Rnao.ca

Appendix L: Chart found on page 114-121 of original guideline Nursing Care of Dyspena: The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease (COPD) has been replaced with the chart below.
Short acting β2 agonists:
• Promotes bronchodilation through stimula- • tremor tion of 2-adrenergic receptors thereby relax- • tachycardia Absorption: 20% inhaled, well absorbed (PO)
• Ratio-Salbutamol® MDI (HFA) 100 μg Distribution: 30% inhaled, crosses blood brain
Onset of action: a few minutes
Metabolism: liver extensively, tissues
Peaks: 15-20 minutes
Excretion: mostly urine, feces, breast milk
Duration: 2-4 hours, fenoterol up to 8 hours
Half-Life: 4-6 hrs
Absorption: partially absorbed (PO), minimal
(inhalation)
Distribution: crosses placenta
Metabolism: liver, gut wall
Excretion: bile, feces, urine, breast milk
Half-Life: unknown
Absorption: inhalation, minimal; incomplete PO
Distribution: unknown
Metabolism: liver, 90%
Excretion: breast milk, kidney 12%
Half-Life: 7 hours
• Oxeze® Turbuhaler® PD 6 μg and 12 μg Absorption: rapid, lung deposition 21-37%
Distribution: plasma protein binding
approximately 50%
Metabolism: liver, extensive
Excretion: 10% unchanged in urine
Half-Life: approximately 8-10 hours
Anticholinergic:
An anticholinergic drug that has been shown • dry mouth Absorption: minimal
• Atrovent® Wet Nebulization 125 μg/ml Distribution: does not cross blood-brain barrier
Onset of action: 5 – 15 minutes
Metabolism: liver, minimal
Peaks: 1 – 2 hours
Excretion: urine feces
Duration: 4 – 5 hours
Half-Life: 3-5 hrs
• An anticholinergic drug that inhibits M3- • dry mouth receptors at the smooth muscle leading to • constipation Absorption: highly bioavailable in the lung,
• 18 μg tiotropium light green capsule Onset of action: 30 minutes
Distribution: does not cross blood-brain barrier
Peaks: 1 – 4 hours
Metabolism: liver, minimal
Administer at the same time each day.
Duration: 24 hours
Excretion: urine feces
Capsules sensitive to light and moisture. Half Life: 5 – 7 days
Half-Life: 5-7 days
Methylxanthine:
• May have some anti-inflammatory effect concentration or the patient’s inability Absorption: well absorbed (PO), slowly
• Patients may benefit even when serum Distribution: crosses placenta, widely
Metabolism: liver
Excretion: kidneys, breast milk
Half-Life: 3-13 hrs, increased in liver disease,
Inhaled/ Oral Steroids:
• Prevents and suppresses activation and Rinsing, gargling and expectorating after Absorption: 20%
• Alti-beclomethasone® MDI (CFC) 50 g • Reduces airway swelling, mucus production, • hoarse voice Distribution: 10-25% in airways (no spacer)
Metabolism: minimal
• Increases responsiveness of smooth muscle Excretion: less than 10% in urine/feces
Half-Life: 15 hrs
• Pulmicort® Nebuamp® Wet Nebulization Absorption: 39%
Distribution: 10-25% in airways (no spacer)
• Pulmicort® Turbuhaler® PD100 μg, 200 Metabolism: liver
Excretion: 60% urine, smaller amounts in feces
Half-Life: 2-3 hrs
Same as other inhaled corticosteroids.
glucocorticoid prodrug that is hydrolyzed propellant and ethanol as a solution aerosol.
to the pharmacologically active metabolite Absorption: > 50% (active metabolite)
des-ciclesonide following administration.
Distribution: protein binding 99%, lung
• Des-ciclesonide has a high affinity for the glucocorticoid receptor and exhibits Metabolism: ciclesonide hydrolyzed to active
metabolite, des-ciclesonide via esterases in lungs,
further metabolism via hepatic CYP3A4 and 2D6
Excretion: feces (78%)
Half-Life: 6 hours
• Flovent® Diskus® PD 50 μg, 100 μg, Absorption: 30% aerosol, 13.5% powder
Absorption: 10-25% in airways (no spacer), 91%
• Flovent® MDI(HFA) 50 μg, 125 μg, and Metabolism: liver
Excretion: less than 5% in urine, 97-100% in feces
Half-Life: 14 hrs
Oral or IV route-short term (less than 2 weeks): Absorption: well absorbed
Distribution: widely distributed; crosses placenta
Metabolism: liver, extensively
Excretion: urine, breast milk
Half-Life: 3-4 hrs
• Medrol® 4 mg tablets and 16 mg tablets Oral route-long term (more than 2 weeks): Absorption: rapid
