Claire S.

Libat Drug Study

N-2C

Bronchodilators

Drug Order Mechanism of Action Indication Contraindication Side effects Adverse effects Nursing Responsibilities
Generic Name: When beta2- Indicated in the:  Cardiac  Nervousness  Angina Before:
Salbutamol adrenergic receptors  Prevention and disease  Restlessness  Hypertension  Check doctor’s
on airway smooth control of  Hypertension  Tremor  Arrhythmias order
Brand name: muscle are activated, reversible  Hyperthyroidi  Hyperglycemi  Consider 10 rights
Albuterol adenyl cyclase is  Palpitation
airway sm a of medication
activated, and the obstruction  Diabetes  Insomnia  Hypokalemia administration
Classification: intracellular caused by  Glaucoma  Headache  Monitor vital signs
Bronchodilator concentration of asthma or  Geriatric especially lung
s, and more cyclic-3′,5′-adenosine chronic patients- sounds
specifically, β2- monophosphate rises obstruction older During:
adrenergic (cyclic AMP). This pulmonary individuals  Monitor vital signs
agonists increase in cyclic disorder are at high (BP,PR,RR) and lung
AMP activates (COPD) risk for sounds during peak
Dosage, route, protein kinase A,  Quick relief for adverse of medication
frequency: which inhibits myosin bronchospasm reactions and  Observe for
1 nebule q4hrs phosphorylation and s may require adverse reactions
for inahalation decreases  For the low dosage After:
intracellular ionic prevention of  Pregnancy  Advise patient to
calcium exercise- especially rinse mouth with
concentrations, induced near term and water after each
resulting in bronchospasm lactating inhalation
relaxation.  Long term mothers  Inform the patient
control agents  Children <2 that albuterol may
for patients yrs old cause an unusual
with chronic or bad taste
persistent  Document and
bronchospasm record
s
Generic Name: The stimulation of Indicated in the: Patients who has:  Shaking of a  Hypersensitivi Before:
Salmeterol + beta-2 adrenoceptors  Treatment of  Thyrotoxicosis part of your ty reactions  Check doctor’s
Fluticasone causes bronchial asthma with  Diabetes body that  Subjective order
propionate smooth muscle an inhaled  Low amount you cannot palpitations  Consider 10 rights
relaxation, corticosteroid of potassium control.  Cardiac of medication
Brand name: bronchodilation, and  Prevention of in the blood  Headache. arrhythmias administration
Seretide increased airflow. It exercise  High blood  Nervousness.  Oropharyngea  Monitor vital signs
is hypothesized that induced pressure  Dizziness. l irritation especially lung
Classification: salmeterol binds to bronchospasm  Diminished  Cough.  Paradoxical br sounds
Bronchodilator two sites on the , and blood flow  Stuffed nose. onchospasm  Instruct patient to
s; beta-2 beta-2 adrenoceptor.  Maintenance through  Runny nose. avoid excessive use
adrenergic The saligenin moiety of airflow arteries of the  Ear pain During:
agonists; long- binds to the beta-2 obstruction heart  Monitor vital signs
acting beta- adrenoceptor active and prevention  Prolonged QT (BP,PR,RR) and lung
agonists site. Salmeterol's of interval on sounds during peak
(LABAs) hydrophilic tail binds exacerbations EKG of medication
to leucine residues in of chronic  Abnormal  Observe for
Dosage, route, the beta-2 obstructive EKG with QT adverse reactions
frequency: adrenoceptor's exo- pulmonary changes from After:
250/50 mcg site almost disease. birth  Monitor
inhalation irreversibly, allowing  Asthma attack effectiveness of
powder; for salmeterol to persist  Seizures
inhalation; BID in the active site and drug
 Worsening
account for its long
chronic  Document and
duration of action.
