Week 5

Question 1

Methylprednisolone

Answer 1

Methylprednisolone Corticosteroid

Brand: Solu-Medrol

MOA: Anti-inflammatory. Suppress immune response; decrease inflammation.

IND: Anaphylaxis, COPD, asthma.

CON: Sensitivity, measles, Varicella, Cushing syndrome, fungi infection.

Adverse:G.I. Bleed, extended time to heal, suppression of natural steroids, HTN, fluid retention.

Dose/Route: 40-125mg IV, IO, IM
Spinal injury: 30mg/kg
Pedi: 1-2mg/kg

    special: onset 1-2 hrs, may cause signs of infection, reconstitute & use immediately, pregnancy class C.

Question 2

Sodium Bicarbonate

Answer 2

sodium bicarbonate Electrolyte-Alkalizing Agent

MOA: Alkalizes pH. Combines with excessive Hydrogen reversing clinical acidosis manifestations.

IND: Hyperkalemia, severe acidosis due to hyperventilation, tricyclic antidepressant OD, cardiac arrest with prolonged down time, compartment syndrome(release)

CON: Alkalotic state.

Adverse: Overcompensation (alkalosis), seizures, hypernatremia, fluid retention, peripheral edema

Dose/Route: 0.5-1mEq/kg IV, IO every 10 min

Special: IV flush after use! Class C pregnancy, deactivates catecholamine, precipitation of Calcium (chalk), Na+ overload.

Question 3

Magnesium Sulfate

Answer 3

magnesium sulfate Electrolyte-Antidysrhythmic-Anticonvulsant
MOA: CNS depressant, smooth muscle relaxant, dilation of bronchial

IND: Polymorphic V-tach (torsades de pointes) (often caused by malnutrition). Bronchospasm

CON: Shock, heart block, GI obstruction hypotension, hypothermia, bradycardia, dialysis, renal insufficiency.
Adverse: potentiates digoxin/digitalis, flushing respiratory depression, hypotension, hypothermia, bradycardia.

Dose/Route: VF or VT—1-2g in 1-2 min. (3rd/4th line treatment)
Torsade de Pointes—5-10g @ 1g/min
Pedi—25-50mg/kg over 2-5 min.
Infusion—max 2g/30-60min.
Resp.—1-2g @ 1g/min
Pedi 25-50mg/kg over 2-5min.
OBGYN/Eclamptic Seizures—2-4g IV Drip @ 1g/min
Special: Prego Class A. Do not exceed 1g a minute, burns injection site. Ca++ is antidote. Renal failure = electrolyte dysfunction.

Question 4

Dextrose 50

Answer 4

dextrose 50% Carbohydrate

MOA: elevate BGL; glucose for cellular metabolism.

IND: Hypoglycemia.

CON: intracranial hemorrhage, Delirium Tremens (DT’s).

Adverse: Venous irritation, hyperglycemic.

Dose/Route: 10g-25g SIVP, IO

Pedi: 0.5 g/kg slow IV push, diluted 1:1 in sterile water, 25% solution

SPCL: Class C pregnancy, Necrosis of the tissue if infiltrated.