Respiratory Medications Flashcards
albuterol sulfate (Proventil)
a BRONCHODILATOR BETA AGONIST that binds and stimulates beta2 receptors, resulting in the relaxation of bronchial smooth muscle.
Onset - 5-15 minutes after inhalation
Duration - 3-4 hours after inhalation
albuterol sulfate (Proventil) Indications
Asthma, bronchitis with bronchospasm, and COPD.
Known or suspected hyperkalemia with EKG changes such as peaked T waves and QRS widening.
albuterol sulfate (Proventil) Contraindications
Sensitivity to albuterol or levalbuterol.
Severe tachycardia (relative)
albuterol sulfate (Proventil) Adverse Effects
Tachycardia, palpitations, and dysrhythmias.
albuterol sulfate (Proventil) Drug Interactions
Sympathomimetics may exacerbate adverse cardiovascular effects. Beta Blockers may antagonize albuterol.
albuterol sulfate (Proventil) Dosage and Administration
Single Neb:
One 2.5 mg/3 mL dose at a flow rate of 6-8 liters per minute was delivered over 5 to 15 minutes. May be repeated 2 times for a total of 3 administrations.
Continuous Neb:
3 2.5 mg/3 mL bullets for a total of 7.5 mg/9 mL at a flow rate of 6-8 liters per minute
albuterol sulfate (Proventil) Special Considerations
Use with caution in lactating patients, patients with cardiac dysrhythmias, suspected or known coronary disease, diabetes, hyperthyroidism, prostatic hypertrophy, or seizure disorders.
May precipitate angina and dysrhythmias.
Wheezing associated with anaphylaxis should first be treated with epinephrine IM.
Consider inline nebs for patients requiring endotracheal intubation or CPAP.
Pregnancy Class C.
epinephrine (Adrenalin)
An INOTROPIC ADRENERGIC catecholamine alpha, beta1 and beta2 adrenergic receptor agonist.
epinephrine (Adrenalin) Indications
Pulseless Arrest
Anaphylaxis
ASTHMA
Bradycardia with poor perfusion
epinephrine (Adrenalin) Adverse Reactions
Tachycardia and tachydysrhythmia
Hypertension
Anxiety
May precipitate angina pectoris
epinephrine (Adrenalin) Dosage for Asthma
Adult: 0.3 mg (0.3 mL of 1:1000) IM. May repeat dose 1 time.
Pediatric: 1 to 12 years old - 0.01 mg/kg (0.01 mL/kg of 1:1000) IM. May repeat dose one time after 5 minutes.
ipratropium bromide (Atrovent)
An ANTICHOLINERGIC BRONCHODILATOR that is chemically related to atropine, meaning it competes with acetylcholine at the site of the muscarinic receptor.
Onset - 5-15 minutes
Duration - 6-8 hours
ipratropium bromide (Atrovent) Indications
Bronchospasm
ipratropium bromide (Atrovent) Contraindications
Children under the age of 2
Soy or peanut allergy (MDI)
ipratropium bromide (Atrovent) Adverse Reactions
Palpitations
Tremors
Dry Mouth
ipratropium bromide (Atrovent) Dosage and Administration
Adult: 0.5 mg/2.5 mL along with albuterol in a nebulizer.
Pediatric: 2-12 years old - 0.5 mg/2.5 mL along with albuterol.
1-2 years - 0.25 mg with albuterol in a nebulizer.
Not indicated for repetitive dose or continuous neb use.
Pregnancy Class B.
magnesium sulfate
An ELECTROLYTE that reduces striated muscle contractions and blocks peripheral neuromuscular transmission by reducing acetylcholine release at the myoneural junction. It may act as a bronchodilator in acute bronchospasm due to asthma or other bronchospastic diseases.
magnesium sulfate Indications
Severe bronchospasm unresponsive to continuous albuterol, ipratropium, and IM epinephrine.
magnesium sulfate Precautions and Adverse Reactions
Bradycardia
Hypotension
Respiratory depression
magnesium sulfate Dosage and Administration
2 g IV bolus
Not indicated for pediatrics
methylprednisolone (Solu-Medrol)
A CORTICOSTEROID that suppresses acute and chronic inflammation and may alter the immune response. It potentiates vascular smooth muscle relaxation by beta-adrenergic agonists and may alter airway hyperactivity.
methylprednisolone (Solu-Medrol) Indications
Anaphylaxis
Severe Asthma
COPD
Suspected Addisonian crisis (cardiovascular collapse in patient at risk for adrenal insufficiency)
methylprednisolone (Solu-Medrol) Contraindications
Evidence of GI bleed
methylprednisolone (Solu-Medrol) Adverse Reactions
Gastrointestinal bleeding
Hypertension
Hyperglycemia
(all typically results of long-term therapy)