Airway and Pulmonology

Question 1

Epinephrine 1mg/1mL (1:1000)

Answer 1

Class- Sympathomimetic

Route- IM

Action- Bronchodilation

Indications- Bronchial asthma, Exacerbation of COPD, Allergic reactions, PEDS cardiac arrest (after initial epi dose)

Contraindications- Underlying cardiovascular disease, Hypertension, Pregnancy, tachyarrhythmias

Precautions- protect from light, BP Pulse and EKG must be monitored

Side effects- Palpitations, tachycardia, anxiousness, headache, tremors

Adult-
0.3-0.5mg IV
5-15mg IM

Peds-
0.01mg/kg

Question 2

Terbutaline

Answer 2

Class- Sympathomimetic

Route- Metered dose inhaler or sub Q

Actions- Bronchodilator, increase HR

Indications- Bronchial asthma, Reversible bronchospasm associated with COPD, preterm labor

Contraindications- Hypersensitivity

Precautions- BP Pulse and EKG must be monitored

Side effects- Palpitations, tachycardia, premature ventricular contractions, anxiety, tremors, headache

Adult-
0.25mg

Peds-
0.01mg/kg

Question 3

Magnesium Sulfate

Answer 3

Class- Anticonvulsant and antiarrhythmic

Route- IV, IM

Actions- CNS depressant, Anticonvulsant and antiarrhythmic

Indications-

• • Obstetrical: Eclampsia
• -Cardo: irregular polymorphic ventricular tachycardia

Contraindications- Shock, Heart block

Precautions- Hypotension, Calcium chloride should be on hand for antidote for respiratory depression

Side effects- flushing, Respiratory depression, Drowsiness

Adult-
2g (2000mg)

Peds-
25mg/kg

**Administered slowly over 2-5 minutes

Question 4

Methylprednisolone “Solu-Medrol”

Answer 4

Class- Steroid

Route- IV, IM

Actions- Anti inflammatory, suppresses immune response especially in allergic reactions

Indications- Severe anaphalaxis, Asthma, COPD

Contraindications- None

Precautions- Onset may be 2-6 hours

Side effects- GI bleed, prolonged wound healing, suppression of natural steroids

Adult-
125-250mg

Peds-
7.5mg/kg

Question 5

Diphenhydramine “Benadryl”

Answer 5

Class- Antihistamine

Route- Slow IV Push, Deep IM

Actions- Blocks histamine receptors, minor sedative effects

Indications- Anaphylaxis, Allergic reactions, Dystonic reactions due to phenothiazines

Contraindications- Asthma, nursing mothers

Precautions- Hypotension

Side effects- Sedation, Dries bronchial secretions, Blurred vision, Headache, Palpitations

Adult-
25-50mg

Peds-
2-5mg/kg