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EMT-101 > Chapter ___ - Pharmocology > Flashcards

Chapter ___ - Pharmocology Flashcards

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1
Q

Medication name: Activated Charcoal

A

Activated charcoal, SuperChar, InstaChar, Actidose, LiquiChar

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2
Q

Indications: Activated Charcoal

A

rarely used, may be ordered if it can be administered shortly after ingestion of opioids, anticholinergics, or medications with a sustained release.

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3
Q

Contraindications: Activated Charcoal

A

1) Altered mental status (not fully conscious)
2) Swallowed acids or alkalis.
3) Unable to swallow.
4) Cyanide overdose.

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4
Q

Medication Form: Activated Charcoal

A

12.5 grams premixed in water; powder form should be avoided.

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5
Q

Dosage: Activated Charcoal

A

1 gram of activated charcoal per kilogram of body weight; usual adult dose 25-50 grams, infants and children 12.5-25 grams. (1 kg = 2.2 lb)

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6
Q

Administration: Activated Charcoal

A

Requires orders from medical direction; shake container; encourage patient to drink through a straw from a covered container; record time and response; if patient vomits, notify medical direction to authorize a repeat dose.

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7
Q

Actions: Activated Charcoal

A

binds with poisons in the stomach and prevents their absorption in to the body.

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8
Q

Side Effects: Activated Charcoal

A

Blackening of the stools, possible vomiting.

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9
Q

Reassessment: Activated Charcoal

A

1) Check for abdominal pain or distress upon administration.
2) Watch for vomiting; position the patient and be prepared to suction.

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10
Q

Medication Name: Aspirin

A

ASA, Bayer, Ecotrin, St. Joseph’s, Bufferin, Excedrin

Children–> Tylenol

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11
Q

Indications: Aspirin

A

Chest discomfort that is suggestive of a heart attack, and approval from medical direction.

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12
Q

Contraindications: Aspirin

A

pt with known allergy to drug or a pt with suspected aortic dissection.

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13
Q

Medication Form: Aspirin

A

Tablet

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14
Q

Dosage: Aspirin

A

160-325 mg; recommended 160-325 mg of a nonenteric aspirin to be chewed and swallowed. (5 min effect if chewed and 20-30 min effect if swallowed)

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15
Q

Administration: Aspirin

A

Determine the pt is suffering from an acute syndrome suggestive of a heart attack; obtain approval to administer the medication; ensure that the patient is alert and oriented; have the patient chew a 160-325mg nonenteric tablet; reassess the patient and record the vital signs.

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16
Q

Actions: Aspirin

A

Decreases the ability of platelets to clump together; this reduces the formation of additional clots at the site of the coronary artery blockage.

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17
Q

Side Effects: Aspirin

A

stomach irritation, heartburn, nausea or vomiting.

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18
Q

Reassessment: Aspirin

A

perform reassessment after administration. The aspirin is not being used as a pain reliever, but to prevent platelets from continuing to clump together and occlude the coronary artery. Record any changes in the patient’s condition.

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19
Q

Medication Name: Epinephrine Auto-Injector

A

Epinephrine (Adrenalin), Epinephrine autoinjectors: EpiPen, EpiPen Jr. and Twinject (adult and child).

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20
Q

Indications: Epinephrine

A

1) Signs and symptoms of a moderate to severe allergic reaction (anaphylaxis) with respiratory distress and shock.
2) Medication is prescribed to the patient
3) EMT has received an order from medical direction.

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21
Q

Contraindications: Epinephrine

A

none, when used to treat life-threatening allergic reaction

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22
Q

Medication Form: Epinephrine

A

liquid drug contained with an auto-injector.

23
Q

Dosage: Epinephrine

A

Auto-injectors deliver a single dose;
adult (greater than 66 lb) dose 0.3mg,
infant and child ( less than 66 lb) 0.15 mg; a second dose may be required; Twinject can deliver a second dose.

24
Q

Administration: Epinephrine

A

Push the uncapped tip of the autoinjector firmly against the lateral aspect of the midthigh until the needle is deployed and the medication delivered.

25
Q

Actions: Epinephrine

A

Mimics the response of the sympathetic nervous system:

1) Constricts blood vessels to improve the blood pressure and reduces swelling or hives (alpha).
2) Relaxes smooth muscle in the lungs to improve breathing (beta2).
3) Stimulates the heartbeat (beta1).

26
Q

Side Effects: Epinephrine

A

Increased heartrate, pale skin (pallor), dizziness, chest pain, headache, nausea and vomiting, excitability, and anxiousness.

27
Q

Reassessment: Epinephrine

A

1) Reassess for decreasing mental status, decreasing blood pressure, increased breathing difficulties, stridor, or increased hoarseness.
2) If condition worsens, you may have to call medical direction for a second dose and treat for hypoperfusion. May need CPR and AED.

28
Q

Medication Name: Metered-Dose Inhaler (MDI) / Small-Volume Nebulizer (SVN)

A

Albuterol (Proventil, Ventolin), metaproterenol (Metaprel, Alupent), isoetharine (Bronkosol), bitolterol mesylate (Tornalate), salmeterol xinafoate (Serevent), ipratropium (Atrovent), levalbulterol (Xopenex), pirbuterol (Maxair).

