DRUG MECHANISM OF
ACTION
IPRATROPIUM/ALBUTE
ROL
Brand name: Ipratropium
Salbutamol
Classification:
Clinical: Bronchodilators
Dosage:
Nebulizer solution (generic)
(2.5mg/0.5mg)/3mL
Onset:
5-15 minutes
Administration:
Nebulizer solution
Administer via jet nebulizer
connected to air compressor
with adequate air flow
Equip with mouthpiece or
suitable air mask
DRUG
Generic name:
ACETYLCYSTEINE
(Acetadote, Mucomyst,
INDICATIONS CONTRAINDICATIO SIDE EFFECTS NURSING
N CONSIDERATIONS
Albuterol: Beta2- This product is used Hypersensitivity to Headache,  Monitor rate, depth,
adrenergic to treat and prevent albuterol, ipratropium, dizziness, nausea, rhythm, type of
bronchodilator symptoms atropine and derivatives, dry mouth, shaking respiration; quality and
(wheezing and soy, or peanut (tremors), rate of pulse.
 Assess lung sounds for
Ipratropium: shortness of breath) nervousness, or
wheezing
Anticholinergic caused by cold symptoms (bronchoconstriction) and
(parasympatholytic) ongoing lung such as stuffy nose, rales.
agent; inhibits vagally disease (chronic sneezing, cough, or  Protect solution for
mediated reflexes by obstructive sore throat. inhalation from light.
antagonizing pulmonary Store unused vials in foil
acetylcholine action; disease-COPD whi pouch.
prevents increase in ch includes  Use nebulizer mouthpiece
intracellular calcium bronchitis and instead of face mask to
concentration caused by emphysema). avoid blurred vision or
interaction of aggravation of narrow-
angle glaucoma.
acetylcholine with
 Can mix albuterol in
muscarinic receptors on nebulizer for up to 1 hr.
bronchial smooth  Ensure adequate
muscle hydration, control
environmental
temperature to prevent
hyperpyrexia.
 Have patient void before
taking medication to
avoid urinary retention.
 Teach patient proper use
of inhaler.
MECHANISM OF INDICATIONS CONTRAINDICATIO SIDE EFFECTS NURSING
ACTION N CONSIDERATIONS
Mucolytic splits Inhalation: Adjunctive None known. IV: (10%): BASELINE ASSESSMENT
linkage of treatment for Nausea, vomiting. Mucolytic: Assess pretreatment
respirations for rate, depth,
mucoproteins, abnormally viscid (7%– 6%): Acute rhythm. IV antidote: Obtain
reducing viscosity of mucous secretions flushing, erythema. baseline labs and drug screen.
Parvolex, Fluimucil)
Classification:
PHARMACOTHERAPEUT
IC: Respiratory inhalant,
intratracheal.
CLINICAL: Mucolytic,
antidote.
Dosage:
Inhalation, Nebulization
ADULTS, ELDERLY,
CHILDREN: 3–5 ml (20%
solution) 3–4 times a day or
6–10 ml (10% solution) 3–4
times a day. Range: 1–10 ml
(20% solution) q2–6h or 2–20
ml (10% solution) q2–6h.
Administration:
IV
Onset: Not indicated
DRUG
Generic name:
PIPERACILLIN SODIUM /
TAZOBACTAM SODIUM
(Tazocin , Zosyn)
Classification:
PHARMACOTHERAPEUT
IC: Penicillin
CLINICAL: Antibiotic
pulmonary secretions. present in acute and (4%): Pruritus. For use as antidote, obtain
Acetaminophen chronic acetaminophen level to
determine need for treatment
toxicity: bronchopulmonary Frequent: with acetylcysteine.
Hepatoprotective by disease and pulmonary Inhalation:
restoring heptic complications of cystic Stickiness on face, INTERVENTION/EVALUAT
glutathione and fibrosis and surgery, transient ION If bronchospasm occurs,
discontinue treatment, notify
enhancing nontoxic diagnostic bronchial unpleasant odor. physician; bronchodilator may
conjugation of studies. be added to therapy. Monitor
acetaminophen. Occasional: rate, depth, rhythm, type of
Inhalation: respiration (abdominal,
Therapeutic Effect: Increased bronchial thoracic). Observe sputum for
color, consistency, amount. IV
Facilitates removal of secretions, throat antidote: Administer within 8 hrs
pulmonary secretions irritation, nausea, of acetaminophen ingestion for
by coughing, postural vomiting, and maximal hepatic protection;
drainage, mechanical rhinorrhea. Rare: ideally, within 4 hrs after
immediate-release and 2 hrs
means. Protects Inhalation: Rash. after liquid acetaminophen
against PO: Facial edema, formulations.
acetaminophen bronchospasm,
overdose-induced wheezing, nausea, PATIENT/FAMILY
hepatotoxicity vomiting TEACHING •  Slight,
disagreeable sulfuric odor from
solution may be noticed during
initial administration but
disappears quickly.  • 
Adequate hydration is important
part of therapy.  • Follow
guidelines for proper coughing
and deep breathing techniques.
MECHANISM INDICATIONS CONTRAINDICATIO SIDE EFFECTS NURSING
OF ACTION N CONSIDERATIONS
Piperacillin: Treatment of Hypersensitivity to any Frequent: BASELINE ASSESSMENT
Inhibits cell wall moderate to severe penicillin. Diarrhea, Question for history of allergies,
synthesis by bacterial headache, esp. to penicillins,
binding to infections, constipation, cephalosporins.
bacterial cell including nausea, insomnia,
membranes. community- rash. INTERVENTION/EVALUAT
acquired/ ION Monitor daily pattern of
Therapeutic nosocomial Occasional: bowel activity, stool
Effect: pneumonia, intra- Vomiting, consistency; mild GI effects may
Bactericidal. abdominal, pelvic, dyspepsia, be tolerable, but increasing
Tazobactam: skin, and skin pruritus, fever, severity may indicate onset of
Dosage: Inactivates structure agitation, antibiotic-associated colitis.
Severe Infections IV: bacterial beta- infections. candidiasis, Be alert for superinfection:
ADULTS, ELDERLY, and lactamase. Tazobactam dizziness, fever, vomiting, diarrhea, and
CHILDREN 12 YRS AND expands abdominal pain, anal/genital pruritus, oral
OLDER: 4.5 g q6–8h or Therapeutic piperacillin edema, anxiety, mucosal changes (ulceration,
3.375 g q6h. Maximum: 18 g Effect: Protects activity to include dyspnea, rhinitis. pain, and erythema).
daily. piperacillin from beta-lactamase- Monitor I&O, urinalysis.
enzymatic producing strains Monitor serum electrolytes, esp.
Administration: degradation, of S. aureus, H. potassium, and renal function
IV Reconstitution  extends its influenzae, tests.
•  Reconstitute each 1 g with spectrum of Bacteroides.
5 ml D5W or 0.9% NaCl. activity, prevents
Shake vigorously to bacterial
dissolve.  overgrowth.
•  Further dilute with at least
50 ml D5W or 0.9% NaCl.

Onset: Immediate