MEDICATIONS Flashcards
Ipratropium Bromide Dosages
-Adult:
.5mg via handheld neb
Duoneb with 2.5mg albuterol
No repeat dose
-Pediatric
(Over 2/20kg) .5mg w/ 2.5mg Albuterol Duoneb
(Under 2/20kg) .25mg w/ 1.25mg Albuterol
Ipratropium Bromide Classification & MoA
Classifications:
Anti Cholinergic
Bronchodilator
MoA
Inhibits interaction of acetylcholine at receptor site on bronchial smooth muscle.
Ipratropium Bromide Indications, Contraindications, adverse effects
Indications:
Bronchial Asthma, COPD, Emphysema, Chronic Bronchitis, Anaphylaxis, Burns, Toxic Inhalation
Contraindication:
Hypersensitivity
Adverse Effects
Tachycardia, Nausea/vomiting, headache, blurred vision
Albuterol Classifications / MoA
Classifications:
Beta2 Agonist, Sympathomimetic Bronchodilator
MoA
Relaxes bronchial smooth muscle but stimulating Beta2 receptors resulting in bronchodilation and decreased airway resistance.
Albuterol Indications, Contraindications, Adverse Effects
Indications:
Bronchial Asthma, COPD/Emphysema/Chronic Bronchitis, Bronchospasm due to Anaphylaxis, burns, toxic inhalation, crush syndrome > 4 hours
Contraindications:
Tachydysrhythmias
Adverse Effects:
Tachycardia, Anxiety, Dysrhythmias, throat irritation, tremors, palpations, dry mouth.
Albuterol Dosages
-Adult:
2.5MG-5MG via handheld Neb
Duoneb with .5mg Atrovent
-Pediatric (>2/20kg)
2.5mg via Neb
Duoneb with .5mg Atrovent
-Pediatric (<2/20kg)
1.25mg via Neb
Duoneb with .25mg Atrovent
Ondansetron Classifications / MoA
Classification: Antiemetic
MoA: Selective 5-HT3 Serotonin receptor antagonist
Ondansetron Indications / Contraindications
Indications: Control / prevent nausea & vomiting
Contraindications:
Prolonged QT Syndrome
Ondansetron Adverse Effects / Dosages
Adverse Effects: GI Symptoms, Headache,Fever,Blurred Vision, Chest Pain, EKG Changes
Dosages: -Adult: 4mg undiluted slow IV / 4mg ODT Tablet -Pediatric 0.1mg/kg slow IV max 4mg Over 2/20kg 4mg tablet ODT Under 2/20kg 2mg Tablet ODT
Naloxone Classification / MoA/ Pharm
Classification : Narcotic Antagonist
MoA: Reverses all effects due to opioid agents. Reverses respiratory depression and all CNS PNS system effects.
Pharm: Onset within few minutes via IV
IM/ET results in slower onset of action
Naloxone Indications/Contraindications/ Adverse Effects
Indications:
Reverse respiratory and CNS System depression induced by opiates
Contraindications:
Newborns / neonates of addicted mothers.
Adverse Effects:
NONE
Naloxone Dosages
-Adult:
.4mg - 2mg IV/IO/IM or 2mg in 2ml IN, Repeat as necessary to maintain respiratory activity.
-Pediatric:
.1mg/kg IVP/IO/IM/IN up to max initial dose of 2mg, Max of .5mg/kg total dose.
Magnesium Sulfate Classifications
Electrolyte, Antidysrhythmic, Anticonvulsant, CNS Depressant, Smooth Muscle Relaxant
Magnesium Sulfate MoA
As antidysrhythmic, Magnesium sulfate is a physiological calcium channel blocker reducing SA Node impulse formation and prolongs conduction time in the myocardium.
As anticonvulsant, Magnesium sulfate redusces striated muscle contractions and blocks peripheral neuromuscular transmission by reducing acetylcholine release at the myoneural junction.
Magnesium Sulfate Indications / Contraindications
Indications:
Preeclampsia/eclampsia, Torsades des Pointes, Refractory Ventricular Fibrillation, Pulseless Ventricular Tachycardia with suspected hypomagnesemia, Status asthmaticus
Contraindications:
Myasthenia Gravis, Impaired renal function
Magnesium Sulfate Dosages
Eclamptic Seizure:
4g diluted in 50ml NS / D5W and slow IV infusion over 5-10 Min
Torsades De Pointes w/ pulse:
2g diluted in 50ml D5W slow IVP over 10 min.
Refractory VF & Torsades De Pointes w/o Pulse:
Adult : 1-2g diluted in 50ml D5W slow IVP over 2min.
Pediatric : 25mg - 50mg/kg diluted in 50ml Slow IV/IO push over 2 minutes. Max dose of 2g
Status Asthmaticus;
1g-2g in 50ml NS / D5W IV over 5-10 min
Methylprednisolone Classifications / MoA
Classifications:
Corticosteroid, Anti-inflammatory, Suppresses immune response
MoA:
Enters target cells and causes many complex reactions that are responsible for its anti-inflammatory and immunosuppressive effects. Thought to stabilize cellular and intracellular membranes. Onset within 1-6 hours
Methylprednisolone Indications / Contraindications / Adverse effects
Indications:
Allergic Reaction, Anaphylaxis, Asthma, COPD
Contraindications:
Known hypersensitivity, Premature Infant, Systemic fungal infection
Adverse Effects: None from single dose
Methylprednisolone Dosages
Adult:
125mg Slow IV/IO/IM
Pediatric:
2mg/kg slow IV/IO/IM (max dose of 125mg)
Epinephrine
Indications, Contraindications, Adverse Effects
Indications:
Cardiac Arrest, Anaphylaxis, Bronchial Asthma, Respiratory Stridor (suspected croup), sympathomimetic bradycardia, return of spontaneous circulation
Contraindications:
Hypertension
Adverse Effects:
Tachydysrhythmias, hypertension, may induce early labor in pregnancy women, headache, nervousness, tremors/shakes, rebound edema after 20-30 minutes in croup patients
Epinephrine
Classification, MoA
Class: Adrenergic Catecolamine, Sympathomimetic Vasopressor
MoA: Administration of epi causes “fight or flight” response
Alpha: Peripheral Vasoconstriction
Beta1: Increased inotropy, chronograph, dromotrophy, automaticity.
Beta2: Bronchodialation & skeletal muscle vasodialation
Epinephrine
Dosage
Anaphylaxis / Asthma:
**for severe anaphylaxis with life threatening manifestations, consider 0.1MG (1:10,000) slow IV/IO infusion over 5 minutes.
Adult: 0.3-0.5mg (1:1,000) SQ/IM
Ped: 0.01mg/kg (1:1,000) SQ / IM Not exceeding 0.3mg
Croup:
Ped: 1:1,000 3mg via nebulizer, diluted in 3mg NS, 1 repeat dose. / 0.01mg/kg (not to exceed .3mg) SC/IM
Furosemide
Classification, MoA
Class: Loop Diuretic
MoA: Inhibits reabsorption of sodium chloride in the loop of Henle & proximal tubule of the nephron in the kidneys.
Furosemide
Indications, Contraindications
Indications: CHF, Pulmonary Edema
Contraindications: Hypovolemia/ Dehydration, Hypokalemia/ electrolyte diffusion
Furosemide
Adverse Effects, Precautions
Adverse Effects: Hypotension, Electrolyte Imbalance
Precaution: Flush line well before & after administration
Furosemide
Dosage
Dosage:
0.5mg-1mg / kg IV/IO
(40mg if not taking Lasix, 80mg If taking lasix)