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Pharmacology and Fluid Therapy > Drug Cards (LO3) > Flashcards

Drug Cards (LO3) Flashcards

1
Q

Acetaminophen

  • Generic name
  • Trade name
  • Classification
A

Generic name:
-Acetaminophen

Trade name:
-Tylenol®

Classification
-Analgesic, antipyretic

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2
Q

Acetaminophen

-Mechanism of action

A

MOA
-Antipyretic action by acting on heat regulating centers in the hypothalamus causing increased heat loss through vasodilation and sweating

-Analgesic action by inhibiting prostaglandin synthesis in the central nervous system

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3
Q

Acetaminophen

  • Indications
  • Contraindications
A

Indications

  • Pyrexic child
  • Severe sepsis
  • septic shock

Contraindications

  • hypersensitivity
  • Acetaminophen-induced liver disease
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4
Q

Acetaminophen

  • precautions
  • side effects
A

Precautions

  • hepatotoxicity
  • medications that induce hepatic enzymes
  • All acetaminophen containing products taken by patient need to be accounted for during 24-hour period including cough and cold remedies, analgesic or arthritis formulations and antipyretics

Side Effects

  • Nausea / vomiting
  • Cramping: overdoses in children
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5
Q

Acetaminophen

  • route
  • dose
  • pharmacokinetics
A

Route
-PO/PR

Dose

  • A: 325–650 mg p 4–6 hours, DNE 4000 mg/24 hrs
  • P: 10–15 mg/kg p 4–6 hours, DNE 5 doses in 24 hours

Pharmacokinetics

  • Onset: 48 minutes
  • Peak effects: 48 minutes
  • Duration: 4–6 hours
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6
Q

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Acetaminophen
-how supplied

A 
How Supplied
-Oral
Immediate release tablet (325 mg, 500 mg), 
caplet (325 mg, 500 mg), 
extended release caplet (650 mg), 
gel cap (500 mg), 
chewable tablet (80 mg, 160 mg), 
rapidly-dissolving tablet (80 mg, 160 mg),
 suspension (80 mg/mL, 32 mg/mL)
-
Rectal – 
Suppository (120 mg, 160 mg, 325 mg, 650 mg)
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7
Q

Activated Charcoal

  • Generic name
  • Trade name
  • Classification
A

Generic:
-Activated charcoal

Trade names:
- Liqui-Char®, Actidose®, Charcodote®

Classification
-Antidote

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8
Q

Activated Charcoal

-Mechanism of action

A

Mechanism of Action

-Binds and adsorbs ingested toxins from the gastrointestinal tract

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9
Q

Activated Charcoal

  • Indications
  • Contraindications
A

Indications
-Oral poisoning or overdose

Contraindications

  • Caustic or corrosive substances
  • petroleum distillates
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10
Q

Activated Charcoal

  • precautions
  • side effects
A

Precautions

  • decreased LOC.
  • If ipecac has been administered, wait 10 minutes.

Side Effects

  • Nausea, vomiting
  • Constipation, cramping, bloating
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11
Q

Activated Charcoal

  • route
  • dose
  • pharmacokinetics
A

Route
-PO

Dose

  • 1 g/kg
  • In massive overdoses, may consider 2 g/kg for adults
  • *Requires Online Medical Control

Pharmacokinetics

  • Onset: Immediate
  • Peak effects: Varies
  • Duration: Varies based on gastrointestinal function, will act until excreted
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12
Q

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Activated Charcoal
-how supplied

A
  • Premixed with water or sorbitol
  • 25 g / 125 mL bottle (200 mg/mL)
  • 50 g / 250 mL bottle (200 mg/mL)
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13
Q

Amyl Nitrate

  • trade name
  • classification
A

Trade name:
-Amyl Nitrate®

Classification

  • Vasodilator
  • Antidote
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14
Q

Amyl Nitrate

-Mechanism of Action

A

-Binds with hemoglobin to help biodegrade cyanide

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15
Q

Amyl Nitrate

  • indications
  • contraindications
A

Indications
-Acute cyanide poisoning with impaired LOC

Contraindications
-no concrete proof of cyanide poisoning

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16
Q

Amyl Nitrate

  • precautions
  • side effects
A

Precautions
-Flammable

Side Effects
-Drowsiness

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17
Q

Amyl Nitrate

  • route
  • dose
  • pharmacokinetics
A

Route
-Inhalation

Dose

  • 0.2–0.3 mL inhaled for 15–30 sec with breaks for 15–30 sec.
  • New ampoule every 3 min until arrival at emergency department

