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ACP > 200's Pharmo > Flashcards

200's Pharmo Flashcards

1
Q

Opioids

Narcotics

A
  • morphine sulfate (Statex) acts on opiate receptor
  • fentanyl citrate (Sublimaze) acts on Mu receptors
  • meperidine (Demerol) acts on Mu receptors
  • nalbuphine (Nubain) acts on opiate receptors
  • used for pain management

contraindications

  • CNS depressed
  • head injury
  • resp depressed
  • MAOI’s in 14 days
  • hypotension
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2
Q

morphine sulfate (generic name)

A
  • MS contin statex (trade)
  • class
    • opioid
    • analgesic
    • narcotic
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3
Q

morphine-MOA

A
  • acts on the CNS opiate receptors

- vasodilation due to depression of A receptors and baroreceptors

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4
Q

morphine-dose

A

STEMI

  • 2-4mg SIVP
  • 5-15mg IM

PAIN
-2-10mg SIVP q 5-30 min

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5
Q

morphine-indications

A
  • cardiac chest pain

- moderate to server pain (acute or chronic)

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6
Q

morphine-contraindications

A
  • hypotension
  • allergy to codeine
  • altered LOC
  • head injury
  • severe resp depression
  • MAOI’s within 14 days
  • undiagnosed abdo pain

PRECAUTIONS

  • use caution with RVI’s
  • resp compromised
  • pt’s with other CNS depressant
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7
Q

fentanyl citrate (generic)

A

Sublimaze (trade)

  • opioid
  • analgesic
  • narcotic
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8
Q

fentanyl MOA

A
  • acts on Mu receptors in the CNS altering pain preception
  • less emetic effects than other narcotics
  • 50-100x stronger than MS but shorter acting
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9
Q

fentanyl indications

A
  • severe pain panagment

- RSI

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10
Q

fentanyl contraindications

A
  • MAOI’s within 14 days
  • severe hemorrhage
  • head injury
  • hypotension
  • Myasthenia gravis

Precautions

  • bradycardia
  • hepatic or renal failure
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11
Q

meperidine (generic)

A

Demerol (trade)

  • opioid
  • analgesic
  • narcotic
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12
Q

meperidine MOA

A
  • acts on Mu and Kappa opiate receptors in the CNS

- greater affinity for Kappa than morphine causing increased dysphoria but does not have the same hemodynamic properties

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13
Q

meperidine dose

A

25-50mg IV q 3-4 hours

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14
Q

meperidine indications

A

-moderate to severe pain

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15
Q

meperidine contracations

A

MAOI’s or SSRI’s within 14 days

  • head injury
  • undiagnosed abdo pain

Precautions
-phenytoin may decrease analgesic effects

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16
Q

fentanyl dose

A

pain managment
-.5-1 mcg/kg SIVP

RSI
-2-5 mcg/kg IV
or
-1-3 mcg/kg IV if hypotensive

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17
Q

nalbuphine (generic)

A

Nubain (trade)

  • opioid
  • analgesic
  • narcotic
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18
Q

nalbuphine dose

A

5mg SIVP followed by 2mg titrated to effect

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19
Q

nalbuphine MOA

A
  • decrease pain preception by acting on opioid recptors
  • simillar strength to morphine but faster and longer acting
  • analgesic effects with antagonist properites to reduce risk of abuse
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20
Q

nalbuphine indications

A

moderate to severe pain

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21
Q

nalbuphine contraindications

A
  • head injury
  • undiagnosed abdo pain

precautions
-may cause withdrawal in opiate dependant patients

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22
Q

naloxone (generic)

A

Narcan (trade)

-opioid antagonist

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23
Q

naloxone dose

A

titrate to effect

  • .4mg IV/IO/IM to total max 2mg
  • 2mg IN q3-5 min
24
Q

naloxone MOA

A
  • narcotic antagonist
  • competes for narcotic (opioid) receptors in the CNS but has a higher affinity
  • works with both narcotics and synthetic narcotics
25
Q

naloxone indication

A

CNS and resp depression induced by opioids

26
Q

naloxone contraindications

A

-hypersensitivity

precautions

  • narcotic dependance
  • decreases effectiveness of any opioids administered
27
Q

acetaminophen (generic)

