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NU 302 Respiratory
Review of beta-2 agonists, anticholinergics, and corticosteroids for respiratory
Term | Definition |
---|---|
Albuterol Drug Class | Beta-2 agonist |
Albuterol Mechanism of Action | Stimulation of SNS beta-2 receptors Smooth muscle relaxation of bronchioles |
Albuterol Adverse Effects | Tachycardia, palpitations, restlessness H/A |
Albuterol Contraindications | Cardiac disease, hyperthyroidism |
Albuterol Interactions | Beta blockers |
Albuterol Nursing Indications | Monitor HR, respiratory status Teach regarding rescue inhaler use Use 30-60 minutes before exercise Avoid caffeine |
Ipratropium Drug Class | Anticholinergic |
Ipratropium Mechanism of Action | Increased PNS stimulation on CN X Antagonizes muscarinic receptors |
Ipratropium Adverse Effects | Dry mouth, blurry vision, tachycardia, urinary retention, constipation |
Ipratropium Contraindications | Narrow angle glaucoma Bladder neck obstruction/BPH Allergy to soy or peanuts (propellant sensitivity) |
Ipratropium Interactions | Other anticholinergics |
Ipratropium Nursing Indications | Monitor VS, respiratory status Monitor UOP Teach to void prior to drug administration Lozenges Fiber/fluids |
Budesonide Drug Class | Corticosteroid |
Budesonide Mechanism of Action | Inhibition of inflammatory response |
Budesonide Adverse Effects | Sore throat Xerostomia Oral candidiasis |
Budesonide Contraindications | Active infections Oral lesions increase systemic absorption |
Budesonide Nursing Indications | Monitor respiratory status, oral mucosa Taper the dose Rinse mouth after inhalation |
Drug of choice for rescue inhaler | SABA - albuterol |
Theophylline Drug Class | Methylxanthines |
Theophylline Mechanism of Action | Smooth muscle relaxation via mobilization of calcium and activation of prostaglandins Inhibition histamine |
Theophylline Adverse Effects | Typically only associated with toxicity 20-25 mcg/mL: N/V/D, insomnia, diaphoresis, H/A and irritability >30-35 mcg/mL: hyperglycemia, hypokalemia, hypotension, dysrhythmias, tachycardia, seizures, brain damage and death |
Theophylline Interactions | Multiple interactions – including caffeine Smoking increases metabolism of theophylline With smoking cessation – toxicity! |
Theophylline Contraindications | Caution with cardiac disease, hyperthyroidism |
Theophylline Nursing Indications | Monitor VS, lung sounds Serum drug level Decrease caffeine intake Toxicity treatment Activated charcoal, lidocaine, benzodiazepines |
Montelukast Drug Class | Leukotriene receptor antagonist |
Montelukast Mechanism of Action | Decreases: neutrophil, eosinophil migration, aggregation, leukocyte adhesion, capillary permeability, smooth muscle contraction |
Montelukast Adverse Effects | H/A, dizziness Elevated LFTs Suicidal ideation |
Montelukast Interactions | Increases toxicity of theophylline, warfarin |
Montelukast Nursing Indications | Monitor respiratory status Take on empty stomach Taper dose Avoid triggers |