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DAANCE > Drugs & Emergencies > Flashcards

Drugs & Emergencies Flashcards

1
Q

What would be the drugs used in an angina/MI emergency?

A

Nitroglycerin,Aspirin,Morphine,Fentanyl & No2

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2
Q

What do you look for when a patient is hyperventilating?

A

Rapid breathing with tingling, chest pain, loss of consciousness, carpal pedal spasm

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3
Q

When a patient has unstable Bradycardia, what should be done & considered?

A
  1. Patient’s BP decreases with hypoxia
  2. 100% O2
  3. Confirm adequate oxygenation & ventilation
  4. Give Atropine
  5. Consider epinephrine or dopamine infusion
  6. Consider transcutaneous pacing
  7. Consider drug induced causes (eg. beta blockers, calcium blockers, digoxin)
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4
Q

What are the 6 H’s & the 5 T’s?

A

Hypovolemia
Hypoxia
Hydrogen Ion (acidosis)
Hypo-hyperkalemia
Hypoglycemia
Hypothermia

Tension pneumothorax
Tamponade (cardiac)
Toxins
Thrombosis cardiac/pulmonary
Trauma (hypovolemia)

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5
Q

How can a bronchospam be recognized?

A

Wheezing & difficulty breathing

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6
Q

What are doses for the drugs used in an angina/MI emergency?

A

Nitroglycerin: 0.4mg sublingual q 3-5 mins. for a total of 3 doses, also available as a sublingual spray

Aspirin: 325mg

Morphine: 1-2mg IV every 5 mins.

Fentanyl: 50 mcg IV every 5 mins.

Nitrous Oxide: 20-30%

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7
Q

Would Atropine be used in a hypotension emergency?

A

Yes
Atropine: 0.01mg/kg IV up to 0.05mg/kg

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8
Q

Emergency protocol for patient with hypoglycemia & Insulin shock

A
  1. Activate EMS
  2. Establish IV access
  3. Measure blood sugar with glucometer
  4. 1 amp of IV glucose
  5. IV infusion of dextrose. If no IV access, then 1mg glucagon IM
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9
Q

What are the drugs/doses used when a patient has a laryngospasm?

A

Succinylcholine (Anectine) low dose, 10-20 mg IV
high dose, 1-1.5 mg/kg IV

Atropine: 0.5mg IV for bradycardia associated with second dose of Succinylcholine

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10
Q

What drugs are used in an unstable tachycardia patient?

A

Adenosine, Labetalol, Esmolol, Amiodarone

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11
Q

How much Diazepam & Midazolam are used when a patient has a convulsion?

A

Diazepam: 5 mg then 1 mg/min. IV

Midazolam: 2 mg then 1mg/min. IV

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12
Q

What are the steps to treat a patient with hypotension?

A
  1. Place patient in trendelenberg position
  2. Support airway, 100% O2, monitor vital signs
  3. Consider activating EMS if condition deteriorates
  4. IV access
  5. Fluid bolus of normal saline 10-20 ml/kg
  6. Ephedrine 2.5-5 mg IV or Phenylephrine 50-100 mcg IV
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13
Q

Should 02 be administered when a patient has anaphylaxis before or after & how often should the BP be measured & with what device?

A

Before for O2 administration

Every 5 mins. with a pulse oximeter

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14
Q

What are the emergency steps for a patient with malignant hyperthermia?

A
  1. Activate EMS
  2. Hyperventilate with 100% O2
  3. Dantrolene sodium 2.5mg/kg rapid injection IV
  4. IV cold saline 15mL/kg every 15 mins. X 3
  5. Ice packs to groin, axilla & neck
  6. Cold saline lovage to stomach, bladder & rectum
  7. Transport to hospital
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15
Q

What cardioversions can be expected to be found with unstable tachycardia?

A

Cardioversions: Narrow complex regular biphasic start @ 50 J & increase to 200J
Narrow complex irregular biphasic 120J-150J-200J
Wide complex regular biphasic start @ 100J-150J-200J
Wide complex irregular treat as VF

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16
Q

Emergency treatments for Asystole/PEA

A
  1. Administer CPR
  2. Epinephrine 1 mg. IV. May repeat every 3-5 mins. May give 1 dose of Vasopressin 40 U to replace first or second dose of Epinephrine
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17
Q

What are the 3 Beta-blockers considered on a patient with hypertension?

