NR 293 Edapt

NR 293 Edapt

Student Name

Chamberlain University

NR-293: Pharmacology for Nursing Practice

Prof. Name:

Date

Week 3: Gas Exchange and Bronchodilators

Introduction to Bronchodilators

Effective gas exchange begins with a thorough respiratory assessment, guiding nursing actions and interventions. Pharmacotherapeutic measures, especially bronchodilators, are pivotal in managing respiratory conditions. Bronchodilators function by dilating airways, clearing secretions, and minimizing inflammation. Respiratory medications may act singularly or combine multiple drug actions, with prioritization based on the administration sequence for optimal efficacy.

Conditions Treated by Respiratory Medications

Respiratory medications are essential for addressing various conditions:

• Allergies and hay fever
• Chronic Obstructive Pulmonary Disease (COPD)
• Asthma
• Emphysema
• Chronic bronchitis

Rescue Inhalers and Drug Classifications

Short-acting beta2-agonists (SABAs) are recommended for acute symptom relief as rescue inhalers but not for daily maintenance. The primary classes of respiratory medications include bronchodilators, antihistamines, expectorants, antitussives, and decongestants.

Use of Bronchodilators

Bronchodilators are categorized into short-acting and long-acting beta2-agonists (SABAs and LABAs), anticholinergics, and methylxanthines.

1. SABAs (e.g., albuterol): Used for acute relief during asthma attacks.
2. LABAs (e.g., salmeterol): Designed for maintenance therapy in chronic conditions like COPD and asthma.
3. Anticholinergics (e.g., ipratropium): Prevent bronchospasm in COPD, bronchitis, and emphysema.

Patient Education

Patient education is critical for the effective use of respiratory medications. Key considerations include proper administration techniques, understanding adverse effects, and recognizing when to seek medical attention.

Bronchodilators and other respiratory medications significantly improve gas exchange and alleviate symptoms associated with respiratory diseases. Understanding their classifications, mechanisms, and proper use is essential for optimizing treatment and ensuring patient safety.

Dosages and Therapeutic Range

Theophylline is available in extended-release tablets with dosages ranging from 100 mg to 600 mg and as an injectable solution at a concentration of 80 mg per 15 mL. There are no specific dose adjustments required for patients with liver or kidney impairments. Theophylline has a narrow therapeutic window, and both overdose and slow metabolism can lead to toxicity. Regular monitoring of serum theophylline levels is essential to prevent such complications. Acute toxicity usually develops rapidly after a single large dose or multiple high doses, whereas chronic toxicity may develop more gradually. Symptoms of acute toxicity often include gastrointestinal issues, while seizures and cardiovascular symptoms are more common in chronic cases.

Therapeutic Levels Table

Patient Education

Patients taking theophylline should be informed of key considerations to ensure safety and effectiveness:

1. Report any alcohol use or smoking history, particularly if recently quit.
2. Notify the healthcare provider of high fevers lasting over 24 hours.
3. Pregnant or breastfeeding women must consult their doctor before use.
4. Theophylline is not suitable as a rescue treatment for asthma attacks.
5. Capsules must be swallowed whole and not crushed or chewed.
6. Patients should not take two doses at the same time.
7. Avoid sudden changes in smoking habits without consulting a healthcare provider, as dosage adjustments may be necessary.
8. Refrain from hazardous activities until the medication’s effects are understood.
9. Inform healthcare providers of all medications and supplements being taken, as many can alter theophylline levels.

Preventive Medications in Asthma Management

Preventive medications are critical for long-term asthma management but should not replace rescue treatments. They are best used in combination with other asthma therapies. Monoclonal antibody therapies (MAA) are recommended for severe asthma, with effectiveness varying based on receptor targets. Common corticosteroids include prednisone and methylprednisolone.

Preventive Medications Table

Non-Bronchodilator Medications
Understanding the roles of specific medications helps in asthma management:

• Omalizumab binds to IgE.
• Mepolizumab and Benralizumab act as interleukin-5 receptor antagonists for patients aged six and twelve years or older, respectively.
  One advantage of inhaled corticosteroids over systemic ones is their targeted action on the lungs, reducing systemic effects.

References

American Thoracic Society. (2021). Guidelines for the Management of Asthma. Retrieved from https://www.thoracic.org

National Institute of Health. (2020). Understanding Allergic Rhinitis. Retrieved from https://www.nih.gov

MedlinePlus. (2022). Antihistamines. Retrieved from https://medlineplus.gov

Dhingra, N. (2020). Pharmacotherapy for respiratory disorders. Journal of Clinical Pharmacy, 45(2), 150-162.

National Heart, Lung, and Blood Institute. (2023). Asthma medications. Retrieved from NHLBI

NR 293 Edapt

U.S. Food and Drug Administration. (2021). Ipratropium Bromide Inhalation Solution. Retrieved from FDA

U.S. National Library of Medicine. (2022). Albuterol. Retrieved from MedlinePlus

American Pharmacological Association. (2022). Pharmacotherapy: A Pathophysiologic Approach (11th ed.). McGraw Hill.
Global Initiative for Asthma (GINA). (2023). Global strategy for asthma management and prevention. www.ginasthma.org
National Heart, Lung, and Blood Institute. (2023). Asthma management guidelines. https://www.nhlbi.nih.gov/