Breath activated (no hand-lung coordination requiredd.Easier to usee.Tend to deliver more drug to the lung and less to the oropharynx3.Nebulizersa.Small machine that converts drug to a mistb.Mist is finer than other inhalersc.Uses face mask or mouth piece to deliver the medicationd.Takes longer to deliver medication as compared to inhalerse.Used more in hospital and/or home settingf.Good for children you can’t teach coordination toSpacers lower the velocity of the drug being administered and improve the distribution of inhaledmeds21% of dose to lungs with spacer9% withoutReview table 76-1 960GIVE BETA 2 AGONIST BEFORE GLUCOCORTICOID INHALERAllergic Rhinitis, Colds, CoughAllergic rhinitis:oInflammatory disorderoUpper and lower airway & eyesoSneezing, runny nose, pruritis, nasal congestion, conjunctivitis, sinusitisoSymptoms triggered by airborne allergans which bind to IgE antibodies on mast cellsReleases histamine, leukotrienes, & prostaglandinsRhinitis is the most common allergic disorderoSeasonal: hay feveroPerennial (non-seasonal): indoor allergans (dust mites, pet dander)oHistamine receptorsH1 activation causes vasodilation, increased capillary permeability, pain, itching, bronchoconstriction, & CNS effectsTreat allergic reactionsH2 activation causes release of gastric acid from parietal cells in stomachTreat gastric and duodenal ulcers
Bipolar DisorderAcute therapy: manic episodeoLithiumoValproic acidoAntipsychotic or benzo if neededAcute therapy: depressive phaseoMood stabilizer alone or w/ antidepressantLong-term preventionoOne or more mood stabilizers & other drugs to be used acutelySchizophreniaSymptomsoPositive: hallucinations and delusionsoNegative: flat affect, alogia (speech), avolition (drive), anhedonia (desire)oDisorganized: disorganized speech, disorganized behavior, poor attentionOnset in adolescence & early adulthood4 phasesoProdromaloAcuteoStabilizationoStableAdjunctive meds..oLithiumMay augment antipsychotic actionoAnticonvulsants (Carbamazepine & valproic acid)May augment antipsychotics, role in therapy undeterminedMay be useful in pts with agitated or violent behavioroBenzosUseful in acute phase for agitation or anxiety
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- Fall '12
- Nursing, Glucose tolerance test, plasma glucose, oral glucose tolerance