A
  1. Labetolol (Normodyne or Trandate) 20 mg IV over 2 mins. or
  2. Esmolol (Brevibloc) 500 mcg/kg over 1 min. or
  3. Atenolol (Tenormin) 10mg over 1 min.
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18
Q

Drug doses & treatments for patient with Hypotension

A
  1. Trendelenburg position
  2. Support airway, 100% O2, monitor vital signs
  3. Consider activating EMS if condition deteriorates
  4. IV access
  5. Fluid bolus of normal saline 10-20 ml/kg
  6. Ephedrine 2.5-5 mg IV or Phenylephrine 50-100 mcg IV
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19
Q

Acute coronary syndrome consists of 2 components: Angina & Myocardial Infarction. What is the emergency treatment for this patient ?

A
  1. Activate EMS, closely observe vital signs
  2. 100% O2 via mask
  3. Make patient comfortable/reassure
  4. Attach AED or difribrillator
  5. Aspirin 325 mg
  6. Establish IV access with normal saline slow drip
  7. Morphine surface for pain 2-4 mg IV push. Repeat every 5-10 mins. as needed
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20
Q

What could be specific causes for a patient with Hypertension?

A

Anxiety, pain, full bladder, medications, non compliance with high blood pressure meds, hypoxia, cardiovascular drugs & pregnancy

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21
Q

Drug doses for allergic reactions/anaphylaxis

A

Epinephrine: 0.3-0.5 mg IM in adults or 0.15 mg IM in children
Benadryl: 50mg IV
Decadron: 4-8mg IV or IM

22
Q

What are the symptoms to recognize when a patient has laryngospasm/airway obstruction?

A

High pitched crowing sounds, suprasternal retraction, absence of breath sounds &/ or paradoxical chest movements (a “rocking “ pattern of the chest & abdomen)

23
Q

Is it Amiodarone or Atropine given to treat a patient with cardiac arrest-VF/VT?

A

Amiodarone 300mg IV bolus second dose 150 mg IV

24
Q

Emergency treatment for patient with
Cardiac arrest-Asystole/PEA

A
  1. Start CPR
  2. Give epinephrine every 3-5 mins. May give 1 dose of Vasopressin 40 U to replace first or second dose of Epinephrine
  3. Determine the causes (6 H’s & 5 T’s)
25
Q

For a patient with a difficult airway, would a needle/surgical cricothyrotomy & tracheostomy be considered? Or would it be just 1 or the other?

A

Have both ready to be considered when dealing with a difficult airway

26
Q

MONA is the acronym used for Angina/MI emergencies, but what is the correct order to which treatments/drugs are given?

A

ONAM
O2
Nitroglycerin
Aspirin
Morphine

27
Q

Treatment for patient with seizure emergency

A
  1. Obtain IV access
  2. Midazolam 3mg/min. IV or IM up to 6mg or Valium 5mg IV/min. up to 10mg
  3. Continue to monitor & support
  4. Activate EMS if refractory or recurrent seizures
28
Q

What are 2 drugs(Benzodiazepines) that provide excellent amnesia?

A

Versed(Midazolam)
Valium (Diazepam)

29
Q

Analgesia is the inability to feel pain. What are 2 narcotics that provide analgesia to the patient?

A

Fentanyl
Ketamine

30
Q

Pharmacodynamics is the effect that a drug has on the body. What is Pharmacokinetics?

A

Pharmacokinetics is the effect that the body has on the drugs, or what the body does to the drug.

31
Q

The drugs that are most used today by the OMS exert the primary effect on the brain & CNS. The primary target areas are:

A
  1. The center for emotion of the brain-Benzodiazepines are anxiolytics
  2. The centres for wakefulness of the brain-Propofol & Brevital
  3. The core of the brain: The relay center of the brain-Ketamine
  4. The Medulla: The vital centers of the brain-most anesthetic agents have some effect, an exception is Ketamine resulting in increased BP
  5. The Cerebral Cortex:Opioid receptors-located in the CNS, they receive painful stimuli & alert the brain. In other parts of the brain, OR produce calming & euphoric effects-narcotics have their primary effect on these receptors
32
Q

Ketamine (Ketalar) is a dissociative anesthetic. Methohexital & Fentanyl are the generic names what are drug names?

