Module 1 Drugs

Question 1

Ondanestron Hydrochloride (Zofran) classification

Answer 1

Anti-emetic

Question 2

Ondanestron Hydrochloride (Zofran) MOA

Answer 2

Selective 5-HT3 serotonin receptor antagonist

Question 3

Ondanestron Hydrochloride (Zofran) indications

Answer 3

Control and Prevention of nausea and vomiting

Question 4

Ondanestron Hydrochloride (Zofran) contraindications

Answer 4

Known hypersensitivity, prolonged QT Syndrome

Question 5

Ondanestron Hydrochloride (Zofran) adverse effects

Answer 5

GI symptoms, headaches, fever, blurred vision, chest pain, EKG changes

Question 6

Ondanestron Hydrochloride (Zofran) Dosage: adult

Answer 6

4 mg undiluted slow IV
4 mg ODT tablet

Question 7

Ondanestron Hydrochloride (Zofran)
Dosage: pediatric

Answer 7

0.1 mg/kg undiluted slow IV; max 4 mg
> 2 YO = 4 mg ODT
< 2 YO = 2 mg ODT

Question 8

Albuterol Sulfate (Proventil, Ventolin) classification

Answer 8

Beta 2 agonist
Sympathomimetic bronchodilator

Question 9

Albuterol Sulfate (Proventil, Ventolin) MOA

Answer 9

Relaxes bronchial smooth muscle
Stimulates beta 2 receptors
Bronchodilation
Decreased airway resistance

Question 10

Albuterol Sulfate (Proventil, Ventolin) pharmacokinetics

Answer 10

Onset: 5-14 minutes after inhalation, prompt improvement

Question 11

Albuterol Sulfate (Proventil, Ventolin) indications

Answer 11

Bronchial asthma
COPD/Emphysema/Chronic bronchitis
Bronchospasm due to anaphylaxis, burns, toxic inhalation
Crush syndrome > 4 hours

Question 12

Albuterol Sulfate (Proventil, Ventolin) contraindications

Answer 12

Known hypersensitivity
Tachydysrythmias

Question 13

Albuterol Sulfate (Proventil, Ventolin) Adverse effects

Answer 13

Tachycardia
Tremors
Anxiety
Palpitations
Dysrhythmias
Dry mouth
Throat irritation

Question 14

Albuterol Sulfate (Proventil, Ventolin) precautions

Answer 14

Dysrhytmias
Tachycardia

Question 15

Albuterol Sulfate (Proventil, Ventolin) dosage: adult

Answer 15

2.5 - 5 mg via handheld nebulizer
Duoneb with 0.5 mg atrovent

Question 16

Albuterol Sulfate (Proventil, Ventolin) dosage: pediatric over 2 YO >20 kg

Answer 16

2.5 mg via handheld nebulizer
W/duoneb 0.5 mg atrovent

Question 17

Albuterol Sulfate (Proventil, Ventolin) dosage: pediatric <2 YO or <20 kg

Answer 17

1.25 mg handheld nebulizer
Duoneb w/Atrovent 0.25 mg

Question 18

Albuterol Sulfate (Proventil, Ventolin) pearls

Answer 18

1st dose w/Atrovent; the rest Albuterol only
6 - 8 LPM oxygen required
Chamber upright

Question 19

Ipratropium Bromide (Atrovent) Classification

Answer 19

Anticholinergic
Bronchodilator

Question 20

Ipratropium Bromide (Atrovent) MOA

Answer 20

Inhibits interaction of acetylcholine at receptor sites on bronchial smooth muscle.

Question 21

Ipratropium Bromide (Atrovent) Indications

Answer 21

Bronchial asthma
COPD/Emphysema/Chronic Bronchitis
Anaphylaxis
Burns
Toxic inhalations

Question 22

Ipratropium Bromide (Atrovent) Contraindications

Answer 22

Hypersensitivity to atrovent or atropine.

Question 23

Ipratropium Bromide (Atrovent) Adverse effects

Answer 23

Tachycardia
Nausea/vomiting
Headache
Blurred vision

Question 24

Ipratropium Bromide (Atrovent) Dosage

Answer 24

Adult: 0.5 mg nebulizer, DuoNeb with 2.5 mg albuterol, no repeat dose

Pediatric: 2 yo+ or >20 kg = 0.5 mg DuoNeb w/2.5 mg albuterol

<2 yo or <20kg = 0.25 mg DuoNeb w/1.25 mg albuterol, no repeat dose

Question 25

Ipratropium Bromide (Atrovent) pearls

Answer 25

Soy Lethcin allergy in Combivent MDI Local protocols

Question 26

Magnesium Sulfate Classification

Answer 26

Electrolyte Antidysrhythmic Anticonvulsant CNS depressant Smooth muscle relaxant

Question 27

Magnesium Sulfate MOA

Answer 27

Antidysrhytmic: calcium channel blocker, reducers SA Node impulse, prolongs conduction time in myocardium Anticonvulsant: reduces striated muscle contractions and blocks peripheral neuromuscular transmission by reducing Acetylcholine release at myoneural junction

Question 28

Magnesium Sulfate Indications

Answer 28

Preeclampsia/Eclampsia Torsades des pointed Refractory V Fib Pulse V Tach w/suspected hypomagnesemia Status asthmaticus

Question 29

Magnesium Sulfate Contraindications

Answer 29

Myasthenia Gravis Impaired renal function (includes dialysis)

Question 30

Magnesium Sulfate Dosage

Answer 30

Eclamptic seizure: 4 g diluted in 50 ml normal saline / D5W and slow IV infusion over 5 - 10 mins Torsades des Pointes w/pulse: 2 g diluted in 50 ml D5W IVP over 10 mins Refractory VF and Torsades des Pointes w/o a pulse: adult = 1-2 g diluted in 50 ml D5W slow IVP over 2 minutes, pediatric = 25-50 mg/kg diluted in 50 ml slow IV/IO push over 2 minutes (max 2 g) Status asthmaticus: 1-2 g in 50 ml normal saline / D5W IV over 5-10 minutes

Question 31

Magnesium Sulfate Pearls

Answer 31

Torsades des Pointes: may require 5-9 g Smooth muscle relaxant: second line intervention for refractory asthma Eclamptic seizures refractor to magnesium sulfate? Proceed to benzodiazepines