Drug Quiz 2

Question 1

Albuterol Sulfate

Answer 1

Proventil HFA, ProAir HFA

Question 2

Albuterol Sulfate Drug Classification

Answer 2

Sympathomimetic/Sympathetic agonist (b2 selective)

Question 3

Albuterol Sulfate Mechanism of Action

Answer 3

B2 agonist->bronchodilation

Question 4

Albuterol Sulfate Pharmacokinetics

Answer 4

Onset of Action=5-15 min
Peak effects=1-1.5 hours
Duration of effect=3-6 hours
Half-Life=< 3 hours

Question 5

Albuterol Sulfate Indications/Field use

Answer 5

1) Asthma

2) Reversible bronchospasm associated with COPD

Question 6

Albuterol Sulfate Contraindications

Answer 6

Symptomatic tachycardia, pts with a history of hypersensitivity to this drug

Question 7

Albuterol Sulfate Side Effects/Adverse Reactions

Answer 7

Anxiety, HA, palpitations, sweating, dizziness, nervousness, tremor, HTN, arrhythmias, chest pain, N+V

Question 8

Albuterol Sulfate Dose

Answer 8

MDI: (Adult) 1 or 2 sprays (90mg/spray)
Small-volume nebulizer: (Adult) 2.5mg in 2.5mL NS over 5-15min
Small-volume nebulizer: (Pedi) 2.5mg in 2.5mL NS over 5-15min

Question 9

Albuterol Sulfate Precautions

Answer 9

1) BP, pulse, and EKG should be monitored
2) use caution with pts with known heart disease or HTN
3) auscultate LS before and after treatment

Question 10

Albuterol Sulfate Drug-Drug Interactions

Answer 10

1) SE may increase with other sympathetic agonists
2) B blockers may blunt effects of this drug
3) MAOI and TCA may potentiate cardiovascular effects

Question 11

Ipratroprium Bromide

Answer 11

Atrovent

Question 12

Ipratroprium Bromide Drug Classification

Answer 12

Anticholinergic/Parasympathetic

Question 13

Ipratroprium Bromide Mechanism of Action

Answer 13

Muscarinic ACh-R blocker->inhibits parasympathetic stimulation and vagally mediated responses by preventing increase in intracellular cGMP in bronchial smooth muscle->dries respiratory tract secretions and allows for bronchodilation

Question 14

Ipratroprium Bromide Pharmacokinetics

Answer 14

Onset of Action=varies
Peak Effects=1.5-2hours
Duration of Effect=4-6hours
Half-Life=1.5-2hours

Question 15

Ipratroprium Bromide Indications/Field use

Answer 15

1) Bronchial Asthma

2) Reversible bronchospasm associated with COPD

Question 16

Ipratroprium Bromide Contraindications

Answer 16

1) pts with history of hypersensitivity?

2) should not be used as primary acute treatment of bronchospasm

Question 17

Ipratroprium Bromide Side Effects/Adverse Reactions

Answer 17

Anxiety, HA, palpitations, dizziness, nervousness, rash, N+V

Question 18

Ipratroprium Bromide Dose

Answer 18

Small-volume nebulizer: (Adult) 500mg-typically administered with a beta agonist
Small-volume nebulizer: (Pedi) 250-500mg q20min PRN
Also available as MDI

Question 19

Ipratroprium Bromide Precautions

Answer 19

1) BP, pulse, and EKG should be monitored
2) use caution with pts with known heart disease or HTN and elderly
3) auscultate LS before and after treatment

Question 20

Ipratroprium Bromide Drug-Drug Interactions

Answer 20

Few prehospitally, not specified

Question 21

Magnesium Sulfate drug classification

Answer 21

Electrolyte/Antidysrhythmic/Mineral

Question 22

Magnesium Sulfate Mechanism of Action

Answer 22

Psycologic Ca2+ channel blocker->blocks neuromuscular transmission, causes CNS depressants and smooth muscle relaxation