Pharmacokinetics

  • Onset: Immediate
  • Peak effects: 3-5 minutes
  • Duration: 20 minutes
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18
Q

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Amyl Nitrate
-how supplied

A

0.2 mL or 0.3 mL glass ampoule

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19
Q

Amyl Nitrate

-Special Considerations

A

Only services that respond to industries where cyanide exposure can occur will stock drug.

Retraining and certification is required by a physician every 2 years.

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20
Q

Acetylsalicylic Acid (ASA)

  • generic names
  • trade name
  • classification
A

Generic name:
-Acetylsalicylic Acid (ASA)

Trade name:
-Aspirin®

Classification

  • Platelet inhibitor
  • anti-inflammatory
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21
Q 
Acetylsalicylic Acid (ASA)
- mechanism of action
A

Reduces production of thromboxane which mediates platelet aggregation.

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22
Q

Acetylsalicylic Acid (ASA)

  • indications
  • contraindications
A

Indications
-Chest pain, cardiac in origin

Contraindications

  • Hypersensitivity to ASA or other NSAIDs
  • active peptic ulcers
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23
Q

Acetylsalicylic Acid (ASA)

  • precautions
  • side effects
A

Precautions
-Asthma patient

Side Effects

  • Heartburn,
  • nausea/vomiting,
  • wheezing,
  • prolonged bleeding
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24
Q

Acetylsalicylic Acid (ASA)

  • route
  • dose
  • pharmacokinetics
A

Route
-PO, chewed

Dose
-160–325 mg

Pharmacokinetics

  • Onset: Within 20 min
  • Peak effects: Varies
  • Duration: 2–3 hours
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25
Q

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Acetylsalicylic Acid (ASA)
-how supplied
A

81 mg and 325 mg tablets

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26
Q 
Acetylsalicylic Acid (ASA)
-special considerations
A

Administer regardless whether patient has taken their daily ASA dose

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27
Q

Glucose

  • trade name
  • classification
A

Trade name:

  • Dextrose 50% (D50W),
  • Dextrose 25% (D25W),
  • Dextrose 10% (D10W),
  • Dextrose 5% (D5W)

Classification

  • Carbohydrate,
  • Antihypoglycemic agent
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28
Q

Glucose

- mechanism of action

A

Increases blood sugar levels rapidly

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29
Q

glucose

  • indications
  • contraindications
A

Indications
Hypoglycemia

Contraindications
Hyperglycemia

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30
Q

glucose

  • precautions
  • side effects
A

Precautions
-Intracranial pressure
– may worsen cerebral edema

Side Effects

  • Tissue necrosis
  • local venous irritation
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31
Q

glucose

  • route
  • dose
  • pharmacokinetics
A

Route
-IV

Dose
-Adult: 0.5 g/kg IV/IO max 10 g
(if suspected head injury or stroke, give in 5-10g increments)

-Pediatric: 2 mL/kg D10W IV/IO

Pharmacokinetics

  • Onset: Less than 1 min
  • Peak effects: Varies
  • Duration: Varies
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32
Q

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glucose
-how supplied

A

-How Supplied
25 g in 50 mL prefilled syringe (D50W)

12.5 g in 25 mL prefilled syringe (D25W)

10 g/100 mL in 50 mL, 100 mL, 250 mL, 500 mL and 1000 mL IV bag (D10W)

5 g/100 mL in 50 mL, 100 mL, 250 mL, 500 mL and 1000 mL IV bag (D5W)

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33
Q

glucose

-special considerations

A

Always ensure that a blood glucose reading is obtained before administration.

Since tissue necrosis can occur if IV is interstitial, you must aspirate blood to ensure IV is patent prior to medication administration.

