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POC 27 Module 3 > Drugs > Flashcards

Drugs Flashcards

1
Q

Adenosine

Other name for it?

A

Adenocard

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2
Q

Adenosine

Action?

A

Slows the conduction through the AV Node.

Blocks re-entrant pathways in SVT

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3
Q

Adenosine

Indications

A

Treatment of SVT

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4
Q

Adenosine

Contraindications

A
  • Heart Blocks
  • AFlutter/Afib
  • VTach
  • Wolff Parkinsons
  • Asthma
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5
Q

Albuterol

Action?

A

Bronchodilator

Beta 2 Smooth Muscle relaxer

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6
Q

Albuterol

Indications?
Contraindications?

A

Indications
Bronchospasms
Asthma-COPD

Contraindications
Hypertension

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7
Q

Albuterol

Side Effects

A 
Headache
Drowsiness
Vertigo
Nausea
Hypertension
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8
Q

Albuterol

Adult
Pediatric

A

Both are 2.5mg in 3-6ml

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9
Q

Amiodarone

Action

A

Antiarrhythmic medication

Calcium, potassium, and sodium channel blocker.

negative chronotropic, negative dromotropic, and vasodilator.

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10
Q

6 Rights

A 
Patient 
Route
Time
Drug
Dose
Date
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11
Q

Amiodarone

Indications

A

V fib
PVtach
Adjunct to elecrical cardioversion of SVT and PSVT

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12
Q

Amiodarone

Contraindications

A

Cardiogenic shock
sinus bradycardia
high degree AV block

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13
Q

Amiodarone

Side effects

A

Bradycardia
Nausea
AV block
Vasodilation/Hypotension

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14
Q

Amiodarone

Dose in Cardiac Arrest?

A

300 mg IV/IO push followed by 20-30ml flush.

second dose 150mg IV/IO push followed by 20-30ml flush

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15
Q

Amiodarone

Other name?

A

Cordarone

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16
Q

Amiodarone

VTach with pulse and unstable PSVT

A

150mg in 100ml

D5W over 10 minutes

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17
Q

Amiodarone Drop ROSC

recurrent Vfib

A

150mg IV over 10 minutes

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18
Q

Aspirin

Action

A

Interferes with platelet aggregation and is known as an anti-platelet medication

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19
Q

Aspirin

Indications

A

Myocardial Infarction
Unstable Angina
Chest Pain

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20
Q

Aspirin

Contraindications

A

Hypersensitivity
Ulcers
Diabetice Meds
GI Bleeds

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21
Q

Aspirin

Dosage

A

324mg PO

4 baby aspirin

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22
Q

Atropine

Action?

A

parasympatholytic drug that inhibits the actions of acetylcholine at
the postganglionic parasympathetic neuroeffector sites. Effects include dilation of the
pupils, relaxation of the bronchioles, decreased gastric motility and increased heart rate.
It produces both positive chronotropic and positive dromotropic effects.

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23
Q

Atropine

Indications

A

INDICATIONS
• symptomatic bradycardia
• organophosphate poisoning

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24
Q

Atropine

CONTRAINDICATIONS

A

CONTRAINDICATIONS
tachycardia
• narrow angle glaucoma
• myasthenia gravis

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25
Q

Atropine

SIDE EFFECTS

A

palpitations tachycardia
headache vertigo
dry mouth blurred vision
urinary retentio

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26
Q

Atropine

Dosage and Admin

Adult Bradycardia

A

Adults:
• 0.5mg IV push, rapidly
• May be repeated every 3 - 5 minutes
• Maximum dose is 3 mg.

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27
Q

Atropine

Dosage and Admin

Pedi Bradycardia

A

Pediatric:
• 0.02 mg/kg, minimum dose 0.1 mg, maximum dose 0.5 mg
• May repeat for a second dose
• Refer to “Weight Based Resuscitation Tape” for pediatric dosing.