A

Tylenol (trade)

  • analgesic
  • antipyretic
28
Q

acetaminophen dose

A
  • 325-650mg PO q 4 hrs

- to a max of 4gs (4000mg) per day

29
Q

acetaminophen MOA

A
  • acts on the hypothalamus to produce antipyresis
  • may potentially block pain impulses
  • may inhabit prostaglandin synthesis in the CNS
30
Q

acetaminophen indications

A
  • fever

- mild pain

31
Q

acetaminophen contraindications

A
  • severe acute liver disease
  • hypersensitivity

precautions

  • altered LOC
  • NV
  • angioedema
32
Q 
ASA
acetylsalicylic acid (generic)
A

Asprin (trade)

  • antiplatelet (platelet inhibitor)
  • analgesic
  • anti-inflammatory
  • antipyretic
33
Q

ASA MOA

A
  • changes surface of platelets decreasing the ability to clot
  • blocks the formation of thromboxane A2
34
Q

ASA dose

A

chest pain
-160-325 mg PO (chewed)
mild pain or fever
-325-650 mg PO q 4hrs

35
Q

ASA indications

A
  • chest pain
  • fever
  • minor pain
36
Q

ASA contraindications

A
  • hypersenseitivity ro ASA or NSAIDS
  • active bleed (internal or external)

precautions

  • bleeding disorder
  • active ulcers
  • bronchoconstriction in asthmatics
37
Q

diazepam (generic)

A

Valium (trade)

38
Q

diazepam class

A

Benzodiazepine
anticonvulsant
antianxiety
sedative

39
Q

diazepam dose

A

seizure 5-10mg SIVP

cardioversion
5-15mg SIVP

anxiety
2-5mg SIVP/IM

40
Q

diazepam MOA

A

potentiating effects of GABA

41
Q

diazepam indications

A
  • status epilepticus
  • seizure
  • cardioversion
  • sedation
  • anxiety
42
Q

diazepam contraindacations

A
  • substance abuse (relative)
  • CNS depressed due to head injury
  • resp depression
  • severe hypotension
  • shock
  • hypersensitivity

Precaution
-short acting due to water solubility

43
Q

lorazepam (generic)

A

Ativan (trade)

44
Q

lorazepam class

A
  • Benzodiazepine
  • anticonvulsant
  • antianxiety
  • sedative
45
Q

lorazepam MOA

A

-potentiating effects of GABA

46
Q

lorazepam dose

A

seizure
0.5-2mg SIVP

anxiety/withdrawal
1-4mg IM
1mg SL

47
Q

lorazepam indications

A
  • status
  • seizure
  • cardioversion
  • sedation
  • anxiety
  • withdrawl
48
Q

lorazepam contracations

A
  • CNS depressed
  • headinjury
  • resp depression
49
Q

Benzodiazepines
anticonvulsants
antianxiety
sedatives

A

lorazepam (Ativan)
diazepam (Valium)
midazolam (Versed)

  • all potentiate the effects of GABA
  • used for seizures, sedation and anxiety
  • contraindications CNS or resp depressed
50
Q

midazolam (generic)

A

Versed (trade)

51
Q

midazolam calss

A
  • benzo
  • anticonvulsant
  • antianxiety
  • sedative
52
Q

midazolam MOA

A

potentiates GABA

53
Q

midazolam dose

A

sedation
-1-2.5mg SIVP (5-10mg SIVP AHS)

seizure
-1-2.5mg SIVP

RSI
-0.1-0.3mg/kg SIVP

54
Q

midazolam indications

A
  • seizures
  • sedation
  • status
  • cardioversion
  • anxiety
55
Q

midazolam contraindications

A
  • severe hypotension
  • CNS depressed
  • head injuried
  • resp depression
  • substance abuse
56
Q

flumazenil (generic)

A

Anexate (trade)

ACP (15 decks)

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