Drug Quiz 2 Flashcards
Albuterol Sulfate
Proventil HFA, ProAir HFA
Albuterol Sulfate Drug Classification
Sympathomimetic/Sympathetic agonist (b2 selective)
Albuterol Sulfate Mechanism of Action
B2 agonist->bronchodilation
Albuterol Sulfate Pharmacokinetics
Onset of Action=5-15 min
Peak effects=1-1.5 hours
Duration of effect=3-6 hours
Half-Life=< 3 hours
Albuterol Sulfate Indications/Field use
1) Asthma
2) Reversible bronchospasm associated with COPD
Albuterol Sulfate Contraindications
Symptomatic tachycardia, pts with a history of hypersensitivity to this drug
Albuterol Sulfate Side Effects/Adverse Reactions
Anxiety, HA, palpitations, sweating, dizziness, nervousness, tremor, HTN, arrhythmias, chest pain, N+V
Albuterol Sulfate Dose
MDI: (Adult) 1 or 2 sprays (90mg/spray)
Small-volume nebulizer: (Adult) 2.5mg in 2.5mL NS over 5-15min
Small-volume nebulizer: (Pedi) 2.5mg in 2.5mL NS over 5-15min
Albuterol Sulfate Precautions
1) BP, pulse, and EKG should be monitored
2) use caution with pts with known heart disease or HTN
3) auscultate LS before and after treatment
Albuterol Sulfate Drug-Drug Interactions
1) SE may increase with other sympathetic agonists
2) B blockers may blunt effects of this drug
3) MAOI and TCA may potentiate cardiovascular effects
Ipratroprium Bromide
Atrovent
Ipratroprium Bromide Drug Classification
Anticholinergic/Parasympathetic
Ipratroprium Bromide Mechanism of Action
Muscarinic ACh-R blocker->inhibits parasympathetic stimulation and vagally mediated responses by preventing increase in intracellular cGMP in bronchial smooth muscle->dries respiratory tract secretions and allows for bronchodilation
Ipratroprium Bromide Pharmacokinetics
Onset of Action=varies
Peak Effects=1.5-2hours
Duration of Effect=4-6hours
Half-Life=1.5-2hours
Ipratroprium Bromide Indications/Field use
1) Bronchial Asthma
2) Reversible bronchospasm associated with COPD
Ipratroprium Bromide Contraindications
1) pts with history of hypersensitivity?
2) should not be used as primary acute treatment of bronchospasm
Ipratroprium Bromide Side Effects/Adverse Reactions
Anxiety, HA, palpitations, dizziness, nervousness, rash, N+V
Ipratroprium Bromide Dose
Small-volume nebulizer: (Adult) 500mg-typically administered with a beta agonist
Small-volume nebulizer: (Pedi) 250-500mg q20min PRN
Also available as MDI
Ipratroprium Bromide Precautions
1) BP, pulse, and EKG should be monitored
2) use caution with pts with known heart disease or HTN and elderly
3) auscultate LS before and after treatment
Ipratroprium Bromide Drug-Drug Interactions
Few prehospitally, not specified
Magnesium Sulfate drug classification
Electrolyte/Antidysrhythmic/Mineral
Magnesium Sulfate Mechanism of Action
Psycologic Ca2+ channel blocker->blocks neuromuscular transmission, causes CNS depressants and smooth muscle relaxation
Magnesium Sulfate Pharmacokinetics
Onset of Action=Immediate IV, 1 hour IM
Peak Effects=Varies
Duration of Effect=1 hour
Half-Life=N/A
Magnesium Sulfate Indications/Field Use
1) Severe Asthma/ Bronchospasm
2) Severe refractory VF or pulseless VT with hypoMg2+ and Torsades de Pointes
3) Post-MI prophylaxis of dysrhythmias
4) Ecclampsia, Pre-Term Labor
Magnesium Sulfate Contraindications
Pt with 3rd degree heart block, shock, severe/persistent hypertension, impaired renal function, hypocalcemia
Magnesium Sulfate Side Effects\Adverse Reactions
Flushing, Sweating, Bradycardia, Decreased Deep tendon reflexes, drowsiness, respiratory depression, dysrhythmias, hypotension, hypothermia, itching, rash
Magnesium Sulfate Dose
Asthma (Adult): 2g in 100cc NS IV, IO infusion over 10 minutes
VT, VF Torsades-no pulse (Adult): 2g IVP (IO) over 1-2 minutes
VT/Torsades +pulse (Adult): 1-2g in 50-100cc NS, slow IVP (IO) over 5-60 minutes
Eclampsia (Adult): 2-4g slow IV, IO over 25 minutes, IM if IV access unavailable
Asthma (Pedi): 25-50mg/kg slow IV, IO infusion over 15-30 minutes, max dose 2g
VT -no pulse (Pedi): 25-50mg/kg IVP (IO), max dose 2g
VT +pulse (Pedi): 25-50mg/kg IV, IO over 10-20 minutes, max dose 2g
Magnesium Sulfate Precautions
1) Monitor Vitals
2) Watch for Respiratory Depression
3) Have CaCl2 available if OD
Magnesium Sulfate Drug-Drug Interactions
Cardiac conduction abnormalities if given with digitalis
Methylpredisolone
Solu-Medrol
Methylpredisolone drug classification
Corticosteroid/Anti-inflammatory
Methylpredisolone Mechanism of action
Diffuses across the cell membrane, binds to DNA, regulates gene expression and increases synthesis of proteins and enzymes that inhibit inflammatory agents (cytokines, interleukin, interferon); inhibits synthesis of pro-inflammatory enzymes. It is an immunosupressant
Methylpredisolone Pharmacokinetics
Onset of Action=2-6 hours
Peak Effects=4-8 days
Duration of Effect=1-5 weeks
Half-Life=3.5 hours
Methylpredisolone Indications/Field Use
1) Severe Anaphylaxis, hives
2) Asthma, COPD
3) Spinal cord injury
Methylpredisolone Contraindications
None in EMS
Methylpredisolone Side Effects/Adverse Reactions
Fluid retention, CHF, HTN, abd. distension, vertigo, HA, nausea malaise, hiccups
Methylpredisolone dose
Asthma/Anaphylaxis (Adult): 125-250mg IV, IO
Spinal Cord Injury (Adult): 30mg/kg IV, IO over 15 min, maintenance 5.4mg/kg/hr for 24-48 hours
Asthma/Anaphylaxis (Pedi): 2mg/kg IV, IO, IM; max dose 80mg
Methylpredisolone Precautions
1) Give only one dose prehospitally
2) LT steroid use can cause GI bleeding
3) prolonged wound healing
4) and suppression of adrenocortical steroids
Methylpredisolone drug-drug interactions
1) Lasix and thiazide diuretics increase potassium loss
2) Decreased effect with phenytoin, phenobarbital, and rifampin due to increased metabolism of steroids
