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Bronchodilators
Pharmacology
| Question | Answer |
|---|---|
| Alpha Response | Results in vasoconstriction of arteriolar smooth muscle. Most vasopressors are __________-stimulating drugs. |
| Beta1 Response | Results in an increased rate (chronotropic) and strength of contraction (inotropic) of the cardiac muscle. |
| Methylanthines | Phospodiesterase inhibitors, relaxes smooth muscle, off label as a respiratory stimulant. |
| Safe therapeutic blood level for methylanthines is: | 10-20 mcg/mL |
| Examples of Methylxanthines: | Theophylline/aminophylline, Theo-Dur, Oxtriphylline, Theolair, Caffeine |
| Side effects of theophylline include: | tachycardia, palpitations, jitters, irritability and diuresis |
| Toxicity level of theophylline | Occurs with serum levels exceed 20 mcy/mL. |
| Signs of theophylline toxicity include: | Tremors, N&V, nervousness, seizures, tachycardia and other arrhythmias that may lead to cardiac arrest. |
| Leukotriene Modifiers | Non-steroidal drugs that have been approved for use in patients with mild to moderate persistent asthma. Not to be used for treatment of acute asthma attacks. Improve lung function, reduce symptoms and the need for beta agonist drugs. |
| Available leukotriene modifiers include: | Montelukast (Singulair), Zafirlukast (Accolate), Zilueton (Zyflo) |
| Doxapram (Dopram) | Activation of peripheral carotid chemoreceptors. At higher doses, medullary respiratory centers are stimulated. |
| Indications for Doxapram (Dopram) | COPD, post-anesthesia respiratory depression, prevent acute hypocapnia |
| Side effects of Doxapram (Dopram) | Hypertension, tachycardia, arrhythmias, seizures, laryngospasm, bronchospasm |
| Contraindications of Doxapram (Dopram) | Severe acute asthma, severe cardiac disorders, seizure disorders |
| Long Acting Beta Agonists (LABA) | Maintenance/Long-term control medications |
| Examples of LABA drugs: | Salmeterol (Serevent), Formoterol, Arformoterol (Brovana) |
| Salmeterol (Serevent) MDI dosage | 21 mcg/puff - 2 puffs every 12 hrs |
| Salmeterol (Serevent) DPI (Discus) dosage | 50 mcg/inhalation - 1 inhalation every 12 hrs |
| Formoterol DPI (Foradil Aerolizer) dosage | 12 mcg/25 mg lactose - 1 inhalation every 12 hrs |
| Formoterol Aqueous Solution | Perforomist |
| Perforomist dosage | 20 mcg/2mL - 1 vial every 12 hrs |
| Arformoterol (Brovana) - Aqueous Solution dosage | 15 mcg/2mL every 12 hrs |
| Anticholinergic bronchodilators | These drugs block the bronchoconstriction caused by the parasympathetic nervous system (decrease cyclic GMP) |
| Examples of Anticholinergic bronchodilators | Atropine sulfate, Ipratropium bromide (Atrovent), Tiotropium bromide (Spiriva), Oxitropium bromide (Oxivent) |
| Atropine Sulfate (Aqueous solution) | Nebulized: 0.05 mg/kg in 3 mL NS every 6-8 hrs |
| Ipratropium bromide (Atrovent) Unit dose vial dosage | 500 mcg in 2.5 mL NS - 1 vial every 8 hrs |
| Ipratropium bromide (Spiriva - MDI) dosage | 18 mcg/inhalation - 1 inhalation per day |
| Oxitropium bromide (Oxivent- MDI) dosage | 100 mg/puff - 2 puffs every 8-12 hrs |
Created by:
JannSpicer
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