Respiratory Flashcards
Indications for Adrenaline 1:1,000?
Anaphylaxis.
Life-threatening asthma.
Actions of Adrenaline 1:1,000?
Reverses allergic manifestations of anaphylaxis.
Relieves bronchospasm in acute severe asthma.
Cautions of Adrenaline 1:1,000? Route?
Severe hypertension may occur in patients on non-cardioselective beta blockers (e.g. propranolol).
Only given IM.
Dose of Adrenaline 1:1,000?
500 mcg in 0.5 ml, every 5 minutes with no limit.
Indications of Ipratropium Bromide?
Acute, severe or life-threatening asthma.
Asthma unresponsive to salbutamol.
Exacerbation of COPD unresponsive to salbutamol.
Expiratory wheezing.
Actions of Ipratropium Bromide?
Antimuscarinic bronchodilator. Considered greater benefit in children suffering asthma, and adults suffering with COPD.
Cautions of Ipratropium Bromide?
Use in care with patients with glaucoma, pregnancy, and prostatic hyperplasia.
If COPD is a possibility limit nebulisation to 6 minutes.
Side effects of Ipratropium Bromide?
Nausea.
Dry mouth.
Tachycardia/arrhythmia.
Paroxysmal tightness of the chest.
Allergic reaction.
Dose of Ipratropium Bromide?
500 mcg in 2 ml. Only once.
Indications of Salbutamol?
Acute asthma attack where normal inhaler failed to relieve symptoms.
Expiratory wheezing associated with allergy, anaphylaxis, beta-blocker overdose, smoke inhalation etc.
Exacerbation of COPD.
Actions of Salbutamol?
Selective beta2 adrenoreceptor stimulator. Relaxant effect on the smooth muscle in medium and smaller airways which are in spasm during asthma attacks.
Cautions for Salbutamol?
Patients with:
Hypertension.
Angina.
Overactive thyroid.
Late pregnancy (can relax uterus).
Bronchomalacia / laryngomalacia / tracheomalacia (abnormal softening of bronchial tubes, larynx, trachea).
Severe hypertension may occur in patients on beta-blockers and half doses should be used, unless profound hypotension.
Side effects of Salbutamol?
Tremor.
Tachycardia.
Palpitations.
Headache.
Feeling of tension.
Peripheral vasodilation.
Muscle cramps.
Rash.
Dose of Salbutamol? Impact of clinically significant side effects?
5 mg in 5 ml/2.5 ml, every 5 minutes.
No limit unless side effects are clinically significant (>140 bpm in adults, but NOT children)
Indications for Prednisolone?
Moderate to severe asthma exacerbations.
Exacerbation of COPD.
AND able to swallow.
Only treat COPD if response to nebuliser is poor.
Actions of Prednisolone?
Glucocorticoid (steroid) that suppresses part of the immune system, reduces inflammation and swelling.
Contra-indications for Prednisolone?
Known administration within last 2 hours.
Not included in criteria.
Vomiting/unable to swallow.
Known hypersensitivity to steroids.
Suspected or known systemic infection.
Active peptic ulcer disease.
Cautions of Prednisolone?
Heart failure.
Hypertension.
Diabetes (increases blood sugars).
Concurrent use of aspirin and NSAIDs can increase GI bleed risk.
Cyclosporin or methotrexate.
Glaucoma.
Recent MI.
Pregnant/breastfeeding.
Side effects of Prednisolone?
GI discomfort.
Altered mood.
Anxiety.
Dose of Prednisolone?
40 mg in 40 ml. One dose only.
Indications for Hydrocortisone?
Severe or life-threatening asthma.
Acute COPD exacerbation.
Adrenal crisis (including Addisonian crisis).
Patients with suspected adrenal insufficiency or long-term steroid therapy that have become unwell.
Actions of Hydrocortisone?
Glucocorticoid.
Restores blood pressure, blood sugar, cardiac synchronicity and volume.
Suppresses inflammation and immune response.
Contra-indications and cautions of Hydrocortisone?
Contra-indication: Known allergy.
Caution: Avoid IM if patient likely to require thrombolysis.
Side effects of Hydrocortisone?
May cause stinging or burning sensations due to phosphate preservative.
Dose of Hydrocortisone? And route?
IV (slowly over 2 minutes) or IM (upper arm or thigh).
100 mg. One dose only.
Indications of Dexamethasone?
Croup.
Actions of Dexamethasone?
Corticosteroid - reduces subglottic inflammation.
Contra-indications of Dexamethasone?
Impending respiratory failure.
Cautions of Dexamethasone?
Upper airway compromise can be worsened by any procedure that distresses the child - includes adminstration.
Side effects of Dexamethasone?
GI upset.
Hypersensitivity/ anaphylactic reaction.
Dose of Dexamethasone?
6 mg.
One dose only.