Skin care education re: dry, thin, bruising. Distribution: widely distributed
Metabolism: liver
Excretion: urine
Half-Life: 18 to 36 hrs, depending on the drug
• weight gain• cataracts• glaucoma• peptic ulcer• ecchymosis• avascular necrosis of the hip Long-Acting β2 agonists:
• Promotes bronchodilation through stimula- • Oxeze® Turbuhaler® PD 6 μg and 12 μg tion of 2-adrenergicreceptors thereby relax- Absorption: rapid, lung deposition 21-37%
Distribution: plasma protein binding
Metabolism: liver, extensive
Onset of action: 1-3 minutes
Excretion: 10% unchanged in urine
Duration: 12 hours
Half-Life: approximately 8-10 hours
Onset of action: 10-20 minutes
Absorption: minimal systemic
Duration: 12 hours
Distribution: local
Metabolism: liver first pass
Excretion: unknown
Half-Life: 5.5 hrs
Combination Drugs:
• the same as those listed for each medication Dry Mouth-Rinse mouth due to dryness.
ipratropium/ 3 mg salbutamol per 2.5 ml vial and inhaled steroids: budesonide and formoterol • Symbicort® Turbuhaler® PD 100/6 βg, fluticasone and salmeterol • Advair® Diskus® PD 100/50 μg, • Advair® MDI(HFA) 125/25 μg, 250/25 μg Macrolides/Anti-Infectives:
Binds to 50S ribosomal subunits of subunits Absorption: 50%
Be aware whether the antibiotic the patient is of susceptible bacteria and suppresses protein Distribution: widely distributed
prescribed is to be taken with or without food.
Metabolism: liver
Excretion: kidney’s unchanged (20%-30%)
Determine if the patient has a sensitivity or Half-Life: 4-6 hrs
allergy to the prescribed medication.
• Binds to 50S ribosomal subunits of subunits Absorption: rapid, (PO) up to 50%
• PO 500 mg on day 1 then 250mg qd on of susceptible bacteria and suppresses protein Distribution: widely distributed
synthesis, much greater spectrum of activity Metabolism: unknown, minimal metabolism
• IV 500 mg qd > 2 days then 250 mg qd to Excretion:unchanged (bile); kidney’s, minimal
Half-Life: 11-70 hrs
• Binds to 50S ribosomal subunits of subunits Absorption: well absorbed (PO),
• PO 250-500 mg q6h (base, estolate, state), of susceptible bacteria and suppresses protein minimally absorbed (topically, ophthalmic) Distribution: widely distributed; minimally
• IV inf 15-20 mg/kg/day (lactobionate) Metabolism: liver partially
Excretion: unchanged (bile); kidney’s,
minimal unchanged
Half-Life: 1-3hrs
• Interfers with cell wall replication of susceptible Absorption: well absorbed (90%)
• PO 750 mg-1.5g qd in divided doses q8h organisms by binding to the bacterial cell wall, Distribution: readily in body tissues, fluids,
the cell wall, rendered osmotically unstable, Metabolism: liver (30%)
Excretion: breast milk, kidney, unchanged (70%)
Half-Life: 1-1.3hrs
• Inhibits protein synthesis, phosphorylation in Absorption: well absorbed
• PO/IV 100 mg q12h on day 1 then 100mg/ microorganisms by binding to 30S ribosomal Distribution: widely distributed; crosses placenta
subunits, reversibly binding to 50S ribosomal Metabolism: some hepatic recycling
Excretion: bile, feces, kidney, unchanged (20%-40%)
Half-Life: 15-22 hours; increased in severe renal
• Interferes with conversion of intermediate Absorption: well absorbed (75%) (PO)
• For respiratory infections PO 500 mg q12h DNA fragments into high-molecular-weight Distribution:widely distributed
Metabolism: liver (15%)
Excretion: kidneys (40-50%)
Half-Life: 3-4 hr; increased in renal disease
Fluoroquinolone/Antibacterial:
• Bacterialcidal, interferes with DNA replication, Absorption: unknown
repair, transcription and recombination in Distribution: crosses placenta
susceptible gramnegative and gram-positive Metabolism: liver
bacteria, preventing cell reproduction and Excretion: feces, urine
Half-Life: 12-13.5 hrs
Psychotropics:
• Acts by inhibiting the action of serotonin by Absorption: rapidly absorbed
• PO 5 mg tid; may increase by 5 mg/day q2-3 binding to serotonin and dopamine receptors Distribution: unknown
Metabolism: liver extensively
Excretion: feces
Half-Life: 2-3 hours
