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PC1-2 > Drugs Cards > Flashcards

Drugs Cards Flashcards

1
Q

Succinylcholine*

A

Brand Name: Anectine

Classification: Depolarizing neuromuscular blocker

Action: Binds to ACh receptors at the neuromuscular junction, causing depolarization and subsequent paralysis.

Indications: Rapid Sequence Intubation (RSI)

Contraindications: Hyperkalemia, Neuromuscular
disease, Crush Injuries, Burns, Increased ICP, Severe Trauma

Dose: 1-2 mg/kg

Routes: IV, IO

Adverse Effects: Hyperkalemia, Bradycardia, Prolonged Paralysis, Malignant hyperthermia, Increased ICP, Muscle fasciculations, Trismus

Other: Should only be used by a skilled provider

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2
Q

Ipratropium*

A

Brand Name: Atrovent

Classification: Muscarinic anticholinergic (parasympathetic stimulation)

Action: Selectively blocks muscarinic receptors inhibiting parasympathetic stimulation

Indications: Bronchospasms associated with obstructive lung disease

Contraindications: Hypersensitivity

Dose: 500 mcg

Routes: Inhaled

Adverse Effects: Blurred Vision, Dry Mouth, Dilated Pupils, Cough, Confusion

Other: Typically administered with a beta agonist (although not as frequently)

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3
Q

Rocuronium*

A

Brand Name: Zemuron

Classification: Nondepolarizing neuromuscular blocker

Action: Binds to ACh receptors at the neuromuscular junction, causing paralysis

Indications: Rapid Sequence Intubation (RSI)

Contraindications: Hypersensitivity

Dose: 1 mg/kg

Routes: IV, IO

Adverse Effects: Hypertension, Hypotension, Skeletal muscle weakness, Malignant Hyperthermia, Apnea

Other: Should only be used by a skilled provider

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4
Q

Vecuronium*

A

Brand Name: Norcuron

Classification: Nondepolarizing neuromuscular junction, causing paralysis

Action: Binds to ACh receptors at the neuromuscular junction, causing paralysis

Indications: Rapid Sequence Intubation (RSI)

Contraindications: Hypersensitivity

Dose: 0.1-0.15 mg/kg

Routes: IV, IO

Adverse Effects: Skeletal Muscle Weakness, Malignant Hyperthermia, Apnea

Other: Should only be used by a skilled provider

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5
Q

Midazolam*

A

Brand Name: Versed

Classification: Benzodiazepine (Class IV)

Action: Binds to Type A GAGA receptors, causing sedations

Indications: Anxiety, Sedation, Seizures

Contraindications: History of Hypersensitivity

Dose: 1-5 mg

Routes: IV, IM, IO

Adverse Effects: Hypotension, Sedation, Amnesia, Amnesia, Respiratory Depression, Nausea, Vomiting

Other: Flumazenil is an antagonist

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6
Q

Etomidate*

A

Brand Name: Amidate

Classification: Nonbarbiturate, nonbenzodiazepine sedative

Action: Appears to modulate GABA receptors

Indications: Sedation

Contraindications: History of Hypersensitivity

Dose: 0.1-0.3 mg/kg

Routes: IV

Adverse Effects: Myoclonic jerks, Respiratory Depression, Laryngospasm

Other: Does not have analgesic properties. Calcium-channel blockers can prolong respiratory depression. Can cause increased cortisol levels. All monitors should be in place. Resuscitative equipment should be immediately available.

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7
Q

Ketamine*

A

Brand Name: Ketalar

Classification: Dissociative Anesthetic (Schedule III)

Action: Causes Dissociation between the cortical and limbic system

Indications: Sedation and Analgesia

Contraindications: History of Hypersensitivity and Hypertension

Dose: 0.5-2 mg/kg(IV) 2-4 mg/kg(IM)

Routes: IV and IM

Adverse Effects: Hallucinations

Other: All monitors should be in place. Resuscitative Equipment should be immediate available.

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8
Q

Morphine*

A

Brand Name: Duramorph

Classification: Narcotic (opioid) (Schedule II)

Action: Analgesia and sedation through binding to opiate receptors

Indications: Moderate-severe pain

Contraindications: Hypotension and Hypersensitivity

Dose: 2-10 mg

Routes: IV, IO, IM, SQ, PO

Adverse Effects: Hypotension, Syncope, Tachycardia, Bradycardia, Apnea, Nausea, Vomiting, Respiratory depression

Other: Use appropriate monitors, Naloxone is an antagonist

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9
Q

Hydromorphone*

A

Brand Name: Dilaudid

Classification: Narcotic (opioid) (Schedule II)

Action: Analgesia and sedation through binding to opiate receptors

Indications: Moderate-Severe Pain

Contraindications: Hypersensitivity

Dose: 0.5-2.0 mg

Routes: IV, IO, IM, SQ, PO

Adverse Effects: Nausea, Vomiting, Cramps, Respiratory Depression

Other: Use appropriate monitors. Naloxone is an antagonist

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10
Q

Fentanyl*

A

Brand Name: Sublimaze

Classification: Narcotic (opioid) (Schedule II)