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34
Q

Dimenhydrinate

  • generic name
  • trade name
  • classification
A

Generic name:
-Dimenhydrinate

Trade name:
-Gravol®, Dramamine®

Classification
-Antiemetic (med for N/V)

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35
Q

Dimenhydrinate

-mechanism of action

A

Not precisely known, but evidence is that it acts to depress hyperstimulated labyrinthine functions or associated neural pathways.

It is also thought to inhibit cholinergic stimulation in the vestibular and associated neural pathways.

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36
Q

Dimenhydrinate

  • indications
  • contraindications
A

Indications
-Relief of nausea and vomiting

Contraindications
-Hypersensitivity to dimenhydrinate or tartrazine.

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37
Q

Dimenhydrinate

-interactions

A

-Narcotics, sedatives or hypnotics, and alcohol – potentiates CNS depression

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38
Q

Dimenhydrinate

-side effects

A

Drowsiness, dizziness, blurred vision

Dry mouth, dry nose and bronchi

Tinnitus

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39
Q

Dimenhydrinate

  • route
  • dose
A

Route
-IM, IV

Dose
IV
-Adult: 50 mg over 2 minutes.
-Peds: 1 mg/kg over 2 minutes, not to exceed 50 mg.

  • IM: Concentration 50 mg/1mL
  • Over 12 yrs: 50 mg q4 hrs.
  • 8–12 yrs: 25–50 mg q8 hrs.
  • 6–8 yrs: 12.5–25 mg q8 hrs.
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40
Q

Dimenhydrinate

-pharmacokinetics

A

Excreted in urine, crosses placenta

Onset: Immediate (IV), 20–30 minutes (IM)

Peak effects: Varies

Duration: 3–6 hours

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41
Q

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Dimenhydrinate
- how supplied

A

50 mg/mL

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42
Q

Dimenhydrinate

-special considerations

A

-Should be used cautiously ) in patients with: glaucoma, (COPD), asthma, prostatic hypertrophy, are intoxicated, decreased (LOC).

patients with a head injury as it may result in a decreased level of consciousness.

C-spine immobilized on a back board, emesis may result in aspiration and obstruction of the airway.

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43
Q

Epinephrine 1 mg/mL

  • generic name
  • trade name
  • classification
A

Generic Name:
-Epinephrine

Trade name:
-Adrenaline

Classification
-Sympathomimetic

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44
Q

Epinephrine 1 mg/mL

-mechanism of action

A

Mechanism of action: Alpha and beta agonist

  • Alpha-1: Systemic vasoconstriction
  • Beta-1: Positive inotropic, chronotropic, and dromotropic effects
  • Beta-2: Bronchial smooth muscle relaxation
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45
Q

Epinephrine 1 mg/mL

  • indications
  • contraindications
A

Indications
-Anaphylaxis, status asthmaticus, and croup

Contraindications
-Hypersensitivity

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46
Q

Epinephrine 1 mg/mL

  • precautions
  • side effects
A

Precautions
-Patients with cardiac history, pregnancy

Side Effects
-Tachycardia, palpitations, arrhythmias
Headache, anxiety, nausea/ vomiting

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47
Q

Epinephrine 1 mg/mL
-route

-

A

IM, SQ, Nebulized

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48
Q

Epinephrine 1 mg/mL

-dose adult anaphylaxis

A

Anaphylaxis:
-Mild / Moderate: 0.3 mg IM (of a 1 mg/mL concentration) q 5 minutes prn to a total maximum of 0.9 mg

-Severe: 0.5 mg IM (of a 1 mg/mL concentration) q 5 minutes prn to a total maximum of 1.5 mg

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49
Q

Epinephrine 1 mg/mL

-dose adult status asthmaticus

A

0.3 – 0.5 mg SC/IM (of 1 mg/mL concentration) q 5 – 10 minutes prn to a total of 1 mg

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50
Q

Epinephrine 1 mg/mL

- dose Peds anaphylaxis

A

Anaphylaxis
-Mild / Moderate: 0.01 mg/kg (0.01 mL/kg of a 1 mg/mL concentration) IM to a single maximum dose of 0.3 mg q 5 minutes prn to a total maximum of 0.9 mg

-Severe: 0.01 mg/kg (0.01 mL/kg of a 1 mg/mL concentration) IM to a single maximum dose of 0.5 mg q 5 minutes prn to a total maximum of 1.5 mg

