MODULE 1 MEDICATIONS Flashcards
ALBUTUEROL SULFATE (Proventil, Ventolin)
CLASSIFICATION
- Beta 2 Agonist
- Sympathomimetic Bronchodialtor
ALBUTEROL SULFATE (Proventil, Ventolin)
ADULT Dosages
- 2.5mg - 5mg via nebulizer
- Can be administered as a DuoNeb with 0.5mg Atrovent
ALBUTEROL SULFATE (Proventil, Ventolin)
PEDIATRIC Dosages
OVER 2 YEARS OLD or GREATER THAN 20 kg
- 2.5mg via nebulizer
-can be administer as DuoNeb with 0.5 mg Atrovent
UNDER 2 YEARS OLD or LESS THAN 20 kg
- 1.25mg via nubulizer
- Can be administered as DuoNeb with 0.25 mg Atrovent
ALBUTEROL SULFATE (Proventil, Ventolin)
Mechanism of Action
-Relaxes bronchial smooth muscles by stimulating beta 2 receptors resulting in bronchodialation and decrease airway resistance
ALBUTEROL SULFATE (Proventil, Ventolin)
Pharmacokinetics
-onset of action within 5 to 15 minutes after inhalation, usually prompt improvement
ALBUTEROL SULFATE (Proventil, Ventolin)
Indications
- Bronchial Asthma
- Bronchospasm due to
•anaphylaxis
•Inhalation of toxic inhalation
•burns - COPD
- Chronic Bronchitis
- Emphysema
- Crush Syndrome (greater than 4hrs)
ALBUTEROL SULFATE (Proventil, Ventolin)
Contraindications
-Known Hypersensitivity
-Tachydysrythmias
ALBUTEROL SULFATE (Proventil, Ventolin)
Adverse Reactions
- Tachycardia
- Tremors
- Throat irritations
- Dysrhythmias
- Dry mouth
- Anxiety
- Palpitations
ALBUTEROL SULFATE (Proventil, Ventolin)
PEARLS
- 1st dose administered in conjunction with Atrovent. Subsequent doses are Albuterol ONLY.
- 6 to 8 LMP O2 necessary to activate nebulizer medications
- Medication chamber must remain upright for effective delivery
- Nebulizers can be adapted to accommodate a mask or for use during BVM and/or ET intubation administration
IPRATROPIUM BROMIDE (Atrovent)
Classification
- Anticholinergic
- Bronchodilator
IPRATROPIUM BROMIDE (Atrovent)
ADULT Dosages
- 0.5 mg via nebulizer
- Adminster as DuoNeb with 2.5 mg Albuterol
- NO repeat Dosage for Atrovent
IPRATROPIUM BROMIDE (Atrovent)
PEDIATRIC Dosages
OVER 2 YEARS OLD or OVER 20 kg
- 0.5mg via nebulizer with 2.5 mg Albuterol
UNDER 2 YEARS OLD or UNDER 20 kg
- 0.25 mg via nebulizer with 1.25 mg Albuterol
- NO Repeat dosage for Atrovent
IPRATROPIUM BROMIDE (Atrovent)
Indications
- Bronchial Asthma
- Anaphylaxis
- Burns
- Toxic Inhalation
- COPD
- Emphysema
- Chronic Bronchitis
IPRATROPIUM BROMIDE (Atrovent)
Mechanism of Action
- Inhibits interaction of acetylcholine at receptor sites on bronchial smooth muscle
IPRATROPIUM BROMIDE (Atrovent)
Contraindications
- Known Hypersensitivity to Ipratopium Bromide AND/OR Atropine
IPRATROPIUM BROMIDE (Atrovent)
Adverse Effects
- Tachycardia
- Nausea
- Vomiting
- Headache
- Blurred vision
IPRATROPIUM BROMIDE (Atrovent)
PEARLS
- Soy and Peanut allergies may be a contraindication for Atrovent. The soy lecithin indgrient that causes the cascade is found in Combivent MDI’s
- Always follow local protocols
MAGNEIUM SULFATE
Classification
- Antidysrythmia
- Anticonvulsant
- Electrolyte
- CNS Depressant
- Smooth Muscle Relaxant
MAGNEISUM SULFATE
DOSAGE - Eclamptic Seizure
- 4 g Diluted in 50 ml normal saline (OR D5W)
- Slow IV infusion over 5 - 10 min
MAGNESIUM SULFATE
DOSAGE - Status Asthmaticus
- 1 to 2 g in 50 ml normal saline (OR D5W)
- IVP over 5 - 10 minutes
MAGNESIUM SULFATE
DOSAGE - Torsades de Pointes w/ pulse
- 2 g diluted in 50 ml D5W
- Slow IVP over 10 min
MAGNEIUM SULFATE
DOSAGE - Refractory VF and Torsades de Pointes WITHOUT pulse
ADULT
ADULT
- 1 to 2 g diluted in 50 ml D5W
- Slow IVP over 2 min
MAGNESIUM SULFATE
DOSAGE - Refractory VF and Torsades de Pointes WITHOUT pulse
PEDIATRIC
PEDIACTRIC
- 25 to 50 mg /kg in 50 ml
- Slow IV/IO over 2 minutes.
