FIELD Meds Flashcards
Dosages
Mag Sulfate Drug class
Electrolyte
Anticonvulsant
Mag MOA
Reduces striated muscle contractions &
blocks peripheral neuromuscular transmission by reducing acetylcholine release at the myoneural junction
(seizure control, uterine relaxation, bronchodilation)
Mag Sulfate indications
Hypomagnesemia
Eclampsia seizures
Respiratory distress
Torsades
Mag Sulfate contraindications
Hypermagnesemia or Hypercalcemia
Hypotension
Heart Block or Myocardial damage
Myasthenia Gravis
Diabetic coma
Pulmonary Edema
Mag Special Considerations
- CNS depressant effects can be amplified if the pt is on downers
- Not recommended 2 hrs prior Delivery (Calcium is antagonist)
- Caution in pt’s w/ Renal Failure (cleared by the kidneys & toxicity can be achieved w/ ease)
Mag Supplied
10mL Vial of 5g of 50% Mag Sulfate
0.5g/mL
Mag Sulfate Respiratory
14 y/o & over =
2g (4ml) infused in 50ml of NS over 15 minutes
13 y/o & under =
25mg/kg (2g Max) infused in 50ml of NS over 15 minutes
Mag Sulfate Eclampsia
5g (10ml) infused in 50ml of NS over 15 minutes
Mag Sulfate for Torsades
2g SIVP push over 1-2 minutes
13y/o & under =
Pulse: 25mg/kg (2g Max) infusion over 15 minutes
CA: 25mg/kg SIVP over 2-3 minutes
Methylprednisolone Drug Class
Glucocorticoid Steroid
Methylprednisolone MOA
Synthetic steroid that suppresses acute & chronic inflammation
Increases vascular smooth muscle relaxation by beta adrenergic agonists (alter airway hypersensitivity)
Methylprednisolone Indications
Anaphylaxis
Respiratory distress
Adrenal Insufficient Hypotension
Methylprednisolone Contraindications
Pulmonary Edema
TBI
Severe Infection
IM administration w/ Idiopathic thrombocytopenic purpura
Methylprednisolone Special Considerations
Caution:
- GI bleeds
- Diabetes
May blunt hypoglycemia responses to Insulin & Oral hypoglycemic agents
Potassium-Depleting agents may enhance hypokalemia
Methylprednisolone Supplied
ACT-O Vial w/ sterile powder of the compound w/ 2mL of bacteriostatic water to equal 125mg
Methylprednisolone Dosage
IV/IM
2mg/kg
*125mg Max Dose, 60mg for Peds
Ondansetron Drug Class
Serotonin 5-HT3 receptor antagonists
Antiemetic
Ondansetron MOA
Binds to the serotonin receptors located on the vagal neurons lining the GI tract, which then blocks signaling to the vomiting center in the brain
Ondansetron Contraindications
<3 Month
Prolonged QT
Liver Disease
GI Obstruction
Apomorphine
Ondansetron Special Considerations
May prolong QT interval
QT Prolongation Causes
Hypokalaemia
Hypomagnesaemia
Hypocalcaemia
Hypothermia
MI’s
ROSC Post-cardiac arrest
Raised ICP
Congenital long QT syndrome
Medications/Drugs (Psych Meds)
Ondansetron Supplied
2mL Vial of 4mg
2mg/mL
2 Total Vials
Ondansetron Dosage
IV/PO/SL
0.15mg/kg (4mg Max Single Dose)
*May repeat in 15 minutes for a max total of 8mg
Diphenhydramine Drug Class
Antihistamine
Diphenhydramine MOA
Acts as an inverse agonist at the H1 receptor, thereby reversing the effects of histamine on capillaries, reducing allergic reaction symptoms. The H1 receptor is similar to muscarinic receptors
Diphenhydramine Indications
Allergic reactions
Anaphylaxis (after Epi)
Dystonic reactions from antipsychotics
Diphenhydramine Contraindications
Caution in pts w/ CNS depression or lower respiratory tract diseases (asthma)
Newborns & Nursing Moms
Nonselective MAO inhibitors (rare)
Diphenhydramine Special Considerations
Drowsiness
Hypotension
Downers
Diphenhydramine Supplied
1mL Vial of 50mg
Diphenhydramine Dosage
1mg/kg Slow IV Push
Adults = 50mg Max
<13yrs = 25mg max
Tranexamic Acid Drug Class
Antifibrinolytic
Hemostatic Agent
TXA MOA
A synthetic version of enzyme Lysine, which disrupts the cycle of clot formation & breakdown during bleeding episodes
