Drug Class/Actions & OPD

Question 1

Ipratropium Bromide (Atrovent)

Answer 1

Class:
Bronchodilator: Anticholinergic
Action:
-Antagonizes action of acetylcholine, preventing interaction of acetylcholine with muscarinic receptors in bronchial smooth muscle causing bronchodilation
-Dries respiratory tract secretions

ONSET= within 15-30 min PEAK= 1-2 hours DURATION= 4-5 hours

Question 2

Fentanyl Citrate

Answer 2

Class:
Analgesic; Opioid Agonist
Action:
-Potent narcotic analgesic and sedative

ONSET= < 1-2 min DURATION= 30-60 min

Question 3

Epinephrine “Push Dose”

Answer 3

Class:
Catecholamine: Sympothomimetic (both alpha and beta effects)
Action: “on the bph, hcava”
-On the bronchi: Bronchodilation (beta-2)
-On the peripheral vasculature: Vasocontriction (alpha)
-On the heart: “increased HCAVA”
Increased heart rate (beta-1) / Chronotropic
Increased Contractility / Inotropic
Increased AV conduction / Dromotropic
Increased automaticity / Dromotropic

ONSET= IV/IO 1-2 min DURATION= IV/IO 5-10 min

Question 4

Dextrose / Glucose (50%, D50 / 10%, D10, D10W)

Answer 4

Class:
Carbohydrate
Action:
-Increases blood glucose by providing a quick release of free sugar into the circulation

ONSET= 1 min DURATION= depends on degree of hypoglycemia

Question 5

Diphenhydramine (Benadryl)

Answer 5

Class:
Antihistamine
Action:
-Binds to histamine receptor sites, blocking H1 and H2 receptors
H1 causes bronchoconstriction, airway swelling and vasodilation
H2 causes secretion of gastric acid
-Does not prevent histamine release

ONSET= 15-30 min DURATION= 6-12 hours

Question 6

Calcium Chloride (10% CaCl2)

Answer 6

Class:
Electrolyte
Action:
-Increases myocardial contractility
-Enhances ventricular automaticity
-Reverses cardio-electric changes produced by hyperkalemia
-Shifts potassium back into cell to prevent intravascular hyperkalemia

ONSET= 5-15 min DURATION= may persist 4 hours after IV/IO

Question 7

Charcoal (Activated Charcoal)

Answer 7

Class:
Absorbant
Action:
-Binds and absorbs ingested toxins present in the GI tract
-Inhibits intestinal absorption, preventing systemic toxicity

ONSET= Immediate DURATION= 4-12 hours

Question 8

Aspirin, ASA (Acetylsalicylic Acid)

Answer 8

Class:
Platelet Aggregation Inhibitor
Action:
-Inhibits normal tendency for platelets to accumulate inside injured or occluded coronary arteries, thereby improving blood flow through vessels to better perfuse the heart
-Blocks formation of thromboxin A2

ONSET= 15-30 min DURATION= days (antiplatelet effects)

Question 9

Atropine Sulfate

Answer 9

Class:
Antiarrhythmic
Anticholinergic
Action:
-Competes with ACH for receptor sites blocking the PNS response at the SA & AV nodes
-Increases heart rate by increasing electrical conduction through the heart
-Positive chrono properties with little or no inotropic effects
-Inhibits secretions by decreasing PNS effect on the bronchial, salivary, sweat & GI glands

ONSET= IV/IO 2-4 min, IM 10-15 min DURATION= 2-6 hours

Question 10

Glucagon

Answer 10

Class:
Antihypoglycemic: Pancreatic hormone
Action:
-Increases blood glucose by converting glycogen stored in the liver to glucose.
-Inhibits synthesis to glycogen from glucose

ONSET= 20 min DURATION= 60-90 min

Question 11

Ketamine

Answer 11

Class:
Anesthetic / Analgesic
Action:
-Low and slow dosing provides strong analgesic effects acting on the limbic system and cortex to block afferent transmission of impulses associated with pain perception
-High and rapid dosing provides fast acting dissociative anesthesia (blocks sensory perception) which can lead to distortion of sights, sounds, self, colors, and one’s own environment

ONSET= IV 30 sec IN 2 min DURATION= 15-30 min

Question 12

Albuterol (Proventil, Ventolin)

Answer 12

Class:
Bronchodilator: Sympathomimetic (Beta-2 specific)
Action:
-Relaxes bronchial smooth muscles by stimulating beta-2 adrenergic receptors
-Produces bronchodilation, relieves bronchospasm, and reduces airway resistance

