GENERIC NAME: salbutamol

BRAND NAME: ventolin, proventil, airet, albuterol

GENERAL CATEGORY: Bronchodilator
INDICATION: to treat bronchospasm in patients with reversible obstructive airway disease
or acute bronchospastic attack
MECHANISM OF ACTION: Albuterol attaches to beta2 receptors on bronchial cell
membrane, which stimulates the intercellular enzyme adenylate cyclase to convert to ATP to
cyclic adenosine monophosphate (cAMP).
- Salbutamol (albutrerol in the USA) is a selective B2-adrenoceptor stimulant that causes the
relaxation of the smooth muscles through the increase of the intracellular cyclic adenosine
monophosphate (cAMP)
SIDE EFFECTS: fine tremor, anxiety, headache, muscle cramps, dry mouth, and
palpitation.[17] Other symptoms may include tachycardia, arrhythmia, flushing of the skin,
myocardial ischemia (rare), and disturbances of sleep and behaviour.
NURSING RESPONSIBILITIES:
- listening to lung sounds
- obtaining blood pressure and heart rate prior to use and during use of albuterol.
-If with productive cough,assess amount, color, and consistency of sputum.

GENERIC NAME: epinephrine

BRAND NAME: adrenaline, anaguard
GENERAL CATEGORY: vasopressor, anti-asthmatic, bronchodilator, adrenergic, cardiac
stimulant
INDICATION: relief of respiratory distress due to bronchospasm, treatment and prophylaxis
to cardiac arrest, acute hypersensitivity reaction
MECHANISM OF ACTION: produces vasoconstriction to counteract the vasodilation and
resulting hypotension to associated with anaphylaxis. The bronchodilatory effects of
epinephrine and it’s ability to reduce mucosal edema relieve bronchoconstiction and improve
respiratory effort.
SIDE EFFECTS: Nausea or vomiting, Pounding, fast, or irregular heartbeat, Pale skin,
Headache,Sweating, Dizziness, Nervousness, anxiety, or restlessness, Weakness,
Uncontrollable shaking
NURSING RESPONSIBILITIES:
- Assesslungsounds,respiratorypattern,pulse,andBPbefore administration and during peak of
medication. Note amount, color, and character of sputum produced, and notify health care
professional of abnormal findings.
-Monitorpulmonaryfunctiontestsbeforeandperiodicallyduringtherapy.
- Observeforparadoxicalbronchospasm(wheezing).Ifconditionoccurs, withhold medication
and notify health care professional immediately.
-Observepatientfordrugtoleranceandreboundbronchospasm.Patientsrequir-
ing more than 3 inhalation treatments in 24 hr should be under close supervision. If minimal
or no relief is seen after 3 – 5 inhalation treatments within 6 – 12 hr, further treatment with
aerosol alone is not recommended.
-Assess for hypersensitivity reaction (rash; urticaria; swelling of the face, lips, or eyelids). If
condition occurs, withhold medication and notify health care profesional immediately.
-vasopressor:MonitorBP,pulse,ECG,andrespiratoryratefrequentlyduringIV administration.
Continuous ECG, hemodynamic parameters, and urine output should be monitored
continuously during IV administration.
- Monitor for chest pain, arrhythmias, heart rate 􏰃 110 bpm, and hypertension. Consult
physician for parameters of pulse, BP, and ECG changes for adjusting dose or discontinuing
medication.
-Shock: Assess volume status. Correct hypovolemia prior to administering epiephrine IV.
-nasal Decongestant:Assess patient for nasal and sinusc ongestion prior to and periodically
during therapy.

