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Tellsyouonthedisk table2910p623 inhaleruse

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Unformatted text preview: ed to treat _____________________, rescue medications, if used too much can cause rebound bronchospasm – Albuterol (Proventil) –may cause tremors & tachycardia – Pirbuterol (Maxair) may cause tremors & tachycardia – Anticholinergic Drugs u Short Acting – Ipratropium (Atrovent)—will cause dry mouth u Long Acting – – Tiotropium (Spiriva) Methylxanthines u Theophylline, rarely used, narrow therapeutic range Drugs u Combination Agents (Bronchodilator & Anti inflammatory) – – Ipratroprium & albuterol (Combivent) Fluticasone & salmeterol (Advair) *If ordered to be inhaled separately, administer the bronchodilator first, so that the anti inflammatory can be better absorbed Comparison of Metered-Dose and Dry Powder Inhalers Metered­Dose Inhaler (MDI) Dry Powder Inhaler (DPI) Shaking Before Use Yes, shake well No Inspiration Slow Rapid Spacer Yes, at least with inhaled corticosteroids; improves inhalation of drug None required Counting Device No external device Most preloaded forms include counter Inhalations/dose Often 2/dose Often 1/dose Cleaning Use water for plastic case Avoid moisture Measuring Remaining Doses DO NOT FLOAT IN WATER; Tells you on the disk TABLE 29­10 P. 623 Inhaler Use http://healthguide.howstuffworks.com/nebulizer­use­picture.htm Chronic Obstructive Pulmonary Disease (COPD) COPD u u u u u u COPD is complex, chronic obstructive and destructive process Not fully reversible Develops over years COPD encompasses 2 types of obstructive airway diseases: – Emphysema – Chronic Bronchitis Results in decreased gas exchange Inability to expire air is primary feature COPD u Chronic Bronchitis – Presence of chronic, productive cough for 3months in 2 years back to back in someone whom other causes of cough were ruled out (Kaufmann, 2011, p. 610) u Emphysema – Abnormal, irreversible enlargement of air spaces distal to terminal bronchioles with destruction of alveolar walls resulting in decreased elastic recoil properties Risk Factors u Smoking­ #1 – – u u Decreases ciliary action – u Hyperplasia of goblet cells → increased mucus → narrowed airway Destroys alveolar walls→ dilate distal air space Occupational Hazards Air Pollution Recurring Lung Infections – Damage and change mucociliary mechanisms in respiratory tract and make COPD patients more prone to respiratory infections u Heredity – AAT (Alpha 1 Antitrypsin) Deficiency→ COPD u u Aging Usually occurs before age 40, minimal to no tobacco use, family hx of emphysema Air goes in easily but stays in lung and is harder to come out. • Bronchioles collapse • Air trapped in alveoli → hyperinflation and alveoli over distention • Signs & Symptoms COPD u Intermittent cough then progresses to frequent u Dyspnea­ gets worse as disease progresses u Towards en...
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