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Drug Quiz 9 Flashcards

0
Q

Diphenhydramine Drug Classification

A

Antihistamine

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1
Q

Diphenhydramine

A

Benadryl

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2
Q

Diphenhydramine Mechanism of Action

A

Nonspecific competetive H1/H2 antagonist-blocks histamine release, suppresses central cholinergic activity and inhibits reuptake and storage of DA, leading to prolonged action of DA and reduction of bronchoconstriction, vasodilation, increased vascular permeability

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3
Q

Diphenhydramine Pharmacokinetics

A

Onset of Action=10-15 min IV, 15-30 min PO
Peak Effects=1-4 hours
Duration of Effect=6-8 hours
Half-Life=1-4 hours

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4
Q

Diphenhydramine Indications/Field Use

A

Allergic reaction
Anaphylaxis
Dystonic reactions due to phenothiazine administration (EPS)

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5
Q

Diphenhydramine Contraindications

A

Hypersensitivity
Asthma
Nursing mothers

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6
Q

Diphenhydramine Side Effects/Adverse Reactions

A 
Sedation
Dries bronchial secretions
Blurred vision
Headache
Palpitations
Dizziness
Drowsiness
Fatigue
Euphoria
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7
Q

Diphenhydramine Dose

A

Adult: 25-50mg IV, IO, IM, PO
Pedi: 1mg/kg IV, IO, IM, PO max dose 50mg

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8
Q

Diphenhydramine Precautions

A

Caution with pts with severe liver disease asthma, narrow angle glaucoma, and BPH
May cause hypotension

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9
Q

Diphenhydramine Drug-Drug Interactions

A

Potentiates sedative effects of alcohol, benzos, narcotics, TCA’s, MAOI’s, furosemide and other anti-HTN’s

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10
Q

Amyl Nitrate Drug Classification

A

Antidote/ Nitrate Vasodilator

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11
Q

Amyl Nitrate Mechanism of Action

A

Short acting vasodilator and SMC relaxant that oxidizes hemoglobin to become methemoglobin, which forms a non-toxic complex with cyanide ion to form cyanomethemoglobin, which can be enzymatically degraded

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12
Q

Amyl Nitrate Pharmacokinetics

A

Onset of Action=10-30 seconds
Peak Effects=30 seconds
Duration of Effect=3-5 minutes
Half-Life=N/A

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13
Q

Amyl Nitrate Indications/ Field Use

A

Cyanide Poisoning

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14
Q

Amyl Nitrate Contraindications

A

None

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15
Q

Amyl Nitrate Side Effects/Adverse Reactions

A 
Headache
Dizziness
Weakness
Flushing
Cold Sweats
Tachycardia
Syncope
Orthostatic Hypotension
N+V
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16
Q

Amyl Nitrate Dose

A

Adult & Pedi: 0.3mL ampule crushed, inhaled over 15-30sec, q 1 min until sodium nitrate infusion is available

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17
Q

Amyl Nitrate Precautions

A

May be a medication of abuse, should be stored in secure place with narcotics
Smells like dirty sweaty socks
Ensure pt is sitting prior to administration, hypotension and syncope may be sudden

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18
Q

Amyl Nitrate Drug-Drug Interactions

A

Hypotension potentiated by antihypertensives, B blockers, and certain antiemetics (phenothiazines)

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19
Q

Activated Charcoal

A

Actidose, Liqui-Char

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20
Q

Activated Charcoal Drug Classification

A

Antidote

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21
Q

Activated Charcoal Mechanism of Action

A

Liquid suspension binds (absorbs) toxic substances, thereby inhibiting their GI absorption, enterohepatic circulation, and bioavailability.
Drug charcoal complex is then excreted by the body

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22
Q

Activated Charcoal Pharmacokinetics

A

Onset of Action=Immediate
Peak Effects=Unknown
Duration of Effect=Unknown
Half-Life=Unknown

