NURS 251 Portage Study Guide 3

NAEEP - - National Asthma Education and Prevention Program - commonly refer to for recommendations on treating asthma Chronic Obstructive Pulmonary Disease (COPD) is made up of what 2 disease - - Chronic bronchitis - emphysema albuterol (Proventil) - Bronchodilator - stimulates beta-2 (bronchodilaton) - albuterol is inhaled (rescue inhaler), first choice of treatment - use: asthma - adverse: increases HR and force of contraction - contraindications: cardiac tachyarrythmias, severe CAD, HTN, DM epinephrine (Adrenalin) - Bronchodilator - stimulates beta-2 (bronchodilaton) - given SubQ; commonly given in ER during significant events of respiratory distress - use: asthma - adverse: increases HR and force of contraction - contraindications: cardiac tachyarrythmias, severe CAD, HTN, DM salmeterol (Serevent) - Bronchodilator - stimulates beta-2 (bronchodilaton) - long acting, maintenance drug; pt will take BID - use: asthma - adverse: increases HR and force of contraction - contraindications: cardiac tachyarrythmias, severe CAD, HTN, DM Nursing implications for bronchodilators - - teach prevention (avoid things that trigger attacks) - how to use inhaler: wait 3-5 minutes between puffs, rinse mouth after to prevent fungal infections - may use space - use bronchodilator first, then other inhaler - mark rescue inhaler for easy ID ipratropium (Atrovent) - Anticholinergics - blocks action of acetylcholine in smooth muscle - preventing broncoconstriction - use: maintenance - adverse: nervousness, HA, hypotension, GI distress, dry mouth tiotropium (Spiriva) - Anticholinergics - blocks action of acetylcholine in smooth muscle - preventing broncoconstriction - use: maintenance - adverse: nervousness, HA, hypotension, GI distress, dry mouth theophylline (Theo-dur, Aminophylline) - Xanthines - causes bronchodilation - Theo-dur is given po, Aminophylline, given IV - use: asthma, chronic bronchitis, emphysema - adverse: CNS stimulation, increased CO, restlessness, convulsions, tachycardia - not first line agent for treatment - many drug interactions - Therapeutic level: 5-15 mcg/mL - toxicity: seizures, arrhythmias zafirlukast (Accollate), montelukast (Singulair) - Leukotriene Modifiers - reduce leukotrienes which cause bronchoconstriction and inflammation - use: asthma, along with bronchodilators and steroids - adverse: n/v, HA, infection - contraindications: liver disease - used for prevention only - take 1 hour before meals or 2 hours after meals fluticasone (Flonase), beclomethasone (Beclovent), budesonide (Pulmicort), triamcinolone (Azmacort) - Corticosteroids - suppress inflammation, decrease mucous production, decrease edema - all inhaled - adverse: inhaled steroids avoids systemic problems, impaired growth in children, dry mouth, cough