01C - Respiratory Drugs

Lesson 43

29 flashcards · Other · by Chuck Ferrell

1. What is the adult dosage of Etomidate?

   0.2-0.6 mg/kg IV over 30-60 seconds (typical adult dose is 20 mg). Etomidate begins working in 30 to 60 seconds, peaks in approximately 60 seconds, and lasts approximately 5 minutes.

2. What is the pediatric dosage of Etomidate?

   0.2-0.4 mg/kg IV/IO over 30-60 seconds for rapid sequence intubation (older than 10 years), 1 time only.

3. What Benzodiazepine medications are widely used in the prehospital setting?

   Diazepam, lorazepam, and midazolam. Benzodiazepines have potent antiseizure, anxiolytic, and sedative properties. These medications are pregnancy class D, which means they have demonstrated potential harm to the fetus. These medications should be administered to pregnant patients only during life-threatening situations when no safer alternative medications are available.

4. What is Flumazenil used for ?

   Flumazenil is used to reverse a benzodiazepine overdose and has the potential of exposing patients to numerous life-threatening conditions.

5. What is the dosage for Ketamine?

   2 mg/kg induces sedation. Commonly given as a neuromuscular blocker to facilitate intubation. Causes profound dissociation and general anesthesia.

6. What is the dosage for Succinylcholine (Anectine)? Depolarizing neuromuscular blocking agent.

   1-2 mg/kg IVP. Repeat dose can be given based on patient response. A competitive depolarizing paralytic agent. It reaches the neuromuscular junction, binds with nicotinic receptors on muscles, causes a brief activation known as fasciculation , and prevents additional activation by ACh. Succinylcholine rapid onset (30 to 60 seconds) and relatively brief duration (3 to 8 minutes). Can cause hyperkalemia (elevated potassium level), bradycardia (especially in children), and elevate intraocular pres…

7. Rocuronium (Zemuron)

   0.6-1.2 mg/kg. Same does for kids over three months old. Nondepolarizing agent that competes with ACh at nicotinic receptor sites. They occupy but do not activate receptor sites, preventing activation by ACh. Onset (1 to 3 minutes) combined with a shorter duration (15 to 60 minutes), maks it an appropriate nondepolarizing agent for placement of airway devices in emergency situations.

8. What is Albuterol (Ventolin, Proventil) used for ?

   A selective beta-2 agonist medication that is typically nebulized or administered using an MDI for the emergency treatment of bronchospasm. Terbutaline (Brethaire) and epinephrine are additional beta-agonist medications that may be used for the emergency treatment of bronchospasm

9. What is the adult dosage of ipratropium (Atrovent) ?

   0.5 mg nebulized

10. What is the pediatric dosage of ipratropium (Atrovent) ?

    0.25 mg nebulized

11. What is the adult dosage of Albuterol (Proventil, Ventolin) ?

    2.5 mg or 5 mg over 5–15 minutes Nebulized with 6–8 LpM o2; usually prepackaged in a solution of 2.5 mg in 3 mL NaCl onset: 5–15 minutes

12. What is the pediatric dosage of Albuterol (Proventil, Ventolin) ?

    0.05–0.15 mg/kg, pRN Nebulized with 6–8 LpM o2; usually prepackaged in a solution of 2.5 mg in 3 mL NaCl onset: 5–15 minutes

13. What is the dosage of albuterol/ipratropium (DuoNeb, Combivent) ?

    Adult: Nebulization: 3 mL every 20 minutes for 3 doses, then as needed Pediatric: Nebulization 1.5 mL every 20 minutes for 3 doses, then as needed Contraindications: allergy to soybeans or peanuts onset: 15 minutes

14. Vecuronium (Norcuron)

    0.1-0.2 mg/kg

15. Beta-2 receptor sites on bronchial smooth muscle cause?

    Muscle relaxation and bronchodilation when activated by beta-2 agonist chemicals.

16. What are two naturally occurring beta-2 agonists in the body?

    Norepinephrine and epinephrine

17. Racemic epinephrine is what form of epinephrine?

    Nebulized

18. Ipratropium bromide antagonizes what type of receptor cells?

    Muscarinic Causes bronchodilation and decreased mucus in the upper and lower airways.

19. Corticosteroid medications are administered to?

    Reduce airway inflammation from asthma, COPD, allergic reactions, and other causes of airway inflammation. Examples: Methylprednisolone (Solu-Medrol) dexamethasone (Decadron) prednisone

20. Patients with asthma have an overproduction of chemicals called?

    Leukotrienes, which bind to receptor sites within the lungs causing powerful bronchoconstriction as well as inflammatory, mucus-promoting, and vascular permeability effects.

21. The adult & pediatric dosage of methylprednisolone, (Solu-Medrol) for respiratory distress is?

    1–2 mg/kg IVP

22. Sedation is used in airway management to?

    Reduce a patient’s anxiety Induce amnesia Decrease the gag reflex

23. What type of neuromuscular blocking agent is Succinylcholine?

    Depolarizing Competitively binds with the ACh receptor sites but is not affected as quickly by acetylcholinesterase, so it causes depolarization of the muscle and prevents future signals for depolarization from having an effect because the ACh receptor sites are already occupied.

24. What are the most commonly used nondepolarizing neuromuscular blockers?

    Vecuronium, Pancuronium, Rocuronium

25. What is the defasciculating dose for succinylcholine?

    Typically 10% of the normal dose

26. Where is an LMA placed?

    It surrounds the opening of the larynx with an inflatable silicone cuff positioned in the hypopharynx. When properly inserted, the opening is positioned at the glottic opening, and the tip is inserted into the proximal esophagus, the lateral portions in the piriform fossae, and the upper border at the base of the tongue. The inflatable cuff conforms to the contours of the airway and forms a relatively airtight seal.

27. The LMA is ineffective for what type of patients?

    The LMA is ineffective for the ventilation of patients requiring high pulmonary pressures (such as patients with COPD or heart failure).

28. How does the i-gel supraglottic airway protect the airway?

    It creates a noninflatable, anatomical seal of the pharyngeal, laryngeal, and perilaryngeal structures, while avoiding compression trauma that may occur from devices with an inflatable cuff.

29. Where is the needle inserted in a needle cricothyrotomy ?

    While stabilizing the patient’s larynx, carefully insert the needle into the midline of the cricothyroid membrane at a 45° angle toward the feet (caudally). You should feel a pop as the needle penetrates the membrane. After the pop, insert the needle approximately 0.5 inch (1 cm) farther, and aspirate with the syringe. If the catheter has been correctly placed, you should be able to aspirate air and see the saline or water bubbling within the syringe. If blood aspirates or if you meet resistanc…