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CCC Paramedic Class 69 > CCC Medic Drugs Module 1-2(Weeks 1-6) > Flashcards

CCC Medic Drugs Module 1-2(Weeks 1-6) Flashcards

Module 1 Drugs for EMT296. Classification, Indication, Contraindication, Adult dosing, Peds dosing.

1
Q

What is the classification of Aspirin?

A

NSAID/Anticoagulant

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2
Q

What are the indications of Aspirin?

A

Suspected ischemic chest pain

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3
Q

What are the contraindications of Aspirin?

A

Hypersensitivity, Hx of bleeding disorder, suspected aortic dissection, ulcer or GI bleed, aspirin induced asthma.

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4
Q

What is the appropriate dose for aspirin?

A

324mg or four 81mg tabs for adults. Do not give to pediatrics.

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5
Q

What is the classification for Ibuprofen?

A

NSAID

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6
Q

When is Ibuprofen indicated?

A

Pain or Fever

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7
Q

What are the contraindications for Ibuprofen?

A

NSAID hypersensitivity, Pregnancy, <6 months old, GI bleed, suspected cardiac chest pain, other NSAIDS within 6 hours

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8
Q

What is the dosage for Ibuprofen?

A

400mg PO for adults, 10mg/kg for pediatrics

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9
Q

What classification is Morphine Sulfate?

A

Analgesic/Opioid Agonist/narcotic

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10
Q

Indications for Morphine Sulfate?

A

Pain from burns or musculoskeletal injury, suspected ischemic chest pain unresponsive to nitroglycerine.

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11
Q

Contraindications for Morphine Sulfate?

A

Hypersensitivity, BP<100 Systolic, Respirations < 12 per min.

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12
Q

Dosage for Morphine Sulfate?

A

Adults: 2-8mg IV/IO every 5 min, maximum dose 20mg. 5-10mg IM every 15 min.
Peds: 0.1mg/kg IV/IO/IM every 15 min, do not exceed adult dosing.

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13
Q

Is Morphine Sulfate a Sulfa class drug?

A

No, sulfates and sulfas are different, therefore, sulfa hypersensitivity does not affect this drug.

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14
Q

Classification of Atropine?

A

Anticholinergic and Antimuscarinic

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15
Q

Indications of Atropine?

A

Symptomatic bradycardia secondary to increased
vagal stimulation,
Antidote for nerve gases and symptomatic insecticide
exposures (e.g. carbamates and organophosphates).
Bradycardia not due to hypoxia when using succinylcholine.

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16
Q

Contraindications of Atropine?

A

Afib and Atrial Flutter,
Neonatal resuscitation.

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17
Q

Dosage of Atropine for Bradycardia?

A

Adults: 1mg IV/IO, repeat every 3-5 min, max dose 3mg.
Peds: 0.02mg/kg IV/IO, max single dose of 0.5mg, may repeat once.

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18
Q

Dosage of Atropine for Organophosphate poisoning?

A

Adults: 1-2mg every 2-5min for moderate case. 3-5mg every 5 min for severe case. Repeat until symptoms improve.
Peds: 0.05mg/kg initially while doubling dose every 5 min until symptoms reverse.

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19
Q

Classification of Succinylcholine?

A

Paralytic, Neuromuscular blocking agent

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20
Q

Indications of Succinylcholine?

A

Paralysis for RSI

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21
Q

Contraindications of Succinylcholine?

A

Hypersensitivity, Hx of malignant hyperthermia, * Major burns, crush injuries, CVA, or spinal cord injuries between 48 hours and 6 months old, neuromuscular disease, hyperkalemia.

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22
Q

Dosage of Succinylcholine?

A

Anyone >6y/o: 1.5mg/kg IV/IO
Anyone <6y/o 2mg/kg IV/IO

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23
Q

What is the time of onset for Succinylcholine?

A

45-90 seconds.

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24
Q

How long do the effects of Succinylcholine last?

A

4-6 minutes.

