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Bronchodilators/Anti-asthmatics Cheat Sheet by

guide to Bronchodilator medications

Class: Xanthines

Prototype: Aminop­hylline

Action: smooth muscle in resp. tract

Inhibits release of inflam­matory chemicals

Indica­tion:

S/S relief and prevention of asthma
Reversible bronch­ospasm associated with COPD
Acute/­Cri­tical asthma attack­/br­onc­hospasm

Contra­ind­ica­tions:

Pregnancy category: C
Lactation

Caution:

GI issues such as PUD & Gastritis
Heart disease
Respir­atory dysfun­ction: chronic persistent hypoxia
Renal/­Hepatic disease; Chronic ETOH
Hypert­hyroid
Parenteral use increases risk & severity of Adverse Effects

Adverse Effects:

10-20 mcg/mL: uncommon AE
Levels 20-25 mcg/mL: N/V/D, HA, irrita­bility, insomnia
Levels >30-35 mcg/mL: hyperg­lyc­emia, cardiac effects, seizur­es/­brain damage, & death

Drug Intera­ctions:

Nicotine: Increases speed of metabolism of drug; dose adjustment required if wanting to quit

Nursing Interv­ent­ions:

Smoking education: contact provider if wanting to quit
Monitor serum drug concen­tration level regularly
 

Class: Sympat­hom­imetics

Prototype: Epinep­hrine

Action:

Dilates bronchi & increases RR rate and depth

Indica­tion: rescue medication

Anytime bronch­oco­nst­riction is occurring

Contra­ind­ica­tio­n/C­aution:

Cardiac disease
Vascular disease
Arrhyt­hmias
Diabetes
Hypert­hyr­oidism
All of the diseases listed above can be worsen­ed/­exa­cer­bated

Adverse Effects:

CNS stimul­ation: anxiet­y/n­erv­ousness
GI upset
Rapid/­Racing heartbeat
HTN
Bronch­ospasm
Sweating, pallor, flushing
Effects listed above are related to sympat­hetic stimul­ation

BLACK BOX WARNING:

LABA (another category of sympat­hom­ime­tics) increase risk of Asthma related death

Nursing Interv­ent­ions:

Give 30-60 min. before exercising
LABA: used as preventive treatment; not used to treat acute symptoms
 

Class: Antich­oli­nergics

Prototype: Ipratr­opium

Action:

Inhibits vagus nerve stimul­ation resulting in bronch­odi­lation

Indica­tion:

Indivi­duals who cannot tolerate side effects of Sympat­hom­imetics

Contra­ind­ica­tion:

Peanut/Soy allergy
Acute Bronch­ospasm
Narrow Angle Glaucoma
Bladder neck obstru­ction or BPH

Caution:

Conditions worsened by antich­oli­nergic effects
Pregna­ncy­/la­ctation

Adverse Effects:

CNS effects
Dry mouth
Palpit­ations
Urinary retention
Sore throat
The above effects are r/t the antich­oli­nergic effects of the drug

Drug Intera­ctions:

Avoid other antich­oli­nergic medica­tions because they will potentiate the adverse effects

Drug Intera­ctions:

Avoid other antich­oli­nergic medica­tions because they will potentiate the adverse effects
 

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