Drug Protocol Practice: Asthma Disease

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Drug Protocol Practice: Asthma Disease

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Drug Protocol Practice: Asthma Disease

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Question:
Discuss about the Drug Protocol Practice for Asthma Disease.

Answer:

Introduction
Asthma disease requires careful consideration of the management and diagnostic plan in order to offer the right medication. As a nursing practitioner there is need to follow the right diagnosis path with the use of right protocol steps so as to achieve positive health state. Salbutamol has been used to offer medical therapy for asthma. It is a B2 androgenic receptor stimulating compound that performs the functions of bronchial dilations; it is also referred to as venolin. Its pharmacotherapy role is to break open the medium cavity of the airways in the lung walls. Common medication is by use of nebulizer or inhaler and available also as pill. In reviewing Asthma care, this case study adopts a protocol plan for health assessment for patient Bella.
Body
The scientific pharmacology associated with the drug is that is a chemically composed of ethanol and sulfate, (Jiang et al., 2016). When ingested, half of the drug is directly absorbed in the small intestines for the intestinal tract. However slower paces of action is achieved. Its action reaches peak after 2 hours of intake, in inhalation salbutamol gets into lungs attaining action level after 3-5 minutes with peak of 15-20 minutes. Hover theaction of salbutamol depended on the patient, it is expected maximum activity to have been attained after 4-6 hours, and it is taken through intestinal tract metabolism and via the liver for excretion in urinary tract. It is for this short acting duration on the body that is chosen for medical treatment inn asthma, as asthma.
Its mechanism of action is that it acts as a stimulator of B2 androgenic receptors which are receptors in the bronchial muscles in the lungs. B2 receptor stimulation leads to activation of enzymes referred to adenosine cycle that initiates cyclic adenosine mono phosphate form adenosine tri phosphate. The elevated levels of adenosine mono phosphate ensures the smooth muscles are relaxed and lowers the air way through lowering the airway resistance through intracellular ionic calcium concentration. Thus with complex chemical and physical activities, salbutamol relaxes the muscles in the airway from the tracheal ending at the terminal bronchioles, (Zhou et al., 2016).
The usage and utilization of this drug involves a number of steps, It is exploited in bronchi spasm in the reversal obstructive airway diseases, Used in exercise induced broncho spasm. Situations which have been considered to influence broncho spasm include contraindications. This occurs in person who has reactions to the administration of salbutamol or any contents of it. It is also contraindicated in patients with history of cardiac tachyarrhythmias related to the functioning of the heart.
The drug is always available in various forms which include tablet, syrup intake, nebulizer compound and injections via the muscles and venibular. Tablets form contains 2 and 4 mg which are able to release the salbutamol. The syrup solution is taken each with 5 ml which has 2 mg of salbutamol. The inhaler mixture entails presence of two types of compound; salbutamol metered dose inhaler and dry powder inhaler compound. The mixture compound with MDI is usually compressed in aerosol form, it uses the oral inhalation, and where it contains 100mg salbutamol drug in hydrofluoralkane form .the hydrocarbon is a carbon begins which has salbutamol in 200 mg in dry powder form. The nebulizer solution content of salbutamol ingredient of 5 mg and finally the injection form which has 50 mg salbutamol, (Lavaforest et al., 2016).

