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Paramedic School > Respiratory Drugs - Pharm > Flashcards

Respiratory Drugs - Pharm Flashcards

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1
Q

Albuterol Dose

A

Nebulized 2.5-5mg in 3ml NS (5-15min)
MDI 1-2 inhalations (90-180mcg); q4-6hrs; Max 12/d
Severe dose - 6 inhalations or 5mg in 3ml

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2
Q

Albuterol Indications

A

-Relief of bronchospasm with eversible obstructive airway disease
- Prevention of exercise induced bronchospasm
- Anaphylaxis
- Hyper K

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3
Q

Albuterol onset and duration

A

Onset - 5-8min
Duration - 2-6hrs

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4
Q

Albuterol Contraindication

A
  • Prior hypersensitivity reaction
  • Cardia Dysrhythmias associated with Tachycardia
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5
Q

Albuterol Class

A

Sympathomimetic, Bronchiodialator, Beta 2 agonist

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6
Q

Albuterol drug interactions

A
  • Other sympathomimetics may exacerbate adverse cardiovascular effects
  • MAO inhibitors and Tricyclic antidepressants may potentiate effects on vasculature
  • Betablockers may antagonize
    Albuterol may potentiate diuretic induced hypokalemia
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7
Q

Albuterol Special Considerations

A
  • Pregnancy category C
  • May worsen angina and dysrhythmias
  • Use with caution for diabetes hyperthyroidism, prostatic hypertrophy
  • Seizure disorders
    -Cardiovascular disorder
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8
Q

Ipratropium Bromide (Atrovent) Dose

A

.5mg Nebulized; repeat twice

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9
Q

Ipratropium Bromide (Atrovent) Indications

A
  • Persistent Bronciohospasm
  • COPD Exasperation
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10
Q

Ipratropium Bromide (Atrovent) Onset and Duration

A

Onset: less than 15min
Duration: 2-4hrs

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11
Q

Ipratropium Bromide (Atrovent) Contraindications

A
  • Hypersensitivity to the medication: Atropine, Alcholoid, Soybean Proteins or peanuts
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12
Q

Ipratropium Bromide (Atrovent) class

A
  • Anticholinergic, Bronchodilator
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13
Q

Ipratropium Bromide (Atrovent) drug interactions

A
  • None
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14
Q

Epinephrine dose (Bradycardia and Hypotenion)

A

2-10 Mcg/min infusion until response

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15
Q

Epinephrine dose (Pulseless arrest)

A
  • IV/IO 1mg q3-5min during resucitation
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16
Q

Epinephrine dose (anaphylactic or bronchorestriction)

A
  • .3 to .5ml IM or SubQ
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17
Q

Epinephrine Indications

A

-Anaphylaxis
- Cardiac arrest
- PEA
- VF
- Pulseless VTach
- Symptomatic Brady
- Hypotension with Bradycardia when pacing and atropine fail
- Bronchial Asthma

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18
Q

Epinephrine Onset and Duration

A
  • Onset: Subq 5-10 min
    IV/ET 1-2min
  • Duration; IM 5-10min
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19
Q

Epinephrine Contraindications

A
  • Hypovolemic shock
  • Dilated Cardiomyopathy
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20
Q

Epinephrine Class

A
  • Sympathomimetic
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21
Q

Epinephrine Drug Interactions

A
  • MAO inhibitors may potentiate the effects of epi
  • Sympathomimmetics and phosphosdiesterase inhibitors may exacerbate disrytmia response
  • May be deactivated by alcholine solutions
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22
Q

Racemic EPI dose

A
  • MDI 2-3 inhalations q5min prn
  • Solution dilute .5ml in 5 ml of saline; give over 15min
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23
Q

Racemic EPI Indications

A
  • Bronchial Asthma
  • Treatment of Bronchospasm
  • Croup
  • Laryngeal Edema
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24
Q

