Class notes
NURB 3150 Chapter 55 Notes
- Course
- Nurb 3150
- Institution
- Northwestern State University Of Louisiana
This is a comprehensive and detailed note Chapter 55 - Drugs Acting on the Lower Respiratory Tract.
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1 Chapter 55:Drugs Acting on the Lower Respiratory Tract
2 Changes in the Airway With COPD
3 Manifestations of COPD
Air is trapped in the lower respiratory tract
The alveoli degenerate and fuse together
The exchange of gases is greatly impaired
4 Prevention and Treatment for COPD
Reduce environmental exposure to irritants
Smoking cessation
Filter allergens from the air
Avoid exposure to known irritants and allergens
Open the conducting airways through muscular bronchodilation
Decrease the effects of inflammation on the airway lining
5 Adult Respiratory Distress Syndrome (ARDS)
Characteristics
o Progressive loss of lung compliance and increasing hypoxia
Causes
o Cardiovascular collapse; major burns; severe trauma; rapid depressurization
Treatment
o Reversal of the underlying cause combined with ventilatory support
6 Use of Lower Respiratory Tract Agents Across the Lifespan
7 Bronchodilators/Antiasthmatics
Used to facilitate respiration by dilating the airways
Xanthines
Sympathomimetics
Anticholinergics
8 Xanthines #1
Caffeine (Caffedrine, and others)
Theophylline (generic)
9 Xanthines #2
Actions
o Direct effect on the smooth muscles of the respiratory tract, both in the bronchi and in
the blood vessels
Indications
o Symptomatic relief or prevention of bronchial asthma and for reversal of bronchospasm
1
, associated with COPD
Pharmacokinetics
o Narrow therapeutic margin
o Rapidly absorbed for the GI tract
o Metabolized in the liver and excreted in the urine
10 Xanthines #3
Contraindications
o GI problems, coronary disease, respiratory dysfunction, renal or hepatic disease,
alcoholism, or hyperthyroidism
Adverse Effects
o Related to theophylline levels in the blood
o GI upset, nausea, irritability, and tachycardia to seizure, brain damage, and even death
Drug-Drug Interactions
o Many drugs interact with xanthines
o Substances in cigarettes
11 Nursing Considerations for Xanthines
Assess:
o History and Physical Exam and known allergy
o Peptic ulcer, gastritis, renal or hepatic dysfunction, and coronary disease
o Monitor blood pressure, pulse, cardiac auscultation, peripheral perfusion, and baseline
electrocardiogram
o Skin, BS, liver and renal function, appropriate lab values, as well as theophylline levels
12 Prototype Xanthines
13 Sympathomimetics #1
1 Mimic effects of the sympathetic nervous system: dilation of bronchi with increased rate and
depth of respiration
o Albuterol (Proventil HFA, and others)
o Arformoterol (Brovana)
o Ephedrine (generic)
o Epinephrine (EpiPen)
o Formoterol (Foradil)
o Indacaterol (Arcapta)
o Isoproterenol (Isuprel and others)
2 o Levalbuterol (Xopenex HFA)
o Metaproterenol (generic)
o Olodaterol (Striverdi)
o Salmeterol (Serevent)
o Terbutaline (generic)
14 Sympathomimetics #2
2
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