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Paramedic > Drug Quiz 9 > Flashcards

Drug Quiz 9 Flashcards

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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
Q

Activated Charcoal Contraindications

A

Ingestion of caustic or petroleum based agent (mineral acid, caustic alkali, organic solvent, iron, methanol, ethanol)
Poisoning by cyanide

25
Q

Activated Charcoal Side Effects/Adverse Reactions

A 
Vomiting
Diahrrhea
Abdominal cramping
Bloating
Constipation
Black/Tarry stool for several days
26
Q

Activated Charcoal Dose

A

Adult: 1g/kg (30-100g) PO
Pedi: 1-2g/kg PO

27
Q

Activated Charcoal Precautions

A

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
Q

Activated Charcoal Drug-Drug Interactions

A

Food or other medications administered concurrently will decrease absorptive capacity of charcoal

29
Q

Albuterol Sulfate

A

Proventil HFA, ProAir HFA

30
Q

Albuterol Sulfate Drug Classification

A

Sympathomimetic/ Sympathetic agonist (B2 selective)

31
Q

Albuterol Sulfate Mechanism of Action

A

B2 agonist - bronchodilation

32
Q

Albuterol Sulfate Pharmacokinetics

A

Onset of Action=5-15 minutes
Peak Effects=1-1.5 hours
Duration of Effect=3-6 hours
Half-Life=<3 hours

33
Q

Albuterol Sulfate Indications/Field Use

A

Asthma

Reversible bronchospasm associated with COPD

34
Q

Albuterol Sulfate Contraindications

A

Symptomatic tachycardia

pts with history of hypersensitivity

35
Q

Albuterol Sulfate Side Effects/Adverse Reactions

A 
Anxiety
Headache
Palpitations
Sweating
Dizziness
Nervousness
Tremor
HTN
Arrhythmia
Chest Pain
N+V
36
Q

Albuterol Sulfate Dose

A

Adult MDI: 1-2 sprays (90mcg/spray)

Adult & Pedi Neb: 2.5mg in 2.5mL of NS over 5-15 min

37
Q

Albuterol Sulfate Precautions

A

BP, pulse, and EKG should be monitored
use caution with pts with known heart disease or HTN
auscultate LS before and after

38
Q

Albuterol Sulfate Drug-Drug Interactions

A

SE may increase with other sympathetic agonists

B blockers may blunt effects of this drug

39
Q

Epinephrine

A

Adrenalin, EpiPen, EpiPen Jr.

40
Q

Epinephrine Drug Classification

A

Sympathomimetic/Sympathetic agonist/Catecholamine

41
Q

Epinephrine Mechanism of Action

A

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
Q

Epinephrine Pharmacokinetics

A

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
Q

Epinephrine Indications/Field Use

A

Cardiac arrest
Anaphylaxis/Severe reactive airway disease
Symptomatic bradycardia/hypotension

44
Q

Epinephrine Contraindications

A

HTN and tachydysrhythmias

use caution with pregnancy and CAD

45
Q

Epinephrine Side Effects/Adverse Reactions

A

Anxiety, HA, dysrhythmias, tremulousness, dizziness, N+V, leads to increased myocardial O2 demand

46
Q

Epinephrine Dose

A

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
Q

Epinephrine Precautions

A

Should be protected from light

48
Q

Epinephrine Drug-Drug Interactions

A

pH dependent, deactivated by alkaline solutions
effect intensified with pts taking antidepressants
react with CaCl2 and NaHCOe to form PPT in IV tubing

49
Q

Methylprednisolone

A

Solu-Medrol

50
Q

Methylprednisolone Drug Classification

A

Corticosteroid/Anti-inflammatory

51
Q

Methylprednisolone Mechanism of Action

A

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
Q

Methylprednisolone Pharmacokinetics

A

Onset of Action=2-6 hours
Peak Effects=4-8 days
Duration of Effect=1-5 weeks
Half-Life=3.5 hours

53
Q

Methylprednisolone Indications/Field Use

A

Severe anaphylaxis, hives
Asthma, COPD
Spinal cord injury

54
Q

Methylprednisolone Contraindications

A

None EMS

55
Q

Methylprednisolone Side Effects/Adverse Reactions

A

Fluid Retention, CHF, HTN, Abdominal distension, Vertigo, HA, Nausea, Malaise, Hiccups

56
Q

Methylprednisolone Dose

A

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
Q

Methylprednisolone Precautions

A

Give only one dose prehospitally
LT steroid use can cause GI bleeding
Prolonged wound healing
Suppression of adrenocortical steroids

58
Q

Methylprednisolone Drug-Drug Interactions

A

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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