Action: Analgesia through binding to opiate receptors

Indications: Moderate-Severe Pain and Anesthetic

Contraindications: Hypersensitivity

Dose: 50-100 mcg

Routes: IV, IO, IM, SQ, IN

Adverse Effects: Nausea, Vomiting, Cramps, Chest wall rigidity, Respiratory Depression

Other: Use Appropriate monitors. Naloxone is an antagonist

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11
Q

Aspirin*

A

Brand Name: Aspirin

Classification: NSAID

Action: Anti-inflammatory and antipyretic through inhibition of thromboxane A2

Indications: Mild-Moderate pain, Fever, Platelet Aggregation inhibitor

Contraindications: Hypersensitivity, Bronchospasm, Angioedema, Patient receiving monoamine oxidase inhibitor (MAOIs)

Dose: 350-650 mg

Routes: PO

Adverse Effects: Nausea, Vomiting, GI bleeding, Allergic reactions

Other: Commonly causes gastric upset. Avoid enteric-coated aspirin in chest pain

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12
Q

Naloxone*

A

Brand Name: Narcan

Classification: Opiate Antagonist

Action: Opioid antagonist without opiate agonist properties (it has not activity when given in the absence of an opiate agonist

Indications: Partial reversal of opiate drug effects, Opiate overdose

Contraindications: Hypersensitivity

Dose: 0.4-2.0 mg

Routes: IV, IO, SQ, IN, Nebulizer

Adverse Effects: Fever, Chills, Nausea, Vomiting, Diarrhea, Opiate withdrawal

Other: Administer enough to reverse respiratory depression and avoid full narcotic withdrawal syndrome

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13
Q

Nalmefene*

A

Brand Name: Revex

Classification: Opiate antagonist

Action: Opioid Antagonist without opiate agonist properties (if no activity when given in the absence of an opiate agonist)

Indications: Partial reversal of opiate drug effects, Opiate overdose

Contraindications: Hypersensitivity

Dose: 0.4-2.0 mg

Routes: IV, IM, SQ, IO, nebulizer

Adverse Effects: Fever, Chills, Nausea, Vomiting, Diarrhea, Opiate withdrawal

Other: Duration of effect much longer than naloxone

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14
Q

Nalbuphine*

A

Brand Name: Nubain

Classification: Opiate agonist-antagonist

Action: Analgesia and sedation through binding to opiate receptors. It also has some opiate receptor antagonistic properties

Indications: Moderate-Severe Pain

Contraindications: Hypersensitivity, Opiate dependence, Respiratory depression

Dose: 10-20 mg

Routes: IV, IO, SQ

Adverse Effects: Sedation, Dizziness, Nausea, Vomiting, Opiate withdrawal

Other: Use with caution in patients with liver and renal disease

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15
Q

Diazepam*

A

Brand Name: Valium

Classification: Benzodiazepine (Schedule IV)

Action: Binds to Type A GABA receptors, causing sedation

Indications: Anxiety, Seizures, Sedation, Muscle relaxation

Contraindications: Hypersensitivity

Dose: 2-10 mg

Routes: IV, IM, IO, PO, rectal

Adverse Effects: Hypotension, Sedation, Amnesia, Respiratory depression, nausea, vomiting

Other: Incompatible with other medication because it is not water soluble. Can cause irritation with injection. Flumazenil is an antagonist

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16
Q

Lorazepam*

A

Brand Name: Ativan

Classification: Benzodiazepine (Schedule IV)

Action: Binds to Type A GABA receptors, causing sedation

Indications: Anxiety, Sedation, Seizures

Contraindications: Hypersensitivity

Dose: 1-4 mg

Routes: IV, IM, IO, PO, rectal

Adverse Effects: Hypotension, Sedation, Amnesia, Respiratory depression, Nausea, Vomiting

Other: Flumazenil is an antagonist

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17
Q

Nitrous Oxide*

A

Brand Name: Nitrous Oxide

Classification: Sedative/anesthetic gas

Action: CNS depressant

Indications: Pain and Sedation

Contraindications: COPD, Pneumothorax, Bowel obstruction

Dose: Self-Administered

Routes: Inhalation

Adverse Effects: Dizziness, Hallucinations, Nausea, Vomiting, Altered Mental Status

Other: Should not be used in any patient who cannot comprehend verbal instructions or who is intoxicated with alcohol or other medications

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18
Q

Haloperidol*

A

Brand Name: Haldol

Classification: Butyrophenone

Action: Blocks dopamine receptors associated with mood and behavior

Indications: Psychosis

Contraindications: Hypotension and Hypersensitivity

Dose: 2-10 mg

Routes: IM, PO

Adverse Effects: Extrapyramidal reactions, insomnia, restlessness, dry mouth, hypotension, tachycardia

