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Albuterol (Proventil, Ventolin)
Albuterol is a synthetic Sympathomimetic that causes bronchodilation with less cardiac effect than epinephrine. It reduces mucus secretions, pulmonary cappilary leaking and edema in the lungs during an allergic reaction.
Bronchospasm and asthma in COPD, Hyperkalemia.
Patient may experience tachycardia, anxiety, nausea, cough, wheezing, and/or dizziness. Vital signs and breath sounds must be monitored. Use caution with elderly, cardiac, or hypertensive patients.
- - Dosage/Route: 2.5 in 2.5 to 3 mL NS via Nebulizer, repeat as needed. The duration of the effect is 3 to 6 hours.
- Hyperkalemia: 20-30 mg nebulizer
Aminophylline is a methylxanthine that prolongs bronchodilation and decreased mucus production and has mild cardiac and CNS stimulating effects.
Bronchospasm in asthma with COPD refractory to sympathomimetics and other bronchodilators and in CHF.
Uncontrolled cardiac dysrhythmias.
Cardiovascular disease, hypertension, or taking theophylline, hepatic impairment, diabetes, hyperthyroidism, young children, glaucoma, peptic ulcers, acute influenza or influenza vaccination, and the elderly. Watch for PVCs or tachycardia. May cause hypotension.
- - Dosage/Route: 250 to 500 mg IV over 20 to 30 mins.
- Pedi: 6 mg/kg over 20 to 30 mins. Max 12 mg/kg/day
Ipratropium is a bronchodilator used in the treatment of respiratory emergencies that causes bronchial dilation and dries respiratory tract secretions by blocking acetylcholine receptors
Bronchospasm associated with asthma, COPD, and inhaled irritants.
Hypersensitivity to atropine or its derivatives, or as a primary treatment for acute bronchospasm. Nut allergy
Elderly, cardiovascular disease, or hypertension
- - Dosage/Route: 500 mcg 2.5 to 3 mL NS via nebulizer or 2 sprays from metered dose inhaler
- Pedi: 125 to 250 mcg NS via nebulizer or 1 to 2 sprays from metered dose inhaler.
Furosemide is a rapid-acting, potent diuretic and antihypertensive that inhibits sodium reabsorption by the kidney. Its vasodilating effects reduce venous return and cardiac workload.
CHF and pulmonary edema
Infants, elderly, hepatic impairment, cardiogenic shock associated with acute MI, gout, or patients receiving digitalis or patassium depleting steroids.
- - Dosage/Route: 40 to 120 mg slow IV or could cause tinitis.
- Pedi: 1 mg/kg slow IV
Magnesium sulfate (Magnesium)
Magnesium sulfate is an electrolyte that acts as a calcium channel blocker, acting as a CNS depressant and anticonvulsant. It also depresses smooth, skeletal and cardiac muscles.
Refractory ventricular fibrillation, pulseless ventricular tachycardia (especially torsade depointes) AMI, eclamptic seizures, asthma, COPD.j
Heart block, myocardial damage, shock, persistant hypertension and hypocalcemia.
CNS depressants, or neuromuscular blocking agents
- - Dosage/Route:
- Vfib: 1 - 2 g IV over 2 mins
- Torsade de Pointes: 1 to 2 g IV followed by infusion of 0.5 to 1 g/hr IV
- Asthma/COPD: 1- 2 g over 10 mins
- Eclampsia: 2 - 6 g IV/IM over 15 - 30 mins
Racemic Epinephrine (microNefrin, Vaponefrin)
Racemic epinephrine is a variation of epinephrine used only for inhilation to induce bronchodilation and to reduce laryngeal edema, and mucus secretion.
Hypersensitivity, hypertension, epiglottitis
- Precautions be monitored:
May result in tachycardia and other dysrhythias. Patient vitals and ECG should.
- - Dosage/Route: 0.25 - 0.5 mg in 3 mL NS once by nebulizer.
- Pedi: same as adult
Terbutaline (Brethine, Bricanyl)
- Description: Terbutaline is a synthetic sympathomimetic that causes bronchodilation with less cardiac effect than epinephrine.
- Indications: Bronchial asthma and bronchospasm in COPD.
- Contraindications: Hypersensitivity to the drug
- Precautions: The patient may experience palpatations, anxiety, nausea and/or dizziness; use caution with cardiac and hypertensive patients.
- Dosage/Route: Two inhilations with a metered dose inhaler, repeated once in 1 min or 0.25 mg SQ repeated 15 to 30 mins