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Everything Paramedic > Hypoglycemia and Opioid Toxicity > Flashcards

Hypoglycemia and Opioid Toxicity Flashcards

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1
Q

What are the indications for the hypoglycemia medical directive?

A

Suspected hypoglycemia

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2
Q

What are the conditions for dextrose (hypoglycemia m.d.)

A

Age ≥ 2 years
LOA altered
Hypoglycemia

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2
Q

What are the drugs that can be administered under the hypoglycemia m.d.

A

Dextrose and glucagon

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3
Q

What are the conditions for glucagon (hypoglycemia m.d.)

A

LOA altered
Hypoglycemia

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4
Q

What are the contraindication to dextrose (hypoglycemia m.d.)

A

Allergy or sensitivity to dextrose

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5
Q

What are the contraindications to glucagon (hypoglycemia m.d.)

A

Allergy or sensitivity to glucagon
Pheochromocytoma

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6
Q

What is dextrose

A

It’s a liquid formula of carbohydrates

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7
Q

What is glucagon

A

It’s a hormone (made by the liver) in powder form. It stimulates the liver to move stored glycogen into glucose (glycogenolysis) to be released into the bloodstream.
Produced by pancreas

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8
Q

What are the values of hypoglycemia, normal, and hyperglycemia in an adult

A

Normal: 4-7 mmol/L
Hypoglycemia: < 4 mmol/L
Hyperglycemia: > 8-9 mmol/L

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9
Q

What are the values of pediatric hypoglycemia

A

< 2 years old: < 3 mmol/L
≥ 2 years old: < 4 mmol/L

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10
Q

What kind of drug is Naloxone

A

Non-selective and competitive opioid receptor antagonist

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11
Q

What kind of drug is Buprenorphine

A

Mixed opioid agonist-antagonist

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12
Q

What is the treatment of dextrose (hypoglycemia m.d.)

A

D10W
- Dose: 0.2g/kg (2mL/kg)
- Max single dose: 25 g (250mL)
- Dosing interval: 10 minutes
- Max # of doses: 2
D50W
- Dose: 0.5g/kg (1mL/kg)
- Max single dose: 25 g (50 mL)
- Dosing interval: 10 minutes
Max # of doses: 2

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13
Q

What is the treatment for glucagon (hypoglycemia m.d.) for a patient <25 kg

A

Route: IM
Dose: 0.5 mg
Max single dose: 0.5 mg
Dosing interval: 20 minutes
Max # of doses: 2

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14
Q

What is the treatment of glucagon (hypoglycemia m.d.) for a patient ≥ 25 kg

A

Route: IM
Dose: 1mg
Max single dose: 1mg
Dosing interval: 20 minutes
Max # of doses: 2

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15
Q

What are the indications for the opioid toxicity and withdrawal medical directive?

A

Suspected opioid toxicity

16
Q

What are the conditions for naloxone? (opioid tox. m.d.)

A

Age: ≥ 24 hours
LOA: altered
RR: <10 breaths/min
Other: Inability to adequately ventilate OR persistent need to assist ventilations

17
Q

What are the conditions to buprenorphine (opioid tox. m.d.)

A

Age: ≥ 16 years
LOA: unaltered
Other: Received naloxone for current opioid toxicity episode AND patient is exhibiting acute withdrawal with a COWS score ≥ 8

18
Q

What are the 11 categories of the COWS scale (opioid tox. m.d.)

A

Resting pulse rate
Sweating
Restlessness
Pupil size
Bone of Joint aches
Runny nose or tearing
GI upset
Tremor
Yawning
Anxiety or iterability
Gooseflesh skin

19
Q

What are the contraindication to naloxone (opioid tox. m.d.)

A

Allergy or sensitivity to naloxone

20
Q

What are the contraindication to buprenorphine

A

Allergy or sensitivity to buprenorphine
Taken methadone in the past 72 hours

21
Q

What’s the treatment for naloxone (opioid tox. m.d.)

A

IV
Dose: up to 0.4mg
Max single dose: 0.4 mg
Dosing interval: 5 mins
Max # of doses: 3
IM
Dose: 0.4 mg
Max single dose: 0.4 mg
Dosing interval: 5 min
Max # of doses: 3
IN
Dose: 2-4mg
Max single dose: 2-4 mg
Dosing interval 5 minutes
Max # of doses: 3
SC
Dose: 0.8 mg
Max single dose: 0.8 mg
Dosing interval: 5 minutes
Max # of doses: 3

22
Q

What is the treatment for buprenorphine (opioid tox. m.d.)

A

Route: PO
Initial dose: 16 mg
Subsequent dose: 8 mg
Dosing interval: 10 minutes
Max cumulative dose: 24 mg

23
Q

What are the s/s of hypoglycemia

A
  • Rapid radial pulse
  • shaky
  • Confused
  • Irritable
  • Sweaty
24
Q

What does COWS stand for

A

Clinical Opiate Withdrawal Scale

25
Q

Why is methadone a contraindication for buprenorphine/naloxone

A
  • It has an agonist effect
  • Long half life
  • If mixed it can cause an OD
26
Q

Why don’t we give glucagon to someone with a pheochromocytoma?

A
  • It will cause a sympathetic response.
  • It will increase HR, RR, BP, BGL, and contractility of the heart
27
Q

Over how many minutes should you gradually administer dextrose IV?

A

Gradually over 3 minutes

Everything Paramedic (16 decks)

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