Drug Profiles

Question 1

Abciximab (RePro) Action:

Answer 1

Prevents the aggregation of platelets by inhibiting the integrin GP IIb/IIIa receptor

Question 2

Abciximab (RePro) Indications:

Answer 2

UA/NSTEMI patients undergoing planned or emergent PCI

Question 3

Abciximab (RePro) Adverse Effects:

Answer 3

Bleeding from the GI tract, internal bleeding, intracranial hemorrhage, hypotension, stroke, anaphylactic shock

Question 4

Abciximab (RePro) Contraindications:

Answer 4

Bleeding from any source, severe uncontrolled hypertension, surgery or trauma within the previous 6 weeks, stroke within the previous 30 days, renal failure, thrombocytopenia, intracranial mass

Question 5

Abciximab (RePro) Dosage:

Answer 5

UA/NSTEMI with Planned PCl within 24 hours:
* 0.25 mg/kg/ IV, IO (10 to 60 minutes prior to procedure), then 0.125 mcg/kg/min IV, IO infusion for 12 to 24 hours.
Percutaneous Coronary Intervention Only:
* 0.25 mg/kg IV, IO, then 10 mcg/min IV, IO infusion

Question 6

Abciximab (RePro) Special Considerations:

Answer 6

Pregnancy class C

Question 7

Activated Charcoal Classification:

Answer 7

Antidote, adsorbent

Question 8

Activated Charcoal Action:

Answer 8

When certain chemicals and toxins are in proximity to the activated charcoal, the chemical will attach to the surface of the charcoal and become trapped.

Question 9

Activated Charcoal Indications:

Answer 9

Toxic ingestion

Question 10

Activated Charcoal Adverse Effects:

Answer 10

Nausea/vomiting, constipation, or diarrhea. If aspirated nto the lungs, charcoal can induce a potentially fatal form of pneumonitis

Question 11

Activated Charcoal Contraindications:

Answer 11

Ingestion of acids, alkalis, ethanol, methanol, cyanide, ferrous sulfate or other iron salts, lithium; coma; GI obstruction

Question 12

Activated Charcoal Dosage:

Answer 12

Adult: 50 to 100 g/dose
Pediatric: 1 to 2 g/kg

Question 13

Activated Charcoal Special Considerations:

Answer 13

Pregnancy Class C

Question 14

Adenosine (Adenocard) Classification:

Answer 14

Antiarrhythmic

Question 15

Adenosine (Adenocard) Action:

Answer 15

Slows the conduction of electrical impulses at the AV node

Question 16

Adenosine (Adenocard) Indications:

Answer 16

Stable narrow-QRS regular tachycardias; unstable narrow-QRS regular tachycardia while preparations are made for synchromized cardioversion; and stable, regular, wide-QRS tachycardia

Question 17

Adenosine (Adenocard) Adverse Effects:

Answer 17

Common adverse reactions are generally mild and short lived: sense of impending doom, complaints of flushing, chest pressure, throat tightne, numbness. Patients will have a brief episode of asystole after administration

Question 18

Adenosine (Adenocard) Contraindications:

Answer 18

Sick sinus syndrome, second- or third-degree heart block, or poison-/drug-induced tachycardia

Question 19

Adenosine (Adenocard) Dosage:

Answer 19

Note: Adenosine should be delivered only by rapid IV bolus with a peripheral IV or directly into a vein in a location as close to the heart as possible, preferably in the antecubital fossa. Administration of adenosine must be immediately followed by a saline flush, and then the extremity should be elevated.

• Adult: Initial dose 6 mg rapid IV, IO (over a 1- to 3-second period) immediately followed by a 20-mL rapid saline flush. If the first dose does not eliminate the rhythm in 1 to 2 minutes, 12 mg rapid IV, IO, repeat a second time if required.
• Pediatric
  
  • Children >50 kg: Same as adult dosage
  • Children /= 5-mL rapid saline flush; may repeat at 0.2 mg/kg (max dose: 12 mg)

Question 20

Adenosine (Adenocard) Special Considerations:

Answer 20

• Use with caution in patients with preexisting bronchospasm and those with a history of AF.
• Elderly patients with no history of PSVT should be carefully evaluated for dehydration and rapid sinus tachycardia requireing volume fluid replacement rather than simply treated with adenosine.
• Pregnancy class C

Question 21

Albumin Classification:

Answer 21

Volume expander, colloid

Question 22

Albumin Action:

Answer 22

Increases oncotic pressure in intravascular space

Question 23

Albumin Indications:

Answer 23

Expand intravascular volume

Question 24

Albumin Adverse Effects:

Answer 24

Allergic reaction in some patients; an excessive volume of fluid can result in CHF and pulmonary edema in susceptible patients

Question 25

Albumin Contraindications:

Answer 25

Severe anemia or cardiac failure in the presence of normal or increased intravascular volume, solution appears turbid or after 4 hours since opening the container, known sensitivity

Question 26

Albumin Dosage:

Answer 26

Two preparations: 500 mL of a 5% solution and 100 mL of a 25% solution

• Adult:
  
  • 5% albumin: 500 to 1000 mL IV, IO
  • 25% albumin: 50 to 200 mL IV, IO
• Pediatric:
  
  • 5% albumin: 12 to 20 mL/kg IV; the initial dose may be repeated in 15 to 30 minutes if the clinical response is inadequate
  • 25% albumin: 2.5 to 5 mL/kg IV, IO
  • Alternatively, one may administer based on grams of albumin at 0.5 to 1 g/kg/dose IV, IO. May repeat as needed (max dose: 6 g/kg/day)

Question 27

Albumin Special Considerations:

Answer 27

• Patients with a history of CHF, cardiac disease, hypertension, and pulmonary edema should be given 5% albumin, or the 25% albumin should be diluted. Because 25% of albumin increases intravascular volume greater than the volume administered, slowly administer 25% albumin in normovolemic patients to prevent complications such as pulmonary edema
• Pregnancy class C