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AEMT class > AEMT meds > Flashcards

AEMT meds Flashcards

1
Q

Cetacaine

A

Topical anesthetic (benzocaine, aminobenzoate and tetracaine)

Dont use if pt is allergic and dont use with other meds
Use caution with pts <2yo and elderly pts

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2
Q

Etomidate name and class

A

Name: Amidate

Class: Nonbarbiturate hypnotic, anesthesia induction agent, CNS depressant

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3
Q

Etomidate indication contraindication

A

Indication: Sedation/Premedication for medication-facilitated intubation or procedural sedation

Contraindication: Hypersensitivity, labor/delivery, septic shock (particularly in children), Renal impairment (impairs RAAS)

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4
Q

Etomidate action and side effects

A

Action: short-acting (effects last less than 10 minutes) hypnotic that acts at the level of the reticular activating system

Side effects: apnea, resp depression, hypoventilation, hyperventilation, dysrhythmias, hypotension, hypertension, nausea, vomiting, involuntary muscle movement, pain at injection site

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5
Q

Etomidate dosage and special considerations

A

Adult: 0.2 to 0.6 mg/kg IV over 30-60 seconds (typical adult dose is 20mg)

Pedi: 0.2 to 0.4 mg/kg IV/IO over 30-60 seconds for RSI (older than 10 years old), one time only. Max dose: 20mg

Special considerations: Use cation with pregnancy and weigh risks to the baby.
Consider lowering dosage in older pts and pts with cardiac conditions

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6
Q

Ketamine name and class

A

Name: Ketalar

Class: Sedative, general anesthetic, analgesic dissociative anesthetic

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7
Q

Ketamine indications and contraindications

A

Indications: excited delirium, pain management, procedural sedation

Contraindications: hypersensitivity, conditions where hypertension would be hazardous to the pt’s care

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8
Q

Ketamine action and side effects

A

Action: blocks pain receptors and minimizes spinal cord activity, affecting the association pathways of the brain between the thalamus and limbic system

Side effects: hypertension, dysrhythmia, bronchodilator, resp depression

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9
Q

Ketamine dosage and special considerations

A

Adult: 1 to 2 mg/kg IV push over 1-2 minutes

Pedi: 1 to 2 mg/kg IV push over 1-2 minutes

  • Starts taking effect after about 30 seconds
  • Lasts about 5-10 mins

Special considerations: pts may have excessive drooling. Some pts may experience an emergence reaction after the full duration of the meds effect.

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10
Q

Midazolam name and class

A

Name: Midazolam hydrochloride, Versed

Class: Benzodiazepine, short/intermediate-acting; schedule IV drug

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11
Q

Midazolam indications and contraindications

A

Indications: Seizures, sedation for medical procedures, chemical restraint

Contraindications: Acute narrow-angle glaucoma, shock, coma, alcohol intoxication, overdose, depressed vitals. Concomitant use with barbiturates, alcohol, narcotics, or other CNS depressants

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12
Q

Midazolam action and side effects

A

Action: Reversibly interacts with GABA receptors in the CNS causing sedative, anxiolytic, amnesic, and hypnotic effects

Side effects: Headache, somnolence, resp depression, resp arrest, apnea, hypotension, cardiac arrest, nausea, vomiting, pain at the injection site

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13
Q

Midazolam dosage and special considerations

A

adult: - Seizures: 0.2 mg/kg IM or IN, max dose 10mg; 0.1 mg/kg IV, max dose 4mg.
- Procedural sedation: 0.5 to 2.5 mg IV. May be repeated to total max: 0.1mg/kg
- Chemical restraint: 5mg IV or IN; 5mg IM

Pedi: - Seizure: 0.1 to 0.3 mg/kg IV/IM (max single dose 10mg) 0.2 mg/kg IN
- Procedural sedation 0.05 to 0.5 mg/kg IV; 0.1 to 0.15 mg/kg IM; 0.3 mg/kg IN

Special considerations: Risk to Fetus needs to be considered before administering. Should not breastfeed after administration.
Administer immediately prior to intubation.
Decrease dose by 50% in older pts and in pts with hepatic and renal dysfunction.
IM and IN control seizures faster that IV if IV needs to be placed

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14
Q

Rocuronium name and class

A

Name: Rocuronium Bromide, Zemuron

Class: Nondepolarizing neuromuscular blocker

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15
Q

Rocuronium indications and contraindications

A

Indications: RSI/DSI

Contraindications: Known sensitivity to bromides; use with caution in heart and liver disease

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16
Q

Rocuronium action and side effects

A

Action: Antagonizes acetylcholine at the motor end plate producing skeletal muscle paralysis

Side effects: Bronchospasm, wheezing, rhonchi, resp depression, apnea, dysrhythmias, tachycardia, transient hypotension and hypertension, nausea, vomiting

