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Hey guys nurse mike here and welcome to simplenursing.com check out our brand new app get access to our new pharmacology and med surg mastery courses plus a massive quiz bank loaded with detailed rationales to test your knowledge join for free click the link in our description below now for lower respiratory drugs we have two teams the bam team and the slam team
So bam is for our bronco dilators that act to dilate the bronchi in the lungs and slam is our anti-inflammatory agents to soothe the inflammation so guys let’s start with our bronco team bam first off we have b for beta2 agonist these guys end in butyrol like albuterol and level butyrol so guys just remember the b in butyrol is used for brutal asthma attacks
Since it’s the first drug we use during severe asthma attacks and it’s the fastest acting bronchodilator so the nclex key word here is it’s the only rescue inhaler during acute asthma attacks to be used before steroid inhalers that’s always a common nclex question now guys big caution here sally metro is a beta2 agonist as well but it’s a slower acting not a
Rescue inhaler so not to be used during an acute asthma attack since it ends in terrell and not buterol now it’s used commonly with a combination of steroids for longer term control of moderate to severe asthma now a common nclex question is do not use fluticasone or salimetrol for the first signs of acute asthma attack so during acute asthma attacks guys we
Give three drugs and to be honest sequence is key on the nclex so use the memory trick aim for the acute asthma attack a for albuterol which is always used first during brutal asthma and not selimetrol which is the slower acting one i is for hypertrophium always use second which we’ll be covering next and m is for methylprednisolone brand name sully metro which
Is our steroid always to be used last since steroids act so slow and it has the word prednisolone which kind of sounds like prednisone so that’s how you know it’s a steroid now for the mechanism of action these are beta 2 agonists which activate beta 2 in the lungs which dilates the bronchi resulting in increased airflow but it also activates beta 1 in the heart
Which makes the heart go crazy fast so the common side effect is a rapid heart rate so just think albuterol amps up the body now expected side effects for albuterol just think of the three t’s t for tachycardia and palpitations t for tremor and t for tossing and turning at night keyword for exams are insomnia and difficulty sleeping so teach patients not to take
It at bedtime and guys don’t let the nclex trick you commonly chosen distractors not constipation that’s a side effect for opioid pain meds and not hives that’s totally an allergic reaction not expected finding now patient education a little side note for asthmatic patients we always avoid beta blockers that end in lol like atenolol which can cause bronchospasms
And avoid nsaids like naproxen and ibuprofen which can worsen asthma now during an attack or a severe asthma attack we instruct patients to take two to four puffs every 20 minutes for three rounds now the big key point here guys write this down if it doesn’t work after three doses then you notify the hcp and how do we evaluate if the med is effective well we
Have decrease in respiratory rate example 34 respirations go down to 24. and guys the oxygen saturation is at least 90 percent or higher now a common hesi question asks about albuterol nebulizer some expected findings after treatment well there’s going to be increased productive cough reports of decreased anxiety as well as mild bilateral hand tremors guys these
Are totally normal now as far as administration make sure you shake it before you take it so remember come on shake shake it come come on shake shake it now guys the key point here is always make sure to shake it well then you breathe all the way out push the inhaler inhale and hold for a few seconds then exhale now if we’re taking with steroids too the correct
Order is albuterol first to bronchodilate and open the lungs and steroids seconds to get all that powder down into the deep lungs now as far as cleaning the meter-dosed inhaler we always clean the mouthpiece one to two times per week with warm water now this does not have to be done after every use common nclex question only steroids are washed after every use
So guys just think steroid inhalers go right in the sink after each use now a common question on exit exams they’ll present a patient with severe asthma with their vital signs all screwed up and they’ll ask which medication would you give select all that apply so guys remember during asthma attacks we give aim albuterol hypertrophium and methylpredazole so guys
Our correct options here are two for albuterol inhaler three nebulizer hypertropium and five iv methyloprednizolone now our next drug is a for anticholinergics ending in trophium like iprotroprium or teotropium now these guys dry the body out so think tropium you can’t pee with them with your pms used for moderate to severe asthma and copd it’s a longer-acting
Bronchodilator that reduces secretions and commonly given in combination with albuterol now they’re used second in line during a severe or acute asthma attack remember our acronym aim a for albuterol first hypertrophium second and methylprednisolone third guys that is a brand name sully metro always our steroids are given last since steroids act slow now the
