Bronchoconstriction + Allergy Flashcards
Bronchoconstriction Standard
What are the INDICATIONS?
Respiratory distress
AND
Suspected bronchoconstriction
Bronchoconstriction Standard
What are the MEDICATIONS and what receptors of the body do they effect?
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)
Bronchoconstriction Standard
What are the CONDITIONS of salbutamol in bronchoconstriction?
What are the CONTRAINDICATIONS for salbutamol?
N/A
Allergy or sensitivity
Bronchoconstriction Standard
What are the CONDITIONS for Epinephrine?
What are the CONTRAINDICATIONS for epinephrine?
BVM ventilation required
AND
hx of asthma
Allergy or sensitivity
Bronchoconstriction Standard
What are the CONDITIONS for Dexamethasone?
What are the CONTRAINDICATIONS for dexamethasone?
Hx of asthma
OR
COPD
OR
20-pack year hx of smoking
Allergy or sensitivity to steroids
OR
currently on PO/parenteral
Common Corticosteroids Include:
9 including dex
- Beclomethasone
- Betamethasone
- Budesonide
- Cortisone
- Dexamethasone
- Hydrocortisone
- Methylprednisolone
- Prednisolone and Prednisone
What are the 5 Rights?
Patient
Drug
Dose
Route
Time
Bronchoconstriction Standard
What is Salbutamol’s TREATMENT plan for either route in a patient LESS than 25kg?
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
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?
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.
Bronchoconstriction Standard
What is the TREATMENT plan, concentration, and route for Epinephrine?
Dose - 0.01mg/kg
Max (Single) Dose - 0.5mg
Dosing Interval - no interval
Max # of doses - 1
Concentration is 1:1000
Route is IM
Bronchoconstriction Standard
What is the TREATMENT plan AND route of dexamethasone for bronchoconstriction?
Dose - 0.5mg.kg
Max (Single) Dose - 8mg
Dosing Interval - no interval
Max # of doses - 1
Route is PO/IM/IV
Which medication do you administer for an apneic patient?
Epinephrine
What is the rate to give MDI medication?
100mcg (1 puff) every 4 breaths
When is nebulization CONTRAINDICATED?
Patient is known or suspected to have a fever (FRI)
Patient is unconcious
Patient is not in a position (physical) to be nebulized
What is a spacer?
The plastic apparatus that hold the medication between the MDI and the patients mouth
Bronchoconstriction Standard
Symptoms of bronchoconstriction?
How do you hear that?
Wheezing, coughing, dyspnea, and decreased air entry with silent chest
Auscultation
Bronchoconstriction Standard
When do you give Dexamethasone IM or IV over giving it PO.
extremely short of breath
suspected respiratory failure
and
all other care has been provided
Bronchoconstriction Standard
Can you use Dexamethasone with any other bronchoconstriction medications?
Yes you can use it in conjunction with salbutamol, epinephrine, AND CPAP.
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?
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
Moderate to Severe Allergic Reaction Medical Directive
What are the MEDICATIONS used?
Epinephrine and Diphenhydramine (benadryl)
Moderate to Severe Allergic Reaction Medical Directive
What are the CONDITIONS for Epinephrine?
What are the CONTRAINDICATIONS?
For anaphylaxis
Allergy or sensitivity
Moderate to Severe Allergic Reaction Medical Directive
What are the CONDITIONS for Diphenhydramine?
What are the CONTRAINDICATIONS?
The patient must be GREATER/EQAUL to 25kg
Allergy or sensitivity
Moderate to Severe Allergic Reaction Medical Directive
What is the TREATMENT plan, CONCENTRATION, and ROUTE for Epinephrine?
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
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?
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
