drip.

  • Low-Molecular-Weight Heparin: Given as subcutaneous injections (SQ) such as Enoxaparin.

  • Warfarin: Oral anticoagulant used for long-term management.

• Nursing Considerations:

  • Monitor bleeding times according to hospital protocols.

  • Watch for signs and symptoms of bleeding during therapy, such as unusual bruising or blood in urine/stools.

  • Educate patients about long-term therapy expectations.

  • Discuss the route of administration, dietary considerations while on anticoagulants, and safety precautions to prevent bleeding.

2. Direct Factor Xa Inhibitors

• Function: Inhibit thrombin production.

• Usage: Used typically as a “bridge” from other anticoagulation therapies.

• Examples:

  • Rivaroxaban

  • Apixaban

• Nursing Duties:

  • Assess for signs and symptoms of bleeding.

  • Monitor bleeding times as per protocol.

  • Provide education about long-term therapy and safety measures.

3. Thrombolytic Therapy

• Purpose: Used to dissolve blood clots and restore normal circulation.

• Contraindications: Share similarities with anticoagulation therapy.

• Examples:

  • Alteplase (Activase)

  • tPA

4. Medication Administration Summary