Other: Hypotension more common in patients taking antihypertensive

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19
Q

Epinephrine*

A

Brand Name: Epinephrine

Classification: Sympathetic agonist

Action: α and β adrenergic agonist (β effects more pronounced although dose-related)

Indications: Cardiac arrest, symptomatic bradycardia, Normovolemic hypotension, Allergies/anaphylaxis, Severe bronchospasm

Contraindications: Few in the emergency setting

Dose: 0.3-1.0 mg

Routes: IV, IO, IM, SQ, ET, inhaled

Adverse Effects: Palpitations, anxiety, tremulousness, headache, dizziness, hypertension, Can worsen cardiac ischemia

Other: Two preparations are commonly available 1:1,000 (1mg/mL) 1:10,000 (1mg/10mL)

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20
Q

Norepinephrine*

A

Brand Name: Levophed

Classification: Sympathetic agonist

Action: α and β adrenergic agonist (α effects more pronounced)

Indications: Normovolemic hypotension, Septic Shock, Cardiogenic shock

Contraindications: Should not be used in hypovolemia until volume replacement has occurred

Dose: 0.1-0.5 mcg/kg/min (titrate to effect)

Routes: IV

Adverse Effects: Palpitations, Anxiety, Tremulousness, Headache, Dizziness, Hypertension, Can worsen cardiac ischemia, reflex bradycardia

Other: Extravasation can cause localized tissue damage. Best administered through a central line

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21
Q

Dopamine (not found in book or OK Protocol)

A

Brand Name: Intropin

Classification: Sympathetic agonist

Action: α and β adrenergic agonist

Indications: Normovolemic hypotension, Symptomatic bradycardia, Septic shock, Cardiogenic Shock

Contraindications: Should not be used in hypovolemia until volume replacement has occured

Dose: 2-20 mcg/kg/min (titrated to effect)

Routes: IV

Adverse Effects: Palpitations, Anxiety, Tremulousness, Headache, Dizziness, Hypertension, Can worsen cardiac ischemia, Reflex bradycardia

Other: Extravasation can cause localized tissue damage. Best administered through central line. Proposed renal benefit has been disproven

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22
Q

Phenylephrine*

A

Brand Name: Neo-Synephrine

Classification: Sympathetic agonist

Action: Almost a pure α agonist causing vasoconstriction

Indications: Normovolemic hypotension, Septic Shock, Spinal Shock

Contraindications: Avoid in cardiogenic shock

Dose: 100-180 mcg/min (0.5-2.0 mcg/kg/min and titrate to effect)

Routes: IV

Adverse Effects: Palpitations, Anxiety, Tremulousness, Headache, Dizziness, Can worsen cardiac ischemia, Reflex bradycardia

Other: can be applied to nasal mucosa to shrink tissues prior to nasal procedures

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23
Q

Albuterol*

A

Brand Name: Ventolin, Proventil

Classification: β agonist

Action: β agonist with preference for β2 adrenergic receptors.

Indications: Bronchospasm, Allergies/anaphylaxis, Hyperkalemia

Contraindications: Hypersensitivity

Dose: 2.5 mg (SVN) 90 mcg (MDI)

Routes: Inhalation

Adverse Effects: Palpitations, Anxiety, Tremulousness, Headache, Dizziness, Tachycardia

Other: Patient’s heart rate and SpO2 should be monitored during treatment

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24
Q

Amiodarone*

A

Brand Name: Cordarone

Classification: Class III antiarrhythmic

Action: Prolongs action potential and duration in cardiac tissues through sodium, potassium, and calcium channels; block α and β adrenergic receptors

Indications: Maybe consider for V-Tach, V-fib that is unresponsive to CPR defib, and vasopressor therapy

Contraindications: Breastfeeding, Bradycardia, High-grade heart block, Hypersensitivity

Dose: 150-300 mg

Routes: IV

Adverse Effects: Hypotension, Bradycardia, Prolonged PR, QRS, and QT

Other: Constant ECG monitoring, Now first-line agent in V-fib and tachycardia

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25
Q

Lidocaine*

A

Brand Name: Xylocaine

Classification: Class 1B antiarrhythmic, local anesthetic

Action: Amide-type local anesthetic; slows depolarization and automaticity

Indications: May be considered for: V-Tach, V-fib what is unresponsive to CPR, Defib, and vasopressor therapy, or Local Anesthetic

Contraindications: Should not be administer to patients receiving IV calcium channel blockers

Dose: 1.0-1.5 mg/kg

Routes: IV

Adverse Effects: Drowsiness, Slurred Speech, Confusion, Seizures, Hypotension

Other: Use with caution when administered with other antiarrhythmics

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26
Q

Adenosine*

A

Brand Name: Adenocard

Classification: Nucleoside

Action: Slows AV conduction; short half-life

Indications: Supraventricular Tachyarrhythmias (SVT)

Contraindications: A-Fib, Torsades de pointe

Dose: 6 mg

Routes: IV

Adverse Effects: Facial flushing, Headache, Chest Pain, Nausea

Other: Should be given by rapid IV push followed by saline bolus, Arrhythmias common following administration

