Ch 38 & 39
Bronchodilator: Beta 2 agonist
• Short-acting
• Long-acting
• Method
o Activating beta 2 receptors in bronchial smooth muscle, causing
bronchodilation.
SABA
• Short-acting Beta 2 agonist
o Adrenergic
o Acute symptom relief
o Albuterol, epinephrine
Complications
• TACHYCARDIA, ANGINA-----REDUCE DOSE
• Report if pulse increases by 20-30/min
• Report jaw pain, chest or arm pain, palpitations
• Avoid caffeine
• Caution: dysrhythmias, thyroid disease, heart disease, HTN
• Do NOT use beta blockers
• Interacts with MAOIs
o Use bronchodilator first, then steroid
o Do not exceed prescribed dosage
Methylxanthines
• Oral theophylline: used for long term control of chronic Asthma and COPD.
o THERAPEUTIC RANGE IS 5-15 MG/ML
• Toxicity
o Can cause GI distress and restlessness
• Severe reaction
o Dysrhythmias and seizures
• Monitor blood levels
o 5-15 MCG/ML
• Contraindications
o Heart disease
, o Avoid caffeine
• SMOKERS REQUIRE AN INCREASED DOSE
Anticholinergic
• ATROVENT IS USED IF PATIENT IS ALLERGIC TO ALBUTEROL
o Usually used in COPD
• Side effects
o Dry mouth
▪ Treated by oral hygiene and hard candies
• Contraindicated
o NARROW ANGLE GLAUCOMA, BPH
• Care
o WAIT 5 MINUTES BEFORE NEXT MED
o ORAL HYGIENE
Steroids
Glucocorticoids
▪ Prevent inflammation, suppress mucus production, reduce edema
▪ Does NOT give immediate relief
▪ Treat thrush with nystatin oral suspension
▪ Use spacer if needed
▪ Using for more than 10 days increases risk of side effects
▪ Alternate oral and inhaled steroids
▪ Can develop s/s of Cushing's
▪ ORAL HYGIENE
o Excessive use
▪ Bone loss, osteoporosis
• Ed. On safety, adequate intake of Vit. D and calcium, weight
baring exercises
▪ Hyperglycemia
▪ Myopathy: decrease use
▪ Peptic ulcer: administer with food, avoid NSAIDS, ask if they have
dark, tarry stools.
o Infection: sore throat
▪ Avoid large crowds
▪ Thinning of the skin with prolonged use
o Fluid and electrolyte imbalance
Bronchodilator: Beta 2 agonist
• Short-acting
• Long-acting
• Method
o Activating beta 2 receptors in bronchial smooth muscle, causing
bronchodilation.
SABA
• Short-acting Beta 2 agonist
o Adrenergic
o Acute symptom relief
o Albuterol, epinephrine
Complications
• TACHYCARDIA, ANGINA-----REDUCE DOSE
• Report if pulse increases by 20-30/min
• Report jaw pain, chest or arm pain, palpitations
• Avoid caffeine
• Caution: dysrhythmias, thyroid disease, heart disease, HTN
• Do NOT use beta blockers
• Interacts with MAOIs
o Use bronchodilator first, then steroid
o Do not exceed prescribed dosage
Methylxanthines
• Oral theophylline: used for long term control of chronic Asthma and COPD.
o THERAPEUTIC RANGE IS 5-15 MG/ML
• Toxicity
o Can cause GI distress and restlessness
• Severe reaction
o Dysrhythmias and seizures
• Monitor blood levels
o 5-15 MCG/ML
• Contraindications
o Heart disease
, o Avoid caffeine
• SMOKERS REQUIRE AN INCREASED DOSE
Anticholinergic
• ATROVENT IS USED IF PATIENT IS ALLERGIC TO ALBUTEROL
o Usually used in COPD
• Side effects
o Dry mouth
▪ Treated by oral hygiene and hard candies
• Contraindicated
o NARROW ANGLE GLAUCOMA, BPH
• Care
o WAIT 5 MINUTES BEFORE NEXT MED
o ORAL HYGIENE
Steroids
Glucocorticoids
▪ Prevent inflammation, suppress mucus production, reduce edema
▪ Does NOT give immediate relief
▪ Treat thrush with nystatin oral suspension
▪ Use spacer if needed
▪ Using for more than 10 days increases risk of side effects
▪ Alternate oral and inhaled steroids
▪ Can develop s/s of Cushing's
▪ ORAL HYGIENE
o Excessive use
▪ Bone loss, osteoporosis
• Ed. On safety, adequate intake of Vit. D and calcium, weight
baring exercises
▪ Hyperglycemia
▪ Myopathy: decrease use
▪ Peptic ulcer: administer with food, avoid NSAIDS, ask if they have
dark, tarry stools.
o Infection: sore throat
▪ Avoid large crowds
▪ Thinning of the skin with prolonged use
o Fluid and electrolyte imbalance
