ER drugs Flashcards
crash cart/box
contents are usually things that are needed for emergencies: IV catheters, syringes, bandage material, ambu bag, ET tubes, drugs
information that should be shared with all medical professionals working on a specific animal as soon as possible
nature of illness/injury, condition of animal, time injury/event occurred or was noticed, any preexisting illness or meds, age/breed/sex/weight
CPCR
cardiopulmonary cerebral resuscitation
what are the two types of CPCR?
basic life support: BLS
advanced life support: ALS
what is the goal of CPCR?
maintain adequate oxygenation, restore ventilation, correct acidosis
CPA
cardiopulmonary arrest
sudden total failure of circulatory and respiratory systems
warning signs of CPA
sudden changes in respiratory rate, HR, pulse quality, body temperature, collapse, wide-eyed stare, rigid front legs, no blink reflex
basic life support
goals: aid ventilation, oxygenation, circulation
administer chest compressions, ventilation, establish airway, breathe for patient, maintain circulation with thoracic compression
can add in IV fluids only if hypovolemia existed/was suspected or if experiencing ongoing blood loss
advanced life support
establishing venous access
interpretation of ECG
can monitor end tidal CO2
drugs administered ET
NAVEL
naloxone, atropine, vasopressin, epinephrine, lidocaine
small saline chaser given immediately after drug
red rubber catheter inserted down ET and drugs administered through the catheter deep into lungs
vasopressors
epinephrine, vasopressin
epinephrine
injectable adrenergic
affects alpha 1, beta 1, and beta 2 receptors
increases HR, CO, vasoontricts vessels to skin, vasodilates vessels to muscles, bronchiole dilation
how much more of a drug do you give when it is an ET dose?
2-3 x normal drug dose
sometimes needs to be diluted too
vasopressin
vasoconstrictor
increases rate and force of contractions and increases vascular resistance
only use in non-shockable arrest ECG rhythm (any except V-fib)
parasympathetic anticholinergic agents
atropine, glycopyrrolate
inhibits actions of acetylcholine by occupying receptors
by blocking parasympathetic nerve the SNS dominates
atropine
crosses placental barrier
treatment for bradycardia in Sx
treats organophosphate poisoning
usually given after epinephrine
fast acting, short duration, may cause tachycardia
glycopyrrolate
similar to atropine
doesn’t cross placental barrier
slow acting
when should you give a reversal agent for an ER drug?
after patient with CPA is given a drug that has a reversal
unless they are dead
atipamezole
reverses alpha 2 adrenergic agonists (like Dexmedetomidine)
flumazenil reverses benzodiazepines
naloxone reverses opioids
antiarrhythmic agents
amiodarone, magnesium chloride, esmolol, lidocaine
lidocaine treats v-tach and VPCS
alkalinizing agents
routine admin not recommended
used for prolonged CPA
sodium bicarbonate treats metabolic acidosis and raises pH
Doxapram
not used routinely in CPCR
reverses CNS depression caused by depressants
stimulates brainstem to increase RR
used in C-section neonates
transmucosal
adrenergic agents
Dobutamine, dopamine, norepinephrine
dobutamine
affects beta 1 receptors, at higher doses affects beta 2 and alpha 1 receptors
treats heart failure, increases contractions without as much vasoconstriction as dopamine
dopamine
affects beta 1 receptors, at higher doses affects beta 2, alpha 1, and alpha 2 receptors
treats shock, CHF, hypotension
increases contractions and heart rate
norepinephrine
affects alpha 1 and beta 1 receptors
increases BP
diazepam
anticonvulsant
controls seizures
IV or rectal
quick onset and action
controlled substance
midazolam
anticonvulsant
longer onset
controlled substance
electrolytes
magnesium, potassium, calcium
assess with bloodwork
administer as needed
oxygen
patient receives room air and oxygen
invasive: nasal cannulas, nasal catheters, nasopharyngeal catheters, nasotracheal catheters
noninvasive: less effective, face mask, O2 cage
