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Paramedic School > Respiratory Drugs - Pharm > Flashcards

Respiratory Drugs - Pharm Flashcards

1
Q

Albuterol Dose

A

Nebulized 2.5-5mg in 3ml NS (5-15min)
MDI 1-2 inhalations (90-180mcg); q4-6hrs; Max 12/d
Severe dose - 6 inhalations or 5mg in 3ml

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2
Q

Albuterol Indications

A

-Relief of bronchospasm with eversible obstructive airway disease
- Prevention of exercise induced bronchospasm
- Anaphylaxis
- Hyper K

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3
Q

Albuterol onset and duration

A

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

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4
Q

Albuterol Contraindication

A
  • Prior hypersensitivity reaction
  • Cardia Dysrhythmias associated with Tachycardia
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5
Q

Albuterol Class

A

Sympathomimetic, Bronchiodialator, Beta 2 agonist

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6
Q

Albuterol drug interactions

A
  • Other sympathomimetics may exacerbate adverse cardiovascular effects
  • MAO inhibitors and Tricyclic antidepressants may potentiate effects on vasculature
  • Betablockers may antagonize
    Albuterol may potentiate diuretic induced hypokalemia
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7
Q

Albuterol Special Considerations

A
  • Pregnancy category C
  • May worsen angina and dysrhythmias
  • Use with caution for diabetes hyperthyroidism, prostatic hypertrophy
  • Seizure disorders
    -Cardiovascular disorder
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8
Q

Ipratropium Bromide (Atrovent) Dose

A

.5mg Nebulized; repeat twice

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9
Q

Ipratropium Bromide (Atrovent) Indications

A
  • Persistent Bronciohospasm
  • COPD Exasperation
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10
Q

Ipratropium Bromide (Atrovent) Onset and Duration

A

Onset: less than 15min
Duration: 2-4hrs

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11
Q

Ipratropium Bromide (Atrovent) Contraindications

A
  • Hypersensitivity to the medication: Atropine, Alcholoid, Soybean Proteins or peanuts
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12
Q

Ipratropium Bromide (Atrovent) class

A
  • Anticholinergic, Bronchodilator
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13
Q

Ipratropium Bromide (Atrovent) drug interactions

A
  • None
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14
Q

Epinephrine dose (Bradycardia and Hypotenion)

A

2-10 Mcg/min infusion until response

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15
Q

Epinephrine dose (Pulseless arrest)

A
  • IV/IO 1mg q3-5min during resucitation
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16
Q

Epinephrine dose (anaphylactic or bronchorestriction)

A
  • .3 to .5ml IM or SubQ
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17
Q

Epinephrine Indications

A

-Anaphylaxis
- Cardiac arrest
- PEA
- VF
- Pulseless VTach
- Symptomatic Brady
- Hypotension with Bradycardia when pacing and atropine fail
- Bronchial Asthma

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18
Q

Epinephrine Onset and Duration

A
  • Onset: Subq 5-10 min
    IV/ET 1-2min
  • Duration; IM 5-10min
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19
Q

Epinephrine Contraindications

A
  • Hypovolemic shock
  • Dilated Cardiomyopathy
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20
Q

Epinephrine Class

A
  • Sympathomimetic
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21
Q

Epinephrine Drug Interactions

A
  • MAO inhibitors may potentiate the effects of epi
  • Sympathomimmetics and phosphosdiesterase inhibitors may exacerbate disrytmia response
  • May be deactivated by alcholine solutions
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22
Q

Racemic EPI dose

A
  • MDI 2-3 inhalations q5min prn
  • Solution dilute .5ml in 5 ml of saline; give over 15min
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23
Q

Racemic EPI Indications

A
  • Bronchial Asthma
  • Treatment of Bronchospasm
  • Croup
  • Laryngeal Edema
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24
Q