obstructive record
pulmonary
disease
Generic Name: Formoterol is a Indicated in the:  Hypersensitivi  Nausea  Chest pain, Before:
Budesonide + bronchodilator with  Treatment, ty  Vomiting  Fast or  Check doctor’s
Formoterol long-acting beta- prevention, or  Asthma  Diarrhea pounding order
adrenergic receptor decrease whee treatment  Nervousness heartbeats,  Consider 10 rights
Brand name: agonist activity. zing and troubl without an  Trouble  Wheezing, of medication
Perforomist Formoterol binds to e inhaled sleeping choking, or administration
beta-2 adrenergic breathing caus corticosteroid  Headache other  Monitor vital signs
Classification: receptors in ed  Dizziness breathing  Advise patient to
Bronchodilator bronchial smooth by asthma or  Tremor problems, not take the drug
s; long-acting muscle, activating ongoing lung  Tiredness  Worsening more frequently
beta-agonists intracellular adenyl disease (chroni breathing than every 12 hours
 Muscle
(LABAs) cyclase, an enzyme c obstructive problems, During:
cramps
that catalyzes the pulmonary  High blood  Monitor vital signs
 Dry mouth
Dosage, route, conversion of ATP to disease-COPD, sugar (BP,PR,RR) and lung
frequency: cyclic-3',5'-adenosine which  Low sounds during peak
20 mcg inhaled monophosphate includes chroni potassium of medication
via nebulizer (cAMP). Increased c level  Observe for
q12hrs cAMP levels relax bronchitis and adverse reactions
bronchial smooth emphysema)  Use a short-acting
muscle, relieve inhaler if symptoms
bronchospasms, develop between
improve mucociliary doses of formoterol
clearance, and After:
decrease mediator  Monitor
substance release effectiveness of
from inflammatory drug
cells, particularly  Monitor serum
mast cells. potassium and
blood glucose
periodically
 Document and
record
Generic Name: Vilanterol is a long- Indicated in the: The use of BREO  Fever  Decreasing Before:
Vilanterol acting, selective  Maintenance ELLIPTA is  UTI effectiveness  Check doctor’s
beta2-adrenergic treatment of contraindicated  Runny nose  Need for order
Brand name: agonist. Its Chronic in the following  Sore throat  Consider 10 rights
more
Breo Ellipta therapeutic effect is Obstructive conditions:  Headache of medication
due to the  Primary
inhalations
Pulmonary  Cough administration
Classification: stimulation of Disease treatment of than usual  Monitor vital signs
 Mouth pain
Bronchodilator intracellular adenylyl  Treatment of status  Significant  Administer before
 Joint pain
s; long-acting cyclase, which asthma asthmaticus  Oral decrease in meals
beta-agonists catalyzes the or other acute candidiasis lung function  Asses for severe
(LABAs) conversion of episodes of  Increase in milk allergies; may
adenosine COPD or mucus be allergic to
Dosage, route, triphosphate (ATP) to asthma where fluticasone
(sputum)
frequency: cyclic-3',5'-adenosine intensive vilanterol
1 inhalation monophosphate measures are production
 Assess respiratory
once daily by (cAMP). Increases in required  Change in
status
the orally cyclic AMP are  Severe mucus color During:
inhaled route associated with hypersensitivi  Hypotension  Monitor vital signs
only bronchial smooth ty to milk (BP,PR,RR) and lung
muscle relaxation proteins or sounds during peak
and inhibition of demonstrated of medication
hypersensitivity hypersensitivi  Observe for
mediator release ty to adverse reactions
from mast cells in the fluticasone After:
lungs. furoate,  Monitor
vilanterol, or effectiveness of
any of the drug
excipients
 Advise patient to
rinse mouth
without swallowing
to reduce risk of
oropharyngeal
candidiasis
 Document and
record
Generic Name: Ipratropium is a Indicated in the:  Patients with  Change in  Hypotension Before:
Ipratropium muscarinic  Management hypertrophic taste  Edema  Check doctor’s
Salbutamol acetylcholine of reversible obstructive sensation  Glaucoma order
receptor antagonist. bronchospasm cardiomyopat  Coughing  Bronchospas  Consider 10 rights
Brand name: This effect inhibits associated hy or  Dryness of m of medication
Duavent the parasympathetic with tachyarrhyth mouth  Urinary administration
nervous system in obstructive mia  Hoarseness retention  Monitor vital signs
Classification: the airways, thereby airway  Patients with  Increased  Assess history of
Bronchodilator inhibiting their diseases (e.g., known sweating allergies
s; combination function. Because the bronchial hypersensitivi  Sore throat  Have patient void