Question 23

Magnesium Sulfate Pharmacokinetics

Answer 23

Onset of Action=Immediate IV, 1 hour IM
Peak Effects=Varies
Duration of Effect=1 hour
Half-Life=N/A

Question 24

Magnesium Sulfate Indications/Field Use

Answer 24

1) Severe Asthma/ Bronchospasm
2) Severe refractory VF or pulseless VT with hypoMg2+ and Torsades de Pointes
3) Post-MI prophylaxis of dysrhythmias
4) Ecclampsia, Pre-Term Labor

Question 25

Magnesium Sulfate Contraindications

Answer 25

Pt with 3rd degree heart block, shock, severe/persistent hypertension, impaired renal function, hypocalcemia

Question 26

Magnesium Sulfate Side Effects\Adverse Reactions

Answer 26

Flushing, Sweating, Bradycardia, Decreased Deep tendon reflexes, drowsiness, respiratory depression, dysrhythmias, hypotension, hypothermia, itching, rash

Question 27

Magnesium Sulfate Dose

Answer 27

Asthma (Adult): 2g in 100cc NS IV, IO infusion over 10 minutes VT, VF Torsades-no pulse (Adult): 2g IVP (IO) over 1-2 minutes VT/Torsades +pulse (Adult): 1-2g in 50-100cc NS, slow IVP (IO) over 5-60 minutes Eclampsia (Adult): 2-4g slow IV, IO over 25 minutes, IM if IV access unavailable Asthma (Pedi): 25-50mg/kg slow IV, IO infusion over 15-30 minutes, max dose 2g VT -no pulse (Pedi): 25-50mg/kg IVP (IO), max dose 2g VT +pulse (Pedi): 25-50mg/kg IV, IO over 10-20 minutes, max dose 2g

Question 28

Magnesium Sulfate Precautions

Answer 28

1) Monitor Vitals 2) Watch for Respiratory Depression 3) Have CaCl2 available if OD

Question 29

Magnesium Sulfate Drug-Drug Interactions

Answer 29

Cardiac conduction abnormalities if given with digitalis

Question 30

Methylpredisolone

Answer 30

Solu-Medrol

Question 31

Methylpredisolone drug classification

Answer 31

Corticosteroid/Anti-inflammatory

Question 32

Methylpredisolone Mechanism of action

Answer 32

Diffuses across the cell membrane, binds to DNA, regulates gene expression and increases synthesis of proteins and enzymes that inhibit inflammatory agents (cytokines, interleukin, interferon); inhibits synthesis of pro-inflammatory enzymes. *It is an immunosupressant*

Question 33

Methylpredisolone Pharmacokinetics

Answer 33

Onset of Action=2-6 hours Peak Effects=4-8 days Duration of Effect=1-5 weeks Half-Life=3.5 hours

Question 34

Methylpredisolone Indications/Field Use

Answer 34

1) Severe Anaphylaxis, hives 2) Asthma, COPD 3) Spinal cord injury

Question 35

Methylpredisolone Contraindications

Answer 35

None in EMS

Question 36

Methylpredisolone Side Effects/Adverse Reactions

Answer 36

Fluid retention, CHF, HTN, abd. distension, vertigo, HA, nausea malaise, hiccups

Question 37

Methylpredisolone dose

Answer 37

Asthma/Anaphylaxis (Adult): 125-250mg IV, IO Spinal Cord Injury (Adult): 30mg/kg IV, IO over 15 min, maintenance 5.4mg/kg/hr for 24-48 hours Asthma/Anaphylaxis (Pedi): 2mg/kg IV, IO, IM; max dose 80mg

Question 38

Methylpredisolone Precautions

Answer 38

1) Give only one dose prehospitally 2) LT steroid use can cause GI bleeding 3) prolonged wound healing 4) and suppression of adrenocortical steroids

Question 39

Methylpredisolone drug-drug interactions

Answer 39

1) Lasix and thiazide diuretics increase potassium loss | 2) Decreased effect with phenytoin, phenobarbital, and rifampin due to increased metabolism of steroids