Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

29
Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing

Transcript of Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Page 1: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Bronchodilating Drugs

Pat Woodbery, ARNP, CS

Professor of Nursing

Page 2: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

How Do These Drugs Work?

• Relieve Bronchoconstriction

Page 3: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Types of Bronchodilators

• Adrenergics

• Anticholinergic

• Anti-inflammatory

• Leukotriene Inhibitor

• Mast Cell Stabilizer

Page 4: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Adrenergics

Albuterol (Proventil)

• Stimulate Beta 2 Receptors in the bronchi and bronchioles

Page 5: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Anticholinergic

Ipratropium bromide (Atrovent)

• Block the Action of Acetylcholine in bronchial smooth muscle

Page 6: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Anti-inflammatory

Beclomethasone (Vanceril)

• Suppress inflammation in the airways

Page 7: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Leukotriene Inhibitors

Zafirlukast (Accolate)

• Decrease mucus secretion and mucus production

Page 8: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Mast Cell StabilizerCromolyn (Intal)

• Prevents the release of bronchoconstrictive and inflammatory substances

Page 9: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

XanthinesTheophylline (Theo-Dur)

• Multi-Action: Not used often

Page 10: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Patient Teaching

• Chronic Illness• Inhaled bronchodilators work

fast, others work slow! • Take bronchodilators FIRST!

Page 11: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Nursing Actions

• Respiratory Rate and Character

• Respiratory Improvement or Distress

• Therapeutic Levels of Theophylline

• Adverse Effects

Page 12: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Antihistamines

Lecture by Pat Woodbery ARNP, CS

Page 13: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Antihistamines Antagonize the Action of

Histamine• Histamine found in tissues exposed to

environment(eyes, nose, lungs, GI)

• Histamine mainly found in Mast Cell

• Histamine found in Basophils (RBC)

Page 14: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Histamine Causes: Stimulation of H1 Receptors

• Contraction of smooth muscle= Wheeze

• Stimulation of Vagus = Cough

• Permeability veins = Edema

• Vasodilation = Flushing

• secretions = Mucous

• Stimulation of nerve endings = Pruritus

Page 15: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Histamine Causes: Stimulation of H2 Receptors

• Gastric Acid and Pepsin = Abdominal Pain

• Rate & Force of Myocardial Contraction = Tachycardia

• Vasodilation = Hypotension, Flushing, HA

Page 16: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

When Histamine is Stimulated How Does the Client Look?

• Allergic Rhinitis

• Allergic Bronchitis

• Allergic Conjunctivitis

• Allergic Dermatitis

• Anaphylaxis

Page 17: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Prototype Drugs

Diphenhydramine (Benedryl)

Page 18: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Nursing Assessment

• Why is the client getting this drug?• Is there any reason the client should not

get an Antihistamine?• Pregnancy, glaucoma, ulcer, medication

interaction, allergy???• Drowsiness ?• Dry secretions ? ( Think of Asthma)• Alcohol ?

Page 19: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Special Considerations

• Prevention of Allergic Reaction is the Best Care

• Paradoxical Excitement May Occur

• Use in Elder May Cause Confusion

• Consider Side Effects: Dryness, Drowsiness

Page 20: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

The END

Page 21: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Nasal Decongestant, Antitussive, Expectorant, Mucolytic

Lecture by Pat Woodbery,MSN ARNP, CS

Page 22: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Drugs for Respiratory Disorders

Adrenergic Agents• Sympathomimetic Drugs

• Relieve Nasal Obstruction by constricting arterioles and blood flow

• Treatment of rhinitis

Page 23: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Prototype DrugsNasal Decongestants

• Pseudoephridine (Sudafed)

Page 24: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Antitussive Drugs

• Suppress the cough center in the Medulla• Suppress the cough receptors in the throat, lungs• Narcotic, nonnarcotic• Local anesthetics• Lozengers

Page 25: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Prototype DrugsAntitussive

• Codeine

• Dextromethorphan (Benylin DM)

Page 26: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Expectorants

• Prototype Drug: Guaifenesin (Robitussin)

• Liquefy Respiratory Secretions

Page 27: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Mucolytic Drugs

• Prototype Drug: Acetylcysteine (Mucomyst)

• Inhalant

• Liquefy mucous

• Effective within 1 minute peaks in 5-10 minutes

• Used for Tylenol overdose... given orally

Page 28: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

Nursing Interventions

• Relieve Symptoms…NOT a cure

• Nose drops for no more then 7 days

• Read the labels carefully

• Note if syrups……remember sugar!

• Report palpitations, dizziness, drowsiness

Page 29: Bronchodilating Drugs Pat Woodbery, ARNP, CS Professor of Nursing.

• Side effects: tachycardia, arrhythmias, hypertension (adrenergic effects)

• Rebound nasal congestion• Many drugs alter the effects of OTC cold

remedies……BE CAREFUL…..HTN, Arrhythmias!

Summary