A

Methohexital (Brevital)
Fentanyl (Sublimaze)

33
Q

There are reversal agents for narcotics & benzodiazepines, what are the 2 agents?

A

Naloxone (Narcan) is used to reverse the effects of opioids
Flumazenil (Romazicon) is used to reverse the effects of benzodiazepines

34
Q

What are 9 routes of administration?

A
  1. By mouth (PO)
  2. Intravenous (IV)
  3. Intramuscular (IM)
  4. Inhalation
  5. Intraoral Transmucosal
  6. Transdermal
  7. Rectal Transmucosal
  8. Subcutaneous (SQ)
  9. Intranasal Transmucosal
35
Q

Treatment for CVA or Stroke

A
  1. Activate EMS, note time of incident, closely monitor all vital signs
  2. Place patient in position of comfort
  3. 100% O2 via mask or nasal cannula
  4. IV access, give bolus of NS or lactated ringers’ solution, 250 cc if hypotensive
  5. Do not treat BP unless it is >180/120
  6. Transport to a stroke center as rapidly as possible!!
36
Q

The most common allergic reactions to drug administration-there are 3

A

Urticaria (rash)
Erythema (redness)
Angioedema (swelling of the lips)

37
Q

Bright red or pulsatile blood is indicative of

A

Intra-arterial catheter

38
Q

What is hypertension?

A

High blood pressure

39
Q

Ventricular tachycardia is evidenced by?

A

Wide, blunt, rapid waveform with no P waves & the QRS & T waves cannot be discerned

40
Q

Yes or No, does Asystole have any waveform of any type?

A

No
No P, QRS or T waves of any kind

41
Q

What is acute adrenal insufficiency?

A

When there’s inadequate production of cortisol, which is hormone produced & released by the adrenal gland

42
Q

What are symptoms of acute adrenal insufficiency?

A

Hypotension
Pallor
Diaphoresis
Nausea
Tachycardia
Headache
Extreme fatigue
High fever
Shaking
Abdominal pain
Confusion

43
Q

What is 100 times more potent than Morphine?

A

Fentanyl (sublimaze)

44
Q

Antichlolinergics decrease secretions from the salivary glands & also increase the heart rate. What are 2 types of anticholinergic medications?

A

Atropine
Glycopyyrrolate (Robinul)

45
Q

Antiemetics (anti-nausea) act to prevent the activation of the vomiting center. What are the medications?

A

Ondansetron (Zofran)
Propofol
Corticosteroids
Antihistamines
Benzodiazepines

46
Q

Name 3 corticosteroids

A

Dexamethasone (Decadron)
Methyl prednisone (Solu-Medrol)
Hydrocortisone (Solu-Cortef)

47
Q

What are 2 muscle relaxants that need to be refrigerated?

A

Succinylcholine (Anectine)
Rocuronium

48
Q

What does a Capnograph do?

A

Monitors ventilation in real time by measuring the level of CO2 as the patient exhales

49
Q

What are the different emergencies & drugs used involving conducting systems of the heart?

A
  1. Supraventricular dysthymias-Atropine 0.5 mg
  2. Supraventricular tachycardia-Adenosine 6mg
  3. Ventricular dysthymias-Lidocaine 0.5-1.5 mg/kg
  4. Ventricular tachycardia-Amiodarone 150 mg IV
  5. Ventricular fibrillation-CPR & after second sequence, prepare to give Epinephrine, third sequence, 1mg IV Epinephrine & prepare Amiodarone, fourth sequence, 300 mg IV Amiodarone
  6. Asystole/PEA-CPR & 1mg IV Epinephrine
50
Q

What are the 3 Ventricular dysthymia’s?

A
  1. Premature ventricular contractions (PVC)
  2. Ventricular tachycardia (VTach)
  3. Ventricular fibrillation (VFib)

DAANCE (1 decks)

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