ALS Medication Flashcards
1
Q
Sodium Bicarbonate (Bicarb, NaHCO2) Onset
A
2-10 minutes
2
Q
Dextrose/ Glucose (50%, D50/ 10%, D10, D10W)
Side effects
A
- Local venous irritation/ infection
* Hyperglycemia
3
Q
Cyanide KIT
Side effects
A
Amyl Nitrate - Hypertension, tachycardia, palpitations, syncope, headache and nausea Sodium Thiosulfate - Cirrhosis of liver - Congestive heart failure - Renal function impairment Hydroxocobalamin - Mild increase in Blood pressure - Reddish orange skin color which clears over days
4
Q
Amiodarone Hydrochloride ( Cordarone, Pacerone, Nexterone) Onset
A
Minutes
5
Q
Midazolam (Versed)
Contraindications
A
NONE
6
Q
Epinephrine (Adrenalin, EPI)
Side effects
A
- Anxiety / restlessness
- Palpitations / tachyarrhythmias
- Ventricular irritability
- Increased myocardial Oxygen demand
- Hypertension
- Angina
7
Q
Albuterol (Priventil, Ventilin)
Class
A
Bronchodilator: Sympathomimetic (Beta-2 specific)
8
Q
Lidocaine (2% xylocaine)
Duration
A
10-20 minutes
9
Q
Atrovent (Ipratropium Bromide)
Class
A
Bronchodilator: anticholinergic
10
Q
Atrovent (Ipratropium Bromide)
Contraindications
A
NONE
11
Q
Lidocaine (2% xylocaine)
Class
A
Anti-arrhythmic / Anesthetic
12
Q
Naloxone (Narcan)
Contraindications
A
NONE
13
Q
Fentanyl Citrate
Side effects
A
- Respiratory depression / Apnea
- Decreased LOC
- Transient Hypotension
- Nausea / Vomiting / Dizziness
- Muscular rigidity
- Bradycardia
14
Q
Fentanyl Citrate
Contraindications
A
NONE
15
Q
Adenosine(Adenocard)
Duration
A
1-2 minutes
16
Q
Fentanyl Citrate
Onset
A
< 1 to 2 minutes
17
Q
Ketamine (Ketalar)
Requirements
A
• > or equal too 15 years old
AND with GCS of 15
AND not pregnant
AND no known or suspected alcohol or drug intoxication
And have not received opioid analgesic in past 6 hours
(Prior to Medic arrival)
18
Q
Ketamine (Ketalar)
Class
A
Anesthetic / Analgesic
19
Q
Dopamine Hydrochloride(Intropin) Contraindications
A
NONE
20
Q
Dopamine Hydrochloride(Intropin) Action
A
- At low and medium doses, Selectively dilates blood vessels supplying the brain, kidneys, heart and GI tract.
- At medium to high doses, Increases cardiac output by improving contractility and stroke volume, thereby increasing blood pressure.
- At high doses, causes vasoconstriction and increased heart rate.
21
Q
Naloxone (Narcan)
Side effects
A
- Acute withdrawal symptoms
- Nausea / vomiting
- Tachycardia / hypertension
22
Q
Epinephrine (Adrenalin, EPI)
Action
A
• On the Bronchi: bronchodilation (Beta-2)
• On the peripheral vasculature: vasoconstriction (Alpha)
• On the heart:
-Increased heart rate (Beta-1) / chronotropic
-Increased contractility / Inotropic
-Increased AV conduction/ dromotropic
-Increased automaticity / dromotropic
23
Q
Atrovent (Ipratropium Bromide)
Action
A
- Antagonizes the action of acetylcholine, preventing the interaction of acetylcholine with muscarinic receptors in bronchial smooth muscles causing bronchodilation
- Dries respiratory tract secretions
24
Q
Nitroglycerin ( NTG,Nitro)
Action
A
- Produces vasodilation by relaxing systemic venous & arterial vessels, thereby:
- Decreasing preload & afterload
- Decreasing myocardial workload
- Decreasing myocardial Oxygen consumption
- Dilates coronary arteries
25
```
Amiodarone Hydrochloride ( Cordarone, Pacerone, Nexterone)
Contraindications
```
* Hypotension
* 2nd and 3rd degree heart block
* idioventricular rhythms
26
Diphenhydramine(Benadryl)
| Class
Antihistamine
27
Ketamine (Ketalar)
| Onset
IV 30 seconds
| IN 2 minutes
28
```
Sodium Bicarbonate (Bicarb, NaHCO2)
Side effects
```
• Electrolyte / PH imbalances
29
```
Morphine sulfate (MS, M50,)
Class
```
Opioid
| Narcotic Analgesic
30
Albuterol (Priventil, Ventilin)
| Contraindications
* None in adults
