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31 Cards in this Set

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Four groups of bronchodilators?
adrenergics
anticholinergics
leukotriene antagonists
xanthines
Eight adrenergics?
albuterol
epinephrine
formoterol
levalbuterol
metaproterenol
pirbuterol
salmeterol
terbutaline
One anticholinergic?
ipratropium
Three leukotriene antagonists?
montelukast
zafirlukast
zileuton
Two xanthines?
aminophylline
theophylline
What is the general use of bronchodilators?
treatment of REVERSIBLE airway obstruction due to asthma or COPD
For management of asthma, use rapid-acting inhaled beta-agonist bronchodilators as acute relievers of bronchospasm...not ______
salmeterol
Repeated or chronic use indicates the need for additional long-term control agents, including? (4)
inhaled corticosteroids
mast cell stabilizers
long-acting bronchodilators
(oral theophylline or
beta-agonists)
leukotriene modifiers
(montelukast,
zafirlukast)
Beta-adrenergic agonists:
albuterol
epinephrine
isoproterenol
metaproterenol
pirbuterol
terbutaline

these produce ________ by stimulating the production of cyclic adenosine monophosphate (cAMP)
bronchodilation
Newer agents:
albuterol
metaproterenol
pirbuterol
terbutaline

these are relatively SELECTIVE for pulmonary receptors which are 1._____ receptors, whereas older agents produce cardiac stimulation which are 2.____-_____ effects in ADDITION to bronchodilation.
1. beta2
2. beta2-adrenergic
Onset of action allows use in management of acute attacks except for the agent _____, which has delayed onset.
salmeterol
Phosphodiesterase inhibitors (name 2) inhibit the breakdown of cAMP.
aminophylline
theophylline
Ipratropium is an anticholinergic compound that produces bronchodilation by blocking the action of _______ in the _____ tract.
acetylcholine
respiratory
Leukotrienes (name 3) are components of slow-reacting substance of anaphylaxis A (SRS-A), which may be a cause of bronchospasm.
montelukast
zafirlukast
zileuton
Contraindications?
hypersensitivity to:
agents
preservatives (bisulfites)
propellants used in their
formuation

avoid use in uncontrolled
cardiac arrhythmias
Use cautiously in patients with? (3)
diabetes
cardiovascular disease
hyperthyroidism
Therapeutic effectiveness may be antagonized by concurrent use of ___ ____.
beta blockers
Additive sympathomimetic effects with other adrenergic (sympathetic drugs, including _____ and ______.
vasopressors
decongestants
Cardiovascular effects may be potentiated by _____ and ____ ____.
antidepressants
MAO inhibitors
What 5 things should be assessed before and throughout bronchodilator therapy?
blood pressure
pulse
respiration
lung sounds
character of secretions
Patients taking bronchodilators and with a history of a cardiovascular problem should be monitored for ____ changes and ____ pain.
ECG
chest
List 3 potential nursing diagnoses?
Airway clearance, ineffective
Activity intolerance
Knowledge, deficient, related
to disease processes and
medication regimen
IMPLEMENTATION:
Administer around the clock to maintain therapeutic ______ levels.
plasma
Emphasize the importance of taking only the prescribed dose at the prescribed time intervals.
okay
Encourage the patient to drink adequate liquids (______ ml/day minimum) to decrease the viscosity of the airway secretions.
2000 ml/day
Advise patient to avoid _____ cough, cold or breathing preparations without consulting hcp and to minimize intake of xanthine-containing foods or beverages (colas, coffee, and chocolate), as these may increase side effects and cause arrhythmias.
OTC
Caution patient to avoid _____ and other respiratory irritants.
smoking
Instrut patient on proper use of metered-dose _____.
inhaler
Advise patient to contact hcp promptly if the usual dose of medication fails to produce the desired results, symptoms worsen after treatment, or toxic effects occur.
okay
Patients using other inhalation medications and ______ should be advised to use _____ first and allow 5 min to elpase before administering the other medication, unless otherwise directed by hcp.
bronchodilators
bronchodilator
EVALUATION:
Effectiveness of therapy can be demonstrated by?
Decreased bronchospasm.
Increased ease of breathing.