Other Respiratory Agents Lilley Pharmacology Text: Chapter 35

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Other Respiratory AgentsLilley Pharmacology
Text Chapter 35

• Original Text modified by
• Anita A. Kovalsky, R.N., M.N.Ed.,
• Professor of Nursing
• Original PPT by
• Professor Pat Woodbery, ARNP, CS

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Overview of Drugs Affecting the Respiratory
System

• Bronchodilators
• Xanthine derivatives
• Beta-agonists (Adrenergics)
• Anticholinergics
• Antileukotriene agents
• Corticosteroids
• Mast cell stabilizers

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AnticholinergicsBlock the action of
acetylcholine in bronchial smooth
muscle?preventing bronchoconstriction and causing
airways to dilate

• Prototype Drug Anticholinergic (Brand name in
  parentheses) (Refer to Prototype List in
  syllabus Also listed in Lilley, pg. 550)
• Ipratropium bromide (Atrovent)

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Antileukotreines Prevent leukotreines from
attaching to receptors on cells in the lungs and
circulation

• Prototype Drug Antileukotreines (Brand name in
  parentheses) (Refer to Prototype List in
  syllabus Also listed in Lilley, pg.
  552)Zafirlukast (Accolate)

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Corticosteroids Purpose of Endogenous

• Metabolic
• Inflammatory
• Immune processes
• Fluid and Electrolyte Balance

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Corticosteroids Desired Effect of Exogenous
Preparations

• Anti-inflammatory
• Immunosuppressive
• Anti-allergic
• Anti-stress

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Disorders treated with Exogenous Corticosteroids

• Allergic
• Respiratory
• Dermatological
• Endocrine
• Neoplastic

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CorticosteroidsMechanism of ActionRefer to
Lilley pg. 553, Table 35-4

• Suppress leukoctyes (WBCs)? thereby reducing
  inflammation and causing bronchodilation
• Increase responsiveness of bronchiole smooth
  muscle to beta-adrenergic receptor stimulation
  (this produces an enhanced effect to
  beta-agonists)

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Corticosteroids

• Prototype Drug Corticosteroids (Brand name in
  parentheses) (Refer to Prototype List in
  syllabus Also listed in Lilley, pg.
  555)Beclomethasone (Vanceril)
• Methylprednisolone (Medrol)

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Nursing Assessment

• History of Steroid Use gt2 weeks
• Time Frame
• Dosage
• Rationale for taking
• Infection Present
• GI Problems
• Skin or Bone Problems

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Corticosteroids

• More than 2 weeks of steroid use results in
  higher risk of long term effects of steroid usage
• Persons taking systemic steroids are at higher
  risk for infection, GI problems (GI bleed), and
  osteoporosis.
• A complete list of side effects is on page 488,
  Table 31-4

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Long Term Use of Corticosteroids

• Dont Stop Abruptly
• Avoid Infected People and Places
• Avoid Falls
• Watch for Weight Gain
• Take with Food

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Mast Cell Stabilizers Prevent the release of
bronchoconstrictive and inflammatory
substancesNo direct bronchodilating
effectUsed for PREVENTION of attacks caused by
allergens and exercise

• Prototype Drug Mast Cell Stabilizers (Brand
  name in parentheses) (Refer to Prototype List in
  syllabus Also listed in Lilley, pg.
  557)Cromolyn (Intal)

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Administering Medications Via Metered-Dose
InhalersRefer to Lilley, pp.114-115

• Preparation
• Administration (optional use of spacers
• Documentation
• Precautions!!!!!
• Client teaching!!!!!

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Patient Teaching for Other Respiratory Agents

• Assess for other chronic illnesses
• Inhaled bronchodilators work fast, others work
  more slowly
• Take bronchodilators FIRST!

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THE END