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17
Q

Rocuronium dosage and special considerations

A

Adult: 0.6 to 1.2 mg/kg IV/IO

Pedi (older than 3 months): 0.6 to 1.2 mg/kg IV/IO

Special considerations: always make sure to sedate pt before administration.
Decrease doses for pts with renal disease

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18
Q

Succinylcholine name and class

A

Name: Succinylcholine Chloride, Anectine

Class: Neuromuscular blocker, depolarizing; skeletal muscle relaxant

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19
Q

Succinylcholine indications and contraindications

A

Indications: RSI/DSI

Contraindications: Acute narrow-angle glaucoma, penetrating eye injuries, malignant hyperthermia; acute injury after multisystem trauma, major burns, or extensive muscle injury that may result in hyperkalemia

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20
Q

Succinylcholine action and side effects

A

Action: Ultra-short-acting depolarizing skeletal muscle relaxant that mimics acetylcholine as it binds with the cholinergic receptors on the motor end plate, producing a phase 1 block as manifested by fasciculations

Side effects: Apnea, resp depression, dysrhythmia, cardiac arrest, salivation, prolonged muscle rigidity, rhabdomyolysis, malignant hyperthermia, increased intraocular pressure, hyperkalemia

21
Q

Succinylcholine dosage and special considerations

A

Adult: 1 to 2 mg/kg rapid IV. Repeat once if needed

Pedi: 1 to 2 mg/kg rapid IV. Repeat once if needed

Special considerations: sedate pt before administration.
Time management is needed since such short-acting.

22
Q

Vecuronium name and class

A

Name: Vecuronium Bromide, Norcuron

Class: neuromuscular blocker, nondepolarizing

Page 1532

23
Q

Vecuronium indications and contraindications

A

Indications: RSI/DSI

Contraindications: Acute narrow-angle glaucoma, penetrating eye injuries, inability to control airway or support ventilations with oxygen and positive pressure, newborns, myasthenia gravis, hepatic or renal failure

24
Q

Vecuronium action and side effects

A

Action: Neuromuscular agent with intermediate duration of action that competes with acetylcholine for receptors at the motor endplate resulting in neuromuscular blockade

Side effects: weakness, prolonged neuromuscular block, bronchospasm, apnea, dysrhythmias, bradycardia, tachycardia, PVCs, transient hypotension, cardiac arrest, excessive salivation

25
Q

Vecuronium dosage and special considerations

A

Adult: 0.1 to 0.2 mg/kg IV push. Maintenance dose within 45 to 60 minutes: 0.8 to 1.2 mg/kg IV push

Pedi: 0.1 to 0.3 mg/kg IV/IO. Maintenance dose within 20-40 minutes: 0.01 to 0.15 mg/kg IV push

Special considerations: Decrease doses for pts with renal disease

26
Q

Acetaminophen name and class

A

Name: Tylenol

Class: centrally-acting analgesic, antipyretic

27
Q

Acetaminophen indications and contraindications

A

Indications: reducing pain, reducing fever

Contraindications(/cautions): Hypersensitivity, hepatic impairment (liver failure), liver disease, renal impairment, hypovolemia, malnutrition, chronic alcohol use

28
Q

Acetaminophen side effects

A

Side effects: anaphylaxis, skin reaction, hepatotoxicity (liver poisoning), renal tubular necrosis, nephropathy, anemia, thrombocytopenia, nausea, rash, headache

29
Q

Acetaminophen dosage and special considerations

A

Adult (12 and older): 1-2 tabs/caps PO q4-6h prn; Max: 10 tabs/caps in 24h. Do not exceed 1g/4h and 4g/day
Normally is 325mg per tab/caps

Pedi (6-11): 1 tab/cap PO q4-6h prn; Max: 5 tabs/caps in 24h. Do not exceed 75mg/kg/day, up to 1g/4h and 4g/day

Special considerations: Can damage liver.

30
Q

Butorphanol name and class

A

Name: Butorphanol Tartrate, Stadol

Class: Opioid agonist/antagonist

31
Q

Butorphanol indications and contraindications

A

Indications: pain reliever

Contraindications: hypersensitivity, resp depression, asthma, GI obstruction, paralytic ileus, coma/impaired consciousness, labor and delivery

32
Q

Butorphanol side effects

A

Side effects: Sedation, dissiness, nausea, vomiting, diaphoresis, headache, resp depression, resp arrest, apnea, central sleep apnea, hypotension, bradycardia, biliary spasm, adrenal insufficiency, seizures, anaphylaxis, Hypertension, dependency, abuse, withdrawal symptoms if stopped abruptly

33
Q

Butorphanol dosage and special considerations

A

Adult: - Pain: 0.5-2mg IV q3-4h prn. Use lowest effective dose, shortest effective duration
- Anesthesia adjunct: 2mg IV x1 then 0.5-1mg IV prn before induction

Pedi: Not recommended

Special considerations: is an opioid so can be very addictive. Use caution when using on elderly pts.