of adrenergics parasympathetic asthma) ty to any  Tremor before taking
with nervous system's  Treatment in ingredient in medication to avoid
anticholinergic function in the patients with the product urinary retention
s, that may airway is to generate chronic or to atropine  Assess respiratory
also include a bronchial secretions obstructive and its status
corticosteroid and constriction, pulmonary derivatives During:
inhibiting this action disease (COPD)  Monitor vital signs
Dosage, route, can result in on a regular (BP,PR,RR) and lung
frequency: bronchodilation and inhaled sounds during peak
500mcg/2.5mg fewer secretions. bronchodilator of medication
/2.5mL; via who continue  Observe for
inhalation; to have adverse reactions
q6hrs evidence of After:
bronchospasm  Monitor
and who effectiveness of
require a drug
second  Advise patient to
bronchodilator notify physician if
symptoms persist
 Document and
record
Corticosteroids

Drug Order Mechanism of Indication Contraindication Side effects Adverse effects Nursing Responsibilities
Action
Generic Name: Hydrocortisone Indicated for the  Neonates,  Thinning  Hyperglycemi Before:
Hydrocortisone binds to the treatment of the infants skin, bruising a  Check doctor’s
glucocorticoid following:  Local/system or  Hyperkalemia order
Brand name: receptor, inhibiting  Inflammation ic infections discoloration  Delayed  Consider 10 rights
Cortef phospholipase A2,  Status  Herpetic/fun  Increased wound of medication
NF-kappa B, and asthmaticus gal keratitis sweating healing administration
Classification: other inflammatory  Acute and  Amebiasis  Stomach  Water and  Assess for any
Corticosteroids transcription chronic  Hepatitis B bloating sodium allergies
factors, as well as adrenal  Cataract  Changes in retention During:
Dosage, route, promoting anti- insufficiency  hypertension your  Osteoporosis  Advise patient the
frequency: inflammatory genes.  Physiologic menstrual  Calcium possible effects of
Anaphylaxis: Hydrocortisone has replacement periods deposition the drug
100-150 mg/dose a broad therapeutic in pediatric  Increased  Monitor vital signs
IM q6hrs index and a use appetite/ during
relatively short  Allergic weight gain administration
Status duration of action. disorders  Headache After:
Asthmaticus :  Multiple and dizziness  Check for
1-2 mg/kg IV q6hr sclerosis, or  Trouble Hyperglycemia/
initially for 24 lung sleeping. Hyperkalemia
hours disorders(asth  Plasma cortisol
ma/COPD) level if long term
 Check any signs of
infection with WBC
counts
 Ensure antacids are
there or not
 Document and
record
Generic Name: Prednisone is a Prednisone is  Contraindica  Nausea  Convulsions Before:
Prednisone glucocorticoid and indicated as an ted with  Vomiting  Cataracts  Check doctor’s
anti-inflammatory anti- infections,  Loss of  Glaucoma order
Brand name: synthetic inflammatory or especially appetite  Hypotension  Consider 10 rights
Prolix corticosteroid. It immunosuppressi tuberculosis  Heartburn  Thrombophle of medication
reduces ve drug for  Fungal  Trouble bitis administration
Classification: inflammation by allergic, infections sleeping  Cardiac  Assess for any
Corticosteroids reversing increased dermatologic,  Amebiasis  Increased arrhythmias allergies
capillary gastrointestinal,  Vaccinia and sweating  Fluid  Determine if pt is
Dosage, route, permeability and hematologic, varicella  Acne may retention sensitive to other
frequency: inhibiting ophthalmologic,  Antibiotic- occur  Hypokalemia corticosteroids
Adults: Orally polymorphonuclear nervous system, resistant  Hypocalcemia  Monitor vital signs
40 to 60 mg daily leukocyte migration; renal, respiratory, infections During:
 Shock
for 5 to 7 days; it suppresses the rheumatologic,  lactation  Advise patient the
administer in 1 or immune system by infectious, possible effects of
2 divided doses. If lowering lymphatic endocrine, or the drug
symptoms do not activity and volume. neoplastic  Monitor vital signs
resolve and peak Its anti-tumor conditions as well during
expiratory flow is activity could be as in organ administration
not at least 70% attributed to the transplant. After:
of personal best, inhibition of glucose  Monitor
then longer transport, effectiveness of the
treatment may be phosphorylation, or drug
required the induction of cell  Watch out for any
death in immature adverse effects
lymphocytes.