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27
Q

Diltiazem*

A

Brand Name: Cardizem

Classification: Class IV antiarrhythmic; calcium channel blocker

Action: Lowers BP by relaxing vascular smooth muscle; slows AV conduction

Indications: A-fib w/ Rapid Ventricular Rate (RTR) and Stable narrow-complex Tachyarrhythmias

Contraindications: Hypotension, CHF, Cardiogenic shock, Wide-complex V-Tach

Dose: 15-20 mg

Routes: IV

Adverse Effects: Nausea, Vomiting, Dizziness, Headache, Hypotension

Other: Can be given IV bolus or IV infusion. Calcium chloride can reverse some of the untoward effects

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28
Q

Magnesium Sulfate*

A

Brand Name: Magnesium Sulfate

Classification: Mineral/electrolyte

Action: Physiologic calcium-channel blocker; bronchodilator

Indications: Torsades des pointes, Asthma, Hypertensive disorders of pregnancy

Contraindications: High-Degree Heart block, Shock, Dialysis, Hypocalcemia, V-fib/pulseless V-Tach in adults

Dose: 1-2 g

Routes: IV

Adverse Effects: Flushing, Sweating, Bradycardia, Respiratory Depression, Hypothermia

Other: Can cause cardiac conduction problems in conjunction with digitalis

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29
Q

Nitroglycerin*

A

Brand Name: Nitrostat

Classification: Nitrate

Action: Relaxes vascular smooth muscle causing vasodilation, decreased cardiac work, and improved coronary blood flow.

Indications: Chest Pain and CHF

Contraindications: Hypotension and Increased ICP

Dose: 0.4 mg

Routes: SL (tablet or spray)

Adverse Effects: Headache, Dizziness, Weakness, Tachycardia, Hypotension

Other: Tablets will lose effectiveness after exposure to air. Monitor BP closely

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30
Q

Nitroglycerin Paste*

A

Brand Name: Nitroglycerin Paste

Classification: Nitrate

Action: Relaxes vascular smooth muscle causing vasodilation, decreased cardiac work, and improved coronary blood flow

Indications: Chest pain and CHF

Contraindications: Hypotension and Increased ICP

Dose: 0.5-1.0 inch

Routes: Transdermal

Adverse Effects: Headache, Dizziness, Weakness, Tachycardia, Hypotension

Other: Do not get paste on your finger, as this may cause a headache. Monitor BP closely

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31
Q

Diphenhydramine*

A

Brand Name: Benadryl

Classification: antihistamine

Action: Nonselectively blocks H1 and H2 histamine receptors

Indications: Allergies, Extrapyramidal reactions, Parkinson’s disease, Sedation, Anaphylaxis

Contraindications: Hypersensitivity, Glaucoma, Pregnancy

Dose: 25-50 mg

Routes: IV, IM, IO, PO

Adverse Effects: Drowsiness, Dizziness, Sedation, Dry Mouth

Other: If given IM give deep in muscle

32
Q

Ondansetron*

A

Brand Name: Zofran

Classification: Serotonin antagonist

Action: Selectively blocks 5-HT3 serotonin receptors, including those in the CTZ and vagus nerve terminals

Indications: Nausea and Vomiting

Contraindications: Hypersensitivity

Dose: 4-8 mg

Routes: IV, IM, PO, SL

Adverse Effects: Dizziness and Lightheaded

Other: Commonly used in emergency medicine because of good safety profile

33
Q

Oxytocin*

A

Brand Name: Pitocin

Classification: Hormone (oxytocin)

Action: Oxytocic; caused uterine contractions and lactations

Indications: Postpartum vaginal bleeding,
Induction/augmentation of labor

Contraindications: Anything other than postpartum bleeding (in the prehospital setting)

Dose: 10-20 units in 500 mL IV; 3-10 units IM

Routes: IV, IM

Adverse Effects: Anaphylaxis and Arrhythmias

Other: Ensure placenta (and possible additional baby) has delivered before administering

34
Q

Glucagon*

A

Brand Name: Glucagon

Classification: Hormone (glucagon)

Action: Elevates blood glucose levels through conversion of glycogen to glucose and other factors

Indications: Hypoglycemia and Beta-blocker overdose

Contraindications: Hypersensitivity

Dose: 0.25-0.5 units (IV); 1.0 mg (IM)

Routes: IV, IM, IO

Adverse Effects: Few in the emergency setting

Other: Less effective in patients with decreased glycogen stores (e.g., alcoholics)

35
Q

Dextrose, 50%*

A

Brand Name: Dextrose, 50%

Classification: Carbohydrate

Action: Substrate for carbohydrate metabolism

Indications: Hypoglycemia

Contraindications: None in the emergency setting

Dose: 12.5-25.0 g

Routes: IV, PO

Adverse Effects: Local venous irritation common, Tissue injury

Other: Less concentrated solutions (e.g., 10%) equally effective with fewer side effects

