2130 Flashcards
Albuterol
Brand name
Brand name: proventil/ ventolin
Albuterol
Drug class
Drug class: sympathomimetic
Albuterol
Indications
Indications: treatment of bronchospasm in patients with reversible obstructive airway disease (COPD, asthma) prevention of exercise-induced bronchospasm.
Albuterol
Mechanism of action
Mechanism of action: selective beta-2 agonist that stimulates adrenergic receptors of the sympathomimetic nervous system. Results in smooth-muscle relaxation in the bronchial tree and peripheral vasculature. More selective for beta-2 than Albuterol
Albuterol
Contraindications
Contraindications: hypersensitivity, tachycardia, dysrhythmias, especially those caused by digitalis. Synergistic with other sympathomimetic
Albuterol
Adverse effects
Adverse effects: headaches, fatigue, lightheadedness, irritability, restlessness, aggressive behavior, pulmonary edema, hoarseness, nasal congestion, increased sputum, hypertension, tachycardia, dysrhythmias, chest pain, palpitations, N/V, dry mouth, epigastric pain, and tremors.
Albuterol
Precautions
Precautions: TCA’S may potentiate vasculature effects, beta blockers will antagonize effects may cause hypokalemia
Albuterol
Dose & administration
Dose & administration: adult 2.5mg dilute in 3ml NS nebulized over 10-15 minutes. Pediatric <20kg - 1.25mg/ dose via hand held nebulizer or mask over 20 minutes. Pediatrics >20kg - 2.5mg/ dose via hand held nebulizer or mask over 20 minutes
Etomidate
Brand name
Brand name: amidate
Etomidate
Drug class
Drug class: non-barbiturate hypnotic anesthesia induction agent.
Etomidate
Indications
Indications: premedication for tracheal intubation (RSI/SAI) or cardioversion
Etomidate
Mechanism of action
Mechanism of action: short- acting hypnotic that acts at the level of the reticular activating system within the brain.
Etomidate
Contraindications
Contraindications: hypersensitivity, labor & delivery
Etomidate
Adverse effects
Adverse effects: hypoventilation, hyperventilation, dysrhythmias, hypotension, hypertension, N/V, involuntary muscle movement, pain at injection site.
Etomidate
Precautions
Precautions: may be enhanced when given with other CNS depressants.
Etomidate
Dose & administration
Dose & administration: adult 0.2 to 0.6mg/kg iv over 30-60 seconds. Pediatrics 0.2 to 0.4mg/kg iv over 30-60 seconds
Lpratropium
Brand name
Brand name: atrovent
Ipratropium
Drug class
Drug class: anticholinergic
Ipratropium
Indications
Indications: persistent bronchospasm (asthma), COPD exacerbation.
Ipratropium
Mechanism of action
Mechanism of action: inhibits interaction of acetylcholine at receptor sites of bronchial smooth muscle ( in the lungs), resulting in decreased contractility of the bronchial smooth muscle and decrease in mucous production
Ipratropium
Contraindications
Contraindications: hypersensitivity to ipratropium, atropine, alkaloids, peanuts. Note new manufacturing has eliminated the contraindications pertaining to peanuts and soy allergy
Ipratropium
Adverse effects
Adverse effects: headache, dizziness, nervousness, fatigue, tremor, blurred vision, cough, dyspnea, worsening COPD symptoms, tachycardia, palpitations, flushing, MI, dry mouth, N/V, GI distress.
Ipratropium
Precautions
Precautions: no drug interactions reported
Ipratropium
Drug & administration
Drug & administration: adult 250 to 500 mcg (.25 to .5mg) inhalation with nebulizer every 20 minutes up to 3 times. Pediatrics same as adult.
Levalbuterol
Brand name
Brand name: xopenex
Levalbuterol
Drug class
Drug class: sympathomimetic, bronchodilator
Levalbuterol
Indications
Indications: treatment of acute bronchospasm in patients with reversible obstructive airway disease (COPD, asthma). Bronchospasm prophylaxis (prevention/treatment) in asthma patients.
Levalbuterol
Mechanism of action
Mechanism of action: stimulates beta-2 receptors resulting in smooth muscle relaxation of the bronchial tree and peripheral vasculature. More selective for beta-2 than albuterol.
