Chapter 13 Flashcards
1
Q
A patient who overdosed on acetaminophen is at greatest risk for?
A
Liver failure
2
Q
The paramedic should suspect altered medication metabolism in a patient with?
A
Chronic alcoholism
3
Q
Which route of medication administration is no longer considered a correct route?
A
The endotracheal route
4
Q
Despite the advanced science of pharmacology, what is still commonplace?
A
Adverse reactions
5
Q
What is a common indication or purpose of benzodiazepines?
A
Treat seizures
6
Q
Patients with which condition are at significant risk for toxic effects of medications or metabolic waste products in the body?
A
Renal failure
7
Q
What is a common component of a medication profile?
A
Pregnancy risk factors
8
Q
The ideal body weight for a woman who is 5 feet and 5 inches tall is?
A
57 kg
9
Q
Promethazine is most likely to come in which form?
A
Suppository
10
Q
In what situation would the paramedic likely administer a drug via the rectal route?
A
Seizure termination
11
Q
Fresh frozen plasma is used to?
A
Replace critical clotting factors
12
Q
Medications that may need to be administered in multiple doses to obtain the desired response demonstrate which of the following?
A
Idiosyncratic reaction
13
Q
What ability does the paramedic have when he administers a medication via the IV route?
A
The ability to titrate the medication carefully in a rapidly evolving clinician situation.
14
Q
What is the preferred IV fluid for Y-site tubing administration during a blood product transfusion?
A
Normal saline.
15
Q
Why is the rectal route preferred over the oral route for certain emergency medications?
A
Rectal medications are usually not subject to first-pass metabolism.
16
Q
What is a common site for emergency IO cannulation?
A
Proximal humerus.
17
Q
Why are beta-blockers used with extreme caution in patients with reactive airway?
A
Beta-2 receptors can potentially be antagonized resulting in bronchospasm.
18
Q
What condition is sodium nitroprusside used for?
A
Unstable vascular aneurysm.
19
Q
Stimulation of beta-1 adrenergic receptors would produce which of the following effects?
A
Increased heart rate.
20
Q
Which structure contains epithelial cells that create a continuous barrier to medication absorption?
A
Urinary tract.
21
Q
Which medication is used to provide cardiac cell membrane stabilization following tricyclic antidepressant overdose?
A
Sodium bicarbonate
22
Q
When does first-pass metabolism of a medication occur?
A
The bioavailability of a medication is reduced before it reaches the systemic circulation.
23
Q
The dose-response curve illustrates the relationship between medication dose (or concentration) and..?
A
Efficacy.
24
Q
Which medications promotes the cellular uptake of potassium, making it a potential temporary treatment for hyperkalemia?
A
Albuterol
25
Assuming no ongoing blood loss, one unit of packed red blood cells will increase the hematocrit by what percentage?
3%
26
The vagus nerve releases which hormone?
Acetylcholine.
27
Which condition would make a patient the most susceptible to an adverse effect from a medication?
Renal failure.
28
A patient takes 500 mg of a medication that has a half-life of 2 hours. How much medication will be in the patient’s body after 6 hours?
62.5 mg
29
When would massive doses of atropine be required?
When acetylcholine increases dramatically due to acetylcholinesterase inhibition.
30
What is the primary physiological effect of dobutamine?
Increased inotropy.
31
Why is fentanyl the preferred opioid analgesic for patients in critical or unstable condition?
Fentanyl is not as prone to cause hypotension as morphine.
32
Which medication will actually dissolve a clot?
Activase.
33
In order to cause a negative inotropic effect on the heart, you would have to administer what?
Beta-1 adrenergic antagonist.
34
Decreased efficacy or potency of a medication when taken repeatedly by a patient is called?
Tolerance.
35
In general, what do alpha adrenergic receptor antagonists do to the circulatory system?
Lower the blood pressure.
36
Compared to succinylcholine, rocuronium
Has a rapid onset of action, a longer (15 to 60 minutes) duration of action, and a fewer adverse effects.
37
What is the brand name of metoprolol that may be a subtle reference to lowering blood pressure?
Lopressor
38
In contract to epinephrine, norepinephrine:
Primarily stimulates alpha receptors.
