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AZDHS Profiles > Respiratory Drug Profiles > Flashcards

Respiratory Drug Profiles Flashcards

1
Q

Albuterol Names/Class

A

Albuterol Sulfate

Brand: Ventolin, ProAir, Proventil

Class: Sympathomimetic, bronchodilator

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2
Q

Albuterol MOA

A

Beta2 agonist, relaxes bronchial smooth muscle, vascular, and uterine smooth muscle

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3
Q

Albuterol Indications

A

Bronchospasm

HyperK

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4
Q

Albuterol Contraindications

A

Synergistic with other sympathomimetics

Caution: PTs with diabetes, hyperthyroidism, and cerebrovascular disease

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5
Q

Albuterol Adverse Reactions

A

CV: Dysrhythmias, tachycardia, peripheral vasodilation
Resp: Bronchospasm (paradoxical with excessive use)
CNS: Tremors, nervousness
GI: N/V
Endocrine: Hyperglycemia

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6
Q

Albuterol Incompatibilities/Drug interaction

A

TCA’s and MAO inhibitors

Other sympathomimetics

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7
Q

Albuterol Dosage (Ad and Ped)

A

Adult: 2.5mg in premix (.083%) for via SVN, repeat per protocol

Peds: 2.5mg in premix (.083%) via SVN, repeat per protocol. MAX 5 mg per dose protocol.

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8
Q

Etomidate (RSI Drug) Names/class

A

Etomidate

Brand: Amidate

Class: Sedative/hypnotic agent

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9
Q

Etomidate MOA

A

Produces hypnosis rapidly causing depression and anesthesia, no analgesic effect

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10
Q

Etomidate Indications

A

Induction of anesthesia for RSI

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11
Q

Etomidate Contraindication

A

Hypersensitivty

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12
Q

Etomidate adverse reaction

A

Transient muscle movement
Apnea
Minimal (not clinically significant) suppresion of cortisol levels
May cause myoclonus (muscular faciculations)

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13
Q

Etomidate Dose (ad)

A

.3 mg/kg IV over 30-60 seconds

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14
Q

Ipatropium Bromide (IB) Names/Class

A

Ipatropium Bromide

Brand: Atrovent

Class: Antocholinergic, bronchodilator

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15
Q

IB indications

A

Bronchospasm associated with COPD

Used alone or in combo with other bronchodilators (esspecially beta adrenergics)

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16
Q

IB contraindications

A

Hypersensitivy to IB or atropine and derivatives

Caution: PTs with narrow angle glaucoma

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17
Q

IB adverse reactions

A

Resp: coughing, sputum increase
CNS: Dizziness, insomnia, tremors, nervousness
GI: Nausea

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18
Q

IB incompatbility/drug reaction

A

None!

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19
Q

IB dose (ad and ped)

A

Adult: 500mcg in 2.5 mL NS, can be mixed with a fish of albuterol. Repeat per protocol

Peds: 500mcg n 2.5 mL NS, DO NOT REPEAT

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20
Q

Magnesium Sulfate (Mag) Name/Class

A

Magnesium Sulfate

Class: Electrolyte, tocolytic

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21
Q

Mag indications

A 
Torsades (drug of choice)
Hypomagnesemia
Preterm Labor
Pregnancy induced HTN
Hyperactive airway - Severe asthma (COPD)
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22
Q

Mag Contraindications

A

Hypermagnesemia

Caution: PTs with impaired renal function, pre-existing heart blocks, use of barbituates, narcotics or other hypnotics

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23
Q

Mag Adverse Reaction

A

CV: hypotension (may be transient), flushing, circulatory collapse, depressed cardiac function, heart block, asystole, smooth muscle relaxant
Resp: Resp depression and/or paralysis, (can happen in mother or infant up to 24 hours after admin)
CNS: Sweating, drowsiness, hypothermia, depressed reflexes from flaccidity or paralysis ( possible 24 hours after admin to mother/infant)
GI: Nausea
Meta: Hypocalcemia, Hypermagnesemia

24
Q

Mag incompatabilities/drug reactions

A

Concurrent digitilization increases risk of dysrhythmias

25
Q

Mag dose (ad and ped) 1 heart 2 lungs 4 lungs

A

Adult
Torsades: 1-2 gm diluted in 50-100 mL NS or D5W over 1-2 mins, same amount infused over 1 hour

Hypomagnesemia: 1-2 gm diluted in 50-100 mL NS or D5W over 5-60 mins

Resp/Severe asthma: 2 gm in 50 mL NS/D5W in microdrip over 5-10 mins. Stop if hypotension, respiratory depression, or bradycardia develop. (AFTER Albuterol/IB and .3 IM 1:1000 epi)

PTL: BOLUS: 4-6gm over 15-20 mins (4gm in 100 mL D5W, LR, or NS for 40mg/mL) Look at profiles for maintenance dose
PIH/Pre/eclampsia: BOLUS: 3-6gm over 10-15 mins (same as above for 40mg/hr) Look at profiles for maintenance.

26
Q

Methylprednisone Sodium Succinate Names/Class

A

Methylprednisone Sodium Succinate

Brand: Solu-medrol

Class: Corticosteroid, glucocorticoid, steroid, anti-inflammatory

27
Q

Solu-medrol MOA

A

Though to stabilize intracellular membranes, enters cells and causes complex reactions responsible for its anti-inflammatory and immunosuppresive effects.