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23
Q

Activated Charcoal Indications/Field Use

A

Acute toxic ingestion

24
Activated Charcoal Contraindications
Ingestion of caustic or petroleum based agent (mineral acid, caustic alkali, organic solvent, iron, methanol, ethanol) Poisoning by cyanide
25
Activated Charcoal Side Effects/Adverse Reactions
``` Vomiting Diahrrhea Abdominal cramping Bloating Constipation Black/Tarry stool for several days ```
26
Activated Charcoal Dose
Adult: 1g/kg (30-100g) PO Pedi: 1-2g/kg PO
27
Activated Charcoal Precautions
Best if given within 30 minutes of overdose | Administer PO to conscious pt only, if pt is comatose or intubated, administer through NG tube
28
Activated Charcoal Drug-Drug Interactions
Food or other medications administered concurrently will decrease absorptive capacity of charcoal
29
Albuterol Sulfate
Proventil HFA, ProAir HFA
30
Albuterol Sulfate Drug Classification
Sympathomimetic/ Sympathetic agonist (B2 selective)
31
Albuterol Sulfate Mechanism of Action
B2 agonist - bronchodilation
32
Albuterol Sulfate Pharmacokinetics
Onset of Action=5-15 minutes Peak Effects=1-1.5 hours Duration of Effect=3-6 hours Half-Life=<3 hours
33
Albuterol Sulfate Indications/Field Use
Asthma | Reversible bronchospasm associated with COPD
34
Albuterol Sulfate Contraindications
Symptomatic tachycardia | pts with history of hypersensitivity
35
Albuterol Sulfate Side Effects/Adverse Reactions
``` Anxiety Headache Palpitations Sweating Dizziness Nervousness Tremor HTN Arrhythmia Chest Pain N+V ```
36
Albuterol Sulfate Dose
Adult MDI: 1-2 sprays (90mcg/spray) | Adult & Pedi Neb: 2.5mg in 2.5mL of NS over 5-15 min
37
Albuterol Sulfate Precautions
BP, pulse, and EKG should be monitored use caution with pts with known heart disease or HTN auscultate LS before and after
38
Albuterol Sulfate Drug-Drug Interactions
SE may increase with other sympathetic agonists | B blockers may blunt effects of this drug
39
Epinephrine
Adrenalin, EpiPen, EpiPen Jr.
40
Epinephrine Drug Classification
Sympathomimetic/Sympathetic agonist/Catecholamine
41
Epinephrine Mechanism of Action
Alpha 1 agonist: peripheral vasoconstriction, increases SVR and BP Beta 1 agonist: positive inotropy, chronotropy, dromotropy Beta 2 agonist: bronchodilation Blocks destruction of MAST cells (which release Histamine) in anaphylaxis
42
Epinephrine Pharmacokinetics
Onset of Action=<5 min IV, 20 min IM Duration of Effect=5-10 min IV, 20-30 min IM Half-Life=5 min IV
43
Epinephrine Indications/Field Use
Cardiac arrest Anaphylaxis/Severe reactive airway disease Symptomatic bradycardia/hypotension
44
Epinephrine Contraindications
HTN and tachydysrhythmias | use caution with pregnancy and CAD
45
Epinephrine Side Effects/Adverse Reactions
Anxiety, HA, dysrhythmias, tremulousness, dizziness, N+V, leads to increased myocardial O2 demand
46
Epinephrine Dose
Cardiac arrest (Adult): 0.5-1mg IV, IO 1:10,000 q 3-5 min Bradycardia/Hypotension (Adult): 2-10mcg/min Anaphylaxis/Asthma (Adult): 0.3-0.5mg IM, SC 1:1,000 then 0.1mg 1:10,000 slow IV, IO over 3 min ``` Cardiac arrest (Pedi): 0.01mg/kg IV, IO 1:10,000 q 3-5min Anaphylaxis/Asthma (Pedi): 0.01mg/kg IM, SC 1:1,000, then 0.01 mg/kg slow IV, IO 1:10,000; max dose 0.3mg ```
47
Epinephrine Precautions
Should be protected from light
48
Epinephrine Drug-Drug Interactions
pH dependent, deactivated by alkaline solutions effect intensified with pts taking antidepressants react with CaCl2 and NaHCOe to form PPT in IV tubing
49
Methylprednisolone
Solu-Medrol
50
Methylprednisolone Drug Classification
Corticosteroid/Anti-inflammatory
51
Methylprednisolone Mechanism of Action
Diffuses across cell membrane, binds to DNA, regulates gene expression and increases synthesis of proteins and enzymes that inhibit inflammatory agents (cytokines, interleukin, interferon); inhibits synthesis of pro-inflammatory enzymes. Is an immunosuppressant
52
Methylprednisolone Pharmacokinetics
Onset of Action=2-6 hours Peak Effects=4-8 days Duration of Effect=1-5 weeks Half-Life=3.5 hours
53
Methylprednisolone Indications/Field Use
Severe anaphylaxis, hives Asthma, COPD Spinal cord injury
54
Methylprednisolone Contraindications
None EMS
55
Methylprednisolone Side Effects/Adverse Reactions
Fluid Retention, CHF, HTN, Abdominal distension, Vertigo, HA, Nausea, Malaise, Hiccups
56
Methylprednisolone Dose
Asthma/Anaphylaxis (Adult): 125-250 IV, IO Spinal Cord Injury (Adult): 30mg/kg IV, IO over 15 min, maintenance 5.4mg/kg/hr for 24-48 hours Asthma/Anaphylaxis (Pedi): 2mg/kg IV, IO, IM; mag dose 80 mg
57
Methylprednisolone Precautions
Give only one dose prehospitally LT steroid use can cause GI bleeding Prolonged wound healing Suppression of adrenocortical steroids
58
Methylprednisolone Drug-Drug Interactions
Lasix and thiazide diuretics increase potassium loss | Decreased effect with phenytoin, phenobarbital, and rifampin due to increased metabolism of steroids

Paramedic (10 decks)

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