Drugs and Tx Guidelines

Question 1

Acetaminophen Classification

Answer 1

antipyretic
analgesic

Question 2

acetaminophen indications

Answer 2

mild to moderate pain and pyrexia

Question 3

acetaminophen contraindications

Answer 3

-hypersensitivity
-severe hepatic impairment or severe active liver disease
- acetaminophen has been given within 4 hrs
- overdose is suspected

Question 4

acetaminophen dose

Answer 4

adults: 500-1000mg PO. Max all sources 4000mg per day
peds: 15mg/kg

Question 5

acetaminophen mechanism of action

Answer 5

inhibits prostaglandin synthesis in the central nervous system, reducing pain and pyrexia

Question 6

acetylsalicylic acid classification

Answer 6

antiplatelet
antithrombotic

Question 7

acetylsalicylic acid Indications

Answer 7

chest pain or signs and symptoms od cardiac ischemia

Question 8

acetylsalicylic acid contraindications

Answer 8

-hypersensitivity to ASA
- Patients who have experienced bronchospasm from ASA or NSAIDS
- active bleeding of any kind
- peds with signs and symptoms of viral disease

Question 9

acetylsalicylic acid mechanism of action

Answer 9

Inhibits formation of thromboxane A2 which is a platelet aggregator. irreversible for life of platelet which is 7-10 days

Question 10

Amioderone mechanism of action

Answer 10

class 3 antiarrythmic but has qualities of all classes:
- blocks sodium channels in heart
- antagonize beta receptors to inhibit some sympathetic activity
- produces negative chronotropic effects in nodal tissues
- lengthening cardiac action potential
- prolongs refractoriness by blocking potassium channels

Question 11

amioderone contraindications

Answer 11

-hypersensitivity
- 2nd or 3rd degree block
- cardiogenic shock
- marked sinus bradycardia

Question 12

dexamethasone mechanism of action

Answer 12

• suppresses neutrophil migration
• decreases production of inflammatory mediators
• reverses increased vascular permeability

Question 13

Dexamethasone classification

Answer 13

anti- inflammatory
- systemic corticosteroid

Question 14

dimenhydrinate classification

Answer 14

-antiemetic
-anticholinergic
- antihistamine
-antivertigo

Question 15

dimenhydrinate mechanism of action

Answer 15

inhibits cholinergic vestibular and reticular stimulation from motion

Question 16

diphenhydramine classification

Answer 16

antihistamine
anticholinergic

Question 17

diphenhydramine mechanism of action

Answer 17

antihistamine with anticholinergic effect, appears to compete with histamine for receptors in effector cells

Question 18

you are transporting a patient who had an anaphylactic reaction, to whom you administered epi. What are the mechanisms of Epi that work in this patients favor?

Answer 18

• alpha effects of vasoconstriction and decreased vascular permeability
• beta effects result in bronchial smooth muscle relaxation
• inhibits histamine release

Question 19

What are the effects of Epi that are not favorable ?

Answer 19

beta effects of increased heart rate and increased cardiac contractility

Question 20

True or false:

fentanyl and ketamine work synergistically but targeting both ascending and descending pain pathways

Answer 20

true

Question 21

fentanyl works on the _________ pain pathway

Answer 21

ascending

Question 22

ketamine works in the ________ pain pathway

Answer 22

descending

Question 23

define inotropy

Answer 23

inotropic drugs effect heart’s contractions.

Question 24

define chronotropy

Answer 24

chronotropic drugs effect the heart rate

Question 25

Adenosine classification

Answer 25

antiarrythmic and endogenous nucleoside

Question 26

adenosine Indications

Answer 26

conversion and termination of supraventricular tachycardias

Question 27

Adenosine Contraindications

Answer 27

-sensitivity
- 2nd or 3rd degree heart blocks
- sick sinus syndrome with no pacemaker

Question 28

Atropine Indications

Answer 28

• bradydysrythmias
  -sinus bradycardia less than 50
  -bradycardia secondary to atrioventricular nodal blocks
  -organophosphate poisoning
  -control of secretions in palliative care

Question 29

Atropine contraindications

Answer 29

-hypersensitivity to atropine or anticholinergic
-tachycardia
-narrow angle glaucoma
-thyrotoxicosis
-prostatic hypertrophy
-myasthenia gravis

Question 30

Atropine dosages

Answer 30

bradycardia: 0.6mg IV push, max 0.04mg/kg
organopbosphate : 1-2mg Q 5-60mins until symptoms resolve
Secretion control: 0.6mg IM

Question 31

Calcium chloride contraindications

Answer 31

• hypersensitivity
  -primary or secondary hypercalemia

Question 32

Dimenhydrinate Contraindications

Answer 32

-known sensitivity to dimenhydrinate, diphenhydramine or caffeine derivatives

Question 33

dimenhydrinate contraindications

Answer 33

• hypersensitivity
• neonates
  -premature infants

Question 34

True or false: there are no absolute contraindications to epinephrine

Answer 34

true

Question 35

Fentanyl Contraindications

Answer 35

• hypersensitivity to opioids
  -myasthenia gravis
  -pre-existing respiratory depression
  -acute asthma
  -upper airway obstruction

Question 36

Ibuprofen classification

Answer 36

analgesic
-antipyretic
-non steroidal anti inflammatory

Question 37

Ibuprofen contraindications

Answer 37

hypersensitivity
-Active GI bleed
-pregnancy

Question 38

Ketamine contraindications

Answer 38

-hypersensitivity
-unable to manage ketamine effects
-conditions where elevated blood pressure may be harmful
-less than 6 months old