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Drug Cards Flashcards

1
Q

Aspirin (ASA)

A

Class: NSAID
MECHANISM OF ACTION: NSAID, that decreases inflammation and decreases platelet aggregation.
INDICATIONS: ACS/Chest pain
CONTRAINDICATIONS: hypersensitivity/allergic, no ability to chew.
ADVERSE REACTIONS: GI symptoms.
DOSE: 324 mg, oral
SPECIAL CONSIDERATION: complete the dose of 4 baby aspirin, patient must have intact airway, and watch for G.I. symptoms.

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2
Q

Nitroglycerin (Nitrostat)

A

Class: ANTI-ANGINAL AGENT
MECHANISM OF ACTION: Vasodilator, relaxes smooth muscle, decreases pre-load and oxygen demand.
INDICATIONS: Chest pain/ACS/CHF
CONTRAINDICATIONS: hypersensitivity/allergic, ED meds last 48 hours, hypertension, right ventricular infarction.
ADVERSE REACTIONS: dizziness, headache, hypotension.
DOSE: 0.4 Mg SL 3-5 min, IV nitroglycerin 10–50 MCG/minute
SPECIAL CONSIDERATION: wear gloves, when administering, watch for hypotension/syncope, have two IVs placed for IV drip dosing.

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3
Q

Dopamine (Intropin)

A

Class: SYMPATHETIC AGONIST
MECHANISM OF ACTION: dopamine is a sympathetic agonist that acts on alpha1, beta1, and D1 + D2 (dopamine) receptors. Which effect depends on the dose. Alpha1: vasoconstriction. Beta1: increased HR/contractility. D1 + D2: increased blood flow, kidneys/intestines.
INDICATIONS: hypotension (severe) , cardiogenic shock, bradycardia (if atropine doesn’t work)
CONTRAINDICATIONS: adrenal tumor, hypovolemic shock.
ADVERSE REAcTIONS: nausea/vomiting, palpitations, headaches, nervousness.
DOSE- Titrate to Effect: D1 + D2: 2-5 mcg/kg/min (IV drip)
Alpha1: 5-10 mcg/kg/min (IV drip)
Beta1: 10-20 mcg/kg/min (IV drip)
Pedi: 2-20 mcg/kg/min (IV drip)
SPECIAL CONSIDERATION: make sure your IV is patent and secured. Fix hypovolemia before using dopamine.

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4
Q

Lidocaine (Xylocaine)

A

Class: ANTI- DYSRHYTHMIC
MECHANISM OF ACTION: Sodium channel blocker that decreases ventricular irritability and reduces the speed of impulses.
INDICATIONS: V-tach/V-fib
CONTRAINDICATIONS: hypersensitivity/allergic, bradycardia
ADVERSE REACTIONS: anxiety, nausea/vomiting, drowsy.
DOSE: 1 mg/kg IV/IO
SPECIAL CONSIDERATION: cardiac monitoring, consider 12 lead ECG, after administering, use a different IV site, if giving after amiodarone. Is it

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5
Q

Adenosine (Adenocord)

A

Class: ANTIDYSRHYTHMIC
MECHANISM OF ACTION: derived from the breakdown of ATP, adenosine slows AV conduction, decreases heart rate, acts as a chemical cardioversion.
INDICATIONS: SVT, rapid tachycardia.
CONTRAINDICATIONS: bradycardia, hypersensitivity/allergic.
ADVERSE REACTIONS: palpitations, near syncope, dizziness, lightheadedness, chest pain, flushing, anxiety.
DOSE: adult: 6 mg, rapid IV/IO push. Can be followed up by 12 mg. Pediatric: 0.1 mg/kg
SPECIAL CONSIDERATION: while giving drug press print button on monitor to have print out of the affect on ECG. Do your best to get IV placement in AC or higher with larger bore.

