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PCP Treatment Guidelines > Drug Monographs > Flashcards

Drug Monographs Flashcards

1
Q

What are the PCP indications for EPINEPHrine?

A

Anaphylaxis
Severe bronchospasm
Severe croup

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2
Q

What are the contraindications of EPINEPHrine?

A

Trick question, there is no absolute contraindications to use in life threatening situations.

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3
Q

What are the adult doses and repeat doses for EPINEPHrine in anaphylaxis?

A

0.5mg IM every 5 minutes, may repeat up to 3 times

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4
Q

What are the adult doses and timing of repeat doses for EPINEPHrine in severe bronchospasm?

A

0.5mg IM every 5-20 minutes
REMEMBER prior to the first dose, you must call CliniCall

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5
Q

What are the pediatric doses and timing of repeat doses for EPINEPHrine in anaphylaxis?

A

0.01mg/kg IM to a maximum of 0.5mg
Every 5 minutes, you may repeat 3 times.

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6
Q

What are the pediatric doses of EPINEPHrine in severe croup?

A

0.5mg/kg to a maximum of 5mg.
Total vomune of fluid in nedulizer mask should be 5mL
CliniCall is required.

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7
Q

What are the pediatric doses and timing of repeat dose for EPINEPHrine in severe bronchospasm?

A

0.01mg/kg IM to a maximum of 0.5mg
NO repeat
CliniCall is required.

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8
Q

What are the indications for DimenhyDRINATE (Gravol)?

A

Prevention and control of nausea caused by notion sickness.
Relied of moderate to severe nausea and vomiting.

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9
Q

What are the contraindications for DimenhyDRINATE (Gravol)?

A

Known sensitivity to DimenhyDRINATE, DiphenhyDRAMINE (benadryl ) or caffeine derivatives.
Children under 12 years of age

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10
Q

What are the doses and repeat dose time for DimenhyDRINATE (Gravol) for adults?

A

25-50mg IV/IM
12.5 IV/IM for elderly or frail patients

Repeating every 4-6 hours if required.

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11
Q

What is the appropriate way to administer IV DimenhyDRINATE (Gravol)

A

IV dose should be diluted with saline and administered at a rate of 25mg/minute.

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12
Q

What is the pediatric dose and repeat dose times for DimenhyDRINATE (Gravol)?

A

Not authorized for patients under 12 years of age.

1.25mg/kg IV/IM with a maximum of 25mg.

Repeating every 4-6 hours if required

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13
Q

What are the side effects of DimenhyDRINATE (Gravol)

A

Drowsiness and dizziness
Most side effects are dose related

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14
Q

What is the indication of Naloxone

A

Reversal of respiratory depression caused by suspected narcotic intoxication

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15
Q

What are the different adult doses of Naloxone and timing between each one?

A

IM/IV every 3 minutes, to a max of 4 doses before calling CliniCall for more.

First dose: 0.4 mg IM
Second dose: 0.4 mg IM if required
Third dose: 0.8 mg IM if required
Fourth dose: 2 mg IM if required

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16
Q

What is the pediatric dosing and time between doses for naloxone?

A

0.1 mg/kg (to maximum of 2 mg per dose); repeat every 3 minutes; maximum 4 doses

Do NOT administer to neonates.

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17
Q

What are the contraindications for Naloxone?

A

Allergy or known hypersensitivity to naloxone
Neonates

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18
Q

What are the adverse effects of Naloxone?

A

Sudden reversal of narcotic intoxication may provoke combativeness
May produce withdrawal signs and symptoms
Hypotension or hypertension
Nausea and vomiting, sweating, tachycardia

Dose appropriately and oxygenate prior to administration to reduce adverse effects.

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19
Q

What are the PCP indications for Salbutamol?

A

Bronchospasm

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20
Q

What are the contraindications for Salbutamol?

A

Known hypersensitivity to salbutamol
Hemodynamically significant tachycardia

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21
Q

What are the adult dosages and repeat rules for Salbutamol?

A

4 x 100 mcg via metered dose inhaler; repeat as required

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22
Q

What are the pediatric dosages and repeat rules for Salbutamol?

