AZDHS Drug Profiles Flashcards

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1
Q

ASA, acetylsalicylic acid, aspirin - trade name(s)

A

Bayer, Ecotrin, St. Joseph, others

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2
Q

ASA - class

A

analgesic, antipyretic, anti-inflammatory

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3
Q

ASA - mechanism of action

A

in small doses, blocks thomboxane A2, a potent platelet aggregate and vasoconstrictor; this property has led to its use in the acute phase of management of the MI; decreased platelet aggregation

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4
Q

ASA - indications

A

chest pain or other signs suggestive of AMI; ECG changes suggestive of AMI; unstable angina; pain, discomfort, fever in adult patient only

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5
Q

ASA - contraindications

A

bleeding ulcer, hemorrhagic states, hemophilia; known hypersensitivity to salicylates or other NSAIDs that has led to hypotension and/or bronchospasm; children and adolescents

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6
Q

ASA - adverse reactions

A

use with caution in the pt with hx of asthma, other SE are rare with single dose

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7
Q

ASA - incompatibilities/drug interactions

A

N/A with single dose therapy

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8
Q

ASA - adult dosage

A

cardiac 160-325 mg (2-4 pediatric chewable tabs) chew or swallow; pain/discomfort/fever 325 mg (4 pediatric chewable tabs) chew or swallow

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9
Q

ASA - pediatric dosage

A

Not recommended for prehospital use in children

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10
Q

ASA - route of admin

A

PO

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11
Q

ASA - onset of action

A

20-30 mins

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12
Q

ASA - peak effects

A

2 hrs

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13
Q

ASA - duration of action

A

4-6 hrs

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14
Q

ASA - AZ drug box minimum supply

A

324 mg

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15
Q

ASA - special notes

A

heat and light sensitive; the odor of acetic acid (vinegar-like smell) indicates degradation

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16
Q

adenosine - trade name

A

Adenocard

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17
Q

adenosine - class

A

antiarrthymic, endogenous nucleoside

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18
Q

adenosine - mechanism of action

A

slows conduction time through AV node; can interrupt re-entrant pathways through the AV node; slows sinus rate; larger doses decrease BP by decreasing peripheral resistance

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19
Q

adenosine - indications

A

conversion of supraventricular tachycardias with no known atrial fibrillation or atrial flutter; undifferentiated regular monomorphic wide-complex tachycardia

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20
Q

adenosine - contraindications

A

sick sinus syndrome, 2nd or 3rd degree AV blocks, except in pt with a functioning ventricular pacemaker; use cautiously in pt with known asthma; pt on theophylline and related methylxanthines, dipyridamole (Persantine) or carbamazepine (Tegetrol); cardiac transplant patients are more sensitive and require only a small dose; known afib or atrial flutter; pregnancy

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21
Q

adenosine - adverse reactions

A

transient dysrhythmias, palpitations, chest pressure/pain, hypotension, transient HTN, facial flushing, sweating, dyspnea, hyperventilation, tightness in throat, bronchospasm, lightheadedness, headache, dizziness, paresthesias, apprehension, blurred vision, neck-back pain, nausea, metallic taste

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22
Q

adenosine - incompatibilities/drug interactions

A

not blocked by atropine, theophylline and related methylxanthines (caffeine and theobromine-xanthine) in therapeutic concentrations decrease effectiveness, dipyridamole (Persantine) and carbamazepine (Tegretol, Atretol) block uptake and potentiate effects

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23
Q

adenosine - adult dosage

A

initial 6 mg rapid IVP, follow immediately with 20 ml NS flush, recommended site is AC (close to central circulation), use injection port nearest hub of IV catheter, arm elevated during procedure, constant ECG monitoring; if no response in 1-2 mins (respectively), may repeat 12 mg utilizing the same procedure

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24
Q

adenosine - pediatric dosage

A

initial 0.1 mg/kg rapid IVP, follow immediately with 2-3 ml NS flush, use injection port nearest the hub of IV catheter, constant ECG monitoring; if no response, dose may be doubled 1 time (0.2 mg/kg) using same procedure; max single dose not to exceed 12 mg

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25
Q

adenosine - route of administration

A

rapid IVP

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26
Q

adenosine - onset of action

A

within seconds

27
Q

adenosine - peak effects

A

seconds

28
Q

adenosine - duration of action

A

10-12 secs (half life is 5 secs)

29
Q

adenosine - AZ drug box minimum supply

A

18 mg

30
Q

adenosine - special notes

A

dysrhythmias may recur; dysrhythmias appear in 55% of patients at cardioversion, lasting for a few seconds, do not usually require intervention; second dose must be prepared and available; check for crystallization in cold climates

31
Q

albuterol - trade name

A

Proventil

32
Q

albuterol - class

A

sympathomimetic, bronchodilator

33
Q

albuterol - mechanism of action

A

beta agonist (primarily beta 2); relaxed bronchial smooth muscle, resulting in bronchodilation; also relaxes vascular and uterine smooth muscle; decreases airway resistance

34
Q

albuterol - indications

A

bronchospasm; hyperkalemia

35
Q

albuterol - contraindications

A

synergistic with other sympathomimetics; use caution in pt with diabetes, hyperthyroidism; and cerebrovascular disease

