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Paramedic > Analgesics/Sedatives/Anticonvulsive Drugs > Flashcards

Analgesics/Sedatives/Anticonvulsive Drugs Flashcards

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1
Q

Funtanyl Citrate (Sublimaze) Class

A

Opiod analgesic ; schedule II drug

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2
Q

Funtanyl Citrate (Sublimaze) Mechanism of Action

A

Binds to opiate receptors, producing analgesia and euphoria.

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3
Q

Funtanyl Citrate (Sublimaze) Indications

A

Pain management, anesthesia adjunct

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4
Q

Funtanyl Citrate (Sublimaze) Contraindications

A

Known hypersensitivity. Use with caution in traumatic brain injury.

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5
Q

Funtanyl Citrate (Sublimaze) Adverse Reactions/ Side effects

A

Confusion, paradoxical excitation, delirium, drowsiness, CNS depression, sedation, respiratory depression, apnea, dyspnea, dysrhythmias, bradycardia, tachycardia, hypotension, syncope, nausea, vomiting, abdominal pain, dehydration, fatigue

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6
Q

Funtanyl Citrate (Sublimaze) Drug Interactions

A

Increased respiratory effects when given with other CNS depressants.

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7
Q

Funtanyl Citrate (Sublimaze) Adult Dosage and administration

A

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

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8
Q

Funtanyl Citrate (Sublimaze) Pediatric Dosage and administration

A

1 to 2 mcg/kg IM, IV, or IN slow push(over 1 to 2 minutes) . The safety in children under 2 years has not been established.

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9
Q

Funtanyl Citrate (Sublimaze) Duration of action

A

onset: 1 to 3 minutes
peak: 3 to 5 minutes
duration: 30 to 60

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10
Q

Funtanyl Citrate (Sublimaze) pregnancy class

A

C

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11
Q

Funtanyl Citrate (Sublimaze) special considerations

A

Chest wall rigidity passible with a high dose rapid infusion. A dose of 100mcg of fentanyl citrate is equivalent to 10mg of morphine or 75mg of meperidine.

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12
Q

Ketorolac Tromethamine(Toradol) class

A

NSAID analgesic

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13
Q

Ketorolac Tromethamine(Toradol) Mechanism of action

A

Potent analgesic that does not possess any sedative or anxiolytic activities by inhibiting prostaglandin synthesis

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14
Q

Ketorolac Tromethamine(Toradol) Indications

A

Short term management of moderate to severe pain.

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15
Q

Ketorolac Tromethamine(Toradol) Contraindications

A

Allergy to salicylates or other NSAIDs. Patients with a history of asthma, bleeding disorders(especially GI related, such as peptic ulcer disease), renal failure.

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16
Q

Ketorolac Tromethamine(Toradol) Adverse reactions/ Side effects

A

Drowsiness, dizziness, headache, sedation, bronchospasm, dyspnea, edema, vasodilation, hypotension, hypertension, GI bleeding, diarrhea, dyspepsia, nausea.

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17
Q

Ketorolac Tromethamine(Toradol) Drug Interactions

A

May increase bleeding time in patients taking anticoagulants.

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18
Q

Ketorolac Tromethamine(Toradol) Adult Dosage and Administration

A

30 to 60 mg IM, 15 to 30mg IV

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19
Q

Ketorolac Tromethamine(Toradol) Pediatric Dosage and Administration

A

Not recommended

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20
Q

Ketorolac Tromethamine(Toradol) Duration of Action

A

onset: 10 min
peak: 1 to 2 hours
duration 2 to 6 hours.

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21
Q

Ketorolac Tromethamine(Toradol) pregnancy safety category

A

C

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22
Q

Ketorolac Tromethamine(Toradol) Special Considerations

A

Use with caution in older patients due to higher risk of renal and fatal GI adverse reactions. Because it is a salicylate derivative, it is important to use caution if pain is possibly from a traumatic source.

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23
Q

Morphine Sulfate (Roxanol, MS Contin) Class

A

Opiod analgesic; schedule II drug

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24
Q

Morphine Sulfate (Roxanol, MS Contin) Mechanism of Action

A

Alleviates pain through CNS action. Suppresses fear and anxiety centers in the brain. Suppresses fear and anxiety centers in the brain. Depresses brain stem respiratory centers. Increases peripheral venous capacitance and decreases preload and after load, which decreases mycardial oxygen demand.