 Monitor patient for
signs and
symptoms of
infection
 Document and
record
Generic Name: Corticosteroids Dexamethasone  Hypersensiti  Aggression.  Hyperglycemi Before:
Dexamethasone reduce vasodilation is indicated for vity to the  Agitation. a  Check doctor’s
and capillary the treatment of drug  Anxiety.  Glycosuria order
Brand name: permeability in the the following:  Systemic  Decrease in  Delayed  Consider 10 rights
Dexavin short term, as well  Arthritis fungal the amount wound of medication
as leukocyte  Blood/hormo infections of urine. healing administration
Classification: migration to sites of ne disorders  Cerebral  Fast, slow,  Osteoporosis  Assess potassium
Corticosteroids inflammation.  Allergic malaria pounding, or  Cushing level
Corticosteroids bind reactions  Tuberculosis irregular syndrome  Monitor vital signs
Dosage, route, to the glucocorticoid  Skin diseases disease of heartbeat or During:
frequency: receptor, causing  Eye problems the eye pulse.  Advise patient the
Adults: changes in gene  Breathing  Pregnant  Headache. possible effects of
expression that have problems woman  Mental the drug
Acute respiratory many downstream  Bowel  Diabetes depression.  Monitor vital signs
distress effects that might disorders mellitus  Mood during
syndrome, last for hours or  Cancer  Osteoporosis changes administration
moderate to days.  Immune  Heart failure After:
severe: Glucocorticoids system  Renal failure  Frequent
IV: 20 mg once inhibit neutrophil disorders monitoring of VS
daily from days 1 apoptosis and  Monitor for
to 5, then 10 mg demargination; they hypo/hyperglycemi
once daily from inhibit a
days 6 to 10 phospholipase A2,  Assess for signs of
which reduces the infections
formation of
 Document and
arachidonic acid
record
derivatives; they
inhibit NF-Kappa B
and other
inflammatory
transcription
factors; and they
promote anti-
inflammatory genes
such as interleukin-
10.
Cromoglycates

Drug Order Mechanism of Action Indication Contraindication Side effects Adverse effects Nursing Responsibilities

Generic Name: Cromolyn sodium Indicated for the  Hypersensitivit  Headache  Itching or Before:
Cromolyn prevents the release treatment of the y to the drug  Diarrhea rash  Check doctor’s
Sodium of inflammatory following:  Nausea  Trouble order
mediators such as  Abdominal breathing or
 Consider 10 rights
Brand name:
 Prophylaxis pain wheezing
Gastrocrom histamine and of medication
of mild to  Muscle aches  Swelling of
leukotrienes, which face, lips, or administration
moderate
Classification: cause allergic  Assess for any
bronchial eyelids
Mast Cell symptoms and asthma and allergies to the drug
Stabilizers 
bronchoconstriction. Adjunctive  Assess respiratory
It also inhibits mast treatment of status
Dosage, route,
cell degranulation, allergic
frequency: During:
rhinitis and
which is normally  Advise patient the
 Systemic
Oral Solution: associated with possible effects of
mast cell
Adults and anaphylaxis after disease the drug
Adolescents (13 exposure to reactive (mastocytosi  Monitor vital signs
Years and allergens. Cromolyn s) in during
Older): Two sodium differs from pediatric administration
ampules four antihistamine patients and
After:
adults.
times daily, medications in that it  Advise patient to
taken one-half inhibits the action of notify physician if
hour before histamines after they symptoms persist
meals and at are released from  Educate patient
bedtime. mast cells. knowledge about
Children 2-12 the drug
Years: One  Document and
ampule four record
times daily,
taken one-half
hour before
meals and at
bedtime.
