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NURS 1566 Clinical Form 3: Clinical Medications Worksheets

(You will need to make additional copies of these forms)

Generic Name Trade Name Classification Dose Route Time/frequency


Ipratroprium BR Combivent (with albuterol) Therapeutic: 18 mcg INH TID
allergy, cold, and
cough remedies,
bronchodilators
Pharmacologic:
anticholinergics
Peak Onset Duration Normal dosage range
1-2 hr 5-15 min 3-4 hr (up to 8 250-500 mcg 3-4 times daily given q 6-8 hr as needed (up to 500 mcg q 4
hr) hr)

Why is your patient getting this medication For IV meds, compatibility with IV drips and/or solutions
hypoxia N/A

Mechanism of action and indications Nursing Implications (what to focus on)


(Why med ordered) Contraindications/warnings/interactions
Mechanism of action: Inhibits cholinergic receptors in bronchial . Hypersensitivity to ipratroprium, atropine, belladonna alkaloids,
smooth muscle, resulting in decreased concentrations of cyclic bromide or fluorocarbons; Peanut or soy allergy (inhaler contains soy
guanosine monophosphate (cGMP). Decreased levels of cGMP lecithin); Avoid use during acute bronchospasm; Use Cautiously in:
produce local bronchodilation. Patients with bladder neck obstruction, glaucoma, or urinary retention.
Indications: Adjunctive management of bronchospasm Interactions: Potential ↑ fluorocarbon toxicity when used with other
inhalation bronchodilators having a fluorocarbon propellant; ↑
anticholinergic properties with other drugs having anticholinergic
properties ( antihistamines , phenothiazines , disopyramide )
Common side effects
CNS: dizziness, headache, nervousness, EENT: blurred vision, sore
throat, nasal only: epistaxis, nasal dryness/irritation, Resp:
bronchospasm, cough, CV: hypotension, palpitations, GI: GI irritation,
nausea, Derm: rash, Misc: allergic reactions
Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine
medicines (ask patient specifically) None found
none
Be sure to teach the patient the following about this
medication
Instruct patient in proper use of inhaler, nebulizer, or nasal spray and to
take medication as directed. Take missed doses as soon as remembered
unless almost time for the next dose; space remaining doses evenly
during day. Do not double doses. Advise patient that rinsing mouth after
using inhaler, good oral hygiene, and sugarless gum or candy may
minimize dry mouth. Health care professional should be notified if
stomatitis occurs or if dry mouth persists for more than 2 wk. Explain
need for pulmonary function tests prior to and periodically during therapy
to determine effectiveness of medication. Caution patient to avoid
spraying medication in eyes; may cause blurring of vision or irritation.
Advise patient to inform health care professional if cough, nervousness,
headache, dizziness, nausea, or GI distress occurs.
Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this Check after giving
Assess for allergy to atropine and belladonna med? respiratory status (rate, breath
alkaloids; patients with these allergies may also be if severe bronchospasm is present; onset of sounds, degree of dyspnea, pulse)
sensitive to ipratroprium. Assess for peanut or soy action is too slow for patients in acute distress.
allergy. Assess respiratory status (rate, breath If wheezing occurs, withhold medication and
sounds, degree of dyspnea, pulse) before notify physician or other health care
administration professional immediately