| * PEDS: for croup/strider (Nebulized saline / epinephrine is indicated)
31
Atrovent (Ipratropium Bromide)
| Duration
4-5 hours
32
```
Amiodarone Hydrochloride ( Cordarone, Pacerone, Nexterone)
Duration
```
Days
33
Cyanide KIT onset
Minutes
34
```
Normal saline (0.9% solution sodium chloride, NS)
Contraindications
```
• Rales (except for sepsis S-143)
35
```
Sodium Bicarbonate (Bicarb, NaHCO2)
Class
```
Electrolyte
| Alkalinizing agent
36
Cyanide KIT Drugs
* Amyl Nitrate inhaler
* Sodium Thiosulfate 25%
* Hydroxocobalamin
37
Diphenhydramine(Benadryl)
| Duration
6-12 hours
38
```
Sodium Bicarbonate (Bicarb, NaHCO2)
Contraindications
```
NONE
39
```
Morphine sulfate (MS, M50,)
Side effects
```
* Respiratory depression / apnea
* Decreased LOC
* Transient Hypotension
* Nausea / Vomiting
* Pinpoint pupils
40
Ondansetron (Zofran)
| Duration
IV/IM and ODT 2 hours
41
Aspirin, ASA ( Acetysalicylic Acid)
| Onset
15-30 minutes
42
Ketamine (Ketalar)
| contraindications
* Pediatrics
* Pregnancy
* Severe Hypertension
* Alcohol intoxicated
43
Albuterol (Priventil, Ventilin)
| Duration
Up to 5 hours
44
Nitroglycerin ( NTG,Nitro)
| Side effects
* Orthostatic hypotension
* Dizziness / syncope
* Temporary pulsating headache
* Facial flushing
45
Lidocaine Jelly 2% (Xylocaine Jelly)
| Side effects
NONE
46
Charcoal (Activated Charcoal)
| Class
Absorbent
47
Nitroglycerin ( NTG,Nitro)
| Class
Vasodilator
48
Atrovent (Ipratropium Bromide)
| Peak
1-2 hours
49
```
Normal saline (0.9% solution sodium chloride, NS)
Class
```
• Electrolyte / Isotonic crystalloid
50
Acetaminophen (Ofirmev)
| Onset
15 minutes
51
Fentanyl Citrate
| Use with caution: BHPO only
* Isolated head injuries
* Acute onset severe headache
* Drug/ETOH intoxication
* Multiple Trauma with GCS < 15
* Suspected Active Labor
52
Ondansetron (Zofran)
| Side effects
* GI symptoms, especially diarrhea
| * Headache
53
Lidocaine (2% xylocaine)
| Action
* Depresses depolarization and automaticity in the ventricles
* Increases the ventricular fibrillation threshold by increasing phase IV re-polarization
* Amide-type local anesthetic
54
Ondansetron (Zofran)
| Contraindications
NONE
55
Acetaminophen (Ofirmev)
| Class
Analgesic/ Antipyretic
56
Atropine Sulfate
| Action
* Competes with acetylcholine for receptor sites blocking the PNS response at SA and AV nodes.
* Incresses heart rate by increasing electrical conduction through the heart.
* Positive chronotropic properties with little or no inotropic effects.
* inhibits secretions by decreasing PNS effects on bronchial, Salivary, Sweat, and GI glands.
57
Albuterol (Priventil, Ventilin)
| Onset
5 minutes
58
```
Morphine sulfate (MS, M50,)
Use with caution: BHPO Only
```
* Isolated head injuries
* Acute onset severe headache
* Drug/ETOH intoxication
* Multiple Trauma with GCS < 15
* Suspected Active Labor
59
Ondansetron (Zofran)
| Onset
IV/IM and ODT up to 30 minutes
60
Cyanide KIT Duration
Days
61
Dextrose/ Glucose (50%, D50/ 10%, D10, D10W)
| Onset
1 minute
62
Naloxone (Narcan)
| Class
Opioid antagonist
63
```
Calcium Chloride (10% CaCL2)
Side effects
```
* Decressed heart rate (may cause asystole)
* Hypotension
* Syncope
* Nausea/Vomiting
* Metallic taste
64
```
Dopamine Hydrochloride(Intropin)
Onset
```
<5 minutes
65
Ketamine (Ketalar)
| Duration
15-30 minutes
66
Atropine Sulfate
| Duration
2-6 hours
67
```
Calcium Chloride (10% CaCL2)
Duration
```
May persist for 4 hours after IV/IO
68
Midazolam (Versed)
| Onset
IV/IO/IN 2 minutes
| IM 15 minutes
69
Aspirin, ASA ( Acetysalicylic Acid)
| Action
* inhibits normal tendency for platelets to accumulate inside injured or occluded coronary arteries, thereby improving blood flow through vessels to better perfuse the heart.
