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Medications Used for the Respiratory System

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Abstract

Commonly acquired respiratory conditions may be acute or chronic and range from acute rhinitis to chronic obstructive pulmonary disease (COPD). In this chapter the pathophysiology of the selected conditions are explained and the subsequent pharmacological approach to treatment identified and applied to nursing care and practice.

The core concepts of inflammation and receptor-mediated muscle relaxation are explained in order to explain the effect of aspects of pharmacological treatment. Medications such as antihistamines, corticosteroids, nedocromil and leukotriene antagonists are examined in relation to the allergenic-inflammatory response of the respiratory tract. Classic-receptor mediated bronchodilation-constriction theory will also be explored in relation to sympathetic agonists and parasympathetic antagonists.

Pharmacological aspects such as pharmacokinetic interactions together with specific nursing responsibilities associated with the medications concerned are addressed.

Keywords

  • Antihistamines
  • Corticosteroids
  • Beta agonists
  • Muscarinic antagonists
  • Leukotriene receptor antagonists
  • Phosphodiesterase inhibitors

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Notes

  1. 1.

    An ‘off-label’ use of a medication is when it is utilised in a way other than specified in the licence.

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Authors

Corresponding author

Correspondence to Shelley Peacock .

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Appendices

Multiple Choice Questions

  1. 1.

    Terbutaline is a type of bronchodilator known as:

    1. (a)

      Corticosteroid

    2. (b)

      Beta-2 adrenoceptor antagonist

    3. (c)

      Beta-blocker

    4. (d)

      Beta-2 adrenoceptor agonist

  2. 2.

    High doses of beta-2 adrenoceptor agonist can cause:

    1. (a)

      Hypokalaemia

    2. (b)

      Anaemia

    3. (c)

      Vitamin B12 deficiency

    4. (d)

      Scabies

  3. 3.

    Muscarinic receptor antagonists are used as bronchodilators because of their antagonism of muscarinic acetylcholine receptors in the:

    1. (a)

      Sympathetic nervous system

    2. (b)

      Parasympathetic nervous system

    3. (c)

      Cerebral cortex

    4. (d)

      Organ of Corti

  4. 4.

    Common adverse reactions of corticosteroids include which of the following:

    1. (a)

      Blinking

    2. (b)

      Hoarseness

    3. (c)

      Dehydration

    4. (d)

      Candidiasis

  5. 5.

    Montelukast belongs to which class of drug:

    1. (a)

      Muscarinic receptor antagonist

    2. (b)

      Calcium channel blocker

    3. (c)

      Leukotriene receptor antagonist

    4. (d)

      Decongestant

  6. 6.

    Antihistamines should be used cautiously in patients with a history of:

    1. (a)

      Eczema

    2. (b)

      Diabetes

    3. (c)

      Headaches

    4. (d)

      Phobias

  7. 7.

    Which one of the following is a corticosteroid?

    1. (a)

      Beclometasone dipropionate

    2. (b)

      Amoxicillin

    3. (c)

      Salbutamol

    4. (d)

      Pseudoephedrine

  8. 8.

    When should intranasal corticosteroids be avoided?

    1. (a)

      In acute rhinitis

    2. (b)

      In chronic rhinitis

    3. (c)

      In those with an untreated nasal infection

    4. (d)

      After surgery

Answers

  1. 1.

    d

  2. 2.

    a

  3. 3.

    b

  4. 4.

    b and d

  5. 5.

    c

  6. 6.

    b

  7. 7.

    a

  8. 8.

    c and d

Appendix

Nasal spray and technique (Scadding et al. 2017)

  • First gently blow the nose to try and clear.

  • Shake the bottle well.

  • Close off one nostril and put the nozzle in the other, directing it away from the midline. Tilt head forward slightly and keep the bottle upright.

  • Squeeze a fine mist into the nose while breathing in slowly. Do not sniff hard.

  • Breathe out through the mouth.

  • Take a second spray in the same nostril then repeat this procedure for the other nostril.

Nasal drop technique (Harper 2018)

  • Gently blow the nose to try and clear.

  • Shake the container well.

  • Tilt the head backwards.

  • Place the drops in the nostril (squeeze the container gently if necessary).

  • Keep the head tilted and sniff gently to let the drops penetrate.

  • Repeat for the other nostril, if required.

  • Replace the bottle lid after using.

  • Wash your hands after using the drops.

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Peacock, S. (2020). Medications Used for the Respiratory System. In: Hood, P., Khan, E. (eds) Understanding Pharmacology in Nursing Practice . Springer, Cham. https://doi.org/10.1007/978-3-030-32004-1_10

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  • DOI: https://doi.org/10.1007/978-3-030-32004-1_10

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