Download 4×6 Module 5 drug cards

Action – Target ADVERSE/se:
Dose
Metered-dose
broncodilator
PARADOXICAL
inhaler--2-3
Beta2
BRONCHOSPASM
inhalations q 3-4 hr
Agonist/short- (EXCESSIVE USE OF
term control
INHALERS). nervousness, (not to exceed 12
inhalations/day).
agent./inhibits restlessness, tremor
release of
SHORT ACTING
mediators from
mast cells.
Nursing considerations: • use other inhalation meds first-wait 5 min. rinse
w/water. Adequate fluid intake2-3L.
Drug
Metaproter
enol
(Alupent)
O= 1 min
P=1
D = 1-5
Drug
Action – Target
ADVERSE/se:
Dose
Metered-dose
Ipratropium Anticholinergic no major adverse/se.
inhaler--2
bromide
s- not beta2,
Quick Relief medication inhalations 4 x
(Atrovent) but added
daily (not to
O= 1-3 min benefit in
exceed 12
P = 1-2 hr severe
inhalations/day).
D = 4-6
exacerbations
of asthma –
more
frequently
used in COPD
Nursing considerations: assess for allergy to atropine, belladonna
alkaloids. Assess RR, breath sounds, Dyspnea, HR. Rinse mouth, oral
hygiene.
Drug
Action – Target
ADVERSE/se:
Dose
PO 2-4 mg 3-4 x daily
broncodilator
 nervousness,
(not to exceed
Beta2
restlessness, tremor,
Agonist/shortchest pain, palpitations. 32mg/day) Geriatric:
not exceed 2mg 3term control
In O= 5-15 min
4xday 2 Inhalations q
agent./inhibits
SHORT ACTING
P = 1-1.5 hr
4-6 hr or 2 inhalations
release of
D = 3-6
PO O=15-30 min mediators from
15 min before exercise
P=2-3 hr
(90 mcg/spray);
mast cells.
D=4-6 hr
Nursing considerations: •Assess lung sounds, pulse, BP before admin and
during peak. Note amount, color and character of sputum.
•Advise patients to use albuterol first if using other inhalation medications
and allow 5 min to elapse before administering other inhalant medications
unless otherwise directed.
•Advise patient to rinse mouth with water after each inhalation dose to
minimize dry mouth.
albuterol
(Proventil,
Ventolin,
Volmax)
Drug
Action – Target
ADVERSE/se:
Dose
Diskus-50 mcg
Salmeterol Bronchodilator/ headache
(one inhalation as
(Serevent Adrenergic.
LONG... ACTING
dry powder) twice
Diskus)
LONG Term
O= 10-15 min control of
daily
P = 3-4
(approximately 12
reversible
D = 12
hr apart)
airway
obstruction.
Nursing considerations: maintenance treatment of COPD. Not for acute
asthma attacks.
Drug
Action – Target
Solu-Medrol intermediatemethyipredn acting
corticosteroids –
isolone
suppresses
O= UNK
P = 1-2 hr inflammation
D = 1.25 –
1.5 days
ADVERSE/se:
Dose
2-60 mg/day as a
single dose or in 24 divided doses.
Asthma
exacerbations-120-180 mg/day in
divided doses 3-4
times/day for 48
hr, then 60-80
mg/day in 2
Intermediate ACTING
divided doses.
Nursing considerations: monitor I/O, electrolytes/glucose/WBC. Admin in
morning to coincide w/normal secretions of cortical. stress/surgery may
increase need.
PEPTIC ULCERATION,
THROMBOEMBOLISM,
anorexia, nausea, acne,
decreased wound healing,
ecchymosis, fragility,
hirsutism, petchiae, adrenal
suppression, muscle
wasting, osteoporosis,
cushingoid appearance
Drug
Action – Target
Prednisone
(Sterapred)
O= UKN
P = UKN
D = 1.25 –
1.5 days
Oral
Glucocorticoid
s acting as
antiinflammatory
agents
reducing
edema of the
airways.