Racemic EPI Onset and Duration

A

Onset: within 5min
Duration: 1-3hrs

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25
Q

Racemic EPI Contrindications

A
  • Hypertension
  • Underlying Cardiovascular disease
  • Epiglottitis
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26
Q

Racemic EPI Class

A
  • Sympathomimetic
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27
Q

Racemic EPI Drug Interactions

A
  • MAO inhibitors may potentiate the effects of epi
  • Sympathomimmetics and phosphosdiesterase inhibitors may exacerbate disrytmia response
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28
Q

Dexamethasone (Decadrone, Hexadrol and others) Dose

A
  • .6mg/kg; max dose 16mg
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29
Q

Dexamethasone indications

A
  • Endocrine, rheumatic and hematologic
  • Allergic states
  • Septic shock
  • Chronic inflammation
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30
Q

Dexamethasone onset and Duration

A

onset: 4-8hrs after parental admin
durations: 24-72hrsss

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31
Q

Dexamethasone contraindications

A
  • Allergy to drug
  • Active and untreated infections
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32
Q

Dexamethasone Class

A
  • Glucocorticoid
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33
Q

Dexamethasone Drug Interactions

A
  • Barbituates
  • Phenytoyn can decrease effects
34
Q

Solumedrol (Methylprednisolone) Dose

A
  • 2mg/kg up to 125mg IV
  • 40-125 mg IV
35
Q

Methylprednisolone indications

A
  • Anaphylaxis
  • Bronchodilator; unresponsive asthma
  • Shock
36
Q

Methylprednisolone onset and duration

A

onset: 1-2hrs
duration: 8-24hrs

37
Q

Methylprednisolone contraindications

A

-use caution with GI bleed
diabetes or severe infection
-IM route is contraindicated in patients with idiopathic thrombocytopenic purpura

38
Q

Methylprednisolone class

A

glucocorticoid

39
Q

Methylprednisolone drug interactions

A
  • hypoglycemic responses to insulin
  • oral hypoglycemic agents may be blunted
  • potassium depleating agents may potentiate hypokalemia
40
Q

Magnesium sulfate dose seizure activity associated in pregnancy

A

4g diluted in D5W or NS for IV piggyback over 15-20 min. followed by continuous infusion of 1-2 g per hour max dose of 30-40g per day

41
Q

Magnesium sulfate dose
pulseless arrest or status asthmatics

A

1-2g diluted in 10ml of D5W IV or IO push

42
Q

Magnesium sulfate dose
torsade de pointes with pulse or acute MI with hypomagnesemia

A

loading dose of 1-2g in 50-100ml of D5W over 5-60 min IV follow with .5-1g per hour IV

43
Q

Magnesium sulfate indications

A

-seizures of eclampsia in pregnancies
- toxemia in pregnancy
- cardiac arrest only is torsade is expected or hypomagnesemia is present
- life threatening ventricular dysrhythmias attributable to digitalis toxicity.
- suspected hypomagnesemia or hyperkalemia
- status asthmatics not responsive to beta adrenergic drugs

44
Q

Magnesium sulfate onset and duration

A

onset: IV immediate
IM 3-4 hours
Duration: IV 30 min
IM 3-4 hours

45
Q

Magnesium sulfate contraindications

A

-heart block or myocardial damage
-hypermagnesemia or -hypercalcemia
-diabetic coma

46
Q

Magnesium sulfate class

A

electrolyte, anticonvulsant

47
Q

Magnesium sulfate drug interactions

A

-CNS depressants effects may be enhanced if pt is taking other CNS depressants
- serious changes in cardia function may occur in cardiac glycosides

48
Q

Benadryl dose

A

1 mg/kg max dose of 50 mg IM /PO or slow IV

49
Q

Benadryl indications

A

-moderate to severe allergic reactions
-anaphylaxis (after epi)
- acute extrapyramidal reactions

