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Chapter 55:
Drugs Acting on the Lower Respiratory
Tract
Chapter 55:
Drugs Acting on the Lower Respiratory
Tract
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Changes in the Airway With COPD
Changes in the Airway With COPD
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Manifestations of COPD
Manifestations of COPD
•
Air is trapped in the lower respiratory tract
•
The alveoli degenerate and fuse together
•
The exchange of gases is greatly impaired
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Prevention and Treatment for COPD
Prevention and Treatment for COPD
•
Reduce environmental exposure to irritants
•
Smoking cessation
•
Filter allergens from the air
•
Avoid exposure to known irritants and allergens
•
Open the conducting airways through muscular
bronchodilation
•
Decrease the effects of inflammation on the airway lining
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Adult Respiratory Distress Syndrome
(ARDS)
Adult Respiratory Distress Syndrome
(ARDS)
•
Characteristics
–
Progressive loss of lung compliance and increasing
hypoxia
•
Causes
–
Cardiovascular collapse; major burns; severe trauma;
rapid depressurization
•
Treatment
–
Reversal of the underlying cause combined with
ventilatory support
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Use of Lower Respiratory Tract Agents
Across the Lifespan
Use of Lower Respiratory Tract Agents
Across the Lifespan
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Xanthines
Xanthines
•
Facilitate respiration by dilating the airways
–
Include two categories
•
Sympathomimetics and Anticholinergics
–
Aminophylline (generic)
–
Caffeine (
Caffedrine
, and others)
–
Dyphylline (generic)
–
Theophylline (generic)
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Xanthines
Xanthines
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Xanthines (cont.)
Xanthines (cont.)
•
Contraindications
–
GI problems, coronary disease, respiratory dysfunction,
renal or hepatic disease, alcoholism, or hyperthyroidism
•
Adverse Effects
–
Related to theophylline levels in the blood
–
GI upset, nausea, irritability, and tachycardia to seizure,
brain damage, and even death
•
Drug-to-Drug Interactions
–
Many drugs interact with xanthines
–
Nicotine increases the metabolism
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Nursing Considerations for Xanthines
Nursing Considerations for Xanthines
•
Assess:
–
History and Physical Exam and known allergy
–
Peptic ulcer, gastritis, renal or hepatic dysfunction,
and coronary disease
–
Monitor blood pressure, pulse, cardiac auscultation,
peripheral perfusion, and baseline electrocardiogram
–
Skin, BS, liver and renal function, appropriate lab
values, as well as theophylline levels
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Prototype Xanthines
Prototype Xanthines
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Prototype Xanthines (Continued)
Prototype Xanthines (Continued)
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