ONSET= 5 min PEAK= 1 hour DURATION= up to 5 hours

Question 13

Amiodarone Hydrochloride

Answer 13

Class:
Antiarrhythmic
Action:
-Blocks sodium, potassium and calcium channels in cardiac cells slowing conduction and prolongs repolarization
-Has alpha and beta adrenergic blocking properties causing negative inotropic effects and reduces peripheral vascular resistance (afterload)

ONSET= minutes DURATION= days

Question 14

Acetaminophen

Answer 14

Class:
Analgesic
Action:
-Inhibits synthesis of prostaglandins in the CNS which transmit pain signals. Reduces pain by blocking these signals. Reduces pain by blocking these signals centrally & peripherally

ONSET= 15 min PEAK= 1 hour DURATION= up to 4 to 6 hours

Question 15

Adenosine (adenocard)

Answer 15

Class:
Antiarrhythmic
Action:
-Slows electrical conduction through AV node, and interrupts re-entry pathway, converting SVT to NSR

ONSET= within 30 sec. DURATION= 1-2 min

Question 16

Ondansetron (Zofran)

Answer 16

Class:
Antiemetic
Action:
-Blocks serotonin receptors in vagus nerve terminals and in small intestine that trigger the vomiting reflex

ONSET= IV/IM, & ODT up to 30 min DURATION= IV/IM & ODT 2 hours

Question 17

Tranexemic Acid (TXA, Cyklokapron, Lysteda)

Answer 17

Class:
Antifibronolytic
Action:
-Prevents clot breakdown: By blocking plasminogen from being converted to plasmin.
This is the opposite action of TPA
-Increases fibrin formation: resulting in clot preservation and continued hemostasis

ONSET= IV/IO 5-15 minutes DURATION= IV/IO 3 hours

Question 18

Sodium Bicarbonate

Answer 18

Class:
Electrolyte
Alkalinizing agent
Action:
-Reduces acidosis or causes alkalosis by direct release of bicarbonate ion into the circulation

ONSET= 2-10 minutes DURATION= 30-60 minutes

Question 19

Naloxone (Narcan)

Answer 19

Class:
Opioid Antagonist
Action:
-Reverses respiratory depression, sedation and hypotensive effects of opioid overdose by occupying opiate receptor sites

ONSET= IV/IN 1-2 min, IM 2-5 min DURATION= IV 30-60 min, IM longer

Question 20

Nitroglycerin

Answer 20

Class:
Vasodilator
Action:
-Produces vasodilation by relaxing systemic venous & arterial vessels, thereby:
-Decreasing preload & afterload
-Decreasing myocardial workload and
-Decreasing myocardial O2 consumption
-Dilates coronary arteries

ONSET= 2 min DURATION= 30-60 minutes

Question 21

Morphine sulphate

Answer 21

Class:
Opioid
Narcotic Analgesic
Action:
-CNS depressant acting on opiate receptors in the brain
-Potent analgesic and sedative

ONSET= 1-2 minutes DURATION= 2-7 hours

Question 22

Midazolam (Versed)

Answer 22

Class:
Benzodiazepine: Sedative / Anticonvulsant
Action:
-CNS depressant
-Produces anterograde amnesia, then sedation
-Stops and prevents seizures

ONSET= IV/IO/IN 2 min IM 15 min DURATION= 1-4 hours

Question 23

Lidocaine (2% Xylocaine)

Answer 23

Class:
Antiarrhythmic / Anesthetic
Action:
-Depresses depolarization and automaticity in the ventricles
-Increases the ventricular fibrillation threshold by increasing phase IV repolarization
-Amide-type local anesthetic

ONSET= 1-2 min DURATION= 10-20 minutes

Question 24

Epinephrine (Adrenalin, Epi)

Answer 24

Class:
Catecholamine: Sympothomimetic (both alpha and beta effects)
Action: “on the bph, hcava”
-On the bronchi: Bronchodilation (beta-2)
-On the peripheral vasculature: Vasocontriction (alpha)
-On the heart: “increased HCAVA”
Increased heart rate (beta-1) / Chronotropic
Increased Contractility / Inotropic
Increased AV conduction / Dromotropic
Increased automaticity / Dromotropic

ONSET= IV/IO 1-2 min, IM 5-10 min DURATION= IV/IO 5-10 min, IM 1-4 hours