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51
Q

Epinephrine 1 mg/mL

- dose Peds status asthmaticus

A

0.01 mg/kg IM single minimum dose of 0.1 mg to a single maximum dose of 0.3 mg (of a 1 mg/mL concentration) q 5 minutes prn to a total maximum of 0.03 mg/kg

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52
Q

Epinephrine 1 mg/mL

- dose Peds croup

A

0.5 mg/kg to a max of 5 mg diluted in 2-3 ml NaCl, repeat dose x 1 prior to Online Medical Control (OLMC)

53
Q

Epinephrine 1 mg/mL

-pharmacokinetics

A

Onset: Immediate
Peak effects: Varies
Duration: 5–10 min

54
Q

Epinephrine 1 mg/mL

  • how supplied
  • special considerations
A

1 mg/mL

Can be deactivated by alkaline solutions

55
Q

Glucagon

  • trade name
  • classification
A

Trade name:
-Glucagon

Classification

  • Hormone
  • anti-hypoglycemic agent
56
Q

Glucagon

-mechanism of action

A

Increases blood glucose levels by causing breakdown of glycogen to glucose, increases heart rate and cardiac contractility

57
Q

glucagon

  • indications
  • contraindications
A

Indications
-LOC due to hypoglycemia where an IV cannot be established

Contraindications

  • Hypersensitivity,
  • hyperglycemia
58
Q

glucagon

  • precautions
  • side effects
A

Precautions
-Hepatic or renal insufficiency

Side Effects

  • Tachycardia,
  • nausea/vomiting,
  • hypertension
59
Q

glucagon

  • route
  • dose
  • pharmokinetics
A

Route
-SQ, IM

Dose
-12 years and older: 1 mg with repeat in 15 min as needed

-Under 12 years: 0.1 mg/kg to a max of 1 mg with repeat in 15 min as needed

Pharmacokinetics

  • Onset: 13-20 min
  • Peak effects: 30 min
  • Duration: 1–2 hours
60
Q

glucagon

  • how supplied SKIP FOR NOW
  • special considerations
A

How Supplied
-1 mg/mL (requires reconstitution)

Special Considerations
-Ineffective if glycogen stores are depleted

61
Q

Ibuprofen

  • generic name
  • trade name
  • class
A

Generic name:
-Ibuprofen

Trade name:
-Motrin®, Advil®

Classification
-NSAID, Analgesic, Antipyretic

62
Q

Ibuprofen

-MOA

A
  • Anti-Inflammatory, analgesic, and antipyretic activities by inhibiting prostaglandin synthesis in the central nervous system. 
  • Inhibits both COX-1 and COX-2
63
Q

Ibuprofen

  • Indications
  • Contraindications
A

Indications
-Mild to moderate pain, fever reduction

Contraindications
-Hypersensitivity

64
Q

Ibuprofen

  • precautions
  • side effects
A

Precautions

  • Use caution with cardiovascular dysfunction, hypertension, peptic ulcers, GI bleeds, pregnancy, and impaired hepatic or renal function
  • When taken with lithium, may cause increase risk of lithium toxicity
  • If taken with a diuretic may cause diuretic to have a decreased effect
  • May cause a decreased antihypertensive effect of B-adrenergic blocking drugs
65
Q

Ibuprofen

-side effects

A

GI upset, epigastric pain, heartburn, and abdominal pain

66
Q

Ibuprofen

  • route
  • dose
  • pharmacokinetics
A

Route
-PO

Dose
-Adult: 200–400 mg every 4–6 hours, not to exceed 3200 mg/24 hours

-Pediatric: 5–10 mg/kg every 6 hours, not to exceed 40 mg/kg in 24 hours

Pharmacokinetics

  • Onset: 30 min
  • Peak effects: 1–2 hours
  • Duration: 4–6 hours
67
Q

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Ibuprofen
- how supplied

A

-Oral – tablet (100 mg, 200 mg, 400mg, 600mg, 800mg), chewable tablets (50 mg, 100 mg), capsules (200 mg), Suspension (100 mg/2.5mL, 100 mg/5mL), oral drops (40 mg/mL)

