Respiratory Pharmacology - Bronchodilators

Created by Jstrand82 

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Drugs (generic and trade name) and types

Adrenergic

- Relaxes smooth muscle

Anticholinergic

- Blocks smooth muscle constriction

Metaproternol

- Alupent
- Adrenergic
- Short acting 2 - 6 hours

Salmeterol and fluticasone

- Advair
- Adrenergic
- Long acting 12 hours

Ipratropium Bromide

- Atrovent
- Anticholinergic
- short acting 4 - 6 hours

Brovana

- Arformotorol
- Adrenergic
- Long acting 12 hours

Combivent

- Albuterol and Ipratropium
- MDI
- 2 puff(s) QID

Duoneb

- Albuterol and Ipratropium Bromide
- Nebulizer
- 3mL QID and 2 extra doses a day PRN

Foradil

- Formotorol
- Adrenergic
- Long acting 12 hours

Maxair

- Pirbuterol
- Adrenergic
- Short acting 2 - 6 hours

Performist

- Formotorol
- Adrenergic
- Long acting 12 hours

Primatene Mist

- Epinephrine
- Adrenergic
- Short acting 2 - 6 hours

Proventil

- Albuterol
- Andrenergic
- Short acting 2 - 6 hours

Spiriva

- Tiotropium Bromide
- Anticholinergic
- Long acting 24 hours

Symbicort

- Formotorol and budesonide
- Adrenergic
- Long acting
- 2 puff(s), BID

Vaponefrin, S2

- Racemic epinephrine
- Adrenergic
- Short acting 2 - 6 hours

Xopenex

- Levalbuterol
- Adrenergic
- Intermediate acting 8 hours

Serevent

- Salmeterol
- Adrenergic
- Long acting 12 hours

Instructions for use of an MDI WITHOUT a spacer:

In what order should inhaled medications be taken?

1) Bronchodilator
2) Anticholinergic
3) Mucolytic
4) Corticosteroids

What would be the best way to deliver a bronchodilator to a patient who cannot cooperate?

- SVN with a mask

What type of nebulizer reduces the amount of medication wasted during exhalation?

- Breath activated nebulizer

How can thrush be avoided when using inhaled corticosteroids?

- Rinse mouth after use

Why would a HEART (high-output extended aerosol respiratory therapy) nebulizer be used?

- To deliver continuous nebulization in instances of severe bronchospasm
- Patient must be monitored closely (heart monitor, vitals, etc.) and not left alone

Bronchoconstriction refers to:

- A decrease in the diameter of the airway

Physiological effects of bronchoconstriction include:

- Constriction
- Inflammation
- Edema

Alpha receptors:

- Found primarily in blood vessels
- Stimulation = Vasoconstriction of blood vessels

Beta 1 receptors:

- Found primarily in the heart
- Stimulation = increase the heart rate

Beta 2 receptors:

- Found primarily in smooth muscle
- Stimulation = smooth muscle relaxation

What drug can be used to stop labor and as a bronchodilator?

- Magnesium sulfate
- Terbutaline

How are xanthines delivered?

- Orally
- IV

What bronchodilators are best for maintenance in asthmatic patients?

- Salmeterol
- Formotorol
- Arformotorol

What classification of drug is Levalbuterol?

- Saligenin

Which drug has less side effects than albuterol?

- Levalbuterol

What are the two anticholinergic bronchodilators?

- Ipratropium Bromide (Atrovent)
- Tiotropium Bromide (Spiriva)

What conditions would racemic epinephrine be used to treat?

- Croup
- Epiglottitis

Side effects of Beta-agonists include:

- Tachycardia - Nervousness
- Arrythmias - Insomnia
- Increased HR and BP - Hyperglycemia
- Hypokalemia - Dizziness, HA, N

How would it be determined that bronchodilator therapy worked?

- Peak flow

If a patient is not responsive to 2 albuterol treatments what would you do?

- Administer continuous nebulization via LVN

Side effects of theophylline include:

- Nausea
- Vomiting
- Seizures
- Tachycardia

Characteristics of asthma include:

- Reversible
- Airway narrowing
- Inflammation

What medications are best for patients with an acute exacerbation of COPD?

- Anticholinergics

IV corticosteroid =

- Methylprednisolone

Nicotine replacement medications:

- Nicotrol patch
- Nicorette gum
- Commit lozenge
- Nicotrol nasal spray
- Nicotrol inhaler
- Zyban

Fagerstrom test for nicotine dependance:

- Standard instrument for assessing the intensity of physical addiction to nicotine
- The higher the Fagerström score, the more intense is the patient's physical dependence on nicotine
- Higher scores indicate that treatment of withdrawal symptoms, usually with nicotine replacement therapy, will be an important factor in the patient's plan of care.

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