1st Semester- Trauma

Question 1

NALOXONE
HYDROCHLORIDE
(Narcan)

Answer 1

Classification: Narcotic antagonist
the effect of Morphine.

Indications: Opiate overdose, coma; complete or partial reversal of CNS or
respiratory depression induced by opioids; decreased level of consciousness
(LOC); coma of unknown origin.

Contraindications: Use with caution in narcotic-dependent patients and
neonates of narcotic-addicted mothers.

Adverse Reactions: Withdrawal symptoms in the addicted patient,
tachycardia, arrhythmia, N/V, diaphoresis.

Precautions: half-life that is shorter than that of most narcotics; possible
violent behavior in opiate-addicted patients.

Dosage/Route: Adult: 0.4 to 2 mg IV/MAN/SC/ET; max dose of 10 mg.
For IN route administer half a dose per nostril max 1 ml per nostril Pediatric:
0.1 mg/kg/dose IVAM/SC or ET max dose 0.8 mg; if no response in 10 min,
administer additional 0.1 mg/kg/dose; max dose 2 mg

Question 2

TRANEXAMIC ACID

(TXA, Cyklokapron, Lysteda)

Answer 2

Classification: Hemostatic agent, Antifibrinalytic

Mechanism of Action: Inhibits plasminogen activation which
then inhibits plasmin, prevents clot breakdown

Indications: Blunt or penetrating trauma less than 3 hours
from onset with hemodynamic compromise, bleeding

Contraindications: Hypersensitivity, subarachnoid
hemorrhage, stroke, pulmonary embolus, DVT

Precautions: renal disease, leukemia; Pregnancy D

Adverse Effects: Hypotension, nausea and vomiting

Dosage: Adult: 1g IV infusion over 10 minutes
Pediatric: Not recommended

Question 3

ONDANSETRON

Zofran

Answer 3

Classification: 5-HT3 receptor antagonist; anti-nausea

Mechanism of Action: Blocks action of serotonin, which is a
natural substance that causes nausea and vomiting

Indications: Prevention or control of nausea or vomiting.

Contraindications: Known allergy or 5-hydroxytryptamine-3
receptor (5-HT3) antagonists.

Precautions: Pregnancy B

Adverse Reactions: headache

Dosage/Route: Adult: 4 mg IV/IM (may repeat in 10 min)
Pediatric: 0.1 mg/kg IV/IM.

Question 4

DOPAMINE

Intropin

Answer 4

Classification: Sympathomimetic/ inotropic agent

Mechanism of Action: Increases systemic vascular resistance, increases
myocardial contractility and stroke volume increasing cardiac output without
appreciably increasing myocardial oxygen consumption.

Indications: Cardiogenic, septic, or spinal shock, distributive shock.
hypotension with low cardiac output states.
Contraindications: Hypovolemic shock, tachyarrhythmias, V-fib.

Precautions: Myocardial infarction; occlusive vascular disease (arterial
embolism).

Adverse Reactions: Arrhythmias, palpitation, headache, local irritation at the
IV site.

Dosage/Route:
Adult / Pediatric: 2 to 20 mcg/kg/min infusion titrated to effect.

Question 5

LORAZEPAM

Ativan

Answer 5

Classification: Benzodiazepine (Schedule C-IV); Sedative; Anticonvulsant

Mechanism of Action: Binds to the benzodiazepine receptors an inhibitory
transmitter, results in sedation, hypnosis, skeletal muscle relaxation

Indications: Pre-procedural sedation; anxiety; status epilepticus

Contraindications: Acute narrow-angle glaucoma; sleep apnea; shock

Precautions: Potentate CNS depressant effect of alcohol; Geriatrics;
Pregnancy C; COPD

Adverse Reactions: Respiratory depression, drowsiness, sedation, apnea,
ataxia, hypotension, bradycardia, short half-life

Dosage:
Adult: 1-2 mg IV/IO
Pediatric: 0.05 mg/kg IV

Question 6

HALOPERIDOL

Haldol

Answer 6

Classification: Tranquilizer; Antipsychotic
Mechanism of Action: Blocks CNS dopa minergie receplors

Indication: Acute psychotic disorders, agitation

Contraindications: Agitation secondary to shock or hypoxia;
hypersensitivity; Parkinson
s Disease

Precautions: Enhanced ¿NS depression in combination
with alcohol; other CNS depressants may potentate effects.
Pregnancy C. Not recommended for Pediatric patients