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25
Classification of Diltiazem?
Calcium Channel Blocker
26
Indications of Diltiazem?
AFib/ Atrial Flutter with rapid ventricular response
27
Contraindications of Diltiazem?
Hypersensitivity, 2nd or 3rd degree heart block, hypotension, pulmonary edema, Wolff-Parkinson-White.
28
Proper dosage of Diltiazem?
Adults: 0.25 mg/kg slow IV push over 2 min. If no effect in 15 min, repeat with 0.35mg/kg. Peds: Call OLMC
29
Classification of Nitroglycerine?
Vasodilator
30
Indications of Nitroglycerine?
Pulmonary Edema, Chest pain due to suspected cardiac ischemia
31
Contraindications of Nitroglycerine?
BP<100 Systolic, use of erectile dysfunction meds within 48 hours.
32
Proper Dosage of Nitroglycerine for chest pain?
Adults: 0.4mg SL every 5 min to a max of 3 doses. Peds: Contact OLMC.
33
Proper dosage of Nitroglycerine for Pulmonary Edema?
Adults: 0.4-2mg SL every 3 minutes. Peds: contact OLMC.
34
Classification of Lidocaine?
Sodium Channel Blocker
35
Indications of Lidocaine?
Antiarrhythmic use for Vfib or pulseless Vtach, Pain management for IO placement.
36
Contraindications of Lidocaine?
None for cardiac arrest
37
Proper Dosage of Lidocaine for Vfib/pulseless Vtach?
Both Adults and Peds: Bolus dose: 1.5 mg/kg IV/IO. Repeat to a max of 3 mg/kg if needed. Maintenance dose: 0.75 mg/kg IV/IO every 10 minutes.
38
Proper dosage of Lidocaine for IO Placement?
Adults and Peds:0.5mg/kg IO, not to exceed 50mg.
39
Classification of Diphenhydramine?
Antihistamine
40
Indications of Diphenhydramine?
Symptom relief for severe allergic reaction and anaphylaxis, relief for dystonic/dysphoric antipsychotic reactions, nausea/vomiting in pregnant patients.
41
Contraindications of Diphenhydramine?
Hypersensitivity. Weird.
42
Proper dosage for Diphenhydramine?
Adults: 1mg/kg IV/IM to a max of 50mg.
43
Classification of Dopamine?
Adrenergic Agonist, Inotropic agent
44
Indications of Dopamine?
3rd line vasopressor for shock following Epinephrine and Norepinephrine, Symptomatic bradycardia unresponsive to atropine, pacing, or epinephrine.
45
Contraindications of Dopamine?
Hypovolemic shock
46
Proper dosage of Dopamine for bradycardia?
Adults and Peds: Start at 5 mcg/kg/min. Titrate up as needed to a maximum of 20 mcg/kg/min
47
Proper dosage for Dopamine for non-hypovolemic shock refractory to norepinephrine and epinephrine?
Adults and Peds: 5 mcg/kg/min IV drip. Increase by 5 mcg/kg/min every 5 minutes to max of 20 mcg/kg/min or until systolic BP is 90 mmHg
48
Indications for Activated Charcoal?
Absorbtion or ingestions of toxins
49
Contraindications of Activated Charcoal?
Altered mental status, inability to protect airway, concern for possible aspiration
50
Proper Dosage for Activated Charcoal?
1g/kg PO or NG, max of 50g
51
Classification of Albuterol?
B2 receptor agonist, Bronchodilator
52
Indications for Albuterol?
Bronchospasm due to asthma or COPD, Hyperkalemia
53
Contraindications of Albuterol?
Hypersensitivity, which is very rare.
54
Proper Dosage for Albuterol for respiratory distress?
3.0mg(albuterol/ipratropium). May repeat every 10 minutes for two doses as needed * 2.5 mg via nebulizer if no response to DuoNeb. May repeat every 10 minutes for two doses as needed
55
What is the classification for Epinephrine?
Adrenergic agonist, both A and B receptors
56
Indications for Epinephrine?
Ventricular fibrillation/pulseless VT * PEA * Asystole * Anaphylaxis * Second-line vasopressor * Asthma in patients < 40 refractory to β2 -agonists * Children 6 months to 6 years with audible stridor at rest
