Week 3: Respiratory Drugs Flashcards
What is oxygen?
- a gas that can be regulated
- delivered to the patient via plastic tubing attached to a mask/nasal cannula
When is oxygen needed?
- to reverse hypoxia
- critical illnesses requiring supplementary oxygen e.g. major trauma
- it is essential for tissue oxygenation
What are controlled-indications of oxygen?
Being in an explosive environment (inc properties when patient is smoking)
What cautions are there with using oxygen?
- oxygen increases fire hazard
- defib pads must be firmly placed to reduce spark hazard (ensure 1m away when shock is delivered)
What are some side effects of oxygen?
- irritate mucous membranes/make patient dry
- COPD patients (high oxygen levels can increase CO2 )
How do you administer oxygen, and for how long?
Administer until a reliable reading is obtained, change the mask if SPO2 cannot be maintained
What are the target saturation levels?
No COPD= 94-98%
COPD= 88-92%
How is salbutamol presented?
Nebules containing salbutamol
- 2.5mg/2.5ml
- 5mg/2.5ml
How does salbutamol work?
It is a selective beta2 adrenorecptor which works on the smooth muscle in the airways which spasm in an asthma attack
When would you use salbutamol?
- acute asthma where inhaler has no effect
- expiratory wheeze associated with allergy, anaphylaxis, overdose, smoke inhalation, etc
- exacerbation of COPD
What are some cautions associated with salbutamol?
Used in care with patients who have:
- hypertension
- angina
- overactive thyroid
- severe hypotension
- bronchomalcia
In COPD patients limit nebulisation to 6 minutes
What are possible side effects of salbutamol?
- tremours
- tachycardia
- palpitations
- headache
- feeling of tension
- rash
- muscle cramps
- peripheral vasodilation
What is the dosage and administration of salbutamol in adults?
- nebulised with 6-8 litres per min of O2
- initial dose is 5mg/2.5ml
- repeat dose is 5mg/2.5ml
- dose interval is 5 mins
- no max dose
How is ipratropium presented?
In nebules:
- 250mcg/1ml or;
- 500mcg/2ml
When would you use ipratropium bromide?
- acute severe or life threatening asthma
- acute asthma unresponsive to salbutamol
- exacerbation of COPD unresponsive to salbutamol
- expiratory wheeze
How does ipratropium bromide work?
It is a bronchodilator
What works quicker in acute asthma ?
Beta2
What does ipratropium bromide have a greater benefit in?
- paediatric acute asthma
- adults with exacerbation of COPD
What is the dosage of ipratropium bromide for an adult?
- nebulised with 6-8 litres/min of O2
- initial dose is 500mcg/2ml
- repeat dose is N/A
- max dose is 500mcg
How is adrenaline presented?
In a profiled syringe containing 1mg of adrenaline
When would you use adrenaline?
- life threatening asthma
- when a patient has failing ventilation
- continued disorientation despite nebulised therapy
How does adrenaline work?
Relieves bronchospasm in acute severe asthma
What are some cautions associated by using adrenaline?
- severe hypertension in patients on beta-blockers
- administration route is IM
- patients with a larger BMI will need a longer needle
What is the dosage and administration of adrenaline?
- IM antero-laternal aspect of the thigh
- 500mcg initial dose
- 500mcg repeat dose
- 5 minute intervals
- no max dose
What does hydrocortisone do?
A glucocorticoid that restores BP, blood sugar, cardiac synchronicity and volume and the therapeutic actions suppress the inflammation and immune response
What is a contra-indication to hydrocortisone?
- known allergy
- avoid IM admin if patient is likely to require thrombolysis
What is the dosage and administration of hydrocortisone?
- IV slow injection over 2 minutes to avoid burning/stinging
- IM in deltoid or upper arm
- 100mcg/1ml
- no repeat dose
When else should you not administer hydrocortisone?
If there is any doubt over previous steroid administration