Adverse Reactions: Extrapyradim al symptoms (dystonia,
drooling, spasm, Parkinson-like symptoms); hypotension;
orthostatic hypotension; nausea and vomiting

Dosage;
Adults: 2-5 mg IN every 30 -60 minutes to achieve sedation

Question 7

OXYGEN

Answer 7

Classification: A naturally occuring atmospheric gas.
Mechanism of Action: Reverses hypoxemi
Indications: hypoxemia, ischemic chest pain, respiratory insufficiency, carbon
Dosage/Route;
Adult / Pediatric:
Cardiac arrest / carbon monoxide polsoning: 100%;
sp02

Question 8

ACTIVATED CHARCOAL

Liqui-Char

Answer 8

Classification: adsorbent

Mechanism of Action: Activated charcoal is specially
prepared charcoal that will adsorb and bind toxins from the
gastrointestinal tract.

Indications: Most oral poisonings and medication
overdoses; can be used after the evacuation of poisons.

Contraindications: None known or reported
Precautions: not recommended for poisonings due to
cyanide, iron, lithium, lead, or arsenic (does not adsorb);
use cautiously with ingestion of corrosives, petroleum
distillates, caustics, organic solvents (may induce vomiting
leading to aspiration)

Dosage/Route:
Adult / Pediatric: 1-2g/kg PO or NG tube

Question 9

ORAL GLUCOSE

Insta-Glucose

Answer 9

Classification: Hyperglycemic

Mechanism of Action: Provides quickly absorbed
glucose to increase blood glucose levels.

Indications: Conscious patients with suspected
hypoglycemia with an intact gag reflex.

Contraindications: Decreased level of
consciousness (LOC), vomiting, and nausea.

Adverse Reactions: Nausea and vomiting

Dosage/Route:
Adult: 25g PO
Pediatric: 0.5-1.0 g PO

Question 10

IPRATROPIUM

Atrovent

Answer 10

Classification: Anticholinergic Mechanism of Action:
Parasympatholytic. Inhibits cholinergic receptors in the
bronchial smooth muscle causing bronchodilation.
Indications: Maintenance treatment of bronchospasm in
patients with reversible obstructive airway disease
(Asthma/COPD). Can be used alone or in combination with
other bronchodilators
Contraindications: Hypersensitivity to Ipratropium, or
Atropine Precautions: Used with caution in patients with
known prostatic hypertrophy, bladder neck obstruction,
urinary retention, glaucoma. Pregnancy Category B.
Adverse Effects: Palpitations, Hypertension, Dizziness,
inhalation every 6-8 hours.
Dose: 250-500 mcg in 2ml

Question 11

ALBUTEROL
(Proventil,
Ventolin)

Answer 11

Classification: Bronchodilator; Sympathomimetic
Mechanism of Action: Selective Beta-2 agonist; induces bronchodilation by
relaxation of smooth muscles in the bronchial tree.
Indications: Control bronchospasm; Asthma, COPD; prevention of
exercise-induced bronchospasms.
Contraindications: Known hypersensitivity
Precautions: Used cautiously in cardiac disease, hypertension,
hyperthyroidism, diabetes, seizure disorder, patients with tachyarrhythmias
taking Digoxin. Safety not established for pregnant patients near term,
breastfeeding, and children <2y/o
Adverse Reactions: Restlessness, tremors, nervousness, paradoxical
bronchospasm, chest pain, tachycardia, N/V, hyperglycemia.
Dosage/Route:
Adults: 2.5 mg added to 2 mL of normal saline (NS) for inhalation by
nebulize, repeat every 20 min up to 3 times.
Pediatrics: > 20 kg: same as aduit
<20kg: 1.25 mg/dose via nebulizer

Question 12

FENTANYL

Sublimase

Answer 12

Classification: Opioid analgesic
Mechanism of Action: Narcotic analgesic; binds to opiate
receptors in the CNS altering the perception of pain
Indications: Severe pain; maintain analgesia in tracheal
intubation.
Contraindications: Myasthenia gravis, children under 2
years old.
Adverse Effects: Apnea, Laryngospasm, bronchospasm,
respiratory depression, bradycardia, hypotension
Precautions: Pregnancy C; patients taking MAO inhibitors;
myasthenia gravis.
Dosage:
Adult: 0.5-1 mcg/kg IM/lO/IV.
Pediatric: 2-12 years old 1 to 2 mcg/kg IM/1O or IV.