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CHAPTER 2 Respiratory System
TREATMENT
The focus of treatment is to return the respiratory status to normal, deliver ade-
quate oxygen, and limit the number of recurrences. Patient education should focus
on understanding the disease, its management, and when emergency care may be
necessary.
•
Administer supplemental oxygen to help meet body’s needs.
•
Identify and remove allergens and known triggers to avoid causing an asthma
attack.
•
Give patient 3 liters/day of fluid to help liquefy any secretions.
•
Administer short-acting beta
2
-adrenergic drugs to bronchodilate:
•
albuterol, pirbuterol, metaproterenol, terbutaline, levalbuterol
•
Administer long-acting beta
2
-adrenergic drugs to manage symptoms day to
day; keep airways open, not for acute symptoms:
•
salmeterol, formoterol
•
Administer leukotriene modulators to reduce local inflammatory response in
lung to reduce exacerbations; does not have immediate effect on symptoms:
•
zafirlukast, zileuton, montelukast
•
Administer anticholinergic drugs
•
ipratropium inhaler, tiotropium handihaler
•
Administer antacid, H2 blocker, or proton pump inhibitor to decrease the
amount of acid in the stomach, reducing the possibility of ulcers due to stress
of disease or medication effects.
•
Antacids: aluminum hydroxide/magnesium hydroxide, calcium carbonate
•
H2 blockers: ranitidine, famotidine, nizatidine, cimetidine
•
Proton pump inhibitors: omeprazole, lansoprazole, esomeprazole, rabepra-
zole, pantoprazole
•
Administer mast cell stabilizer to retain an early component of the initial
response to allergens, which will prevent further reactions from occurring;
this is not for acute symptoms. This is useful for pretreatment for allergen
exposure or chronic use to improve control of symptoms.
•
cromolyn, nedocromil
•
Administer steroids to decrease inflammation, which will help open airways;
these are not for acute symptoms:
•
hydrocortisone, methylprednisolone intravenously