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AEMT > Chapter 12 Phramacology > Flashcards

Chapter 12 Phramacology Flashcards

1
Q

Albuterol (proventil, ventolin) class

A

Sympathomimetic, bronchodialator

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2
Q

Albuterol (proventil, ventolin) Mechanism of action

A

B2 agonist, stimulates adrenergic receptors of sympathetic nervous system.
Smooth muscle relaxation in bronchial tree

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3
Q

Albuterol (proventil, ventolin) Indication

A

Bronchospasm

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4
Q

Albuterol (proventil, ventolin) Contraindication

A

Hypersensitivity, Tachycardia dysrythmias. Other sympathomimetics

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5
Q

Albuterol (proventil, ventolin) Adverse reactions/side effects

A

Heache, fatigue, light headedness, irritability, restlessness, aggressive behavior, pulmonary edema, hoarseness, nasal congestion, increased sputum, hypertension, tachycardia, dysrhythimas, chest pain, palpitations, nausea/vomiting, dry mouth, epigastric pain, tremors.

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6
Q

Albuterol (proventil, ventolin) Drug interactions

A

Tricyclic antidepressants increased vasculature effects, Beta-blockers are antagonistic, diuretics may potentiate hypokalemia

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7
Q

Albuterol (proventil, ventolin) Route

A

Inhalation

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8
Q

Albuterol (proventil, ventolin) Dosage

A

Adult: 2.5 mg in 0.5 mL of 0.5% solution with 2.5 mL normal saline nebulizer over 10-15 minutes. 1-2 inhalations, wait 5 minutes.
Ped: < 20 kg 1.25 mg/dose over 20 min
> 20kg 2.5 mg/dose over 20 min
Repeat every 20 min

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9
Q

Albuterol (proventil, ventolin) Duration of action

A

Onset: 5-15 minutes. Peak effect: 30 min to 2 hr. Duration 3-4 hrs

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10
Q

Albuterol (proventil, ventolin) Special considerations

A

Pregnancy: Safer than withholding.

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11
Q

Asprin (Acetylsalicyclic Acid) Class

A

Platelet inhibitor, Anti-inflammatory

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12
Q

Asprin (Acetylsalicyclic Acid) MOA

A

Prevent thromboxane A2 (Causes platelet to clump and obstruct)
Antipyretic and analgesic properties

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13
Q

Asprin (Acetylsalicyclic Acid) indications

A

New-onset chest discomfort that suggests ACS

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14
Q

Asprin (Acetylsalicyclic Acid) Contraindications

A

Hypersensitivity. Relative to active ulcer disease or asthma

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15
Q

Asprin (Acetylsalicyclic Acid) adverse reactions/ side effects

A

Bronchospasm, anaphylaxis, wheezing, prolonged bleeding, GI bleed, epigastric distress, NV, Hearburn, reye syndrome

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16
Q

Asprin (Acetylsalicyclic Acid) Interactions

A

Cation in patients allergic to NASAIDs

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17
Q

Asprin (Acetylsalicyclic Acid) Route

A

Oral

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18
Q

Asprin (Acetylsalicyclic Acid) Dose and admin

A

Adult: 160 - 325 mg PO. Chew
Ped: not recommended

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19
Q

Asprin (Acetylsalicyclic Acid) Duration

A

Onset: 5-30 min. Peak effect 1-3 hrs Duration: 3-6 hrsq

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20
Q

Asprin (Acetylsalicyclic Acid) Special considerations

A

Pregnancy: Use with caution

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21
Q

Dextrose class

A

Carbohydrate, antihypoglycemic, hypertonic solution

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22
Q

Dextrose MOA

A

Rapid increase serum glucose levels. Short term osmotic diuresis.

