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Neo/Peds Pharmacology

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