Drug Study (Albuterol and ipratropium inhaler) Patient: Demitrio De Asis Age: 82 years old Sex: Male Physician:

Dr. Garlitos

Medical Diagnosis: COPD in AE, Varicelle Infection

Drug Name Generic Name:

Dosage Dosage:

Mechanism of Action Combivent Inhalation Solution is a combination of the anticholinergic bronchodilator, ipratropium bromide, and the beta2-adrenergic bronchodilator, salbutamol sulfate. Ipratropium bromide is a quaternary ammonium derivative of atropine and is an anticholinergic drug which has bronchodilator properties. Salbutamol produces bronchodilation through stimulation of beta2-adrenergic receptors in bronchial smooth muscle, thereby causing relaxation of muscle fibres. This action is manifested by an increase in pulmonary function as demonstrated by spirometric measurements.

Indication For the management of bronchospasm in patients suffering from chronic obstructive pulmonary disease (COPD) who requires regular treatment with both ipratropium and salbutamol.

Contraindications Patients with cardiac tachyarrhythmias, hypertrophic obstructive cardiomyopathy and patients with a history of hypersensitivity to any of its components or to atropine or its derivatives.

Adverse Reactions

Nursing Responsibilities

100/20 mcg Albuterol and ipratropium inhaler per actuation of the inhaler Brand Name: Route: Combivent Inhalation Classification: Frequency: Bronchodilators q6 hours

CNS: lightheadedness, Assessment and Drug Effects: drowsiness, insomnia, 1. Monitor respiratory status; auscultate dizziness, vertigo, lungs before and after inhalation CNS stimulation 2. Report treatment failure (exacerbation CV: hypertension, of respiratory symptoms) to physician arrhythmia, Patient and Family Education: hypotension, tachycardia, angina 1. Do not allow the solution/ mist to enter the eyes EENT: sinusitis, blurred vision, taste 2. Consult a doctor immediately in the perversion, dry mouth, event of acute, rapidly worsening paradoxical dyspnea. In addition, the patient should bronchospasm, be warned to seek medical advice bronchitis should a reduced response become GIT: abdominal pain, apparent. dyspepsia, gastrointestinal 3. The concomitant use of Combivent with distress, vomiting, other sympathomimetic agents is not diarrhea, constipation recommended since such combined use may lead to deleterious cardiovascular GUT: dysuria, urinary effects. retention, urinary difficulty 4. Eye pain or discomfort, blurred vision, MS: Fatigue, visual halos or colored images in

weakness Others: alopecia, itching, rash, flushing, , edema

association with red eyes from conjunctival and corneal congestion may be signs of acute narrow-angle glaucoma. Should any combination of these symptoms develop, treatment with miotic drops should be initiated and specialist advice sought immediately. 5. Allow 30-60 sec between puffs for optimum results. 6. Wait 5 min between this and other inhaled medications. 7. Rinse mouth after medication puffs to reduce bitter taste