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23
Q

Dextrose indications

A

Hypoglycemia, ALOC, coma of unknown origin, seizure of unkown origin, status epilepticus

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24
Q

Dextrose Contraindications

A

Intracranial hemorrhage with normal blood glucose level

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25
Q

Dextrose side effects

A

Extravasation leads to tissue necrosis. Cerebral hemorrhage; cerebral ischemia; pulmonary edema; warmth, pain, burning from iv infusion; hyperglycemia

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26
Q

Dextrose drug interactions

A

Sodium bicarbonate, warfin (coumadin)

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27
Q

Dextrose Route

A

IV, IO

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28
Q

Dextrose Dose

A

Adult: 12.5 - 25g slow iv push. Condsider 10% Dextrose over 50% or 25%.
Ped: 1yr+ D25 or D10 0.5-1g/kg/dos slow iv push.
-1yr D10 only 200-500 mg/kg slow iv push.

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29
Q

Dextrose Duration

A

Onset: < 1 min. Peak: variable Duration: variable

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30
Q

Dextrose Special considerations

A

Pregnancy: check glucose level.
No CVA without hypoglycemia.

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31
Q

Epinephrine (Adrenaline) class

A

Sympathomimetic

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32
Q

Epinephrine (Adrenaline) MOA

A

Alpha and beta agonist.
Alpha: vasoconstiction
Beta 1: positive inotropic, chronotropic, and dromotropic effects.
Beta 2: Bronchial smooth muscle relaxation, dilation of skeletal vasculature.
Histamine blocker

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33
Q

Epinephrine (Adrenaline) indications

A

Allergic reaction; anaphylaxis, asthma.

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34
Q

Epinephrine (Adrenaline) contraindications

A

None
Relative: hypertension, hypothermia, pulmonary edema, myocardial ischemia, hypovolemic shock

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35
Q

Epinephrine (Adrenaline) side effects

A

Nervousness, restlessness, headache, tremor, pulmonary edema, dysrhythmias, chestpain, hypertension, tachycardia, NV

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36
Q

Epinephrine (Adrenaline) drug interactions

A

Other sympathomimetics, MAOIs, beta blockers

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37
Q

Epinephrine (Adrenaline) Route

A

IM, Subq

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38
Q

Epinephrine (Adrenaline) Dosage

A

Adult: 0.3-0.5 mg (1mg/mL 1:1000) IM
Ped: Anaphylaxis/ sever status asthmaticus: 0.01 mg/kg 1:1000 dose. Max single dose 0.3 mg.

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39
Q

Epinephrine (Adrenaline) special considerations

A

Pregnancy: Anaphylaxis = administer.
Syncope in children with asthma
Increase in myocardial oxygen demand

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40
Q

Glucagon (glucagen) Class

A

Hyperglycemic agent, pancreatic hormone, insulin antagonist

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41
Q

Glucagon (glucagen) MOA

A

Increase blood glucose level by stimulating glycogenolysis.
Minimal positive inotropic and chronotropic response. Decrease GI motility and secretions

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42
Q

Glucagon (glucagen) Indications

A

ALOC when hypoglycemic
Reversal in beta-blocker overdose

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43
Q

Glucagon (glucagen) contraindications

A

Hyperglycemia, hypersensitivity

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44
Q

Glucagon (glucagen) side effects

A

Dizziness, headache, hypertension, tachycardia, NV, rebound hypoglycemia

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45
Q

Glucagon (glucagen) interactions

A

Incompatible in solution with other substances,
No significant interaction

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46
Q

Glucagon (glucagen) Route

A

IM, IN

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47
Q

Glucagon (glucagen) Dose

A

Adult: hypoglycemia; 1 mg Im/IN, may repeat 7-10 min
Ped: hypoglycemia 1 mg IM/IN if 20 kg+ (or 5+)
0.5 mg IM/IN if < 20 kg or < 5 yo

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48
Q

Glucagon (glucagen) Duration

A

Onset: 1 min Peak: 5-20 duration: 60-90 min

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49
Q

Glucagon (glucagen) Considerations

A

Pregnancy: Only if cleared. Not recommended if lactating. Used in conjunction with D50 when possible. Administer D50 if 2nd does is ineffective.

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50
Q

Naloxone hydrochloride (Narcan) Class

A

Opioid antagonist/ antidote

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51
Q

Naloxone hydrochloride (Narcan) MOA

A

Competitive inhibition. Reverse respiratory depression. Inhibits effects of morphine

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52
Q

Naloxone hydrochloride (Narcan) indication

A

Opiate overdose. Partial CNS depression from opiods.
DLOC or Coma when unknown.