28
Q

Solu-medrol Indications

A

Reactive airway disease (acute exacerbation of emphysema, chronic bronchitis, asthma, anaphylaxis)

Burns that potentially involve the airway

29
Q

Solu-medrol contraindications

A

Pre-term infants

30
Q

Solu-medrol adverse reactions

A

None from single dose

31
Q

Solu-medrol incompatabilities/drug interactions

A

NONE

32
Q

Solu-medrol dose (ad and ped)

A

Adult: 125mg IV bolus, much larger doses can be used

Peds: 2-4 mg/kg IV bolus

33
Q

Midazolam Hydrochloride Names/Class

A

Midazolam Hydrochloride

Brand: Versed

Class: CNS depressant, Benzodiazepine

34
Q

Versed indications

A

Anticonvulsant
Sedation
Management of acute agitation/excited delirium
Induction for intubation

35
Q

Versed Contraindications

A

Hypersensitivity

Relative: Pregnancy and Myasthenia Gravis or other nueromuscular disorders, Acute alcohol intoxication, COPD, and Acute pulmonary insufficiency

Note: May cause phlebitis, may need to adjust for PTs on erythromycin

36
Q

Versed Adverse Reactions

A

CV: Hypotension (especially in those on narcotics), cardac arrest, irregular or fast heartbeat
Resp: Apnea, resp depression/arrest, paradoxical hyperventilation, wheezing/dyspnea, hiccups, coughing
CNS: Emergence delirium, muscle tremor, uncontrolled or jerky movements of the body, unusual excitement, irritability, restlessness, dizziness, lightheadedness, drowsiness, headache, prolonged drowsiness
GI: N/V

37
Q

Versed incompatabilities/interactions

A

Potentiate effects of other CNS depressants (opiate agonist , analgesics, barbituates or sedatives, anethetics, alcohol)

38
Q

Versed Dose (ad and ped)

A

Adult: (total dose should not exceed 20mg)
14-60 y/o : 2-5mg IM; 1-10 mgIV/IO titrated slowly in 2.5mg increments over at least 2minutes
Over 60: 1-5mg IM; 1-3.5mg IV/IO titrated slowly in increments of 1.5mg over at least 2 minutes

Peds: 0.05 - 0.1 mg/kg slow IV/IO push; 0.2mg/kg IM/0.3mg/kg IN if no access (IN divided each nostril)

39
Q

Phenylephrine Nasal Spray 0.5% Names/Class

A

Phenylephrine Nasal Spray

Class: Topical vasoconstrictor

40
Q

Phenylephrine Indications

A

Facilitation of nasotracheal intubation

41
Q

Phenylephrine contraindications

A

Known allergy

42
Q

Phenylephrine Incompatibilities/interactions

A

NONE

43
Q

Phenylephrine Dose (ad)

A

Adult: 2-4 sprays each nostril

44
Q

Racemic Epinephrine Names/Class

A

Racemic Epinephrine

Class: Sympathomimetic

45
Q

Racemic Epi MOA

A

Alpha receptor stimulation causes vasoconstriction, resulting in reduction of mucosal and submucosal edema

46
Q

Racemic Epi Indications

A

Croup
Chronic obstructive lung disease, Chronic bronchitis, bronchiolitis, bronchial asthma, or other peripheral airway disease

47
Q

Racemic Epi Contrandications

A 
Allergy to ingredients (may contain sulfites)
Coronary artery disease/ insufficiency
Arrythmias
Epiglottitis
HTN
48
Q

Racemic Epi Adverse Reactions

A 
Tachycardia
Dysrhythmias
Headache
Nausea
Palpitations
Angina
49
Q

Racemic Epi Incompatibilities/interactions

A

Potentiate other sympathomimetics
MAO inhibitors may cause HTN crisis
Alpha adrenergic blockers may cause hypotension

50
Q

Racemic Epi dose

A

Adult and Ped: 0.5 mL in 2.5-4.5 mL (3mg 1:1000 in 3 mL NS)

51
Q

Succinylcholine Names/Class

A

Succinylcholine

Brand: Anectin

Class: Ultrashort acting depolarizing type skeletal muscle relaxant (paralytic)

52
Q

Succinylcholine MOA

A

Combines with cholinergic receptors of motor end plates to produce depolarization
Hydrolyzed by ACHesterase

53
Q

Succinylcholine Indications

A

ET intubation requiring RSI (by PM with Medical direction/protocol)

54
Q

Succinylcholine Contraindications

A 
Muscle disorders
Personal or family history of malignant hyperthermia
History of HyperK
Burn injured PTs* (increased K levels)
Ocular injuries
If ET intubation is doubtful
55
Q

Succinylcholine adverse reactions

A 
Vagal stimulation leading to bradycardia/asystole
HyperK
Rhabdo
Hypersalivation
Elevated intraocular pressure
Release of Histamine
Malignant hyperthermia
Dysrhythmias
Hypotension
56
Q

Succinylcholine Incompatibilities/Reactions

A

Beta-blockers, procanamide, lithium, and quinide all prolong effects

57
Q

Succinylcholine Dose (ad and ped)

A

Adult: 0.6 -2 mg/kg IV, ,may repeat once in 2-3 mins to achieve paralysis, contact medical direction to administer more

Peds: 1-2 mg/kg IV, Same as adult for rest

AZDHS Profiles (3 decks)

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