Levalbuterol
Contraindications
Contraindications: hypersensitivity, angioedema, tachydysrhythmias, severe cardiac disease.
Levalbuterol
Adverse effects
Adverse effects: headache, anxiety, dizziness, restlessness, hallucinations, throat irritation, tachycardia, hypotension, hypertension, dysrhythmias, angina, N/V, dyspepsia, tremors, hypokalemia, hyperglycemia.
Levalbuterol
Precautions
Precautions: increases action of bronchodilators, MAOI’S, TCA’s and other adrenergics. May cause a prolonged QT interval with sotalol or phenothiazine’s
Levalbuterol
Dose & administration
Dose & administration: adult 1.25mg to 2.5mg in 3ml normal saline administered by nebulizer every 20 minutes to a maximum of 3 doses. Pediatrics 0.075mg/kg (minimum of 1.25mg) administered by nebulizer every 20 minutes to a maximum of 3 doses.
Succinylcholine
Brand name
Brand name: anectine
Succinylcholine
Drug class
Drug class: neuromuscular blocker, depolarizing; skeletal muscle relaxant
Succinylcholine
Indications
Indications: RSI
Succinylcholine
Mechanism of action
Mechanism of action: ultra short acting depolarizing skeletal muscle relaxant that mimics acetylcholine as it binds with the cholinergic receptors on the motor end plate, producing a phase 1 blocker as manifested by fasciculations.
Succinylcholine
Contraindications
Contraindications: acute narrow-angle glaucoma, penetrating eye injuries, malignant hyperthermia. Acute injury after multisystem trauma, major burns, or extensive muscle injury. Inability to control airway or support ventilation with oxygen and positive pressure.
Succinylcholine
Adverse effects
Adverse effects: bradydysrhythmia, tachydysrhythmia, dysrhythmia, cardiac arrest, salivation, prolonged muscle rigidity, rhabdomyolysis, malignant hyperthermia, increased intraocular pressure, hyperkalemia (trauma patients)
Succinylcholine
Precautions
Precautions: oxytocin, beta blockers and organophosphates may potentiate effects, diazepam can reduce duration of action
Succinylcholine
Dose & administration
Dose & administration: adult 1 to 1.5mg/kg rapid iv. Repeat once if needed. Pediatrics same as adult. Onset of 1 minute, peak 1 to 3 minutes, duration 5 to 10 minutes.
Lidocaine
Brand name
Brand name: xylocaine
Lidocaine
Drug class
Drug class: antidysrhythmic (sodium channel blocker)
Lidocaine
Indications
Indications: alternative to amiodarone in cardiac arrest from ventricular tachycardia, ventricular fibrillation, stable wide complex tachycardia (poly- or monomorphic) with normal baseline QT interval, stable monomorphic VT with preserved ventricular function.
Lidocaine
Mechanism of action
Mechanism of action: decreases automaticity by slowing the rate of spontaneous phase 4 depolarization: blocks Na+ channels in cardiac myocyte, slows depolarization, suppresses automaticity, resulting in stabilizing ectopic foci by increasing the threshold needed for depolarization.
Lidocaine
Contraindications
Contraindications: hypersensitivity, second or third AV heart block in the absence of an artificial pacemaker, stokes Adam’s syndrome, wide complex ventricular escape beats with bradycardia.
Lidocaine
Adverse effects
Adverse effects: anxiety, drowsiness, confusion, seizures, slurred speech, respiratory arrest, hypotension, bradycardia, dysrhythmias, cardiac arrest, AV block, N/V
Lidocaine
Precautions
Precautions: caution in wolf Parkinson white syndrome cardiac depression seen with phenytoin metabolic clearance reduced with liver disease or use of beta blockers
Lidocaine
Dose & administration
Dose & administration: adult v-tach/V-fib- 1.0 to 1.5mg/kg iv/io may be repeated in 5 to 10 minutes; dose - 0.5 to 0.75mg/kg iv/io maximum dose of 3mg/kg. Stable v-tach 0.5 to 0.75mg/kg iv/io. May repeat does in 5 to 10 minutes with maximum dose of 3mg/kg. Pediatrics 1mg/kg iv/io push with maximum dose of 100mg.