* Blocks formation of Thromboxin A2
70
Adenosine(Adenocard)
| Onset
Within 30 seconds
71
Adenosine (Adenocard)
| Class
Antiarrhythmic
72
```
Dopamine Hydrochloride(Intropin)
Class
```
Vasopressor: Sympathomimetic(both Alpha and Beta properties)
73
```
Sodium Bicarbonate (Bicarb, NaHCO2)
Action
```
• Reduces acidosis or causes alkalosis by direct release of bicarbonate ion into the circulation
74
Lidocaine Jelly 2% (Xylocaine Jelly)
| Action
* Prohibits the initiation and conduction of impulses thereby effecting local anesthetic action
* Decreases irritation when airway tube is inserted thereby decreasing intracranial pressure
75
Charcoal (Activated Charcoal)
| Duration
4-12 hours
76
Ketamine (Ketalar)
| indications
* Burns
* Envenomation injury
* Trauma
77
Charcoal (Activated Charcoal)
| Indications
* Acetaminophen
* Colchicine
* Beta Blockers
* Calcium channel blockers
* Salicylates
* Valproate
* Oral anticoagulants including rodenticides
* Paraquat
* Amanita Mushrooms
78
Nitroglycerin ( NTG,Nitro)
| Onset
Sublingual 2 minutes
| Topical 30-60 minutes
79
Adenosine(Adenocard)
| Side effects
• Shortness of Breath/ Dyspnea
[ May cause bronchospasm in COPD patients(BHO)]
• Chest pressure / palpitations
• Facial flushing / headache
• Dizzy / lightheadedness
• Nausea
• Transient arrhythmias
( PVC’s, PAC’s, Sinus Bradycardia, AV block, Sinus tach or asystole).
Generally not treated and are quickly self limiting
80
Ondansetron (Zofran)
| Class
Antiemetic
81
Diphenhydramine(Benadryl)
| Contraindications
NONE
82
Naloxone (Narcan)
| Duration
IV 30-60 minutes
| IM longer
83
Charcoal (Activated Charcoal)
| Contraindications
* isolated alcohol
* Heavy metal
* Caustic agent
* hydrocarbons
* Iron ingestion
84
Diphenhydramine(Benadryl)
| Side effects
* Drowsiness / Sedation(excitement in children)
* Dry mouth/ thickened bronchial secretions
* Hypotension
* Palpitations / Tachycardia
85
```
Amiodarone Hydrochloride ( Cordarone, Pacerone, Nexterone)
Side effects
```
* Hypotension
* Exacerbation of the presenting arrhythmia
AFTER DAYS OF USE
* Liver injury
* Pulmonary injury: pulmonary infiltrates, bronchospasm, SOB cough, Hemoptysis, Hypoxia
86
Atropine Sulfate
| Onset
IV/IO 2-4 minutes
IM 10-15 minutes
87
Aspirin, ASA ( Acetysalicylic Acid)
| Class
• Platelet aggression inhibitor
88
Diphenhydramine(Benadryl)
| Action
• Binds to histamine receptor sites, Blocking H1 and H2 receptors
- H1 causes Bronchoconstriction, Airway swelling and vasodilation
- H2 causes secretion of gastric acid
• Does not prevent histamine release
89
Albuterol (Priventil, Ventilin)
| Side effects
* Tachycardia / Palpitations
* Dizziness, headache
* Tremors, nervousness
90
```
Sodium Bicarbonate (Bicarb, NaHCO2)
Duration
```
30-60 minutes
91
Dextrose/ Glucose (50%, D50/ 10%, D10, D10W)
| Contraindications
NONE
92
Nitroglycerin ( NTG,Nitro)
| Contradiction
* Patients who have taken a sexual enhancement medication such as Viagra, Cialis, Levitra within 48 hours
* patients taking medication for pulmonary hypertension, usually sildenafil (trade names: Revatio, Flolan, and Veletri)
93
Midazolam (Versed)
| Class
Benzodiazepine: Sedative / Anticonvulsant
94
Aspirin, ASA ( Acetysalicylic Acid)
| Contraindications
• NONE
95
Naloxone (Narcan)
| Action
• reverses respiratory depression, sedation and hypotensive effects of opioid overdose by occupying opiate receptor sites
96
Epinephrine (Adrenalin, EPI)