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6
Q

Epinephrine (Adrenalin)

A

Class: SYMPATHETIC AGONIST
MECHANISM OF ACTION: naturally occurring catecholamine, that directly affects the alpha1, beta1, beta2 receptors. Effects include: vasoconstriction, increase heart rate/blood pressure, increased contractility, bronchodilation.
INDICATIONS: 1:10,000- cardiac arrest, 1:1,000- asthma, anaphylaxis, COPD.
CONTRAINDICATIONS: hypersensitivity/allergic, tachycardia, or hypertension.
ADVERSE REACTIONS: nausea/vomiting, palpitations, headaches, nervousness.
DOSE: 1:10,000- 1 mg IV/IO 3–5 minutes
1:1,000- 0.3 mg IM, 5 mg nebulizer (Stridor)
Pediatric: 0.01 mg/kg
SPECIAL CONSIDERATION: caution in elderly patients, or with history of heart disease, connect to cardiac monitoring.

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7
Q

Norepinephrine (Levophed)

A

Class: SYMPATHETIC AGONIST
MECHANISM OF ACTION: naturally occurring catecholamine that acts on both the alpha and beta receptors as an agonist. Potent vasoconstrictor, increased blood pressure. Alpha effects tend to be more profound.
INDICATIONS: shock (to maintain blood pressure/tissue perfusion) severe hypertension, and post resuscitation.
CONTRAINDICATIONS: hypersensitivity/allergic, bradycardia.
ADVERSE REACTIONS: palpitations, anxiety, tachycardia, tremors
DOSE: 1–30 mcg/minute via IV pump
SPECIAL CONSIDERATION: one of the strongest, vasopressors available, monitor blood pressure closely.

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8
Q

Amiodarone (Cordarone)

A

Class: ANTI- DYSRHYTHMIC
MECHANISM OF ACTION: prolongs the action potential and refractory period, slows electrical conduction rate. Sodium, calcium, potassium, channel blocker.
INDICATIONS: V-tach, V-fib, wide complex rapid tachycardia.
CONTRAINDICATIONS: hypersensitivity/allergic, bradycardia.
ADVERSE REACTIONS: dizziness, drowsiness.
DOSE: arrest: 150–300 mg IV/IO
STABLE: 150 mg over 10 minutes via IO/IV drip
SPECIAL CONSIDERATION: vitals an ECG before and after administering with cardiac monitoring. this medication has a half-life of 45 days.

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9
Q

Atropine

A

Class: ANTI-CHOLINERGIC AGENT
MECHANISM OF ACTION: Potent parasympatholytic, that inhibits actions of acetylcholine. Thus indirectly increased heart rate and AV conduction, decreases GI secretions and dilates pupils.
INDICATIONS: Organophosphate poisoning, symptomatic bradycardia.
CONTRAINDICATIONS: hypersensitivity/ allergic, tachycardia.
ADVERSE REACTIONS: tachycardia, foolish, hot Skin.
DOSE: bradycardia: 0.5-1 IV/IO every 3-5 mins as needed.
Organophosphate OD: 2 mg, then 4 mg, then 8 mg can be given every 5 minutes until desired effect achieved.
SPECIAL CONSIDERATION: your RSI protocol may include atropine to be given prior to intubation to decrease chance of reflex bradycardia.

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10
Q

Diltiazem (Cardizem)

A

Class: CALCIUM CHANNEL BLOCKER.
MECHANISM OF ACTION: a calcium channel blocker slows AV conduction, results and decrease heart rate and blood pressure, decreased oxygen demand on heart.
INDICATIONS: rapid atrial fibrillation, rapid atrial flutter, can be used as second line treatment after adenosine for SVT.
CONTRAINDICATIONS: bradycardia, hypersensitivity/allergic, hypotension.
ADVERSE REACTIONS: bradycardia, hypertension, dizziness, lightheadedness, syncope.
DOSE: 0.25 mg/kg IV/IO (common dosing would be 15 mg IV/IO in adult for example)
SPECIAL CONSIDERATION: watch closely for hypotension or bradycardia, after administering, use cardiac monitoring, and consider a 12 lead ECG.

