Beta selective adrenergic agonists
Albuterol Routes: Inhaled (short acting), or Oral (long acting)
Salmeterol Route: Inhaled (long acting)
They selectively activating the beta2 receptors in the lungs. This relieves bronchospasms, inhibits histamine and increased ciliary motility.
Albuterol-short acting, acute asthma attacks
Salmeterol-long acting for prevention of asthma attacks Salmeterol is used every 12 hours. These aren’t used alone they are normally used with inhaled glucocorticoid
Uses: Acute asthma exacerbations. Short term relief of bronchoconstriction due to bronchitis and emphysema, long term control of chronic airway problems
Side effects: tremors, anxiety, convulsions, tachycardia, HA
Nursing Interventions: evaluate the client’s respiratory status and vital signs
If the patient is taking an inhaled glucocorticoid as well. Teach them to take the beta2 agonist 1st then the glucocorticoid second. Wait at least 1 minute in between. This way the Beta 2 agonist caused bronchodilation and enhances the absorption of the glucocorticoid.
Beta adrenergic blockers can negate the effects of both medications. MAOIS and tricyclic antidepressants can increase the risk of tachycardia and angina.
(Methyl)Xanthines
Theophylline long term control of asthma or COPD
Relaxation of bronchial smooth muscle causing bronchodilation
Not used as often d/t the side effects
Route: oral or IV in emergencies
Side Effects: HA, anxiety, nausea, vomiting diarrhea, insomnia
Pt needs regular blood draws to monitor therapeutic amount 5- 15mcg/mL
| Toxicity: >20mcg/mL dysthymias, seizures Treatment for toxicity: stop the med, may have to give activated charcoal to decrease absorption, lidocaine for dysthymias and diazepam for seizures |
Teaching: Avoid caffeine, phenobarbital, phenytoin and rifampin and antibiotics
Inhaled Anticholinergics
Ipratropium
Route: inhalation
COPD, rhinitis, rarely used for asthma
Works by blocking muscarinic acetylcholine receptors of the bronchi causing bronchodilation their job is to cause constriction.
Side Effects: dry mouth
Nursing Interventions: increase fluids, hard candy, rinse mouth after inhalation
Contraindicated in people who have a peanut allergy