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53
Q

Naloxone hydrochloride (Narcan) Contraindications

A

Use caution on narcotic dependent patients, neonates and addicted mothers

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54
Q

Naloxone hydrochloride (Narcan) Side effects

A

Restlessness, seizures, dyspnea, pulmonary edema, tachycardia, hypertension, dysrhythmias, NV, withdrawl symptoms, diaphoresis.

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55
Q

Naloxone hydrochloride (Narcan) Drug interactions

A

Incompatible with bisulfite and alkaline solutions

56
Q

Naloxone hydrochloride (Narcan) route

A

IV, IN, IO, IM (auto-injector)

57
Q

Naloxone hydrochloride (Narcan) Dose

A

Adult: 0.4-2.0 mg IM/IV/IO. Min recommended is 2mg. Repeat every 5 min for max of 10 mg. IN = half of dose in each nostril. Max dose is 1 mL per nostril.
Ped: 0.1 mg/kg per dose IV/IO/IM every 2 min as needed. Max = 2 mg. If no response in 10 min do an additional 0.1 mg/kg dose

58
Q

Naloxone hydrochloride (Narcan) Duration

A

Onset: < 2 min
Peak: variable
Duration: 30-60 min

59
Q

Naloxone hydrochloride (Narcan) Special considerations

A

Pregnancy: when clearly indicated.
Not beneficial in cardiac arrest

60
Q

Nitroglycerin (Nitrostat, Nitro-bid, tridil) Class

A

Vasodilator

61
Q

Nitroglycerin (Nitrostat, Nitro-bid, tridil) MOA

A

Smooth muscle relaxant acting on vasculature, bronchial, uterine, intestines.
Dilation of atrioles and veins in the periphery. Reduces preload and afterload, decreasing work lod of the heart and myocardial oxygen demand.

62
Q

Nitroglycerin (Nitrostat, Nitro-bid, tridil) indication

A

Acute angina pectoris, ischemic chest pain, hypertension, heart failure, pulmonary edema.

63
Q

Nitroglycerin (Nitrostat, Nitro-bid, tridil) Contraindications

A

Hypotension, hypovelemia, intracranial bleeding or head injury, pericardial tamponade, severe bradycardia or tachycardia,
previous administration in the last 24 hrs: Sildenafil (Viagra) or
48 hrs: vardenafil (levitra) or tadalafil (cialis)

64
Q

Nitroglycerin (Nitrostat, Nitro-bid, tridil) Side effects

A

Headache, dizziness, weakness, reflex tachycardia, syncope, hypotension, NV, dry mouth, diaphoresis, muscle twitching.

65
Q

Nitroglycerin (Nitrostat, Nitro-bid, tridil) interactions

A

Additive to vasodilators. Incompatible with other IV drugs

66
Q

Nitroglycerin (Nitrostat, Nitro-bid, tridil) Route

A

SL (rapid absorption) IV

67
Q

Nitroglycerin (Nitrostat, Nitro-bid, tridil) Dose

A

Adult: 0.4 mg SL: repeat 3-5 min max 3 dose
Spray: 0.4 mg under tounge; 1-2 sprays.
IV: begin at 10-20 mcg/min every 5 min untill desired effect
Ped: not recommended.

68
Q

Nitroglycerin (Nitrostat, Nitro-bid, tridil) Duration

A

Onset: 1-3 min
Peak: 5-10 min
Duration: SL:20-30 min IV 1-10 min after IV

69
Q

Nitroglycerin (Nitrostat, Nitro-bid, tridil) Special considerations

A

Pregnancy: safe. Monitor infant if breast feeding.
Hypotension common in elderly.
Decomposes when exposed to light or heat’ airtight containers.
Sting when administered.

70
Q

Nitropaste (nitro-bid ointment) Class

A

Vasodilator

71
Q

Nitropaste (nitro-bid ointment) MOA

A

Muscle relaxant on vasculature smooth muscle,Bronchial, uterine, intestinal.
Dilation of arterioles and vein in periphery.
Reduces preload and afterload, decreasing workload of the heart and thereby myocardial oxygen demand.

