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Other Respiratory Agents Lilley Pharmacology Text: Chapter 35

Other Respiratory Agents Lilley 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. Overview of Drugs Affecting the Respiratory System. Bronchodilators Xanthine derivatives

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Other Respiratory Agents Lilley Pharmacology Text: Chapter 35

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  1. 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

  2. Overview of Drugs Affecting the Respiratory System • Bronchodilators • Xanthine derivatives • Beta-agonists (Adrenergics) • Anticholinergics • Antileukotriene agents • Corticosteroids • Mast cell stabilizers

  3. 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)

  4. 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)

  5. Corticosteroids: Purpose of Endogenous • Metabolic • Inflammatory • Immune processes • Fluid and Electrolyte Balance

  6. Corticosteroids: Desired Effect of Exogenous Preparations • Anti-inflammatory • Immunosuppressive • Anti-allergic • Anti-stress

  7. Disorders treated with Exogenous Corticosteroids • Allergic • Respiratory • Dermatological • Endocrine • Neoplastic

  8. Corticosteroids:Mechanism 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)

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

  10. Nursing Assessment • History of Steroid Use >2 weeks • Time Frame • Dosage • Rationale for taking • Infection Present • GI Problems • Skin or Bone Problems

  11. 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

  12. Long Term Use of Corticosteroids • Don’t Stop Abruptly • Avoid Infected People and Places • Avoid Falls • Watch for Weight Gain • Take with Food

  13. Mast Cell Stabilizers Prevent the release of bronchoconstrictive and inflammatory substances;No direct bronchodilating effect;Used 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)

  14. Administering Medications Via Metered-Dose InhalersRefer to Lilley, pp.114-115 • Preparation • Administration (optional use of spacers • Documentation • Precautions!!!!! • Client teaching!!!!!

  15. Patient Teaching for Other Respiratory Agents • Assess for other chronic illnesses • Inhaled bronchodilators work fast, others work more slowly • Take bronchodilators FIRST!

  16. THE END

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