Drug Monographs Flashcards
What are the 6 “Rights” Of medication administration?
- Right patient
- Right dose
- Right route
- Right medication
- Right time (in the call)
- right documentation
+Expiry date!
What class of drug is acetaminophen? When are you indicated to give it?
It is an analgesic (and antipyretic, but not for us). We give for relief of mild to moderate pain.
What findings (if any) would contraindicate the administration of acetaminophen?
- Hypersensitivity to acetaminophen
- Severe alcoholic hepatitis or liver dysfunction with active alcohol consumption
- Acute liver injury
- Acetaminophen-induced liver disease
What dosage of acetaminophen would you administer to an adult patient with moderate pain? How often can you repeat this dose?
500-1000mg PO, Q4H.
What class of drug is acetylsalicylic acid (ASA)? When are you indicated to give it?
It is an antiplatelet and an antithrombotic. We give it for chest pain or signs and symptoms consistent with cardiac ischemia.
What findings (if any) would contraindicate the administration of ASA?
- Hypersensitivity to ASA or NSAIDs
- Active or recent bleeding
- Pediatric patients with signs and symptoms of viral illness
What dosage of ASA would you administer to an adult patient with chest pain?
162mg PO chewed and swallowed.
When are you indicated to give Dextrose (D10W)?
Suspected or known hypoglycemia.
What findings (if any) would contraindicate the administration of dextrose to a patient?
None! As long as you’re indicated you can give it.
What dosage of dextrose (D10W) would you administer to an adult patient with known hypoglycemia?
10-25g IV (equivalent to 100-250 mL of D10W solution).
What class of drug is dimenhydrinate? When are you indicated to give it?
It is an antiemetic, antihistamine, anticholinergic, and antivertigo medication. Indicated for the relief of moderate to severe nausea and vomiting.
What findings (if any) would contraindicate the administration of dimenhydrinate?
Known sensitivity to dimenhydrinate, diphenhydramine, or caffeine derivatives.
What dosage of dimenhydrinate would you administer to an adult patient to control nausea/vomiting? What about for the elderly?
25-50mg IV/IM. 12.5mg IV/IM in the elderly. Give IM dose as direct injection over 2 minutes. IV dose gets diluted in 9mL saline.
What class of drug is epinephrine? When are you indicated to give it?
It is a catecholamine and a sympathomimetic CNS stimulant. Indicated for anaphylaxis, severe bronchospasm, and severe croup.
What findings (if any) would contraindicate the administration of epinephrine?
None. Never contraindicated for life-threatening airway compromise.
What dosage of epinephrine would you administer to an adult patient with severe bronchospasm? How often can you repeat this?
0.5mg IM. Repeat every 5-20 minutes up to 3 times total. Additional doses require CliniCall consultation.
What class of drug is glucagon? When are you indicated to give it?
It is a pancreatic hormone and insulin antagonist. Indicated for hypoglycemia when IV access is unavailable.
What findings (if any) would contraindicate the administration of glucagon?
- Known hypersensitivity
- Pheochromocytoma
What dosage of glucagon would you administer to an adult patient experiencing hypoglycemia?
1mg IM.
What class of drug is ibuprofen? When are you indicated to give it?
It is an analgesic, an antipyretic, and an NSAID. Indicated for the relief of mild to moderate pain.
What findings (if any) would contraindicate the administration of ibuprofen?
- Known hypersensitivity
- Active GI bleeds/ulcers
- Pregnancy
What dosage of ibuprofen would you administer to an adult patient with moderate pain? How often can you give it?
300-400mg PO. Q4-6H
What class of drug is naloxone? When are you indicated to give it?
It is a narcotic antagonist. Indicated when there is respiratory depression as a result of narcotic intoxication.
What findings (if any) would contraindicate the administration of naloxone?
- Known hypersensitivity
- Patient is a neonate
What dosage of naloxone would you give to an adult patient experiencing a narcotic overdose? What if it doesn’t work?
First 0.4mg, then 0.4mg, then 0.8mg, then 2mg. Can be IV or IM, but prefer IV.
What class of drug is nitroglycerin? When are you indicated to give it?
It is an antianginal medication. Indicated for the relief of chest pain suggestive of acute coronary syndrome (angina).
What findings (if any) would contraindicate the administration of nitroglycerin?
- Known hypersensitivity
- Viagra/Levitra used in last 24H
- Cialis used in last 48H
- Anemia
- Pericarditis/Pericardial tamponade
- Documented R-sided MI
- BPS <110 mmHg
- HR<50 or >150 bpm
What dosage of nitroglycerin would you give an adult patient experiencing an angina exacerbation? How often can you repeat this?
0.4mg SL every 3-5 minutes. Must maintain BPS >110 and HR >50 but <150 bpm!
What class of drug is nitrous oxide (entonox)? When are you indicated to give it?
An inhaled anaesthetic. Indicated for moderate to severe pain.
What findings (if any) would contraindicate the administration of nitrous oxide?
- C an comply
- D ecompression sickness
- C onsciousness altered
- P neumothorax
- A ir embolism
- I nhalation injury
- N itro used in last 5 mins
What class of drug is salbutamol? When are you indicated to give it?
It is a bronchodilator and a sympathomimetic CNS stimulant. Indicated for bronchospasm (wheezing).
What findings (if any) would contraindicate the administration of salbutamol?
- Known hypersensitivity
- Tachycardia >150 bpm (hemodynamically significant)
What dosage of salbutamol would you give an adult patient experiencing an asthma exacerbation?
4x100ug MDI. Shake MDI between each. Repeat as required.
What class of drug is tranexamic acid (TXA)? When are you indicated to give it?
It is a hemostatic and antifibrinolytic agent. Indicated for signs of shock/hypoperfusion with injury indicating occult or ongoing hemorrhage.
What findings (if any) would contraindicate the administration of tranexamic acid (TXA)?
- Known hypersensitivity
- GI hemorrhage
- > 3H since injury
- Patient <12 years old
What dosage of tranexamic acid (TXA) would you give an adult patient suffering from internal bleeding?
1g IV (10 mL diluted in 50mL NS) given over 10 minutes.
