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

Copyright © 2017 Wolters Kluwer • All Rights Reserved Sympathomimetics Sympathomimetics • Mimic the effects of the sympathetic nervous system. One of the actions of the sympathetic nervous system is dilation of the bronchi with increased rate and depth of respiration – Albuterol ( Proventil HFA , and others), – Arformoterol ( Brovana ) – Rphedrine (generic) – Epinephrine – ( EpiPen ), formoterol ( Foradil ) and more.

Copyright © 2017 Wolters Kluwer • All Rights Reserved Sympathomimetics Sympathomimetics • Actions – Beta 2 selective adrenergic agonists • Indications – Acute asthma attach – Bronchospasm in acute or chronic asthma – Prevention of exercise-induced asthma • Pharmacokinetics – Rapidly distributed after injection, transformed in the liver to metabolites that are excreted in the urine • Contraindications – Depends on the severity of the underlying condition

Copyright © 2017 Wolters Kluwer • All Rights Reserved Sympathomimetics (cont.) Sympathomimetics (cont.) • Adverse Effects – Sympathomimetic stimulation – CNS stimulation – GI upset, cardiac arrhythmias, hypertension, bronchospasm, sweating, pallor, and flushing • Drug-to-Drug Interactions – General anesthetics

Copyright © 2017 Wolters Kluwer • All Rights Reserved Nursing Considerations for Sympathomimetics Nursing Considerations for Sympathomimetics • Assess: – History and Physical Exam and known allergy – Cigarette use, pregnancy and lactation – Cardiac disease, vascular disease, arrhythmias, diabetes, and hyperthyroidism – Reflexes and orientation, VS, reflexes and orientation and appropriate lab values

Copyright © 2017 Wolters Kluwer • All Rights Reserved Question Question Please answer the following question as true or false. The adverse effects of the Xanthines are related to theophylline levels in the blood and include brain damage.

Copyright © 2017 Wolters Kluwer • All Rights Reserved Answer Answer True Rationale: Adverse Effects: Related to theophylline levels in the blood; GI upset, nausea, irritability, and tachycardia to seizure, brain damage, and even death.