AZDHS Drug Profiles Flashcards
ASA, acetylsalicylic acid, aspirin - trade name(s)
Bayer, Ecotrin, St. Joseph, others
ASA - class
analgesic, antipyretic, anti-inflammatory
ASA - mechanism of action
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
ASA - indications
chest pain or other signs suggestive of AMI; ECG changes suggestive of AMI; unstable angina; pain, discomfort, fever in adult patient only
ASA - contraindications
bleeding ulcer, hemorrhagic states, hemophilia; known hypersensitivity to salicylates or other NSAIDs that has led to hypotension and/or bronchospasm; children and adolescents
ASA - adverse reactions
use with caution in the pt with hx of asthma, other SE are rare with single dose
ASA - incompatibilities/drug interactions
N/A with single dose therapy
ASA - adult dosage
cardiac 160-325 mg (2-4 pediatric chewable tabs) chew or swallow; pain/discomfort/fever 325 mg (4 pediatric chewable tabs) chew or swallow
ASA - pediatric dosage
Not recommended for prehospital use in children
ASA - route of admin
PO
ASA - onset of action
20-30 mins
ASA - peak effects
2 hrs
ASA - duration of action
4-6 hrs
ASA - AZ drug box minimum supply
324 mg
ASA - special notes
heat and light sensitive; the odor of acetic acid (vinegar-like smell) indicates degradation
adenosine - trade name
Adenocard
adenosine - class
antiarrthymic, endogenous nucleoside
adenosine - mechanism of action
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
adenosine - indications
conversion of supraventricular tachycardias with no known atrial fibrillation or atrial flutter; undifferentiated regular monomorphic wide-complex tachycardia
adenosine - contraindications
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
adenosine - adverse reactions
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
adenosine - incompatibilities/drug interactions
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
adenosine - adult dosage
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
adenosine - pediatric dosage
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
adenosine - route of administration
rapid IVP
adenosine - onset of action
within seconds
adenosine - peak effects
seconds
adenosine - duration of action
10-12 secs (half life is 5 secs)
adenosine - AZ drug box minimum supply
18 mg
adenosine - special notes
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
albuterol - trade name
Proventil
albuterol - class
sympathomimetic, bronchodilator
albuterol - mechanism of action
beta agonist (primarily beta 2); relaxed bronchial smooth muscle, resulting in bronchodilation; also relaxes vascular and uterine smooth muscle; decreases airway resistance
albuterol - indications
bronchospasm; hyperkalemia
albuterol - contraindications
synergistic with other sympathomimetics; use caution in pt with diabetes, hyperthyroidism; and cerebrovascular disease
albuterol - adverse reactions
dysrhythmias, tachycardia, peipheral vasodilation, bronchospasm, tremors, nervousness, nausea, vomiting, hyperglycemia
albuterol - incompatibilities/drug interactions
TCAs, MAOIs, other sympathomimetics
albuterol - adult dosage
2.5 mg of premixed solution for inhalation (0.083%) via SVN; repeat according to medical control
albuterol - pediatric dosage
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
albuterol - route of administration
nebulized, mouth piece or in-line via mask; patient’s inhaler device; ET/NT in-line
albuterol - onset of action
5-15 mins
albuterol - peak effects
30 mins - 2 hrs
albuterol - duration of action
3-4 hrs
albuterol - AZ drug box minimum supply
10 mg
albuterol - special notes
must be sulfite-free
amiodarone - generic name
Cordarone
amiodarone - class
antiarrhthymic agent
amiodarone - mechanism of action
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
amiodarone - indications
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
amiodarone - contraindications
bradycardia; 2nd or 3rd degree heart block unless a functioning pacemaker is present; cardiogenic shock; hypotension; pulmonary congestoin
amiodarone - adverse reactions
bradycardia, hypotension, asystole, AV block, Torsades de Pointes, CHF, nausea, vomiting, slate-blue pigmentation, fever, headache, dizziness, flushing, abnormal salivation, photophobia
amiodarone - incompatibilities/drug interactions
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
amiodarone - adult dosage
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)
amiodarone - pediatric dosage
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
amiodarone - route of administration
IV, IO; bolus, infusion
amiodarone - onset of action
variable
amiodarone - peak effects
variable
amiodarone - duration of action
half-life may exceed 40 days
amiodarone - AZ drug box minimum supply
optional 300 mg
amiodarone - special notes
subject to foaming, draw with at least an 18 ga needle; use caution if hepatic failure is present; pt must be on ECG monitoring
atropine - class
anticholinergic, antidote, antispasmodic agent, antiarrhythmic, antimuscarinic
atropine - mechanism of action
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
atropine - indications
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)
atropine - contraindications
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