Binds w/ lysine sites on plasminogen, prevent it from forming into plasmin, ultimately inhibiting the breakdown of fibrin (what forms clots)
May promote platelet function & decrease inflammation
Tranexamic Acid Indications
Trauma
Excessive Bleeding
Tranexamic Acid Contraindications
Coagulopathy
Thromboembolic Disorder
PE or DVT
Acute MI
Ischemic cerebrovascular accident
Ischemic retinopathy
TXA Special Considerations
Thromboembolisms
TXA Supplied
10mL Vial of 1000mg
100mg/mL
2 Total Vials
Tranexamic Acid Dosage
> 14yrs = 2g SIV/IOP over 2 minutes
<14yrs = 30mg/kg SIV/IOP over 2 minutes
*2g Max Total
Ketamine Drug Class
Anesthetic
Ketamine MOA
Derivative of PCP
Interrupts the afferent transmissions between the Limbic & Cortex systems associated w/ pain
Blocks the following receptors:
- NMDA
- Opiate (analgesia)
- Muscarinic
- Nicotinic Acetylcholine
Stimulates Catecholamine release:
- Increased HR, BP & Cardiac Output
- Bronchodilation
Ketamine Indications
Pain
Painful procedures
Ketamine contraindication
Pregnancy
Increased ICP
CHF
Cardiac Decompensation
Angina
Stroke
Severe Hypertension
Schizo HX
Ketamine Special Considerations
Can cause:
- Hallucinations/delusions/explicit dreams
- Hypotension, Bradycardia, Respiratory Depression if administered too quickly
Increases effects of:
- ETOH
- Opioids
- Downers
Older Adults should receive lower end dose first
Ketamine Supplied
5mL Vial of 500mg
100mg/mL
Ketamine Dosage
0.2mg/kg
Adult = 20mg SIVP Max single dose
*May repeat for a max total dose of 40mg
Ketamine Prep
Waste 1ml from a 10ml flush, draw 1ml of Ketamine into the syringe & MIX
Waste 6ml so 4ml (4Omg) is left, 2ml is a full dose of 20mg
Midazolam Drug Class
Benzodiazepine
Midazolam MOA
Acts on GABA-A receptor to reduce the excitability of neurons, resulting in impairment of multi-domain cognitive functions
Midazolam Indications
Seizures
Sedations
Agitation/Exited Delirium
Painful procedures
Uncontrolled shivering (hypothermia)
Midazolam Contraindications
Respiratory/CNS depression
Shock
Depressed vital signs
Downers (drugs/etoh or meds)
Severe Glaucoma
Midazolam Supplied
2mL Vial of 10mg
5mg/mL
4 Total Vials
Midazolam IM Seizure Dosages
> 60yrs = 5mg (1ml)
*May repeat if seizure continues for a max total of 10mg
> 12yrs - Adults = 10mg (2ml)
*10 max total if under 14yrs (call medical direction)
*May repeat in adults if seizure continues for a max total of 20mg
Midazolam Ped Seizure Dosages
IM
6 - 11yrs = 5mg (1ml)
*May repeat if seizure continues for a max total of 10mg
17mnths - 5yrs = 2.5mg (0.5ml)
*May repeat if seizure continues for a max total of 5mg
Midazolam IV Seizure Dosages
> 60yrs = 2.5 (0.5ml)
*May repeat if seizure continues for a max total of 5mg
Adult = 5mg (1ml)
*May repeat if seizure continues for a max total of 10mg
Midazolam Combative Dosages
IM
Adults = 10mg (2ml)
*May repeat half the dose for a max total of 15mg
<14yrs & >60yrs = 5mg (1ml)
*May repeat half the dose for a max total of 7.5mg
IV is Half the IM Dose
Midazolam Sedation Dosages
IM
Adults = 5mg (1ml)
*May repeat for a max total of 10mg
IV or >60 = 2.5mg (0.5ml)
*May repeat for a max total of 5mg
Morphine Drug Class
Opioid Analgesic
Morphine MOA
Activates:
Mu Receptors which are present in the brainstem & the thalamus
Kappa Receptors which are present in the limbic system (part of the forebrain called the diencephalon), the brain stem & spinal cord
Delta receptors which are widely distributed in the brain & also present in the spinal cord & digestive tract
=
- Pain Relief
- Sedation
- Euphoria
- Respiratory CNS Depression
- Peripheral Venous Capacity
- Decreases Venous Return
- Physical Dependence