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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.

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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
Q

Classification of Diltiazem?

A

Calcium Channel Blocker

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26
Q

Indications of Diltiazem?

A

AFib/ Atrial Flutter with rapid ventricular response

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27
Q

Contraindications of Diltiazem?

A

Hypersensitivity, 2nd or 3rd degree heart block, hypotension, pulmonary edema, Wolff-Parkinson-White.

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28
Q

Proper dosage of Diltiazem?

A

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

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29
Q

Classification of Nitroglycerine?

A

Vasodilator

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30
Q

Indications of Nitroglycerine?

A

Pulmonary Edema, Chest pain due to suspected cardiac ischemia

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31
Q

Contraindications of Nitroglycerine?

A

BP<100 Systolic, use of erectile dysfunction meds within 48 hours.

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32
Q

Proper Dosage of Nitroglycerine for chest pain?

A

Adults: 0.4mg SL every 5 min to a max of 3 doses.
Peds: Contact OLMC.

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33
Q

Proper dosage of Nitroglycerine for Pulmonary Edema?

A

Adults: 0.4-2mg SL every 3 minutes.
Peds: contact OLMC.

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34
Q

Classification of Lidocaine?

A

Sodium Channel Blocker

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35
Q

Indications of Lidocaine?

A

Antiarrhythmic use for Vfib or pulseless Vtach, Pain management for IO placement.

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36
Q

Contraindications of Lidocaine?

A

None for cardiac arrest

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37
Q

Proper Dosage of Lidocaine for Vfib/pulseless Vtach?

A

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.

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38
Q

Proper dosage of Lidocaine for IO Placement?

A

Adults and Peds:0.5mg/kg IO, not to exceed 50mg.

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39
Q

Classification of Diphenhydramine?

A

Antihistamine

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40
Q

Indications of Diphenhydramine?

A

Symptom relief for severe allergic reaction and anaphylaxis, relief for dystonic/dysphoric antipsychotic reactions, nausea/vomiting in pregnant patients.

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41
Q

Contraindications of Diphenhydramine?

A

Hypersensitivity. Weird.

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42
Q

Proper dosage for Diphenhydramine?

A

Adults: 1mg/kg IV/IM to a max of 50mg.

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43
Q

Classification of Dopamine?

A

Adrenergic Agonist, Inotropic agent

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44
Q

Indications of Dopamine?

A

3rd line vasopressor for shock following Epinephrine and Norepinephrine, Symptomatic bradycardia unresponsive to atropine, pacing, or epinephrine.

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45
Q

Contraindications of Dopamine?

A

Hypovolemic shock

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46
Q

Proper dosage of Dopamine for bradycardia?

A

Adults and Peds: Start at 5 mcg/kg/min. Titrate up as
needed to a maximum of 20 mcg/kg/min

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47
Q

Proper dosage for Dopamine for non-hypovolemic shock refractory to norepinephrine
and epinephrine?

A

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

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48
Q

Indications for Activated Charcoal?

A

Absorbtion or ingestions of toxins

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49
Q

Contraindications of Activated Charcoal?

A

Altered mental status, inability to protect airway, concern for possible aspiration

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50
Q

Proper Dosage for Activated Charcoal?

A

1g/kg PO or NG, max of 50g

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51
Q

Classification of Albuterol?

A

B2 receptor agonist, Bronchodilator

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52
Q

Indications for Albuterol?

A

Bronchospasm due to asthma or COPD, Hyperkalemia

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53
Q

Contraindications of Albuterol?

A

Hypersensitivity, which is very rare.

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54
Q

Proper Dosage for Albuterol for respiratory distress?

A

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

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55
Q

What is the classification for Epinephrine?

A

Adrenergic agonist, both A and B receptors

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56
Q

Indications for Epinephrine?

A

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

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57
Q

Contraindications for Epinephrine?

A

None

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58
Q

What two concentrations does Epinephrine come in?

A

1:1000 (Anaphylaxis Epi) and 1:10,000 (Code Epi)

59
Q

Proper dosage for Epinephrine for Vfib, asystole, or PEA?

A

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
Q

Proper Dosage of Epinephrine for anaphylaxis?

A

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
Q

Proper dosage of Epinephrine for asthma?

A

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
Q

Proper dosage of Epinephrine for Bradycardia and/or shock?

