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Respiratory Drugs Flashcards

1
Q

`Albuterol (Proventil and Others)
Class:

A

Sympathomimetic, bronchodilator, beta 2 agonist

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2
Q

Albuterol (Proventil and Others)
Description:

A

Sympathomimetic selective for beta 2 adrenergic receptor. Relaxes smooth muscle of bronchial tree and peripheral vasculature by stimulating adrenergic receptors of the sympathetic nervous system

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3
Q

Albuterol (Proventil and Others)
Onset and duration:

A

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

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4
Q

Albuterol (Proventil and Others)
Indications:

A

Relief of bronchospasm related to toxic inhalation, or pts w obstructive airway disease
Prevention of exercise induce bronchospasm
Anaphylaxis
Hyperkalemia

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5
Q

Albuterol (Proventil and Others)
Contraindications:

A

Hypersensitivity
Cardiac dysrhythmias associated w tachycardia

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6
Q

Albuterol (Proventil and Others)
Adverse reactions

A

Restlessness, apprehension
Dizziness, Palpitations, tachycardia, dysrhythmias, tremors

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7
Q

Albuterol (Proventil and Others)
Drug interactions:

A

Monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs) may potentiate effects on vasodilation
Betablockers may antagonize albuterol
May potentiate diuretic induced hypokalemia

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8
Q

Albuterol (Proventil and Others)
How Supplied:

A

MDI: 90mcg/ spray
Solution: 0.5% (5MG/ML), (2.5mg) in 3 ml unit dose

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9
Q

Albuterol (Proventil and Others)
Dosage and administration:

A

Adult
2.5-5mg diluted in 3ml NS nebulized over 5-15min, 3-4 times a day
MDI 1-2 puffs every 4-6 hours, max 12 a day
Peds
0.1-0.2mg/kg in 2 ml of NS can repeat in 20min
less 44lbs 2.5mg/dose
greater 44 5mg/dose
MDI 4-8 puffs

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10
Q

Albuterol (Proventil and Others)
Special considerations

A

May precipitate angina pectoris

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11
Q

Methylprednisolone (Solu-Medrol)
Class:

A

Glucocorticoid

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12
Q

Methylprednisolone (Solu-Medrol)
Description:

A

Synthetic steroid suppressing inflammation. Potentiates vascular smooth muscle relaxation by beta adrenergic agonists, may alter airway hyperactivity.

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13
Q

Methylprednisolone (Solu-Medrol)
Onset and duration

A

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

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14
Q

Methylprednisolone (Solu-Medrol)
Indications:

A

Anaphylaxis
Bronchodilator unresponsive asthma, COPD
Shock
Adrenal insufficiency

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15
Q

Methylprednisolone (Solu-Medrol)
Contraindications

A

GI bleeds, diabetes mellitus, severe infection
IM route for PTs with idiopathic thrombocytopenia purpura

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16
Q

Methylprednisolone (Solu-Medrol)
Drug interactions:

A

Response to insulin and oral hypoglycemic agents may be blunted
Potassium depleting agents may potentiate hypokalemia

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17
Q

Methylprednisolone (Solu-Medrol)
Adverse reactions:

A

Headache
Hypertension
sodium and water retention
hypokalemia
alkalosis
hyperglycemia
insomnia
psychosis

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18
Q

Methylprednisolone (Solu-Medrol)
How supplied

A

20,40,80mg/ml, 125 mg/2ml

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19
Q

Methylprednisolone (Solu-Medrol)
Dosage and administration:

A

Adult
2mg/kg up to 125 IV, or 40-125mg IV
Peds
2mg/kg IV max 60mg

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20
Q

Dexamethasone (decadron, hexadrol, and others)
Class:

A

Glucocorticoid

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21
Q

Dexamethasone (decadron, hexadrol, and others)
Description:

A

Synthetic steroid related to natural hormone secreted by the adrenal cortex. Suppresses inflammation, relaxes vascular and bronchial smooth muscle by beta adrenergic agonist. Treats allergic reactions and asthma and reduces swelling in the CNS

