Respiratory

Rapid Review

• Mechanism of Action: Beta-2 agonist; relaxes smooth airway muscle and increases intracellular potassium uptake.
• Indications: acute bronchospasm (asthma/COPD exacerbation); hyperkalemia. 
• Contraindications: allergy, tachycardia, ischemic heart disease, hyperglycemia, hypokalemia
• Dosage: Asthma/COPD: 5 mg nebulized q15 minutes; hyperkalemia: 15-20 mg nebulized
• Onset: < 5 minutes
• Duration: 2-4 hours
• Adverse Reactions: hypertension, tachycardia, arrhythmias, tremors, nervousness
• Special Considerations: N/A

Pearls

Deep Dive

• Albuterol (Drugs.com)

Rapid Review

• Mechanism of Action: Anticholinergic; blocks acetylcholine at cholinergic receptors, causing dilation of bronchial smooth muscle and decreased serous/seromucous secretion. 
• Indications: Asthma, COPD
• Contraindications: Allergy to drug/class
• Dosage: 0.3-0.5 mg nebulized q20 minutes (max 3 dosages)
• Onset: 20 minutes
• Duration: 60 minutes
• Adverse Reactions: Urinary retention, dry throat/cough, increased intraocular pressure
• Special Considerations: None

Pearls

Deep Dive

• The role of ipratropium bromide in the emergency management of acute asthma exacerbation: a metanalysis of randomized clinical trials (PubMed)