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28
Q

Atropine

Dosage and Admin

Adult Organophosphate OD/Toxic Ingestion

A

Adults:

• 2 mg every 5 minutes until symptoms controlled, no maximum dose

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29
Q

Atropine

Dosage and Admin

Pedi Organophosphate OD/Toxic Ingestion

A

Pediatrics:
• 0.02 mg/kg IV (minimum dose 0.1mg), repeat every 5 minutes until respiratory
secretions subside

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30
Q

Atropine

Dosage and Admin

Notes and
Warnings

A

Note:
• Atropine may be given via E.T. tube, by adding 2 - 2.5 times the IV dose, mixed
with 5 to 10 mL of sterile water or saline, and injected directly into the ETT.
• Use caution in patients with MI history or myocardial ischemia due to increased
myocardial oxygen consumption

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31
Q

Calcium Chloride

Action

A

ACTION

Calcium chloride is an essential electrolyte for functional integrity of the nervous and
muscular system, cardiac contractility and coagulation of blood.

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32
Q

Calcium Chloride

Indications

A

INDICATIONS

  • hypocalcemia
  • hyperkalemia
  • calcium channel blocker toxicity
  • magnesium sulfate overdose
  • cardiac resuscitation
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33
Q

Calcium Chloride

Contraindications

A

CONTRAINDICATIONS

  • ventricular fibrillation during arrest
  • hypercalcemia
  • digitalis toxicity
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34
Q

Calcium Chloride

Precautions

A

PRECAUTIONS

  • use caution in patients taking digitalis
  • patients with renal disease
  • calcium precipitates on contact with sodium bicarbonate
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35
Q

Calcium Chloride

Side effects

A

SIDE EFFECTS

bradycardia hypotension
peripheral vasodilation tissue sloughing (following accidental IM
administration or secondary to extravasation of
medication)

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36
Q

Calcium Chloride

DOSAGE AND ADMINISTRATION

Adult and Pedi
Hyperkalemia

A

Hyperkalemia:
Adult:
• 1 gram, IV/IO

Pediatric:
• 20 mg/kg, IV/IO, maximum dose 1 gram
• Refer to “Weight Based Resuscitation Tape” for pediatric dosing.

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37
Q

Calcium Chloride

Calcium Channel Blocker Overdose/Toxicity:

A

Adult
1 gram, IV/IO slowly

Pediatric:

  • 20 mg/kg (0.2 ml/kg), IV/IO slowly
  • Refer to “Weight Based Resuscitation Tape” for pediatric dosing.
38
Q

Dextrose

Action

A

ACTION
Dextrose is a carbohydrate (monosaccharide) in a hypertonic solution which, when
given intravenously, increases blood glucose levels.

39
Q

Dextrose

Indications

A

INDICATIONS

  • hypoglycemia
  • altered levels of consciousness
  • coma or seizure of unknown etiology
40
Q

Dextrose

DOSAGE AND ADMINISTRATION

Adults and Pedi

A

DOSAGE AND ADMINISTRATION

Adult:
• 25 grams IV slow
Pediatric:
• Preferentially use Dextrose 25% if age is <8 years old
• Refer to “Weight Based Resuscitation Tape” for pediatric dosing

41
Q

Valium

alternate names

A

Diazepam

and

Diastat

42
Q

Valium

Action

A

ACTION

Diazepam is a sedative-hypnotic benzodiazepine. It acts on the limbic, thalamic and
hypothalamic regions of the CNS to potentiate the effects of inhibitory
neurotransmitters. It raises the seizure threshold and produces sedation and amnesia

43
Q

Valium

Indications

A

INDICATIONS

  • Seizure control
  • Acute anxiety
  • Muscle relaxant
  • Pre-medication prior to cardioversion
44
Q

Valium

Side Effects

A

SIDE EFFECTS

  • Hypotension
  • Respiratory depression
  • Ataxia
  • Confusion
  • Nausea
  • CNS depression
45
Q

Valium

Contraindications

A

CONTRAINDICATIONS

  • Shock
  • Coma
  • Respiratory depression
  • Substance abuse of CNS depressants
  • Hypersensitivity to this medication
46
Q

Valium

DOSAGE AND ADMINISTRATION

A

DOSAGE AND ADMINISTRATION

Adult:
• 5 mg IV/IO or MAD. May repeat as needed after 5 minutes, up to max dose of
10mg

