PN PHARMACOLOGY DRUG CARD ASSIGNMENT Using the Drug Card Assignment Template, ha

Question

PN PHARMACOLOGY DRUG CARD ASSIGNMENT Using the Drug Card Assignment Template, handwrite the following sections for the listed drug classification below 1. Give 2 examples of each classification of drug (include trade and generic name for each drug example 2. Drug actions 3. Uses 4. Give at least 3 Common adverse effects 5. Give at least 2 Serious adverse effects 6. Patient Teaching- must include if applicable, dietary restrictions, activity restrictions, vital signs monitoring, and, drug interactions, lab monitoring

Explanation / Answer

CLASSIFICATION of Bronchodilators

A)2 Sympathomimetics: Salbutamol (ASTHALIN 2, 4 mg tab,

VENTORLIN 2 mg/5 ml syr)

Terbutaline ( BRICAREX 2.5, 5 mg tab, MISTHALER 250 µg/metered dose)

B) Methylxanthines:  

Theophylline (UNICONTIN 400 mg DURALYN-CR 400 mg continuous release cap)

Aminophylline (AMINOPHYLLINE 100 mg tab, 250 mg/10 ml inj.)

Doxophylline (OXYPUR 400 mg tab, DOXORIL 400 mg tab)

C) Anticholinergics:

Ipratropium bromide (IPRAVENT 20 µg and 40 µg/puff metered dose inhaler)

Tiotropium bromide (TIOVA 18 g rotacaps)

A)2 Sympathomimetics:   

Salbutamol

a)Drug action:

A highly selective 2 agonist; cardiac side effects are less prominent.

Selectivity is further increased by inhaling the drug.

b)Uses

used to abort and terminate attacks of asthma.

c) Adverse effect :

Palpitation, restlessness, nervousness, throat irritation and ankle edema.

Muscle tremors (dose related)

Hypokalaemia

Terbutaline

It is similar to salbutamol in properties and use.

B) Methylxanthines:  

Theophylline

a)Drug action:

1)CNS Caffeine and theophylline are CNS stimulants, primarily affect the higher centres.

2)CVS Methylxanthines directly stimulate the heart and increase force of myocardial contractions.

3)Smooth muscles All smooth muscles are relaxed, most prominent effect is exerted on bronchi, especially in asthmatics.

4)Kidney Methylxanthines are mild diuretics; act by inhibiting tubular reabsorption of Na+ and water as well as increased renal blood flow and g.f.r.

5)Skeletal muscles Caffeine enhances contractile power of skeletal muscles.

6)Stomach Methylxanthines enhance secretion of acid and pepsin in stomach, even on parenteral injection.

7)Metabolism Caffeine and to a smaller extent theophylline increase BMR: plasma free fatty acid levels are raised.

8)Mast cells and inflammatory cells Theophylline decreases release of histamine and other mediators from mast cells and activated inflammatory cells.

b)Uses:

1. Bronchial asthma and COPD

2. Apnoea in premature infant

c) Adverse effects:

1)Headache, nervousness and nausea are early symptoms. 2)Children are more liable to develop CNS toxicity.

3)Rapid i.v. injection causes precordial pain, syncope and even sudden death—due to marked fall in BP, ventricular arrhythmias or asystole.

C) Anticholinergics:

Ipratropium bromide

a) Drug action:

It acts selectively on bronchial muscle without altering volume or consistency of respiratory secretions. Another desirable feature is that in contrast to atropine, it does not depress mucociliary clearance by bronchial epithelium.

b)Uses:

1)It is more suitable for regular prophylactic use rather than for rapid symptomatic relief during an asthmatic attack.

2)ipratropium is more effective in COPD than in bronchial asthma.

c)adverse effects:

Transient local side effects like dryness of mouth, scratching sensation in trachea, cough, bad taste and nervousness are reported.

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