Drug Info: Albuterol Atrovent Solu-Medrol Mag Sulfate

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readyreg29
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Drug Info: Albuterol Atrovent Solu-Medrol Mag Sulfate
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2014-01-24 13:03:03
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MEDIC 2013/14
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MEDIC 2013/14
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  1. Albuterol Sulfate
    • Brand name: Proventil, Ventolin
    • Class: Sympathomimetic, Bronchodilator
  2. Albuterol Sulfate:
    indications
    Treatment of bronchospasm
  3. Albuterol Sulfate:
    contraindications
    • Synergistic with other sympathomimetics 
    • Caution in pt's w/:
    • Diabetes
    • Hyperthyroidism
    • Cerebrovascular disease
  4. Albuterol Sulfate:
    MOA
    • ß agonist (primarily ß2) 
    • Relaxes:
    • Bronchial smooth muscle (bronchodilation)
    • Vascular
    • Uterine smooth muscle
    • (decreases airway resistance)
  5. Albuterol Sulfate:
    Adult dosage
    • 2.5 mg of premixed solution (via SVN)
    • ** Repeated according to medical control     preference
  6. Albuterol Sulfate:
    Routes of administration
    • Nebulized, mouth piece or in-line via mask
    • Inhaler, patients own
    • ET/NT in-line
  7. Albuterol Sulfate:
    Onset of Action
    Peak Effects
    Duration of Action
    Onset of Action: 5-15 minutes

    Peak Effects: 30 minutes - 2 hours

    Duration of Action: 3-4 hours
  8. Albuterol Sulfate:
    Adverse reactions
    • CV: Dysrhythmias, tachycardia,peripheral vasodilation
    • Resp: Bronchospasm 
    • CNS: Tremors, nervousness
    • GI: Nausea, vomiting
    • Endocrine: Hyperglycemia
  9. Albuterol Sulfate:
    Dosage Forms/Packaging
    • 2.5mg in premixed 3mL NS
  10. IPRATROPIUM BROMIDE
    • BRAND NAME: Atrovent
    • CLASS: Anticholinergic, bronchodilator
  11. IPRATROPIUM BROMIDE
    indications
    • Treatment of bronchospasm  
    • (emphysema and chronic bronchitis)
  12. IPRATROPIUM BROMIDE
    contraindications
    • Hypersensitivity to Ipratropium bromide or Atropine 
    • Narrow angle glaucoma (high eye pressure)
  13. IPRATROPIUM BROMIDE
    MOA
    Blocks acetylcholine (the neurotransmitter of the parasympathetic nervous system) 

    Slows or stops the effects of the parasympathetic nervous system

    **Takes the foot off the brake pedal 
  14. IPRATROPIUM BROMIDE
    adult dosage
    • 500 mcg in 2.5 ml NS (1 unit dose vial) via SVN w/ mouth piece or in-line ventilatory device 
    • **Repeat according to medical control  
    • **May mix with Albuterol 
  15. IPRATROPIUM BROMIDE
    Routes of administration
    • Nebulized, mouth piece or in-line device
    • Inhaler (patient's own)
  16. IPRATROPIUM BROMIDE
    adverse reactions
    • Resp: Coughing. Sputum increased
    • CNS:Dizziness, Insomnia,Tremor,Nervousness
    • GI: Nausea
  17. IPRATROPIUM BROMIDE
    Onset of Action:
    Peak Effects:
    Duration of Action:
    Onset of Action: 5-15 minutes

    Peak Effects: 60-120 minutes

    Duration of Action: 240-480 minutes
  18. IPRATROPIUM BROMIDE
    Dosage Forms/Packaging
    • Vial of .02% clear, colorless solution
    • containing 2.5 ml w/ 25 vials per foil pouch
  19. METHYLPREDNISOLONE SODIUM SUCCINATE
    • BRAND NAME: Solu-Medrol
    • CLASS: Corticosteroid, glucocorticoid, steroid, anti-inflammatory
  20. METHYLPREDNISOLONE SODIUM SUCCINATE
    indications
    Reactive airway disease: Acute exacerbation of emphysema, chronic bronchitis, asthma

