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Paramedicine > Chapter 13: Pharmacology > Flashcards

Chapter 13: Pharmacology Flashcards

1
Q

Catecholamines and sympathomimetic medications should be administered with caution because they:

A

Can increase cardiac workload and myocardial oxygen demand

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2
Q

What is the primary physiologic effect of dobutamine

A

Increase inotropy (contractility)

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3
Q

What are the 10 patient rights

A 
Right patient
Right medication
Right dose
Right route
Right time
Right documentation
Right assessment
Right to refuse
Right evaluation
Right patient education
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4
Q

Chronotropic effect

A

Increased HR

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5
Q

Inotropic effect

A

Increased myocardial contractility

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6
Q

Dromotropic effect

A

Increased myocardial conduction

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7
Q

Paradoxical bradycardia may occur if atropine is given:

A

In doses less than 0.1 - 0.2 mg

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8
Q

What type of medication is used to eliminate certain toxins from the body?

A

Diuretic

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9
Q

In general, alpha-adrenergic receptor antagonists:

A

Lower blood pressure

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10
Q

Examples of schedule I substances

A

Heroin
marijuana
LSD

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11
Q

Examples of schedule II substances

A

fentanyl
methylphenidate
cocaine

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12
Q

Agonist effect for alpha 1 receptors

A

Vasoconstriction of arteries and veins

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13
Q

Agonist effects for alpha 2 receptors

A

Insulin restriction
Glucagon secretion
Inhibition of norepinephrine

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14
Q

Agonist effects for beta 1 receptors

A

Increased HR (chronotropic)
Increased myocardial contractility (inotropic)
Increased myocardial conduction (dromotropic)
Renin secretion for urinary retention

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15
Q

Agonist effects for beta 2 receptors

A

Bronchus and bronchiole relaxation
Insulin secretion
Uterine relaxation
Arterial dilation in certain key organs

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16
Q

Pinocytosis

A

The process that the cells of large medication molecules use to ingest intracellular fluids and their contents

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17
Q

What situation would you most likely administer a drug rectally

A

Seizure termination

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18
Q

What medications dissolve clots

A

Fibrinolytics (activase)

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19
Q

Patients with _________ are at significant risk for toxic effects of medications or metabolic waste products in the body.

A

Renal failure

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20
Q

What receptors does epinephrine stimulate

A

Alpha, beta 1, and beta 2 receptors

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21
Q

What receptors does norepinephrine stimulate

A

Alpha receptors

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22
Q

Cross-tolerance to a medication occurs when:

A

Repeated exposure to a medication within a particular class causes tolerance to other medications in the same class

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23
Q

Patients who are genetically predisposed to an immune-mediated medication response:

A

Had an initial exposure and sensitization to a particular antigen

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24
Q

When might massive doses of atropine be required

A

When acetylcholine increases dramatically due to acetylcholinesterase inhibition

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25
Q

The vagus nerve releases ________, which acts on ________ receptors.

A

acetylcholine, muscarinic-2

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26
Q

Why should beta-blockers be used with extreme caution in patients with a reactive airway

A

Beta-2 receptors can potentially be antagonized, resulting in bronchospasm

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27
Q

What classification of medication is ketorolac (Toradol)

A

NSAID

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28
Q

Physiologic drug antagonism occurs when:

A

Two medications, each producing opposite effects, are present simultaneously, resulting in minimal or no clinical changes

29
Q

The percentage of an unchanged medication that reaches the systemic circulation is referred to as

A

Bioavailability

30
Q

Metoprolol has the brand name ______, which may be a subtle reference to lowering the blood pressure.

A

Lopressor

31
Q

Lipid-soluble medications require higher weight-based doses in elderly patients because

A

Elderly patients have a higher body fat percentage and fat distribution

32
Q

At 5-10 mcg/kg/min, dopamine:

A

Activates beta-1 receptor sites, causing an increased heart rate and increased cardiac contractility

33
Q

Assuming no ongoing blood loss, one unit of packed red blood cells will increase the hematocrit by

A

3%

34
Q

The rectal route is preferred over the oral route for certain emergency medications because

A

Rectal medications are usually not subject to first-pass metabolism

35
Q

Where does a medication undergo first-pass metabolism

A

Liver

36
Q

What class of medication is typically used to control the heart rate in patients with atrial fibrillation or atrial flutter?