57
Contraindications for Epinephrine?
None
58
What two concentrations does Epinephrine come in?
1:1000 (Anaphylaxis Epi) and 1:10,000 (Code Epi)
59
Proper dosage for Epinephrine for Vfib, asystole, or PEA?
Adults: 1mg IV/IO Epi 1:10,000 every 3-5 min Peds:0.01mg/kg IV/IO Epi 1:10,000, max 1 mg
60
Proper Dosage of Epinephrine for anaphylaxis?
Adults: 0.3 mg IM 1:1000 (ANAPHYLAXIS EPI) every 5 min titrated to effect. If refractory to IM injections, start infusion (DIRTY EPI DRIP) at 2 mcg/min titrated to effect Peds: 0.3 mg IM 1:1000 (ANAPHYLAXIS EPI) every 5 min titrated to effect. If refractory to IM injections, start infusion (DIRTY EPI DRIP) at 2 mcg/min titrated to effect
61
Proper dosage of Epinephrine for asthma?
Adults: 0.3 mg IM 1:1000 (ANAPHYLAXIS EPI) every 5 min titrated to effect Peds: 1:1000 IM (ANAPHYLAXIS EPI) 0.01 mg/kg to max of 0.3 mg per dose every 5 minutes titrated to effect
62
Proper dosage of Epinephrine for Bradycardia and/or shock?
Adults: Start infusion (DIRTY EPI DRIP) at 2 - 10 mcg/min titrating to effect
63
Proper dosage of Epinephrine for hypotension?
Adults: 10-30 mcg (1-3 ml PUSH DOSE EPI) every 1-3 min Peds: 1 mcg/kg to max 10 mcg (0.1-1 ml PUSH DOSE EPI) every 2-3 min
64
Indications for Oral Glucose?
Hypoglycemia
65
Contraindications for Oral Glucose?
Inability to protect airway
66
Proper Dosage for Oral Glucose?
One tube, normally 15-25g. Repeat as needed.
67
Classification of Naloxone?
Opioid Antagonist
68
Indications for Naloxone?
Suspected opioid overdose, respiratory depression due to opioids.
69
Proper dosage for Naloxone?
Adults: 2mg IV/IM, may repeat every 5 min to a max of 8mg. 0.5mg IV, repeat every 5 minutes to a max of 2mg. Peds: 0.1mg/kg IV/IO/IM repeated every 3-5min, max dose of 8mg.
70
Contraindications for Naloxone?
Do not use in neonates.
71
Classification of Dexamethasone?
Corticosteroid
72
Indications of Dexamethasone?
Moderate to severe asthma and COPD, Croup.
73
Contraindications of Dexamethasone?
Corticosteroid Hypersensitivity.
74
Proper Dosage of Dexamethasone?
Adults: 10mg IV/IO/IM/PO Peds: 0.6mg/kg IV/IO/IM/IO up to 10mg. PO recommended for kiddos.
75
Classification of Methylprednisolone?
Corticosteroid
76
Indications of Methylprednisolone?
Moderate to severe asthma and COPD, Croup.
77
Contraindications of Methylprednisolone?
Hypersensitivity to corticosteroids.
78
Proper dosage for Methylprednisolone?
Adults: 125mg IV/IO/IM Peds: 1mg/kg IV/IO/IM max of 40mg.
79
Classification of Furosemide?
Diuretic that inhibits sodium reabsorbtion.
80
Indications of Furosemide?
Third line treatment for acute pulmonary edema after NIPPV and nitroglycerin
81
Contraindications of Furosemide?
Hypersensitivity to sulfa drugs,Hypovolemia, Hypotension, Pregnancy
82
Proper dosage for Furosemide?
Adults: 20mg IV if on Furosemide, 40mg IV if not. Peds: Contact OLMC
83
Classification of Etomidate?
General Anesthetic, Induction agent for RSI
84
Indications of Etomidate?
Induction for RSI, Sedation for synchronized cardioversion.
85
Contraindications of Etomidate?
Hypersensitivity.
86
Proper dosage of Etomidate for RSI?
Adults and Peds: 0.3 mg/kg IV/IO slow push
87
Proper dosage of Etomidate for cardioversion?
Adults and Peds: 0.15 mg/kg IV/IO over 30-60 seconds to a max of 15 mg
88
Classification of Ketamine?
NDMA receptor antagonist; dissociative anesthetic
89
Indications of Ketamine?
Induction for RSI, Hypersensitivity, Pain, Agitated delirium, Status epilepticus refractory to midazolam
90
