Which of the following actions is NOT recommended when administering drugs via ETT?

Administering standard IV doses when delivering medication through an endotracheal tube (ETT) is not recommended as the pharmacokinetics of drug delivery via the airway differ significantly from intravenous administration. Drugs given through the ETT may not reach effective blood concentrations, and therefore, sufficient dosing adjustments are necessary.

For example, many drugs given via the ETT need to be given in higher doses compared to their standard IV dosages because of the decreased absorption via the respiratory mucosa. Additionally, the potential for increased risk of side effects also comes into play. The endotracheal route was primarily meant for emergency scenarios when IV access is impossible or delayed; hence, using standard IV doses could lead to inadequate treatment or complications.

In contrast, flushing the tube after administration ensures that the medication reaches the distal airway and maximizes its effectiveness. Instilling lipid-soluble drugs can also be effective since these drugs can better permeate the pulmonary epithelium. Administering two rescue breaths after medication delivery helps ensure that the drug reaches the alveoli, contributing to absorption.