Racemic EPI Onset and Duration

A

Onset: within 5min
Duration: 1-3hrs

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25
Racemic EPI Contrindications
- Hypertension - Underlying Cardiovascular disease - Epiglottitis
26
Racemic EPI Class
- Sympathomimetic
27
Racemic EPI Drug Interactions
- MAO inhibitors may potentiate the effects of epi - Sympathomimmetics and phosphosdiesterase inhibitors may exacerbate disrytmia response
28
Dexamethasone (Decadrone, Hexadrol and others) Dose
- .6mg/kg; max dose 16mg
29
Dexamethasone indications
- Endocrine, rheumatic and hematologic - Allergic states - Septic shock - Chronic inflammation
30
Dexamethasone onset and Duration
onset: 4-8hrs after parental admin durations: 24-72hrsss
31
Dexamethasone contraindications
- Allergy to drug - Active and untreated infections
32
Dexamethasone Class
- Glucocorticoid
33
Dexamethasone Drug Interactions
- Barbituates - Phenytoyn can decrease effects
34
Solumedrol (Methylprednisolone) Dose
- 2mg/kg up to 125mg IV - 40-125 mg IV
35
Methylprednisolone indications
- Anaphylaxis - Bronchodilator; unresponsive asthma - Shock
36
Methylprednisolone onset and duration
onset: 1-2hrs duration: 8-24hrs
37
Methylprednisolone contraindications
-use caution with GI bleed diabetes or severe infection -IM route is contraindicated in patients with idiopathic thrombocytopenic purpura
38
Methylprednisolone class
glucocorticoid
39
Methylprednisolone drug interactions
- hypoglycemic responses to insulin - oral hypoglycemic agents may be blunted - potassium depleating agents may potentiate hypokalemia
40
Magnesium sulfate dose seizure activity associated in pregnancy
4g diluted in D5W or NS for IV piggyback over 15-20 min. followed by continuous infusion of 1-2 g per hour max dose of 30-40g per day
41
Magnesium sulfate dose pulseless arrest or status asthmatics
1-2g diluted in 10ml of D5W IV or IO push
42
Magnesium sulfate dose torsade de pointes with pulse or acute MI with hypomagnesemia
loading dose of 1-2g in 50-100ml of D5W over 5-60 min IV follow with .5-1g per hour IV
43
Magnesium sulfate indications
-seizures of eclampsia in pregnancies - toxemia in pregnancy - cardiac arrest only is torsade is expected or hypomagnesemia is present - life threatening ventricular dysrhythmias attributable to digitalis toxicity. - suspected hypomagnesemia or hyperkalemia - status asthmatics not responsive to beta adrenergic drugs
44
Magnesium sulfate onset and duration
onset: IV immediate IM 3-4 hours Duration: IV 30 min IM 3-4 hours
45
Magnesium sulfate contraindications
-heart block or myocardial damage -hypermagnesemia or -hypercalcemia -diabetic coma
46
Magnesium sulfate class
electrolyte, anticonvulsant
47
Magnesium sulfate drug interactions
-CNS depressants effects may be enhanced if pt is taking other CNS depressants - serious changes in cardia function may occur in cardiac glycosides
48
Benadryl dose
1 mg/kg max dose of 50 mg IM /PO or slow IV
49
Benadryl indications
-moderate to severe allergic reactions -anaphylaxis (after epi) - acute extrapyramidal reactions
50
Benadryl onset and duration
onset: 1-3 hours duration : 6-12 hours
51
Benadryl contraindications
-pt taking nonselective MAO inhibitors (rare) - allergy - narrow angle glaucoma - newborns and nursing mothers
52
Benadryl class
antihistamine
53
Benadryl drug interactions
- CNS depressants may increase depressant effects - MAO inhibitors may prologue or intensify anticholinergic effects of antihistamines
54
Succinocholine dose
.3 - 1.1 mg/kg (25-75mg) over 10-30 seconds IV .04 - .07 mg/kg to maintain relaxation RSI 1-1.5 mg/kg IV/IO
55
Succinocholine indications
to facilitate intubation - terminate laryngospasm -muscle relaxation
56
Succinocholine onset and durations
onset: less than 1 min duration : 5-10 min after single IV dose
57
Succinocholine contraindications
-burns or crush injuries <72 hours old -allergy -skeletal muscle myopathy -inability to control airway or support ventilations with positive pressure -personal or family history of malignant hyperthermia - acute rabdo
58
Succinocholine class
neuromuscular blocker (depolarizing)
59
Succinocholine drug interactions
oxytocin -beta blockers -chronic contraceptive use - organophosphates may potentiate effects - diazepam may reduce duration of action -cardiac glycosides may induce dysrhythmia
60
Etomidate dose
0.2-0.6mg/kg (often 0.3 IV over 30-60 seconds) limit to 1 dose
61
Etomidate indications
- premedication for tracheal intubation or cardioversion
62
Etomidate onset and duration
onset: less than 1 min duration: 5-10 min
63
Etomidate contraindications
- allergy - labor and delivery
64
Etomidate class
nonbarbiturate hypnotic, anastatic
65
Etomidate drug interactions
- effects may be enhanced when given with other CNS depressants
66
ketamine dose
excited delirium 2mg/kg IV over 1 min or 4mg/kg IM/IN pain management moderate .5mg/kg IN max initial 25mg max of 100mg severe pain .25mg/kg IM/IV/IO max initial 25 max cumulative 100mg
67
ketamine indications
-analgesia - treatment for severe agitation - procedure sedation as adjunct to nitric oxide
68
ketamine onset and duration
onset: within 30 seconds duration: 5-10 min up to 1-2 hours
69
ketamine contraindications
-stroke - increased ICP - severe hypertension -history of schizophrenia -cardiac decomposition -allergy
70
ketamine class
nonbarbiturates anesthetic
71
ketamine drug interactions
may increase effects from ethinol opioid medications CNS depressants and selective serotonin reuptake inhibitors.
72
Midazolam (versed) dose
0.1mg/kg up to 10 mg consider starting with 1-2.5mg iv push .2mg/kg IM or IN excited delirium 5 mg IV/IN/IM end of life care 2-5mg iv
73
Midazolam (versed) indications
pre medication for tracheal intubation cardioversion and other painful procedures
74
Midazolam (versed) onset and durations
onset: IV 1-3 min dose dependent duration: 2-6 hours dose dependent
75
Midazolam (versed) contraindications
-allergy -glaucoma -shock -alcohol intoxication - depressed vital signs - concomitant use of barbiturates alcohol narcotics or other CNS depressants
76
Midazolam (versed) class
short acting benzodiazepine
77
Midazolam (versed) drug interactions
-sedative effect may be accentuated when used in comb with barbiturates alcohol or narcotics
78
neofed
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Paramedic School (8 decks)

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