Drugs

1.
DERIPHYLLIN / THEOPHYLLINE / aminophylline
TRADE NAME: aminophylline, elixophylline, theo24
DRUG CLASS/CATEGORY : bronchodilators
DOSAGE: child iv loading dose 6 mg/ kg IV over 30

min
IV maintance dose
1-9 year , 1 mg/ kg/h
≥ 9 year 0.75 mg/ kg / h
PO 1-9 year 1 mg/ kg/h times 24 h in 4 divided doses
≥ 9 year 0.75 mg/ kg / h times 24 h in 4 divided dose
Infant PO/ IV 6-11 months 0.87g/ kg/h , 2-6 months 0.5 mg/ kg/ h
Neonate : PO/ IV 0.16 mg/ kg/ h
ROUTE : IV, PO
MECHANISM OF ACTION :
theophylline relaxes smooth muscles of respiratory system by blocking

phosphodiesterase.
INDICATION
to prevent and relieve symptoms of acute bronchial asthma and treatment of

bronchospasm associated with chronic bronchitis and emphysema
CONTRAINDICATION
hypersensitivity to xanthine derivatives or to ethyenediaanine compoente ,

cardiac arrhythmias , safety during pregnancy or lactation is not established
ADVERSE REACTION/ SIDE EFFECT
nervousness , restlessness, depression, insomnia, headache, dizziness,

tachycardia, anorexia, diarrhea epigastric pain
NURSING RESPONSIBILITIES
1. Monitor and record vital sign and intake and output , unexplained
increase heart rate
2. Monitor serum theophylline level,
3. Assess allergic reaction, urticarial, flushing rash, if occur discontinue
drug
4. To administer drug orally after meals for gastrointestinal syatem
absortion may be affected
5. administer drug with plenty of water
6. To advice patient do not crush, break or chew or dissolve slow release
tablets
2. SALBUTAMOL
TRADE NAME: salbutamol sulphte
DRUG CLASS/CATEGORY : bronchodilators
AVAILABLE FORM : 2mg, 4 mg tablet , syrup salbutamol

2mg per 5ml syrup, asthalin inhaler 1 to 2 inhalation 3 to 4 times daily , asthalin
rotacaps containing salbutamol sulphate 200 mcg, 400 mcg
ROUTE : mouth / inhaler/ in the form of tablet or syrup or inhaler
DOSAGE
adult dose 6mg to 16 mg orally, 6-8 hourly equal divided dos
( Children 1 mg, 6 to 8 hours orally), child 2-12 year INH metered dose
inhaler 0.1 mg/kg tid , NEB 0.1-0.15 mg/kg/dose tid or qid
causes bronchodilation by action on β2 (pulmonary) receptors by increasing

levels of cAMP, which relaxes smooth muscle , produces bronchodilation, CNS,
cardiac stimulation as well as increased diuresis and gastric acid secretion,
longer acting than isoproterenol
INDICATION :
bronchial asthma, chronic bronchitis, emphysema and other broncho
pulmonary disorders including bronchospasm
CONTRAINDICATION :
hyperthyroidism, hypertensive patients, myocardial insufficiency. Excessive use

of spray containing salbutam should not be used, it may give fatal results.
Salbutam is contraindicated in pregnancy
ADVERSE REACTION/ SIDE EFFECT:
nausea, vomiting, headache, palpitation, tachycardia, anorexia, muscle tremors
NURSING RESPONSIBILITY:
1. Assess vital capacity, forced expiratory volume, ABGs, lung sounds,

heart rate and rhythm, B/P, sputum
2. Assess for evidence of allergic reaction
3. Assess for paradoxical bronchospasm , hold medication, notify prescriber
if bronchospasm occur
4. Storage in light –resistant container , do not expose to temperature of
more than 86 degree F
5. Evaluate therapeutic response absence of dyspnea, wheezing after 1 hour
improve air way exchange improved ABGs
6. Teach patient / family to use exactly as prescribed , about use o inhaler
7. Teach patient and family to avoid getting aerosol in eyes,
8. To wash inhaler in warm water daily and dry , to track number of
inhalations,
3. HYDROCORTISONE
TRADE NAME: hydrocortisone acetate, cortef,
DRUG CLASS/CATEGORY : corticosteroid
DOSAGE adults by mouth 5 mg to 30 mg 6 hourly/ 12

hourly IM or intravenous as hydrocortisone sodium succinate , then 50-100 mg
intramuscular as needed
Children 0.16 to 1 mg / kg body weight
ROUTE ;
IM, IV , intra articular injection 0.5 ml to 2 ml , intrathecal 1to 2 ml
theophylline relaxes smooth muscles of respiratory system by blocking

phosphodiesterase.
INDICATION :
rheumatoid arthritis , osteo arthritis, joint sequelae of fracture, scratica,

inflammatory disorders like tubercular meningitis, multiple sclerosis , allergic
rhinitis , allergic sinusitis
CONTRAINDICATION:
pregnancy, lactation,, diabetes mellitus, psychosis, local or systemic infection,

new born babies, premature infant
ADVERSE REACTION/ SIDE EFFECT
Vertigo, headache, insomnia, convulsion, hypotension, shock, electrolyte

disturbance, purpura, glaucoma, growth retardation, peptic ulcer
hypersensitivity , impaired wound healing
NURSING RESPONSIBILITIES
1. to note the weight of patient daily to observe weekly weight gain.

