MOD I Medications

Question 1

Ipratropium Bromide Dosages

Answer 1

-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

Question 2

Ipratropium Bromide Classification & MoA

Answer 2

Classifications:
Anti Cholinergic

Bronchodilator

MoA
Inhibits interaction of acetylcholine at receptor site on bronchial smooth muscle.

Question 3

Ipratropium Bromide Indications, Contraindications, adverse effects

Answer 3

Indications:
Bronchial Asthma, COPD, Emphysema, Chronic Bronchitis, Anaphylaxis, Burns, Toxic Inhalation

Contraindication:
Hypersensitivity

Adverse Effects
Tachycardia, Nausea/vomiting, headache, blurred vision

Question 4

Albuterol Classifications / MoA

Answer 4

Classifications:
Beta2 Agonist, Sympathomimetic Bronchodilator

MoA
Relaxes bronchial smooth muscle but stimulating Beta2 receptors resulting in bronchodilation and decreased airway resistance.

Question 5

Albuterol Indications, Contraindications, Adverse Effects

Answer 5

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

Question 6

Albuterol Dosages

Answer 6

• 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

Question 7

Ondansetron Classifications / MoA

Answer 7

Classification: Antiemetic
MoA: Selective 5-HT3 Serotonin receptor antagonist

Question 8

Ondansetron Indications / Contraindications

Answer 8

Indications: Control / prevent nausea & vomiting

Contraindications:
Prolonged QT Syndrome

Question 9

Ondansetron Adverse Effects / Dosages

Answer 9

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

Question 10

Naloxone Classification / MoA/ Pharm

Answer 10

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

Question 11

Naloxone Indications/Contraindications/ Adverse Effects

Answer 11

Indications:
Reverse respiratory and CNS System depression induced by opiates

Contraindications:
Newborns / neonates of addicted mothers.

Adverse Effects:
NONE

Question 12

Naloxone Dosages

Answer 12

-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.

Question 13

Magnesium Sulfate Classifications

Answer 13

Electrolyte, Antidysrhythmic, Anticonvulsant, CNS Depressant, Smooth Muscle Relaxant

Question 14

Magnesium Sulfate MoA

Answer 14

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.

Question 15

Magnesium Sulfate Indications / Contraindications

Answer 15

Indications:
Preeclampsia/eclampsia, Torsades des Pointes, Refractory Ventricular Fibrillation, Pulseless Ventricular Tachycardia with suspected hypomagnesemia, Status asthmaticus

Contraindications:
Myasthenia Gravis, Impaired renal function

Question 16

Magnesium Sulfate Dosages

Answer 16

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

Question 17

Methylprednisolone Classifications / MoA

Answer 17

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

Question 18

Methylprednisolone Indications / Contraindications / Adverse effects

Answer 18

Indications:
Allergic Reaction, Anaphylaxis, Asthma, COPD

Contraindications:
Known hypersensitivity, Premature Infant, Systemic fungal infection

Adverse Effects: None from single dose

Question 19

Methylprednisolone Dosages

Answer 19

Adult:
125mg Slow IV/IO/IM

Pediatric:
2mg/kg slow IV/IO/IM (max dose of 125mg)