Contraindications of Ketamine?
Hypersensitivity
91
Proper dosage of Ketamine for RSI?
Adults and Peds: 2mg/kg IV/IO
92
Proper dosage of Ketamine for Pain control?
Adults: 0.3 mg/kg IV/IO over 5 minutes. May repeat a second dose after 30 min
93
Proper dosage of Ketamine for agitated delirium?
Adults: 4-5 mg/kg IM
94
Proper dosage of Ketamine for seizures refractory to benzodiazepines?
Adults: Contact OLMC for 1 mg/kg IV
95
Classification of Midazolam?
Benzodiazepine, antiseizure med, sedative/hypnotic.
96
Indications of Midazolam?
Status epilepticus, sedation of agitated patients, amnesia during cardioversion.
97
Contraindications of Midazolam?
Hypersensitivity to Benzodiazepines.
98
Proper dosage of Midazolam for seizures?
Adults: 10 mg IM.111 Repeat every 3-5 minutes until seizure stops. May give 5-10 mg IV, if IV already established Peds: * 0.1 mg/kg IV to a max of 10 mg, or * 0.2 mg/kg IM/IN to a max of 10 mg * Repeat every 5 minutes until seizure stops
99
Proper dosage of Midazolam for agitated delirium?
Adults: 2.5 mg IV/IO or 5 mg IM. Max 5mg IV or 10 mg IM Peds:0.1 mg/kg IV/IO to a max single dose of 2.5 mg (5 mg total), or * 0.2 mg/kg IM/IN to a max single dose of 5 mg (10 mg total)
100
Proper Dosage for Midazolam for RSI?
Adults: 10 mg IV/IO if systolic BP is > 100 mmHg * 5 mg IV/IO if systolic BP < 100 mmHg Peds: 0.1 mg/kg IV/IO not to exceed adult dose
101
Proper Dosage for Midazolam for Cardioversion?
Adults: 5 mg IV/IO if systolic BP is > 100 mmHg. Repeat as necessary to maintain sedation Peds: 0.1 mg/kg IV not to exceed adult dose
102
Classification for Rocuronium?
Paralytic, nondepolarizing neuromuscular blocker.
103
Indications of Rocuronium?
Paralytic for RSI, For sustained neuromuscular paralysis in the intubated patient
104
Contraindications of Rocuronium?
Maintenance of paralysis in status epilepticus
105
Proper dosage for Rocuronium?
Adults and Peds: Induction for intubation: * 1.2-2.2 mg/kg IV/IO. 2 mg/kg is an acceptable dose * Maintenance of post-intubation paralysis * 0.5 mg/kg IV/IO
106
Classification of Vecuronium?
Paralytic, nondepolarizing neuromuscular blocker
107
Indications of Vecumronium?
For sustained paralysis in the intubated patient
108
Contraindications of Vecuronium?
Do not use in status epilepticus. Treat the seizure
109
Proper Dosage of Vecuronium?
Adults and Peds: 0.1mg/kg IV/IO
110
Classification of Magnesium Sulfate?
Antiarrhythmic, smooth muscle relaxant, antiseizure med
111
Indications of Magnesium Sulfate?
Torsades de Pointes, Seizures secondary to eclampsia in pregnant women, Severe asthma refractory to nebulized medications.
112
Contraindications of Magnesium Sulfate?
None.
113
Proper dosage of Magnesium Sulfate for Torsades de Pointes?
Adults without pulse: 2g in 20ml IV/IO push; with pulse: 2g in 100ml IV/IO over 5 minutes. Peds: 25 mg/kg IV/IO over 1-2 minutes
114
Proper dosage of Magnesium Sulfate for Eclampsia or Pre-Eclampsia?
4 g in 100 ml infused IV/IO over 15 minutes
115
Proper dosage of Magnesium Sulfate for asthma?
Adults: 4 g in 100 ml infused IV/IO over 15 minutes Peds: 25-75 mg/kg IV/IO, maximum dose 2 g
116
Classification of Adenosine?
Antidysrhythmic
117
Indications of Adenosine?
Converting PSVT into a normal sinus rhythm.
118
Contraindications of Adenosine?
Hypersensitivity, Tachycardia secondary to infection, toxins, or drugs, 2nd or 3rd degree heart block, Atrial fibrillation/flutter, Sick sinus syndrome
119
Proper dosage of Adenosine?