    Anaphylaxis

    Burns potentially involving the airway

    ** Acute spinal cord trauma (large loading and maintenance doses)
  21. METHYLPREDNISOLONE SODIUM SUCCINATE
    Contraindications
    Preterm infants (born before 37 weeks)
  22. METHYLPREDNISOLONE SODIUM SUCCINATE
    MOA
    Enters target cells and causes many complex reactions that are responsible for its anti inflammatory and immunosuppressive effects 

    Stabilize cellular & intracellular membranes
  23. METHYLPREDNISOLONE SODIUM SUCCINATE
    adult dosage
    • Reactive Airway Disease, Anaphylaxis, Burns Potentially Involving the Airway: 
    • 125 mg slow IV bolus

    **Acute spinal cord trauma: special training is required
  24. METHYLPREDNISOLONE SODIUM SUCCINATE
    Routes of administration
    IV bolus
  25. METHYLPREDNISOLONE SODIUM SUCCINATE
    adverse reactions
    None from single dose
  26. METHYLPREDNISOLONE SODIUM SUCCINATE
    Onset of Action:
    Peak Effects:
    Duration of Action:
    • Onset of Action: 1 - 6 hours
    • Peak Effects: 8 hours
    • Duration of Action: 18 - 36 hours
  27. METHYLPREDNISOLONE SODIUM SUCCINATE
    Dosage Forms/Packaging
    • 125 mg/1 ml
    • 500 mg/4 ml
    • 1 Gm/8 ml mix-a-vial
    • 2 Gm vial with diluent 
  28. MAGNESIUM SULFATE
    • BRAND NAME: Magnesium Sulfate
    • CLASS:
    • Electrolyte 
    • Tocolytic (medications used to suppress premature labor)
  29. MAGNESIUM SULFATE
    indications
    • Torsade de pointes, drug of choice
    • VF/Pulseless
    • VT refractory to lidocaine and/or amiodarone
    • Hypomagnesemia
    • Pre-term labor (PTL)
    • Pregnancy-induced hypertension (PIH, toxemia of pregnancy, pre-eclampsia and/or
    • eclampsia)
    • Hyperreactive Airway - Severe Asthma
  30. MAGNESIUM SULFATE
    contraindications
    Hypermagnesemia

    Use cautiously in patients with impaired renal function and pre-existing heart blocks
  31. MAGNESIUM SULFATE
    MOA
    Decreases myocardial irritability and neuromuscular irritability
  32. MAGNESIUM SULFATE
    routes of administration
    IV/IO infusion
  33. MAGNESIUM SULFATE
    Onset of Action:
    Peak Effects:
    Duration of Action:
    Onset of Action:  Seconds; 20 minutes for IV Infusion (respiratory)

    Peak Effects: Not known

    Duration of Action:  24 hours or greater
  34. MAGNESIUM SULFATE
    Dosage forms/Packaging
    • 1 Gm/2 cc vials (0.5 Gm/cc)
    • 5 Gm/10 cc vials (0.5 Gm/cc) 
  35. MAGNESIUM SULFATE: adult dosage
    Torsade de pointes
    (ventricular tachycardia that can be the result of lengthening the QT interval)
    1-2 Gm IV in 50-100 mL NS or D5W over 1-2 minutes

    ** repeat amount infused over 1 hour
  36. MAGNESIUM SULFATE: adult dosage
    VF/Pulseless VT
    1-2 Gm IV diluted in 50-100 mL NS or D5W, administered over 1-2 minutes
  37. MAGNESIUM SULFATE: adult dosage
    Hypomagnesemia (Abnormalities of magnesium levels)
    Dilute 1-2 Gm in 50-100 ml NS or D5W administered IV push over 5-60 minutes.
  38. MAGNESIUM SULFATE: adult dosage
    Respiratory/Severe Asthma
    • 2 Gm mixed in 50 mL NS or D5W IV infusion 60gtts over 5 to 10 minutes.
    • (Stop infusion if hypotension, respiratory depression or bradycardia develop)
  39. What reverses magnesium toxicity?
    Calcium Chloride (10%) 10 ml
  40. For Respiratory (Asthma) emergencies: Magnesium Sulfate administrations follows
    • Albuterol
    • Atrovent SVN
    • 0.3mg IM Epi (1:1000)

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