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Paramedic > Drug Quiz 3 > Flashcards

Drug Quiz 3 Flashcards

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1
Q

Nitroglycerin

A

Nitrostat

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2
Q

Nitroglycerin Mechanism of Action

A

Nitroglycein is a pro-drug which must be de-nitrated to form the active metabolite nitric oxide (NO). Then, NO activates the conversion of GTP->cGMP +2Pi in vascular smooth muscle cells (VSMC). cGMP activates a cascade of reactions that cause a reduction in intracellular Ca2+, VSMC relaxation (in arterioles and decreased cardiac preload and afterload

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3
Q

Nitroglycerin Pharmacokinetics

A

Onset of Action=1-3 minutes SL, 30 minutes topical
Peak Effects=5-10 minutes SL, varies topical
Duration of Effect=20-30 minutes SL, 3-6 hours topical
Half-Life=1-4 minutes

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4
Q

Nitroglycerin Indications/Field Use

A

1) Chest pain associated with angina or MI

2) Acute pulmonary edema/CHF

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5
Q

Nitroglycerin Contraindications

A

1) Shock, hypotension
2) Increased ICP
3) Children under 12
4) ED drugs within 48 hours

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6
Q

Nitroglycerin Side Effects/Adverse Reactions

A

HA, dizziness, weakness, tachycardia, hypotension, rash, dry mouth, N+V

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7
Q

Nitroglycerin Dose

A

Spray (Adult): 0.4mg SL q3-5min until effect achieved or BP drops (max 3x25min)
Paste (Adult): 0.5-1 inch topical
Tablet (Adult): 0.4mg SL

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8
Q

Nitroglycerin Precautions

A

1) Monitor vitals
2) Expect HA from cerebral vasodilation
3) routine use may cause tolerance
4) 12-lead ECG prior to administration-use extreme caution if R-side MI

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9
Q

Nitroglycerin Drug-Drug Interactions

A

1) Orthostatic hypotension with B-blockers

2) Severe hypotension with alcohol

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10
Q

Oxygen Drug Classification

A

Gas

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11
Q

Nitroglycerin Drug Classification

A

Vasodilator/Nitrate

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12
Q

Oxygen Mechanism of Action

A

Enters body via Respiratory system, transported to cells by hemoglobin, required for efficient breakdown of glucose into usable energy

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13
Q

Oxygen Pharmacokinetics

A

Onset of Action=Immediate
Peak Effects=<2min inhaled
Half-Life=N/A

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14
Q

Oxygen Indications/Field Use

A

1) Hypoxia
2) Difficulty Breathing
3) SPO2<94%

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15
Q

Oxygen Contraindications

A

1) ROSC post cardiac arrest with SPO2 >94%

2) Chest pain, acute MI, suspected cellular injury and death with SPO2>94%

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16
Q

Oxygen Side Effects/Adverse Reactions

A

Free Radical formation in the presence of injured tissues, causing secondary cell death

17
Q

Oxygen dose

A

(Adult): 2-6L NC, 12-15 NRB, 15L BVM
CPAP/Vent (Adult): Varies by O2 demand to meet cmH2O requirement
(Pedi): 2-6L NC, 10-15L NRB, 15L BVM

18
Q

Oxygen Precautions

A

1) Avoid heperoxia

2) high concentrations to neonates can cause eye damage

19
Q

Oxygen Drug-Drug Interactions

A

None EMS

20
Q

Furosemide

A

Lasix

21
Q

Furosemide Drug Classification

A

Loop Diuretic

22
Q

Furosemide Mechanism of Action

A

Furosemide reversibly binds to chloride binding site on NA+/2Cl-/K+ cotransporter found on the luminal surface of the thick ascending limb of the loop of Henle->inhibits sodium and chloride reabsorption in the kidneys, thus impacting the osmotic gradient and reducing water reabsorption in the descending limb; causes venous dilation and subsequently reduces preload

23
Q

Furosemide Pharmacokinetics

A

Onset of Action=5-10 minutes vasodilation, 5-30 minutes diuresis
Peak Effects=30 minutes vasodilation, 20-60 minutes diuresis
Duration of Effect= 2 hours vasodilation, 6 hours diuresis
Half-Life=30 minutes

24
Q

Furosemide Indications/Field Use

A

1) CHF

2) Pulmonary Edema

25
Q

Furosemide Contraindications

A

1) Caution with sulfa allergies
2) Caution with renal failure]
3) Pregnancy unless life threatening

26
Q

Furosemide Side Effects/Adverse Reactions

A

HA, dizziness, hypotension, volume depletion, potassium depletion, dysrhythmias, diarrhea, N+V

27
Q

Furosemide Dose

A

(Adult): 40mg slow IV, IO; if Pt takes Lasix daily incl. today, give their dose, if Pt takes Lasix but didn;t today, double their dose
(Pedi): 0.5-1mg/kg slow IVP (not for children under 12)

28
Q

Furosemide Precautions

A

1) Note LS and BP before and after
2) Protect from Light
3) May cause dehydration

29
Q

Furosemide Drug-Drug Interactions

A

1) May cause additive effects and/or electrolyte imbalance if given with other diuretic
2) NSAIDS may antagonize effects of Lasix

30
Q

Epinephrine

A

Adrenalin, EpiPen, EpiPen Jr.

31
Q

Epinephrine Drug Classification

A

1) alpha 1 agonist->peripheral vasoconstriction, increases SVR and BP
2) beta 1 agonist->positive inotropy, chronotropy, dromotropy
3) beta 2 agonist-> bronchodilation
4) Blocks destruction of MAST cells (which release Histamine) in anaphylaxis

32
Q

Epinephrine Pharmacokinetics

A

Onset of Action= < 2 minutes IV, 3-10 minutes IM
Peak Effects= < 5 minutes IV, 20 minutes IM
Duration of Effect= 5-10 minutes IV, 20-30 minutes IM
Half-Life= 5 minutes IV

33
Q

Epinephrine Indications/Field Use

A

1) Cardiac arrest
2) Anaphylaxis/Severe reactive airway disease/asthma
3) Symptomatic bradycardia/hypotension

34
Q

Epinephrine Contraindications

A

1) HTN and tachydysrhythmias

2) use caution with pregnancy and CAD

35
Q

Epinephrine Side Effects/Adverse Reactions

A

Anxiety, HA, dysrhythmias, tremulousness, dizziness, N+V, Leads to increased myocardial oxygen demand

36
Q

Epinephrine Dose

A

Cardiac arrest (Adult): 0.5-1mg IV, IO (1:10,000) q3-5 min
Bradycardia/Hypotension (Adult): 2-10 ug/min
Anaphylaxis/Asthma (Adult): 0.3-0.5mg IM, SC (1:1000), then 0.1mg (1:10,000) slow IV, IO over 3 minutes
Cardiac arrest (Pedi): 0.01mg/kg IV, IO (1:10,000) q3-5 min
Anaphylaxis/Asthma (Pedi): 0.01 mg/kg IM, SC (1:1000), then 0.01mg/kg (1:10,000), max dose 0.3mg, slow IV,IO

37
Q

Epinephrine Precautions

A

Should be protected from light

38
Q

Epinephrine Drug-Drug Interactions

A

1) pH dependent, deactivated by alkaline solutions
2) effect intensified with pts taking antidepressants
3) reacts with CaCl2 and NaHCO3 to form PPT (in IV tubing)

Paramedic (10 decks)

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