The oral form is given in a dose of 2-4 mg three times in a day for the adults while for children they receive 1-2 given in three times daily. The inhaler formulation solution has 1-2 puffs equivalent to 100-200 mg of salbutamol dose inhaler and given 1-2 capsule containing 200 mg-400 mg of the dry powder drug compound inhaler. The nebulizer solution has 1-2 meals of salbutamol solution which is diluted with the normal saline solution to have a final solution of 2-4 ml which is inhaled till the aerosol ceases, however in severe attacks this may be repeated. The injectable forms are given 5-10 ml each which has 50 mg of salbutamol injection given through the muscles or veins. The side effects degree varies with dosage and the route of administration. Side effects which are common include fine tremor on the skeletal, muscles and the nerves effects, the drug effect also causes palpitation, chest pains, headaches, muscle cramps and tachycardia.
The treatment protocol suits Miss Bella, in that all her diagnosis suits the application of this protocol in that the symptoms she is displaying various characteristics which the protocol plan can handle effectively. Prednisolone drug given to her is meant to prevent inflammation in the chest, however the efficacy of these drug is questionable Miss Bella medical history is that she is chronic smoker since age of 12. Research has shown that smoking increases the prevalence chronic cough and exacebaration, (Polosa & Thomson, 2013). Smoking decreases the decree of cough in Asthmatic patents and blocks the air cycles. (Pilcher et al., 2016). Previously, studies have concentrated on non smokers alone, leaving the smokers who smoke and had asthma without adequate care. A study done by Hancox et al.,(2016) found out that smoking on drug intake impaired with mild asthma. Thus as an active smoker, Miss Bella may experience some little of difficulty and experience mild asthma during her medication process.
The potential problems thus portrayed in her behavior are likely to affect her treatment plan. Bearing in mind she is an active smoker she is likely not follow the drug regime given. The effects of smoke are that, it causes irritations in the lining of the air ways, this cause worsening of asthma case. Also tobacco has been proved to damage the small linings in the lungs which affect her efficacy in terms in terms of the drug regime. Smoke further cause’s allergic inflammation of the bronchial tubes which causes mucus production, leading to increased coughing and phlegm in the body, (Sander et al., 2013).. These are the dangers in which Miss Bella medication might face
For her medication to work she needs to avoid smoking so to enable the drugs to function well in her body. For Miss Bella, smoking cessation is possible; in her medical treatment she should be given nicotine replacement which comes in form of skin patches and prescription of drugs which like bupropion, which reduces the cavity cravings for cigarettes, (Price, Bjermer, Popov & Chisholm, 2014). Corticoids drugs are very effective in management of asthma. Due to the inhalation of these drugs, they function by clearing the chronic airway and enable the clearance of the path way of air to be smooth. Often intake of corticoids is associated with mouth thrush, if this occurs then the advice given is to wash her mouth every day and spitting after taking the drug.
Achieving appropriate medication protocol for Miss Bella, there is need to address the environmental factors which play key role, involving the family as part of the process is essential. There is need to teach the family members on how to offer support to Bella in learning self management skills and monitoring her on long term treatment plan is important.
Conclusion
The overall goal and objective of care to asthma patients is to ensure patent improves and restoration on positive state of health is achieved. There is need to offer quality care in managing these patients while following the correct protocol plan in order to majorly reduce impairment and reduce the risk. Thus to achieve this, it needs right full medication processes and seeking support for the patient.

References
Hancox, R.J., Gray, A.R., Poulton, R. and Sears, M.R., (2016). The effect of cigarette smoking on lung function in young adults with asthma. American journal of respiratory and critical care medicine, 194(3), pp.276-284.
Jiang, B., Ruan, Z., Chen, J., Lou, H., Shao, R., Jin, F. and Shen, H., (2016). Pharmacokinetic properties and bioequivalence of orally inhaled salbutamol in healthy Chinese volunteers. Drug development and industrial pharmacy, 42(9), pp.1476-1481.
Pilcher, J., Patel, M., Reddel, H.K., Pritchard, A., Black, P., Shaw, D., Holt, S., Weatherall, M. and Beasley, R., (2016). Effect of smoking status on the efficacy of the SMART regimen in high risk asthma. Respirology. Polosa, R. and Thomson, N.C., 2013. Smoking and asthma: dangerous liaisons. European respiratory journal, 41(3), pp.716-726.
Price, D., Bjermer, L., Popov, T.A. and Chisholm, A., (2014). Integrating evidence for managing asthma in patients who smoke. Allergy, asthma & immunology research, 6(2), pp.114-120.
Sundar, I.K., Nevid, M.Z., Friedman, A.E. and Rahman, I., (2013). Cigarette smoke induces distinct histone modifications in lung cells: implications for the pathogenesis of COPD and lung cancer. Journal of proteome research, 13(2), pp.982-996.
Zhou, L., Wang, Q., Zhang, Y., Ji, Y. and Yang, X., (2016). Aquatic photolysis of β2-agonist salbutamol: kinetics and mechanism studies. Environmental Science and Pollution Research, pp.1-10.

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