Cromolyn Sodium Spray

Action: Antihistamine 

Therapeutic Effects: Decreased frequency and intensity of asthmatic episodes or allergic reactions

Contraindicated in: Acute attacks of asthma 

Adverse Reactions: nasal and throat irritation ANAPHYLAXIS OR WORSENING OF CONDITIONS

Considerations: Evaluate pulmonary function, assess for rhinitis 

diphenhydramine

Benadryl

Action: Antihistamine

Common side effects: drowsiness anoresxia, dry mouth

Adverse: nothing serious

Considerations: multiple uses, may cause sedation and confusion

loratadine

Claratine

Action: Antihistamine -relieves allergies

Common side effects: 

Adverse reactions: headache, dry mouth

Considerations: Use cautiously w/ liver/renal impairment 

vancanase

beclomethasone

Action: Anti-inflammatory corticosteroid- helps relieve asthma

Common side effects: hoarseness, dry mouth

Adverse reactions: bronchospasm, angioedema, suppresses hypothalamic-pituitary-adrenal function

Considerations: Never give to relieve emergency asthma attack

Give 5 min after bronchodialator

Taper oral corticosteroids slowly

Have pt. rinse mouth out after

pseudoephidrine

isoniazid

rigampin

streptomycin

Action: Inhibits protein synthesis in bacteria

Common side effects: ototoxicity, nephrotoxicity

Adverse reations: neuromuscular blockade, apnea, hemo-disorders

Considerations: Inactivated by penicillins and 

cephalosporins

Use cautiously in renal impairment and hard of hearing pts

albuterol

Action:  Relaxation of airway smooth muscle w/ subsequent bronchodilation

Common side effects: 

tachycardia, nervousness, restlessness,  tremor, chest pain, palpitations

Adverse reations: paradoxical bronchospasm

Considerations: use cautiously w/ HTN, coronary insufficiency, arrhythmias

aminophylline  (am-in-off-i-lin)

Action: Bronchodilation, CNS stimulation, Positive inotropic and chronotropic effects, Diuresis, Gastric acid secretion

Common side effects: anxiety, tachycardia, N/V

Adverse reations: seizures, arrhythmias

Considerations: Patients with a history of cardiovascular problems should be monitored for chest pain and ECG changes 

Monitor ABGs, acid-base, and fluid and electrolyte balance in patients receiving parenteral therapy

Toxicity and Overdose: Monitor drug levels routinely, especially in patients requiring high doses or during prolonged intensive therapy

beclomethasone  (be-kloe-meth-a-sone)

Action: Improves asthma symptoms - Potent, locally acting anti-inflammatory and immune modifier

Common side effects: head ache

Adverse reations:

Considerations:Contraindicated in: Acute attack of asthma/status asthmaticus.

cromolyn†  (kroe-moe-lin)

Action: Antihistamine, Decreased frequency and intensity of asthmatic episodes or allergic reactions

Common side effects: nasal irritation,irritation of throat/trachea, cough, wheezing, nausea, unpleasant taste

Adverse reations: Allergic reaction

Contraindicated in: Hypersensitivity; Acute attacks of asthma (inhalation products).

Advair

Action: Potent, locally acting anti-inflammatory and immune modifier antiasthmatics, anti-inflammatories (steroidal) corticosteroids (inhalation)

Common side effects: headache,fluid retention, hoarseness

Adverse reations: tachycardia, arrhythmias

Considerations: Assess patients changing from systemic corticosteroids to inhalation corticosteroids for signs of adrenal insufficiency (anorexia, nausea, weakness, fatigue, hypotension, hypoglycemia) during initial therapy and periods of stress. If these signs appear, notify health care professional immediately; condition may be life-threatening

ipratropium bromide

Action: anticholenergic, prevents bronchoconstriction 

Common side effects: nervousness, palpitations 

Adverse reations: upper resp infection 

Considerations: warn pt that Rx is not effective for treating acute episodes of bronchoconstriction

montelukast  (mon-te-loo-kast)

