Therapeutics - Croup Flashcards
(19 cards)
croup symptoms peak around day ____ of illness
3-4
4 therapies for croup
humidification
hydration
epinephrine
corticosteroids (anti inflammatories)
MOA of humidification and steam in helping croup
moistens secretions and soothes the inflamed mucosa
” go to” drug for croup and its mechanism and result
racemic epinephrine
stimulates alpha receptors resulting in mucosal vasoconstriction and decreased edema in the inflamed region of the larynx
decreased stridor and airway obstruction, decreased need for intubation
____ is like a SABA for croup
epinephrine
give steroids after!
**do we just give epinephrine for croup
NO
the croup will come back
corticosteroids actually fix the issue. EPI JUST HELPS WITH SYMPTOMS
which isomer of epinephrine is active and which gives the AE
L is active and R gives AE
route and intervals at which epinephrine is given for croup
nubulization
may repeat dose in 20 mins if stridor exists at rest OR every 1-2 hours as needed for symptoms
*onset of racemic epinephrine and duration
10-30 mins
duration is 2-3 hours
**AE’s of epinephrine
tachycardia, high BP, palpitations, anxiety (seen BEFORE rebound vasoconstriction)
observe kid for 2-3 hours after epinephrine treatment for rebound vasoconstriction!!!!
mechanism of corticosteroids to help with croup
suppress local inflammatory reaction and decrease capillary permeability
**onset/peak effect of corticosteroids for croup
30 min onset
4-6 hours at peak (up to 12)
duration is 24 hrs
true or false
systemic CS given to croup patients decreases the need for intubation/length of ventilation
true
***GO TO corticosteroid for croup and its dose
dexamethasone phosphate
0.6mg/kg either PO/IV/IM
ONLY GIVE ONCE!!!!!!!!!
max is 16mg
if symptoms persist, can give same dose 24 hrs later
what can possibly be used instead of dexamethasone for croup
prednisolone
but not really used
dexamethasone has longer duration
inhaled budesonide can also be used if the pt cant tolerate PO/IM/IV – but not really used too often. however you do see the effects faster (2-4 hrs)
true or false
in croup, there’s been shown to be benefit in combining systemic + inhaled corticosteroid
FALSE - NO BENEFIT SHOWN
in what scenario may it be required to repeat doses of dexamethasone
croup associated with SARSCOV2 – unusual tho
we would give 24 hrs after 1st dose
markers of croup improvement that indicate that the pt can be discharged
no stridor at rest (may still have on exertion)
at least 1 CS dose given
at least 2 hours were observed after EPI dose
pt can tolerate PO food
no AE
overall - want the symptoms they came in with gone
