2130

Question 1

Albuterol

Brand name

Answer 1

Brand name: proventil/ ventolin

Question 2

Albuterol

Drug class

Answer 2

Drug class: sympathomimetic

Question 3

Albuterol

Indications

Answer 3

Indications: treatment of bronchospasm in patients with reversible obstructive airway disease (COPD, asthma) prevention of exercise-induced bronchospasm.

Question 4

Albuterol

Mechanism of action

Answer 4

Mechanism of action: selective beta-2 agonist that stimulates adrenergic receptors of the sympathomimetic nervous system. Results in smooth-muscle relaxation in the bronchial tree and peripheral vasculature. More selective for beta-2 than Albuterol

Question 5

Albuterol

Contraindications

Answer 5

Contraindications: hypersensitivity, tachycardia, dysrhythmias, especially those caused by digitalis. Synergistic with other sympathomimetic

Question 6

Albuterol

Adverse effects

Answer 6

Adverse effects: headaches, fatigue, lightheadedness, irritability, restlessness, aggressive behavior, pulmonary edema, hoarseness, nasal congestion, increased sputum, hypertension, tachycardia, dysrhythmias, chest pain, palpitations, N/V, dry mouth, epigastric pain, and tremors.

Question 7

Albuterol

Precautions

Answer 7

Precautions: TCA’S may potentiate vasculature effects, beta blockers will antagonize effects may cause hypokalemia

Question 8

Albuterol

Dose & administration

Answer 8

Dose & administration: adult 2.5mg dilute in 3ml NS nebulized over 10-15 minutes. Pediatric <20kg - 1.25mg/ dose via hand held nebulizer or mask over 20 minutes. Pediatrics >20kg - 2.5mg/ dose via hand held nebulizer or mask over 20 minutes

Question 9

Etomidate

Brand name

Answer 9

Brand name: amidate

Question 10

Etomidate

Drug class

Answer 10

Drug class: non-barbiturate hypnotic anesthesia induction agent.

Question 11

Etomidate

Indications

Answer 11

Indications: premedication for tracheal intubation (RSI/SAI) or cardioversion

Question 12

Etomidate

Mechanism of action

Answer 12

Mechanism of action: short- acting hypnotic that acts at the level of the reticular activating system within the brain.

Question 13

Etomidate

Contraindications

Answer 13

Contraindications: hypersensitivity, labor & delivery

Question 14

Etomidate

Adverse effects

Answer 14

Adverse effects: hypoventilation, hyperventilation, dysrhythmias, hypotension, hypertension, N/V, involuntary muscle movement, pain at injection site.

Question 15

Etomidate

Precautions

Answer 15

Precautions: may be enhanced when given with other CNS depressants.

Question 16

Etomidate

Dose & administration

Answer 16

Dose & administration: adult 0.2 to 0.6mg/kg iv over 30-60 seconds. Pediatrics 0.2 to 0.4mg/kg iv over 30-60 seconds

Question 17

Lpratropium

Brand name

Answer 17

Brand name: atrovent

Question 18

Ipratropium

Drug class

Answer 18

Drug class: anticholinergic

Question 19

Ipratropium

Indications

Answer 19

Indications: persistent bronchospasm (asthma), COPD exacerbation.

Question 20

Ipratropium

Mechanism of action

Answer 20

Mechanism of action: inhibits interaction of acetylcholine at receptor sites of bronchial smooth muscle ( in the lungs), resulting in decreased contractility of the bronchial smooth muscle and decrease in mucous production

Question 21

Ipratropium

Contraindications

Answer 21

Contraindications: hypersensitivity to ipratropium, atropine, alkaloids, peanuts. Note new manufacturing has eliminated the contraindications pertaining to peanuts and soy allergy

Question 22

Ipratropium

Adverse effects

Answer 22

Adverse effects: headache, dizziness, nervousness, fatigue, tremor, blurred vision, cough, dyspnea, worsening COPD symptoms, tachycardia, palpitations, flushing, MI, dry mouth, N/V, GI distress.

Question 23

Ipratropium

Precautions

Answer 23

Precautions: no drug interactions reported

Question 24

Ipratropium

Drug & administration

Answer 24

Drug & administration: adult 250 to 500 mcg (.25 to .5mg) inhalation with nebulizer every 20 minutes up to 3 times. Pediatrics same as adult.

Question 25

Levalbuterol Brand name

Answer 25

Brand name: xopenex

Question 26

Levalbuterol Drug class

Answer 26

Drug class: sympathomimetic, bronchodilator

Question 27

Levalbuterol Indications

Answer 27

Indications: treatment of acute bronchospasm in patients with reversible obstructive airway disease (COPD, asthma). Bronchospasm prophylaxis (prevention/treatment) in asthma patients.

