Medications

Question 1

Epinephrine

Answer 1

Generic Name: Epinephrine
Classification: Adrenergic agonist (sympathomimetic)
Actions: Stimulates the alpha and beta adrenergic receptions of the SNS resulting in;
(1) Bronchodilation (relaxes smooth muscles of bronchi, histamine rls)
(2)Carduivascular (vasoconstriction, positive beta 1 effects)
Indications: Anaphylaxis
Dosage:
(Adult) EpiPen: .3mg-.9mg (rapt 5-10 mins, to max of .3mg)
(Peds) EpiPen: .15-.3 mg(rpt 5-10 mins, to max of .3mg)
Routes: IM (preferred), SQ
Contraindications: None
Precautions: Underlying cardiovascular disease)
Notes: PT must of rx for EpiPen, must admin it themselves

Question 2

Salbutamol (“kicks the door open”)

Answer 2

Generic Name: Ventolin
Classification: Bronchodilator, Beta 2 adrenergiv agonist (sympathomimectic)
Actions: Selevtively stimulates the beta adrenergic receptors of the SNS resulting in
(1) Broncodilation (relieves bronchospams)
(2) high dose shifts serum potassium into the cell
Indications: Bronchospams (asthma, chronic bronchitis, COPD)
Dosage:
(Adult) Neb: 2.5-5 mg (rpt 10 min prn) MDI: 6-20 puffs
(Peds) Neb: .15mg.kg diluted in 2.5 ml of saline OR
*Under 10 KG : 1.25 mg in 2.5ml of saline
*10-20 mg: 2.5 mg in 2.5 ml of saline
*Over 20 kg: 2.5-5mg in 2.5-5ml of saline
Routes: MDI, NEB
Contraindications: Hypersensitivity
Precautions: Tachydysrthymia, Diabetes mellitus, hypoklemiar
Notes: Use a spacer with MDI, must have RX, must admin themselves

Question 3

Ipratropium Bromide (“holds door open”)

Answer 3

Generic Name: Atrovent
Classification: Anti cholinergic, Bronchodilator
Actions: Inhibits cholinergic receptors in the bronchi smooth muscle resulting in
*Bronchodilation (decreasing concentration of GMP)
Indications: Bronchospasms (asthma, chronic bronchitis, COPD)
Dosage:
(Adult) NEB: 250-500mcg (rpt 2x/prn) MDI: 1-4 puffs (rpt max 10 puff)
(Peds 5-11) NEB: 25-250mcg (rpt 2 x/prn), MDI 2-4puffs (rpt 1 x/prn)
Routes: MDI, NEB
Contraindications: Hypersensitvity to IB or atropine or it’s derivatives
Precautions:
*Hypersensitivity to soy lecithin or soybeans, peanuts
*Narrow angle glaucoma
*Take caution that NEB medication doesnt dry membranes of eyes
Notes: Use a spacer with MDI, slower onset that Ventolin, pt must have RX and admin themselves

Question 4

Oral Glucose

Answer 4

Generic Name: Insta-glucose, Monogel
Classification: Anti-hypoglycaemic, Caloric agent
Actions: A monosaccharide that is given oral and absorbed in the GI track resulting in
*Increase BGL
Indications: Hypoglycemic pt who is
*Alert
*able to follow commands
*maintaining a patent airway
Dosage: 
(Adult) 25g PO (rpt 10 min/prn)
Routes: PO
Contraindications: Hyperglycemia, A pt who is
*non alert
*Cannot follow commands
*not maintaining their airway
Precautions: Pt may gag during admin
Notes: Once LOC and BGL are corrected, more complex carbs should be introduced, admin slowly, avoid placing sublingual or buccally

Question 5

Acetylsalicylic Acid

Answer 5

Generic Name: ASA, Aspirin, Novasen
Classification: Anti-platelet, salicylate, antipyretic, anti-inflammatory, non opioid analgesic
Actions: Antiplatlet (at low doses clotting is impeded)
Indications: Acute Coronary syndromes (acute MI)
Dosage: 160-325mg chewed (no rpt)
Routes: PO (chewed/ swallowed)
Contraindications:
*hypersensitivity
*bleeding disorder
*unconsciousness
Precautions: active ulcer disease, asthma (may produce bronchospasms, Reye’s syndrome)
Notes: the effects of aspiring last the life of the platelet (approx 8 days)