quiz on 01/20/14

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quiz on 01/20/14
2014-01-26 19:39:11
quiz 01 20 14

methylprednisolone sodium succinate ipratropium bromide albuterol sulfate magnesium sulfate
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  1. albuterol sulfate

    mechanism of action
    indications and field use
    B agonist(primarily B2) relaxes bronchial smooth muscle, resulting in bronchodilation; also relaxes vascular and uterine smooth muscle decreases airway resistance

    treatment of bronchospasm
  2. albuterol sulfate

    • synergistic with other sympathomimetics
    • caution with diabetes,hyperthyroidism and cerebrovascular disease
  3. albuterol sulfate

    adverse reactions
    • CV-dysrhythmias,tachycardia, periperal vasodilation
    • Resp-bronchospasm(rare paradoxical with excessive use)
    • CNS-nervousnesss,tremors
    • GI-vomit,nausea
    • Endocrine-hyperglycemia
  4. albuterol sulfate

    incompatibilites/drug interactions
    tricyclic antidepressants(TCA's) and monoamine oxidase(MAO) inhibitors 

    other sympathomimetics
  5. Albuterol sulfate

    adult dosage

    routes of adminstratoin
    give 2.5 mg premixed solution for inhalation via SVN with a mouth piece or in-line with a ventilatory device 

    • nebulized,mouth piece or in-line via mask
    • inhaler
    • ET/NT in-line
  6. Albuterol sulfate

    Onset of action
    peak effects
    duration of Action
    OOA 5-15 minutes 

    PE  30-2 hours 

    DOA  3-4 hours
  7. Ipratropium Bromide

  8. Ipratropium Bromide

    mechanism of action
    anticholinergic agent inhibit vagally-mediated reflexes by antagonizing action of acetylcholine
  9. ipratropium bromide

    indicatons and field use
    • bronchospasm with chronic obstructive pulmonary disease 
    • used alone or combination other broncholdilators especially beta adrenergics
  10. ipratropium bromide

    • hypersensitivity to ipratropium bromide or atropine and its derivatives 
    • caution-patients with narrow angle glaucoma
  11. Ipratropium bromide

    adverse reactions
    • RESP-coughing,sputum increased
    • CNS-Dizziness,insomnia,tremor,nervousness
    • GI-nausesa
  12. Ipratropium bromide

    incompatibilities/drug interactions

    can be used with albuterol for bronchodilators
  13. Ipratropium Bromide

    Adult dosage
    • 500mcg in 2.5 ml normal saline via SVN or inline ventilatory device
    • may mix one and one with albuterol
  14. Ipratropium bromide

    onset of action
    peak effects
    duration of action
    5-15 min

    60-120 min

    240-480 min
  15. magnesium sulfate

    magnesium sulfate

    electrolyte, tocolytic
  16. Magnesium sulfate

    mechanism of action-

    • pharmacology-second most plentiful intracellular cation;essential to enhance intracellular potassium replenishment and activity of many enzymes; important role in neurochemical transmission and muscular excitabilitydecreases myocardial irritabilbity and neuromuscular irritability 
    • Clinical-cardia reduces ventricular irritablity,especially with associated with hypomagnesemia;inhibition of muscular excitability
  17. Magnesium sulfate

    indications and field use
    • torsade de pointes
    • VF/pulseless VT refactory to lidocaine and/or amiodarone
    • hypomagnesemia
    • pre-term labor
    • pregnancy-induced hypertension
    • hyperreactive airway-severe asthma
  18. magnesium sulfate

    • hypermagnesemia
    • caution-patients with impaired renal function and preexisting heart blocks
    • caution-when used with barbituates, narcotics or other hyponotics(MS due to the additive central depressive effects of magnesium)
  19. magnesium sulfate

    adverse reactions
    • CVS-hypotension,flushing,circulatory collapse,depressed cardiac funciton,heart block,asystole,smooth muscle relaxant
    • RESP-respiratory depression or paralysis
    • mother or child 24 hours later 
    • CNS-sweating,drowsiness,hypothermia,depressed reflexes progressing to flaccidity and paralysis 
    • mother and/or child 24 hours later
    • GI-nausea 
    • GU-mild diuretic
    • Meta-hypocalcemia,hypermagnesemia
  20. magnesium sulfate

    incompatibilites/drug interactions
    concurrent digitalization increases danger of dysrhythmias
  21. magnesium sulfate

    adult dosage
    • VF/pulseless VT-1-2 gm IV diluted in 50-100 ml NS or D5W or 1-2 minutes
    • torsade de pointes-1-2 Gm IV diluted in 50-100 ml NS or D5W administered over  1-2 minutes followed by smae amount infused over 1 hour
    • Hypomagnesemia-1-2 gm diluted in 50-100 ml NS or D5W admin iv push over 5-60 min
    • Respiratory/severe asthma-
    • initial infusion 2 gm magnesium sulfate mixed in 50 ml NS or D5W infused IV using microdrip tubing over 5-10 minutes-stop if hypotension,respiratory depression or bradycardia develop
  22. methylprednisolone sodium succinate
  23. Solu-medrol
    Corticosteroid ,glucocorticoid,steroid ,antiinflammatory
  24. Solu-medrol 
    Causes complex reactions thata are responsible for anti inflammatory and immunosuppressive effects 

    thought to stabilize cellular and intracellular membranes
  25. Solu medrol 

    indications and field use
    Reactive airway disease :acute exacerbation of emphysema,chronic bronchitis asthma anaphylaxis burns potentially involving the airway

    acute spinal cord trauma 
  26. Solu medrol

    adverse reactions
    drug interactions
    • Preterm infants
    • none 
    • none
  27. Solu medrol
    Drug dosage

    125 mg slow IV push 
  28. Solu medrol 

    onset of actions 
    peak effects 
    duration of action 
    • 1-6 hours 
    • 8 hours
    • 18-36 hours