Question

3. Medications in respiratory distress a. Identify the classification, mechanism of action, dosage range for inhaled administration, and side effects of albuterol. The patient weighs 8.2kg. Review the implications of hydration in respiratory distress a. How does respiratory distress affect hydration in an infant? b. What is the minimum acceptable hourly output for an 8.2kg infant 4. c. Identify 2 strategies to promote PO intake in an infant with respiratory distress.

Answer 1

3) Albuterol :-

Albuterol: Drug Classification

Bronchodilator

Albuterol: Actions

1. Relaxes bronchial smooth muscle by stimulating beta2 receptors resulting in bronchodilation

2. Reduces airway resistance by bronchodilation

Albuterol: Indications

1. BRONCHOSPASM caused by: acute asthma, COPD/ Chronic Bronchitis, toxic gas inhalation, near drowning, pulmonary edema, drug overdose

2. CRUSH SYNDROME: Suspected hyperkalemia or crush/ entrapment more than 4 hours

Albuterol: Contraindications

Not significant due to indications

Albuterol: Adverse Effects

Cardiovascular: tachycardia, hypertension

Gastrointestinal: nausea

Respiratory: cough, wheezing

Neurological: tremors, nervousness, headaches, dizziness

Albuterol: Administration

Bronchospasm: 5mg inhalation by hand-held nebulizer over 5-15 minutes. Repeat PRN.

Crush Syndrome: 5mg inhalation- continuous by hand-held nebulizer

Albuterol: Pediatrics

0-1 yr.: 2.5mg inhalation by hand-held nebulizer over 5-15 minutes. Repeat PRN.

>1yr: Same as adult (respiratory or crush syndrome)

4. a) When respiratory distress is present, hydration is an essential consideration. Usually infants cannot take fluids by the oral route because of the difficulty breathing. Intravenous fluid administration may be necessary.

b) Minimum acceptable hourly fluid output if 1.5-2 ml/kg

For 8.2 kg infant ,it would be 12.3-16.4 ml

c) Two strategies :-

- Give favourite fluids frequently to prevent dehydration

- IV fluid administration