Pharmacotherapy Case Study

β receptor agonists are used in the treatment of asthma and COPD (chronic obstructive pulmonary disease) to relax the muscles in the air passages in the lungs. Salbutamol is a selective β2 adrenergic agonist, although this selectivity is relative and dose-dependent. This means that the selectivity is lost at high concentration and thus causing side-effects.

I have made no changes to Ms. Dahlberg's bronchodilator and inhaled corticosteroid use. She does have a prescription of prednisone at home, as she is well aware of her asthma exacerbation equivalents. She does have a history of steroid use psychosis and I advised her to initiate treatment at 40 mg per day. She should then seek further medical attention after initiating systemic steroids. She should also continue use of her current bronchodilators and inhaled corticosteroids.

When an asthmatic takes an inhaler “Albuterol sulfate”, the medication works by reducing the inflammation in the airway paths “bronchi and bronchioles” of the lungs, allowing the patient to breath without constriction or symptoms of asthma.

Theophylline is one example of xanthine that is usually used to treat bronchial asthma through relaxing the airways. However, this drug may cause severe adverse effects because of its level in the blood. Thus, it is important to teach patient about the use of theophylline. Teach a patient that theophylline can help him to breath easier, decrease wheeze and short of breath if taken exactly as prescribed. The nurse should also tell the patient take the drug of an empty stomach with a full 8-ounc glass of water. If patient has a severe GI problem such as GI upset, nausea, vomiting, heartburn when taking the drug on an empty stomach, the patient may take the drug with food. The patient should swallow all the enteric-coated or time-release capsules. Educating the patient about other common effect of the drug includes restlessness, nervousness, and difficulty in sleeping because of the need of the body to adjust to the usage of this drug. The patient should not take any other stimulant in order to reduce the effect of theophylline on CNS. The nurse should tell the patient that a headache will go away as the patient get used to the drug. However, the patient should notify his physician if the headache is getting worse. The patient should also report any vomiting, severe abdominal pain, tachycardia, confusion, unusual tiredness, muscle twitching, rash, or hives to the physician. There are many drug and food interaction, thus the patient should consult with the doctor about his diet while using theophylline. Additionally, the patient should consult his smoking habit and the use of any over-the-counter medication with the physician. Lastly, the patient should always tell any health care provider in his care about the use of theophylline and to keep the medication in a safe place (Karch, 2013, p.

CURRENT MEDICATIONS: Lovastatin 20 mg po per day, Enalapril 20 mg po bid, Nitroglycerin 0.4 mg sub q prn for chest pain.

Acute severe asthma previously called status asthmaticus is a life threatening medical condition characterized by bouts of repeated and worsening cough, wheezing, chest recession and inability to speak or drink that may result in acute respiratory failure and even death.1 These patients are also at risk for developing serious complications like aspiration pneumonia, pneumo-mediastinum, pneumothorax and hypoxic brain injury etc. 1Inhaled high dose short acting β2 agonists like salbutamol along with systemic steroids and supplemental oxygen are considered as first line treatment in all patients who

A type of bronchodilator, aminophylline is a type of muscle relaxation medicine that helps lungs and chest circulate oxygen better. It is used to treat and prevent wheezing, restricted breathing and shortness of breath. The medicine is usually prescribed to those with bronchitis, asthma and lung diseases. As this medication requires a prescription, it is very important for a user to follow the instructions prescribed and take only at the times and the amount prescribed by his or her physician. Aminophylline can be in the form of liquid syrup, a pill or a cream. How this drug works is by making the lungs less sensitive to any allergens or foreign substances that may be inhaled, thus causing the muscles to relax in the chest and lungs and opening up the air passages so that breathing can be easier. It also increases the contractions in the diaphragm which aids better breathing patterns.