50
Q

Benadryl onset and duration

A

onset: 1-3 hours
duration : 6-12 hours

51
Q

Benadryl contraindications

A

-pt taking nonselective MAO inhibitors (rare)
- allergy
- narrow angle glaucoma
- newborns and nursing mothers

52
Q

Benadryl class

A

antihistamine

53
Q

Benadryl drug interactions

A
  • CNS depressants may increase depressant effects
  • MAO inhibitors may prologue or intensify anticholinergic effects of antihistamines
54
Q

Succinocholine dose

A

.3 - 1.1 mg/kg (25-75mg) over 10-30 seconds IV
.04 - .07 mg/kg to maintain relaxation
RSI 1-1.5 mg/kg IV/IO

55
Q

Succinocholine indications

A

to facilitate intubation
- terminate laryngospasm
-muscle relaxation

56
Q

Succinocholine onset and durations

A

onset: less than 1 min
duration : 5-10 min after single IV dose

57
Q

Succinocholine contraindications

A

-burns or crush injuries <72 hours old
-allergy
-skeletal muscle myopathy
-inability to control airway or support ventilations with positive pressure
-personal or family history of malignant hyperthermia
- acute rabdo

58
Q

Succinocholine class

A

neuromuscular blocker (depolarizing)

59
Q

Succinocholine drug interactions

A

oxytocin
-beta blockers
-chronic contraceptive use
- organophosphates may potentiate effects
- diazepam may reduce duration of action
-cardiac glycosides may induce dysrhythmia

60
Q

Etomidate dose

A

0.2-0.6mg/kg (often 0.3 IV over 30-60 seconds) limit to 1 dose

61
Q

Etomidate indications

A
  • premedication for tracheal intubation or cardioversion
62
Q

Etomidate onset and duration

A

onset: less than 1 min
duration: 5-10 min

63
Q

Etomidate contraindications

A
  • allergy
  • labor and delivery
64
Q

Etomidate class

A

nonbarbiturate hypnotic, anastatic

65
Q

Etomidate drug interactions

A
  • effects may be enhanced when given with other CNS depressants
66
Q

ketamine dose

A

excited delirium 2mg/kg IV over 1 min or 4mg/kg IM/IN

pain management
moderate .5mg/kg IN max initial 25mg max of 100mg

severe pain .25mg/kg IM/IV/IO max initial 25 max cumulative 100mg

67
Q

ketamine indications

A

-analgesia
- treatment for severe agitation
- procedure sedation as adjunct to nitric oxide

68
Q

ketamine onset and duration

A

onset: within 30 seconds
duration: 5-10 min up to 1-2 hours

69
Q

ketamine contraindications

A

-stroke
- increased ICP
- severe hypertension
-history of schizophrenia
-cardiac decomposition
-allergy

70
Q

ketamine class

A

nonbarbiturates anesthetic

71
Q

ketamine drug interactions

A

may increase effects from ethinol opioid medications CNS depressants and selective serotonin reuptake inhibitors.

72
Q

Midazolam (versed) dose

A

0.1mg/kg up to 10 mg consider starting with 1-2.5mg iv push
.2mg/kg IM or IN

excited delirium 5 mg IV/IN/IM

end of life care 2-5mg iv

73
Q

Midazolam (versed) indications

A

pre medication for tracheal intubation cardioversion and other painful procedures

74
Q

Midazolam (versed) onset and durations

A

onset: IV 1-3 min dose dependent
duration: 2-6 hours dose dependent

75
Q

Midazolam (versed) contraindications

A

-allergy
-glaucoma
-shock
-alcohol intoxication
- depressed vital signs
- concomitant use of barbiturates alcohol narcotics or other CNS depressants

76
Q

Midazolam (versed) class

A

short acting benzodiazepine

77
Q

Midazolam (versed) drug interactions

A

-sedative effect may be accentuated when used in comb with barbiturates alcohol or narcotics

78
Q

neofed

Paramedic School (8 decks)

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