68
Q

Ipratropium Bromide

  • generic name
  • trade name
  • class
A

Generic name:
-Ipratropium Bromide

Trade name:
-Atrovent®

Classification
-Anticholinergic

69
Q

Ipratropium Bromide

-MOA

A

-Bronchodilation, smooth muscle relaxation

70
Q

Ipratropium Bromide

  • indications
  • contraindications
A

Indications

  • Bronchial asthma that has not responded to salbutamol
  • Severe bronchospasm
  • Bronchospasm associated with Chronic Obstructive Pulmonary Disease (COPD)

Contraindications

  • Hypersensitivity
  • Administered within last 4 hours
71
Q

Ipratropium Bromide

  • precautions
  • side effects
A

Precautions

  • Monitor vitals
  • Caution in elderly

Side Effects

  • Dry mouth, metallic taste
  • Headache, dizziness
  • Anxiety, palpitations
72
Q

Ipratropium Bromide

  • route
  • dose
  • pharmockinetics
A

Route
-Inhalation via nebulizer

Dose

  • 12 years and older: 250 mcg–500 mcg
  • 5 to 12 years: 125 mcg - 250 mcg

Pharmacokinetics

  • Onset: 5–15 min
  • Peak effects: Varies
  • Duration: 4–6 hours
73
Q

Ipratropium Bromide

  • how supplied SKIP FOR NOW
  • Special Considerations
A

How Supplied
-250 mcg in 2 mL

Special Considerations
-Patients with glaucoma should wear goggles while administered

74
Q

Ketorolac

  • generic name
  • trade name
  • class
A

Generic name:
-Ketorolac
Trade name:
-Toradol®

Classification
-Nonsteroidal Anti-Inflammatory Drug (NSAID)

75
Q

Ketorolac

-MOA

A

-Exhibits peripherally acting non-narcotic analgesia activity by inhibiting prostaglandin synthesis

76
Q

Ketorolac

  • indications
  • contraindications
A

Indications 

  • Pain refractory to opioids
  • Renal colic

Contraindications
-Hypersensitivity to ketorolac or other non-steroidal anti-inflammatory agents
-Asthma
-History of significant renal disease, except renal colic
-Suspected intracranial bleed
-History of GI bleeding
-Subarachnoid hemorrhage (indicated by sudden onset/most severe ever headache/thunderclap)
Pregnancy

77
Q

Ketorolac

  • precautions
  • side effects
A

Precautions
-Can cause peptic ulcers, should not use for abdominal or chest pain

Side Effects
-Headache, heartburn, nausea, vomiting, diarrhea, stomach pain, bloating

78
Q

Ketorolac

  • route
  • dose
  • pharmacokinetics
A

Route
-IV or IM

Dose

  • 30 mg IV/IM
  • 15 mg IV/IM If the patient is over 65 years of age

Pharmacokinetics

  • Onset: approx. 30 minutes
  • Peak effects: 45–60 minutes
  • Duration: 4–6 hours
79
Q

Ketorolac

  • How Supplied SKIP FOR NOW
  • special considerations
A

How Supplied
-Vials or Ampules doses per vial or ampule can vary from 10, 15, 30 or 60 mg/mL

Special Considerations
-Patient should be placed on the cardiac monitor after administration.

80
Q

Naloxone

  • generic name
  • trade name
  • class
A

Generic name:
-Naloxone

Trade name:
-Narcan®

Classification
Opioid Antagonist

81
Q

Naloxone

-MOA

A

Reverses effects of narcotics by competing and displacing narcotic from opiate receptors in the brain

82
Q

Naloxone

  • indications
  • contraindications
A

Indications 
-Suspected narcotic overdose with respiratory depression

Contraindications
-Hypersensitivity

83
Q

Naloxone

  • precautions
  • side effects
A

Precautions
-Use with caution with narcotic-dependent patients and neonates of narcotic-addicted mothers

Side Effects
-Acute withdrawal symptoms

84
Q

Naloxone

  • route
  • dose
  • pharmocokinetics
A

Route
-IM, IV, IN

Dose

  • Adult: 0.4–2 mg (titrate to effect)
  • Pediatric: 0.01 mg/kg–0.1 mg/kg to max of 2 mg (titrate to effect)