| Contraindications
NONE
97
Acetaminophen (Ofirmev)
| Peak
1 hour
98
Adenosine(Adenocard)
| Contraindications
* 2nd and 3rd degree heart blocks
| * Sick sinus syndrome (without pacemaker)
99
```
Morphine sulfate (MS, M50,)
Duration
```
2-7 hours
100
Lidocaine (2% xylocaine)
| Contraindications
* 2nd and 3rd degree heart block
| * Idioventricular rhythms
101
```
Calcium Chloride (10% CaCL2)
Onset
```
5-15 minutes
102
Aspirin, ASA ( Acetysalicylic Acid)
| Duration
Days (antiplatelet effects)
103
Glucagon
| Action
* Increases blood glucose by converting glycogen stores in the liver to glucose
* Inhibits synthesis of glycogen from glucose
104
```
Morphine sulfate (MS, M50,)
Onset
```
1-2 minutes
105
Atropine Sulfate
| Side effects
* Tachycardia/ Palpitations
* Dry mouth/ nausea / vomiting
* Pupil dilation / blurred vision
* Flushed/ hot / dry skin
106
Fentanyl Citrate
| Action
• Potent narcotic analgesic and sedative
107
Diphenhydramine(Benadryl)
| Onset
15-30 minutes
108
Fentanyl Citrate
| Duration
30 to 60 minutes
109
Albuterol (Priventil, Ventilin)
| Action
* Relaxes bronchial smooth muscles by stimulating beta-2 adrenergic receptors.
* Produces bronchodilation, relieves bronchospasm, and reduces airway resistance.
110
Ketamine (Ketalar)
| Side effects
• Increased Heart Rate
• Increased Blood pressure
• Increased Respiratory Rate
• Nausea
• With higher doses and rapid infusion ("dissociative effects")
-Euphoria (pleasant : dream-like states, vivid imagery
-Dysphoria (unpleasant: anxiety, disorientation, hallucinations)
111
Albuterol (Priventil, Ventilin)
| Peak
1 hour
112
Glucagon
| Side effects
* Nausea / Vomiting
| * Tachycardia / Hypertension
113
Naloxone (Narcan)
| Onset
IV/IN 1-2 minutes
| IM 2-5 minutes
114
Charcoal (Activated Charcoal)
| Action
* Binds and absorbs ingested toxins present in the GI tract
| * Inhibits intestinal absorption, preventing systemic toxicity
115
Lidocaine (2% xylocaine)
| Side effets Early
* Anxiety
* Euphoria
* Combative
* Nausea
* Twitching
* Numbness
116
Acetaminophen (Ofirmev)
| Contraindications
* < 2 years of age
* Severe hepatic impairment
* Severe active liver disease
* If known or suspected total dose exceeding 4000 mg in a 24 hour period
117
Atrovent (Ipratropium Bromide)
| Side effects
* Nervousness/ dizziness
* Headache
* Cough
* Paradoxical Bronchospasm
* Palpitations
* Blurred Vision / Eye irritation( with direct contact with mist)
118
Ketamine (Ketalar)
| Action
* Low & slow dosing provides strong analgesic effects acting on the limbic system and cortex to block afferent transmission of impulses associated with pain perception
* High & rapid dosing provides fast acting dissociative anesthesia (blocks sensory perception) which can lead to distortion of sights, colors, sounds, self, and one's environment
119
Dextrose/ Glucose (50%, D50/ 10%, D10, D10W)
| Action
• increases blood glucose by providing a quick release of free sugar into the circulation
120
```
Normal saline (0.9% solution sodium chloride, NS)
Action
```
• Electrolyte solution, which is osmotically equivalent to blood
• Increases the circulating volume of the vascular system
(2/3 of infused volume leaves vascular space within 1 hour)
121
```
Normal saline (0.9% solution sodium chloride, NS)
Side effects
```
NONE
122
Acetaminophen (Ofirmev)
| Action
* Inhibits the synthesis of prostaglandins which transmit pain signals and induce fever.