Pediatric:
• 0.2 mg/kg IV/IO or MAD (maximum 5 mg dose), may repeat as needed after 5
minutes to a maximum of 10mg

47
Q

Cardizem

Alternate Name

A

Diltiazem

48
Q

Cardizem

Action

A

ACTION

Diltiazem is a calcium channel blocker which inhibits transport of calcium into
myocardial and vascular smooth muscle cells resulting in inhibition of excitationcontraction
coupling and subsequent contraction. It causes systemic vasodilation with
resultant decrease in blood pressure and coronary vasodilation

49
Q

Cardizem

Indications

A

INDICATIONS

  • management of supraventricular tachycardia
  • rapid ventricular rates in atrial flutter or fibrillation
50
Q

Cardizem

Contraindications

A

CONTRAINDICATIONS

Hypersensitivity Sick Sinus Syndrome
2nd or 3rd degree AV block Hypotension (<90 mmHg systolic)
Recent myocardial infarction Pulmonary congestion
Wolff-Parkinson-White syndrome (WPW)

51
Q

Cardizem

Precautions

A

PRECAUTIONS

  • patients with renal or hepatic insufficiency or CHF
  • geriatric patients
  • pregnancy, lactation or children
  • history of serious ventricular dysrhythmias
52
Q

Cardizem

SIDE EFFECTS / ADVERSE EFFECTS

A

SIDE EFFECTS / ADVERSE EFFECTS

epistaxis dyspnea dysrhythmias
CHF peripheral edema bradycardia
chest pain hypotension palpitations
syncope tachycardia nausea / vomiting
flushing diaphoresis urticaria
hyperglycemia muscle cramps paresthesia / tremor
53
Q

Cardizem

DOSAGE AND ADMINISTRATION

A

DOSAGE AND ADMINISTRATION

Adult:
• Consider vagal maneuvers as first line for a regular, narrow complex tachycardia
suggestive of SVT (AVNRT)
• 0.25 mg/kg IV over 2 minutes, maximum of 20mg
• May be repeated in 15 min if initial dose is ineffective

Pediatrics
• Consider expert consultation; typical dose is 0.25 mg/kg IV over 2 minutes
• Avoid use in infants

54
Q

Benadryl

Alternate name

A

Diphenhydramine

55
Q

Benadryl

Indications

A

INDICATIONS

  • anaphylaxis
  • extrapyramidal reaction to phenothiazine medications
  • mild to moderate allergic reactions
56
Q

Benadryl

CONTRAINDICATIONS

A

CONTRAINDICATIONS

  • asthma (relative contraindication)
  • narrow angle glaucoma
  • patients taking MAO inhibitors
57
Q

Benadryl

Precautions

A

PRECAUTIONS

• Use caution in pregnant patients
• Benadryl may have additive effects when used with other CNS depressant
medications

58
Q

Benadryl

Side Effects

A

SIDE EFFECTS

drowsiness sedation
hypotension tachycardia
palpitations drying of bronchial secretions
dry mouth urinary retention

59
Q

Benadryl

DOSAGE AND ADMINISTRATION

A

DOSAGE AND ADMINISTRATION

Adults:
• 1 mg/kg (max 50 mg) IV, or IM if no IV access
• Dystonic reaction: give 25 – 50 mg IV/IM
Pediatric:
• 1 mg/kg (max 50 mg) IV, or IM if no IV access

60
Q

Dopamine

Action

A

ACTION

Dopamine is an endogenous catecholamine, which is a precursor to norepinephrine.
Primarily acts upon alpha-1 and beta-1 receptors. Low dose ranges <2mcg/kg/min
results in vasodilation of the renal, mesenteric and cerebral arteries. Dose ranges of 2-
10 mcg/kg/min cause beta stimulation which results in increased cardiac output with
minimal changes in SVR or preload. Dose ranges of 10-20 mcg/kg/min result in alpha
response with vasoconstriction of the renal, mesenteric and peripheral vasculature.

