systemic corticosteroids and additional meds Flashcards
methylprednisolone dosage form
tablets
2,4,6,8,16,32 mg
prednisolone dosage form
tablets - 5mg
oral liquid - 5mg/5mL and 15mg/5mL
prednisone dosage form
tablets - 1,2.5,5,10,20, and 50 mg
oral liquid - 5mg/5mL
dexamethasone dosage form
oral liquid - 1mg/mL and 0.5mg/5mL
tablets - 0.5, 1,4, and 6mg
injection - 4mg/mL and 10mg/mL
methylprednisolone acetate dosage form
repository injection
40mg/mL
80mg/mL
systemic corticosteroids
methylprednisolone
prednisolone
prednisone
dexamethasone
methylprednisolone acetate
decrease inflammation, increase response to b2 agonists
burst methylprednisolone, prednisolone, and prednisone dosing for 0-4 yos
1-2 mg/kg/day
burst methylprednisolone, prednisolone, and prednisone dosing for 5-11 yos
1-2 mg/kg/day as a single dose
2 divided doses for 3 to 5 doses
burst methylprednisolone, prednisolone, and prednisone dosing for adults
40 to 60 mg/day as a single dose
2 divided doses for 3 to 5 days
max of methylprednisolone, prednisolone, and prednisone dosing for 0-4 yos
under 2 yos - 20mg/day for 3 to 7 days
2 to 5 yos - 30mg/day for 3 to 7 days
max of methylprednisolone, prednisolone, and prednisone dosing for 5-11 yos
40mg per day for 3 to 7 days
max of methylprednisolone, prednisolone, and prednisone dosing for adults
60mg per day for 3 to 7 days
burst dexamethasone dosing for 0-4 yos
0.6mg/kg for 1 dose IV or IM
0.6mg/kg for 2 days by mouth
max dexamethasone dosing for 0-4 yos
16mg daily (IV or mouth)
methylprednisolone acetate dosing for 0-4 yos
7.5mg/kg IM once
maximum of 240mg
methylprednisolone acetate dosing 5-11 yos and adults
240mg IM for 1 dose
adverse effects of systemic corticosteroids
short term use - hyperglycemia
increased appetite
fluid retention
demmargination of WBCs
psychiatric disturbances
contraindications of systemic corticosteroids
systemic fungal infections
administration of live vaccines if immunocompromised
drug interactions of systemic corticosteroids
warfarin INR levels increase
decreases efficacy of inactivated vaccines
clinical pearls of systemic corticosteroids
may be used with ICS if patient is already taking ICS before hospitalization
may also be used for chronic therapy in both asthma and COPD only in severe stages
bursts effective for establishing control when initiating therapy or during period of gradual deteriorations
injection may be used in place of burst if adherence is an issue or the patient is vomiting
sq b2 agonists
epinephrine
terbutaline
epinephrine dosing for children
0.01mg/kg up to 0.3 to 0.5mg every 20 minutes for 3 doses sq
epinephrine dosing for adults
0.3 to 0.5 mg every 20 minutes for 2 doses sq
epinephrine comments
no proven advantage of systemic therapy over aerosol
indicated in addition to standard therapy for acute asthma associated with anaphylaxis and/or angioedema
terbutaline dosing for children
0.01 mg/kg every 20 minutes for 3 doses then every 2 to 6 hours sq prn
terbutaline dosing for adults
0.25mg every 20 minutes for 3 doses subcutaneously then prn
terbutaline dosing comments
no proven advantage of systemic therapy over aerosol
magnesium sulfate IV
smooth muscle relaxation through inhibition of calcium influx into smooth muscle cells
magnesium sulfate dosing for children
25 to 75 mg/kg IV for 1 dose
maximum dose of 2gm
magnesium sulfate dosing for adults
2 grams IV for 1 dose
infused over 20 minutes
magnesium sulfate dosing comments
consider if patient remains in life threatening exacerbation after 1 hour of therapy
adverse effects of magnesium sulfate
flushing
hypotension
vasodilation
contraindications of magnesium sulfate
heart block
caution in renal dysfunction