72
Q

Nitropaste (nitro-bid ointment) indications

A

Angina pectoris, chest pain with AMI, hypertension, heart failure, pulmonary edema.

73
Q

Nitropaste (nitro-bid ointment) Contraindications

A

Hypotension, hypovelemia, intracranial bleeding or head injury.
Administered ED in 24 or 48 hrs

74
Q

Nitropaste (nitro-bid ointment) side effects

A

Headache, dizziness, weakness, reflex tachycardia, syncope, hypotension, nausea, nomiting, dry mouth, muscle twitching, diaphoresis.

75
Q

Nitropaste (nitro-bid ointment) interactions

A

Additive with other vasodialators

76
Q

Nitropaste (nitro-bid ointment) Route

A

Transdermal

77
Q

Nitropaste (nitro-bid ointment) Dosage

A

Adult: Paste, 1/2 -3/4 inch line (15-30 mg), Cover, wrap, tape. Max 5 in.
Transdermal: apply unit to intact skin (usually chest wall) in varying doses.
Ped: not recommended.

78
Q

Nitropaste (nitro-bid ointment) Duration

A

Onset: 30 min
Peak: Variable
Duration 18-24 hrs

79
Q

Nitropaste (nitro-bid ointment) Special considerations

A

Pregnancy: safe. Monitor infant if breast feeding.
Not great value in prehospital arena.
Wear gloves
Store in cool place with tube tightly capped.
Erratic absorption rates quite common.

80
Q

Nitrous Oxide 50:50 (Nitronox) Class

A

Gasseous analgesic and anesthetic.

81
Q

Nitrous Oxide 50:50 (Nitronox) MOA

A

Exact mechanism unknown; affects CNS phospholipids

82
Q

Nitrous Oxide 50:50 (Nitronox) Indications

A

Moderate to sever pain, anxiety, apprehension

83
Q

Nitrous Oxide 50:50 (Nitronox) contraindications

A

Impaired level of consciousness, head injury, inability to follow of comply with instructions, decompression sickness, undiagnosed abdominal pain or marked distention bowel obstruction, hypotension, shock, COPD, Cyanosis, Chest trauma w/ pneumothorax.

84
Q

Nitrous Oxide 50:50 (Nitronox) Side effects

A

Light-headedness, drowsiness
Respiratory depression, apnea, NV, malignant hyperthermia

85
Q

Nitrous Oxide 50:50 (Nitronox) Route

A

Inhalation

86
Q

Nitrous Oxide 50:50 (Nitronox) Dosage

A

Adult: instruct patient to inhale deeply through demand valve and mask or mouthpiece
Ped: same

87
Q

Nitrous Oxide 50:50 (Nitronox) Duration

A

Onset: 2-5 min
Peak: Variable
Duration: 2-5 min

88
Q

Nitrous oxide 50:50 (Nitronox) Special considerations

A

Pregnancy: Can cause spontaneous abortion.
Ventilate patient care area during use.
Nitrous oxide is nonflammable and nonexplosive.
Nitrous oxide is ineffective in 20% of the population.

89
Q

Oral Glucose (Insta-glucose) Class

A

Hyperglycemic, carbohydrate

90
Q

Oral Glucose (Insta-glucose) MOA

A

After absorption in the GI tract, glucose is distributed to the tissues providing an increase in circulating blood glucose levels.

91
Q

Oral Glucose (Insta-glucose) Indications

A

Alert patient with suspected hypoglycemia.

92
Q

Oral Glucose (Insta-glucose) contraindications

A

Decreased level of consciousness, nausea vomiting.

93
Q

Oral Glucose (Insta-glucose) side effects

A

Nasea vomiting

94
Q

Oral Glucose (Insta-glucose) route

A

Oral, buccal

95
Q

Oral Glucose (Insta-glucose) Dosage

A

Adult: 25 g PO in patient with intact gag reflex, airway and secretions
Peds: 0.5 - 1 g

96
Q

Oral Glucose (Insta-glucose) Duration

A

Onset: 10 min
Peak: variable
Duration: variable

97
Q

Oral Glucose (Insta-glucose) Special Considerations

A

Able to swallow. Check BGL after 10 minutes

98
Q

Oxygen Class

A

Naturally occurring atmospheric gas

99
Q

Oxygen MOA

A

Reverse hypoxemia

100
Q

Oxygen Indications

A

Hypoxemia, ischemic chest pain, respiratory insufficiency, prophylactically during air transport, confirmed or suspected carbon monoxide poisoning, causes of decreased oxygenation, decreased level of consciousness.

