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343 Pharm Exam 1 > Chapter 58 > Flashcards

Chapter 58 Flashcards

1
Q

Why do we use oxygen as an emergency drug?

A

To promote optimal airway and breathing before administering any pharmacological agents

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2
Q

What is the range of oxygen we want our patients to be at ?

A

94-99%

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3
Q

Why is it dangerous to have high oxygen in our COPD patients ?

Instead we like to give them what?

A

Because it can cause loss of hypoxic respiratory drive

CPAP & BIPAP

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4
Q

Prolonged period of FiO2 above what percentage can lead to oxygen toxicity?

A

50%

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5
Q

What is aspirn ?

A

Decrease platelet aggregation

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6
Q

How much aspirin do we admitted on onset of chest pain?

( 81mg baby aspirin )

A

160-325mg

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7
Q

What does nitroglycerin do?

A

Diliates coronary arteries, improves blood flow to an ischemic myocardium

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8
Q

What does nitroglycerin treat? (3)

A

Angina
Myocardial infarction
Acute carcinogenic pulmonary edema

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9
Q

What are the 3 adverse effects of nitroglycerin?

A

Hypotension
Tachycardia
Bradycardia

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10
Q

What’s super important to note about nitroglycerin?

A

Don’t give with other ED medications

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11
Q

What are the 3A’s?

A

Atropine
Adenosine
Amiodarone

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12
Q

What do all 3 of these cardiac drugs need to have when monitoring?

A

Cardiac monitor
Blood pressure
Heart rate
Frequent VS

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13
Q

What does atropine do?

A

Treats bradycardia and heart attack

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14
Q

What are side effects of atropine?

A

Dysrthythmia
Bradycardia
MI
Restlessness
Anxiety
Pupil dilation
Thirst
Urinary retention

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15
Q

What does adenosine do?

A

Treats paroxysmal SVT
Slows conduction through AV node

( turn off and then turn on )

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16
Q

What are side effects of adenosine?

A

Brief asystole
Ventricular ectopic
Bradycardia
Flushing
Dyspnea
Chest pain
Hypotension

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17
Q

What does amiodarone do?

A

Treatment of life threatening ventricular dysrhythmias and cardiac arrest

Stabilizes heart rate

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18
Q

What are 2 side effects of amiodarone ?

A

Hypotension and bradycardia

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19
Q

What does morphine sulfate do?(4)

A

Relives chest pain
Treats acute cardiogenic pulmonary edema
Dilated venous vessels
Reduced workload of heart

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20
Q

What are the 2 adverse effects of morphine sulfate?

A

Respiratory depression
Hypotension

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21
Q

What is the antidote if morphine sulfate?

How much dose ?

A

Naloxone

0.4-2 q2mjn as needed

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22
Q

What is diltiazem?

( this requires careful monitoring of BP and heart rate )

A

It’s a second line agent after adenosine to treat PSVT

Slows ventricular response rate in a-fib or flutter

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23
Q

What are 4 adverse effects of diltiazem?

A

Dysrhythmias
Bradycardia
Heart block
Hypotension

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24
Q

What does lidocaine do?

A

Treat significant ventricular dysrhythmias by decreasing myocardial irritability

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25
Q

We lidocaine we want to be careful when using with patients who have?

A

Liver impariment

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26
Q

How can you assess a patient who has lidocaine toxicity?

A

Confusion
Drowsiness
Hearing impairment
Cardiac conduction defects
Myocardial depression
Muscle twitching
Seizures

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27
Q

What does magnesium sulfate do?

A

Treats refractory ventricular tachycardia and ventricular fibrillation
Cardiac arrest caused by torsades de pointes life threatening ventricular dysrhythmias from digitalis toxicity

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28
Q

What are big things to monitor for magnesium sulfate? Toxicity ? (3)

A

Respiratory depression & arrest

Circulatory collapse
Cardiac arrest

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29
Q

What is the antidote for magnesium?

A

Calcium gluconate

30
Q

Extra information
Adverse effects for magnesium
Hypotension
Bradycardia
Flushing
Sweating
Diarrhea
Respiratory depression
Flaccid paralysis
Deep tendon reflex impairment
Circulatory collapse

A
31
Q

What does epinephrine do?

( requires constant cardiac and Hemodynamic monitoring )

A

Treats profound bradycardia and hypotension, asystole pulseless ventricular tachycardia and ventricular fibrillation also anaphylaxis and severe asthma

32
Q

What are some adverse effects of epinephrine?

A

Myocardial ischemia
Dysrhymias
Hypertension
Tachycardia
Angina
Excitabikify
Anxiety
Restlessness

33
Q

You should never administer epinephrine at the same site of what? And why?

A

Sodium bicarbonate

Because it’ll deactivate the effects of epinephrine

34
Q

What does sodium bicarbonate do?

( carefully monitor arterial blood gas results )

A

Treats severe metabolic acidosis
Hyperkalemia
Acidotic states related to specific drug overdose situations

35
Q

What are the 3 drugs that are inactived with sodium bicarbonate?

