BronchodilatorsPharmacodynamicsContraindications & PrecautionsADR • usually transient →temporary reduction in dose may alleviate some of the side effects • palpitations • supraventricular & ventricular ectopic be
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BronchodilatorsPharmacodynamicsContraindications & PrecautionsADR • usually transient →temporary reduction in dose may alleviate some of the side effects • palpitations • supraventricular & ventricular ectopic beats • CNS excitation → tremors, dizziness, shakiness, nervousness, and restlessness • headache Drug interactions • digitalis glycosides→ increased risk of cardiac arrhythmias→monitor ECG carefully • Beta agonists used with beta-adrenergic blocking agents (including ophthalmic preparations) may result in mutual inhibition of therapeutic effects • Tricyclic antidepressants and MAOIs used with albuterol, metaproterenol, or terbutaline may potentiate the effects of the bronchodilator on the vascular system. • Hypokalemia or electrocardiogram changes may be seen with coadministration of the beta agonists with drugs that lower the potassium level, such as diuretics. Clinical Use and DosingRational Drug Selection • For treating topical dermatophyte infections, generally the OTC azoles are the first-line therapy because they are easily available without prescription and are low cost. • If OTC products are not effective, then a broader-spectrum antifungal can be prescribed, with little difference found in efficacy in treating common organisms that cause tinea infections. • When treating cutaneous fungal infections, the OTC products clotrimazole and miconazole should be the first medications used because of their low cost and their safety profile. If they are ineffective, then a prescription product with a broader spectrum may be used, but it is generally more expensive. Patient education • instruct patients to take the drug as prescribed for the full course of their treatment, even if they note clinical improvement. • In the treatment of oral candidiasis, the patient should be instructed to continue therapy until 2 days after symptoms have disappeared. • When treating infants with thrush, all pacifiers and bottle nipples should be washed in warm, soapy water and soaked in hot or boiling water for 20 minutes between each use. This step is important to prevent reinfection of the infant with candidiasis.
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