101
Q

Oxygen Contraindications

A

Certain patients with COPD or emphysema who will not tolerate oxygen concentrations greater than 35%, hypertension.

102
Q

Oxygen side effects

A

Decreased level of consciousness (COPD), Decreased respiratory drive in COPD patients, dry mucous membrane.

103
Q

Oxygen interactions

104
Q

Oxygen Route

A

Inhalation

105
Q

Oxygen Dosage

A

Adult: cardiac arrest and CO poisoning: 100% 10-15 L/min via nonrebreathing mask. COPD 0-2 L/min via nasal cannula or 28%-35% venturi mask.
PED: Same for adult except premature infant.

106
Q

Oxygen Duration

A

Onset: Immediate
Peak: n/a
Duration: < 2 min

107
Q

Oxygen Special Considerations

A

Delivery device needs to match flow rate.

108
Q

IV solutions
Lactated ringer (Hartmann) Class

A

Isotonic crystalloid solution

109
Q

IV solutions
Lactated ringer (Hartmann) MOA

A

Lactated ringer solution replaces water and electrolytes

110
Q

IV solutions
Lactated ringer (Hartmann) Indications

A

Hypovolemic shock; Keep open IV line, hypoperfusion.

111
Q

IV solutions
Lactated ringer (Hartmann) Contraindications

A

Lactated ringer solution should not be used in patients with heart failure or renal failure.

112
Q

IV solutions
Lactated ringer (Hartmann) Side effects

A

Rare therapeutic dosages.

113
Q

IV solutions
Lactated ringer (Hartmann) Drug interactions

A

Few in emergency setting.

114
Q

IV solutions
Lactated ringer (Hartmann) Route

115
Q

IV solutions
Lactated ringer (Hartmann) Dosage

A

Hypovolemic shock; titrate according to patient’s physiologic response.

116
Q

IV solutions
Lactated ringer (Hartmann) Duration

A

Short-term therapy

117
Q

IV solutions
Lactated ringer (Hartmann) Special considerations

118
Q

5% dextrose in water Class

A

Hypotonic dextrose -containing solution

119
Q

5% dextrose in water MOA

A

Provide nutrients

120
Q

5% dextrose in water indications

A

IV access for emergency medications; dilution of concentrated medications for IV infusion.

121
Q

5% dextrose in water Contraindications

A

Not used for hypovolemic states

122
Q

5% dextrose in water Side effects

123
Q

5% dextrose in water interactions

A

Not used with phenytoin (dilantin) or amrinone (inocor)

124
Q

5% dextrose in water route

125
Q

5% dextrose in water Dosage

A

Minidrip (60 drop/mL) set at “to keep open” TKO

126
Q

5% dextrose in water Duration

A

Short term

127
Q

5% dextrose in water Special considerations

128
Q

0.9% sodium chloride (normal saline) Class

A

Isotonic crystalloid solution

129
Q

0.9% sodium chloride (normal saline) MOA

A

Saline that replaces water and electrolytes

130
Q

0.9% sodium chloride (normal saline) Indications

A

Heat problems (Heat exhaustion/ heatstroke) Freshwater drowning, hypovolemia, diabetic ketoacidosis. Keep open IV.

131
Q

0.9% sodium chloride (normal saline) Contraindications

A

Not for use in hear failure.

132
Q

0.9% sodium chloride (normal saline) Side effects

133
Q

0.9% sodium chloride (normal saline) interactions

134
Q

0.9% sodium chloride (normal saline) Route

135
Q

0.9% sodium chloride (normal saline) Dosage

A

Titrate to physiological response

136
Q

0.9% sodium chloride (normal saline) Durations

A

Short term

137
Q

0.9% sodium chloride (normal saline) Special considerations

A

Over administration = dependent or pulmonary edema

AEMT (9 decks)

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