A

Epinephrine
Norepinephrine
Dopamine

36
Q

When do you only give sodium bicarbonate? After doing what?

A

Adequate resuscitative efforts
Ventilation
IV fluids
Drug therapy fail to correct acidosis

( last effort )

37
Q

What does mannitol do?

A

Osmotic diuretic

To treat cerebral edema and reduce increasing intracranial pressure

38
Q

When giving mannitol what do you have to use?

A

Use 2 filters since it’s highly irritating to veins

39
Q

What do you want to monitor for mannitol?

A

Neurologic status
Blood pressure
Electrolytes
Serum osmolaity
intakes & Outakes

40
Q

What does naloxone do?

Extra notes
Monitor patient for combative or violent behavior

Requires careful monitoring for recurrent respiratory depression and hypotension

A

Reverses the effects of opiate drugs by competitively binding to opiate receptor sites

41
Q

What does activated charcoal do?
( contact poison control )

A

Prevents absorption of toxin in body if ingested substances is known to be affected by charcoal in the GI tract

42
Q

How much do you give of activated charcoal?

When is this drug given ?

A

Depends on how much position is ingested

30-60mins after ingestion

43
Q

Activated charcoal causes the stool to be ?

We also want to monitor after giving this medication for?

A

Black

Vomiting and aspiration

44
Q

We don’t give activated charcoal with?

A

Milk products

45
Q

What does dopamine do?(2)

A

Treats hypotensive shock states

Increases heart rate in bradycardia when unresponsive to atropine

46
Q

Why do we want to taper off dopamine when giving them?

( notes ; dopamine requires continuous heart and BP monitoring )

A

To avoid severe hypotension

47
Q

If dopamine leaks out of the IV, what can happen?

A

necrosis

48
Q

What’s the antidote for dopamine?

A

Extravasation

( phentolamine 5-10mg diluted in 10-15ml NS info area )

49
Q

What are 4 adverse effects of dopamine?

A

Tachycardia
Dysrhythmias
Myocardial ischemia
Nausea/vomiting

50
Q

What does dobutamine do?

( requires continuous cardiac and BP monitoring )

A

Improved cardiac contractility and increased HR, mild vasodilation

51
Q

What do we use dobutamine in?

A

Used in shock to improve cardiac output

52
Q

Do we taper off gradually for dobutamine?

A

Yes

53
Q

What are some adverse effects of dobutamine?

A

Myocardial ischemia
Tachycardia
Dysrhythmias
Headache
Nausea
Tremors

54
Q

What does albuterol do?

A

Broncho dilator in anaphylactic shock, asthma, COPD, inflammatory narrowing of airways

55
Q

How do we give albuterol?

What do we monitor for?

A

Nebulizer or MDI

Breath sound, subjective feelings of respiratory distress

56
Q

What are some adverse effects of albuterol?

A

Tachycardia
Tremors
Nervousness
Dysthrymias
Hypertension

57
Q

What does diphenhydramine do?

A

Antihistamine administered with epinephrine to treat anaphylactic shock

58
Q

Notes
Some adverse effects of diphenhydramine
Drowsiness
Sedation
Confusion
Vertigo
Excitability
Hypotension
Tachycardia
Gi distress
Dry mouth

A
59
Q

What two drugs treat hypoglycemia?

A

Dextrose 50
Glucagon

60
Q

How do we give dextrose 50?

Monitor for what ? (2)

Can cause?

A

IV in large vein or central line

Phlebitis & extravasation

Hyperglycemia - monitor blood glucose, osmotic diuresis ( urine output)

61
Q

How can we give glucagon?

Adverse effects?

A

SQ,IM,IV

Nausea, vomiting, hypersensitive, bronchodpams
Respiratory distress

62
Q

What is hypertensive crisis?
( pulmonary edema )

A

180-200S
————-
120D

63
Q

Labetalol does what?

A

Lowers heart rate, BP, myocardial contractility, myocardial oxygen combustion

Reduces vasoconstriction resulting from sympathetic nervous system stimulation

64
Q

What are adverse effects of labetalol?

A

Hypotension
Bradycardia
Dysrhythmias
Bronchospams
Dizziness

65
Q

What does nitroprusside do?

A

Artieral and venous vasodilator to reduce severe hypertension

66
Q

Nitroprusside we want to monitor for?

A

Thiocyanate toxicity & cyanide

67
Q

Do we protect nitroprusside from the light?

A

Yes

68
Q

What does furosemide do?

A

Promotes renal excretion of water, sodium, chloride, magnesium, hydrogen, calcium, potassium

Has peripheral and renal vasodilation effects that can lower BP

69
Q

What are 3 big furosemide adverse effects?

A

Severe hypovolemia
Dehydration
Electrolye imbalance

70
Q

What do we want to monitor in furosemide users?

A

Fluid & electrolytes
BUN
Creatinine
Breaths sounds
I&O

343 Pharm Exam 1 (12 decks)

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