CHAPTER 2 Respiratory System^95
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