COPD DRUGS

Name of Drug
Generic Name Salbutamol Brand Name Ventolin Dosage 5mg/ml/nebule Frequency QID Route Nasal

Classification & Action

Sympathomimetics Bronchodilator Stimulates beta -2 receptors of bronchioles by increasing level of cAMP which relaxes smooth muscles to produce bronchodilation.

Indications
>Asthma >Chronic bronchitis >Emphysema

Contraindications
>Hypersensitivity >Cardiac arrhythmias >Thyrotoxicosis

Side Effects
>Fine skeletal muscle tremor >Leg cramps >Palpitations >Hypertension >Dizziness >Dyspepsia

Nursing Responsibilities
>Assess cardiorespiratory function.

Monitoring Parameters
>Monitor for evidence of allergic reactions and paradoxical bronchospasm.

>Inform the patient that Salbutamol may cause an unusual or bad taste.

Name of Drug
Generic Name Ipratropium Brand Name Atrovent Dosage 1 vial Frequency QID Route Nasal

Classification & Action

Anticholinergic Chemically related to atropine, it antagonizes the effect of acetylcholine. It causes a local and site specific bronchodilatation by preventing the increase in intracellular cyclic guanosine monophosphate which is produced by the interaction of acetylcholine with the muscarinic receptors of the bronchial smooth muscles.

Indications
>Acute exacerbation of COPD

Contraindications
>Hypersensitivity to soya lecithin >Atropine or any anticholinergic derivatives.

Side Effects
>Dryness of mouth >Throat irritation >Cough

Nursing Responsibilities
>Assess patient condition before and after drug therapy. >Monitor for evidence of allergic reaction.

Monitoring Parameters
>Monitor peak expiratory flow.

Name of Drug
Generic Name Theophylline Brand Name Phenedrine Dosage 3mg/kg Frequency Q6 hours Route Oral

Classification & Action

Xanthine Bronchodilator Directly relaxes the smooth muscles of the bronchial tree and pulmonary blood vessels.

Indications
>Reversible bronchospasm associated with COPD

Contraindications
>Hypersensitivity to Xanthines >Seizure >Hyperthyroidism >Hypertension >Peptic ulcer

Side Effects
>Palpitation >Tachycardia >Hypotension >Muscle twitching >Epigastric pain

Nursing Responsibilities
>Assess patient condition before and after drug therapy. >Assess for allergic reaction. >Assess for sign of toxicity.

Monitoring Parameters
>Monitor vital signs. >Monitor theophylline blood level (515mcg/ml). >Monitor I&O ratio.

HIV/AIDS DRUGS
Name of Drug
Generic Name Zidovudine Brand Name Retrovir Dosage 500 mg Frequency OD Route Oral

Classification & Action

Nucleoside Reverse Transcriptase Inhibitor (NRTI) Antiviral Converted by intracellular enzymes into zidovudine triphosphate that competes with thymidine triphosphate for incorporation into growing viral DNA chains. Upon incorporation it causes premature termination of the DNA chain formation thereby inhibiting viral replication.

Indications
>HIV infection >AIDS-related complex (ARC)

Contraindications
>Abnormally low neutrophil cell counts. >Low Hb level.

Side Effects
>Anemia >Neutropenia >Leukopenia >GI disturbance >Headache

Nursing Responsibilities
>Assess patient condition before and after drug therapy. >Assess hematologic status before therapy. >Assess for sign of anemia.

Monitoring Parameters
>Monitor CBC especially WBC counts, report if <4,000/mm3 & platelet count <75,000/mm3. >Monitor renal & hepatic function regularly.

Protease Inhibitor

Name of Drug
Generic Name Indinavir Brand Name Crixivan Dosage 400 mg Frequency Q8 hours Route Oral

Classification & Action

Protease Inhibitor Antiviral HIV-protease inhibitor which acts by binding to the protease activity site and inhibiting the activity of this enzyme thereby preventing the cleavage of viral polyproteins. HIV protease is an enzyme required for the cleavage of viral polyproteins precursor into individual functional proteins found in infectious HIV.

Indications
>HIV-1 infection

Contraindications
>Hypersensitivity

Side Effects
>Asthenia/fatigue >Abdominal pain >Acid regurgitation >Dry mouth >Lymhadenopathy

Nursing Responsibilities
>Assess patient condition before and after drug therapy. >Evaluate bowel pattern before and during treatment.

Monitoring Parameters
>Monitor glucose level.

Name of Drug
Generic Name Nelfinavir Brand Name Viracept Dosage 750 mg Frequency TID Route Oral

Classification & Action

Protease Inhibitor Antiviral Inhibit HIV protease enzymes and prevents splitting of the viral polyprotein to produce immature, noninfectious virus.

Indications
>HIV-1 infection

Contraindications
>Hypersensitivity >Concomitant use of with amiodarone, astemizole, cisapride. >Concurrent used with alprazolam, clorazepate, diazepam.

Side Effects
>Headache >Paresthesia .>Sweating >Diarrhea >Abdominal pain >Dyspnea

Nursing Responsibilities
>Obtain baseline of patients condition >Assess allergies before treatment including reactions of each medication. >Assess patient for bleeding tendencies and sign of anemia. Monitor bowel pattern and hydration.

Monitoring Parameters
>Monitor liver function: ALT and AST.