Drugs Flashcards
Drug class of Aspirin
NSAID
How does aspirin work?
Aspirin keeps platelets from sticking together and forming clots. It stops platelets from forming Thromoboxone which causes stickiness. Clots are what block arteries and result in ischemia and muscle death so therefore.
What are the indications for Aspirin use?
AMI, and suspected cardiac chest pain
What are the contraindications for aspirin use?
Hypersensitivity and active bleeding disorder
What is the dosage and how is it found on an RAA ambulance?
Dosage is 324 mg, it is found with the cardiac monitor and in one of the red bins. It is packaged in a powdered form. 1 pack = 324 mg dose.
What is the onset time of aspirin?
5 to 30 minutes
What is the drug class of Fentanyl?
synthetic opiate, narcotic analgesic
How does Fentanyl compare to morphine?
It is faster acting and works for a shorter duration.
What is the MOA of Fentanyl?
It interacts with opiod receptors decreasing pain impulse transmission at spinal cord level.
How might Fentanyl help cardiac patients?
It causes peripheral vasodilation because in increases venous capicitance and decreases venous return, meaning it decreases both preload and after load which decreases myocardial oxygen demand.
What are the indications for Fentanyl?
moderate to severe pain, sedation for mechanically ventilated patients.
What are the contraindications for Fentanyl?
hypovolemia, hypotension, hypersensitivity, head injury, myasthenia gravis, and pts who have taken MAOIs in the past 14 days.
What are some precautions for Fentanyl?
Resp. depression, severe heart disease, geriatrics, liver/kidney failure, can worsen bradycardia and heart block with inferior MI
What are the adult and pediatric dosages of Fentanyl?
Adults: 1 to 3 mcg/kg slow IV/IN q 20 to 30 min.
Peds: 1 mcg/kg slow IV/IN
What is the onset of Fentanyl IV?
1 to 3 min
Side effects of Fentanyl?
dizziness, AMS, euphoria, hypotension, seizures, bradycardia, tachycardia, nausea and vomiting, CNS depression, muscle rigidity
What are 2 important drug interactions to remember with Fentanyl?
1) mixing with antihistamines, anti-emetics, sedatives, hypnotics, barbituates, and alcohol will enhance the effects.
2) do not mix in line with heparin
How MUST Fentanyl be administered?
SLOW b/c chest wall rigidity, seizures, and hypotension have been associated with rapid administration.
How is Fentanyl packaged on an RAA ambulance?
Found in Narc box in vials of 100mcg in 2mL
How is Versed packaged on an RAA ambulance?
Found in Narc box in vials of 5mg in 1 mL
What is the drug class of Versed?
benzodiazepine
What are the indications for Versed?
sedation prior to cardioversion, seizure control
Contraindications for Versed?
shock, coma, hypersensitivity, closed angle glaucoma, pregnancy category D
Precautions for Versed?
Pts with respiratory insufficiency, effects enhanced by other CNS depressants, elderly
In which pts should you use caution with when giving Versed?
hepatic dysfunction, renal failure, drug addiction, parkinson’s disease, myasthenia gravis
Adult doses of Versed for Status epilepticus, cardioversion and pacing?
2.5 to 5 mg IV /IM/ IN q 5 minutes as needed. Max dose is 20 mg
Adult dose of Versed for sedation?
5 mg slow IVP, q 20 to 30 minutes prn
Pediatric dose of Versed for status epi, cardioversion, and pacing?
0.2 mg/kg slow IV (preferred) / IM/ IN, maximum single dose of 2.5 mg. Maximum total dose of 20 mg.
What are the major side effects of Versed?
respiratory depression, apnea, hypotension, paradoxical CNS stimulation (valium rage), cardiac arrest
What are the drug classes of epinephrine?
adrenergic catecholamine, sympathomimetic
What is the Beta 1 MOA of epinephrine?
(Heart) increases contractility, inotropic, increases AV conduction and automaticity.
What is the Beta 2 MOA of epinephrine?
(Lungs) Bronchodilation and skeletal muscle relaxation
What is the Alpha MOA of epinephrine?
peripheral vasoconstriction and “fight or flight” response.
What is the MOA of small doses of epinephrine?
Beta effects dominate increasing vasodilation
What is the MOA of large doses of epinephrine?
Alpha effects dominate increasing vasoconstriction, systemic vascular resistance, and blood pressure.
What are the indications for epinephrine? (4)
1) anaphylaxis 2) acute bronchospasm associated with asthma or COPD exacerbation 3) Pulseless arrest 4) croup, epiglotittis, RSV
What are the contraindications for epinephrine use?
None in cardiac arrest or anaphylaxis; hypersensitivity
What are the precautions of epinephrine use? (9)
1) hypertension, 2) ischemic heart disease 3) cerebrovascular insufficiency 4) deactivates/precipitates with sodium bicarb (alkaline) solutions 5) will increase myocardial oxygen demand 6) pulmonary edema 7) pregnancy 8) geriatrics 9) protect it from light.
All pts. receiving epinephrine medications should
be observed for at least thee hours for return of symptoms following treatment.
Adult dosage of epinephrine for PEA?
(1:10000) 1 mg IVP every 3 to 5 minutes
Adult dosage of epinephrine for initial administration in anaphylaxis?
(1:1000) 0.3 mg IM or SQ
Adult dosage of epinephrine for refractory anaphylaxis?
(1:1000) 2 to 10 mcg/min titrated to BP
What is the dosage of epinephrine for laryngeal edema?
5 mg of 1:1000 nebulized.
