Pharmacology Flashcards
ASA Class
Platelet Aggregation Inhibitor
Acetylsalicylic Acid Trade Name
Aspirin
ASA Mechanism of Action 1
Impedes clotting action and platelet aggregation by inhibiting platelet activation. Blocks formation of thromboxane A2. Effects last the life of each platelet.
ASA Mechanism of Action 2
Has anti-pyretic, analgesic, and anti-inflammatory properties.
ASA Indications
Recent onset of ischemic chest pain suggestive of AMI.
ASA Contraindications 1
Hypersensitivity: Severe allergy
Bleeding disorders (hemophilia, Von willebrand’s)
Unconsciousness
ASA Contraindications 2
Active Gastrointestinal (GI) Bleed
Children under the age of 14 increases the risk of Reye’s Syndrome
Asthmatic with previous sensitivity to ASA or NSAIDS
ASA Precautions/Interactions 1
Impaired renal and hepatic function
May produce bronchoconstrictions in asthmatics
ASA Precautions/Interactions 2
Pregnancy
Children and adolescents with influenza or chickenpox infection (increase risk Reye’s Syndrome)
ASA Precautions/Interactions 3
Symptoms are encephalopathy
May interact with warfarin (Coumadin) and other anti-coagulants and cause bleeding.
ASA Adverse Effects
Nausea and Vomiting, Heartburn, Bronchospasms, Bleeding, Urticaria
ASA Dosage
160 mg po; chew tablet before swallowing.
Given even if patient has taken own.
ASA Supplied
80 mg and 325 mg tablets are common
Epinephrine Trade Name
Adrenalin
Epi Class
Sympathomimetic, Adreneric
Epi Mechanism of Action 1
Directly stimulates alpha and beta-adrenergic receptors in the sympathetic nervous system
Epi Mechanism of Action 2
Bronchodilator and inhibits histamine release
Epi Mechanism of Action 3
CV and vasopressor: produces positive chronotropic and inotropic effects; increasing cardiac output, myocardial oxygen consumption and force of contraction
Epi Mechanism of Action 4
Vasodilation and vasoconstriction in anaphylaxis it restabilizes the mast cells
Epi Indications
Anaphylaxis
Epi Contraindications
None in anaphylactic shock
Epi precautions
Use with caution with pre-existing cardiac problems. Pt must be monitored.
Epi Adverse Effects
Palpations, angina, dysrythmias, N&V, headache, nervousness
Epi Pen Dosage
Epipen - 0.3 mg (pt over 66 lbs/30 kg)
Epipen Jr. - 0.15 mg (pt between 33lbs/15 kg and 66 lbs/30kg)
Epi Adult Dosage
0.3 mg (1:1000) IM q 5-10 minutes prn
Epi Pediatric Dosage
0.1 mg/kg IM/SQ (do not exceed 0.3 mg)
Epi Supplied
1:1000 multi-dose vials 30mg/30ml; 1:1000 ampule 1 mg/ml
Glucose Oral Trade Name
Glucola, Intsa-glucose
Glucose Class
Hyperglycaemic Agent
Glucose Mechanism of Action
Provides a quickly absorbed form of glucose to increase blood glucose levels.
Glucose Indications
Conscious patient with suspected hypoglycaemia and an intact gag reflex.
Glucose Contraindications
Decrease level of consciousness (no gag reflex)
Hyperglycaemia
Glucose Precations/Interactions
N&V
Glucose Adverse Effects
N&V
Glucose Dosage
Adult/Prediatric: 25g administered slowly until improvement is noted.
Glucose Supplied
25 g Gel Paste: Chewable Tabs in various volumes (25 g)
Salbutamol Trade Name
Ventolin
Salbutamol Class
Bronchodilator
Salbutamol Mechanism of Action 1
Selectively stimulates beta-adrenergic receptions of the lungs, uterus, and vascular smooth muscle.
Salbutamol Mechanism of Action 2
Bronchodilation results from relaxation of vascular smooth muscles, which relieves bronchspasms and reduces airway resistance.
Salbutamol Mechanism of Action 3
Higher doses will drive serum potassium (k+) into the cells
Salbutamol Indications 1
Bronchospasms due to bronchial asthma, chronic bronchitis, and other chronic bronchopulmonary disorders
Salbutamol Indications 2
Respiratory distress with Bronchospasms
Salbutamol Precautions/Interactions 1
Use with caution in tachycardias
Should not be used with pt presenting acute heart failure
Cardiovascular disease - cardiac dysrythmias, hypertension
Salbutamol Precautions/Interactions 2
Diabetes mellitus - risk of drug induced hyperglycaemia
Hypokalmia - risk further reducing serum potassium levels and possible adverse cardiovascular events
Salbutamol Adverse Effects
Tachycardia, palpitations, dizziness, headache, angina, anxiety
Salbutamol Adult Dosage
Adult: 2.5 - 5.0 mg nebula - repeat q 10 minutes prn
MDI minimum 6 puff max 20
Salbutamol Paediatric Dosage
0.15 mg/kg diluted to 2.5 ml saline via nebulizer
Or 20kg give 2.5 - 5.0 mg
MDI paediatrics minimum 2 puffs, max 10
Salbutamol Supplied
2.5 mg in 2.5 ml plastic ampules
MDI 100 ug/puff
Combivent (Ventolin 2.5 mg/Atrovent 500 mcg)
Ipratropium Bromide Trade Name
Atrovent
Ipratropium Bromide Class
Anticholinergic, Bronchodilator
Ipratropium Bromide Mechanism of Action 1
Inhibits cholinergic receptors in the bronchial smooth muscles, resulting in decreased concentrations of cyclic guanosine monophosphate (cyclic GMP).
Ipratropium Bromide Mechanism of Action 2
Decreased levels of cyclic GMP produce local, not systemic, bronchodilation .
Ipratropium Bromide Indications
Bronchospasm from asthma, chronic bronchitis, emphysema
Ipratropium Bromide Contraindications
Atropine, aerosol propellants, pt with soy or peanut allergies
Ipratropium Bromide Precations/Indications 1
Use with caution with patients with narrow angle glaucoma, prostatic hertophy, urinary retention.
Hypersensitivity to soy lecithin or related food products.
Ipratropium Bromide Precations/Indications 2
Patients with narrow angle glaucoma.
Be careful to avoid accidental release in to eyes (use mouth price neb if possible).
Ipratropium Bromide Adverse Effects
Dry mouth, vomiting, palpitations, headache, tremor, cough, flushing, dizziness
Ipratropium Bromide Adult Dosage
250-500 mcg via nebulizer with salbutamol mixed. Repeat up to two times if necessary.
Note: Normally only 1-2 doses in other conditions (eg. Emphysema, chronic bronchitis)
Combivent: 2.5-5.0 ml nebule - q 10 minutes prn
MDI: minimum 1-4 puffs prn, max 10
(Take after salbutamol, ipratropium bromide has a much slower onset of action.)
Ipratropium Bromide Paediatric Dosage
Ages 5-11
25-250 mcg via nebulizer with salbutamol mixed, repeat up to two times if necessary
MDI minimum two puff prn, max 4
Ipratropium Bromide Supplied
Unit dose vials are available in the following doses:
125 mcg/ml, 250 mcg/ml, 500 mcg/mg