Bronco dilators are a group of medications that help Breathing by keeping the Airways dilated that being said they are typically used in obstructive lung diseases like asthma and chronic obstructive pulmonary disease or COPD for short where clients suffer from narrowing and obstruction of the Airways asthma is characterized by chronic inflammation in the lungs as well as asthma exacerbations or attacks where certain triggers such as viruses allergens stress aspirin or other NSAIDs and exercise lead to reversible bronchial smooth muscle spasms and mucus production both of which make it hard to breathe as a result clients experience symptoms like dpia wheezing chest tightness and coughing on the other hand in COPD there's chronic inflammation and fibrosis in the lungs most commonly due to smoking as a result the Airways become irreversibly obstructed and the lungs are not able to empty properly which leaves air trapped inside the lungs as a result clients experience symptoms like dpia and a productive cough now COPD generally refers to a group of progressive lung diseases that includes chronic bronchitis and empyema these two differ in that chronic bronchitis is defined by long-term inflammation of the bronchial tubes where whereas empyema is defined by destruction and enlargement of the alvioli although the airway obstruction in COPD is irreversible Bronco dilators can often help prevent the complete closure of the airway during expiration which provides mild symptomatic relief now based on their mechanism of action Bronco dilators can be broadly divided into three main groups beta 2 agonists anticholinergics and meth xanthines the effect of all these medications is bronchial smooth muscle relaxation which in turn results in dilation of the narrowed Airways and improved air flow in particular beta 2 agonists like Albuterol and salmeterol come in an aerosolized form and can be taken via meter dose inhalers or mdis or nebulizers once in the lungs they bind to and activate the beta 2 adrenergic receptor on bronchial smooth muscle cells ultimately promoting relaxation of the smooth muscle beta 2 agonists can be classified based on the duration of action into short acting beta 2 agonists or Sabas such as Albuterol and long acting beta 2 agonists or laas like salmeterol Sabas are typically the treatment of choice for quick symptom relief in acute asmatic attacks whereas labas are often used in combination with an inhaled corticosteroid like budesonide as prophylactic or maintenance treatment for asthma and COPD on the other hand commonly used anticholinergics include ipratropium and tiotropium and can also be given via inhalers or nebulizers once in the Airways they bind to M3 muscarinic receptors on the tracheal and bronchial smooth muscles this blocks acetyl choline from binding to The receptors decreasing smooth muscle constriction in comparison to Beta 2 agonists anticholinergics are less effective for asthma but more effective for COPD where they are the Bronco dilators of choice however for severe cases of asthma or COPD anticholinergics are often given in combination with labas for an additive effect leading to stronger and longer lasting Bronco dilation finally methyl xanthines such as theophine are usually taken orally but can also be administered intravenously once methyl xanthines reach the Airways they inhibit the enzyme phosphodiesterase or pde and ultimately lead to smooth muscle relaxation these medications can be used in asthma and COPD okay now each group of Bronco dilators has its own set of side effects with beta 2 agonists the most common ones are muscle Tremors restlessness and insomnia as well as tacac cardia and palpitations some clients may even develop arrhythmias especially with labas which could result in heart failure or even death as a result beta 2 agonists should be used with caution in clients with concurrent heart or renal disease hyperthyroidism diabetes melodus and pregnancy moving on to anticholinergics common side effects include pupil dilation dry mouth tacac cardia and restlessness for that reason anticholinergics should be used with caution in clients with narrow angle glaucoma heart disease and hyperthyroidism and are contraindicated in clients with a previous hypers sensitivity or allergic reaction finally the methyl xanthine theophyline may result in side effects like insomnia nausea and vomiting in addition theophine has a very narrow therapeutic window meaning it's very easy to overdose and can cause seizures and arrhythmias now theophyline should be avoided in clients with seizure disorders heart renal or liver disease drug interactions with beta blockers phenin beta adrenergic agonists anti-depressants or certain antibiotics like ciprofloxacin can also lead to synergistic effects and cardiac dysrhythmias due to the dangerous potential side effects theophine is now rarely used now before administering Bronco dilators ensure the client understands why the medication is prescribed the correct method of administration and side effects that may be experienced while taking the medication then assess your client's respiratory status Baseline Vital Signs and lung sounds if you're administering theophine assess your client for signs of theophine toxicity and be sure to confirm the serum theophine level because toxicity can occur at levels greater than than 20 microgr per milliliter which is very close to the therapeutic dose next teach your client how to administer their medication when using an MDI demonstrate how to use a spacer and explain that it promotes maximal delivery of the medication to the lungs demonstrate how to shake the MDI canister and attach the spacer then show them how to Exhale all the air out of their lungs put the spacer mouthpiece in their mouth making a Tight Seal and then press down on the MDI at this point explain that the medication is now trapped in the spacer so next they should inhale slowly and deeply hold their breath for 5 to 10 seconds and then fully exhale if the client needs to take more than one puff of the inhaled corticosteroid at one time instruct them to wait 1 minute before administering the second puff after the demonstration ask your client to provide a return demonstration so you're sure or they feel comfortable self-administering their medication finally be sure to educate your client to rinse out their mouth after inhalation since any medication that's left behind in the oral cavity can lead to oral infections such as thrush if administering theophine IV always use an infusion pump and administer it slowly when administering theophan Orly remember to never crush the anic coated or sustained release tablets instruct your client to avoid smoking caffeine and alcohol use when taking theophine as these can increase the side effect after administration of a Bronco dilator assess the client's lung sounds and Vital Signs notify the healthc care provider if there are significant changes from the baseline or if the client experiences any bronos spasms cardiac dymas or seizures finally evaluate for the desired therapeutic effects of decreased dpia improved wheezing and improved Airway exchange all right as a quick recap Bronco dilators are a group of medications that help Breathing by keeping the Airways dilated through smooth muscle relaxation dilation of the narrowed Airways and improved air flow Bronco dilators can be broadly divided into three main groups beta 2 agonists anticholinergics and methyl lines they are typically used in obstructive lung diseases like asthma and COPD before administering Bronco dilators be sure to assess Baseline Vital Signs and lung sounds Bronco dilators come in various forms but are commonly administered as inhaled medication after Administration assess for the desired therapeutic effects of decreased dispnea improved wheezing and improved Airway Exchange helping current and future clinicians Focus learn retain and Thrive learn 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