A

Adults: Start infusion (DIRTY EPI DRIP) at 2 - 10 mcg/min
titrating to effect

63
Q

Proper dosage of Epinephrine for hypotension?

A

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
Q

Indications for Oral Glucose?

A

Hypoglycemia

65
Q

Contraindications for Oral Glucose?

A

Inability to protect airway

66
Q

Proper Dosage for Oral Glucose?

A

One tube, normally 15-25g. Repeat as needed.

67
Q

Classification of Naloxone?

A

Opioid Antagonist

68
Q

Indications for Naloxone?

A

Suspected opioid overdose, respiratory depression due to opioids.

69
Q

Proper dosage for Naloxone?

A

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
Q

Contraindications for Naloxone?

A

Do not use in neonates.

71
Q

Classification of Dexamethasone?

A

Corticosteroid

72
Q

Indications of Dexamethasone?

A

Moderate to severe asthma and COPD, Croup.

73
Q

Contraindications of Dexamethasone?

A

Corticosteroid Hypersensitivity.

74
Q

Proper Dosage of Dexamethasone?

A

Adults: 10mg IV/IO/IM/PO
Peds: 0.6mg/kg IV/IO/IM/IO up to 10mg. PO recommended for kiddos.

75
Q

Classification of Methylprednisolone?

A

Corticosteroid

76
Q

Indications of Methylprednisolone?

A

Moderate to severe asthma and COPD, Croup.

77
Q

Contraindications of Methylprednisolone?

A

Hypersensitivity to corticosteroids.

78
Q

Proper dosage for Methylprednisolone?

A

Adults: 125mg IV/IO/IM
Peds: 1mg/kg IV/IO/IM max of 40mg.

79
Q

Classification of Furosemide?

A

Diuretic that inhibits sodium reabsorbtion.

80
Q

Indications of Furosemide?

A

Third line treatment for acute pulmonary edema after NIPPV and nitroglycerin

81
Q

Contraindications of Furosemide?

A

Hypersensitivity to sulfa drugs,Hypovolemia, Hypotension, Pregnancy

82
Q

Proper dosage for Furosemide?

A

Adults: 20mg IV if on Furosemide, 40mg IV if not.
Peds: Contact OLMC

83
Q

Classification of Etomidate?

A

General Anesthetic, Induction agent for RSI

84
Q

Indications of Etomidate?

A

Induction for RSI, Sedation for synchronized cardioversion.

85
Q

Contraindications of Etomidate?

A

Hypersensitivity.

86
Q

Proper dosage of Etomidate for RSI?

A

Adults and Peds: 0.3 mg/kg IV/IO slow push

87
Q

Proper dosage of Etomidate for cardioversion?

A

Adults and Peds: 0.15 mg/kg IV/IO over 30-60 seconds to a max
of 15 mg

88
Q

Classification of Ketamine?

A

NDMA receptor antagonist; dissociative anesthetic

89
Q

Indications of Ketamine?

A

Induction for RSI, Hypersensitivity, Pain, Agitated delirium, Status epilepticus refractory to midazolam

90
Q

Contraindications of Ketamine?

A

Hypersensitivity

91
Q

Proper dosage of Ketamine for RSI?

A

Adults and Peds: 2mg/kg IV/IO

92
Q

Proper dosage of Ketamine for Pain control?

A

Adults: 0.3 mg/kg IV/IO over 5 minutes. May repeat a
second dose after 30 min

93
Q

Proper dosage of Ketamine for agitated delirium?

A

Adults: 4-5 mg/kg IM

94
Q

Proper dosage of Ketamine for seizures refractory to benzodiazepines?

A

Adults: Contact OLMC for 1 mg/kg IV

95
Q

Classification of Midazolam?

A

Benzodiazepine, antiseizure med, sedative/hypnotic.

96
Q

Indications of Midazolam?

A

Status epilepticus, sedation of agitated patients, amnesia during cardioversion.

97
Q

Contraindications of Midazolam?

A

Hypersensitivity to Benzodiazepines.

98
Q

Proper dosage of Midazolam for seizures?

A

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
Q

Proper dosage of Midazolam for agitated delirium?

A

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
Q

Proper Dosage for Midazolam for RSI?

A

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
Q

Proper Dosage for Midazolam for Cardioversion?

A

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
Q

Classification for Rocuronium?

A

Paralytic, nondepolarizing neuromuscular blocker.

103
Q

Indications of Rocuronium?

