Week 1

Question 1

Albuterol (Proventil, Ventolin, Proair, Accuneb)

Answer 1

Class: Sympathomimetic, bronchodilator, beta 2 adrenergic agonist

MOA: Selective Beta 2 adrenergic agonist that causes bronchial smooth muscle relaxation

Indications:
- Treats & prevents bronchospasms
- Treats inhaled respiratory irritants
- Hyperkalemia treatment

Contraindications:
- dysthymias
-synergistic w/ other sympathomimetics

Dosage:

• Resp. Distress= 2.5-5mg nebulizar or 1-2 puffs via MDI
  -Bronchospasm= 5mg vía neb/ 6 puffs
  -Hyperkalemia= 5mg vía nebulizar

Question 2

Aspirin (Acetylsalicylic Acid)

Answer 2

Class:
Platelet inhibitor, NSAID, anti inflammatory

MOA:
- Prevents platelet formation
-Antipyretic & Analgesic

Indications:
-acute chest pain suggestive of ACS

Contraindications:
- Hypersensitivity to ASA/ NSAIDS
-Bleeding disorders
-Hemolytic anemia
-lactating mothers

Dosage:
- 162-325mg
-NO PEDS, PREG SAFETY CLASS D

Question 3

Dextrose

Answer 3

Class:
-Carb / Glucose elevating agent

MOA:
- Rapidly increases glucose levels
- Short term osmotic diuresis

Indications:
- Status epilepticus
- Coma/ Seizure of unknown origin
-ALOC
-Hypoglycemia

Contraindications:
-Glucose-galactose malabsorption syn.
-intracranial/ intraspinal hemorrhage
-Anuria
-Severe dehydration
-Hyperglycemia
-Diabetic coma

Dosage:

Adult= 25g of D10W- D50W IV

Peds= 0.5-1g/kg of D10-D25W

Infants=0.2g/kg, then 5ml/kg/h D10

Question 4

Naloxone (Narcan/EVZIO)

Answer 4

Class: Opioid antagonist/reversal agent & antidote

MOA: Blocks opioid receptor sites & reverses respiratory depression & opioid sedation

Indications:
-Complete or partial reversal of CNS & respiratory depression caused by opioids or synthetic opioids

Contraindications:
-Be cautious w/ opiate dependent pt
-Cautious w/ neonates of addict mom

Dosage:

Adult= 0.4-2mg IV/IO/IM or max dose of 4mg IN

Ped= 0.1mg/kg IV/IO/IM/IN
- Max dose: 2mg IV/IM or 4mg IN

Question 5

Nitroglycerin (Tridil)

Answer 5

Class: Vasodilator, antianginal, nitrate

MOA:
-Smooth muscle relaxation
-Dilated peripheral arterioles & veins
-Reduces PVR, preload, afterload which decreases the hearts workload & myocardial oxygen demand

Indications:
-Pulmonary edema/ CHF
-Ischemic type chest pain
-Hypertension

Contraindications:
-Hypotension / Hypovolemia
-Severe bradycardia / tachycardia
-Intracranial bleeding / head injury
-Pericardial tamponade
-Right Ventricular infarction (use 12)
-ED meds or “Fil’s” in past 24-48hrs

Dosage:

-SL= 0.3-0.4mg repeat 3x every 5 min
-Spray=1-2 repeat 3x every 5min
-IV= 12.5-25mcg bolus then increase by 10mcg/min every 5min, max of 200
Mild
-Mild CHF= 0.4mg SL repeat at 5min
-Severe CHF:
SBP 100-150 = 0.4mg SL
SBP 150-200= 0.8mg SL
SBP 200+= 1.2mg SL

Question 6

Oral glucose

Answer 6

Class: Hyperglycemic, carbohydrate

MOA: Increases BG levels

Indications: Conscious pt w/ low BG

Contraindications:
-Decreased LOC
-Nausea/vomiting

Dosage:

Adult= 25g orally
Peds=0.5-1g/kg orally, max of 25g

Question 7

Epinephrine

Answer 7

Class:
-Sympathomimetic
-Alpha & Beta adrenergic agonist

MOA:

-Alpha stimulation results in systemic vasoconstrictions & increasing PVR

-Beta 1 stimulation result in increased HR (chronotrope), myocardial contractility (inotrope), cardiac output & myocardial oxygen demand

-Effects of Beta 2 stimulation cause bronchial smooth muscle relaxation

-Secondary relaxation on smooth muscle in stomach, intestine, uterus and urinary bladder

Indications:
-Croup/ bronchiolitis (nebulized)
-Bradycardia
-Shock
-Cardiac arrest
-Anaphylaxis

Contraindications:
-Uncontrolled hypotension
-Myocardial ischemia
-Hypothermia
-Pulmonary edema
-Hypovolemic shock