36
Q

Dextrose, 10%*

A

Brand Name: Dextrose, 10%

Classification: Carbohydrate

Action: Substrate for carbohydrate metabolism

Indications: Hypoglycemia

Contraindications: None in the emergency setting

Dose: 100 mL

Routes: IV, IO

Adverse Effects: Local venous irritation common, Tissue injury

Other: Preferred over D50W due to improved safety profile and cost

37
Q

Amyl nitrite*

A

Brand Name: Amyl nitrite

Classification: Cyanide antidote

Action: Vasodilator; oxidizes hemoglobin to methemoglobin which reacts with cyanide ion to form cyanmethemoglobin, that is enzymatically degraded

Indications: Cyanide poisoning

Contraindications: None in the emergency setting

Dose: 1-2 inhalants

Routes: Inhaled

Adverse Effects: Headache, Weakness, Dizziness, Flushing, Tachycardia, Orthostatic hypotension

Other: Headache and hypotension common, can worsen hypoxia in the setting of CO poisoning

38
Q

Activated Charcoal

A

Brand Name: Activated Charcoal

Classification: Absorbent

Action: Absorbs toxic substances from the GI tract

Indications: Most oral poisonings and medication overdoses

Contraindications: Comatose patient, ingestion of corrosives, caustics, or petroleum distillates

Dose: 1-2 mg/kg

Routes: PO

Adverse Effects: Nausea, Vomiting, Constipations, Black stool

Other

39
Q

Atropine

A

Brand Name: NA

Classification: Anticholinergic

Action: Antagonizes acetylcholine receptors

Indications: Treat Symptomatic Bradycardias especially those arising in the Atria

Contraindications: None in emergency settings

Dose: 0.5mg repeat every 3-5 mins (max 3.0mg)

Routes: IV or IO

Adverse Effects: blurred vision, dilated pupils, dry mouth, tachycardia, drowsiness

Other: Organophosphate poisonings may require a significantly higher dose

40
Q

Insta-Glucose

A

Brand Name: Oral Glucose

Classification: Hyperglycemic

Action: Increases Blood Glucose levels

Indications: Conscious patient with suspected hypoglycemia

Contraindications: Decreased LOC, Nausea, Vomiting

Dose:

Routes: Oral

Adverse Effects: Nausea and Vomiting

41
Q

Dextrose 5% in Water

A

Brand Name: D5W

Classification: Hypotonic Dextrose-containing solution

Action: provides nutrients in the form of dextrose as well as free water

Indications: Dilution of concentrated drugs, IV access for emergency drugs

Contraindications: Hypovolemic state

Dose: TKO via microdrip (60 gtt/mL)

Routes: IV

Adverse Effects: Rare in Therapeutic Doses

42
Q

Normal Saline

A

Brand Name: Normal Saline

Classification: Isotonic Crystalloid Solution

Action: Replaces Water and Electrolytes

Indications: Heat related problems, freshwater
drowning, hypovolemia, DKA, Keep IV open

Contraindications: use caution with CHF and Renal Failure

Dose: titrate to effect, 250 ml at a time, TKO

Routes: IV

Adverse Effects: Rare in Therapeutic doses.

43
Q

Hartman’s Solution

A

Brand Name: Lactated Ringer’s

Classification: Isotonic Crystalloid Solution

Action: replaced water and electrolytes

Indications: Hypovolemic shock and to keep IV open

Contraindications: CHF or renal failure

Dose: Titrate to effect, 250 mL at a time

Routes: IV

Adverse Effects: Rare in Therapeutic Doses

44
Q

Oxygen

A

Brand Name: Oxygen

Classification: Natural Atmospheric Gas

Action: Reverses Hypoxemia

Indications: Hypoxemia, Ischemic Chest Pain, Carbon Monoxide Poisoning, Decreased LOC, Respiratory Insufficiency

Contraindications: COPD or Emphysema use caution,

Dose: 1-15 lpm

Routes: Inhaled

Adverse Effects: Possible Decreased Respiratory drive in COPD or Emphysema patients

Other: Be familiar with the bottles and delivery devices

45
Q

Promethazine*

A

Brand Name: Phenergan

Classification: Phenothiazine

Action: Suppresses the CTZ; has antihistaminic effects

Indications: Nausea, Vomiting

Contraindications: Hypersensitivity to the drug

Dose: 12.5-25 mg

Routes: IV, IM, PO

Adverse Effects: Drowsiness, Dizziness, Sedation, Dry Mouth, Extrapyramidal symptoms

Other: Can potentiate CNS depressants (e.g., alcohol), Extravasation can cause local tissue injury, rarely used

46
Q

Betalin

A

Brand Name: Thiamine

Classification: Vitamin

Action: carbohydrate metabolism

Indications: Alcoholism, delirium tremens, coma of unknown etiology, Wernicke, Korsakoff syndrome

Contraindications: Hypersensitivity to drug, use caution with pregnancy and renal impairment

Dose: 100 mg

Routes: IV or IM

Adverse Effects: Hypotension(rare)

47
Q

Sodium Bicarbonate

A

Brand Name: Sodium Bicarbonate

Classification: Alkalinizing Agent

Action: Buffers excess acid to assist returning the blood to a normal pH balance.