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11
Q

Metroprolol (Lepressor)

A

CLASS: BETA BLOCKER (SELECTIVE)
MECHANISM OF ACTION: A beta adrenergic blocking agent. Selective to the beta 1 receptor, blocking its effects causing; decreased HR, myocardial contractility, cardiac output and conduction velocity.
INDICATIONS: Rapid atrial fibrillation, rapid atrial flutter, can be used as 2nd line agent after adenosine for SVT.
CONTRAINDICATIONS: Bradycardia, hypersensitivity/allergic, hypertension.
ADVERSE REACTIONS: Bradycardia, hypotension, palpitations, dizziness, lightheartedness, syncope.
DOSE: 5 mg IV/IO can be given every 5 minutes. (Up to total of 15 mg until desired effect)
SPECIAL CONSIDERATION: Caution in asthmatic patients or in active bronchoconstriction as even though it is selective there are still some beta 2 blocker effects.

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12
Q

Albuterol (Ventolin)

A

CLASS: SYMPATHOMIMETIC (beta 2 agonist)
MECHANISM OF ACTION: Sympathomimetic that cats on beta 2 receptor as a agonist, causes prompt bronchodilation of the lungs.
INDICATIONS: Asthma, anaphylaxis, COPD, hyperkalemia.
CONTRAINDICATIONS: Hypersensitivity/allergic, CHF.
ADVERSE REACTIONS: Palpitations, tachycardia, headache.
DOSE: 2.5 mg mixed into mask nebulizer.
SPECIAL CONSIDERATION: Caution in heart disease and congestive heart failure patients. Perform cardiac monitoring before and after administering.

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13
Q

Ipratropium (Atrovent)

A

CLASS: ANTI-CHOLINERGIC
MECHANISM OF ACTION: A anti-cholinergic (parasympatholytic) which inhibits acetylcholine at receptor sites. Dries respiratory tract secretions.
INDICATIONS: Asthma, COPD, anaphylaxis.
CONTRAINDICATIONS: Hypersensitivity/ allergic
ADVERSE REACTIONS: Dry mouth
DOSE: 0.5 mg with Albuterol (2.5)
SPECIAL CONSIDERATION: Auscultate lung sounds before and after administering.

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14
Q

Methylprednisone (Solu-medrol)

A

CLASS: CORTICOSTEROID/ ANTI-INFLAMMATORY.
MECHANISM OF ACTION: A synthetic steroid with potent anti-inflammatory effects for acute/chronic inflammation.
INDICATIONS: Asthma, COPD, anaphylaxis, adrenal crisis.
CONTRAINDICATIONS: Hypersensitivity/ allergic
ADVERSE REACTIONS: Headache, hypertension, GI bleeds, prolong wound healing, fluid retention.
DOSE: Adult: 125 mg IV/IO
Pediatric: 1-2 mg/kg IV/IO
SPECIAL CONSIDERATION: Medication takes hours to see effect. Give first line meds first then follow up with Solu-medrol.

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15
Q

Dexamethasone (Decadron)

A

CLASS: STEROID
MECHANISM OF ACTION: A steroid that acts as an anti-inflammatory. Can decrease cerebral edema and suppress immune response.
INDICATIONS: Asthma, COPD, croup, anaphylaxis.
CONTRAINDICATIONS: Hypersensitivity/ allergic
ADVERSE REACTIONS: Prolonged wound healing, GI bleeding, fluid retention, hyperglycemia.
DOSE: 10 mg IV/IO
SPECIAL CONSIDERATION: Treat life threats and perform first line treatments first. This medication has onset of 2-6 hours.

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16
Q

Oral Glucose

A

CLASS: CARBOHYDRATE GEL
MECHANISM OF ACTION: Will raise patients blood glucose levels.
INDICATIONS: Hypoglycemia.
CONTRAINDICATIONS: Can’t maintain consciousness or maintain airway, unable to obey commands.
ADVERSE REACTIONS: None in emergency settings.
DOSE: Entire tube: 15 grams, orally.
SPECIAL CONSIDERATION: Patient must be alert and able to obey commands.

