5. Resp Med 1

• Ipratropium bromide Class + MOA


  Anticholinergic bronchodilator; blocks acetylcholine on bronchial smooth muscle
• Indications for Ipratropium bromide


  Persistent bronchospasm, COPD, exacerbation, toxic inhalation (with albuterol)
• Contraindications for Ipratropium bromide


  Hypersensitivity to ipratropium, atropine, alkaloids, or peanuts; caution in urinary retention, narrow-angle glaucoma, CV disease, HTN
• Dose of Ipratropium bromide


  0.5mg nebulized, up to 3 doses, in conjunction with albuterol
• Route of Ipratropium bromide administration


  Inhalation, usually via small volume nebulizer (SVN)
• Side Effects of Ipratropium bromide


  Includes HA, dizziness, nervousness, flushing, N/V, tremor, dyspnea, worsening COPD, MI, GI distress, HTN, tachycardia, palpitations, dry mouth
• Terbutaline Class + MOA


  Tocolytic; Beta-2 adrenergic agonist; bronchodilator; relaxes smooth muscle of bronchial tree & peripheral vasculature
• Indications for Terbutaline


  Bronchial asthma, exercise bronchospasms, chronic bronchitis, emphysema, labor suppressor (premature uterine contractions)
• Contraindications for Terbutaline


  Prevention/prolonged tx for preterm labor, hypersensitivity, tachydysrhythmias
• Dose of Terbutaline for adults and children (12+)


  0.25mg SQ, repeat 15-30 min, max: 0.5mg in 4 hours
• Dose of Terbutaline for labor suppression


  0.25mg SQ/IV, repeat x 1 15-30 min if contractions not abated, max 0.5mg
• Route of Terbutaline administration

  SQ, IV
• Side Effects of Terbutaline


  Includes CNS stimulation, HA, seizure, restlessness, apprehension, wheezing, coughing, bronchospasm, chest pain, bradycardia, tachycardia, ST wave changes, PVC's, PAC's
• Methylprednisolone Class + MOA


  Corticosteroid; highly potent synthetic glucocorticoid; suppresses chronic inflammation; relaxes vascular smooth muscle by beta adrenergic agonists
• Indications for Methylprednisolone


  Anaphylaxis, bronchodilator for unresponsive asthma
• Contraindications for Methylprednisolone


  Premature infants, systemic fungal infections
• Dose of Methylprednisolone for adults


  125mg IV/IO
• Dose of Methylprednisolone for children

  2mg/kg IV/IO, max: 125 mg
• Route of Methylprednisolone administration


  IV, IO
• Side Effects of Methylprednisolone


  Includes depression, euphoria, HA, restlessness, seizure, increased ICP, HTN, heart failure, N/V, peptic ulcer, fluid retention, hypernatremia, hyperkalemia