Ateneo de Davao University CRITERIA

Content: 35% ____

E. Jacinto Street, 8016
Nursing Responsibility: 35% ____
Davao City Picture: 10% ____
Reference: 10% ____
Name of Student: Lexa Moreene L. Cunado Course/Year/Section: BSN 3E Subject: NCM 3154 Date: August 05, 2022 Neatness/Format: 5% ____
Promptness: 5% ____
DRUG STUDY FORM Total: 100% ___

Drug Name Classification Mechanism of Action Side Effects/ Nursing Responsibilities/

Adverse Effects Patient and Family Health
Teachings

Generic Name Antiasthmatics ipratropium bromide Nasopharyngeal/Respiratory: 1. Provide health teachings to

Ipratropium bromide, salbutamol sulfate (anticholinergic Bronchitis, dyspnea, cough, the patient regarding the
bronchodilator) + salbutamol pneumonia, bronchospasm, importance of taking the
(selective short-acting sinusitis, pharyngitis/sore throat, drug, the correct and
beta2-adrenergic agonist), rhinitis, flu-like symptoms, nasal prescribed dosage, signs
maximizes the response to congestion, wheezing, lung and symptoms of possible
treatment in patients with disease, dysphonia/voice adverse effects, and the drug
Brand Name
bronchial asthma and alterations, increased sputum, name.
Duavent
chronic obstructive hemoptysis, oropharyngeal
pulmonary disease (COPD) edema, laryngospasm, and Rationale: To promote patient’s
by increasing anaphylactic reactions. compliance to the drug regimen
bronchodilation through two and enhance patient’s knowledge
distinctly different Cardiovascular: and understanding
mechanisms Tachycardia, palpitation, angina,
 anticholinergic chest pain, hypotension or 2. Assess for possible
(parasympatholytic) hypertension, arrhythmias, contraindications or special
effects vasodilation, heartburn. precautions (e.g. presence of
 beta2-agonist known allergy to the drug
(sympathomimetic) Neurological: components and
effects Tremor, nervousness, dizziness, pregnancy/lactation status)
headache, drowsiness,
coordination difficulty, reduced Rationale: To avoid the risk of
appetite, insomnia, migraine, hypersensitivity reaction and to
anxiety, vertigo, central nervous prevent potential adverse effects
system stimulation. on the fetus or newborn. Also,
beta2-agonists is known to
Gastrointestinal: interfere with uterine contraction
Dry mouth, throat, and tongue,
mucosal ulcers, thirst, diarrhea,
 dyspepsia, gastrointestinal 3. Conduct a thorough patient’s
distress, constipation, paralytic physical examination
ileus, nausea, vomiting.
Rationale: To establish baseline
Endocrine/Metabolic: data before beginning the therapy,
Slight elevation of serum alanine to determine the effectiveness and
aminotransferase, increased the occurrence of side effects
sweating. related to the drug therapy.

Dermatologic: 4. In administering the

Cases of skin rash, angioedema of medication, shake the
the tongue, lips, and face, inhaler well before each use
urticaria, pruritus, contact
dermatitis. Rationale: To ensure the medicine
and propellant mix properly
Genitourinary:
Urinary tract infection/dysuria, 5. Monitor patient response to
urinary retention/difficulty. the drug especially adverse
Picture Indication Pharmacokinetics Pharmacodynamics therapeutic effect
- Assess pulse and blood
Treatment or management of Absorption: Only a small Route: inhalation with suitable pressure
reversible bronchospasm amount of Ipratropium nebulizing devices and should not - Evaluate respirations
associated w/ obstructive reaches the systemic be taken orally and adventitious sounds
airway diseases (e.g., circulation after inhalation. - Evaluate urinary output
bronchial asthma). Some Ipratropium is Duration of Action: - Assess skin color/lesions
 Indicated also for inadvertently swallowed but Bronchodilation occurs within 15
patients w/ COPD on a it is poorly absorbed from to 30 minutes Rationale: To provide nursing
regular inhaled the gastrointestinal tract. interventions as needed and notify
bronchodilator who Peak of Action: Approximately 1 to the physician immediately
continue to have 2 hours after oral inhalation via
evidence ofDistribution: Ipratropium's nebulization of 400 to 600 mcg. 6. Provide comfort measures
bronchospasm & who peak plasma concentration Bronchodilation generally persists (rest periods and quiet
require a 2nd remains below detectable for 4 to 5 hours, but may last up to environment)
bronchodilator. limits (<100 pg/mL) while 7 to 8 hours in some patients.
maximum salbutamol Rationale: To help patient cope
Dosage: concentration is 492 pg/mL with the effects of drug therapy
Children 2 to 12 years: occurring within 3 hrs. after
3 drops/kg/dose, maximum administration 7. Ensure adequate hydration
dose 2500 mcg (2.5 mg) of and provide environmental
salbutamol every 6 to 8 hours. Metabolism: Metabolized in control such as the use of
the liver, being converted to humidifier
Salbutamol 4'-O-sulfate
 which has little or no beta- Rationale: To ensure that the
Adults (including elderly adrenergic stimulating effect patient is comfortable help relieve
patients) and adolescents and no beta-adrenergic the effects of the drug as it can
over 12 years of age: blocking effect cause constipation because it is
poorly absorbed in the
Treatment of acute attacks: Excretion: 27.1% of the gastrointestinal tract
1 pulmoneb (2.5 mL) is estimated mouthpiece dose
sufficient for prompt symptom of the medication 8. Provide health teachings on
relief in many cases. 2 combination is excreted in proper safety measures if
pulmonebs (5 mL) may be urine as unchanged drug CNS adverse effects are
required in severe cases within 24 hrs. apparent
where an attack has not been -advise the patient to not
relieved by 1 pulmoneb. Or, drive or use hazardous
as prescribed by a physician. machinery if tremor,
nervousness, dizziness
Maintenance Treatment: occur
1 pulmoneb (2.5 mL) every 6-
8 hours daily, or, as Rationale: To prevent the patient
prescribed by a physician. from having injuries and
complications

9. Provide small, frequent

meals and sugarless
lozenges

Rationale: To relieve dry mouth

and GI upset

10. Provide support and

encouragement to the
patient

Rationale: To aid the patient in the

disease management and drug
regimen

References:
Karch, A. (2017). Focus on Nursing Pharmacology Seventh Edition. Wolters Kluwer Health, Inc.
MIMS Pte Ltd. (2022). Duavent. Retrieved from: https://www.mims.com/philippines/drug/info/duavent