Indications: Metabolic acidosis

Contraindications: Hypersensitivity, alkalosis, hypocalcemia, excessive chloride loss

Dose: 1 mEq/kg SIVP may be repeated at 0.5 mEq in 10 mins

Routes: IV

Adverse Effects: Edema, Irritation at IV site

Other: Use Caution in patients with CHF and Kidney insufficiency or with corticosteroid therapy. Monitor for fluid overload.

48
Q

Flumazenil*

A

Brand Name: Romazicon

Classification: benzodiazepine antagonist

Action: Competitively blocks benzodiazepines at the GABA/benzodiazepine receptor complex

Indications: Overdose of Benzodiazepines

Contraindications: Hypersensitivity, Patient taking Benzodiazepine for a life-threatening illness

Dose: 0.2 mg Additional 0.3 mg may be given 30 sec later. Later doses of 0.5 mg may be given at 1 min intervals max dose of 3 mg

Routes: IV

Adverse Effects: fatigue, headache, nervousness, dizziness

Other: Admin with caution in pts dependent on benzodiazepines as life-threatening withdrawal (including seizures) can occur

49
Q

Meperidine*

A

Brand Name: Demerol

Classification: Narcotic (opioid class II)

Action: Analgesia through binding to opiate receptors

Indications: Moderate-severe pain

Contraindications: Hypersensitivity, Pt on monamine oxidase inhibitors (MAOIs)

Dose: 25-100mg

Routes: IV, IO, IM, SQ, PO

Adverse Effects: Nausea, vomiting, euphoria, dysphoria, respiratory depression

Other: use appropriate monitors, naloxone is an antagonist

50
Q

Acetaminophen*

A

Brand Name: Tylenol

Classification: Nonnarcotic analgesic, antipyretic

Action: unknown but approximated to be inhibiting cyclooxygenase

Indications: mild-moderate pain, fever

Contraindications: hypersensitivity, alcoholism, chronic liver disease

Dose: 325-650mg

Routes: PO, IV

Adverse Effects: Rare

Other: can be liver toxic, use minimal dosage necessary

51
Q

Ibuprofen*

A

Brand Name: Motrin, Advil

Classification: NSAID

Action: Anti-inflammatory, antipyretic through inhibition of prostaglandins

Indications: mild-moderate pain, fever, inflammation

Contraindications: hypersensitivity, bronchospasms, angioedema

Dose: 200-800mg

Routes: PO

Adverse Effects: nausea, vomiting, GI bleed, allergic reactions

Other: commonly causes gastric distress

52
Q

Ketorolac*

A

Brand Name: Toradol

Classification: NSAID

Action: Anti-inflammatory and antipyretic through inhibition of prostaglandins

Indications: Mild-moderate pain, fever, inflammation, renal colic

Contraindications: hypersensitivity, bronchospasm, angioedema

Dose: 30mg (IV and elderly 60mg IM)

Routes: IV, IM

Adverse Effects: Nausea, vomiting, GI bleeding, allergic reactions

Other: commonly causes gastric upset, avoid entericcoated aspirin in chest pain

53
Q

Butorphanol*

A

Brand Name: Stadol

Classification: Opiate agonist-antagonist (class IV)

Action: Analgesia and sedation through binding with opiate receptors, it also has some opiate receptor antagonistic properties

Indications: Moderate-Severe pain

Contraindications: Hypersensitivity, opiate dependence, respiratory depression

Dose: 1-4mg

Routes: IV, IM, SQ, IO, IN

Adverse: Sedation, dizziness, nausea, vomiting, opiate withdrawal

Other: use with caution in pts with liver and renal disease

54
Q

Propofol*

A

Brand Name: Diprivan

Classification: Nonbarbiturate, nonbenzodiazepine sedative

Action: Uncertain, Appears to potentiate GABA receptors

Indications: Sedation

Contraindications: Hypersensitivity to drug or egg/soy products

Dose: 25-75 mcg/kg/min

Routes: IV

Adverse: pain on induction, nausea, vomiting, respiratory depression

Other: all monitors in place, resuscitation equipment should be immediately available

55
Q

Chlorpromazine*

A

Brand Name: Thorazine

Classification: Phenothiazine

Action: Blocks dopamine receptors associated with mood and behavior

Indications: Psychosis, intractable hiccups

Contraindications: hypotension and hypersensitivity

Dose: 25-50mg

Routes: IM, PO

Adverse: Extrapyramidal reactions, insomnia, restlessness, dry mouth, hypotension, tachycardia