A

Via metered dose inhaler
< 10 kg: not indicated

10-20 kg: 5 x 100 mcg per course; may repeat up to 3 times

> 20 kg: 10 x 100 mcg per course; may repeat up to 3 times

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23
Q

What are the PCP indications for Acetaminophen?

A

mild to moderate pain
pyrexia (Fever)

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24
Q

What is the pediatric dose and maximum daily limit for Acetaminophen?

A

< 30 kg: 15 mg/kg PO (use liquid preparation)

30-50 kg: 500 mg PO (may use liquid preparation or tablets, depending on patient ability)

> 50 kg: 500-1,000 mg PO
May repeat once after 4 hours
24-hour maximum: 75 mg/kg or 1 g (1,000 mg)

Do not exceed 5 doses in 24-hours in patients < 12 years of age

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25
What is the adult dose and maximum daily limit for Acetaminophen?
500-1,000 mg PO (specifically, 15 mg/kg to a maximum of 1,000 mg) May repeat once after 4 hours 24-hour maximum: 3 g (3,000 mg) In patients with suspected or known liver dysfunction (e.g., advanced chronic liver disease or cirrhosis), the 24-hour maximum should be lowered to 1-2 g (1,000 mg - 2,000 mg) May be used concurrently with ibuprofen for analgesia
26
What are the contraindications for Acetaminophen?
Hypersensitivity to acetaminophen or any component of the formulation Severe alcoholic hepatitis or liver dysfunction with active alcohol consumption Acute liver injury Acetaminophen-induced liver disease
27
What are the indications for Ibuprofen?
Mild to moderate pain
28
What is the adult dose for Ibuprofen?
300-400 mg PO; may repeat every 4-6 hours; maximum daily dose 1,200 mg/day
29
What are the contraindications for Ibuprofen?
Hypersensitivity to ibuprofen or other nonsteroidal anti-inflammatory drugs Active GI hemorrhage or ulcers Pregnancy (first, second, or third trimesters)
30
What is the pediatric dose of Ibuprofen?
10 mg/kg PO; may repeat once after 6 hours; maximum daily dose 40 mg/kg/day
31
What is the indication for Methoxyflurane (Penthrox)?
Self-administered relief from moderate to severe pain in conscious, hemodynamically stable patients
32
What are the contraindication for Methoxyflurane (Penthrox)?
CHECK mnemonic Cardiac instability or respiratory depression Hypersensitivity Established diagnosis of malignant hyperthermia Consciousness (i.e., altered level of consciousness) Kidneys -- signs of kidney failure or renal impairment Anybody under the age of 18
33
What is the adult dose and maximum dose allowed for Methoxyflurane (Penthrox)?
3 mL self-administered via inhaler; may repeat after 20 minutes; maximum total volume 6 mL Maximum 15ml/week
34
What are the adverse effects of Methoxyflurane (Penthrox)?
Altered level of consciousness (mainly drowsiness) Cough: pause use for persistent coughing Discomfort: methoxyflurane has a reported pungent odor/taste. Coach the patient to take slow initial breaths to get used to the odor/taste. Hypotension and bradycardia (rare) Nausea and/or vomiting Susceptibility or suggestibility with decreased inhibition Discontinue use if any occur and treat accordingly
35
What are the indications for Nitrous Oxide (Entonox)?
Self-administered relief from moderate to severe pain
36
What are the contraindications for Nitrous Oxide (Entonox)?
Consider the use of the mnemonic CDCPAIN: Ability to Comply Decompression sickness Altered level of Consciousness Pneumothorax Air embolism Inhalation injury Nitroglycerin use within five minutes
37
What are the adult and pediatric dose for Nitrous Oxide (Entonox)?
Self-administered to effect
38
What are the adverse effects of Nitrous Oxide (Entonox)?
Lightheadedness, dizziness, numbness in lips, sedation, drowsiness, disorientation Nausea and/or vomiting Discontinue use if any occur and treat accordingly
39
What are the indications for Tranexamic Acid?
Signs of shock or hypoperfusion in : -association with an injury suggestive of occult or ongoing hemorrhage -maternal vaginal bleeding >20 weeks or postpartum hemorrhage
