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Sara's - Medical Directives > Bronchoconstriction + Allergy > Flashcards

Bronchoconstriction + Allergy Flashcards

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USMLE® Step 1 flashcards
1
Q

Bronchoconstriction Standard

What are the INDICATIONS?

A

Respiratory distress
AND
Suspected bronchoconstriction

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2
Q

Bronchoconstriction Standard

What are the MEDICATIONS and what receptors of the body do they effect?

A

Salbutamol - selective beta 2 adrenergic receptor agonist
Epinephrine - alpha and beta adrenergic agonist (is a bronchodilator and anti-spasmodic)
Dexamethasone - steroid that binds to glucocorticoid receptors (inhibits pro-inflammatory
signals and promotes anti-inflammatory signals)

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3
Q

Bronchoconstriction Standard

What are the CONDITIONS of salbutamol in bronchoconstriction?

What are the CONTRAINDICATIONS for salbutamol?

A

N/A

Allergy or sensitivity

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4
Q

Bronchoconstriction Standard

What are the CONDITIONS for Epinephrine?

What are the CONTRAINDICATIONS for epinephrine?

A

BVM ventilation required
AND
hx of asthma

Allergy or sensitivity

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5
Q

Bronchoconstriction Standard

What are the CONDITIONS for Dexamethasone?

What are the CONTRAINDICATIONS for dexamethasone?

A

Hx of asthma
OR
COPD
OR
20-pack year hx of smoking

Allergy or sensitivity to steroids
OR
currently on PO/parenteral

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6
Q

Common Corticosteroids Include:

9 including dex

A
  • Beclomethasone
  • Betamethasone
  • Budesonide
  • Cortisone
  • Dexamethasone
  • Hydrocortisone
  • Methylprednisolone
  • Prednisolone and Prednisone
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7
Q

What are the 5 Rights?

A

Patient
Drug
Dose
Route
Time

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8
Q

Bronchoconstriction Standard

What is Salbutamol’s TREATMENT plan for either route in a patient LESS than 25kg?

A

MDI:
Dose - Up to 600mcg (6 puffs)

Max (Single) Dose - 600mcg

Dosing Interval - 5-15min PRN

Max # of doses - 3

NEB:
Dose - 2.5mg

Max (Single) Dose - 2.5mg

Dosing Interval - 5-15min PRN

Max # of Doses - 3

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9
Q

Bronchoconstriction Standard

What is Salbutamol’s TREATMENT plan for either route for a patient GREATER/EQUAL to 25kg?

Can sabutamol be used with a BVM?

A

MDI:
Dose - up to 800mcg (8 puffs)

Max (Single) Dose - 800mcg

Dosing Interval - 5-15min PRN

Max # of doses - 3

NEB:
Dose - 5mg

Max (Single) Dose - 5mg

Dosing Interval - 5-15min PRN

Max # of Doses - 3

YES, you can administer salbutamol using a BVM MDI adapter.

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10
Q

Bronchoconstriction Standard

What is the TREATMENT plan, concentration, and route for Epinephrine?

A

Dose - 0.01mg/kg

Max (Single) Dose - 0.5mg

Dosing Interval - no interval

Max # of doses - 1

Concentration is 1:1000
Route is IM

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11
Q

Bronchoconstriction Standard

What is the TREATMENT plan AND route of dexamethasone for bronchoconstriction?

A

Dose - 0.5mg.kg

Max (Single) Dose - 8mg

Dosing Interval - no interval

Max # of doses - 1

Route is PO/IM/IV

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12
Q

Which medication do you administer for an apneic patient?

A

Epinephrine

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13
Q

What is the rate to give MDI medication?

A

100mcg (1 puff) every 4 breaths

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14
Q

When is nebulization CONTRAINDICATED?

A

Patient is known or suspected to have a fever (FRI)

Patient is unconcious

Patient is not in a position (physical) to be nebulized

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15
Q

What is a spacer?

A

The plastic apparatus that hold the medication between the MDI and the patients mouth

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16
Q

Bronchoconstriction Standard

Symptoms of bronchoconstriction?

How do you hear that?

A

Wheezing, coughing, dyspnea, and decreased air entry with silent chest

Auscultation

17
Q

Bronchoconstriction Standard

When do you give Dexamethasone IM or IV over giving it PO.

A

extremely short of breath
suspected respiratory failure
and
all other care has been provided

18
Q

Bronchoconstriction Standard

Can you use Dexamethasone with any other bronchoconstriction medications?

A

Yes you can use it in conjunction with salbutamol, epinephrine, AND CPAP.

19
Q

Moderate to Severe Allergic Reaction Medical Directive

What are the INDICATIONS for Severe Allergic Reaction?

What’s the clinical consideration for epinephrine?

What are the clinical considerations for diphenhydramine?

A

Exposure to a probable allergen
AND
Signs + Symptoms of a moderate-severe allergic reaction

Epinephrine takes priority over IV access

ONLY IV autonomous PCPs can administer diphenhydramine

20
Q

Moderate to Severe Allergic Reaction Medical Directive

What are the MEDICATIONS used?

A

Epinephrine and Diphenhydramine (benadryl)

21
Q

Moderate to Severe Allergic Reaction Medical Directive

What are the CONDITIONS for Epinephrine?

What are the CONTRAINDICATIONS?

A

For anaphylaxis

Allergy or sensitivity

22
Q

Moderate to Severe Allergic Reaction Medical Directive

What are the CONDITIONS for Diphenhydramine?

What are the CONTRAINDICATIONS?

A

The patient must be GREATER/EQAUL to 25kg

Allergy or sensitivity

23
Q

Moderate to Severe Allergic Reaction Medical Directive

What is the TREATMENT plan, CONCENTRATION, and ROUTE for Epinephrine?

A

Dose - 0.01mg/kg

Max (Single) Dose - 0.5mg/kg

Dosing Intervals - minimum 5 minutues

Max # of Doses - 2

Concentration is 1:1000
Route is IM

24
Q

Moderate to Severe Allergic Reaction Medical Directive

What are the ROUTES and the TREATMENT plan for Diphenhydramine for a patient who is GREATER/EQUAL to 25kg up to LESS than 50kg?

What are the ROUTES and the TREATMENT plan for Diphenhydramine for a patient who is GREATER or EQUAL to 50kg?

A

Routes can be either IV or IM

Dose - 25mg

Max (Single) Dose - 25mg

Dosing Interval - no interval

Max # of Doses - 1

Route can be either IV or IM

Dose - 50mg

Max (Single) Dose - 50mg

Dosing Interval - no interval

Max # of doses - 1

25
Q

Moderate to Severe Allergic Reaction Medical Directive

What should you do if no urticaria?

A

The patient must present with at least one other sign or symptom involving another organ system or severe symptom.

Sara's - Medical Directives (16 decks)

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