GENERIC NAME: levodopropizine

BRAND NAME: levopront
GENERAL CATEGORY: antitussive
INDICATION: Symptomatic therapy of cough
MECHANISM OF ACTION: Levodropropizine is the levo-rotatory (S)-enantiomer of
dropropizine, a racemic non-opiate antitussive agent. Levodropropizine acts through a mainly
peripheral tracheobronchial antitussive effect by inhibition of vagal C-fiber and its sensor
neuropeptide
SIDE EFFECTS: GI effects, exhaustion, faintness, somnolence, clouding of consciousness,
numbness, dizziness, headache, palpitations, paradoxical reaction, restlessness
NURSING RESPONSIBILITIES:
- give with meals
-let patient void if patient have urinary retention problem
-take it as prescribed
-report difficulty urinating, constipation and other adverse effects

GENERIC NAME: Erdosteine

BRAND NAME: ectrin
GENERAL CATEGORY: mucolytic
INDICATION: productive cough
MECHANISM OF ACTION: erdosteine contains two sulfhydryl groups, which are freed
after metabolic transformation in the liver. The liberated sulfhydryl groups break the
disulphide bonds, which hold the glycoprotein fibers of mucus together. This makes the
bronchial secretion more fluid and enhances elimination
SIDE EFFECTS: epigastralgia, nausea, vomiting, loose stools, spasmodic colitis, headache
NURSING RESPONSIBILITIES:
- taken with or without food
-contraindicated with pt with phenylketonuria bec of aspartate
-take precautions with pt with DM and low caloric diet because of sucrose

GENERIC NAME: Guaifenesin

BRAND NAME: Guiatuss, Mucinex, Organidin, Phanasin, Robitussin
GENERAL CATEGORY: expectorant
INDICATION: productive cough
MECHANISM OF ACTION: stimulates respiratory tract secretions by decreasing
adhesiveness, viscosity of phlegm. This agent reduces the viscosity of mucus secretion by
reducing adhesiveness and surface tension as well as increasing hydration of mucus.
Guaifenesin promotes the efficiency of the mucociliary mechanism important in removing
accumulated secretions from the upper and lower airway.
SIDE EFFECTS: Dizziness, headache, rash, diarrhea, nausea, vomiting, abdominal pain
NURSING RESPONSIBILITIES:
- Assess type, severity, frequency of cough.
- Increase fluid intake to reduce viscosity of secretions
- initiate DBE, coughing exercises
-avoid task that requires alertness

GENERIC NAME: Montelukast

BRAND NAME: zykast
GENERAL CLASSIFICATION: Antihistamine
INDICATION: allergic reaction, asthma
MECHANISM OF ACTION: The cysteinyl leukotrienes (LTC4, LTD4, LTE4) are potent
inflammatory eicosanoids released from various cells including mast cells and eosinophils.
These important mediators bind to cysteinyl leukotriene receptors. Cysteinyl leukotriene have
been correlated with the pathphysiology of asthma and allergic rhinitis. In asthma,
leukotriene mediated effects include bronchoconstriction, mucuos secretion, vascular
permeability and eosinophil recruitment. In allergic rhinitis, cysteinyl leukotrienes are
released from nasal mucosa after allergen exposure during both early- and late-phase
reactions and are associated with symptoms of allergic rhinitis. Intranasal challenge with
cysteinyl leukotrienes has been shown to increase nasal airway resistance and symptoms of
nasal obstruction. Montelukast is an orally active compound which binds with high affinity
and selectively to the cysteinyl leukotriene type 1 receptor thereby preventing cysteinyl
leukotriene from exerting their effects.

Levocetirizine
Levocetirizine the active enantiomer of cetirizine, is an antihistamine. Its principal effects are
mediated via selective inhibition of H1 receptors. The antihistamine activity of Levocetirizine
has been documented in a variety of animal and human models.
SIDE EFFECTS: Asthenia, fatigue, fever, abdominal pain, trauma, dyspepsia, infectious
gastroenteritis, dental pain, dizziness, headache, nasal congestion, cough & influenza.
NURSING RESPONSIBILITY:
-Ensure safety
-Promote and instruct to take adequate rest
-Ensure safety
-Monitor HR
-Offer fluid as tolerated
-note for hypersensitivity