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25
Q

Morphine Sulfate (Roxanol, MS Contin) Indications

A

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

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26
Q

Morphine Sulfate (Roxanol, MS Contin) Contraindications

A

Head injury, exacerbated COPD, depressed respiratory drive, hypotension, undiagnosed abdominal pain, decreased level of consciousness, suspected hypovolemia, patients who have taken MAOIs within 14 days.

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27
Q

Morphine Sulfate (Roxanol, MS Contin) Adverse reactions/ Side effects

A

Confusion, sedation, headache, CNS depression, respiratory depression, apnea, bronchospasm, dyspnea, hypotension, orthostatic hypotension, syncope, bradycardia, tachycardia, nausea, vomiting, dry mouth.

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28
Q

Morphine Sulfate (Roxanol, MS Contin) Drug Interactions

A

Potentiates sedative effects of phenothiazines. CNS depressants may potentiate effects of morphine. MAOIs may cause paradoxical excitation.

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29
Q

Morphine Sulfate (Roxanol, MS Contin) Adult Dosage and Administration

A

STEMI: Initial dose of 2 to 4 mg slow IV (over 1 to 5 mins). Repeat Dose: 2 to 8 mg at 5 to 15 min intervals.
NSTEMI/unstable angina: 1 to 5 mg IV push if symptoms not relieved by nitrates, use with caution.

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30
Q

Morphine Sulfate (Roxanol, MS Contin) Pediatric Dosage and administration

A

0.1 to 0.2 mg/kg per dose IV,IO,IM, subcutaneous. Max of 5mg

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31
Q

Morphine Sulfate (Roxanol, MS Contin) Duration of Action

A

onset: immediate
peak effect: 20min
duration: 2 to 7 hours

32
Q

Morphine Sulfate (Roxanol, MS Contin) Pregnancy safety category

A

C

33
Q

Morphine Sulfate (Roxanol, MS Contin) special considerations

A

Use caution weighing risks and benefits during pregnancy. Use cautiously in breastfeeding women. Morphine rapidly crosses the placenta. Safety in neonates has not been established. Use with caution in older patients, those with asthma, and in those susceptible to CNS depression. Vagotonic effect in patients with acute inferior MI (bradycardia, heart block). Naloxone hydrochloride(Narcan) should be readily available as an antidote.

34
Q

Nitrous Oxide 50:50(Nitronox) Class

A

Gaseous analgesic and anesthetic

35
Q

Nitrous Oxide 50:50(Nitronox) Mechanism of action

A

Exact mechanism unknown; affects CNS phospholipids

36
Q

Nitrous Oxide 50:50(Nitronox) Indications

A

Moderate to severe pain, anxiety, apprehension.

37
Q

Nitrous Oxide 50:50(Nitronox) Contraindications

A

Impaired level of consciousness, head injury, inability to follow or comply with instructions, decompression sickness (nitrogen narcosis, air embolism, and air transport), undiagnosed abdominal pain or marked distention, bowel obstruction, hypotension, shock, COPD, cyanosis, chest trauma with pneumothorax.

38
Q

Nitrous Oxide 50:50(Nitronox) Adverse Reactions/Side Effects

A

Light - Headedness, drowsiness, respiratory depression, apnea, nausea, vomiting, malignant hyperthermia.

39
Q

Nitrous Oxide 50:50(Nitronox) Drug interactions

A

None of significance

40
Q

Nitrous Oxide 50:50(Nitronox) Adult Dosage and Administration

A

Instruct the patient to injale deply through demand valve and mask or mouthpiece.

41
Q

Nitrous Oxide 50:50(Nitronox) Pediatric Dosage and Administration

A

Same as adult

42
Q

Nitrous Oxide 50:50(Nitronox) Duration of action

A

onset: 2 to 5 min
peak: variable
duration: 2 to 5 min

43
Q

Nitrous Oxide 50:50(Nitronox) Pregnancy Safety Category

A

C

44
Q

Nitrous Oxide 50:50(Nitronox) Special Considerations

A

Nitrous oxide increases the incidence of spontaneous abortion. Ventilate patient care area during use. Nitrous oxide is nonflammable and nonexplosive. Nitrous oxide is ineffective in 20% of the population.

45
Q

Tetracaine Class

A

Local anesthetic

46
Q

Tetracaine Actions

A

causes a reversible blockade of nerve conduction by decreasing nerve membrane permeability to sodium

47
Q

Tetracaine Indications

A

Used to numb the eye before surgery, certain tests, or procedures

48
Q

Tetracaine Contraindications

A

Hypersensitivity

49
Q

Tetracaine Side effects

A

Blurred vision, sensitivity to light, severe stinging in the eye, tearing, throbbing eye pain.