61
Q

Dopamine

Indications

A

INDICATIONS

• Hypotension with signs and symptoms of shock, which do not respond to volume
replacement
• Second line drug for symptomatic bradycardia

62
Q

Dopamine

CONTRAINDICATIONS

A

CONTRAINDICATIONS

  • tachydysrhythmias
  • patients with Pheochromocytoma
  • hypovolemic shock prior to fluid replacement
63
Q

Dopamine

PRECAUTIONS

A

PRECAUTIONS

• Can cause an increase in myocardial oxygen consumption thus worsening the
cardiac status of the patient. Should be carefully monitored.
• Use with caution in cardiogenic shock with accompanying CHF.

64
Q

Dopamine

Side Effects

A

SIDE EFFECTS

hypertension tachydysrhythmias (dose related)
headache nausea and vomiting
65
Q

Dopamine

DOSAGE AND ADMINISTRATION:

Hypotension/shock refractory to fluid resuscitation

and

Bradycardia w/ a pulse

A

Adult

Hypotension/shock refractory to fluid resuscitation
Adult:

Infusion rate 5-20 mcg/kg/min IV and titrate for response.

Bradycardia with a pulse

Adult
• Infusion rate 2-20 mcg/kg/min IV and titrate for response.

66
Q

Epinephrine

Action

A

ACTION

Epinephrine is an endogenous catecholamine with beta-1, beta-2 (bronchodilation and
vasoconstriction of skeletal muscle) and alpha 1 (peripheral vasoconstriction)
adrenergic effects. It has positive inotropic, chronotropic and dromotropic effects, along
with increased SVR, increased coronary and cerebral perfusion and increased
automaticity. It causes an increase in myocardial oxygen demand.

67
Q

Epinephrine

Indications

A

INDICATIONS

  • cardiac arrest
  • acute bronchospasm from asthma or COPD
  • anaphylaxis
68
Q

Epinephrine

Precations

A

PRECAUTIONS

  • hyperthyroidism
  • diabetes mellitus
  • glaucoma
  • may exacerbate angina, hypertension, SVT and CHF
  • protect solution from intense light sources
  • is unstable in alkaline solutions
69
Q

Epinipherine

A

SIDE EFFECTS

CNS stimulation anxiety
headache nausea, vomiting
palpitations tachycardia
dizziness hyperglycemia

70
Q

Epinepherine

DOSAGE AND ADMINISTRATION

Cardiac Arrest

Adult/Pedi

A

Cardiac arrest:
Adult

  • 1 mg IV / IO of Epinephrine (1:10,000) push every 3-5 minutes
  • Can be given via ET tube at 2 - 2.5 times the normal dose diluted in 10ml of NS

Pediatric
• Epinephrine (1:10,000) 0.01 mg/kg IV or IO every 3-5 minutes

71
Q

Epinepherine

DOSAGE AND ADMINISTRATION

Anaphylaxis:

A

Anaphylaxis:

Adult:
• 0.3mg of Epinephrine 1:1,000 via intramuscular injection
• May repeat if signs and symptoms of shock persist after the initial dose
• If patient appears to be nearing cardiac arrest or develops cardiac arrest, give
1mg IV of 1:10,000 epinephrine

Pediatric:
• Per weight-based tape, inject the 1:1,000 epinephrine intramuscularly
• May repeat if signs and symptoms of shock persist after the initial dose
• If patient develops cardiac arrest, give 1:10,000 epinephrine IV per weight-based
tape dosing

72
Q

Epinepherine

DOSAGE AND ADMINISTRATION

Severe respiratory distress/bronchospasm secondary to asthma/COPD:

A

Severe respiratory distress/bronchospasm secondary to asthma/COPD:

Adult:
• 0.3mg of 1:1000 via intramuscular injection
o Discuss with online medical control prior to use if >55 years old or known
use of beta blockers

Pediatric:
• Per weight-based tape, inject the 1:1,000 epinephrine intramuscularly

73
Q

Epinepherine

DOSAGE AND ADMINISTRATION

Bradycardia with a pulse

A

Bradycardia with a pulse
Adult

• Epinephrine 2-10 mcg/min IV is one option (alternatives are transcutaneous
pacing and Dopamine)
Pediatric (if refractory to chest compressions/oxygenation)
• Epinephrine (1:10,000) 0.01 mg/kg IV or IO every 3-5 minutes

