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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
Q

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

A

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
Q

What are the contraindications for Acetaminophen?

A

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
Q

What are the indications for Ibuprofen?

A

Mild to moderate pain

28
Q

What is the adult dose for Ibuprofen?

A

300-400 mg PO; may repeat every 4-6 hours; maximum daily dose 1,200 mg/day

29
Q

What are the contraindications for Ibuprofen?

A

Hypersensitivity to ibuprofen or other nonsteroidal anti-inflammatory drugs

Active GI hemorrhage or ulcers

Pregnancy (first, second, or third trimesters)

30
Q

What is the pediatric dose of Ibuprofen?

A

10 mg/kg PO; may repeat once after 6 hours; maximum daily dose 40 mg/kg/day

31
Q

What is the indication for Methoxyflurane (Penthrox)?

A

Self-administered relief from moderate to severe pain in conscious, hemodynamically stable patients

32
Q

What are the contraindication for Methoxyflurane (Penthrox)?

A

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
Q

What is the adult dose and maximum dose allowed for Methoxyflurane (Penthrox)?

A

3 mL self-administered via inhaler; may repeat after 20 minutes; maximum total volume 6 mL

Maximum 15ml/week

34
Q

What are the adverse effects of Methoxyflurane (Penthrox)?

A

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
Q

What are the indications for Nitrous Oxide (Entonox)?

A

Self-administered relief from moderate to severe pain

36
Q

What are the contraindications for Nitrous Oxide (Entonox)?

A

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
Q

What are the adult and pediatric dose for Nitrous Oxide (Entonox)?

A

Self-administered to effect

38
Q

What are the adverse effects of Nitrous Oxide (Entonox)?

A

Lightheadedness, dizziness, numbness in lips, sedation, drowsiness, disorientation
Nausea and/or vomiting

Discontinue use if any occur and treat accordingly

39
Q

What are the indications for Tranexamic Acid?

A

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
Q

What are the contraindications for Tranexamic Acid?

A

Hypersensitivity to tranexamic acid
Gastrointestinal hemorrhage
Time since injury to administration > 3 hours
Age < 12 years (PCP) or < 1 year (ACP)

41
Q

What is the adult dose of Tranexamic Acid?

A

2 g IV push over 1 minute with a CliniCall prior to administration.

42
Q

What is the pediatric dose for Tranexamic Acid in pediatrics over 12 years of age.

A

< 12 years of age: 15 mg/kg IV push over 1 minute

43
Q

What is the adverse effects of Tranexamic Acid

A

May potentiate hypotension if administered too quickly. Push over 1 minute.

44
Q

What is the indication for D10W?

A

Suspected or known hypoglycemia

45
Q

What is the adult dose for D10W?

A

10-25 g IV (equivalent to 100-250 mL of D10W solution)

46
Q

What is the pediatric dose for D10W? (above 12 years of age for IV)

A

5 mL/kg D10W IV
May repeat once

47
Q

What are the indications for oral Glucogel

A

Known or suspected hypoglycemia in a conscious patient where there is no risk of aspiration or choking

48
Q

What are the doses for oral Glucogel?

A

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
Q

What are the indications for Glucagon?

A

Confirmed hypoglycemia where patient mentation is unable to safely support administration of oral glucose
Suspected or confirmed hypoglycemia where IV access is unavailable

50
Q

What are the contraindications for glucagon?

A

Hypersensitivity
Pheochromocytoma

51
Q

What is the adult dose for Glucagon?

A

1 mg IM, No repeat

52
Q

What is the pediatric dose for glucagon?

A

If < 25 kg: 0.5 mg IM/SC
If ≥ 25 kg: 1 mg IM/SC

53
Q

What is the indication for ASA?

A

Chest pain or signs and symptoms consistent with cardiac ischemia

54
Q

What are the contraindications for ASA?

A

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
Q

What is the pediatric dose and considerations for ASA?

A

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
Q

What is the Adult dose for ASA?

A

162 mg PO chewed and swallowed

57
Q

What is the indication for Nitroglycerin?

A

Relief from chest pain suggestive of acute coronary syndrome

58
Q

What are the contraindications of Nitroglycerin?

A

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
Q

What is the adult dose for Nitroglycerin?

A

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
Q

When do we need to call Clinical with Nitroglycerin?

A

CliniCall consultation required prior to administration if the patient has no prior prescription for nitroglycerin or if more than 3 doses are required.

61
Q

What are the adverse effects of Nitroglycerin?

A

Hypotension (including in yourself if you’re in an enclosed environment)
Headache
Nausea

PCP Treatment Guidelines (1 decks)

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