1.

DERIPHYLLIN / THEOPHYLLINE / aminophylline

TRADE NAME: aminophylline, elixophylline, theo24

DRUG CLASS/CATEGORY : bronchodilators

DOSAGE: child iv loading dose 6 mg/ kg IV over 30

min

IV maintance dose

1-9 year , 1 mg/ kg/h

≥ 9 year 0.75 mg/ kg / h

PO 1-9 year 1 mg/ kg/h times 24 h in 4 divided doses

≥ 9 year 0.75 mg/ kg / h times 24 h in 4 divided dose

Infant PO/ IV 6-11 months 0.87g/ kg/h , 2-6 months 0.5 mg/ kg/ h

Neonate : PO/ IV 0.16 mg/ kg/ h

ROUTE : IV, PO

MECHANISM OF ACTION :

theophylline relaxes smooth muscles of respiratory system by blocking

phosphodiesterase.

INDICATION

to prevent and relieve symptoms of acute bronchial asthma and treatment of

bronchospasm associated with chronic bronchitis and emphysema

CONTRAINDICATION

hypersensitivity to xanthine derivatives or to ethyenediaanine compoente ,

cardiac arrhythmias , safety during pregnancy or lactation is not established

ADVERSE REACTION/ SIDE EFFECT

nervousness , restlessness, depression, insomnia, headache, dizziness,

tachycardia, anorexia, diarrhea epigastric pain
NURSING RESPONSIBILITIES

1. Monitor and record vital sign and intake and output , unexplained
increase heart rate
2. Monitor serum theophylline level,
3. Assess allergic reaction, urticarial, flushing rash, if occur discontinue
drug
4. To administer drug orally after meals for gastrointestinal syatem
absortion may be affected
5. administer drug with plenty of water
6. To advice patient do not crush, break or chew or dissolve slow release
tablets

2. SALBUTAMOL

TRADE NAME: salbutamol sulphte

DRUG CLASS/CATEGORY : bronchodilators

AVAILABLE FORM : 2mg, 4 mg tablet , syrup salbutamol

2mg per 5ml syrup, asthalin inhaler 1 to 2 inhalation 3 to 4 times daily , asthalin
rotacaps containing salbutamol sulphate 200 mcg, 400 mcg

ROUTE : mouth / inhaler/ in the form of tablet or syrup or inhaler

DOSAGE

adult dose 6mg to 16 mg orally, 6-8 hourly equal divided dos

( Children 1 mg, 6 to 8 hours orally), child 2-12 year INH metered dose
inhaler 0.1 mg/kg tid , NEB 0.1-0.15 mg/kg/dose tid or qid

MECHANISM OF ACTION :

causes bronchodilation by action on β2 (pulmonary) receptors by increasing

levels of cAMP, which relaxes smooth muscle , produces bronchodilation, CNS,
cardiac stimulation as well as increased diuresis and gastric acid secretion,
longer acting than isoproterenol

INDICATION :
bronchial asthma, chronic bronchitis, emphysema and other broncho
pulmonary disorders including bronchospasm

CONTRAINDICATION :

hyperthyroidism, hypertensive patients, myocardial insufficiency. Excessive use

of spray containing salbutam should not be used, it may give fatal results.
Salbutam is contraindicated in pregnancy

ADVERSE REACTION/ SIDE EFFECT:

nausea, vomiting, headache, palpitation, tachycardia, anorexia, muscle tremors

NURSING RESPONSIBILITY:

1. Assess vital capacity, forced expiratory volume, ABGs, lung sounds,

heart rate and rhythm, B/P, sputum
2. Assess for evidence of allergic reaction
3. Assess for paradoxical bronchospasm , hold medication, notify prescriber
if bronchospasm occur
4. Storage in light –resistant container , do not expose to temperature of
more than 86 degree F
5. Evaluate therapeutic response absence of dyspnea, wheezing after 1 hour
improve air way exchange improved ABGs
6. Teach patient / family to use exactly as prescribed , about use o inhaler
7. Teach patient and family to avoid getting aerosol in eyes,
8. To wash inhaler in warm water daily and dry , to track number of
inhalations,

3. HYDROCORTISONE

TRADE NAME: hydrocortisone acetate, cortef,

DRUG CLASS/CATEGORY : corticosteroid

DOSAGE adults by mouth 5 mg to 30 mg 6 hourly/ 12

hourly IM or intravenous as hydrocortisone sodium succinate , then 50-100 mg
intramuscular as needed
Children 0.16 to 1 mg / kg body weight

ROUTE ;

IM, IV , intra articular injection 0.5 ml to 2 ml , intrathecal 1to 2 ml

MECHANISM OF ACTION :

theophylline relaxes smooth muscles of respiratory system by blocking

phosphodiesterase.

INDICATION :

rheumatoid arthritis , osteo arthritis, joint sequelae of fracture, scratica,

inflammatory disorders like tubercular meningitis, multiple sclerosis , allergic
rhinitis , allergic sinusitis

CONTRAINDICATION:

pregnancy, lactation,, diabetes mellitus, psychosis, local or systemic infection,

new born babies, premature infant

ADVERSE REACTION/ SIDE EFFECT

Vertigo, headache, insomnia, convulsion, hypotension, shock, electrolyte

disturbance, purpura, glaucoma, growth retardation, peptic ulcer
hypersensitivity , impaired wound healing

NURSING RESPONSIBILITIES

1. to note the weight of patient daily to observe weekly weight gain.

2. Check blood pressure, pulse, 8 hourly assess chest pain
3. To assess nausea, vomiting, poly urea, fatigue, depression
4. To assess increased temperature , increased WBC count even after
withdrawl of drug, may be cause of infection
5. Provide antacid between meals to help avoid peptic ulcer
6. Use alternate –day maintance therapy with short acting corticosteroid
whenever possible
4.IPRA TROPIUM BROMIDE :

GENERIC NAME:

DOSE : 2 inhalations four hourly not to exceed 12 inhaltaions per

day (24 hours)

ACTION : it is an anticholinergic bronchodilator drug. It acts as

bronchodilators and is used in the treatment of bronchial asthma

INDICATION: bronchial asthma , COPD

CONTRAINDICATION:

hypersensitivity , atropine, pregnancy, lactation, children below 12 years age,

bladder neck obstruction

SIDE EFFECT :

nausea, vomiting, dry mouth, blurred vision, rash, palpitation, cough,

bronchospasm, headache, anxiety, nervousness

NURSING RESPONSIBILITY :

1. to assess palpitation , check respiration rate, rhythm, if abnormality

observed change the drug
2. To change the dose , increase or decrease in case of long term therapy
3. In case of dry mouth , advice patient for frequent drinks
4. To advice patient thee correct method of inhalation and clean the
equipment daily, shake before using
5. To evaluate therapeutic response patient may breathe comfortably