Other: hypotension more common in pts taking antihypertensive

56
Q

Ziprasidone*

A

Brand Name: Geodon

Classification: Unclassified antipsychotic

Action: inhibits uptake of serotonin and dopamine

Indications: psychosis, Tourette’s syndrome

Contraindications: Hypersensitivity

Dose: 50-100mcg

Routes: IM, PO

Adverse: Extrapyramidal reactions, insomnia, restlessness, dry mouth, hypotension, tachycardia

Other: Carbamazepine (Tegretol) can decrease ziprasidone levels

57
Q

Dobutamine*

A

Brand Name: Dobutrex

Classification: Synthetic sympathetic agonist

Action: A and B adrenergic agonist (inotropic properties more pronounced that chronotropic properties)

Indications: Congestive Heart Failure (CHF)

Contraindications: Hypovolemia

Dose: 2-20mcg/kg/min (titrate to effect)

Routes: IV

Adverse: Palpatations, anxiety, tremulousness, headache, dizziness, hypertension, can worsen cardiac ischemia, reflex bradycardia

Other: Extravasation can cause localized tissue damage, best administered through central line, other agents preferred in cardiogenic shock

58
Q

Levalbuterol*

A

Brand Name: Xopenex

Classification: B agonist

Action: B agonist with preference for B2 adrenergic receptors. It is a racemic isomer of albuterol

Indications: Bronchospasms, allergies/anaphylaxis, hyperkalemia

Contraindications: Hypersensitivity

Dose: 0.63mc (SVN)

Routes: Inhalation

Adverse: Palpitations, anxiety, tremulousness, headache, dizziness, tachycardia

Other: The pts heart rate and SpO2 should be monitored during treatment

59
Q

Metaproterenol*

A

Brand Name: Alupent

Classification: B Agonist

Action: B Agonist with preference for B2 adrenergic receptors

Indications: Bronchospasm, allergies/anaphylaxis, hyperkalemia

Contraindications: Hypersensitivity

Dose: 0.2-0.3ml of solution containing 15mg/ml (SVN); 0.65mg (MDI)

Routes: Inhalation

Adverse: Palpitations, anxiety, tremulousness, headache, dizziness, tachycardia

Other: The pts heart rate and SpO2 should be monitored during treatment

60
Q

Terbutaline*

A

Brand Name: Brethine

Classification: B Agonist

Action: Relatively nonselective B agonist

Indications: Bronchospasm, allergies/anaphylaxis, hyperkalemia, preterm labor

Contraindications: hypersensitivity

Dose: 0.25mg

Routes: Inhalation, SQ

Adverse: Palpitations, anxiety, tremulousness, headache, dizziness, tachycardia

Other: The pts heart rate and SpO2 should be monitored during treatment

61
Q

Racemic Epinephrine*

A

Brand Name: S2

Classification: Sympathetic Agonist

Action: Relatively nonselective B agonist. It is a mix of both racemic isomers of epinephrine

Indications: Croup

Contraindications: Hypersensitivity

Dose: 0.25-0.75ml of a 2.5% solution

Routes: Inhalation

Adverse: Palpitations, anxiety, tremulousness, headache, dizziness, tachycardia

Other: The pts heart rate and SpO2 should be monitored during treatment

62
Q

Procainamide*

A

Brand Name: Pronestyl

Classification: Class Ia antiarrhythmic; local anesthetic

Action: Ester-type local anesthetic; reduces automaticity and AV conduction

Indications: V-Tach w/ pulse, pre-excited A-Fib

Contraindications: Do not administer to pts receiving IV calcium channel blockers

Dose: 20-50mg/min

Routes: IV

Adverse: Drowsiness, slurred speech, confusion, seizures, hypotension

Other: Carefully monitor ECG (QRS duration) during administration

63
Q

Phenytoin*

A

Brand Name: Dilantin

Classification: Class Ib antiarrhythmic; anticonvulsant

Action: Depresses automaticity and AV conduction; reduces voltage and spread of electrical discharges in motor cortex

Indications: Life-threatening arrhythmias from digitalis toxicity; & seizures

Contraindications: bradycardia, high-grade heart block, hypersensitivity

Dose: 15-18mg/kg

Routes: IV

Adverse: Drowsiness, dizziness, headache, hypotension, arrhythmias, nausea, vomiting

Other: Fosphenytoin is preferred for seizure management

64
Q

Esmolol*

A

Brand Name: Brevibloc

Classification: Class II antiarrhythmic; beta blocker

Action: slows heart rate through selective blockage of B1 receptors; short half life

Indications: Tachycardia

Contraindications: Asthma, heart block, bradycardia, cardiogenic shock

Dose: 50-100 mcg/kg/min

Routes: IV

Adverse: Bradycardia, hypotension, CHF, lethargy

Other: Hypotension is common but dose related; should not be administered to pts receiving calcium channel blockers

65
Q

Labetalol*

A

Brand Name: Trandate, Normodyne

Classification: Class II antiarrhythmic; beta blocker

Action: lowers BP through nonselective blockage of B receptors (and limit blockage of A2 receptors)