ADVERSE/se:
PEPTIC ULCERATION,
THROMBOEMBOLISM,
anorexia, nausea, acne,
decreased wound healing,
ecchymosis, fragility,
hirsutism, petchiae, adrenal
suppression, muscle
wasting, osteoporosis,
cushingoid appearance
Dose
Most uses--560 mg/day as a
single dose or
in divided
doses.
Quick Relief!!
(intermed. acting) med
Nursing considerations: monitor I/O, electrolytes/glucose/WBC. Admin in
morning to coincide w/normal secretions of cortical. stress/surgery may
increase need.w/water.
Drug
Action – Target
Advair Comb. Beta 2 &
(salmeterol/
Corticosteroid
fluticasone)
fluticasone –
antiasthmatic/
antiinflammatory
(steroidal)/
corticosteroid
(inhalation).
Prophylactic
therapy
Nursing considerations:
ADVERSE/se:
headache
Dose
Drug
Action – Target
Theophylline
(Sloe-bid,
Theo-Dur)
Aminophylline
theo
O= rapid
P = 1-2 hr
D = 6 hr
Xanthines bronchodilator
amino
O=15-60 min
P=1-2 hr
D=6-8 hr
ADVERSE/se:
Dose
SEIZURES,
PO (Adultswith CHF, Cor
ARRHYTHMIAS anxiety, Pulmonale, or Liver
tachycardia, nausea,
Dysfunction): Loading dose--5
vomiting
mg/kg, followed by 5
mg/kg/day divided q 8-12 hr
Long-term control of
(not to exceed 400 mg/day).
reversible airway
obstruction by asthma or geri (not exceed 400mg/day)
COPD
drink +2L water/day, minimize
intake caffine.
Nursing considerations: Monitor theophylline serum level therapeutic 10-15 asthma, 6-14
apnea. Increases the risk of digoxin toxicity and decreases the effects of lithium and
phenytonin (Dilantin). If theoophylline and B2 adrenergic agonist are administered
together, cardiac dysrhythmias may result. cimetidine (Tagamet) and erythromycin
increase the effects of theophylline. used in addition to inhaled corticosteroids, mainly for
relief of NIGHTIME astha symptoms. Barbituarates and carbamazepine (Tregretol)
decrease the effects of theophylline.)
Drug
Action – Target
Montelukast
(Singulair)
O= within 24 hr
P = 3-4
D = 24
leukotriene
antagonist
prevents
bronchoconstriction.
ADVERSE/se:
EOSINOPHILIC
CONDITIONS,
CHURG-STRAUSS
SYNDROME
nervousness,
restlessness, tremor
Dose
ASTHMA – PO 10 mg
once daily.
Exercise induced - 10
mg at least 2 hrs
before exercise. Do
not take within 24 hrs
of another dose; if
taking daily doses, do
not take dose for EIB.
take 1 daily in
evening.
alternative to inhaled
corticosteroids for mild
persistent asthma or
added to regime in severe
asthma.
Nursing considerations: assess lung sounds and resp function.
Drug
Action – Target
Zafirlukast Leukotriene
(Accolate) inhibitor Long
term control
O= UKN
agent. Not for
P = 1 week acute asthma
D = UKN
attacks
ADVERSE/se:
CHURG-STRAUSS
SYNDROME headache
Long term control
Dose
20 mg twice daily.
PO: Administer at
regular intervals on
an empty stomach,
1 hr before or 2 hr
after meals
 Nursing considerations: Blood levels are increased by aspirin.
 Blood levels are decreased by erythromycin and theophylline.
 Increases effects and risk of bleeding with warfarin.
Drug
Action – Target
Zileuton
(Zyflo)
O= UKN
P = 1.7 hr
D = UKN
broncodilator
headache
Beta2
Agonist/shortterm control Long Term Control of
agent./inhibits Asthma
release of
mediators from
mast cells.
Nursing considerations:
ADVERSE/se:
Dose
PO (Adults and
Children ≥12 yr): 600
mg 4 times daily or two
600 mg extended
release tablets twice
daily
with meals and at
bedtime. Administer
extended release
tablets within 1 hr after
morning and evening
meals
↑ blood levels and effects of theophylline, beta blockers,
propranolol, and warfarin.
Drug-Food:
Food slows but does not alter extent of absorption.