Bronchoconstriction MD

Question 1

What are the indications?

Answer 1

respiratory distress or suspected bronchoconstricton

Question 2

What is the first medication we give in this directive?

Answer 2

Ventolin (salbutamol)

Question 3

What are the conditions for salbutamol?

Answer 3

N/A

Question 4

What are conditions for EPINEPhrine?

Answer 4

RR- BVM ventilation required
Other- Hx of ASTHMA

Question 5

What are symptoms of bronchoconstriction?

Answer 5

wheezing
coughing
dyspnea
decreased air entry
silent chest

Question 6

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

Answer 6

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

Question 7

What are the conditions for dex?

Answer 7

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

Question 8

What are the contraindications for salbutamol?

Answer 8

ax or sensitivity

Question 9

What are the contraindications for EPI?

Answer 9

ax or sensitivity

Question 10

What are the contraindications for DEX??

Answer 10

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

Question 11

What is the TREATMENT for salbutamol?

Answer 11

<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

Question 12

What is the TREATMENT for EPI?

Answer 12

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

Question 13

What is the TREATMENT for DEX?

Answer 13

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

Question 14

What is a contraindication to the nebulizer??!

Answer 14

FEVER OR SUSPECTED FEVER

Question 15

At WHAT rate should we administer MDI meds?

Answer 15

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

Question 16

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

Answer 16

a spacer!!

Question 17

Which route is preferred when giving salbutamol?

Answer 17

MDI !!!!

Question 18

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

Answer 18

1 minute (32 breaths/min)

Question 19

When should dexamethasone be given IM/IV?

Answer 19

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.

Question 20

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

Answer 20

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