Drug Classification & Mechanism of Action
This causes the smooth muscle to relax in the airway.
What are bronchodilators?
This is to help open airways.
What are bronchodilators?
What are the 3 routes of administration?
inhalers, nebulizers, and oral pills.
True or False
The Bronchodilators Blood Test helps determine the levels of beta-agonists, anticholinergics, and theophyllines in blood.
True
A nurse teaches a client about the use of a respiratory inhaler. Which action by the client indicates a need for further teaching?
A. Removes the cap and shakes the inhaler well before use.
B. Press the canister down with your finger as he breathes in.
C. Inhales the mist and quickly exhales
D. Waits 1 to 2 minutes between puffs if more than one puff has been prescribed.
C. Inhales the mist and quickly exhales
If the client can, he should hold his/her breath as he/she slowly counts to 10. This lets the medicine reach deep into the lungs. The client should be instructed to hold his or her breath for at least 10-15 seconds before exhaling the mist.
Main receptors in the lungs.
What are Beta2 receptors?
Common indications to use bronchodilators.
What is asthma, pneumonia, emphysema?
What are the 3 types of inhalers?
reliever, preventer, and dry powder
Part A.
What is the bronchodilators blood test value that indicates bronchodilator toxicity?
Part B.
What are some clinical findings that may indicate bronchodilator toxicity?
Part A.
A high value (above 20-25 µg/mL) for the Bronchodilators Blood Test may indicate bronchodilator toxicity, which is marked by:
Part B.
Where are bronchodilators metabolized?
in the gastrointestinal tract
Why are loop diuretics contraindicated with bronchodilators?
Beta-adrenergic bronchodilators already have the possibility to lower serum potassium levels.
Therefore, the combination of loop diuretics and bronchodilators puts the patient at risk for developing hypokalemia.
What is the amount of time it takes to use a nebulizer?
about 15 minutes.
Does COPD cause respiratory acidosis or respiratory alkalosis?
Respiratory Acidosis
pH < 7.35
PCO2 > 48 mm Hg
Aminophylline (Theophylline) is prescribed for a client with acute bronchitis. A nurse administers the medication, knowing that the primary action of this medication is to:
A. Promote expectoration
B. Suppress the cough
C. Relax smooth muscles of the bronchial airway
D. Prevent infection
C. Relax smooth muscles of the bronchial airway
Why are Beta-Blockers contraindicated with bronchodilators?
Beta-Blockers may block the effect of beta-adrenergic bronchodilators, causing bronchospasm in patients with asthma
The physician prescribes a patient to take inhaled Fluticasone (Flovent HFA) and inhaled Albuterol (Ventolin HFA) for the treatment of asthma. As the nurse, how will you administer these medications?
A. First administer the Fluticasone, and then 5 minutes later administer the Albuterol.
B. First administer the Albuterol, then 1 minute later administer the Fluticasone.
C. First administer the Fluticasone, and then immediately administer the Albuterol.
D. First administer the Albuterol, and then 5 minutes later administer the Fluticasone.
D. First administer the Albuterol, and then 5 minutes later administer the Fluticasone.
Does Asthma cause respiratory acidosis or respiratory alkalosis?
Respiratory alkalosis
pH > 7.45
PCO2 < 35 mm Hg
A 66-year-old woman with a long history of heavy smoking presents to her doctor with complaints of shortness of breath and chronic coughing that has been present for about 2 years and has been worsening in frequency. The doctor decides to prescribe a bronchodilator agent that has minimal cardiac side effects, since the patient also has an extensive cardiac history. Which medication did the doctor likely prescribe?
(A) Albuterol
(B) Prazosin
(C) Atenolol
(D) Ipratropium
(E) Pseudoephedrine
D. Ipratropium bromide is used extensively for chronic obstructive pulmonary disease (COPD), which is the most likely diagnosis in this case. It acts by antagonizing muscarinic receptors in bronchial smooth muscle, thereby causing bronchodilation.
Albuterol is also used for treatment of COPD; however, it can cause adverse cardiac effects such as tachycardia and is not recommended in this case.
Prazosin is an α-blocker used for benign prostatic hypertrophy (BPH).
Atenolol is a β-blocker used for hypertension.
Pseudoephedrine is an α-agonist used for nasal congestion.
What are the adverse effects of bronchodilators on the heart?
Adrenergic bronchodilators can stimulate cardiovascular Beta1 and Beta2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression).
Part A:
What are some common side effects of fast-acting bronchodilators?
Part B:
Which drug that is contraindicated with bronchodilators causing exacerbations of side effects?
Part A:
dizziness, headache, muscle cramps, nausea, vomiting, nervousness, tremors, palpitations, rapid heartbeat, increased blood pressure
Part B:
anticholinergics drugs
A patient vitals (blood pressure, heartrate, temperature) indicates bronchodilator overdose.
How do you treat bronchodilators overdose?
While continuously monitoring the vitals: