Lecture Material Flashcards
What are six drug dosage forms/packaging?
Ampules, Vials, Prefilled Syringe, Bristojet, Act-o-Vial, Carpujet
What are the “6 Rights” of medication administration?
Right patient? Right drug? Right route? Right dose? Right time? Right documentation?
What are five sympathetic receptors?
Alpha1, Alpha2, Beta1, Beta2, Dopamine
How do you convert kilograms to pounds?
Example: How many lbs is 220kg?
Divide weight by 2, then subtract 10% -or- divide by 2.2
Example answer = 100lbs
What do the abbreviations DD, V, DH, and gtts stand for?
Desired Dose, Volume, Dose on Hand, and Drip Rate
What is the single dose equation?
DD x V/DH
When deciding what treatment to use first for a critical patient, what rule should you remember?
Always treat SHOCK first.
What are 3 questions for the cause of shock?
- Is it a pump problem?
- Is it a rate problem?
- Is it a volume problem?
Which drugs do we use to slow the heart rate?
Lidocaine, Amiodarone, Adenosine, Cardizem, Verapamil
What is the difference between Lidocaine, Amiodarone and Adenosine, Cardizem, Verapamil?
Lidocaine, Amiodarone are ventricular anti-dysrhythmics. Adenosine, Cardizem, and Verapamil are atrial irrators.
NOTE: Amiodarone is both.
How is Lidocaine administered?
Bolus followed by a maintenance infusion.
How is Amiodarone administered?
Pulseless: Bolus 300mg IV push
Pulse: 150mg IV push
No maintenance infusion needed.
What is special about Adenosine and its administration?
Its half-life is about 7 seconds, therefore you must give through IV access at the AC or higher.
When is Calcium Chloride given?
Overdose of calcium channel blockers (cardizem,verapamil) is suspected.
How is a drug given if the patient is pulseless and why?
Bolus
To get drug’s max effect and since the patient will have little to no circulation, the drug must reach the patients core.
What is the conversion of micrograms to milligrams?
1000mcg = 1mg
What is the conversion of milligrams to grams?
1000mg = 1g
What are the equivalents of the Lidocaine/Epi clock?
1mg=15gtts; 2mg=30gtts; 3mg=45gtts; 4mg=60gtts
What is the Dopamine rule?
Example: 250lbs
10% Rule
Take a patients weight in lbs and figure 10%. That is the gtts.
Example answer = (250lbs) = 25/gtts
How is a Dopamine infusion mixed?
400mg/250mL or 800mg/500mL
Resulting Concentration=1600mcg/mL
How is a Lidocaine infusion mixed?
1g in 250mL or 2g in 500mL
Resulting Concentration= 4mg/mL
How is an Epinephrine infusion mixed?
1mg 1:1,000 in 250mL or 2mg 1:1,000 in 500mL
Resulting Concentration: 4mcg/mL
What is the short-cut for Dopamine?
(Pt. weight in kg x DD)/25
What is the 10% rule for Dopamine?
10% of pts weight in lbs will equal 5mcg/kg/min
Which act established the 5 schedules of substances based on their accepted medical use in the US, abuse protential, and potential for addiction?
The Comprehensive Drug Abuse Prevention and Control Act of 1970
Schedule I drugs?
Heroin, peyote, marijuana, LSD
Schedule II drugs?
Morphine, meperidine, codeine, oxycodone, methadone, pentobarbital, amphetamines, cocaine, opium, methylphenidate (Ritalin)
Schedule III drugs?
Anabolic steroids, hydrocodone with acetaminophen (Vicodin), codeine with acetaminophen (Tylenol 3)
Schedule IV drugs?
Benzodiazepines (diazepam, lorazepam), phenobarbital, chloral hydrate
Schedule V drugs?
Cough medications or antidiarrhea
Schedule I medical use, abuse potential, and potential for addiction?
Medical Use: None
Abuse Potential: High
Potential for Addiction: Severe Dependence
Schedule II medical use, abuse potential, and potential for addiction?
Medical Use: Yes
Abuse Potential: High
Potential for Addiction: Severe Dependence
Schedule III medical use, abuse potential, and potential for addiction?
Medical Use: Yes
Abuse Potential: Less than I & II
Potential for Addiction: Moderate to Low
Schedule IV medical use, abuse potential, and potential for addiction?
Medical Use: Yes
Abuse Potential: Less than III
Potential for Addiction: Limited
Schedule V medical use, abuse potential, and potential for addiction?
Medical Use: Yes
Abuse Potential: Low
Potential for Addiction: Limited
Name 5 sources of drugs?
1- Plants 2- Animals or Humans 3- Minerals 4- Chemical substances (synthetic) 5- Recombinant DNA tech (genetic eng)
Why is it important to know what medications a patient is taking?
To ensure safe medication administration
What is the best course of action if you have doubt about the administration of a particular medication?
Contact medical control
What is the adrenergic (sympathetic) neurotransmitter?
Norepinephrine
What is the cholinergic (parasympathetic) neurotransmitter?
Acetylcholine
Norepinephrine has the greatest affinity towards which receptor sites?
Alpha1, Alpha2, and Beta1
What are the needle size, degree of entry, and volume limits for a subcutaneous injection?
25-28 gauge; 1/2 to 5/8” length
45 degrees
<2mL
What are the needle size, degree of entry, and volume limits for an intramuscular injection?
21 gauge; 1-2” length
90 degrees
<5mL
What are the 4 entral medication routes?
Sublingual
Rectal
Nasogastric
Oral
What are the 5 parenteral medication routes?
IV, intraosseous, intracardiac Tracheal, inhalation, intralingual, intranasal IM, topical Subcutaneous Intradermal
What are 10 local complications involved in IV access?
Pain & irritation; Cellulitis; Phlebitis; Thrombosis; Bleeding; Hematoma; Venous Spasm; Inadvertent arterial puncture; Nerve, tendon, ligament, and/or limb damage; Infiltration & extravasation
What are the needle size, degree of entry, and volume limits for an intravenous cannulation?
10-24 gauge (most commonly 18-20)
15-30 degrees
