COPD Meds - pathomimetic side effects Inhaled and systemic...

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Medications Supplemental oxygen should not be withheld in hospitalized patients. Unless indicated for night- time or exercise use only, 15 hours of nasal oxygen is required per day. A flow rate of 1-3 L achieves a PaO 2 > 55 mm Hg for most patients. Bronchodilators reduce bronchospasm and in- creases oxygen distribution throughout the lungs and improves alveolar ventilation. These med- ications are central to the management of COPD but only offer improvement of symptoms. Ag- gressiveness of regimen depends on severity of the disease. Several classes are used including beta-adrenergic agonists, anticholinergics agents, and methylxanthines. The most commonly pre- scribed short-acting bronchodilators are the anticholinergic ipratropium bromide and beta-adren- ergic agonists albuterol (2.5-5 mg every 20 minutes for 3 doses every 1-4 hours) and metaproter- enol (2-3 inhalations every 3-4 hours) delivered by MDI or nebulizer. Ipratropium bromide (2–4 puffs via MDI every 6 hours) is first-line therapy because it is longer-acting and without sym-
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Unformatted text preview: pathomimetic side effects. Inhaled and systemic corticosteroids may be used in COPD. They improve symptoms but do not slow decline in lung function. Prednisone (30-40 mg) may be given for 10-14 days. Oral theo-phylline (5 mg/kg loading dose followed by 5 mg/kg/day divided every 8-12 hours) is a third line agent for treating COPD who do not achieve adequate symptom control with anticholinergics, beta-adrenergic agonists, and inhaled corticosteroid therapy. Antibiotics are prescribed to outpatients to treat and acute exacerbation, to treat acute bronchitis, and to prevent acute exacerbations of chronic bronchitis. Current antibiotics proven to be more effective than older therapies include macrolides (azithromycin 500 mg followed by 250 mg daily for 5 days), fluoroquinolones (ciprofloxacin 500 mg every 12 hours), and amoxicillin-clavulanate (875/125 mg every 12 hours). All patients with COPD should receive influenza virus each year and a pneumococcal vaccine every 5 to 7 years....
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This note was uploaded on 09/06/2009 for the course NUR 4355 taught by Professor Rodriguez during the Spring '09 term at FIU.

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COPD Meds - pathomimetic side effects Inhaled and systemic...

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