39
The stem “pril” at the end of a drug name signifies that the medication is a member of which medication class?
Angiotensin-converting enzyme (ACE) inhibitor.
40
Stimulation of alpha-2 receptors:
Suppresses the release of norepinephrine.
41
When are IO infusion rates comparable to IV infusion rates?
When a pressure bag or mechanical infusion device is used.
42
When is aspirin indicated for the treatment of a stroke?
Only after an intracranial hemorrhage has been ruled out.
43
Which medication is used to reduce a patient’s heart rate and blood pressure?
Lorazepam.
44
Regarding fresh frozen plasma, what is true?
FFP must be compatible with the recipient’s blood type, but does not have to be Rh compatible.
45
What phases of the cardiac cellular action potential comprise the absolute refractory period?
0 through 3
46
What is the physical, emotional, or behavioral need for a medication in order to maintain a certain level of “normal” function called?
Dependence.
47
Which agents are used to increase the pH of the serum or urine?
Alkalinizing agents.
48
When can paradoxical bradycardia occur if atropine is given?
In doses less than 0.1 to 0.2 mg
49
Give an example of a schedule II medication.
Fentanyl.
50
The generic name of a medication..
Is proposed by the manufacturer.
51
Which medication has the ability to increase cardiac contractility while simultaneously causing dilation of systemic arteries and veins?
Milrinone (Primacor)
52
Following initiation of a dobutamine infusion why might hypotension occur?
It reduces cardiac afterload.
53
What class of medication is typically used to control the heart in patients with atrial fibrillation or atrial flutter
Calcium channel blocker.
54
A paramedic gives a woman with chronic pain an injection of sterile saline and tells her that it is a narcotic analgesic. The paramedic’s actions could result in what?
It could result in criminal prosecution.
55
What side effect might patients taking ACE inhibitor medications experience?
A chronic, dry cough.
56
Why should catecholamines and sympathomimetic medications be administered with caution?
They can increase cardiac workload and myocardial oxygen demand.
57
How would you describe first-order elimination?
The rate of elimination is directly influenced by the plasma levels of the substance.
58
Which blood type and Rh type will almost always be given, for unmatched blood given in the prehospital setting?
O, Rh-negative.
59
Under normal conditions, how do renin-angiotensin systems function?
They promote vasoconstriction and fluid retention in response to hypotension or hypo-perfusion.
60
What is correct regarding the IM route of medication administration?
Medications have a bioavailability of 75% to 100% following IM administration.
61
What is a toxic effect from beta-blockers?
Bradycardia.
62
Why are patients genetically predisposed to an immune-mediated medication response?
They had an initial exposure and sensitization to a particular antigen.
63
Why might a paramedic be called upon to administer platelets to a patient?
For thrombocytopenia.
64
What medication may be administered in patients with pregnancy-induced hypertension?
Hydralazine.
65
What are the physiological effects of nitroglycerin when given to patients with cardiac-related chest pain?
Decreased preload and coronary vasodilation.
66
What is the mechanism of action of anticoagulant medications?
They prevent new clot formation and the growth of existing clots.
67
What classification of medication is ketorolac?
Nonsteroidal anti-inflammatory
68
In up to 60% of all patients, what side effects does morphine sulfate cause?
Nausea and vomiting.
69
What is dopamine commonly used for in the prehospital setting as the primary medication?
Nonhypovolemic hypotension.
70
What is IV calcium routinely used to treat?
Magnesium sulfate toxicity.
71
What is true regarding the sublingual administration of nitroglycerin?
Has a rapid onset of action, but low bioavailability.
72
Unlike a nondepolarizing paralytic, a competitive depolarizing paralytic causes?
It causes muscle fasciculations.
73
Which medication is an endogenous catecholamine?
Dopamine.
74
What type of medication is used to decrease gastric acid secretion?
Histamine-2 receptor antagonist.
75
What is an influencing factor regarding the administration of a fibrinolytic drug to a patient experiencing an acute myocardial infarction?
Time of symptom onset.
76
What will a medication that possesses a negative chronotropic effect cause?
It causes a decrease in heart rate.
77
A patient recently began taking an antipsychotic medication and is experiencing a dystonic reaction. What drug is indicated?
Diphenhydramine.
