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Fourth Set

Medications

QuestionAnswer
Albuterol Also known as Proventil, Ventolin
Albuterol Action binds and stimulates beta2 receptors, resulting in relaxation of bronchial smooth muscle.
Albuterol Indications Asthma, bronchitis with bronchospasm, and COPD.
Albuterol Adverse Effects Hyperglycemia, hypokalemia, palpitations, sinus tachycardia, anxiety, tremor, nausea/vomiting, throat irritation, dry mouth, hypertension, dyspepsia, insomnia, headache, epistaxis, paradoxical bronchospasm.
Albuterol Contraindications Angioedema, sensitivity or sensitivity to levabuterol. ( use caution in lactating patients, cardiovascular disorders, cadiac arrhythmias.
Albuterol Dosage: Acute Bronchospasm: Adult: MDI: 4-8 puffs every 1to 4 hours may be required.
Albuterol Dose Acute Bronchospasm: Adult: Nebulizer 2.5-5mg every 20 mins for a max of three dosses. After intial three doses, esculate the dose or start a continuous nebulizer at 10 - 15 mg/hr.
Albuterol Dosage: Acute Bronchospasm: Pedi: MDI: >4yrs 2 inhalations every 4-6hrs; some pts 1 inhalation every 4-6hrs is suffucuent. more is not recommended.
Albuterol Dosage: Acute Bronchospasm: Pedi: MDI: >4yrs Administer by nebulization.
Albuterol Dosage: Acute Bronchospasm: Pedi: Nebulizer: <12yrs 0.5mg/kg/hr continuous dose.
Albuterol Dosage: Pedi: Nebulizer >12yrs: 0.15mg/kg every 20 minutes for maximum of 3 doses. Alternatively, continuous nebulization @ 0.5 mg/kg/hr can be delivered to children > 12yrs.
Albuterol Dosage: Asthma in Pregnancy: MDI: 2 inhalations every 4 hrs. IN acute exacerbation, start w/ 2-4 puffs every 20 minutes.
Albuterol Dosage: Asthma in Pregnancy: Nebulizer 2.5mg (0.5mL) by 0.5% nebulization solution. Put 0.5mL of albuterol in 2.5mL of sterile norm saline. Flow is regulated to delier the therapy over a 5-20 min period. Refractory cases: some Drs. order 10mg neb's over a 60 min period.
Albuterol Special Considerations Pregnancy class C
Ipratropium Bromide, also known as Atrovent
Ipratropium Bromide Class Bronchodilator, anaticholinergic
Ipratroprium Bromide Action Antagonizes the acetylcholine receptor on bronchial smooth muscle, producing bronchodilation.
Ipratropium Bromide Indications Asthma, bronchospasm associated with COPD.
Ipratropium Bromide Adverse Effects Paradoxical acute bronchospasm, cough, throat irritation, headache, dizziness, dry mouth, palpitations.
Ipratropium Contraindications Closed-angle glaucoma, bladder neck obstruction, prostatic hypertrophy, known sinsitivity including peanuts or soybeans and atropine or atropine derivatives.
Ipratropium Bromide Dosage: Nebulization: Adult: 0.5mg every 6-8 hrs.
Ipratropipum Bromide Dosage: Nebulization: Pedi: 5-14 yrs: 0.25-0.5mg every 20 minutes for 3 doses as needed.
Ipratropium Bromide Dosage: Metered-Dose Inhaler: Adult: 4 inhalations every 10 minutes w/ no more than 24 inhalations per day or closer than 4 hrs apart.
Ipratropium Bromide Dosage: Metered-Dose Inhaler: Pedi: 5-12 yrs: 1-2 puffs inhaled every 6-8 hrs. Maximum of 8 puffs/day.
Ipratropium Bromide Special Considerations *Ipratropium bromide (IB) is not typicall used as sole medication in Tx of acute exacerbation of asthma. IB is commony admin'd after a beta agonist. *Take care not to allow aerosol spray (espec. in MDI) to come into contact w/ eyes. *Pregnancy class B
Furosemide, also known as Lasix
Furosemide Class Loop diuretic.
Furosemide Action Inhibits the absorption of the sodium and chloride ions and water in the loop of Henle, as well as the convoluted tubule of the nephron. This results in decreased absorption of water and increased production of urine.
Furosemide Indications Pulmonary edema, CHF, hypertensive emergency.
