Anticholinergic Ipratropium bromide


G. a. Mg- low 0.60mmol/L (0.70-1.10mmol/L) all other pathology is normal. b. BGL 9.0mmol/L c. Beta-agonist- Salbutamol d. Anticholinergic – Atrovent e. IV Hydrocortisone f. ABG shows respiratory acidosis, (PH 7.32, PaCO2 49, Pa02 70, HCO3 27, BE -2.1, Lactate 1.4)
Plan
— Keep Sp02 92-95%% — Beta- antagonist Salbutamol continuous via nebuliser — Anticholinergic Ipratropium bromide (Atrovent) 500ug 4/24 — Hydrocortisone 100mg 6/24 — MgSO4 4mmol/20 minutes — IVF 53m1/hr — Repeat ABGs in lhour — Monitor BGL — Peak flow /spirometry
Question 1 Explain the pathogenesis causing the clinical manifestations with which Peter presents.
Question 2 1. Sit Peter in a High Fowlers position

— How does positioning a patient with acute asthma in a High Fowlers position assist to alleviate respirato. distress?

Apply and titrate oxygen
— What oxygen delivery device will you use? — Why did you choose this device? — How does providing supplemental oxygen work arid, how will it assist Peter?
Question 3 For each medication below explain

The mechanism of action 1,Vhy your patient is receiviuie this medication iii relation to ner symptoms and diagnosis?

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