Pharmacokinetics

  • Onset: Within 2 min
  • Peak effects: Varies
  • Duration: 45 min
85
Q

Naloxone

  • how supplied SKIP FOR NOW
  • Special Considerations
A

How Supplied
-0.02 mg/mL, 0.4 mg/mL, and 2 mg/2 mL

Special Considerations
-Short acting, may need a repeat dose in 5 min

86
Q

Nitroglycerin

  • generic name
  • trade name
  • class
A

Generic name:
-nitroglycerin

Trade name:
-Nitrostat®, Nitrolingual®

Classification
-Vasodilator, antianginal

87
Q

Nitroglycerin

-MOA

A

Relaxes vascular smooth muscle causing vasodilation (increases blood flow and decreases preload)

88
Q

Nitroglycerin

  • indications
  • contraindications
A

Indications
-Suspected cardiac chest pain, pulmonary edema

Contraindications

  • Systolic blood pressure below 100 mmHg
  • Pulse less than 50/min
  • Viagra® (sildenafil), Levitra® (vardenafil), or Cialis® (tadalafil) within the last 24 hours
89
Q

nitroglycerin

  • Precautions
  • side effects
A

Precautions
-Continuously monitor vitals

Side Effects
-Syncope, dizziness, hypotension, headache,

90
Q

nitroglycerin

  • route
  • dose
  • pharmocokinetics
A

Route
-SL

Dose
-0.3–0.4 mg q 5 min to max of 3

Pharmacokinetics

  • Onset: 1–3 min
  • Peak effects: 5–10 min
  • Duration: 20–30 min
91
Q

nitroglycerin

  • How Supplied SKIP FOR NOW
  • Special Considerations
A

How Supplied

  • Spray: 0.4 mg
  • Tablet: 0.3 mg, 0.6 mg

Special Considerations
-Keep out of heat and light 

92
Q

Nitrous Oxide (N20)

  • generic name
  • trade name
  • class
A

Generic name:
-Nitrous Oxide (N20)

Trade name:
-Nitronox®, Entonox®

Classification
-Analgesic gas

93
Q 
Nitrous Oxide (N20) 
-MOA
A

Depresses the central nervous system and relieves pain

94
Q

Nitrous Oxide (N20)

  • indications
  • contraindications
A

Indications
-Musculoskeletal injuries, burns, active childbirth

Contraindications

  • Abdominal pain indicative of a bowel obstruction
  • Pneumothorax
  • Head injury, impaired mental status, intoxication, decompression sickness, inability to follow commands
  • Severe Chronic Obstructive -Pulmonary Disease (COPD)
95
Q

Nitrous Oxide (N20)

  • precautions
  • side effects
A

Precautions
-Use in well-ventilated area

Side Effects
-Headache, nausea, vomiting

96
Q

Nitrous Oxide (N20)

  • route
  • dose
  • pharmacokinetics
A

Route
-Inhalation

Dose
-Self-administered via demand valve

Pharmacokinetics

  • Onset: 2–5 min
  • Peak effects: Varies
  • Duration: 2–5 min
97
Q

Nitrous Oxide (N20)

  • How Supplied SKIP FOR NOW
  • Special Considerations
A

How Supplied
-Cylinder containing 50% nitrous oxide and 50% oxygen

Special Considerations

  • May not work in low temperatures
  • Monitor SpO2
98
Q

Ondansetron

  • generic name
  • trade name
  • class
A

Generic name:
-Ondansetron

Trade name:
- Zofran®, Zofran ODT®, Zuplenz®

Classification
-Antiemetic, selective 5-HT3 antagonist

99
Q

Ondansetron

-MOA

A
  • Not fully characterized; selective 5-HT3 receptor antagonist; binds to 5-HT3 receptors both in PNS and CNS with primary effect on GI tract.
  • It has no effect on dopamine receptors, therefore does not cause extrapyramidal symptoms.
100
Q

Ondansetron

  • indications
  • contraindications
A

Indications

  • Nausea and vomiting (chemotherapy, postoperative, and radiation)
  • Nausea and vomiting NOT cause by vertigo, motion sickness or inner ear disturbances
  • Hyperemesis