Furosemide Adverse Effects: Vertigo, dizziness, weakness, orthostatic hypotnsion, hypokalemia, thrombophlebitis. PPl w/ anuria, severe renal failure, untreated hepatic coma, increasing azotemia and electrolyte depletion can develop life-threatening consequences.
Furosemide Contraindications Known sensitivity to sulfonamides or furosemide.
Furosemide Dosage: CHF and Pulmonary Edema: Adult: Initial dose is 0.5-1mg/kg IV push, given at a rate no faster than 20 mg/min.
Furosemide Dosage: CHF and Pulmonary Edema: Pedi: 1mg/kg IV, IO or IM. If the response is not satisfactory, an addt'l dose of 2mg/kg may be admin'd no sooner than 2 hrs after the first dose.
Furosemide Dosage: Hypertensive Emergency: Adult: 40-80mg IV, IO.
Furosemide Dosage: Hypertensive Emergency: Pedi: 1mg/kg IV or IM.
Furosemide Special Considerations *Onset of action for IV, IO administration occurs w/in 5 mins and will peak w/in 30 mins. *It is a diuretic, so patient will likely have urinary urgency. Be prepared to help the patient void. *Pregnancy class C.
Methylprednisolone Sodium Succinate, also known as Solu-Medrol
Methylprednisolone Sodium Succinate Class Corticosteroid
Methylprednisolone Sodium Succinate Action Reduces inflammation by multiple mechanisms.
Methylprednisolone Sodium Succinate Indications Anaphylaxis, asthma, COPD.
Methylprednisolone Sodium Succinate Adverse Effects Depression, euphoria, headache, restlessness, hypertension, bradycardia, nausea/vomiting, swelling, diarrhea, weakness, fluid retention, paresthesias.
Methylprednisolone Sodium Succinate Contraindications Cushing's syndrom, fungal infection, measles, varicella, known sensitivity (including sulfites). Use w/ caution in active infections, renal disease, penetrating spinal cord injury, hypertension, seizures, CHF.
Methylprednisolone Sodium Succinate Dosage: Asthma and COPD: Adult: 40-80mg IV.
Methylprednisolone Sodium Succinate Dosage: Asthma and COPD: Pedi: 1mg/kg (up to 60mg) IV, IO per day in 2 divided doses.
Methylprednisolone Sodium Succinate Dosage: Anaphylactic Shock: Adult: 1-2mg/kg/dose, then 0.5-1mg/kg every 6 hrs.
Methylprednisolone Sodium Succinate Dosage: Anapylactic Shock: Pedi: Same as adult dosing.
Methylprednisolone Sodium Succinate Dosage: Blunt Spinal Cord Injury: Adult: 30mg/kg IV, IO over a period of 1 hr, then as an infusion to run for the remaining 23 hrs at a dose of 5.4mg/kg/hr.
Methylprednisolone Sodium Succinate Dosage: Blunt Spinal Cord Injury: Pedi: Same as adult dosing.
Methylprednisolone Sodium Succinate Special Considerations *May mask signs and symptoms of infection. *Pregnancy class C.
Fentanyl Citrate, also known as Sublimaze
Fentanyl Class Narcotic analgesic; schedule C-II.
Fentanyl Action Binds to opiate receptors, producing analgesia and euphoria.
Fentanyl Indications Pain
Fentanyl Adverse Effects Respiratory depression, apnea, hypotension, nausea/vomiting, dizziness, sedation, euphoria, sinus bradycardia, sinus tchycardia, palpitations, hypertension, diaphoresis, syncope, pain at injection site.
Fentalyl Contraindications Known sensitivity. Use w/caution in traumatic brain injury, respiratory depression.
Fentanyl Dosage: Adult: 50-100mcg/dose (0.05-0.1mg) IM or slow IV, IO (administer over 1-2 mins).
Fentanyl Dosage: Pedi: 1-2mcg/kg IM or slow IV, IO (admin'd over 1-2 min).
Fentanyl Special Considerations Pregnancy class B.
Haloperidol, also known as Haldol
Haloperidol Class Antipsychotic agent.
Haloperidol Action Selectively blocks postsynaptic, dopamine receptors.
Haloperidol Indications Psychotic disorders, agitation.
Haloperidol Adverse Effects Extrapyramidal symptoms, drowsiness, tardive dyskinesia, hypotension, hypertension, VT, sinus tachycardia, QT prolongation, torsades de pointes.