Adults: Intially a 6mg rapid IVP, if no conversion, may repeat 12mg IVP x2. If the patient is taking a methylxanthine, may use a 18 mg 3rd dose. Peds: 0.1 mg/kg rapid IVP. May repeat with 0.2 mg/kg once if patient fails to convert after initial dose
120
Classification of Amiodarone?
Antidysrhythmic
121
Indications of Amiodarone?
Vfib, Pulseless Vtach, Vtach with pulses.
122
Contraindications of Amiodarone for Cardiac arrest patients?
None
123
Contraindications of Amiodarone for perfusing patients?
Systolic BP < 90 mmHg, Heart rate < 50, Periods of sinus arrest, 2nd or 3rd degree heart block
124
Proper dosage of Amiodarone for Vfib/Pulseless Vtach?
Adults: 300 mg IV/IO. May repeat once with 150 mg Peds: 5 mg/kg IV/IO. May repeat once with 2.5 mg/kg
125
Proper dosage of Amiodarone for Vtach with pulses?
Adults: 150 mg IV/IO infused over 10 minutes. Mix with 100 ml of NS and infuse via drip or pump. Peds: 5 mg/kg IV/IO. Dilute in a 100 ml bag and infuse over 10 minutes via drip or pump.
126
Indications of Calcium Gluconate?
Hyperkalemia, suspected calcium channel blocker OD, hydrofluoric acid burns.
127
Contraindications of Calcium Gluconate?
None
128
Proper dosage of Calcium Gluconate for Hyperkalemia or Calcium Channel Blocker OD?
Adults: 3 g slow IV/IO over 5 – 10 minutes. Use a proximal IV Peds: 0.6 ml/kg slow IV/IO over 5 – 10 minutes. Use a proximal port. Max dose 30 ml
129
Classification of Fentanyl?
Synthetic opioid/narcotic
130
Indications of Fentanyl?
Pain due to burn or musculoskeletal injury, suspected ischemic chest pain.
131
Contraindications of Fentanyl?
Hypersensitivity, moderate to severe respiratory depression.
132
Proper dosage of Fentanyl for Adults?
IV/IN88: 50-100 mcg. May repeat 25-50 mcg every 5 minutes as needed to a maximum of 300 mcg IM: 50-100 mcg. May repeat every 15 minutes as needed to a maximum of 300 mcg
133
Proper dosage of Fentanyl for Peds?
IV/IN: 1 mcg/kg. May repeat 0.5 -1 mcg/kg every 5 minutes as needed to a maximum of 4 mcg/kg * IM: 1-2 mcg/kg. May repeat every 15 minutes to a max of 4 micrograms/kg * Do not exceed adult dosing. IN is preferred over IM if no IV
134
Classification of Norepinephrine?
Vasopressor, Adrenergic Agonist
135
Indications of Norepinephrine?
Obstructive, cardiogenic and distributive shock un-responsive to fluid administration
136
Contraindications of Norepinephrine?
Hypovolemic or hemorrhagic shock
137
Proper dosage of Norepinephrine?
Adults:Begin at 4 mcg/min. If no response, increase every 5 minutes at 4 mcg/min increments upward to max of 20 mcg/min. Goal is a systolic blood pressure of > 90 mmHg Peds: Begin at 0.1 mcg/kg/min. If no response in 5 min, increase to 0.2 mcg/kg/min. If still no response after 5 more minutes may increase to 0.4 mcg/kg/min. Goal is age appropriate systolic blood pressure
138
Classification of Ondansetron?
Serotonin receptor agonist
139
Indications of Ondansetron?
Controlling uncomplicated nausea and vomiting
140
Contraindications of Ondansetron?
Hypersensitivity to 5-HT3 meds.
141
Proper dosage of Ondansetron?
Adults: 8mg PO, 4-8mg IV/IM. May repeat after 10 min. Peds 6mo-2y: 2mg dissolving tablet Peds 2-12y: 4 mg oral tablet, 0.1 mg/kg IV/IM, maximum dose 4 mg
142
Indications of Sodium Bicarbonate?
Sodium-channel overdose with widening of the QRS, may be beneficial in aspirin OD, contact poison control.
143
Contraindications of Sodium Bicarbonate?
None
144
Proper dosage of Sodium Bicarbonate?
Adults: 1 mEq/kg IV/IO Peds: same as adult, if under 10kg, dilute 1/2 in NS.

CCC Paramedic Class 69 (2 decks)

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