Generic Name: Cromoglicate inhibits Indicated in the:  Hypersensitivit  Abdominal  Polymyositis Before:
Sodium mast cell y to the drug discomfort  Pneumonitis  Check doctor’s
 Maintenance  Cough  Heart failure
Cromoglycate degranulation, order
treatment  Diarrhea  Urticaria
preventing the
for childhood  Consider 10 rights
Brand name:  Difficulty  Anaphylaxis
release of histamine asthma for of medication
Nalcrom sleeping
and the slow-reacting many years administration
 Headache
Classification: substance of  Treatment of  Joint pain  Assess for any
Mast Cell anaphylaxis (SRS-A), food allergy  Nausea allergies to the drug
Stabilizers both of which are  Sneezing  Assess respiratory
mediators of type I  Unpleasant status
Dosage, route,
allergic reactions. taste During:
frequency:  Vomiting
Cromoglicate may  Advise patient the
Oral
also reduce the possible effects of
Administration:
production of the drug
Adults:
inflammatory  Advise patient to
2 capsules four
leukotrienes. take the drug 15-20
times daily
Cromoglicate may minutes before
before meals
work by preventing meals
Children:
calcium influx.  Monitor vital signs
1 capsule four
times daily during
before meals administration
After:
 Advise patient to
notify physician if
symptoms persist

 Educate patient
knowledge about
the drug

 Document and
record
 Leukotriene Receptor Antagonist

Drug Order Mechanism of Action Indication Contraindication Side effects Adverse effects Nursing Responsibilities
Generic Name: Zafirlukast is a Indicated for the  Acute  Nausea,  Difficulty Before:
Zafirlukast selective and prophylaxis and asthma  Diarrhea, breathing  Check doctor’s order
competitive chronic treatment exacerbation  Stomach  Yellowish of  Consider 10 rights of
Brand name: antagonist of the of asthma. s pain, the skin medication
Accolate leukotriene D4 and  Status  Headache, (jaundice) administration
E4 (LTD4 and LTE4) asthmaticus and  Dark urine  Assess for any
Classification: receptors, which are  Patients with  Cold  Skin rash allergies to the drug
Leukotriene components of the hepatic symptoms  Severe  Perform physical
Receptor slow-reacting impairment (stuffy nose, tingling assessment and VS
Antagonist substance of sneezing,  During:
anaphylaxis (SRSA). sore throat)  Advise patient the
Dosage, route, Cysteinyl leukotriene possible effects of the
frequency: production and drug
For chronic receptor occupation  Advise patient to
asthma treatment have been linked to administer on an
and prophylaxis: asthma empty stomach 1hr
20 mg PO twice pathophysiology, before or 2hr after
daily including airway meals
edema, smooth  Advise patient to take
muscle constriction, medication as
and altered cellular prescribed
activity associated After:
with the  Advise patient to
inflammatory notify physician if
process, all of which symptoms persist
contribute to asthma  Advise patient to not
symptoms. take the drug for
acute asthma attack
or acute
bronchospasm
 Document and record
Generic Name: Cysteinyl Indicated in the  Patients with  Stomach  Upper Before:
Montelukast leukotrienes (CysLT), following: a history of pain respiratory  Check doctor’s order
which include LTC4,  For the hypersensiti  Diarrhea infection  Consider 10 rights of
Brand name: LTD4, and LTE4, are prophylaxis vity to the  Fever  Ear infection medication
Singulair eicosanoids and chronic drug or its  Flu  Swelling in administration
produced by a variety treatment of components symptoms your face or  Assess for any
Classification: of cells including asthma in  For acute  Cold tongue allergies to the drug
Leukotriene mast cells and adults and asthma symptoms  Burning in  Monitor vital signs
Receptor eosinophils. When pediatric attack (stuffy your eyes During:
Antagonist such CysLT bind to patients 12  Patients with nose, sinus  Skin pain  Advise patient the
corresponding CysLT months of age phenylketon pain, cough,  Skin rash possible effects of the
Dosage, route, receptors, such as and older. uria (PKU) sore  Muscle drug
frequency: CysLT type-1  For prevention throat), weakness  Advise patient to take
For Asthma receptors on of exercise-  Headache medication as
treatment and respiratory airway induced  Bed-wetting prescribed
prophylaxis: smooth muscle cells, bronchoconstr or loss of After:
10 mg (single 10- airway macrophages, iction (EIB) in bladder  Advise patient to
mg tablet) PO and various pro- patients 6 control in notify physician if
qPM inflammatory cells years of age children symptoms persist
For Exercise- such as eosinophils and older.  Assess pulmonary
Induced and some specific  For the relief function at rest and
Bronchospasm: myeloid stem cells, of symptoms during exercise
10 mg PO 2 hr activities that aid in of seasonal  Monitor and report
before exercise; the pathophysiology allergic rhinitis any changes in mood
do not take of asthma and in patients 2 or behavior
additional dose allergic rhinitis are years of age  Monitor any muscle
within 24 hours activated. and older and weakness or tremor
For Allergic or perennial  Document and record
Perennial Rhinitis: allergic rhinitis
0 mg (single 10-mg in patients 6
tablet) PO qDay months of age
and older.