A

Paralytic for RSI, For sustained neuromuscular paralysis in the intubated patient

104
Q

Contraindications of Rocuronium?

A

Maintenance of paralysis in status epilepticus

105
Q

Proper dosage for Rocuronium?

A

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
Q

Classification of Vecuronium?

A

Paralytic, nondepolarizing neuromuscular blocker

107
Q

Indications of Vecumronium?

A

For sustained paralysis in the intubated patient

108
Q

Contraindications of Vecuronium?

A

Do not use in status epilepticus. Treat the seizure

109
Q

Proper Dosage of Vecuronium?

A

Adults and Peds: 0.1mg/kg IV/IO

110
Q

Classification of Magnesium Sulfate?

A

Antiarrhythmic, smooth muscle relaxant, antiseizure med

111
Q

Indications of Magnesium Sulfate?

A

Torsades de Pointes, Seizures secondary to eclampsia in pregnant women, Severe asthma refractory to nebulized medications.

112
Q

Contraindications of Magnesium Sulfate?

A

None.

113
Q

Proper dosage of Magnesium Sulfate for Torsades de Pointes?

A

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
Q

Proper dosage of Magnesium Sulfate for Eclampsia or Pre-Eclampsia?

A

4 g in 100 ml infused IV/IO over 15 minutes

115
Q

Proper dosage of Magnesium Sulfate for asthma?

A

Adults: 4 g in 100 ml infused IV/IO over 15 minutes
Peds: 25-75 mg/kg IV/IO, maximum dose 2 g

116
Q

Classification of Adenosine?

A

Antidysrhythmic

117
Q

Indications of Adenosine?

A

Converting PSVT into a normal sinus rhythm.

118
Q

Contraindications of Adenosine?

A

Hypersensitivity, Tachycardia secondary to infection, toxins, or drugs, 2nd or 3rd degree heart block, Atrial fibrillation/flutter, Sick sinus syndrome

119
Q

Proper dosage of Adenosine?

A

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
Q

Classification of Amiodarone?

A

Antidysrhythmic

121
Q

Indications of Amiodarone?

A

Vfib, Pulseless Vtach, Vtach with pulses.

122
Q

Contraindications of Amiodarone for Cardiac arrest patients?

A

None

123
Q

Contraindications of Amiodarone for perfusing patients?

A

Systolic BP < 90 mmHg, Heart rate < 50, Periods of sinus arrest, 2nd or 3rd degree heart block

124
Q

Proper dosage of Amiodarone for Vfib/Pulseless Vtach?

A

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
Q

Proper dosage of Amiodarone for Vtach with pulses?

A

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
Q

Indications of Calcium Gluconate?

A

Hyperkalemia, suspected calcium channel blocker OD, hydrofluoric acid burns.

127
Q

Contraindications of Calcium Gluconate?

A

None

128
Q

Proper dosage of Calcium Gluconate for Hyperkalemia or Calcium Channel Blocker OD?

A

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
Q

Classification of Fentanyl?

A

Synthetic opioid/narcotic

130
Q

Indications of Fentanyl?

A

Pain due to burn or musculoskeletal injury, suspected ischemic chest pain.

131
Q

Contraindications of Fentanyl?

A

Hypersensitivity, moderate to severe respiratory depression.

132
Q

Proper dosage of Fentanyl for Adults?

A

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
Q

Proper dosage of Fentanyl for Peds?

A

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
Q

Classification of Norepinephrine?

A

Vasopressor, Adrenergic Agonist

135
Q

Indications of Norepinephrine?

A

Obstructive, cardiogenic and distributive shock un-responsive to fluid administration

136
Q

Contraindications of Norepinephrine?

A

Hypovolemic or hemorrhagic shock

137
Q

Proper dosage of Norepinephrine?

A

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
Q

Classification of Ondansetron?

A

Serotonin receptor agonist

139
Q

Indications of Ondansetron?

A

Controlling uncomplicated nausea and vomiting

140
Q

Contraindications of Ondansetron?

A

Hypersensitivity to 5-HT3 meds.

141
Q

Proper dosage of Ondansetron?

A

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
Q

Indications of Sodium Bicarbonate?

A

Sodium-channel overdose with widening of the QRS, may be beneficial in aspirin OD, contact poison control.

143
Q

Contraindications of Sodium Bicarbonate?

A

None

144
Q

Proper dosage of Sodium Bicarbonate?

A

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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