NURS 1566 Clinical Form 3: Clinical Medications Worksheets
(You will need to make additional copies of these forms)
Generic Name Trade Name Classification
Levalbuterol Xopenex Therapeutic: bronchodilators 1.25 mg INH
Pharmacologic: adrenergics
Peak Onset Duration
90 min 10-17 min 5-6 hr
Why is your patient getting this medication
For short term control of bronchospasm from
pulmonary edema resulting from CHF
Mechanism of action and indications
(Why med ordered)
R-enantiomer of racemic albuterolBinds to beta-2
adrenergic receptors in airway smooth muscle
leading to activation of adenylcyclase and
increased levels of cyclic-3', 5'-adenosine
monophosphate (cAMP). Increases in cAMP
activate kinases, which inhibit the phosphorylation
of myosin and decrease intracellular calcium.
Decreased intracellular calcium relaxes bronchial
smooth muscle. Indicated to treat bronchospasm
due to reversible airway disease (short-term
control agent).
Interactions with other patient drugs, OTC or
herbal medicines (ask patient specifically)
None for this patient
Dose Route Time/frequency
Q6 +Q2 Prn
Respiratory Therapy
Normal dosage range
0.63 mg via nebulization three times daily (every 6-8 hr);
may be increased to 1.25 mg three times daily (every 6-8 hr)
For IV meds, compatibility with IV drips and/or solutions
n/a
Nursing Implications (what to focus on)
Contraindications/warnings/interactions
Contraindicated in patients with known hypersensitivity, Use
Cautiously in Cardiovascular disorders (including coronary
insufficiency, hypertension, and arrhythmias); History of
seizures; Hypokalemia; Hyperthyroidism; Diabetes mellitus;
Unusual sensitivity to adrenergic amines. Beta blockers
block the beneficial pulmonary effects of adrenergic
bronchodilators (choose cardioselective beta blockers if
necessary and with caution); May ↑ risk of hypokalemia
from potassium-losing diuretics; Use with caffeine-
containing herbs ( guarana, tea , coffee ) ↑ stimulant effect
Common side effects
No common or life-threatening side effects
Lab value alterations caused by medicine
May cause ↑ serum glucose and ↓ serum potassium
Be sure to teach the patient the following about this
medication
Instruct patient in the proper use of the nebulizer and to take
levalbuterol exactly as directed. Caution patient not to
exceed recommended dose; may cause adverse effects,
paradoxical bronchospasm, or loss of effectiveness of
medication; Instruct patient to contact health care
professional immediately if shortness of breath is not
relieved by medication or is accompanied by diaphoresis,
dizziness, palpitations, or chest pain; Advise patients to use
levalbuterol first if using other inhalation medications, and
allow 5 min to elapse before administering other inhalant
medications unless otherwise directed; Advise patient to
rinse mouth with water after each inhalation dose to
minimize dry mouth; Instruct patient to notify health care
professional if no response to the usual dose of levalbuterol
Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this Check after giving
Assess lung sounds, pulse, and blood med? Prevention or relief of
pressure before administration and during Observe for paradoxical bronchospasm bronchospasm.
peak of medication. Note amount, color, (wheezing). Tachycardia.
and character of sputum produced.
Closely monitor patients on higher dose
for adverse effects; Monitor pulmonary
function tests before initiating therapy and
periodically during course to determine
effectiveness of medication