 Cough Preparations

Drug Order Mechanism of Action Indication Contraindication Side effects Adverse effects Nursing Responsibilities
Generic Name: Dextromethorphan is Indicated in the  Hypersensitivit  Blurred  Severe Before:
Dextromethorphan an NMDA and sigma- treatment of y to the drug vision dizziness,  Check doctor’s order
1 receptor agonist. It cough caused by  Those with an  Dysuria anxiety,  Consider 10 rights of
Brand name: is also an antagonist the common idiosyncratic  Dizziness restless medication
Robitussin DM of nicotinic receptors cold, the flu, or reaction upon  Nausea or feeling, or administration
3 and 4. However, other conditions administration vomiting nervousness  Assess frequency and
Classification: the mechanism by of the drug  Shaking and  Seizures or nature of cough, lung
Cough which unsteady convulsions sounds, and amount
suppressants; dextromethorphan's walk  Confusion/h and type of sputum
antitussives receptor agonism  Unusual allucinations produced
and antagonism excitement,  Slow,  Monitor vital signs
Dosage, route, translate to clinical nervousness, shallow During:
frequency: effect is unknown. restlessness, breathing.  Instruct patient to
Adults: or irritability cough effectively: sit
Liquid and syrup: upright and take
10-20 mg orally several deep breaths
every 4 hours or before attempting to
30 mg every 6-8 cough
hours  Advise patient to take
Pediatric: medication as
Children 4-6 years prescribed
old: 7.5 mg every After:
6-8 hours, not to  Monitor effectiveness
exceed 30 mg per of the drug
day  Instruct patient about
the possible effects of
the drug
 Document and record
Generic Name: Guaifenesin is Indicated in the  Hypersensitivit  Diarrhea  Trouble Before:
Guaifenesin classified as an following: y to the drug  Hives breathing  Check doctor’s order
expectorant because  For the  Patients with  Nausea or  Swelling of  Consider 10 rights of
Brand name: it increases the treatment of persistent or vomiting face, tongue, medication
Mucinex output of phlegm cough chronic cough  Stomach and throat administration
(sputum) and associated  Hypertension pain  Severe skin  Assess frequency and
Classification: bronchial secretions with colds  Diabetes rash nature of cough, lung
Expectorants by decreasing their and minor  Overactive sounds, and amount
adhesiveness and upper thyroid gland and type of sputum
Dosage, route, surface tension. respiratory  Heart disease produced
frequency: Furthermore, tract  Systemic  Assess any allergies
Adults: guaifenesin causes infections mastocytosis to the drugs
100-400 mg orally an increase in the  For loosening  Monitor vital signs
every 4 hours; not flow of less viscous phlegm and During:
to exceed 2.4 gastric secretions, thin bronchial  Advise patient to take
g/day which promotes secretions to medication as
ciliary action - all of aid in clearing prescribed
Pediatric: which results in bronchial After:
Children 6 months coughs that are more passages and  Monitor effectiveness
to 2 years: 25-50 productive and less making of the drug
mg every 4 hours; frequent. Essentially, coughs more  Instruct patient about
not to exceed 300 guaifenesin improves productive the possible effects of
mg/day the efficacy of the drug
Children 2-6 years: mucociliary activity in  Advise patient to not
50-100 mg orally removing take the drug longer
every 4 hours; not accumulated than 1 week
to exceed 600 secretions from the
 Document and record
mg/day upper and lower
Children 6-12 airways by
years: 100-200 mg decreasing the
orally every 4 viscosity and
hours; not to adhesiveness of such
exceed 1.2 g/day secretions.