34
Q

Fentanyl name and class

A

Name: Fentanyl Citrate, Sublimaze

Class: Opioid analgesic, schedule 2 drug

35
Q

Fentanyl indications and contraindications

A

Indications: Pain management, anesthesia adjunct

Contraindications: Known hypersensitivity. Use with caution in traumatic brain injury

36
Q

Fentanyl action and side effects

A

Action: Binds to opiate receptors, producing analgesia and euphoria

Side effects: Confusion, paradoxical excitation, delirium, drowsiness, CNS depression, sedation, resp depression, apnea, dyspnea, dysrhythmias, bradycardia, tachycardia, hypotension, syncope, nausea, vomiting, abd pain, dehydration, fatigue

37
Q

Fentanyl dosage and special considerations

A

Adule: 50-100 mcg (1 mcg/kg) IM and IV slow push (over 1 to 2 minutes) to maximum 150 mcg. IN is rapid push

Pedi: 1-2 mcg/kg IM, IV or IN slow push (over 1-2 mins).

Special considerations: The safety and efficacy in children younger than age 2 years has not been established. Chest wall rigidity possible with a high dose rapid infusion.

38
Q

Ibuprofen name and class

A

Name: Advil, Motrin

Class: Non-steroidal anti-inflammatory drug (NSAID)

39
Q

Ibuprofen indications and contraindications

A

Indications: For the acute management of pain or antipyretic

Contraindications: Aspirin allergy; preterm infants with untreated proven or suspected infection; bleeding with active intracranial hemorrhage or GI bleed; thrombocytopenia, coagulation defects, significant renal impairment, congenital heart disease

40
Q

Ibuprofen action and side effects

A

Action: Pain reliever

Side effects: GI bleeding, GI perforation, GI ulcer, MI, Stroke, Hypertension, CHF, bronchospasm

41
Q

Ibuprofen dosage and special considerations

A

Adult: 300-800 mg PO tid-qid (3-4 times a day)

Pedi: 6mo - 11yo: 5-10 mg/kg/dose PO q6-8h prn; Max 40mg/kg/day
12+yo: 200-400 mg PO q4-6h prn; Max: 1200 mg/day

42
Q

Morphine name and class

A

Name: Morphine Sulfate, Roxanol, MS Contin

Class: Opioid analgesic; schedule 2 drug

43
Q

Morphine indications and contraindications

A

Indications: Severe heart failure, acute cardiogenic pulmonary edema, chest pain associated with AMI, analgesia for moderate to severe acute and chronic pain

Contraindications: Head injury, exacerbated COPD, depressed respiratory drive, hypotension, undiagnosed abd pain, decreased level of consciousness, suspected hypovolemia, pts who have taken MAOIs within 14 days

44
Q

Morphine action and side effects

A

Action: Alleviates pain through CNS action. Suppresses fear and anxiety centers in the brain. Depresses brainstem resp centers. Increases peripheral venous capacitance and decreases venous return. Decreases preload and afterload, which decreases myocardial oxygen demand.

Side effects: confusion, sedation, headache, CNS depressants, resp depression, apnea, bronchospasm, dyspnea, hypotension, orthostatic hypotension, syncope, bradycardia, tachycardia, nausea, vomiting, dry mouth

45
Q

Morphine dosage and special considerations

A

Adult: STEMI: Initial dose: 2-4mg slow IV (over 1-5 mins) repeat dose: 2-8 mg at 5 - 15 mins intervals
NSTEMI/unstable angina: 1-5 mg IV push if symptoms not relieved by nitrates, use with caution

Pedi: 0.1-0.2 mg/kg per dose IV, IO, IM, subcutaneous. Max dose 5mg

Special consideration: use caution weighing risks and benefits during pregnancy.

46
Q

Tranexamic Acid name and class

A

Name: Cyklokapron, Lysteda

Class: Hemostatic agent, antifibrinolytic, plasminogen inactivator

47
Q

Tranexamic Acid indications and contraindications

A

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

Contraindications: Hypersensitivity, MOI greater than 3 hours; subarachnoid hemorrhage; history of PE, DVT, or other thromboembolic disorder

48
Q

Tranexamic Acid action and side effects

A

Action: reduces plasminogen activation, mitigating conversion to plasmin

Side effects: fatigue, headache, abd pain, anemia, DVT, PE, other thromboembolic disorder. Rapid infusion may cause hypotension

49
Q

Tranexamic Acid dosage and specific considerations

A

Adult: 1g IV over 10 minutes

Pedi: not recommended

Special considerations: Must be mixed into an infusion bag, typically 100ml of NaC1

AEMT class (14 decks)

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