36
Q

albuterol - adverse reactions

A

dysrhythmias, tachycardia, peipheral vasodilation, bronchospasm, tremors, nervousness, nausea, vomiting, hyperglycemia

37
Q

albuterol - incompatibilities/drug interactions

A

TCAs, MAOIs, other sympathomimetics

38
Q

albuterol - adult dosage

A

2.5 mg of premixed solution for inhalation (0.083%) via SVN; repeat according to medical control

39
Q

albuterol - pediatric dosage

A

2.5 mg of premixed solution for inhalation (0.083%) via SVN; repeat according to medical control; may administer up to 5 mg per medical control preference

40
Q

albuterol - route of administration

A

nebulized, mouth piece or in-line via mask; patient’s inhaler device; ET/NT in-line

41
Q

albuterol - onset of action

A

5-15 mins

42
Q

albuterol - peak effects

A

30 mins - 2 hrs

43
Q

albuterol - duration of action

A

3-4 hrs

44
Q

albuterol - AZ drug box minimum supply

A

10 mg

45
Q

albuterol - special notes

A

must be sulfite-free

46
Q

amiodarone - generic name

A

Cordarone

47
Q

amiodarone - class

A

antiarrhthymic agent

48
Q

amiodarone - mechanism of action

A

multiple effect on Na, K, Ca channels; prolongs action potential, refractory period; ventricular automaticity (Ka channel blockade); slows membrane depolarization and impulse conduction (Na channel blockade); negative chronotropic activity in nodal tissue, rate reduction, and antisympathetic activity (Ca channel and beta-blockage); dilates coronary arteries due to Ca channel and alpha-adrenergic blocking action

49
Q

amiodarone - indications

A

Tx of defibrillation-refractory VF, pulseless VT, polymorphic VT, and wide complex tachycardia of unknown origin; control hemodynamically stable ventricular tachycardia when cardioversion unsuccessful; adjunct to cardioversion of SVT and PSVT; rate control in afib or atrial flutter

50
Q

amiodarone - contraindications

A

bradycardia; 2nd or 3rd degree heart block unless a functioning pacemaker is present; cardiogenic shock; hypotension; pulmonary congestoin

51
Q

amiodarone - adverse reactions

A

bradycardia, hypotension, asystole, AV block, Torsades de Pointes, CHF, nausea, vomiting, slate-blue pigmentation, fever, headache, dizziness, flushing, abnormal salivation, photophobia

52
Q

amiodarone - incompatibilities/drug interactions

A

beta blockers, Ca channel blockers, and other antiarrhythmics are additive and can be proarrhythmic when given in combination; precipitates at certain concentrations when mixed at a Y-site with sodium bicarbonate, furosemide, and heparin

53
Q

amiodarone - adult dosage

A

VF, pulseless VT 300 mg IVP, may repeat in 3-5 mins with 150 mg IVP; wide-complex tachycardias, atrial flutter, SVT with cardioversion 150 mg IV over 10 mins (mix in 50 ml bag of D5W), may repeat every 10 mins; maintenance infusion post-ROSC/conversion, 1 mg/min for 6 hrs (mix 450 mg in 250 ml of D5W, concentration 1.8 mg/ml, and run at 33.3 ml/hr)

54
Q

amiodarone - pediatric dosage

A

VF, pulseless VT 5 mg/kg IVP (max 300 mg single dose), may repeat every 5 mins two times to a total max of 15 mg/kg/day; probable VT with a pulse 5 mg/kg IV administered over 20 mins, may repeat two more times to a total of 15 mg/kg/day

55
Q

amiodarone - route of administration

A

IV, IO; bolus, infusion

56
Q

amiodarone - onset of action

A

variable

57
Q

amiodarone - peak effects

A

variable

58
Q

amiodarone - duration of action

A

half-life may exceed 40 days

59
Q

amiodarone - AZ drug box minimum supply

A

optional 300 mg

60
Q

amiodarone - special notes

A

subject to foaming, draw with at least an 18 ga needle; use caution if hepatic failure is present; pt must be on ECG monitoring

61
Q

atropine - class

A

anticholinergic, antidote, antispasmodic agent, antiarrhythmic, antimuscarinic

62
Q

atropine - mechanism of action

A

blocks action of ACh as a competitive antagonist at muscarinic receptor sites in smooth muscle, secretory glands, and the CNS; works by blocking parasympathetic response and allowing sympathetic response to take over, resulting in increase in cardiac output and drying of secretions; reverses the muscarinic effects of cholingergic poisoning by primarily reversing bronchorrhea and bronchoconstriction; at high doses, may have effect on nicotinic receptors responsible for restlessness, hallucinations, disorientation, and/or delirium

63
Q

atropine - indications

A

symptomatic bradycardia (sinus, junctional, and AV blocks causing significant hypotension, ventricular ectopy, chest pain, ALOC, etc), monitor pt closely; AChE inhibitor poisoning (organophosphate, carbamate cholinergic)

64
Q

atropine - contraindications

A

hypersensitivity, Belladonna allergy; glaucoma; tachycardia; obstructive GI disease, severe ulcerative colitis; hepatic disease; renal disease; myasthenia gravis (unless used to treat AChE inhibitor poisoning); asthma; thyrotoxicosis; 2nd degree Type II, 3rd degree blocks