Generic Name: Mucus hypersecretion Indicated in the  Hypersensitivity  Nausea,  Hypoglycemia Before:
Carbocisteine characterizes severe following: to the drug  Stomach  Abnormal  Check doctor’s
respiratory conditions  To relieve  Active peptic discomfort, heart rhythm order
Brand name: such as asthma, cystic cough ulcer  Diarrhea,  Palpitations  Consider 10 rights
Solmux Capsule fibrosis (CF), and characterized  Skin rashes of medication
chronic obstructive by excessive administration
Classification: pulmonary disease or sticky  Assess frequency
Mucolytics (COPD) (COPD). It sputum or and nature of
prevents pulmonary phlegm to cough, lung
Dosage, route, infections by help treat sounds, and
frequency: inhibiting bacterial respiratory amount and type
Adults: adherence to cells. tract of sputum
Orally, 1 Fucomucins, disorders such produced
capsule q8hrs, sialomucins, and as acute  Assess any
or as sulfomucins are bronchitis allergies to the
recommended glycoproteins that  Reduces the drugs
by a doctor regulate the number of  Monitor vital signs
viscoelastic properties exacerbations During:
of bronchial mucus. associated  Advise patient to
Fucomucin levels in with chronic take medication
the mucus of COPD obstructive as prescribed
patients are elevated. pulmonary After:
Carbocisteine works disease  Monitor
to restore the balance (COPD) and effectiveness of
of sialomucins and inhibits the the drug
fucomucins, most adherence of  Instruct patient
likely through bacteria and about the possible
intracellular virus to effects of the drug
stimulation of the human  Document and
sialyl transferase respiratory record
enzyme, lowering cells
mucus viscosity.
Nasal Decongestants

Drug Order Mechanism of Action Indication Contraindication Side effects Adverse effects Nursing Responsibilities
Generic Name: Pseudoephedrine is Indicated in the  Overactive  Nausea  Fast, Before:
Pseudoephedrine primarily an agonist of following: thyroid gland  Vomiting irregular,  Check doctor’s
alpha adrenergic  To relieve  Diabetes  Trouble pounding order
Brand name: receptors and a nasal  Closed angle sleeping heartbeat  Consider 10 rights
Sudafed weaker agonist of congestion glaucoma  Dizziness  Mental/mood of medication
beta adrenergic caused by  High blood  Headache changes administration
Classification: receptors. This colds, pressure  Nervousness  Shaking  Assess for possible
Nasal adrenergic receptor allergies, and  Significant  Dysuria cautions and
Decongestants agonism causes hay fever uncontrolled contraindications
vasoconstriction,  To high blood  Monitor vital signs
Dosage, route, which is used as a temporarily pressure During:
frequency: decongestant and to relieve sinus  Severe  Advise patient to
Adults: Nasal treat priapism. congestion disease of the take medication as
Congestion Pseudoephedrine also and pressure arteries of the prescribed
60 mg orally inhibits the heart After:
every 4-6 hours transporters of  Enlarged  Monitor
as needed norepinephrine, prostate effectiveness of the
dopamine, and  An inability to drug
Priapism: serotonin. completely  Monitor vital signs
60-120 mg orally empty the  Monitor urinary
bladder output
 Evaluate
respirations and
adventitious breath
sounds
 Document and
record
Generic Name: Phenylephrine is an Indicated or the  Overactive  Headache or  Fast, Before:
Phenylephrine alpha-1 adrenergic temporary relief thyroid gland. dizziness irregular, or  Check doctor’s
agonist that, of stuffy nose,  Acidosis, a  Increased pounding order
Brand name: depending on the sinus, and ear high level of sweating heartbeat  Consider 10 rights
Pretz-D route and location of symptoms acid in the  Nervousness  Trembling of medication
administration, causes caused by the blood.  Paleness  Burning, administration
Classification: vasoconstriction and common cold,  High blood  Trouble in dryness, or  Assess for possible
Nasal mydriasis. flu, allergies, or pressure. sleeping stinging of cautions and
Decongestants Phenylephrine also other breathing  Significant  Increase in inside of nose contraindications
causes agonism of illnesses (such as uncontrolled runny or  Paleness  Monitor vital signs
Dosage, route, alpha-1 adrenergic sinusitis, high blood stuffy nose  During:
frequency: receptors, which bronchitis). This pressure.  Advise patient to
For stuffy nose: raises systolic and medication  A heart take medication as
For nose jelly diastolic pressures as works by attack. prescribed
dosage form: well as peripheral decreasing  Coronary After:
Adults—Use a vascular resistance swelling in the artery  Monitor
small amount in when taken nose and ears, disease. effectiveness of the
the nose every systemically. The thereby  Partial heart drug
three or four vagus nerve is lessening block.  Monitor vital signs
hours as needed. stimulated by discomfort and  Rapid  Monitor urinary
increased blood making it easier ventricular output
For nose drops pressure, resulting in to breathe. heartbeat.  Evaluate
dosage form: reflex bradycardia. respirations and
Adults and adventitious breath
children 12 years sounds
of age and
 Document and
older—Use two
record
or three drops of
a 0.25 to 0.5%
solution in the
nose every four
hours as needed.
