Question

Respiratory Drugs

Brett is a 12 y/o boy with a history of asthma, diagnosed 2 years ago.  He is an outgoing, active boy and participates in a swim club and soccer, but he has a difficult time adjusting to the limitations of his asthma.  He has learned to control acute attacks by using albuterol (Proventil) metered-dose inhaler, and because his asthma is often triggered by exercise, he has been using a budesonide (Pulmicort) inhaler and taking montelukast (Singulair).  

After competing in his swim meet at the local indoor pool, Brett began experiencing respiratory distress.  He alerted his coach, who retrieved the albuterol inhaler from Brett’s backpack.  After two inhalations, Brett was still in distress and the rescue team was called.

On admission to the emergency department, Brett is in obvious distress with pulse oximeter readings of 90% to 91%.  He has nasal flaring and bilateral wheezing is heard in is his lung fields, pulse rate is 122 beats/min, and he is orthopneic.  While treatment is started, the nurse asks him questions that he can nod or shake to answer.  He shakes his head “no” when asked if he used his budesonide inhaler today and shrugs when asked about his last dose of montelukast. Course hero

1. According to the onset of action, which specific group of drugs would you anticipate will be prescribed to treat Brett’s acute asthmatic attack and why?  (10 points).  Name an inhaler the patient be taught to use to for rescue? (5points)

2. Considering Brett’s history, medications, and the location where Brett’s asthma attack occurred, what might explain his acute attack? (5 points
3. Use keywords and a textbook as a resource to search for an asthma support group or online support group for children or for adults.  Include the URL and information about what the group does or services provided. (15 points)

Answer 1

#. Drugs that would be prescribed include:

Short-acting beta agonists, such as albuterol. These are the same medications as those in your quick-acting (rescue) inhaler. Used to dilate the bronchioles

Oral corticosteroids. Used to reduce inflamation

Ipratropium (Atrovent HFA). It opens up the medium and large airways of lungs

Intubation, mechanical ventilation and oxygen.

#. A rescue inhaler is a type of inhaler that dispenses medication to relieve or stop the symptoms of an asthma attack.

Examples of rescue inhaler :-

Albuterol

Levalbuterol

Iprotropium

#. Steps of using an inhaler :-

1. Remove the cap and hold inhaler upright

2. Shake the inhaler for 5-10 sec

3. Tilt your head back slightly and breathe out slowly

4. Place mouthpiece in mouth, close lips

5. Breath in slowly and deeply

6. Depress the canister once

7. Continue to breath slowly for 5 seconds through mouth

8. Take inhaler away and close mouth

9. Hold breath for 10 secs

10. Exhale slowly

11. Repeat if necessary

#. The reason behind his acute asthma is suffocation due to water causing interruption of the body's absorption of oxygen from the air leading to asphyxia.