17
Q

Oxygen

A

CLASS: MEDICAL GASES
MECHANISM OF ACTION: Corrects hypoxia, oxygenates blood, reduces cardiac workload.
INDICATIONS: Low oxygen levels, carbon monoxide poisoning, used in conjunction with airway devices to deliver oxygen.
CONTRAINDICATIONS: None if SPO2 is lower then 94%.
ADVERSE REACTIONS: Drying of mucus membranes.
DOSE: 1-15 ppm depending on the O2 device/ airway setup.
SPECIAL CONSIDERATION: Remember don’t overload the patient, we want SPO2 94-99%/ patient normal. (COPD)

18
Q

Oxytocin (Pitocin)

A

CLASS: HORMONE (PITUITARY)
MECHANISM OF ACTION: Pitocin is a hormone that stimulates uterine smooth muscle contraction, which reduces blood loss in the patient.
INDICATIONS: Postpartum vaginal bleeding.
CONTRAINDICATIONS: Presence of 2 fetus, fetal distress.
ADVERSE REACTIONS: Hypertension, tachycardia, anxiety, N/V, convulsions.
DOSE: 10-20/units in 500cc of D5W IV drip, 3-10/ units, IM.
SPECIAL CONSIDERATION: Mother must deliver both baby and placenta before delivery of oxytocin.

19
Q

Levalbuterol (Xopenex)

A

CLASS: SYMPATHOMIMETIC (BETA 2 AGONIST)
MECHANISM OF ACTION: Sympathomimetic that is selective to the beta 2 receptor, its effect includes dilation of all airway from trachea to bronchioles.
INDICATIONS: Treatment for bronchospasm from: Asthma, COPD, Anaphylaxis.
CONTRAINDICATIONS: Hypersensitivity/ allergic
ADVERSE REACTIONS: Tachycardia, palpations, anxiety.
DOSE: 1.25 mg vis nebulizer (every 2 mins)
SPECIAL CONSIDERATION: Caution in cardiac disease patients and assess cardiac monitoring before and after.

20
Q

Diphenhydramine (Benadryl)

A

CLASS: ANTI-HISTAMINE
MECHANISM OF ACTION: A anti-histamine, that blocks H1 and H2 receptors, has slight sedative effects.
INDICATIONS: Anaphylaxis, simple allergic reactions, extrapyramidal reactions.
CONTRAINDICATIONS: Allergic.
ADVERSE REACTIONS: Dry month, drowsiness, dizziness, sedation, hypotension, palpitations.
DOSE: Adult: 25-50 mg IV/IO, IM, PO.
Ped: 1-2 mg/kg IV/IO, IM, PO (max dose 25 mg)
SPECIAL CONSIDERATION: Have this Medication on hand when giving Haldol, risk of extrapyramidal reactions, consider ETCO2 monitoring for possible sedation.

21
Q

Famotidine (Pepcid)

A

CLASS: H2 ANTAGONIST
MECHANISM OF ACTION: an over-the-counter- medication that acts as an H2 antagonist, anti-histamine.
INDICATIONS: GERD, ulcers, anaphylaxis, allergic reactions.
CONTRAINDICATIONS: Hypersensitivity/ allergic.
ADVERSE REACTIONS: Prolongs QTI, angioedema, dizziness, headache
DOSE: Adult: 20 mg IV/IO
Ped: 0.5-1 mg/ kg IV/IO
SPECIAL CONSIDERATION: The patient may be taking this over the counter for GI issues.

22
Q

Dextrose (D50-D10)

A

CLASS: CARBOHYDRATE
MECHANISM OF ACTION: Elevates blood glucose levels rapidly.
INDICATIONS: Hypoglycemia
CONTRAINDICATIONS: None, as long as recorded hypoglycemia is present.
ADVERSE REACTIONS: Hypoglycemia, local venous irritation.
DOSE: D50: 25 g, slow IV/IO
D10: Titrate to effect via IV drip.
SPECIAL CONSIDERATION: If using D50, ensure IV patent and push slow, D10 is preferred if available less chance of IV irritation and ease of administration.