Question 28

Levalbuterol Mechanism of action

Answer 28

Mechanism of action: stimulates beta-2 receptors resulting in smooth muscle relaxation of the bronchial tree and peripheral vasculature. More selective for beta-2 than albuterol.

Question 29

Levalbuterol Contraindications

Answer 29

Contraindications: hypersensitivity, angioedema, tachydysrhythmias, severe cardiac disease.

Question 30

Levalbuterol Adverse effects

Answer 30

Adverse effects: headache, anxiety, dizziness, restlessness, hallucinations, throat irritation, tachycardia, hypotension, hypertension, dysrhythmias, angina, N/V, dyspepsia, tremors, hypokalemia, hyperglycemia.

Question 31

Levalbuterol Precautions

Answer 31

Precautions: increases action of bronchodilators, MAOI'S, TCA's and other adrenergics. May cause a prolonged QT interval with sotalol or phenothiazine's

Question 32

Levalbuterol Dose & administration

Answer 32

Dose & administration: adult 1.25mg to 2.5mg in 3ml normal saline administered by nebulizer every 20 minutes to a maximum of 3 doses. Pediatrics 0.075mg/kg (minimum of 1.25mg) administered by nebulizer every 20 minutes to a maximum of 3 doses.

Question 33

Succinylcholine Brand name

Answer 33

Brand name: anectine

Question 34

Succinylcholine Drug class

Answer 34

Drug class: neuromuscular blocker, depolarizing; skeletal muscle relaxant

Question 35

Succinylcholine Indications

Answer 35

Indications: RSI

Question 36

Succinylcholine Mechanism of action

Answer 36

Mechanism of action: ultra short acting depolarizing skeletal muscle relaxant that mimics acetylcholine as it binds with the cholinergic receptors on the motor end plate, producing a phase 1 blocker as manifested by fasciculations.

Question 37

Succinylcholine Contraindications

Answer 37

Contraindications: acute narrow-angle glaucoma, penetrating eye injuries, malignant hyperthermia. Acute injury after multisystem trauma, major burns, or extensive muscle injury. Inability to control airway or support ventilation with oxygen and positive pressure.

Question 38

Succinylcholine Adverse effects

Answer 38

Adverse effects: bradydysrhythmia, tachydysrhythmia, dysrhythmia, cardiac arrest, salivation, prolonged muscle rigidity, rhabdomyolysis, malignant hyperthermia, increased intraocular pressure, hyperkalemia (trauma patients)

Question 39

Succinylcholine Precautions

Answer 39

Precautions: oxytocin, beta blockers and organophosphates may potentiate effects, diazepam can reduce duration of action

Question 40

Succinylcholine Dose & administration

Answer 40

Dose & administration: adult 1 to 1.5mg/kg rapid iv. Repeat once if needed. Pediatrics same as adult. Onset of 1 minute, peak 1 to 3 minutes, duration 5 to 10 minutes.

Question 41

Lidocaine Brand name

Answer 41

Brand name: xylocaine

Question 42

Lidocaine Drug class

Answer 42

Drug class: antidysrhythmic (sodium channel blocker)

Question 43

Lidocaine Indications

Answer 43

Indications: alternative to amiodarone in cardiac arrest from ventricular tachycardia, ventricular fibrillation, stable wide complex tachycardia (poly- or monomorphic) with normal baseline QT interval, stable monomorphic VT with preserved ventricular function.

Question 44

Lidocaine Mechanism of action

Answer 44

Mechanism of action: decreases automaticity by slowing the rate of spontaneous phase 4 depolarization: blocks Na+ channels in cardiac myocyte, slows depolarization, suppresses automaticity, resulting in stabilizing ectopic foci by increasing the threshold needed for depolarization.

Question 45

Lidocaine Contraindications

Answer 45

Contraindications: hypersensitivity, second or third AV heart block in the absence of an artificial pacemaker, stokes Adam's syndrome, wide complex ventricular escape beats with bradycardia.

Question 46

Lidocaine Adverse effects

Answer 46

Adverse effects: anxiety, drowsiness, confusion, seizures, slurred speech, respiratory arrest, hypotension, bradycardia, dysrhythmias, cardiac arrest, AV block, N/V

Question 47

Lidocaine Precautions

Answer 47

Precautions: caution in wolf Parkinson white syndrome cardiac depression seen with phenytoin metabolic clearance reduced with liver disease or use of beta blockers

Question 48

Lidocaine Dose & administration

Answer 48

Dose & administration: adult v-tach/V-fib- 1.0 to 1.5mg/kg iv/io may be repeated in 5 to 10 minutes; dose - 0.5 to 0.75mg/kg iv/io maximum dose of 3mg/kg. Stable v-tach 0.5 to 0.75mg/kg iv/io. May repeat does in 5 to 10 minutes with maximum dose of 3mg/kg. Pediatrics 1mg/kg iv/io push with maximum dose of 100mg.