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22
Q

Dexamethasone (decadron, hexadrol, and others)
Onset and duration:

A

Onset 4-8hrs
Duration 24-72 hrs

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23
Q

Dexamethasone (decadron, hexadrol, and others)
Indications:

A

Endocrine, rheumatic, and hematologic disorders
Acute mountain sickness
Allergic states
Bronchospasm
Shock w history of adrenal insufficiency, steroid dependence, fluid refractory shock
Cronic inflammation
croup
high altitude cerebral edema

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24
Q

Dexamethasone (decadron, hexadrol, and others)
Contraindications:

A

Hypersensitivity
Active untreated infections

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25
Q

Dexamethasone (decadron, hexadrol, and others)
Adverse reactions:

A

Decreased wound healing, hypertension, GI bleeds, hyperglycemia

26
Q

Dexamethasone (decadron, hexadrol, and others)
Drug interactions:

A

Barbiturates and phenytoin can decrease effect

27
Q

Dexamethasone (decadron, hexadrol, and others)
How supplied:

A

4mg/ml in 1,5,10,25,30 ml vials
10mg/ml in 10ml vials, 1ml syringe, 1ml ampule
20mg/ml in 5 ml vials, 5ml syringe, 24mg/ml in 5 and 10 ml vials

28
Q

Dexamethasone (decadron, hexadrol, and others)
Dosage and administration:

A

Adult
4-20mg/day or in 2-4 doses
0.4-0.8mg/kg max 40mg/day IV/IM
Peds
1 dose .6mg/kg PO/IM/IV max 16mg

Acute mountain sickness
.15mg/kg PO/IM/IV max 4mg
High altitude cerebral edema
8mg IM, IV, PO

29
Q

Magnesium Sulfate
Class:

A

Electrolyte, anticonvulsant, class V antidysrhythmic

30
Q

Magnesium Sulfate
Description:

A

Reduces striated muscle contraction and blocks peripheral neuromuscular transmission by reducing acetylcholine release at the myoneural junction. Slows SA node impulse and prolongs conduction time. Enhances movement of calcium, potassium, and sodium in and out of cells and stabilizes excitable cell membranes.

31
Q

Magnesium Sulfate
Onset and duration:

A

Onset: IV immediate, IM 1hr
Duration: IV 30min, IM 3-4hr

32
Q

Magnesium Sulfate
Indication:

A

Seizures from eclampsia
Cardiac arrest, only torsades/ hypomagnesemia
Life threatening dysrhythmias attributed able to digitalis toxicity
Suspected hypomagnesemia
Status asthmaticus not responsible to beta adrenergic
Bronchodilator after beta agonist and anticholinergic agents have been used
Uterine relaxation (Inhibit contractions)

33
Q

Magnesium Sulfate
Contraindications:

A

Heart block or myocardial damage
Hypermagnesemia or hypercalcemia
Diabetic coma
hypersensitivity

34
Q

Magnesium Sulfate
Adverse Reactions:

A

Diaphoresis
Facial flushing
Hypotension
Depressed reflexes
Hypothermia
Bradycardia
Circulatory collapse
Respiratory depression/ arrest
Diarrhea
Nausea vomiting

35
Q

Magnesium Sulfate
Drug interactions:

A

CNS depressant enhanced if taking other CNS depressants
Cardiac changes

36
Q

Magnesium Sulfate
How supplied:

A

10%, 12.5%, 50%, solution in 40, 80, 100, 125 mg/ml

37
Q

Magnesium Sulfate
Dosage:

A

Status Asthmaticus or Bronchoconstriction
Adult
Max 2g over 10-15min
Peds (less than 12)
50 mg/kg IV with range of 25-75mg/kg over 20min, 2g max

38
Q

Epinephrine (Adrenaline)
Class:

A

Sympathomimetic

39
Q

Epinephrine (Adrenaline)
Description:

