Emergency Drugs

Question 1

oxygen is essential to life– without it, brain death begins within ___ min

Answer 1

6

Question 2

inadequate O2 in the blood

Answer 2

hypoxemia

Question 3

ambient room air contains approximately ___% O2

Answer 3

21%

fraction of inspired oxygen (FiO2) 21% of the total volume of gas taken in

Question 4

cardiac arrest initially require supplemental O2 in high concentrations (FiO2 close to 100%)

The initial emergency oxygen delivery devices of choice for these conditions include a ____ mask w/ an O2 reservoir

what flow rate?

Answer 4

nonrebreather (10-15 L/min)

Question 5

What pt may lose their hypoxic respiratory drive when given high oxygen concentrations?

Answer 5

COPD

Question 6

what should normal SpO2 read?

Answer 6

94-99%

Question 7

rate for nasal cannula

Answer 7

1-6 L/min

Question 8

emergency drugs used for an MI

Answer 8

1) Aspirin
2) Nitro
3) Morphine
4) Atropine
(MOANA)

Question 9

first-line emergency drug used to decrease platelet aggregation in the management of acute coronary syndromes and MI

Answer 9

aspirin

to speed absorption chew instead of swallowing whole

Question 10

dilates coronary arteries and improves blood flow to an ischemic myocardium

treatment choice for angina pectoris and MI

Answer 10

nitroglycerin

SL

repeat q5min (3 tabs/15 min) as long as BP > 90 mmHg

Question 11

relieves pain and anxiety, dilates venous vessels, and reduces the workload on the heart

Answer 11

Morphine sulfate

resp depression and hypotension are common adverse side effects

dose 0.4 - 2 mg every 2 min

Question 12

narcotic antagonist to reverse the side effects of morphine

Answer 12

naloxone

Question 13

primary drug indicated for the treatment of hemodynamically significant bradycardia and some types of heart block

increase HR by inhibiting the action of the vagus nerve

Answer 13

atropine sulfate

also used to reverse toxic effects of organophosphate pesticide and nerve agent exposure

0.04 mg/kg q3-5min (max 3mg)

Question 14

considered a first-line agent in ALS algorithms for the treatment of life-threatening ventricular dysrhythmias and cardiac arrest

indication in pulseless v-tach and v-fib

Answer 14

amiodarone

Question 15

alternative to amiodarone used to treat significant ventricular dysrhythmias such as PVCs, v-tach, and v-fib

exerts a local anesthetic effect on the heart, thus decreasing myocardial irritability

Answer 15

lidocaine

1-1.5 mg/kg bolus, then 0.5 - 0.75 mg/kg q5-10min until dysrhythmia is controlled or a total dose of 3 mg/kg has been administered via the IV or IO route

metabolized in liver (hepatic impairment = HR toxicity); other risks heart failure, shock, advanced age >70yrs

need continuous cardiac monitoring and assessment for signs of toxicity

Question 16

catecholamine with alpha and beta adrenergic effects

emergency cardiac indications for admin IV/IO are bradycardia and hypotension, asystole, pulseless v-tach, and v-fib

Answer 16

epinephrine

Question 17

prescribed to treat severe metabolic acidosis (DKA) as well as the hyperkalemia and acidotic states related to specific drug overdose situations

Answer 17

sodium bicarbonate

IV dose 1 mEq/kg

careful monitoring of ABG

Question 18

opiate antagonist; competitively binding to opiate receptor sites in the body

Answer 18

naloxone
0.4-2mg/2min
IV, IO, IM, SubQ, IN

monitor the pt closely for signs and symptoms of recurrent opiate effects such as resp depression and hypotension

Question 19

may be prescribed for poisoning as a means to prevent absorption of toxins into the body

Answer 19

activated charcoal

contact poison control

1-2g/kg/dose

Question 20

a sympathomimetic agent often used to treat hypotension in shock state; increase HR in bradycardic rhythms

Answer 20

dopamine

dose 5-10mcg/kg/min

increases HR and vasoconstricts

watch for extravasation (phentolamine mesylate 5-10mg in 10-15mL of NS)

Question 21

a synthetic catecholamine; sympathomimetic drug with beta-adrenergic activities

enhance the force of myocardial contraction (positive inotropic) and increasing HR (positive chronotropic)

blood pressure is only elevated through the increase in cardiac output

Answer 21

dobutamine

IV 2-20mcg/kg/min

adverse effects: myocardial ischemia, tachycardia, dysrhythmias, HA, nausea, and tremors

Question 22

a catecholamine with extremely potent vasoconstrictor actions (alpha-adrenergic effect)

when drugs such as dopamine and dobutamine have failed to produce adequate BP or as first-line alternative to dopamine

Answer 22

Norepinephrine

tapered slowly to avoid hypotension

monitor IV site for extravasation

Question 23

the drug of choice in the treatment of anaphylactic shock, an allergic response of the most serious type, brought about by antibody-antigen reaction

causes bronchodilation, enhanced cardiac performance, and vasoconstriction to increase BP

Answer 23

epinephrine

IM 0.3-0.5mg (1:1000)

Question 24

an antihistamine, is administered with epi to treat anaphylactic shock

effective for treating the histamine-induced tissue swelling and pruritus common to a severe allergic reaction

Answer 24

diphenhydramine HCl

adult dose: 25-50mg IV or IM

adverse reactions: hypotension, sedation, confusion, dry mouth

Question 25

generally defined as a systolic BP that exceeds 180-200mmHg, a diastolic BP that exceeds 120mmHg, and pulmonary edema

Answer 25

hypertensive crisis

Question 26

an alpha and beta adrenergic blocker that acts by inhibiting the effects of the sympathetic nervous system

Answer 26

labetalol

initially 20mg IV push over 2min, can be repeated or doubled q10min until desired response max dose of 300mg

contraindicated in asthma or COPD (bronchospasm), severe bradycardia or apparent heart failure AB BEAM <– cardioselective

Question 27

IV agent used to reduce arterial BP in hypertensive emergencies

MOA is immediate, direct arterial and venous vasodilation

Answer 27

nitroprusside sodium

50mg mixed in 250mL D5W; 0.25-0.3mcg/kg/min, max 10mcg/kg/min

on cardiac monitoring and BP increases with drug is stopped

Question 28

when should nitroprusside be discarded

Answer 28

1) inactivated by light (wrapped in aluminum foil or another opaque material to protect the solution from degradation)
2) a faint brown tint is typical, blue or brown discoloration of the solution indicated degradation and needs to be discarded