Indications: Hypertensive emergency

Contraindications: Asthma, heart block, bradycardia, cardiogenic shock

Dose: 10-20mg

Routes: IV, PO

Adverse: Bradycardia, hypotension, CHF, lethargy

Other: Should not be administered to pts receiving calcium channel blockers

66
Q

Cimetidine*

A

Brand Name: Tagamet

Classification: Antihistamine

Action: Selectively blocks H2 histamine receptors

Indications: Duodenal/ peptic ulcer, anaphylaxis

Contraindications: Hypersensitivity

Dose: 300mg

Routes: IV, IM, PO

Adverse: Diarrhea, drowsiness, dizziness

Other: Can be used as an adjunct for severe allergic reactions and anaphylaxis

67
Q

Prochlorperazine*

A

Brand Name: Compazine

Classification: Phenothiazine

Action: Suppresses the CTZ; has antihistaminic effects

Indications: Nausea, vomiting, anxiety, psychosis

Contraindications: Hypersensitivity, small children, or pregnancy

Dose: 5-10mg

Routes: IV, IM, IO, PO

Adverse: Drowsiness, dizziness, sedation, dry mouth, extrapyramidal symptoms

Other: Can potentiate CNS depressants (e.g. alcohol)

68
Q

Droperidol*

A

Brand Name: Inapsine

Classification: Antidopaminergic

Action: Blocks dopamine receptors (D2)

Indications: Nausea, vomiting, psychosis

Contraindications: Hypersensitivity, prolonged QTc on ECG

Dose: 1.25-2.50mg

Routes: IV, IM

Adverse: QTc prolongation, hypotension, tachycardia

Other: Has “Black Box” warning due to possible QT prolongation

69
Q

Vasopressin*

A

Brand Name: Pitressin

Classification: Hormone (analog of antidiuretic hormone)

Action: Non-adrenergic vasoconstrictor; promotes fluid retention in the kidney

Indications: Normovolemic hypotension

Contraindications: Few in the emergency setting

Dose: 40 units

Routes: IV

Adverse: Blanching of the skin, abdominal cramping, nausea, hypertension

Other: Benefits in cardiac arrest are questionable

70
Q

Insulin*

A

Brand Name: Humulin, NovoLog, Novolin

Classification: Hormone (insulin)

Action: causes glucose uptake by the cells thus lowering blood glucose levels

Indications: Diabetes, hyperglycemia, diabetic ketoacidosis

Contraindications: Hypoglycemia, normoglycemia

Dose: Varies

Routes: IV, SQ

Adverse: Few in the emergency setting

Other: Dosage of the various insulin types vary significantly

71
Q

Methylprednisolone*

A

Brand Name: Methylprednisolone

Classification: Hormone (analog of corticosteroid)

Action: anti-inflammatory; suppresses immune response

Indications: asthma, COPD, anaphylaxis

Contraindications: hypersensitivity

Dose: 125-250mg

Routes: IV, IO

Adverse: GI bleeding, increases blood glucose levels

Other: effects are delayed and not typically seen in the prehospital setting

72
Q

Hydroxocobalamin*

A

Brand Name: Cyanokit

Classification: cyanide antidote

Action: chelates cyanide from cytochrome oxidase forming cyanocobalamin (Vitamin B12)

Indications: cyanide or suspected cyanide poisoning

Contraindications: none in the emergency setting

Dose: 5-10mg

Routes: IV

Adverse: Chromaturia, red skin, rash, hypertension, nausea, headache

Other: Be prepared to continue full resuscitative measures following administration

73
Q

Sodium Nitrite*

A

Brand Name: Sodium Nitrite

Classification: Cyanide Antidote

Action: Vasodilator; oxidizes to hemoglobin to methemoglobin which reacts to cyanide ion to form cyanomethemoglobin, which is enzymatically degraded

Indications: cyanide poisoning

Contraindications: should not be administered to asymptomatic pts

Dose: 150-300 mg

Routes: IV

Adverse: Headache, weakness, dizziness, flushing, tachycardia, orthostatic hypotension

Other: Headache and hypotension common; can worsen hypoxia in the setting of carbon monoxide poisoning

74
Q

Sodium Thiosulfate*

A

Brand Name: Sodium Thiosulfate

Classification: Cyanide antidote

Action: converts cyanide to thiocyanate, which is removed by the kidneys

Indications: cyanide poisoning

Contraindications: none in the emergency setting

Dose: 12.5g

Routes: IV

Adverse: Nausea, vomiting, joint pain, psychosis

Other: should be administered as part of the standard (Pasadena) cyanide kit

75
Q

Pralidoxime*

A

Brand Name: 2-PAM, Protpam

Classification: Organophosphate antidote

Action: Reactivates cholinesterase; deactivates certain organophosphates

Indications: organophosphate poisoning

Contraindications: poisoning other than organophosphates

Dose: 1-2g over 30 min

Routes: IV

Adverse: Excitement, manic behavior, laryngospasm, tachycardia

Other: Always protect rescue personnel from the poison; 2-PAM administration should always follow atropinization

PC1-2 (23 decks)

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