2. Check blood pressure, pulse, 8 hourly assess chest pain
3. To assess nausea, vomiting, poly urea, fatigue, depression
4. To assess increased temperature , increased WBC count even after
withdrawl of drug, may be cause of infection
5. Provide antacid between meals to help avoid peptic ulcer
6. Use alternate –day maintance therapy with short acting corticosteroid
whenever possible
4.IPRA TROPIUM BROMIDE :
GENERIC NAME:
DOSE : 2 inhalations four hourly not to exceed 12 inhaltaions per

day (24 hours)
ACTION : it is an anticholinergic bronchodilator drug. It acts as

bronchodilators and is used in the treatment of bronchial asthma
INDICATION: bronchial asthma , COPD
CONTRAINDICATION:
hypersensitivity , atropine, pregnancy, lactation, children below 12 years age,

bladder neck obstruction
SIDE EFFECT :
nausea, vomiting, dry mouth, blurred vision, rash, palpitation, cough,

bronchospasm, headache, anxiety, nervousness
NURSING RESPONSIBILITY :
1. to assess palpitation , check respiration rate, rhythm, if abnormality

observed change the drug
2. To change the dose , increase or decrease in case of long term therapy
3. In case of dry mouth , advice patient for frequent drinks
4. To advice patient thee correct method of inhalation and clean the
equipment daily, shake before using
5. To evaluate therapeutic response patient may breathe comfortably

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1.

DERIPHYLLIN / THEOPHYLLINE / aminophylline

TRADE NAME: aminophylline, elixophylline, theo24

DRUG CLASS/CATEGORY : bronchodilators

DOSAGE: child iv loading dose 6 mg/ kg IV over 30

1-9 year , 1 mg/ kg/h

≥ 9 year 0.75 mg/ kg / h

PO 1-9 year 1 mg/ kg/h times 24 h in 4 divided doses

≥ 9 year 0.75 mg/ kg / h times 24 h in 4 divided dose

Neonate : PO/ IV 0.16 mg/ kg/ h

theophylline relaxes smooth muscles of respiratory system by blocking

to prevent and relieve symptoms of acute bronchial asthma and treatment of

hypersensitivity to xanthine derivatives or to ethyenediaanine compoente ,

ADVERSE REACTION/ SIDE EFFECT

nervousness , restlessness, depression, insomnia, headache, dizziness,

TRADE NAME: salbutamol sulphte

DRUG CLASS/CATEGORY : bronchodilators

AVAILABLE FORM : 2mg, 4 mg tablet , syrup salbutamol

ROUTE : mouth / inhaler/ in the form of tablet or syrup or inhaler

adult dose 6mg to 16 mg orally, 6-8 hourly equal divided dos

causes bronchodilation by action on β2 (pulmonary) receptors by increasing

hyperthyroidism, hypertensive patients, myocardial insufficiency. Excessive use

ADVERSE REACTION/ SIDE EFFECT:

nausea, vomiting, headache, palpitation, tachycardia, anorexia, muscle tremors

1. Assess vital capacity, forced expiratory volume, ABGs, lung sounds,

TRADE NAME: hydrocortisone acetate, cortef,

DRUG CLASS/CATEGORY : corticosteroid

DOSAGE adults by mouth 5 mg to 30 mg 6 hourly/ 12

IM, IV , intra articular injection 0.5 ml to 2 ml , intrathecal 1to 2 ml

theophylline relaxes smooth muscles of respiratory system by blocking

rheumatoid arthritis , osteo arthritis, joint sequelae of fracture, scratica,

pregnancy, lactation,, diabetes mellitus, psychosis, local or systemic infection,

ADVERSE REACTION/ SIDE EFFECT

Vertigo, headache, insomnia, convulsion, hypotension, shock, electrolyte

1. to note the weight of patient daily to observe weekly weight gain.

DOSE : 2 inhalations four hourly not to exceed 12 inhaltaions per

ACTION : it is an anticholinergic bronchodilator drug. It acts as

INDICATION: bronchial asthma , COPD

hypersensitivity , atropine, pregnancy, lactation, children below 12 years age,

nausea, vomiting, dry mouth, blurred vision, rash, palpitation, cough,

1. to assess palpitation , check respiration rate, rhythm, if abnormality

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