Contraindications

  • Hypersensitivity
  • Co-administration with apomorphine has been reported to cause profound hypotension and loss of consciousness
101
Q

Ondansetron

  • cautions
  • side effects
A

Cautions
-Reduce dose with severe hepatic impairment

Side Effects

  • Gastrointestinal: nausea and vomiting
  • Anaphylaxis
  • General: flushing, rare cases of hypersensitivity reactions, sometimes severe (e.g., anaphylactic reactions, angioedema, bronchospasm, cardiopulmonary arrest, hypotension, laryngeal edema, laryngospasm, shock, shortness of breath or stridor)
  • Local reactions: pain, redness, burning feeling at site
  • Lower respiratory: hiccups
  • Neurological: oculogyric crisis
  • Integumentary: Urticaria, Stevens-Johnson syndrome and toxic epidermal necrosis
  • Ocular: transient blindness (mostly IV administration) reported to resolve within 48hrs
  • Musculoskeletal: arthralgia
102
Q

Ondansetron

  • route
  • pharmacokinetics
A

Route
-IM, IV, Orally

Pharmacokinetics

  • Onset: 30 mins
  • Peak effects:  1–2 hours (IV)
  • Duration: 3–6 hours (IV)
103
Q

Ondansetron

-dose

A

Adult <65: 4–8 mg IV/IM-IV push over 2–5 min, repeat q 8 hours (can be diluted in 10 mLs of NS or undiluted)
Adult >65:4–8 mg- IV/IM-IV is mixed in 50 mL bag and infused over 15–20 minutes, repeat q 8 hours

Note:

Can be given orally if necessary, when IV/IM not possible

Pediatrics (8–15 kg): 2 mg IV/IM- IV push over 2–5 minutes (can be diluted in 10 mLs NS or undiluted)

Pediatrics (over 15 kg): 4 mg IV/IM - IV push over 2–5 minutes (can be diluted in 10 mLs NS or undiluted), with one repeat.

104
Q

Ondansetron

  • how supplied SKIP FOR NOW
  • special considerations
A

How Supplied
-2 mg/mL (2 mL) OR 2 mg/mL (4 mL)

Special Considerations

  • Ondansetron is generally given to patients undergoing Chemotherapy and/or radiation therapy to treat the nausea and vomiting.
  • Note: for children, it does not appear to be a drug of choice to treat nausea and vomiting.
  • Dose-dependent  QT  prolongation
  • Avoid in patient with congenital long QT syndrome
  • ECG monitoring recommended in patient who have electrolyte abnormalities, congestive heart failure (CHF) or bradycardia arrhythmias, or who are also receiving other medications that cause QT prolongation.
105
Q

Oral Glucose

  • generic name
  • trade name
  • class
A

Generic name:
- Oral glucose

Trade name:
-Glutose®, Insta-Glucose®

Classification
-Carbohydrate, monosaccharide

106
Q

Oral Glucose

-MOA

A

Provides prompt increase in circulating blood sugar

107
Q

Oral Glucose

  • indications
  • contraindications
A

Indications
-Hypoglycemia

Contraindications
-Hyperglycemia

108
Q

Oral Glucose

  • precautions
  • side effects
A

Precautions
-If patient has decreased level of consciousness, patient must be placed on side and glucose applied buccally

Side Effects
-Nausea and vomiting

109
Q

Oral Glucose

  • route
  • dose
  • pharmacokinetics
A

Route
-PO

Dose
-15–45 g

Pharmacokinetics

  • Onset: Immediate
  • Peak effects: Varies
  • Duration: Varies
110
Q

Oral Glucose

  • how supplied
  • special considerations
A

How Supplied
-In tubes and tablets of varying concentrations

Special Considerations
-Always ensure that a blood glucose reading is obtained before administration

111
Q

oxygen

  • trade name
  • class
A

Trade name:
-Oxygen

Classification
-Gas

112
Q

oxygen

-MOA

A

Reverses hypoxemia, necessary for cellular metabolism

113
Q

oxygen

  • indications
  • contraindications
A

Indications
-Hypoxia, signs of inadequate tissue perfusion

Contraindications
-None

114
Q

oxygen

  • precautions
  • side effects
A

Precautions
-Chronic obstructive pulmonary disease (COPD)

