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Clinical Medications Worksheets

Generic Name Trade Name Classification Dose Route Time/frequency


albuterol Proventil bronchodilators 2.5mg/0.5mL NIH Q 6 hrs per RT
Peak Onset Duration Normal dosage range
60-90 min 5-15 min 3-6 hr 2.5-5 mg q 20 min for 3 doses then 2.5-10 mg q 1-4 hr prn
Why is your patient getting this medication For IV meds, compatibility with IV drips and/or solutions
Used as a bronchodilator to control and prevent reversible airway N/A
obstruction caused by asthma or COPD. Used as a quick-relief agent for
acute bronchospasm and for prevention of exercise-induced
bronchospasm
Mechanism of action and indications Nursing Implications (what to focus on)
(Why med ordered) Contraindications/warnings/interactions
Binds to beta2-adrenergic receptors in airway smooth muscle, leading to Hypersensitivity. Cardiac disease, HTN, hyperthyroidism,
activation of adenyl cyclase and increased levels of cyclic-3', diabetes, glaucoma, seizure disorder, geriatric patients
5'-adenosine monophosphate (cAMP). Increases in cAMP activate (increased risk of adverse reactions; may require dosage
kinases, which inhibit the phosphorylation of myosin and decrease reduction)
intracellular calcium. Decreased intracellular calcium relaxes smooth Common side effects
muscle airways. Relaxation of airway smooth muscle with subsequent Nervousness, restlessness, tremor, chest pain, palpitations
bronchodilation. Relatively selective for beta2 (pulmonary) receptors.

Proventil (albuterol)
Interactions with other patient drugs, OTC or herbal medicines (ask Lab value alterations caused by medicine
patient specifically) May cause transient ↓ in serum potassium concentrations
Coreg: Beta blockers may antagonize the effects of bronchodilator beta- with nebulization or higher-than-recommended doses.
adrenergic agonists, which may result in life-threatening bronchospasm. Be sure to teach the patient the following about this
The mechanism is increased airway resistance and inhibition of beta- medication
agonist-induced bronchodilation due to beta-2-adrenergic blockade. Instruct patient to take albuterol exactly as directed. If on a
Ophthalmically applied beta blockers undergo some systemic absorption scheduled dosing regimen, take missed dose as soon as
and may also interact. Propranolol has been used in the treatment of remembered, spacing remaining doses at regular intervals.
albuterol overdose. Do not double doses or increase the dose or frequency of
Demadex: Beta-2 adrenergic agonist bronchodilators may cause doses. Caution patient not to exceed recommended dose;
hypokalemia and/or prolongation of the QT interval. The may cause adverse effects, paradoxical bronchospasm (more
coadministration of potassium-wasting diuretics may exacerbate likely with first dose from new cannister), or loss of
hypokalemia, potentially increasing the risk of ventricular arrhythmias effectiveness of medication. Instruct patient to contact health
including ventricular tachycardia and torsade de pointes. Patients who are care professional immediately if shortness of breath is not
taking systemic or nebulized beta agonists, high doses of beta agonists, relieved by medication or is accompanied by diaphoresis,
or concomitant theophylline or corticosteroids may be at a greater risk of dizziness, palpitations, or chest pain. Advise patient to
developing hypokalemia. consult health care professional before taking any OTC
Levaquin: Beta-2 adrenergic agonists can cause dose-related medications , natural/herbal products, or alcohol
prolongation of the QT interval and potassium loss. Theoretically, concurrently with this therapy. Caution patient also to avoid
coadministration with other agents that can prolong the QT interval may smoking and other respiratory irritants. Inform patient that
result in elevated risk of ventricular arrhythmias, including ventricular albuterol may cause an unusual or bad taste. Advise patients
tachycardia and torsade de pointes, because of additive arrhythmogenic to use albuterol first if using other inhalation medications
potential related to their effects on cardiac conduction. In general, the and allow 5 min to elapse before administering other inhalant
risk of an individual agent or a combination of agents causing ventricular medications unless otherwise directed. Advise patient to
arrhythmia in association with QT prolongation is largely unpredictable rinse mouth with water after each inhalation dose to
but may be increased by certain underlying risk factors such as minimize dry mouth.
congenital long QT syndrome, cardiac disease, and electrolyte
disturbances (e.g., hypokalemia, hypomagnesemia). In addition, the
extent of drug-induced QT prolongation is dependent on the particular
drug(s) involved and dosage(s) of the drug(s). Clinically significant
prolongation of QT interval and hypokalemia occur infrequently when
beta-2 adrenergic agonists are inhaled at normally recommended
dosages. However, these effects may be more common when the drugs
are administered systemically or when recommended dosages are
exceeded.
Seroquel: There is some concern that quetiapine may have additive
adverse cardiovascular effects in combination with other drugs that are
known to prolong the QT interval of the electrocardiogram. Data are
conflicting. In clinical trials, there was no statistically significant
difference between quetiapine and placebo in the proportions of patients
experiencing potentially important changes in ECG parameters including
QT, QTc, and PR intervals. However, QT prolongation has been reported
in quetiapine overdose and with therapeutic use of other atypical
antipsychotic agents such as sertindole, ziprasidone, and risperidone. In
one case report, torsade de pointes arrhythmia developed in a patient
treated with low-dose quetiapine. However, the relationship to quetiapine
is uncertain, as there were multiple confounding risk factors such as
hypomagnesemia, a history of QT prolongation (possibly prior to
initiation of quetiapine), a history of substance abuse, and uncertain
medication compliance. In general, the risk of an individual agent or a
combination of agents causing ventricular arrhythmia in association with
QT prolongation is largely unpredictable but may be increased by certain
underlying risk factors such as congenital long QT syndrome, cardiac
disease, and electrolyte disturbances (e.g., hypokalemia,
hypomagnesemia). In addition, the extent of drug-induced QT
prolongation is dependent on the particular drug(s) involved and
dosage(s) of the drug(s).
Proventil (albuterol)
Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this med? Check after giving
Assess lung sounds, pulse, and blood pressure Undesirable side effects Prevention or relief of
before administration and during peak of bronchospasm.
medication. Note amount, color, and character of
sputum produced. Monitor pulmonary function
tests before initiating therapy and periodically
during therapy to determine effectiveness of
medication. Observe for paradoxical
bronchospasm (wheezing). If condition occurs,
withhold medication and notify physician or other
health care professional immediately.

Proventil (albuterol)

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