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Original PPT modified by: |
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Anita A. Kovalsky, R.N., M.N.Ed. |
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Professor of Nursing |
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Original by: Professor Edwards, |
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Asthma |
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http://www.whatsasthma.org |
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COPD |
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Chronic Bronchitis |
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Emphysema |
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Alveoli: |
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Antigen: |
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Antibody: |
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Asthma Attack: |
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Bronchial asthma: |
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Chronic Bronchitis: |
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Emphysema: |
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ADDITIONAL TERMS |
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Acute: |
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Exacerbation: |
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Bronchodilators: |
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Xanthines Derivatives |
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Beta-Agonists |
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Prototype Drugs: |
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Theophylline- Theo-dur |
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Aminophylline |
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Relieve Bronchoconstriction |
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Cause bronchodilatation |
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Cause bronchodilation by: |
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Increasing the levels of the energy producing
substance called cAMP |
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Inhibiting PDE the enzyme that breaks down
cAMP…. |
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Subsequently, this causes smooth muscle
relaxation and broncchodilation; also inhibits release of chemical
mediators such as histamine, etc. |
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Slow onset of action, so used more as
preventative measure, however, also used as a continuous IV infusion to
treat reversible bronchospasm in COPD clients who have an exacerbation of
symptoms |
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Relieves bronchopasms by causing airways to
dilate, thereby improving air passage into and out of lungs |
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Stimulates CNS: |
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Increases contractility of heart (+ inotropic) |
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Increases heart rate (+chrontropic) |
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Increases cardiac output, thereby causing a…. |
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Diuretic effect…what would cause this??????? |
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Dilate airways in asthma, chronic bronchitis and
emphysema |
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Adjunct agent in COPD- relieves pulmonary edema
and dyspnea in left sided heart failure |
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Aminophylline used to increase urinary
output-diuresis |
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Nausea |
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Vomiting |
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Anorexia |
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Gastroesophageal reflux |
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CARDIAC!!!!!!!! HIGH ALERT!!!! |
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Sinus Tachycardia |
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Palpitations |
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Ventricular Dysrhythmias |
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Hyperglycemia |
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Increased urinary output |
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Allopurinol |
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Erythromycin |
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Flu Vaccine |
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Oral Contraceptives |
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Need blood levels monitored closely |
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Oral |
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Parenteral |
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(aminophylline infusion) |
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Rectal |
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Prototype Drugs: (Brand name in parentheses) |
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- Albuterol
(Proventil) Beta2 Selective |
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OTHERS: |
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- Ephedrine |
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-Epinephrine
(Adrenalin, Primatene, Bronkaid) |
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-Terbutaline (Brethine) |
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During acute phase of asthmatic attack |
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To quickly reduce airway constriction |
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WHY ARE THEY CALLED AGONISTS???? |
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AGONISTS or stimulators of SNS
receptors-----> |
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SYMPATHOMIMETIC ACTION |
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WHAT IS THE PRIMARY MECHANISM OF ACTION?? |
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Imitate the effects of norepinephrine on
receptors |
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Stimulate beta2-adrenergic receptors in the
lungs causing dilation within the airways of the lungs (Example:
Albuterol/Proventil) |
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Nonselective adrenergic: stimulate the
alpha, beta1 (cardiac), and
beta2- (respiratory) (Example: epinephrine) |
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Nonselective beta-adrenergic: stimulate both
beta1 and beta2 (Example: Isuprel) |
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Selective beta2: stimulate the beta2 (Example:
albuterol) |
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**SELECTIVE BETA2 |
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Beta2 stimulationà causes bronchodilation; also a
decreased diastolic B/P, decreased K+ level |
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NONSELECTIVE ADRENERGIC |
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Alpha & Beta- constriction of arterioles,
dilation skeletal muscle arterioles |
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Begins with specific receptors stimulated and
ends with the dilation of airways |
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cAMP is activated when beta2-adrenergic is
stimulated |
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Smooth muscles relax and airflow increased |
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Alpha receptors causes vasoconstriction-limits
secretions |
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Pulmonary disorders for relief of bronchospasm |
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Nonselective: Used for hypotension and shock
treatment and to relieve nasal congestion and stuffiness |
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Insomnia |
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Restlessness |
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Anorexia |
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Cardiac simulation |
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Tremors |
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Vascular headaches |
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Hypotension |
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Beta-agonist with nonselective beta- adrenergic
blockerà
antagonizes the bronchodilation effect |
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Avoid MAO inhibitors |
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Diabetics may need adjustments |
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Why would this be necessary? |
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Which type of beta agonists??? |
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Nonselective adrenergics such as epinephrine |
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PO |
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SC |
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Inhaler |
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Nebulizer |
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IM |
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Does the client have cardiac disease?? |
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If so, which type of bronchodilator should be
the drug of choice?? |
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Does the client have diabetes?? |
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If the client is receiving a xanthine, what
blood levels should be monitored??? |
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