Pharm 1-5 (Albuterol, Epinephrine Racemic, Ipratropium, Methylprednisolone, Prednisone)

Question 1

Albuterol (Proventil): Class?

Answer 1

Class: Sympathomimetic, bronchodilator, beta-2 agonist

Question 2

Albuterol (Proventil): Action?

Answer 2

Action: Sympathomimetic that is selective for Beta-2 adrenergic receptors/ Relaxes smooth muscles of the bronchial tree and peripheral vasculature by stimulating adrenergic receptors of sympathetic nervous system.

Question 3

Albuterol (Proventil): Indications? (3)

Answer 3

Indications: 1. Asthma 2. Bronchospasms 3. Reversible obstructive airway disease

Question 4

Albuterol (Proventil): Contraindications? (2)

Answer 4

Contraindications: 1. Hypersensitivity 2. Caution with pts with cardiac dysrhythmias

Question 5

Albuterol (Proventil): Onset/Duration?

Answer 5

Onset: 5-8 min Duration: 2-6 hours

Question 6

Albuterol (Proventil): Dose/Route?

Answer 6

Adult/Peds: 2.5 mg diluted in 3 mL of Normal Saline (may be repeated if neccessary. Max 10 mg adults, 5mg peds)

Question 7

Albuterol (Proventil): Side effects? (9)

Answer 7

1. Tremors 2. Anxiety 3. Headache 4. Nausea 5.Dizziness 6. Cough 7. Palpitations 8.Tachycardia 9. Hypertension

Question 8

Albuterol (Proventil): Notes?

Answer 8

NOTE: Albuterol may precipitate angina & cardiac dysrhythmias. Use with caution in pt’s with cardiovascular disorder, diabetes, seizure disorder, hyperthyroidism

Question 9

Epinephrine, Racemic (Micronefrin): Class?

Answer 9

Sympathomimetic

Question 10

Epinephrine, Racemic (Micronefrin): Action?

Answer 10

Racemic Epinephrine is an inhaled version of epinephrine that is used as a bronchodilator and as an anti-inflammatory to treat laryngeal/tracheal swelling and edema. Its actions are the same as epinephrine but since it is inhaled it has both systemic and localized effects.

Question 11

Epinephrine, Racemic (Micronefrin): Indications? (4)

Answer 11

1.Laryngotracheobronchitis (croup) 2.asthma 3.bronchospasms 4.laryngeal edema

Question 12

Epinephrine, Racemic (Micronefrin): Contraindications? (3)

Answer 12

1. Hypertension 2.epiglottitis 3.Use caution in patients with known cardiovascular disease or in pts > 45 y/o.

Question 13

Epinephrine, Racemic (Micronefrin): Onset/Duration?

Answer 13

Onset: 5 min
Duration: 1-3 hrs

Question 14

Epinephrine, Racemic (Micronefrin): Dose/Route?

Answer 14

ADULT: Not usually given to adults. Contact medical control
PEDS: All doses given via aerosolized neb. For pts < 6 months – 0.25 ml 2.25% diluted in 3 ml NS. For pts > 6 months – 0.5 ml 2.25% diluted in 3 ml NS

Question 15

Epinephrine, Racemic (Micronefrin): Side Effects? (5)

Answer 15

1. Tachycardia 2.hypertension 3.Cardiac Dysrhythmia 4. Anxiety 5.Tremors

Question 16

Epinephrine, Racemic (Micronefrin): Notes?

Answer 16

NONE

Question 17

Ipratropium (Atrovent): Class?

Answer 17

Anticholinergic, bronchodilator

Question 18

Ipratropium (Atrovent): Action?

Answer 18

Ipratropium blocks interaction of acetylcholine at receptor sites on bronchial smooth muscle resulting in bronchodilation, reduced mucus production, and decreased levels of cyclic guanosine monophosphate

Question 19

Ipratropium (Atrovent): Indication?

Answer 19

1. Persistent bronchospasms 2.asthma 3.COPD exacerbation

Question 20

Ipratropium (Atrovent): Contraindication?

Answer 20

1.Hypersensitivity to ipratropium 2.atropine 3.soybean protein 4.peanuts

Question 21

Ipratropium (Atrovent): Onset/Duration?

Answer 21

Onset: < 15 min
Duration: 2-4 hrs

Question 22

Ipratropium (Atrovent): Dose/Route?

Answer 22

ADULT: 0.5 mg diluted in 2.5 ml NS via nebulizer. May repeat dose twice per most protocols
PEDS: Not typically given prehospital. 250-500 mcg diluted in 2.5 ml saline via nebulizer every 20 mins up to 3 doses

Question 23

Ipratropium (Atrovent): Side Effects? (6)

Answer 23

1. Tachycardia 2.Headache 3. blurred vision 4.nausea/vomiting 5.Mydriaisis 6.anxiety

Question 24

Ipratropium (Atrovent): Notes?

Answer 24

None

Question 25

Methylprednisolone (Solu-Medrol): Class?

Answer 25

Corticosteroid, Glucocorticoid

Question 26

Methylprednisolone (Solu-Medrol): Action?

Answer 26

Synthetic steroid that suppresses acute and chronic inflammation. It also potentiates vascular smooth muscle relaxation by beta-adrenergic agonists and may alter airway hyperactivity

Question 27

Methylprednisolone (Solu-Medrol): Indication?

Answer 27

1. Anaphylaxis 2. asthma unresponsive to bronchodilators 3.adrenal insufficiency

Question 28

Methylprednisolone (Solu-Medrol): Contraindication?

Answer 28

1. Caution in pt’s with GI bleeding 2. diabetes 3.severe infection

Question 29

Methylprednisolone (Solu-Medrol): Onset/Duration?

Answer 29

Onset: 1-2 hrs Duration: 8-24 hours

Question 30

Methylprednisolone (Solu-Medrol): Dose/Route?

Answer 30

ADULT: 125 mg IV/IO PEDS: 1-2 mg/kg IV/IO

Question 31

Methylprednisolone (Solu-Medrol): Side Effects?

Answer 31

1. hypertension 2. Headache 3.hypokalemia 4.alkalosis 5.sodium and water retention

Question 32

Methylprednisolone (Solu-Medrol): Note?

Answer 32

Use in spinal injury and shock is controversial

Question 33

Prednisone: Class?

Answer 33

Corticosteroid

Question 34

Prednisone: Action?

Answer 34

Prednisolone suppresses acute and chronic inflammation, potentiates vascular smooth muscle relaxation, and may alter airway hyperactivity

Question 35

Prednisone: Indication

Answer 35

1.Bronchoconstriction (COPD, asthma) 2.Anaphylaxis

Question 36

Prednisone: Contraindication

Answer 36

1. Known hypersensitivity 2.Systemic fungal infections

Question 37

Prednisone: Onset/Duration?

Answer 37

Onset: Variable Duration: 1-1.5 days

Question 38

Prednisone: Onset/Duration?

Answer 38

Adults: At first, 5 to 60 milligrams (mg) per day PEDS: Depends on doctor ROUTE: oral

Question 39

Prednisone: Side Effects?

Answer 39

1.Headache 2.hypertension 3.sodium and water retention 4.hypokalemia 5.alkalosis 6.gastritis

Question 40

Prednisone: Notes?

Answer 40

DRUG INTERACTIONS: Anticoagulants – their actions could be enhanced or inhibited. Potassium-depleting agents - may potentiate hypokalemia