40
What are the contraindications for Tranexamic Acid?
Hypersensitivity to tranexamic acid Gastrointestinal hemorrhage Time since injury to administration > 3 hours Age < 12 years (PCP) or < 1 year (ACP)
41
What is the adult dose of Tranexamic Acid?
2 g IV push over 1 minute with a CliniCall prior to administration.
42
What is the pediatric dose for Tranexamic Acid in pediatrics over 12 years of age.
< 12 years of age: 15 mg/kg IV push over 1 minute
43
What is the adverse effects of Tranexamic Acid
May potentiate hypotension if administered too quickly. Push over 1 minute.
44
What is the indication for D10W?
Suspected or known hypoglycemia
45
What is the adult dose for D10W?
10-25 g IV (equivalent to 100-250 mL of D10W solution)
46
What is the pediatric dose for D10W? (above 12 years of age for IV)
5 mL/kg D10W IV May repeat once
47
What are the indications for oral Glucogel
Known or suspected hypoglycemia in a conscious patient where there is no risk of aspiration or choking
48
What are the doses for oral Glucogel?
15 g glucose PO (equivalent to one 38 g tube or 32 ml pouch) Repeat at 5 minutes as necessary NO limit for Adults, 30g Glucose max for pediatrics
49
What are the indications for Glucagon?
Confirmed hypoglycemia where patient mentation is unable to safely support administration of oral glucose Suspected or confirmed hypoglycemia where IV access is unavailable
50
What are the contraindications for glucagon?
Hypersensitivity Pheochromocytoma
51
What is the adult dose for Glucagon?
1 mg IM, No repeat
52
What is the pediatric dose for glucagon?
If < 25 kg: 0.5 mg IM/SC If ≥ 25 kg: 1 mg IM/SC
53
What is the indication for ASA?
Chest pain or signs and symptoms consistent with cardiac ischemia
54
What are the contraindications for ASA?
Hypersensitivity to ASA or drug components Patients who have experienced bronchospasm or other respiratory reaction precipitated by ASA or nonsteroidal anti-inflammatory drugs Active or recent bleeding of any kind, including head injury or peptic ulcer disease Pediatric patients with signs and symptoms consistent with viral illnesses (due to Reye's Syndrome)
55
What is the pediatric dose and considerations for ASA?
CliniCall consultation required prior to pediatric administration. Chest pain in children is unlikely to be the result of ischemia; ASA is therefore not indicated unless there are rare, specific histories of disease.
56
What is the Adult dose for ASA?
162 mg PO chewed and swallowed
57
What is the indication for Nitroglycerin?
Relief from chest pain suggestive of acute coronary syndrome
58
What are the contraindications of Nitroglycerin?
Known allergy or hypersensitivity Use of Viagra (sildenafil) or Levitra (vardenafil) within the previous 24 hours Use of Cialis (tadalafil) within the previous 48 hours Hypotension or uncorrected hypovolemia Systolic blood pressure < 110 mmHg - for EMRs and PCPs Heart Rate <50 or >150 - for EMRs and PCPs Severe anemia Restrictive pericarditis or pericardial tamponade Documented right sided acute myocardial infarction Pediatrics
59
What is the adult dose for Nitroglycerin?
0.4 mg SL every 3-5 minutes Verify systolic blood pressure prior to administering each dose; systolic blood pressure must be ≥ 110 mmHg and heart rate must be between 50 and 150 beats/minute CliniCall consultation required prior to administration if the patient has no prior prescription for nitroglycerin or if more than 3 doses are required.
60
When do we need to call Clinical with Nitroglycerin?
CliniCall consultation required prior to administration if the patient has no prior prescription for nitroglycerin or if more than 3 doses are required.
61
What are the adverse effects of Nitroglycerin?
Hypotension (including in yourself if you're in an enclosed environment) Headache Nausea

PCP Treatment Guidelines (1 decks)

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