74
Q

Etomidate

Alternate name

A

Amidate

75
Q

Etomidate

Action

A

ACTION

Etomidate is a hypnotic drug without analgesic or muscle relaxing properties. It usually
causes myoclonus on injection; for this reason, it is usually given concomitantly with
neuromuscular blocking agents and analgesics

76
Q

Etomidate

INDICATIONS

A

INDICATIONS

  • induction prior to use of neuromuscular blocking agents and/or analgesics
  • supplement to use of neuromuscular blocking agents and/or analgesics
77
Q

Etomidate

CONTRAINDICATIONS

A

CONTRAINDICATIONS

  • hypersensitivity
  • pregnancy or lactation
  • patients under 3 months of age
78
Q

Etomidate

PRECAUTIONS

A

PRECAUTIONS

• Patients with renal or hepatic insufficiency

79
Q

Etomidate

SIDE EFFECTS / ADVERSE EFFECTS

A

SIDE EFFECTS / ADVERSE EFFECTS

  • Transient venous pain at injection site
  • Transient skeletal muscle spasms/ twitching (myoclonus).
80
Q

Etomidate

COMPLICATIONS

A

COMPLICATIONS

• Anticipate that the patient will awaken rapidly and be left without residual
analgesia.
• Medicate with additional narcotics and neuromuscular blockers, as needed.

81
Q

Etomidate

DOSAGE AND ADMINISTRATION

A

Adult/Pediatrics Dose:

• 0.3 mg/kg IV
• Administered IV, the onset of action is usually within 1 minute with duration of
action of 5 minutes
• Patient is usually fully awake within 7-14 minutes

82
Q

Fentanyl

Alternate Name

A

Sublimaze

83
Q

Fentanyl

Action

A

ACTION

Fentanyl is an opioid analgesic. It binds to opiate receptors in the CNS, altering the
response to and the perception of pain. It may produce CNS and/or respiratory
depression in higher doses

84
Q

Fentanyl

INDICATIONS
• Pain control
• Sedation of the intubated patient

A

INDICATIONS

  • Pain control
  • Sedation of the intubated patient
85
Q

Fentanyl

CONTRAINDICATIONS

A

CONTRAINDICATIONS

  • Patients currently taking MAO inhibitors
  • Hypersensitivity to this medication
  • Hypotension
  • Abnormalities in lead V4R or other indications of inferior wall myocardial infarct
86
Q

Fentanyl

Precautions

A

USE WITH PRECAUTION

  • Head injury
  • COPD history
  • Respiratory difficulty
87
Q

Fentanyl

Side Effects

A

SIDE EFFECTS

apnea laryngospasm
respiratory depression arrhythmia
bradycardia circulatory depression
hypotension nausea and vomiting
skeletal and thoracic muscle rigidity
88
Q

Fentanyl

DOSAGE AND ADMINISTRATION

Pain Control

Adult

A

Pain Control
Adult:

• 50 - 100 mcg, IV push slowly over 1-2 minutes, or IM injection, may repeat every
5 minutes to a total of three doses or a maximum cumulative dose of 250 mcg
• Recheck a pain score & vitals including a HR, RR, and BP between doses

89
Q

Fentanyl

DOSAGE AND ADMINISTRATION

Pain Control

Pedi

A

Pain Control

Pediatric:
• 0.5 mcg/kg, IV push slowly over 1-2 minutes, not to exceed 100 mcg.
• 1.5mcg/kg via mucosal atomization device if IV access unsuccessful or not
otherwise needed.
• May repeat every 5 minutes to a total of three doses or a maximum cumulative dose of 250 mcg
• Recheck a pain score & vitals including a HR, RR, and BP between doses

90
Q

Fentanyl

DOSAGE AND ADMINISTRATION

Sedation in a patient with an advanced airway

Adult

A

Sedation in a patient with an advanced airway
Adult:

  • 100 to 250 mcg IV, may repeat to a maximum cumulative dose of 250mcg
  • Discuss with online medical control if additional doses are needed

POC 27 Module 3 (15 decks)

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