23
Q

Glucagon

A

CLASS: HORMONE
MECHANISM OF ACTION: Converts glycogen to glucose int he liver to raise blood glucose level. Also has smooth muscle relaxant properties.
INDICATIONS: Hypoglycemia, beta blocker overdose, calcium channel blocker overdose, obstructed esophageal food impaction.
CONTRAINDICATIONS: Hypersensitivity/ allergic
ADVERSE REACTIONS: None.
DOSE: Hypoglycemia: Adult: 1 mg IM
Ped: 0.5 mg IM
BB/CCB OD: 5 mg IV/IO over 3-5 mins.
SPECIAL CONSIDERATION: Consider that is the patient has no liver stores glucagon wont work.

24
Q

Ondansetron (ZOFRAN)

A

CLASS: ANTI-EMETIC
MECHANISM OF ACTION: Blocks serotonin receptors, anti-emetic.
INDICATIONS: Nausea/vomiting.
CONTRAINDICATIONS: Hypersensitivity/ allergic.
ADVERSE REACTIONS: Dizziness, drowsiness, headache.
DOSE: 4-8 mg IV/IO/PO/IM
SPECIAL CONSIDERATION: Caution in pregnant patients, ask if already taking serotonin blockers.

25
Q

Prochlorperazine (Compazine)

A

CLASS: PHENOTHIAZINE ANTIEMETICS
MECHANISM OF ACTION: Anti_ emetic (Phennothiazine)
INDICATIONS: N/V, migraine.
CONTRAINDICATIONS:

26
Q

Olanzapine ( zyprexa )

A

Class: atypical anti - psychotic
Mechanism of action: atypical anti- psychotic sedative
Indications: acute psychosis, emergency sedation for agitation / excited delirium
Contraindications: allergic
Adverse reactions: dizziness, drowsy
Dose: 5-10 mg Im
Special consideration: most protocols allow you to give alongside benzodiazepines for sedation. Monitoring ETCO2 and cardiac monitoring after administering and gather blood glocose level.

27
Q

Naloxone (narcan)

A

Class: opioid antagonist
Mechanism of action: opioidantagonist that will reverse the effects of the opiate at the mu-opiate receptor
Indications: opiate overdose with resp. Depression (low rr)
Contraindications: none in EMS
Adverse reactions: confusion, agitation, AMS, tachycardia
Dose: adult: 2-4 mg IN/IM - 0.4 -2 mg IV/IO.
Ped: 0.1 mg/kg (max dose 2mg)
Special consideration: watch for violent or withdrawal symptoms when patient awakes. Goal of narcan is to restore normal respiratory effort in opiate od.

28
Q

Acetylcysteine (mucomyst)

A

Class: anti-dote
Mechanism of action: A mucolytic agent used to reduce thickness of mucous respiratory secretions, also can delay hepatotoxicity due to Tylenol od
Indications: Tylenol OD. Also used to treat respiratory mucous secretions.
Contraindications: hypersensitivity
Adverse reaction: n/v, tachycardia, flushed skin
Dose:PO: 140 mg /kg (70 mg/kg every 4 hours for long transport)
IV: 150 mg/kg in 200 cc IV bag 5% dextrose (1-hour) 50 mg/kg in 500 cc (4-hours) 100 mg/kg in 1000 cc (16 hours)
Special consideration: poison control and /or medical control may be contacted for lengthy transport.

29
Q

Vecuronium (norcuron)

A

Class: paralytic ( non-depolarizing)
Mechanism of action: prevents neuromuscular activity by blocking the effect of acetylcholine at the myoneural Junction. Acts as paralytic for RSI
Indication: RSI
Contraindications: hypersensitivity and allergic
Adverse reactions: hypotension, bradycardia
Dose: 0.1 mg/kg IV/IO
Special consideration: have back up airways available during RSI. Cardiac monitoring, heart rate, and blood pressure, ETCO2 continuously reassessments

30
Q

Metoclopramide (reglan)

A

Class: anti-emetic
Mechanism of action: an anti-emetic, suppresses vomiting.

Drug Cards (2 decks)

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