A

Stimulates alpha, beta 1 and 2, increasing HR and broncho dilation. Causes vasoconstriction and antagonizes effects of histamine

40
Q

Epinephrine (Adrenaline)
Onset and duration:

A

Onset
Subcutaneous 5-10 min
IV 1-2min
Duration
IM 5-10min

41
Q

Epinephrine (Adrenaline)
Indications

A

Anaphylaxis
Cardiac arrest
PEA
VF and pulseless VT unresponsive to deliberation
Symptomatic bradycardia when pacing and atropine fail
Shock
Bronchial asthma
CROUP/ bronchiolitis

42
Q

Epinephrine (Adrenaline)
Contraindications

A

Hypersensitivity
Hypovolemic shock
Dilated cardiomyopathy
Coronary insufficiency
Epinephrine (Adrenaline)
VT from cocaine

43
Q

Epinephrine (Adrenaline)
Adverse reactions:

A

Tachycardia
headache
nausea vomiting
restlessness
weakness
dysrhythmias, VT and VF
hypertension
angina pectoris

44
Q

Epinephrine (Adrenaline)
How supplied

A

Parenteral
0.1mg/ml or 1mg/ml
Autoinjector
1mg/ml

45
Q

Epinephrine (Adrenaline)
Dosage

A

Anaphylactic Or Bronchoconstriction
Adult
0.3mg IM in anterolateral thigh repeat 5-15min if needed
Peds
0.01mg/kg IM max single dose 0.3mg, repeat 15min

Stridor or bronchospasm
Anaphylaxis: 5ml (.1mg/ml) nebulized
Croup: 3MG in 3ml NS nebulized

46
Q

Ipratropium (Atrovent)
Class:

A

Anticholinergic, bronchodilator

47
Q

Ipratropium (Atrovent)
Description:

A

Inhibits interaction of acetylcholine on bronchial smooth muscle, causing bronchial dilation

48
Q

Ipratropium (Atrovent)
Onset and Duration:

A

Onset
15min
Duration
2-4hrs

49
Q

Ipratropium (Atrovent)
Indication:

A

Bronchospasm
COPD exacerbation

50
Q

Ipratropium (Atrovent)
Contraindications:

A

Hypertensives to ipratropium, atropine, soybean oil, or peanuts

51
Q

Ipratropium (Atrovent)
Adverse Reactions:

A

Nausea and vomiting
Cramps
Coughing
Worsening symptoms
Headache
Tachycardia
Dry mouth
blurred vision
anxiety

52
Q

Ipratropium (Atrovent)
Dosage:

A

Adult
0.5mg in 2.5ml nebulized, repeat twice
Peds
250-500mcg nebulized upto 3 doses

53
Q

Nitroglycerine (Nitrostat)
Class

A

Vasodilator

54
Q

Nitroglycerine (Nitrostat)
Description:

A

Dilates arterioles and veins, reduces preload and afterload, decreasing work of heart

55
Q

Nitroglycerine (Nitrostat)
Onset and duration

A

Onset
1-3 min
Duration
IV 3-5min, IM25min

56
Q

Nitroglycerine (Nitrostat)
Dosage (Pulmonary Edema)

A

Adult
2 tablets .8mg pressure over 160
3 tablets 1.2mg pressure over 200

57
Q

Morphine Sulfate (Astramorph PF)
Class:

A

Opioid analgesic

58
Q

Morphine Sulfate (Astramorph PF)
Description:

A

Respiratory and CNS depressant

59
Q

Morphine Sulfate (Astramorph PF)
Onset and Duration:

A

Onset 5-10min
Peak 20min
Duration 4-5hrs

60
Q

Morphine Sulfate (Astramorph PF)
Indications:

A

End of life dyspnea

61
Q

Morphine Sulfate (Astramorph PF)
Dosage (End of life dyspnea)

A

1-5mg, repeat as needed for

Drug Profiles (5 decks)

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