A

Calcium channel blocker

37
Q

What are the 5 phases of cardiac cell activity

A

Phase 4: Cardiac cells at rest

Phase 0: Cells receives an impulse; sodium ion rapidly enter the cell

Phase 1: Sodium channels close while potassium exits the cell

Phase 2: Sodium and calcium slowly enter the cell; potassium continues to leave

Phase 3: Calcium channels slowly close and calcium leaves; potassium channels open, rapid movement of potassium out of the cell

38
Q

Compared to succinylcholine, rocuronium

A

Has a rapid onset of action, a longer (15 to 60 minutes) duration of action, and fewer adverse effects

39
Q

Fresh frozen plasma is used to

A

Replace critical clotting factors

40
Q

Common medications administered intranasally

A

fentanyl
midazolam
naloxone

41
Q

The therapeutic index of a medication is defined as the

A

Difference between the median effective dose and the median toxic dose

42
Q

IV calcium is routinely used to treat:

A

Magnesium sulfate toxicity

43
Q

A drug that possesses the same desired clinical effect in several smaller doses as it does in a larger single dose has demonstrated

A

A cumulative action

44
Q

Fentanyl (Sublimaze) is the preferred opioid analgesic for patients in critical or unstable condition because:

A

It is not as prone to causing hypotension as morphine

45
Q

Define tachyphylaxis

A

A condition in which repeated doses of medication within a short period rapidly cause tolerance, making the medication virtually ineffective

46
Q

What is the MOA of anticoagulant medications

A

To prevent new clot formation and the growth of existing clots

47
Q

What is the preferred IV fluid for Y-site tubing administration during a blood product transfusion

A

Normal saline

48
Q

Acetylcholinesterase is an enzyme that:

A

Breaks down acetylcholine

49
Q

What type of medication is used to decrease gastric acid secretion

A

Histamine-2 receptor antagonist

50
Q

Tranexamic acid (TXA) has been shown to significantly decrease patient mortality when administered

A

within 3 hours of a traumatic injury

51
Q

Unlike a nondepolarizing paralytic, a competitive depolarizing paralytic:

A

Causes muscle fasciculations

52
Q

A patient recently began taking an antipsychotic medication and is experiencing a dystonic reaction. What drug is indicated?

A

Diphenhydramine

53
Q

What is Stevens-Johnson syndrome

A

Severe, possibly fatal reaction that mimics a burn

54
Q

The physical, emotional, or behavioral need for a medication in order to maintain a certain level of “normal” function is called:

A

Dependance

55
Q

When is aspirin indicated for the treatment of a stroke

A

Only after an intracranial hemorrhage has been ruled out

56
Q

Dopamine is commonly used in the prehospital setting as the primary medication for:

A

Nonhypovolemic hypotension

57
Q

A medication that has a negative chronotropic effect will

A

Cause a decrease in the heart rate

58
Q

A patient who overdosed on acetaminophen is at greatest risk for:

A

Liver failure

59
Q

A malnourished patient with a history of long-tern alcohol abuse would most likely recieve:

A

Thiamine

60
Q

Why might hypotension occur following the initiation of dobutamine infusion

A

It reduces cardiac afterload

61
Q

How does ACE inhibitor medications lower blood pressure

A

They block the conversion of angiotension I to angiotension II

62
Q

Newer medications are designed to target only specific receptor sites on certain cells in an attempt to:

A

Minimize the adverse effects

63
Q

What is an abnormal susceptibility to a medication that is peculiar to an individual patient called

A

Idiosyncratic reaction

64
Q

What is the physiologic effects of nitroglycerin when given to patients with cardiac related chest pain

A

Decrease preload and coronary vasodilation

65
Q

How does the renin-angiotensin system function under normal conditions

A

Promote vasoconstriction and fluid retention in response to hypotension or hypoperfusion

66
Q

At 15 mcg/kg/min, dopamine:

A

Causes vigorous vasoconstriction

67
Q

First pass metabolism of a medication occurs when:

A

The bioavailability of a medication is reduced before it reaches the systemic circulation

68
Q

Patients who take alpha-blocking medications at home are frequently prone to:

A

Postural hypotension

Paramedicine (2 decks)

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