MAX DOSE OF 2 G
MAGNESIUM SULFATE
Mechanism of Action
- As an antidysrhymthmic, Magnesium Sulfate is a physiological Calcium Channel Blocker that reduces SA node impulse formation and prolongs conduction in the myocardium
- As an anticonvulsant, Magnesium Sulfate reduces striated muscle contractions and blocks peripheral neuromuscular transmission by reducing acetylcholine at the myoneural junction
MAGNESIUM SULFATE
Indications
- Preeclampsia/Eclampsia
- Status Asthmaticus
- Torsades des Pointes
- Refractory Ventricular Fibrillation
- Pulseless Ventricular Tachycardia w/ suspected hypomagnesemia
MAGNESIUM SULFATE
Contraindications
- Myasthenia Gravis
- Impaired renal function ( Includes dialysis patients)
MAGNESIUM SULFATE
Pearls
- Torsades de Pointes may require doses of 5 to 9 g of Magnesium Sulfate
- As a smooth muscle relaxant, Magnesium Sulfate is an effective second line intervention for refractory asthma
- If eclamptic seizures are refractory to Magnesium Sulfate, proceed to Benzodiazepine medication
METHYLPREDNISOLONE (Solu-Medrol)
Classification
- Corticosteroid
- Anti-inflammatory
- Suppresses immune response (especially in allergic reactions)
METHYLPREDNISOLONE (Solu-Medrol)
ADULT Dosage
- 125 mg slow IV/IM/IO
METHYLPREDNISOLONE (Solu-Medrol)
PEDIATRIC Dosage
- 2 mg/kg
- Slow IV/IO/IM
*MAX DOSE 125 mg
METHYLPREDNISOLONE (Solu-Medrol)
Mechanism of Action
- Onset of action is within 1 to 6 hours
- Thought to stabilize cellular and intracellular membranes
- Enters target cells and causes many complex reactions that are responsible for its anti-inflammatory and immunosuppressive effects
METHYLPREDNISOLONE (Solu-Medrol)
Indications
- Allergic reactions
- Anaphylaxis
- Asthma
- COPD
METHYLPREDNISOLONE (Solu-Medrol)
Contraindications
- Known hypersensitivity to the drug
- Systemic fungal infection
- Premature infant
*** Act-O-Vial contains Benzyl Alcohol (fatal to premature infants)
METHYLPREDNISOLONE (Solu-Medrol)
Adverse Effects
- None from a single dose
NALOXONE (Narcan)
Classification
- NARcatic ANtagonist (Opioids)
NALOXONE (Narcan)
ADULT Dosage
- 0.4 to 2.0 mg IV/IO/IM
- 2 mg/2ml IN
*** Repeat as necessary to maintain respiratory activity/drive
NALOXONE (Narcan)
PEDIATRIC Dosage
- 0.1 mg/kg IVP/IO/IM/IN
***MAX initial dose of 2 mg - Maximum total dose of 0.5 mg/kg
*** may be repeated as necessary to maintain respiratory activity/drive
NALOXONE (Narcan)
Mechanism of Action
- Reverses all effects due to opioid agents
- Reverse the respiratory depression
- Reverse Central AND Peripheral Nervous System effects
NALOXONE (Narcan)
Pharmacokinetics
- Onset of action within a few minutes if administered IV
- Intramuscular and Endotracheal administration results in a slower onset of action
- May require additional doses and transport to hospital since narcotics last longer than Naloxone
NALOXONE (Narcan)
Indications
- To reverse respiratory and central nervous system depression induced by opiates
NALOXONE (Narcan)
Contraindications
- Newborns/Neonates of addicted mothers.
*** Usage may cause seizures due to abrupt withdrawal
NALOXONE (Narcan)
Adverse Effects
- Not clinically significant
NALOXONE (Narcan)
PEARLS
- May induce opiate withdrawal opiate addicted patients
- Certain drugs may require much higher doses than are currently use
- Should be administered and titrated to return respiratory drive but not intended to restore full consciousness
ONDANSETRON HYDROCHLORIDE (Zofran)
Classification
- Anti-emetic
ONDANSETRON HYDROCHLORIDE (Zofran)
ADULT Dosage
- 4 mg undiluted IV
- 4 mg ODT Tablet dissolved in mouth
ONDANSETRON HYDROCHLORIDE (Zofran)
PEDIATRIC Dosage
- 0.1 mg/kg undiluted slow IV
***MAX DOSE OF 4 mg
GREATER THAN 2 YEARS OLD
- 4 mg ODT tablet dissolved in mouth
LESS THAN 2 YEARS OLD
- 2 mg ODT Tablet dissolved in mouth
(Cut 4 mg in half)
ONDANSETRON HYDROCHLORIDE (Zofran)
Mechanism of Action
- MOA not fully understood but it is a selective 5-HT3 receptor antagonist
ONDANSETRON HYDROCHLORIDE (Zofran)
Indications
- Control & Prevention of nausea and vomiting
ONDANSETRON HYDROCHLORIDE (Zofran)
Contraindications
- Known Hypersensitivity
- Prolonged QT Syndrome
ONDANSETRON HYDROCHLORIDE (Zofran)
Adverse Effects
- Chest pain (rarely)
- EKG changes
- Headache
- Fever
- Blurred vision
- Gastrointestinal symptoms
