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Pharmacology
Neo/Peds Pharmacology
| Question | Answer |
|---|---|
| Clarks Rule | Weight of child(lbs) X normal adult dose / 150 |
| To solve for mg | mg = mL x (% x 10) |
| To solve for mL | mL = mg x (% x 10) |
| Three categories of bronchodilators | Front door, back door, side door |
| Define SABA | Short acting beta2 agonists |
| Define LABA | Long acting beta2 agonists |
| SABA Drugs | Albuterol, levalbuterol, metaproterenol, terbutaline, pirbuterol |
| LABA Drugs | Salmeterol, Formoterol |
| Parasympatholytics (anticholinergics) | work against bronchoconstriction caused by the parasympathetic nervous system |
| Anticholinergics | Atropine sulfate, Ipratropium bromide, tiotropium bromide(spiriva), oxitropium bromide(oxivent) |
| Methylxanthines (side door bronchodilators) | Theophylline (aminophylline), theobromine, caffeine |
| Caffine levels for apnea of prematurity are kept at | 5-10 mcg/mL |
| Side effects of methylxanthines | tachycardia, palpitations, jitters, irritability, and diuresis. |
| When does toxicity occur with methylxanthines | When serum levels exceed 20 mcg/mL |
| Signs of toxicity from methylxanthines | nausea, vomiting, headaches and seizures |
| Leukotriene modifiers | non-steroid drugs that have been approved for mild to moderate asthma |
| When are leukotriene modifiers not appropriate for use | During an acute asthma attack |
| Leukotriene modifiers examples | Zarfirlukast (accolate) Zileton (Zyflo) Montelukast (singulair) |
| How do leukotriene modifiers work? | Act by blocking leukotriene at their receptor sites |
| IgE blocker | Omalizumab (Xolair) |
| IgE blockers are used to treat what | Allergic asthma (pts 12 yrs and older) |
| Wetting agents | used to thin secretions, best is good hydration, aersol can also be used (USN, mist tents, jet nebulizers) |
| When are mucolytics recommended | when secretions are so thick and tenacious (inspissated) that they can not be easily removed |
| Primary hazard for mucolytics | bronchospasm, always given with a bronchodilator |
| Pulmozyme is also known as | Recombinant human DNAse (dornase alpha) |
| How does pulmozyme work | reduces mucus viscosity by cutting DNA in sputum |
| Anti-Asthmatic Drugs are also known as | Mast cell stabilizers |
| How do anti-asthmatics work? | They help prevent an asthmatic attack by inhibiting the degranulation of mast cells and preventing the release of histamine |
| Cromolyn sodium is also known as | Intal, Aarane |
| Cromolyn sodium dosage | 20mg Q4 |
| Nedocromil sodium also known as | Tilade |
| Corticosteroids have what effect? | Anti-inflammatory, immunosuppressive agents with direct and indirect bronchodilating effects |
| What are steroids indicated for? | asthma and BPD |
| IV corticosteroids | Prednisone, methylprednisolone, solumedrol, |
| Dexamethazone (Decadrone) | Can be IV or inhaled |
| Decongestants (alpha adrenergic) | Reduce swelling (mucosal edema) |
| Indications for decongestants | upper airway conditions such as croup and post extubation swelling where mild/moderate stridor is present |
| Antiviral agents | Ribavirin (Virazole), Respigam, Palivizumab (synagis) |
| Antiviral agents must be given via | SPAG, scavenger system |
| Exogenous surfactants are used for what | to prevent and treat IRDS/HMD |
| What two ways can surfactant be administered | prophylactic and rescue |
| Adverse effects of surfactants | pneumothorax, bradycardia, hypotension, hemorrhage, apnea |
| Topical anesthetics indication | to reduce coughing reflex during bronchoscopy or in patients with persistent coughing |
| Examples of topical anesthetics | Lidocaine, benzocaine, cetacaine, novocaine |
| Neuromuscular blocking agents indication | for patients receiving mechanical ventilation in order to: Reduce spontaneous breathing, prevent movement that can dislodge airways, reduce oxygen consumption, improve patient synchrony with ventilator |
| Depolarizing neuromuscular blocking agents | Example: succinylcholine (Anectine) |
| Nondepolarizing neuromuscular blocking agents | Pancuronium(Pavulon), Vecuronium (norcuron), Atracurium(Tracrium), Cisatracurium(Nimbex) |
| Sedatives action | decrease anxiety and promote relaxation |
| Indications for sedatives | Manage fear and anxiety, increase comfort while receiving mechanical ventilation, induce sleep |
| Most common class of sedatives | Benzodiazepines |
| Examples of benzos | Alprazolam, diazepam, midazolam, lorazepam |
| Reversal agent for benzos | Romazicon (flumazenil) |
| Ideal level of sedation on the Ramsay scale | Level 3: Responds to verbal commands |
| Anesthetics action | reduces patients ability to perceive sensations |
| IV anesthetics | Propofol (Diprivan), Ketamine (Ketalar) |
| Analgesics action | reduce sensation of pain |
| Opiods | Most common class of analgesics (narcotics) |
| Examples of opiods (narcotics) | Morphine, hydromorphone, fentaynl, codeine, hydrocodone, oxycodone, meperedine |
| Diuretics | Furosemide (Lasix), mannitol (osmitrol), CAI-- acetazolamide (diamox) |
Created by:
bbrashears0004
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