Action: Antagonizes effects of leukotrienes that mediate smooth muscle constriction= decreased inflammatory process - Improves breathing

Common side effects: agitation, aggression, anxiety, depression, dream abnormalities, fatigue, hallucinations, headache, insomnia

Adverse reactions: SUICIDAL THOUGHTS

Considerations: Doses of inhaled corticosteroids may be gradually decreased with supervision of health care professional; do not discontinue abruptly

Monitor closely for changes in behavior that could indicate the emergence or worsening of depression or suicidal thoughts

zileuton  (zye-loo-ton)

Action: Bronchodilator, decreases inflammatory process that is part of asthma; decreased incidence and severity of asthma

Common side effects: headache 

Adverse reations: suicidal thoughts

Considerations: monitor liver functions

Advise patient to notify health care professional of behavioral changes or thoughts of suicide.

Contraindicated in: Active liver disease

acetylcysteine

Action: assists in thinning secretions; reverses toxic effects of of acetaminophen 

Common side effects: rhinorrhea 

Adverse reations: bronchospasm

Considerations: use cautiously in pt w/ resp insufficiency 

keep suction nearby in case pt cannot clear secretions

Bactrim

trimethoprim/sulfamethoxazole  (trye-meth-oh-prim/sul-fa-meth- ox-a-zole)

Action: Bactericidal; inhibits the metabolism of folic acid in bacteria; used for UTI and travelers diarrhea

Spectrum: Active against many strains of gram-positive aerobic pathogens

Common side effects: rash, N/V, phlebitis at IV site 

Adverse reations: allergic reactions; erythema, stevens-johnson syndrome

Considerations: give w/ full glass of water, never give IM

Cipro

ciprofloxacin†  (sip-roe-flox-a-sin) 

Action: Inhibits bacterial DNA synthesis by inhibiting DNA gyrase enzyme; Death of susceptible bacteria

Common side effects: diarrhea, nausea

Adverse reations: seizures, pseudomembranous colitis

Considerations: Observe for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Discontinue drug and notify physician or other health care professional immediately if these problems occur. Keep epinephrine, an antihistamine, and resuscitation equipment close by in case of an anaphylactic reaction. 

-Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of pseudomembranous colitis. May begin up to several weeks following cessation of therapy.

-Instruct patient to notify health care professional if fever and diarrhea develop, especially if stool contains blood, pus, or mucus. Advise patient not to treat diarrhea without consulting health care professional.

-Instruct patient to notify health care professional immediately if rash, jaundice, signs of hypersensitivity, or tendon (shoulder, hand, Achilles, and other) pain, swelling, or inflammation occur. If tendon symptoms occur, avoid exercise and use of the affected area. Increased risk in >65 yrs old, kidney, heart and lung transplant recipients, and patients taking corticosteroids concurrently. Therapy should be discontinued.

levaquin

levofloxacin  (le-voe-flox-a-sin)

Action: Fluroquinolone; Inhibits bacterial DNA synthesis; Treatment of the following bacterial infections: Urinary tract infections, including cystitis, pyelonephritis, and prostatitis, Respiratory tract infections, including acute sinusitis, acute exacerbations of chronic bronchitis, community-acquired pneumonia, and nosocomial pneumonia, Uncomplicated and complicated skin and skin structure infections. Post-exposure treatment of inhalational anthrax.

Common side effects: nausea

Adverse reactions: heptatoxicity, seizures, arrhythmias, colitis

Considerations: avoid sun exposure, may decrease H&H and glucose in lab results

• Instruct patient to notify health care professional if fever and diarrhea develop, especially if stool contains blood, pus, or mucus. Advise patient not to treat diarrhea without consulting health care professional.
• Instruct patient to notify health care professional immediately if rash, jaundice, signs of hypersensitivity, or tendon (shoulder, hand, Achilles, and other) pain, swelling, or inflammation occur. If tendon symptoms occur, avoid exercise and use of the affected area. Increased risk in >65 yr old, kidney, heart and lung transplant recipients, and patients taking corticosteroids concurrently. Therapy should be discontinued.