Intranasal Corticosteroids

Drug Order Mechanism of Action Indication Contraindication Side effects Adverse effects Nursing Responsibilities
Generic Name: Beclomethasone Indicated in  Active  Dry/irritated  White Before:
Beclomethasone dipropionate is a preventing tuberculosis. throat patches in  Check doctor’s
corticosteroid and difficulty  Inactive  Hoarseness, your mouth order
Brand name: prodrug that is rapidly breathing, chest tuberculosis.  Coughing or tongue  Consider 10 rights
Beclovent hydrolyzed to the tightness,  Herpes  A bad taste  Puffy face of medication
active monoester, 17 wheezing, and simplex in the  Unusual hair administration
Classification: monopropionate (17- coughing caused infection of mouth or growth  Assess for possible
Corticosteroids BMP), which has anti- by asthma the eye. voice  Slow wound cautions and
inflammatory adults and  A nasal fungal changes healing contraindications
Dosage, route, properties. children 5 years infection due  Runny or  Bone pain  Monitor vital signs
frequency: Glucocorticoid of age and older to Candida. stuffy nose  Mental/mood During:
For patients not receptors dimerize  An infection  Back pain changes  Have the patient
previously and translocate into due to a  Vision use decongestant
receiving the nucleus, where parasite. problems drops before using
inhaled they bind to  Decreased  Sign of the inhaled steroid
corticosteroid glucocorticoid function of infection  Advise patient to
(ICS): Initial response elements the adrenal take medication as
dose: 40 to 80 (GRE) on gland. prescribed
mcg via oral glucocorticoid-  Increased After:
inhalation BID responsive genes, pressure in  Have the patient
causing transcription the eye. rinse
For patients to change.  Wide-angle the mouth after
switching from glaucoma. using the inhaler
another ICS:  Monitor
Initial dose effectiveness of the
selection should drug
be based on the  Monitor the patient
previous ICS for any sign of
strength: 40 to respiratory
320 mcg via oral infection
inhalation BID
 Document and
record
Generic Name: Corticosteroids reduce Indicated in the  TB involving  Dry/irritated  Puffy face Before:
Budesonide vasodilation and following: the lungs. throat,  Unusual hair  Check doctor’s
capillary permeability  For the  Inactive  Hoarseness, growth order
Brand name: in the short term treatment tuberculosis.  Voice  Consider 10 rights
 Slow wound
Pulmicort effect, as well as and  Herpes changes, of medication
healing
leukocyte migration to maintenance simplex  Bad taste in administration
Classification: sites of inflammation. of mild to infection of the mouth,  Trouble  Assess for possible
Corticosteroids Corticosteroids bind moderate the eye.  Runny nose, breathing cautions and
to the glucocorticoid Crohn's  A herpes  Nosebleeds  Mental/mood contraindications
Dosage, route, receptor, causing disease simplex changes  Monitor vital signs
frequency: changes in gene  To control infection. During:
Age 18 years expression that have  Vision
and prevent  Candidiasis  Have the patient
and older: The multiple downstream symptoms problems
fungal use decongestant
recommended effects that can last (wheezing infection of  Sign of drops before using
starting dose of for hours or and the infection the inhaled steroid
inhaled days. Glucocorticoids shortness of oropharynx.  Thinning skin  Advise patient to
Pulmicort inhibit neutrophil breath)  An infection take medication as
 Increased
Flexhaler apoptosis and caused by due to a prescribed
(budesonide) is demargination; they thirst/urinatio
asthma. parasite. After:
360 mcg inhibit phospholipase  COPD, hay n
 Have the patient
(micrograms) A2, which reduces fever and rinse
twice daily. arachidonic acid allergies, and the mouth after
derivative formation; ulcerative using the inhaler
Age 6 to 17 they inhibit NF-Kappa colitis.  Monitor
years old: The B and other effectiveness of the
recommended inflammatory drug
starting dose of transcription factors;  Monitor the patient
inhaled and they promote for any sign of
Pulmicort anti-inflammatory respiratory
Flexhaler genes such as infection
(budesonide) is interleukin-10.
 Educate client
180 mcg twice
about the drug
daily.
 Document and
record