50
Q

Tetracaine Dosage

A

1 to 2 drops in the eye every 5 to 10 minutes for 1 to 3 instillations

51
Q

Tetracaine route

A

eye drops

52
Q

Tetracaine how supplied

A

0.5% sterile eye drops in 15 ml dispensers

53
Q

Tetracaine Pediatric dosage

A

1 to 2 drops in the eye every 5 to 10 minutes for 1 to 3 instillations

54
Q

Tetracaine onset/ duration

A

30 secs, 10 - 15 mins

55
Q

Diazepam(valium and others) Class

A

Benzodiazepine, long acting; sedative hypnotic; anticonvulsant; schedule IV drug

56
Q

Diazepam(valium and others) Mechanism of action

A

Potentiates effects of inhibitory neurotransmitters. Raises the seizure threshhold. Induces amnesia and sedation.

57
Q

Diazepam(valium and others) Indications

A

Acute anxiety states and agitation, acute alcohol withdrawal, muscle relaxant, seizure activity, sedation for medical procedures(intubation, ventilated patients, cardioversion), chemical restraint, may be helpful in acute symptomatic cocaine overdose.

58
Q

Diazepam(valium and others) Contraindications

A

Hypersensitivity, narrow angle glaucoma, myasthenia gravis, respiratory depression, coma, head injury.

59
Q

Diazepam(valium and others) Adverse reactions/side effects

A

Dizziness, drowsiness, confusion, headache, respiratory depression, hypotension, reflex tachycarida, nausea, vomiting, muscle weakness, tissue necrosis, ataxia, thrombosis, phlebitis.

60
Q

Diazepam(valium and others) Adult Dosage and administration

A

Seizure activity: 5mg IV over 5 minutes or 10 mg IM.

Anxiety: 2 to 10 mg IM/IV. Premedication for cardioversion: 5 to 15mg IV over 5 to 10 min prior to cardioversion

61
Q

Diazepam(valium and others) Pediatric Dosage and Administration

A

Seizure activity: 0.05 to 0.1 mg/kg slow IV or 0.1 to 2 mg/kg IM

62
Q

Diazepam(valium and others) Duration of Action

A

onset: 2 to 5 minutes IV; 15 to 30 minutes IM.
peak: 15 to 30 minutes
duration: 20 to 50 mins

63
Q

Diazepam(valium and others) Pregnancy safety category

A

D

64
Q

Diazepam(valium and others) special considerations

A

Contraindicated in pregnancy especially during the first trimester. Rectal administration of anticonvulsants is no longer recommended.

65
Q

Lorazepam(Ativan) Class

A

Benzodiazepine, short/intermediate acting; sedative, anticonvulsant; schedule IV drug

66
Q

Lorazepam(Ativan) Mechanism of Action

A

Anxiolytic, anticonvulsant, and sedative effect; suppresses propagation of seizure activity produced by foci in cortex, thalamus, and limbic areas

67
Q

Lorazepam(Ativan) Indications

A

Initial control of status epilepticus or severe recurrent seizures, severe anxiety, sedation, chemical restraint.

68
Q

Lorazepam(Ativan) Contraindications

A

Acute narrow angle glaucoma, coma, shock, suspected drug abuse

69
Q

Lorazepam(Ativan) Adverse reactions/side effects

A

Dizziness, drowsiness, CNS depression, headache, sedation, respiratory depression, apnea, hypotension, bradycardia.

70
Q

Lorazepam(Ativan) Drug interactions

A

May precipitate CNS depressant medications

71
Q

Lorazepam(Ativan) Adult Dosage and Administration

A

When given IV it must be diluted with an equal volume of sterile water or sterile saline. When given IM, Lorazepam is not diluted. Anxiety/sedation: 2mg IV; 4mg IM. Seizures: 0.1 mg/kg IV, max of 4mg.

72
Q

Lorazepam(Ativan) Pediatric Dosage and Administration

A

0.05 mg/kg IV or IM

73
Q

Lorazepam(Ativan) Duration of Action

A

onset: 2 to 5 min IV; 15 to 30 min IM
peak: Variable
duration: 6 to 8 hours

74
Q

Lorazepam(Ativan) pregnancy safety category

A

D

75
Q

Lorazepam(Ativan) special considerations

A

Monitor respiratory rate and BP during administration. Have advanced airway equipment readily available. Inadvertent arterial injection may result in vasospasm and gangrene. lorazepam expires in 6 weeks when not refrigerated.

Paramedic (9 decks)

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