Mechanism of action is that it blocks secretions so you can’t see p spit or sh poop now this is called anticholinergic effects and i remember by saying anticholinergic or anti-secretions since they block a c to choline and again you can simply say tropium means you can’t pee with them so the obvious side effect is dry mouth and hoarseness and we teach patients
These key points to treat the dry mouth and throat for all anticholinergics we use gum and candy and we also drink fluids now the big key point here and the big test tip is no swallowing teotropium capsules guys put the capsule inside the inhaler device and then inhale never swallow the pill this came up on both the sc and ati exams now a big contraindication
To all anticholinergics we never give for patients who are already dry so those who can’t see like with glaucoma those who can’t pee like with urinary retention and bph and those who can’t spit or sh poop like with bowel obstructions our last bronchodilator m for methyloxane things ending in fillin like theophylline or aminophylline it’s kind of like given
Caffeine that makes your heart race and can be very toxic so think fill in has you fill in caffeinated and toxic with a super rapid heart rate now the key points are the three t’s t for toxicity over 20 now that’s the biggest nclex tip there theophilin has a very narrow therapeutic range between 10 and 20 so we constantly need frequent blood draws now the next
T is for tonic clonic seizures that’s the number one sign for severe toxicity and always the first priority as a nurse so guys we report signs and symptoms of toxicity like anorexia nausea vomiting and even restlessness and insomnia now the last t is for tachycardia and dysrhythmias a big nclex tip right there now these are common adverse effects of the drug but
Two common test questions on the hessie were to teach patients to avoid beta blockers that lower the heart rate which can also block the effects of theophylline and also to alert the hcp of tachycardia before administering the next dose now patient education the two drugs that increase toxicity risk and big nklex tip again is semetidine the h2 blocker given for
Heartburn and also ciproflaxin the antibiotic and guys always teach the patients to take in the am since you get amped up in the am and avoid caffeine technically avoid all stimulants and lastly we stop before a cardiac stress test which can augment the test now three common questions which of the following prescription should the nurse question so number one
Naproxen for asthmatic patients yes guys we always question this one never nsaids or beta blockers for patients with asthma how about number two hypertrophium for a patient with glycoma no we never do tropiums for a patient who can’t see spit or sh poop you get the idea now option number three low certain for a patient with diabetes oh yeah that’s okay how about
Option number four theophylline for a patient taking cemetidine well guys we’re going to question this order because it increases the risk for toxicity always cementidine and ciproflaxin and number five atenolol for a patient with asthma yes guys always question this one never give beta blockers to asthmatic patients now question number two what patient teaching
Should be included with a new prescription of albuterol ibuprofen teotropium and beclomethazone select all that apply now option number one tinnitus is an expected side effect no guys tinnitus is a serious side effect basically tells us that the drug is hard on the kidneys usually caused by antibiotics here now option number two here tachycardia is expected
After albuterol yes guys the t’s of albuterol one of them is tachycardia totally normal option 3 report dark stool to the provider yes guys nsaids like ibuprofen can cause gi bleeding so we report dark tarry stools now option number four drink fluids to prevent dry mouth and throat yes guys trophiums dry the mouth so we can’t pee with them with tropium so we
Get urinary retention as well as dry mouth and last thing guys is five hypertrophium is used first during an attack no we always use buterols for brutal asthma commonly albuterol now last question which medication prescribed for asthma causes tachycardia and dysrhythmias option number one phenobarbital now guys this is a sedative for anxiety option number two
Is the correct one aminophylline guys remember fillins have you fill in caffeinated and amped up now the last two options salmetrol and albuterol technically both can cause tachycardia but usually don’t cause dysrhythmias so we have to throw that out here now for anti-inflammatory agents are slam team we have s for steroids which decreases the swelling ending
In zone like beclo methazone now the key points to know for the exam are the four thanks for watching for our full video and new quiz bank click right up here to access your free trial and please consider subscribing to our youtube channel last but not least a big thanks to our team of experts helping us make these great videos all right guys see you next time
Transcribed from video
Pharmacology – Bronchodilators – Respiratory Drugs nursing RN PN NCLEX By Simple NursingliveBroadcastDetails{isLiveNowfalsestartTimestamp2020-07-23T024509+0000endTimestamp2020-07-23T030003+0000}
