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
Beta-agonists (Adrenergics)
Anticholinergics
Antileukotriene agents
Corticosteroids
Mast cell stabilizers
Anticholinergics
Block the action of acetylcholine in bronchial smooth muscleà 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)
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)
Corticosteroids:
Purpose of Endogenous
Metabolic
Inflammatory
Immune processes
Fluid and Electrolyte Balance
Corticosteroids:
Desired Effect of Exogenous Preparations
Disorders treated with Exogenous Corticosteroids
Allergic
Respiratory
Dermatological
Endocrine
Neoplastic
Corticosteroids:
Mechanism of Action
Refer to Lilley pg. 553, Table 35-4
Suppress leukoctyes (WBCs)à 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)
Corticosteroids
Prototype Drug: Corticosteroids
(Brand name in parentheses)
(Refer to Prototype List in syllabus
Also listed in Lilley, pg. 555)
Beclomethasone (Vanceril)
Methylprednisolone (Medrol)
Nursing Assessment
History of Steroid Use >2 weeks
Time Frame
Dosage
Rationale for taking
Infection Present
GI Problems
Skin or Bone Problems
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
Long Term Use of Corticosteroids
Don’t Stop Abruptly
Avoid Infected People and Places
Avoid Falls
Watch for Weight Gain
Take with Food
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)
Administering Medications Via Metered-Dose
Inhalers
Refer to Lilley, pp.114-115
Preparation
Administration (optional use of spacers
Documentation
Precautions!!!!!
Client teaching!!!!!
Patient Teaching for Other
Respiratory Agents
Assess for other chronic illnesses
Inhaled bronchodilators work fast, others work more slowly
Take bronchodilators FIRST!
THE END