29
Q

Indications: Metered-Dose Inhaler (MDI) / Small-Volume Nebulizer (SVN)

A

1) Exhibits signs and symptoms of breathing difficulty.
2) Patient has a physician-prescribed MDI or medication for nebulization.
3) EMT has received medical direction approval.

30
Q

Contraindications: Metered-Dose Inhaler (MDI) / Small-Volume Nebulizer (SVN)

A

1) Patient is not responsive enough to use the MDI/SVN
2) MDI/SVN is not prescribed for the patient.
3) Maximum dose allowed is reached prior to your arrival
4) Permission denied by medical direction.

31
Q

Medication Form: Metered-Dose Inhaler (MDI) / Small-Volume Nebulizer (SVN)

A

Aerosolized medication in a metered-dose inhaler or liquid medication poured into the nebulizer chamber.

32
Q

Dosage: Metered-Dose Inhaler (MDI) / Small-Volume Nebulizer (SVN)

A

Each depression of MDI delivers precise dose. # of times medication can be delivered is determined by medical control.

SVN takes 5-10 minutes and should be inhaled until a mist is no longer produced.

33
Q

Administration: Metered-Dose Inhaler (MDI) / Small-Volume Nebulizer (SVN)

A

1) Ensure right pt, right medication, right dose, right route and right date. Determine if any doses have already been administered.
2) Determine pt is alert enough to use MDI or SVN
3) Obtain order from medical direction.

34
Q

Actions: Metered-Dose Inhaler (MDI) / Small-Volume Nebulizer (SVN)

A

Beta-agonist, relaxes bronchiole smooth muscles, dilates lower airway.

35
Q

Side Effects: Metered-Dose Inhaler (MDI) / Small-Volume Nebulizer (SVN)

A

Tachycardia, tremors, shakiness, nervousness, dry mouth, nausea and vomiting.

36
Q

Reassessment: Metered-Dose Inhaler (MDI) / Small-Volume Nebulizer (SVN)

A

Reassess vital signs, question pt about effect, conduct focused history and physical exam, monitor airway, record and document.

37
Q

Medication Name: Nitroglycerin

A

Nitro, Nitrostat, Nitro-Bid, Nitrolingual Pumpspray

38
Q

Indications: Nitroglycerin

A

1) Pt exhibits signs and symptoms of chest pain.
2) Pt has physician-prescribed nitroglycerin.
3) EMT has approval from medical direction.

39
Q

Contraindications: Nitroglycerin

A
  1. Baseline bp below 90 mmHg systolic, or systolic pressure decreased more than 30 mmHg from baseline.
  2. Suspected head injury
  3. Pt is child/infant
  4. Three doses have already been taken
  5. Heart Rate less than 50 or greater than 100 bpm.
  6. Pt has recently taken tadalafil (Cialis), vardenafil (Levitra), or sildenafil (Viagra)
40
Q

Medication Form: Nitroglycerin

A

Tablet or sublingual spray.

41
Q

Dosage: Nitroglycerin

A

1 tablet, or 1 spray under tongue; may be repeated in 3-5 mins if:

(1) pt experiences no relief
(2) bp remains above 90 mmHg systolic, not falling more than 30 mmHg below systolic baseline bp.
(3) Heart rate remains above 50 and below 100 bpm
(4) medical direction gives approval. (total dose=3 tablets including what pt took prior to your arrival)

42
Q

Administration: Nitroglycerin

A

1) Ensure meds belong to pt, bp greater than 90 mmHg systolic, heart rate between 50 and 100 bpm.
2) Obtain approval from medical direction
3) Ensure pt is alert, check expiration date, ask pt when last dose,
4) Place or spray medication under tongue; keep mouth closed.
5) Reassess bp in two minutes; record your actions.

43
Q

Actions: Nitroglycerin

A

Dilates blood vessels, decreases workload and oxygen demands of heart.

44
Q

Side Effects: Nitroglycerin

A

Vessel Dilation may cause headache, drop in bp, pulse rate changes.

45
Q

Reassessment: Nitroglycerin

A

1) Monitor bp frequently
2) Question pt about effects
3) Obtain approval from medical direction before readministering.
4) Record and Document all findings and reassessment.

46
Q

Medication Name: Oral Glucose

A

Oral glucose, Glutose, Insta-Glucose

47
Q

Indications: Oral Glucose

A

Must meet all:

(1) Altered mental status w/ (2) Hx of diabetes controlled by meds or a blood glucose level less than 60 mg/dL and
(3) Ability to swallow medication.

48
Q

Contraindications: Oral Glucose

A
  1. Unresponsive
  2. Unable to swallow medication
  3. Has blood glucose level greater than 60mg/dL
49
Q

Medication Form: Oral Glucose

A

Gel, in toothpaste type tube. (15 grams)

50
Q

Dosage: Oral Glucose

A

Typical dose is one tube

51
Q

Administration: Oral Glucose

A

Obtain order from medical direction

Obtain glucose reading

Ensure pt responsive and can swallow

Squeeze or place a small portion between cheek and gum

52
Q

Action: Oral Glucose

A

Increases blood- and brain-sugar levels

53
Q

Side Effects: Oral Glucose

A

May cause airway obstruction or aspirated in pt’s w/o gag reflex.

54
Q

Reassessment: Oral Glucose

A

Reassess the mental status and blood glucose level to determine if drug had effect; may take up to 20 minutes to see any improvement.

EMT-101 (4 decks)

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