78
Tranexamic acid (TXA) has been shown to significantly decrease patient mortality when adminstered:
Within 3 hours of a traumatic injury.
79
What factor would be the least likely to affect a patient’s response to a medication?
Past medical history.
80
Which of the following medications can be administered via the intranasal route?
Midazolam~Diazepam~Atropine~Morphine
Midazolam.
81
Patients who take alpha blocking medications at home are frequently prone to what?
Postural hypotension.
82
What occurs during phase 1 of the cardiac cellular action potential?
Sodium influx decreases while potassium slowly exits the cell.
83
What is true regarding sympathomimetic chemicals?
They are not found naturally in the body.
84
What may you need to consider regarding transdermal medication patches?
They may alter a patient’s clinical presentation or interfere with medications administered by the paramedic.
85
Octreotides may be used in patients with?
Bleeding esophageal varices.
86
Which of the following medication would most likely cause an immune-mediated medication response?
Fentanyl~Penicillin~Ibuprofen~Atropine
Penicillin.
87
What specific abnormality does tranexamic acid (TXA) address in a trauma patient?
Hyperfibrinolysis
88
What is true regarding plasma protein binding?
Plasma protein binding releases medication as circulating levels of a particular medication begin to fall, leading to a longer duration of action. ]
89
Why are newer medications designed to target only specific receptor sites on certain cells?
To minimize adverse effects.
90
Why do lipid-soluble medications require higher weight-based doses in elderly patients?
Elderly patients have a higher body fat percentage and fat distribution.
91
A patient experiences profound sedation when an opioid, such as fentanyl, is given together with a benzodiazepine, such as Midazolam. What is this an example of?
Synergism.
92
Which of the following medications possess antiemetics properties?
Dextrose~Dolasetron~Famotidine~Diphenhydramine
Diphenhydramine.
93
What is true regarding packed red blood cells (PRBCs)?
In general, the rate of administration of PRBCs should be proportional to the rate of blood cell loss.
94
Medication X is given to increase the effects of medication Y, which provides more relief than if medication Y were given alone. What is this an example of?
Potentiation.
95
In contrast to morphine, fentanyl:
Has a lower risk of causing nausea and histamine release.
96
What type of medication is used to eliminate certain toxins from the body?
Diuretic.
97
Why is glucagon used in the treatment of beta-blocker overdose?
It produces positive inotropic and chronotropic effects.
98
Acetylcholinesterase is an enzyme that does what?
It breaks down acetylcholine.
99
When confronted with larger medication molecules, what process do cells use to ingest extracellular fluids and their contents?
Pinocytosis.
100
Certain antibiotics and antiseizure medications are known to cause Stevens-Johnson syndrome, which is a:
severe, possibly fatal reaction that mimics a burn.
101
Oral administration of acetaminophen should be avoided in patients who are at high risk for
Seizures
102
The paramedic should administer promethazine (Phenergan) by:
diluting it in 50 mL of normal saline and administering it over 10 minutes.
103
A medication undergoes first-pass metabolism in the:
Liver
104
An abnormal susceptibility to a medication that is peculiar to an individual patient is called an:
idiosyncratic reaction
105
A patient receives several doses of the same drug within a short period of time, after which point the medication does not relieve his symptoms. Which of the following has occurred?
Tachyphylaxis
106
As a medication undergoes biotransformation, it becomes a(n):
metabolite
107
Which of the following medications is derived from a plant source?
Atropine
108
Which of the following statements regarding the endotracheal route of medication administration is correct?
The endotracheal route is no longer considered a reliable method of medication administration.
109
Which type of medication typically includes a “stem” that links it to other medications in the same class?
Generic
110
Which type of medication typically includes a “stem” that links it to other medications in the same class?
Generic
111
Physiologic drug antagonism occurs when:
two medications, each producing opposite effects, are present simultaneously, resulting in minimal or no clinical changes.
112
Patients who receive opioid substances on a long-term basis:
often need higher doses of an opioid medication for pain relief.
113
Stimulation of alpha-1 receptors results in:
Vasoconstriction
114
The therapeutic index of a medication is defined as the:
difference between the median effective dose and the median toxic dose.
115
The therapeutic index of a medication is defined as the:
difference between the median effective dose and the median toxic dose.
