Pharmacology Update May 2013 - PowerPoint PPT Presentation

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Pharmacology Update May 2013

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  1. Pharmacology UpdateMay 2013 Presence Regional EMS System

  2. Objectives • Describe the two actions of Duo-nebs for patients with asthma • Discuss the precautions involved using Duo-nebs • Identify the indications for using Fentanyl. • Outline the precautions and contraindications for the use of Fentanyl

  3. Requirements • All PRO Ambulance providers must review this PowerPoint presentation • Everyone must review this presentation by Saturday June 1, 2013 • Once you have reviewed the presentation, email Mary Butzow Mary.butzow@presencehealth.org

  4. 2013 Region 6 Protocols • Medications added to the Protocols • DuoNeb for Bronchospasm/Asthma • Fentanyl for pain relief

  5. DuoNeb • Blended solution of • Albuterol Sulfate (Albuterol) • Ipratropium Bromide (Atrovent) • Two medications work in different ways to achieve bronchodilation

  6. Albuterol • Albuterol- • Synthetic sympathetic nervous system stimulant • Beta 2 agonist – bronchodilation • Less cardiac effect ( Beta 1, Alpha 1) than epinephrine • Reduces mucus secretion, pulmonary capillary leaking and edema in the lungs in allergic reactions

  7. Albuterol • Precautions: Patient may experience • Tachycardia • Anxiety • Nausea • Cough • Wheezing • Dizziness

  8. Ipratropium (Atrovent) • Ipratropium • Anticholinergic blocks the acetylcholine receptors of the parasympathetic nervous system • Bronchodilation • Drying of respiratory tract secretions

  9. Ipratropium • Contraindications • Hypersensitivity to Atropine • Precautions • Elderly • Cardiovascular disease • Hypertension

  10. Myth-Buster • Duo-Nebs can be given to patients with nut allergies. • There is a problem with a preservative used in Duo-neb INHALERS. • Duo-neb nebulizer treatments are safe.

  11. DuoNeb • Combining Albuterol and Ipratropium produces a greater bronchodilation effect than when either drug is used alone.

  12. DuoNeb Dosage • Comes pre-mixed • 0.5 mg Ipratropium • 3 mg Albuterol • In 3 ml solution • Nebulize with 6-8 L Oxygen May repeat x 2

  13. Fentanyl • Potent synthetic narcotic analgesic • Similar to morphine and Demerol • More rapid action • Less prolonged action • Acts on specific pain receptors in brain to decrease the feeling of pain and reduce the emotional response to pain

  14. Fentanyl • Used as an alternative to morphine in cardiac and trauma protocols • Contraindications • Use of MAO inhibitors (i.e. Nardil, Parnate) • Myasthenia gravis

  15. Fentanyl • Precautions • Increased intracranial pressure • Elderly • Debilitated • Respiratory problems • Hepatic and renal insufficiency

  16. Fentanyl • Dose • 1 microgram / kg IV • Slow push (2-3 minutes)

  17. Report Completion Mary.butzow@presencehealth.org