• hypertension• hypotension• dizziness• headache• tremors• nausea• diarrhea• constipation • Depresses cerebral cortex, hypothalamus, Absorption: variable PO, well absorbed IM
• PO 10-50 mg q1-4h initially then increase up Distribution: widely distributed; crosses placenta
Metabolism: liver, GI mucosa extensively
produced by dopamine at synapse, exhibits Excretion: kidneys
• In elderly, use lowest effective dose a strong alphaadrenergic, anticholinergic Half-Life: 30 hours
blocking action, mechanism for antipsychotic Opioid Analgesics:
• Depresses pain impulse transmission at the Absorption: variably absorbed (PO); well absorbed
Nebulized opioids are almost exclusively spinal cord level by interacting with opioid (IM, SC, rectally); completely absorbed IV used in palliative care in patients with • PO 10-30 mg q4h prn; ext rel q8-12h; rectal Distribution: widely distributed, crosses placenta
Metabolism: liver extensively
• IV 4-10 mg diluted in 4-5 ml water for Excretion: kidneys
Half-Life: 1.5- 2 hours
• bradycardia• hypotension• nausea• vomiting• constipation• urinary retention • Depresses pain impulse transmission at the Absorption: well absorbed (PO); completely
spinal cord level by interacting with opiod (e.g., egg allergy, thimersol sensitivity) • Analgesic PO 2 mg q3- 6h prn, may increase receptors, increases respiratory tract fluid by Distribution: unknown, crosses placenta
decreasing surface tension and adhesiveness, Metabolism: liver extensively
• SC/IM 1-2 mg q3-6h prn, may increase to which increases removal of mucus, analgesic, Excretion: kidneys
Half-Life: 2-3 hours
• IV 0.5-1mg q3h prn; rec 3 mg q4-8h prn Vaccination:
• Inhibits influenza virus neuraminidase with • pain and/or erythema at injection site Absorption: rapidly absorbed
possible alteration of virus particle aggregation • anaphylaxis Distribution: protein binding is low
Metabolism: converted to oseltamivir carboxylate
Excretion: eliminated by conversion
Half-Life: 1-3 hours
• pain and/or erythema at the injection site Allergy to any components of the drug.
• IM/SC immunizing dose is a single injection • Revaccination: One injection of 0.5ml • pain and/or erythema at the injection site • Administer a single 0.5ml dose of the vaccine SC or IM (preferably in the deltoid muscle or Antiviral:
• Selectively inhibits influenza virus neuroam- Absorption: inhalation 4% - 17%
inidase; by blocking the action of this enzyme, Distribution: protein binding, plasma<10%
5mg/blister (4 blisters per Rotadisk), packaged there is decreased viral release from infected Metabolism: liver
with Diskhaler inhalation device 2 inhalations cells, increased formation of viral aggregates, • bronchospasm-use cautiously with patients Excretion: feces and urine
(10mg) twice daily x 5 days. Begin within 2 days with asthma or COPD-Fast acting bronchodilator Half-Life: 2.5-5 hrs
• Inhibits influenza virus neuraminidase with Absorption: rapidly absorbed
• PO 75 mg x 5 days begin treatment within possible alteration of virus particle aggregation • fatigue Distribution: protein binding is low
Metabolism: converted to oseltamivir carboxylate
Excretion: eliminated by conversion
Half-Life: 1-3 hours

Source: http://rnao.ca/sites/rnao-ca/files/storage/related/6136_COPD_Supp_AppL_FA.pdf

medicosdeelsalvador.com

Efavirenz Marca comercial: Clase de medicamento: Inhibidor de la transcriptasa inversa no análogo El efavirenz, conocido también como EFV o Sustiva, es un tipo de antirretroviral llamado inhibidor de latranscriptasa inversa no análogo de los nucleósidos (NNRTI). Esta clase de medicamentos bloquea latranscriptasa inversa, una proteína que necesita el VIH para multiplicarse.

Pommering

Primary Immunodeficiencies MEGAN A. COOPER, PH.D., The Ohio State University College of Medicine and Public Health, Columbus, Ohio THOMAS L. POMMERING, D.O., Grant Family Practice Residency, Columbus, Ohio KATALIN KORÁNYI, M.D., Children’s Hospital, Columbus, Ohio Primary immunodeficiencies include a variety of disorders that render patients more susceptible to infections. If left untreate

© 2010-2018 PDF pharmacy articles