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ALS Medical Directives > Bronchoconstriction MD > Flashcards

Bronchoconstriction MD Flashcards

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USMLE® Step 1 flashcards
1
Q

What are the indications?

A

respiratory distress or suspected bronchoconstricton

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2
Q

What is the first medication we give in this directive?

A

Ventolin (salbutamol)

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3
Q

What are the conditions for salbutamol?

A

N/A

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4
Q

What are conditions for EPINEPhrine?

A

RR- BVM ventilation required
Other- Hx of ASTHMA

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5
Q

What are symptoms of bronchoconstriction?

A

wheezing
coughing
dyspnea
decreased air entry
silent chest

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6
Q

When does the administration of EPI need to happen FIRST? (before salbutamol)

A

If the pt is in SEVERE distressssss!!!!!!!!
- apneic

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7
Q

What are the conditions for dex?

A

other- Hx of asthma OR COPD, OR 20-pack year history of smoking!!

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8
Q

What are the contraindications for salbutamol?

A

ax or sensitivity

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9
Q

What are the contraindications for EPI?

A

ax or sensitivity

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10
Q

What are the contraindications for DEX??

A

ax or sensitivity
currently on PO or parenteral steroids (tablets or diff routes of steroids)

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11
Q

What is the TREATMENT for salbutamol?

A

<25kg - MDI
up to 600 mcg (6 puffs)
dose interval: 5-15PRN
max # of doses= 3

NEB - 2.5mg
dose interval: 5-15PRN
max # of doses= 3

> =25kg - MDI
up to 800 mcg (8 puffs)
dose interval: 5-15PRN
max # of doses= 3

NEB - 5mg
dose interval: 5-15PRN
max # of doses= 3

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12
Q

What is the TREATMENT for EPI?

A

IM
Concentration= 1mg/ml
Dose- 0.01mg/kg
MAX single dose- 0.5mg
Dosing interval- N/A
Max # of doses- 1

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13
Q

What is the TREATMENT for DEX?

A

PO/IM/IV
Dose- 0.5mg/kg
Max- 8mg
Dosing Interval- N/A
Max # of doses- 1

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14
Q

What is a contraindication to the nebulizer??!

A

FEVER OR SUSPECTED FEVER

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15
Q

At WHAT rate should we administer MDI meds?

A

Should be 100mcg (1 puff) every FOUR breaths!!

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16
Q

What do we need to remember to use when administering a medication MDI?

A

a spacer!!

17
Q

Which route is preferred when giving salbutamol?

A

MDI !!!!

18
Q

How long would it take to administer a full dose of salbutamol MDI?

A

1 minute (32 breaths/min)

19
Q

When should dexamethasone be given IM/IV?

A

PO is the preferred route and it should ONLY be given IM/IV if the pt is extremely short of breath in suspected respiratory failure and all other care has been provided.

20
Q

When treating with dexamethasone, the contraindication only applies to systemic steroids (PO, parenteral) and not inhaled or topical steroids. Why is that?

A

Inhaled steroids are very specific to LUNG tissue and do NOT contribute to systemic absorption.

ALS Medical Directives (12 decks)

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