Fluticasone propionate is a synthetic triflourinated corticosteroid that possess anti-inflammatory properties (RxList). This corticosteroid targets cells and mediators involved in inflammation, having an anti-inflammatory effect on the airways (RxList). Salmeterol Xinafoate is a long acting- beta agonist (LABA), targets the beta2-adrenoceptors that are present in the smooth muscle of the bronchioles (RxList). By targeting the beta2-adrenoceptors, intracellular adenyl cyclase is stimulated, which will lead to the production of more cyclic AMP. An increased level of cyclic AMP then leads to relaxation of the smooth muscle of bronchioles

Asthma control varies over time due to severity and changes in the environment, for example, home, school and or work environments. There are several medications and combinations used to control asthma attacks. The first line of medication are inhaled corticosteroids used to prevent and reduce airway swelling and inhaled long-acting beta agonist used to keep the airways open and relaxed (AAFA, 2015). Examples of long-acting corticosteroids are fluticasone, budesonide, mometasone, beclomethasone, ciclesonide, flunisolide. Examples of LABA medications are salmeterol and formoterol; it is important to remind patients that these medications are not to be used in emergency situations. At times, both medications are used together in a single medication to treat asthma and prevent attacks. Some caution that patients should be aware that when using combination medication, the risk for severe asthma attacks increase (Mayo Clinic, 2015). Examples of combination medications are Advair (fluticasone and salmeterol), Symbicort (budesonide and formoterol), Dulera (mometasone and formoterol) and Breo (fluticasone and

Murphy discusses is the versatility of inhaled corticosteroid (ICS) and how it helps people with asthma. Kevin R. Murphy states “ICS is the recommended cornerstone therapy for persistent asthma” (153).In his article Kevin R. Murphy does mention other treatment options but does not discuss them or provide any information other than the information he provided for inhaled corticosteroid. It seemed that all he talked about was inhaled corticosteroids which is not bad but left me wanting to know more about other treatment options. The Asthma and Allergy Foundation of America gives many treatment options on their website. They list over seven different treatment options that come in all forms and give summaries of what each asthma treatment does and the when they should be used. Some examples that the Asthma and Allergy Foundation of America used were Omalizumab, which is a shot that asthma patients can take in replace of an inhaler. Another treatment option is Theophylline, it comes in a pill form and act as a replacement for ICS. The Asthma and Allergy Foundation of America provided great information and more information about other treatment options for asthma that Kevin R. Murphy provided in his

However, there is a multitude of effective ways to treat the disease that can increase the lifespan of an affected person. Constant vigilance for changes in one’s health is crucial. The main goals of treating the disease are clearing out mucus from the lungs and pancreas to prevent infection and providing necessary nutrition due to metabolic problems. A common treatment is the use of antibiotics, which aid in thinning excess mucus, lowering the risk of infection and increasing metabolism. Devices called nebulizers, which convert liquid medicine into a breathable “mist”, are used to easily move medication into the lungs through inhalation. Another common treatment is anti-inflammatories, which lessen swelling in your airways. To address digestive problems, people may take supplements of pancreatic digestive enzymes to increase the amount of absorbed nutrients within the body. In severe cases, surgical procedures may be applied to control the disease. Procedures include nasal polyp removal, where doctors remove any obstructive buildups in the nose, Endoscopy, where mucus is physically removed through endoscopes. In the most critical or life-threatening cases, a lung transplant may be performed to completely rid the patient of mucus buildup in the thoracic cavity. Unfortunately, due to the way mucus builds up in the lungs, a lung transplant requires both lungs to be

The good thing about asthma is that there are a lot of medications available to help treat asthma sufferers with acute onset of symptoms as well as help with the long term prognosis of patients. Asthma medications are classified into two groups, Controller and quick-relief. Controller medications are designed to help prevent asthma attacks. Their purpose is to try and reduce the chronic inflammation thus making the body less likely to react to triggers. Some of these include long-acting beta-agonists, Leukotriene modifiers, Mast cell stabilizers, Theophylline, and immunomodulators. Long-acting beta agonists are bronchodilators that assist in opening up your airways. These are normally aerolized medications. The bronchodilator causes the muscles

Miss Brightman has been diasgnosed with asthma. Her current medication includes a short-acting beta2 agonist, when required, as well as a regularly inhaled corticosteroid. By referring to the BNF, this places Miss Brightman at step 2 on the asthma step therapy chart.

Steroids and other anti-inflammatory drugs - Steroids and other anti-inflammatory drugs work by reducing inflammation, swelling, and mucus production in the airways of a person with asthma. As a result, the airways are less inflamed and less likely to react to asthma triggers, allowing people with symptoms of asthma to have better control over their condition.

Drug Class: Therapeutic class: bronchodilator. Pharmacologic class: sympathomimetic (stimulates the sympathetic nervous system). It is also classified as a SABA (short acting β2-agonist).