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Page 9 of 13 Medication continued... | Drug Name | Albuterol (Proventil, Ventolin) | | Description | Common bronchodilator used in clinical medicine. | | Adult Dose | 2.5-5 mg (0.5 mL of 5% solution diluted to a final volume of 3 mL with 0.9% saline) nebulized over 5-15 min q20min, not to exceed 6 doses; also available in unit dose vials (3 mL of 0.083% solution) for nebulization | | Pediatric Dose | Administer as in adults | | Contraindications | Documented hypersensitivity | | Interactions | Beta-adrenergic blockers antagonize effects; inhaled ipratropium may increase duration of bronchodilatation by albuterol; cardiovascular effects may increase with MAOIs, inhaled anesthetics, TCAs, and sympathomimetic agents | | Pregnancy | C - Safety for use during pregnancy has not been established.
| | Precautions | Caution in hyperthyroidism, diabetes mellitus, and cardiovascular disorders; avoid excessive use with cardiac disease, arrhythmia, hypertension, hyperthyroidism, seizure disorders, labor, and delivery; not recommended for nursing mothers | | Drug Name | Metaproterenol (Alupent, Dey-Dose, Prometa) | | Description | Beta2-adrenergic agonist that relaxes bronchial smooth muscle with little effect on heart rate. | | Adult Dose | 0.3 mL of 5% solution diluted in 2.5 mL of 0.45% or 0.9% normal saline nebulized over 5-15 min q4h | | Pediatric Dose | 0.1-0.2 mL of 5% solution diluted in 3 mL of 0.45% or 0.9% normal saline nebulized over 5-15 min q4h | | Contraindications | Documented hypersensitivity; arrhythmia associated with tachycardia | | Interactions | Decreases effect of beta-receptor blockers; increases toxicity of MAOIs, TCAs, and sympathomimetics | | Pregnancy | C - Safety for use during pregnancy has not been established.
| | Precautions | Caution in hypertension, cardiovascular disease, congestive heart failure, hyperthyroidism, diabetes, and seizures; not recommended for nursing mothers; adverse reactions include tachycardia, headache, nervousness, dizziness, tremor, gastrointestinal upset, hypertension, paradoxical bronchospasm, and cough | | Drug Name | Theophylline (Aquaphyllin, Aminophyllin) | | Description | Potentiates exogenous catecholamines and stimulates endogenous catecholamine release and diaphragmatic muscular relaxation, which, in turn, stimulates bronchodilation. | | Adult Dose | 5-6 mg/kg IV loading dose in 20 mL D5W over 10-15 min, followed by a maintenance dose of 0.5-1 mg/kg/h | | Pediatric Dose | Not established | | Contraindications | Documented hypersensitivity; uncontrolled arrhythmias, peptic ulcers, hyperthyroidism, and uncontrolled seizure disorders | | Interactions | Aminoglutethimide, barbiturates, carbamazepine, ketoconazole, loop diuretics, charcoal, hydantoins, phenobarbital, phenytoin, rifampin, isoniazid, and sympathomimetics may decrease effects; effects may increase with allopurinol, beta-blockers, ciprofloxacin, corticosteroids, disulfiram, quinolones, thyroid hormones, ephedrine, carbamazepine, cimetidine, erythromycin, macrolides, propranolol, and interferon | | Pregnancy | C - Safety for use during pregnancy has not been established.
| | Precautions | Caution in peptic ulcer, hypertension, tachyarrhythmias, hyperthyroidism, and compromised cardiac function; do not inject IV solution >25 mg/min; patients with pulmonary edema or liver dysfunction are at greater risk of toxicity because of reduced drug clearance | Drug Category: Corticosteroids Ameliorate delayed effects of anaphylactoid reactions and may limit biphasic anaphylaxis. In severe cases of serum sickness, parenteral steroids may be beneficial to reduce inflammatory effects of this immune complex–mediated disease. | Drug Name | Methylprednisolone (Medrol, Adlone, Solu-Medrol) | | Description | For treatment of inflammatory and allergic reactions. By reversing increased capillary permeability and suppressing PMN activity, may decrease inflammation. | | Adult Dose | 60-80 mg IV for 1 dose; then q6h | | Pediatric Dose | 1-2 mg/kg/dose IV q6h; not to exceed 60-80 mg | | Contraindications | Documented hypersensitivity; viral, fungal, or tubercular infections | | Interactions | Coadministration with digoxin may increase digitalis toxicity secondary to hypokalemia; estrogens may increase levels; phenobarbital, phenytoin, and rifampin may decrease levels (adjust dose); monitor patients for hypokalemia when taking medication concurrently with diuretics | | Pregnancy | C - Safety for use during pregnancy has not been established.
| | Precautions | Hyperglycemia, edema, osteonecrosis, peptic ulcer disease, hypokalemia, osteoporosis, euphoria, psychosis, growth suppression, myopathy, and infections are possible complications of glucocorticoid use |
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