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Xopenex (levalbuterol)

Xopenex (levalbuterol)

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Published by Adrianne Bazo

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Published by: Adrianne Bazo on Dec 06, 2008
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03/09/2013

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NURS 1566 Clinical Form 3: Clinical Medications Worksheets
(You will need to make additional copies of these forms)
Generic Name
Levalbuterol
Trade Name
Xopenex
Classification
Therapeutic:
 
 bronchodilatorsPharmacologic:
 
adrenergics
Dose
1.25 mg
Route
INH
Time/frequency
Q6 +Q2 PrnRespiratory Therapy
Peak 
90 min
Onset
10-17 min
Duration
 
5-6 hr 
Normal dosage range
0.63 mg via nebulization three times daily (every 6-8 hr);may be increased to 1.25 mg three times daily (every 6-8 hr)
Why is your patient getting this medication
For short term control of bronchospasm from pulmonary edema resulting from CHF
For IV meds, compatibility with IV drips and/or solutions
n/a
Mechanism of action and indications
(Why med ordered)
R-enantiomer of racemic albuterolBinds to beta-2adrenergic receptors in airway smooth muscleleading to activation of adenylcyclase andincreased levels of cyclic-3', 5'-adenosinemonophosphate (cAMP). Increases in cAMPactivate kinases, which inhibit the phosphorylationof myosin and decrease intracellular calcium.Decreased intracellular calcium relaxes bronchialsmooth muscle. Indicated to treat
 
 bronchospasmdue to reversible airway disease (short-termcontrol agent).
Nursing Implications (what to focus on)
Contraindications/warnings/interactions
Contraindicated in patients with known hypersensitivity, UseCautiously in Cardiovascular disorders (including coronaryinsufficiency, hypertension, and arrhythmias); History of seizures; Hypokalemia; Hyperthyroidism; Diabetes mellitus;Unusual sensitivity to adrenergic amines. Beta blockers block the beneficial pulmonary effects of adrenergic bronchodilators (choose cardioselective beta blockers if necessary and with caution); May ↑ risk of hypokalemiafrom potassium-losing diuretics; Use with caffeine-containing herbs ( guarana, tea , coffee ) ↑ stimulant effect
Common side effects
 No common or life-threatening side effects
Interactions with other patient drugs, OTC orherbal medicines
(ask patient specifically)
 None for this patient
Lab value alterations caused by medicine
May cause ↑ serum glucose and ↓ serum potassium
Be sure to teach the patient the following about thismedication
Instruct patient in the proper use of the nebulizer and to takelevalbuterol exactly as directed. Caution patient not toexceed recommended dose; may cause adverse effects, paradoxical bronchospasm, or loss of effectiveness of medication; Instruct patient to contact health care professional immediately if shortness of breath is notrelieved by medication or is accompanied by diaphoresis,dizziness, palpitations, or chest pain; Advise patients to uselevalbuterol first if using other inhalation medications, andallow 5 min to elapse before administering other inhalantmedications unless otherwise directed; Advise patient torinse mouth with water after each inhalation dose tominimize dry mouth; Instruct patient to notify health care professional if no response to the usual dose of levalbuterol

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