Week 3: Respiratory Drugs
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What is oxygen?
• a gas that can be regulated • delivered to the patient via plastic tubing attached to a mask/nasal cannula
When is oxygen needed?
• to reverse hypoxia • critical illnesses requiring supplementary oxygen e.g. major trauma • it is essential for tissue oxygenation
What are controlled-indications of oxygen?
Being in an explosive environment (inc properties when patient is smoking)
What cautions are there with using oxygen?
• oxygen increases fire hazard • defib pads must be firmly placed to reduce spark hazard (ensure 1m away when shock is delivered)
What are some side effects of oxygen?
• irritate mucous membranes/make patient dry • COPD patients (high oxygen levels can increase CO2 )
How do you administer oxygen, and for how long?
Administer until a reliable reading is obtained, change the mask if SPO2 cannot be maintained
What are the target saturation levels?
No COPD= 94-98% COPD= 88-92%
How is salbutamol presented?
Nebules containing salbutamol - 2.5mg/2.5ml - 5mg/2.5ml
How does salbutamol work?
It is a selective beta2 adrenorecptor which works on the smooth muscle in the airways which spasm in an asthma attack
When would you use salbutamol?
• acute asthma where inhaler has no effect • expiratory wheeze associated with allergy, anaphylaxis, overdose, smoke inhalation, etc • exacerbation of COPD
What are some cautions associated with salbutamol?
Used in care with patients who have: - hypertension - angina - overactive thyroid - severe hypotension - bronchomalcia In COPD patients limit nebulisation to 6 minutes
What are possible side effects of salbutamol?
• tremours • tachycardia • palpitations • headache • feeling of tension • rash • muscle cramps • peripheral vasodilation
What is the dosage and administration of salbutamol in adults?
• nebulised with 6-8 litres per min of O2 • initial dose is 5mg/2.5ml • repeat dose is 5mg/2.5ml • dose interval is 5 mins • no max dose
How is ipratropium presented?
In nebules: - 250mcg/1ml or; - 500mcg/2ml
When would you use ipratropium bromide?
• acute severe or life threatening asthma • acute asthma unresponsive to salbutamol • exacerbation of COPD unresponsive to salbutamol • expiratory wheeze
How does ipratropium bromide work?
It is a bronchodilator
What works quicker in acute asthma ?
Beta2
What does ipratropium bromide have a greater benefit in?
• paediatric acute asthma • adults with exacerbation of COPD
What is the dosage of ipratropium bromide for an adult?
• nebulised with 6-8 litres/min of O2 • initial dose is 500mcg/2ml • repeat dose is N/A • max dose is 500mcg
How is adrenaline presented?
In a profiled syringe containing 1mg of adrenaline
When would you use adrenaline?
• life threatening asthma • when a patient has failing ventilation • continued disorientation despite nebulised therapy
How does adrenaline work?
Relieves bronchospasm in acute severe asthma
What are some cautions associated by using adrenaline?
• severe hypertension in patients on beta-blockers • administration route is IM • patients with a larger BMI will need a longer needle
What is the dosage and administration of adrenaline?
• IM antero-laternal aspect of the thigh • 500mcg initial dose • 500mcg repeat dose • 5 minute intervals • no max dose