Haloperidol Contraindication Depressed mental status, Parkinson's disease.
Haloperidol Dosage: Mild agitation: Adult: 0.5-2mg PO or IM.
Haloperidol Dosage: Moderate agitation: Adult: 5-10mg PO or IM.
Haloperidol Dosage: Severe agitation: Adult: 10mg PO or IM.
Haloperidol Dosage: Pedi: Not recommended for pediatric patients.
Haloperidol Special Considerations Pregnancy class C.
Diazepam, also known as Valium
Diazepam Class Benzodiazepine; schedule C-IV.
Diazepam Action Binds to benzo receptor and enhances the effects of GABA. Benzo's act @ level of limbic, thalamic, and hypothalamic regions of the CNS & can produce any level of CNS depression req'd sedation, skeletal muscle relaxation and anticonvulsant activity.
Diazepam Indications Anxiety, skeletal muscle relaxation, alcohol withdrawl, seizures.
Diazepam Adverse Effects Respiratory depression, drowsiness, fatigue, headache, pain at the injetion site, confusion, nausea, hypotension, oversedation.
Diazepam Contraindications Children <6months, acute-angle glaucome, CNS depression, alcohol intoxication, known sensitivity.
Diazepam Dosage: Moderate Anxiety: Adult: 2-5mg slow IV, IM.
Diazepam Dosage: Severe Anxiety: Adult: 5-10mg slow IV, IM (administer no faster than 5mg/min).
Diazepam Dosage: Low Anxiety: Adult: Low dosages are often required for elderly or debilitated patients.
Diazepam Dosage: Anxiety: Pedi: 0.04-0.3mg/kg/dose IV, IM every 4 hrs to a max dose of 0.6mg/kg.
Diazepam Dosage: Delirium Tremens from Acute Alcohol Withdrawl: Adult: 10mg IV.
Diazepam Dosage: Seizure: Adult: 5-10mg slow IV, IO every 10-15 minutes to a max total dose of 30mg.
Diazepam Dosage: Seizure: IV, IO: Pedi >5 yrs: 1mg over a 3 minute period every 2-5 minutes to a max total dose of 10 mg.
Diazepam Dosage: Seizure: IV, IO: Pedi older than 30 days to < 5 yrs: 0.2-0.5mg over a 3 minute period; may repeat every 2-5 minutes to a max total dose of 5mg.
Diazepam Dosage: Seizure: IV, IO: Pedi Neonate: 0.1-0.3mg/kg/dose given over a 3-5 minute period; may repeat every 15-30 minutes to a max total dose of 2mg. (Not a first line agent due to sodium benzoic acid in the injection).
Diazepam Dosage: Rectal Administration (If vascular access is not obtained, may be admin'd rectall to children): >12 yrs: 0.2mg/kg.
Diazepam Dosage: Rectal Administration (If vascular access is not obtained, may be admin'd rectall to children): 6-11 yrs: 0.3mg/kg.
Diazepam Dosage: Rectal Administration (If vascular access is not obtained, may be admin'd rectall to children): 2-5 yrs: 0.5 mg/kg.
Diazepam Dosage: Rectal Administration (If vascular access is not obtained, may be admin'd rectall to children): <2 yrs: Not recommended.
Diazepam Special Considerations *Make sure that IV, IO lines are well secured. Extravasation of diazepam causes tissue necrosis. *Diazepam is insoluble in water; must be dissolved in propylene glycol.Give slowly to prevent pain on injection. *Pregnancy class D.
Metoclopramide, also known as Reglan
Metoclopramide Class Antiemetic
Metoclopramide Actions Stimulates motility of upper GI tract w/o stimulating gastric, biliary or pancreatic secretions. The antiemetic prop's appear to be a result of its antagonism of central and peripheral dopamine recptrs. May produce sedation and extrapyramidal reactions.
Metoclopramide Indications Tx of severe intractable vomiting.
Metoclopramide Adverse Effects Restlessness, anxiety.
Metoclopramide Contraindications Known pheochromocytoma, known Parkinson's disease, hypertensive crisis, under age 8, known bowel obstruction, known allrety to medicine.
Metoclopramide Dosage: Adult: 10mg IV slow push, may be given IM.
Metoclopramide Dosage: Pedi: over age 8 only.
Metoclopramide Special Considerations Side effects and extra-pyramidal reactions may be increased with rapid administration.
Albuterol Class Bronchodilator, beta agonist.
Created by: 1300311346