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CORTICOSTEROID
INDICATIONS
Maintenance treatment of asthma prophylactic
ACTION LOCALLY ACTING ANTI-INFLAMMATORY, Immune modifier, improves asthma attacks
CONTRAINDICATIONS
hypersensitivity, use cautiously in active untreated DM and glaucoma
NURSING INTERVENTIONS
monitor respiratory status and lung sounds, monitor growth rate in children receiving chronic therapy, withdraw symptoms
SIDE EFFECTS
HA, bronchospasms, cough, decreased growth (children)
SAFE DOSE
Adults and children over 12  40-80mcg BID, inhalation
children 5-11yo 40mcg daily
PO DOSE

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used to treat diseases and conditions, esp those associated with inflammation
CONTRAINDICATIONS
use cautiously in chronic treatment may lead to adreanal suppression -low dose for short periods of time, and in active untreated infections
INTERVENTIONS
assess pt before and during therapy, assess for adreanal insufficiency, monitor I and O and daily weights
SIDE EFFECTS
depression, euphoria, wt gain or loss, muscle loss, osteoporosis, headache
SAFE DOSE
PO 5-60mg single or divided dose daily, ER tablets should be administered once daily

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Safe dose: 50mcg (one inhalation) BID
Side effects: headache, nervousness, palpatations, tachycardia, abdominal pain, diarrhea, nausea.
Indications: treatment of asthma and the prevention of bronchospasm in patients who are currently taking meds but are inadequately controlled on long term asthma control medications.
Contraindications: Patient whose assthma is ccurrntly controlled on low or mediom dose inhaled corticosteriod therapy.
Nursing interventions: Assess lung sounds, pulse and BP periodically during therapy; monitor pulmonary function tests; observe for paradoxical bronchospasm and hypersensitivity reaction.
Albuterol
Safe dose: 2 inhales Q4hrs
Side effects: nervousness restlessness, tremor, headache, insomnia, chest pain, palpitations, nausea, vomiting.
Indications: used as a quick relief agent for acute bronchospasm and for prevention of exercise induced brochospasm.
Contraindications: hypersensitivity to adrenergic amines.
Nursing interventions: assess lung sounds, BP and pulse; monitor pulmonary function tests, observe for paradoxical bronchospasm.

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(AXID)

INDICATIONS

histamine-2 blocker that works by decreasing the amount of acid produced by the stomach. Nizatidine is used to treat ulcers in the stomach and intestines. Nizatidine also treats heartburn and erosive esophagitis caused by gastroesophageal reflux disease (GERD)
CONTRAINDICATED
hypersensitivity
SIDE EFFECTS
HA, dizziness, blurred vision, dyspnea, loss of hearing, pain at IV site
DOSAGE
300mg nightly or 150mg BID, maintenance dose 150mg nightly
MAX DAILY DOSE
300mg day
NURSING INTERVENTION
Monitor when being administered via IV for extravasation, monitor AST/ALT, Creatine. monitor vision and hearing

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Indications: Cimetidine (Tagamet) is an H2 histamine blocker normally used for the treatment of stomach and intestional ulcers. It works by reducing the amount of acid in your stomach. It's role in the treatment of asthma is to enhance the bronchial response in patients that have not responded to other treatment. 

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Indications: Cimetidine (Tagamet) is an H2 histamine blocker normally used for the treatment of stomach and intestional ulcers. It works by reducing the amount of acid in your stomach. It's role in the treatment of asthma is to enhance the bronchial response in patients that have not responded to other treatment. 

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Contraindications: Immune suppressed patients, AKD, COPD, diabetes.
Nursing interventions: Educate patient to avoid smoking, spicy foods, caffeine, and alcohol.
Side effects: headaches, dizziness, drowsiness, hallucinations (severe).
Dose: 300-800mg Q12 PO daily. Not given to patient's under 12 years unless prescribed by a doctor.

Ranitidine (Zantac)
Indications:

Relief of heartburn

Short-term and maintenance therapy of gastric and duodenal ulcers

Ranitidine can also be given with NSAIDs to reduce the risk of ulceration. Proton-pump inhibitors (PPIs) are more effective for the prevention of NSAID-induced ulcers.[8]

Pathologic gastrointestinal (GI) hypersecretory conditions such as Zollinger–Ellison syndrome

Gastroesophageal reflux disease (GERD)

Erosive esophagitis

Part of a multidrug regimen for Helicobacter pylori eradication to reduce the risk of duodenal ulcer recurrence

Recurrent postoperative ulcer

Upper GI bleeding

Prevention of acid-aspiration pneumonitis during surgery: ranitidine can be administered preoperatively to reduce the risk of aspiration pneumonia. The drug not only increases gastric pH, but also reduces the total output of gastric juice.

Prevention of stress-induced ulcers in critically ill patients[10]

Used together with diphenhydramine as secondary treatment for anaphylaxis; after first-line epinephrine.

Contraindications:

Stomach Cancer

Porphyria

Liver Problems

kidney disease with reduction in kidney function

Allergies:

Histamine H2 Inhibitors

Nursing interventions:

Use caution in presence of renal or hepatic impairment

Assess potential for interactions with other pharmacological agents patient may be taking (e.g. increased or decreased levels/effects and toxicity)

Monitor AST, ALT, serum creatinine; when used to prevent stress-related GI bleeding, measure the intragastric pH and try to maintain pH > 4; signs and symptoms of peptic ulcer disease, occult blood with GI bleeding, monitor renal function to correct dose; monitor for side effects

Evaluate results of laboratory tests, therapeutic effectiveness, and adverse reactions (e.g., bradycardia, PVCs, tachycardia, CNS changes [depression, hallucinations, confusion, malaise], rash, gynecomastia, GI disturbances, hepatic failure)

Assess knowledge/teach patient appropriate use, possible side effects/appropriate interventions, and adverse symptoms to report.

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FAMOTIDINE
Common brands: Pepcid, Heartburn Prevention, Pepcid AC
INDICATIONS
Famotidine a histamine-2 blockers. Famotidine works by decreasing the amount of acid the stomach produces.
CONTRAINDICATED
Hypersensitivity, pregnancy (B), children under 12, geriatrics, severe renal/hepatic disease
SIDE EFFECTS TO NOTIFY MD ABOUT
fast or pounding heartbeats with severe dizziness; or
unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine.
COMMON SIDE EFFECTS
HEADACHES/DIZZINESS/DIARRHEA

DOSAGE
Oral:
-Usual dose: 40 mg orally once a day at bedtime OR 20 mg orally 2 times a day
-Maintenance dose: 20 mg orally once a day at bedtime
-Duration of therapy: 4 weeks
Parenteral:
-Usual dose: 20 mg IV every 12 hours
Max adult dose 40mgtwice daily
NURSING INTERVENTIONS
monitor for seizures, use cautiously with renal impairment, dysrhythmias, and QT prolongation, stevens-johnson syndrome