Side Effects
-Drying of mucus membranes

115
Q

oxygen

  • route
  • dose
  • pharmacokinetics
A

Route
-Inhalation

Dose
-2–15 lpm (titrate to effect)

Pharmacokinetics

  • Onset: Immediate
  • Duration: Less than 2 min
116
Q

oxygen

  • how supplied
  • special considerations
A

How Supplied
-Oxygen cylinders containing 100% compressed gas

Special Considerations
-Humidify if using for long periods of time

117
Q

Methoxyflurane (Penthrox®)

  • generic name
  • trade name
  • class
A

Generic name:
-Methoxyflurane

Trade name: 
-Penthrox®

Classification
Analgesic gas -

118
Q

Methoxyflurane (Penthrox®)

-MOA

A

Active ingredient is methoxyflurane, works by decreasing the CNS and making patients less responsive to pain.

Research is unsure how this drug effects the CNS.

119
Q

Methoxyflurane (Penthrox®)

  • indications
  • contraindications
A

Indications
-Moderate to severe pain related to trauma

Contraindications

  • Inadequate understanding/patient cooperation
  • Decreased level of consciousness
  • Psychosis
  • Pre-eclampsia
  • Moderate to severe renal and/or liver impairment
  • Hypersensitivity/ family history of malignant hyperpyrexia without negative personal test
  • Significant cardiovascular compromise
  • Raised intracranial pressure
120
Q

Methoxyflurane (Penthrox®)

  • precautions
  • side effects
A

Precautions

  • Used with care in patients with underlying hepatic conditions
  • Previous exposure to halogenated hydrocarbon anesthetic (methoxyflurane when used as an anesthetic agent) especially if the interval is less than 3 months. 
  • May increase the potential for hepatic injury.

Side Effects

  • Altered level of consciousness
  • Cough
121
Q

Methoxyflurane (Penthrox®)

  • route
  • dose
  • pharmacokinetics
A

Route
-Inhalation

Dose

  • Self-administered
  • One bottle containing 3 mL of Penthrox® to be vaporized is a supplied inhaler
  • Maximum dose is 6 mL in a 48-hour period

Pharmacokinetics

  • Onset 1 to 3 minutes
  • Duration 1 hour
  • Half-life unavailable
122
Q

Methoxyflurane (Penthrox®)

  • how supplied SKIP FOR NOW
  • special notes
A

How Supplied
-Bottle containing 3 mL Penthrox®

Special Notes
-When disposing Penthrox®, the inhaler and medication is to be placed in plastic bags provided, sealed and disposed

123
Q

Salbutamol

  • generic name
  • trade name
  • class
A

Generic name:
-Salbutamol

Trade name:
-Ventolin®

Classification
-Bronchodilator

124
Q

Salbutamol

- MOA

A
  • Beta adrenergic agonist.

- Predominant Beta 2 effects: relax bronchiole smooth muscle and cause bronchodilation

125
Q

Salbutamol

  • indications
  • contraindications
A

Indications
-Bronchospasms due to exacerbation of Chronic Obstructive Pulmonary Disease (COPD) and Asthma

Contraindications
-Hypersensitivity, symptomatic tachycardia

126
Q

Salbutamol

  • precautions
  • side effects
A

Precautions
-Caution with cardiac patients

Side Effects

  • Palpitations, tachycardia, increased blood pressure, anxiety
  • Headache, dizziness
  • Sweating, trembling
127
Q

Salbutamol

  • route
  • dose
  • pharmacokinetics
A

Route
-Inhalation

Dose

  • Adult: 2.5–5 mg
  • Pediatric: 1.25–2.5 mg with 2–4 mL of NaCl

Pharmacokinetics

  • Onset: 5–15 min
  • Peak effects: 30 min–2 hours
  • Duration: 3–4 hours
128
Q

Salbutamol

  • how supplied SKIP FOR NOW
  • special considerations
A

How Supplied

  • Metered dose inhaler: 100 mcg/ metered spray
  • Nebules: 2.5 mg/2.5 mL

Special Considerations
-Monitor blood pressure, pulse and electrocardiogram (ECG)

Pharmacology and Fluid Therapy (12 decks)

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