* Reduces pain by blocking the signals produced by prostaglandins
123
Midazolam (Versed)
| Action
* CNS Depressant
* Produces anterograde Amnesia then sedation
* Stops and prevents seizures
124
Lidocaine (2% xylocaine)
| Onset
1-2 minutes
125
Nitroglycerin ( NTG,Nitro)
| Duration
Sublingual 30-60 minutes
| Topical 24 hours
126
Lidocaine (2% xylocaine)
| Side effets Late
* Seizure
* Decreased Blood pressure
* Coma
* Widening QRS
* Prolonged PRI
* V-FIB
127
Acetaminophen (Ofirmev)
| Side effects
* Nausea, vomiting
* Headache, sleep problems
* Constipation
* itching , agitation
* Partial or total lung collapse in pediatric patients
128
Cyanide KIT Contraindications
NONE
129
Glucagon
| Class
Anti-hypoglycemic: Pancreatic hormone
130
Fentanyl Citrate
| Class
Analgesic: Opioid Agonist
131
Epinephrine (Adrenalin, EPI)
| Onset
IV/IO 1-2 minutes
| IM 5-10 minutes
132
```
Dopamine Hydrochloride(Intropin)
Duration
```
Approximately 10 minutes after drip is stoped
133
```
Dopamine Hydrochloride(Intropin)
Side effects
```
* At Hugh infusion rates, hypertension and extreme vasoconstriction may occur
* At low infusion rates, hypotension may occur
* Tachyarrythmias/ palpations
* Incressed myocardial oxygen demand
134
```
Amiodarone Hydrochloride ( Cordarone, Pacerone, Nexterone)
Action
```
* Blocks sodium, potassium and calcium channels in cardiac cells slowing conduction and prolongs repolarization.
* Has alpha and beta adrenergic blocking properties causing negative inotropic effects and reduces peripheral vascular resistance(afterload).
135
Dextrose/ Glucose (50%, D50/ 10%, D10, D10W)
| Duration
Depends on degree of hypoglycemia
136
Atrovent (Ipratropium Bromide)
| Onset
Within 15-30 minutes
137
Glucagon
| Contraindications
NONE
138
Epinephrine (Adrenalin, EPI)
| Class
Catecholamine: Sympathomimetic (both Alpha and Beta effects)
139
Charcoal (Activated Charcoal)
| Onset
Immediate
140
Lidocaine Jelly 2% (Xylocaine Jelly)
| Contraindications
NONE
141
Atropine Sulfate
| Class
* Antiarrythmic
| * Anticholinergic
142
Charcoal (Activated Charcoal)
| Side effects
* Nausea/ Vomiting
* Constipation/ diarrhea
* Abdominal cramping
143
Epinephrine (Adrenalin, EPI)
| Duration
IV/IO 5-10 minutes
| IM 1-4 hours
144
Dextrose/ Glucose (50%, D50/ 10%, D10, D10W)
| Class
Carbohydrate
145
Midazolam (Versed)
| Duration
1-4 hours
146
Atropine Sulfate
| Contraindications
• Asystole
147
Aspirin, ASA ( Acetysalicylic Acid)
| Side effects
* GI upset (Indigestion, Nausea/vomiting, Epigastric pain, heartburn)
* Occult or prolonged bleeding
148
Midazolam (Versed)
| Side effects
• Respiratory depression / apnea
149
Ondansetron (Zofran)
| Action
• Blocks serotonin receptors in vagus nerve terminals and in small intestine that trigger the vomiting reflex
150
```
Amiodarone Hydrochloride ( Cordarone, Pacerone, Nexterone)
Class
```
Antiarrythmic
151
```
Calcium Chloride (10% CaCL2)
Class
```
Electrolyte
152
Adenosine(Adenocard)
| Action
• Slows electrical conduction through AV node, and interrupts re-entry pathway, converting SVT to normal sinus rhythm
153
```
Calcium Chloride (10% CaCL2)
Contraindications
```
NONE
154
```
Calcium Chloride (10% CaCL2)
Action
```
* Increases myocardial contractility
* Enhances Ventricular Automaticity
* Reverses cardio-electric changes produced by hyperkalemia
* Shifts potassium back into cells prevent intravascular hyperkalemia
155
```
Morphine sulfate (MS, M50,)
Action
```
* CNS Depressant acting on opiate receptors in the brain
| * Potent Analgesic and sedative
156
Lidocaine Jelly 2% (Xylocaine Jelly)
| Class
Topical Anesthetic
157
```
Morphine sulfate (MS, M50,)
Contraindications
```
NONE
158
Acetaminophen (Ofirmev)
| Duration
Up to 4 to 6 hours