GENERIC NAME: Indacaterol-Glycopyrrolate

BRAND NAME: Utibron Neohaler
GENERAL CATEGORY: Bronchodilator
INDICATION: control wheezing and SOB caused byo ngoing lung disease (chronic
obstructive pulmonary disease-COPD, which includes chronic bronchitis and emphysema)
MECHANISM OF ACTION: Indacaterol works by stimulating adrenergic beta-2 receptors
in the smooth muscle of the airways. This causes relaxation of the muscle, thereby increasing
the diameter of the airways, which become constricted in asthma and COPD. It is also long
acting due to its high affinity to the lipid raft domains in the airway membrane so it slowly
dissociates from the receptors. Indacaterol also has a high intrinsic efficacy so it is also very
rapid acting - onset of action occurs within 5 minutes.
NURSING RESPONSIBILITIES:
- Assess respiratory status (rate, breath sounds, degree of dyspnea, pulse) before
administration and at peak of medication. Consult health care professional about alternative
medication if severe bronchospasm is present; onset of action is too slow for patients in acute
distress. If paradoxical bronchospasm (wheezing) occurs, withhold medication and notify
health care professional immediately.
- Monitor for signs and symptoms of allergic reactions (difficulties in breathing or
swallowing, swelling of tongue, lips and face, urticaria, skin rash). Discontinue therapy if
symptoms occur.
- Lab Test Considerations: May cause transient hypokalemia and hyperglycemia

GENERIC NAME: N-Acetylcysteine

BRAND NAME: Flumucil
GENERAL CATEGORY: Mucolytic
INDICATIONS: Adjunct therapy for abnormal viscid or thickened mucous
secretions in patients with pneumonia, bronchitis, bronchiectasis, primary amyloidosis
of the lung, tuberculosis, cystic fibrosis, emphysema, atelectasis, pulmonary
complications of thoracic surgery, or CV surgery
MECHANISM OF ACTION: Mucolytic that reduces the viscosity of pulmonary
secretions by splitting disulfide linkages between muco protein molecular complexes.
Also, restores liver stores of glutathione to treat acetaminophen toxicity.
NURSING RESPONSIBILITIES:
 Observe 10 rights in drug administration
 Use plastic, glass, stainless steel, or another nonreactive metal when giving by
nebulization. Hand-bulb nebulizers aren’t recommended because output is too
small and particle size too large.
 Drug is physically or chemically incompatible with tetracyclines,
erythromycin lactobionate, amphotericin B, and ampicillin sodium. If given by
aerosol inhalation, nebulize these drugs separately. Iodized oil, trypsin, and
hydrogen peroxide are physically incompatible with acetylcysteine; don’t add
to nebulizer.
 Drug smells strongly of sulfur. Mixing oral form with juice or cola improves
its taste.
 Drug delivered through nasogastric tube may be diluted with water.
 Monitor cough type and frequency.
 Be aware that facial erythema may occur within 30 to 60 minutes after the
start of an I.V. infusion and usually resolves without infusion interruption.

GENERIC NAME: Doxofylline

BRAND NAME: ansimar
GENERAL CATEGORY: Antiasthmatic & COPD Preparations
INDICATIONS: Bronchial asthma & pulmonary disease w/ spastic bronchial
component.
MECHANISM OF ACTION: Adrenergic bronchodilators and phosphodiesterase
inhibitors both work by increasing intracellular level of cyclic-3’, 5’- adenosine
monophosphate (cAMP); adrenergic by increasing production and phosphodiesterase
inhibitors by decreasing breakdown. Increased levels of cAMP produce
bronchodilation.Corticosteroids act by decreasing airway inflammation. Anticholinerg
ics (ipratropium) produce brondhodilation by decreasing intracellular levels of cyclic
guanosine monophosphate (cGMP). Leukotriene receptor antagonists and mast cell
stabilizers decrease the release of substances that can contribute to bronchospasm.
NURSING RESPONSIBILITIES:
 Assess lung sounds, pulse and blood pressure before administration and during
peak of medication. Not 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 conditions occur,
withhold medication and notify physician of other health care professional
immediately