Levalbuterol Xopenex

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

Levalbuterol Xopenex Therapeutic: 1.25 INH Prn Respiratory Therapy
bronchodilators mg
Pharmacologic:
adrenergics
Peak Onset Duration Normal dosage range
90 min 10-17 min 5-6 hr 0.63 mg via nebulization three times daily (every 6-8 hr); may be
increased to 1.25 mg three times daily (every 6-8 hr)
Why is your patient getting this medication For IV meds, compatibility with IV drips and/or solutions
For short term control of bronchospasm from N/A
pulmonary edema resulting from CHF
Mechanism of action and indications Nursing Implications (what to focus on)

(Why med ordered) Contraindications/warnings/interactions
R-enantiomer of racemic albuterolBinds to beta-2 adrenergic . Contraindicated in patients with known hypersensitivity, Use Cautiously
receptors in airway smooth muscle leading to activation of in Cardiovascular disorders (including coronary insufficiency,
adenylcyclase and increased levels of cyclic-3', 5'-adenosine hypertension, and arrhythmias); History of seizures; Hypokalemia;
monophosphate (cAMP). Increases in cAMP activate kinases, Hyperthyroidism; Diabetes mellitus; Unusual sensitivity to adrenergic
which inhibit the phosphorylation of myosin and decrease amines. INTERACTIONS: Concurrent use or use within 2 weeks of
intracellular calcium. Decreased intracellular calcium relaxes tricyclic antidepressants or MAO inhibitors may ↑ risk of adverse
bronchial smooth muscle. Indicated to treat bronchospasm due cardiovascular reactions (use with extreme caution); Beta blockers block
to reversible airway disease (short-term control agent). the beneficial pulmonary effects of adrenergic bronchodilators (choose
cardioselective beta blockers if necessary and with caution); May ↑ risk
of hypokalemia from potassium-losing diuretics; May ↓ serum digoxin
levels; May ↑ risk of arrhythmias with hydrocarbon inhalation anesthetics
or cocaine; Use with caffeine-containing herbs ( guarana, tea , coffee ) ↑
stimulant effect
Common side effects
CNS: anxiety, dizziness, headache, nervousness,
Resp: increased cough, paradoxical bronchospasm, turbinate edema, CV:
tachycardia, GI: dyspepsia, Endo: hyperglycemia,
F and E: hypokalemia, Neuro: tremor,
Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine
medicines (ask patient specifically) May cause ↑ serum glucose and ↓ serum potassium
none
Be sure to teach the patient the following about this
medication: : Instruct patient in the proper use of the nebulizer (see
Appendix B ) and to take levalbuterol exactly as directed. Caution patient
not to exceed recommended dose; may cause adverse effects, paradoxical
bronchospasm, or loss of effectiveness of medication; Instruct patient to
contact health care professional immediately if shortness of breath is not
relieved by medication or is accompanied by diaphoresis, dizziness,
palpitations, or chest pain; Advise patients to use levalbuterol first if
using other inhalation medications, and allow 5 min to elapse before
administering other inhalant medications unless otherwise directed;
Advise patient to rinse mouth with water after each inhalation dose to
minimize dry mouth; Instruct patient to notify health care professional if
no response to the usual dose of levalbuterol
Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this Check after giving
Assess lung sounds, pulse, and blood pressure med? Lung sounds, pulse, and blood
before administration and during peak of Observe for paradoxical bronchospasm pressure during peak of medication
medication. Note amount, color, and character of (wheezing). If condition occurs, withhold
sputum produced. Closely monitor patients on medication and notify physician or other
higher dose for adverse effects; Monitor health care provider immediately. You would
pulmonary function tests before initiating therapy also hold this med if the pt was experiencing
and periodically during course to determine tachycardia.
effectiveness of medication;

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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

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

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