MED QUIZ 2 Flashcards
Glucagon, Dextrose, Epinephrine (non-cardiac), Albuterol, Nitrous Oxide, Nitroglycerin
GLUCAGON - AKA
GlucaGen
GLUCAGON - class
- HYPERGLYCEMIC AGENT
- PANCREATIC HORMONE
- INSULIN ANTAGONIST
GLUCAGON - MOA
INCREASE BLOOD GLUCOSE LEVEL BY STIMULATING GLYCOGENOLYSIS
GLUCAGON - INDICATIONS
- HYPOGLYCEMIA
- BETA-BLOCKER/ CALCIUM CHANNEL BLOCKER TOXICITY (medicines that lower blood pressure) TOXICITY
GLUCAGON - CONTRINDICATIONS
- HYPERGLYCEMIA
- HYPERSENSITIVITY
GLUCAGON - ADVERSE REACTIONS/SIDE EFFECTS
- CNS: DIZZINESS, HEADACHE
- CV: HYPERTENSION, TACHYCARDIA
- GI/GU: N/V
OTHER: REBOUND HYPOGLYCEMIA
GLUCAGON - DRUG INTERACTIONS
INCOMPATABLE IN SOLUTION WITH MOST OTHER SUBSTANCES
GLUCAGON - DOSAGE ADMINISTRATION ADULT
HYPOGLYCEMIA: 1 mg IM
BETA BLOCKER/CALCIUM-CHANNEL BLOCK TOXICITY: 1-5 mg IV/IO (may repeat 1 in 15 min)
GLUCAGON - DOSAGE ADMINISTRATION PEDI
0.1 mg/kg (max: 1mg) IM
GLUCAGON- DURATION OF ACTION
ONSET: 1 minute
PEAK EFFECT: 5-20 minutes
DURATION: 60-90 minutes (1hr-1 1/2 hr)
GLUCAGON - CONSIDERATIONS
- FIRST LINE AGENT-ONLY IF CANT GET IV ACCESS
- INEFFECTIVE IF GLYCOGEN STORES DEPLETED
- HIGHER INCIDENCE OF REBOUND HYPOGLYCEMIA-USE WITH ORAL GLUCOSE/DEXTROSE IF CAN
DEXTROSE - CLASS
Carbohydrate
DEXTROSE -AKA
D5W, D10, D25
DEXTROSE - INDICATIONS
Hypoglycemia (<60 mg/dl) and unresponsive
DEXTROSE -MOA
Rapidly increases serum glucose levels
DEXTROSE -CONTRAINDICATIONS
Suspected ICP or intracranial hemorrhage
DEXTROSE -ADVERSE REACTIONS/SE
CNS: cerebral hemorrhage, cerebral ischemia
Respiratory: PE
Other: hyperglycemia, extravasation leads to tissue necrosis
DEXTROSE - DRUG INTERACTIONS
Sodium bicarb. may decrease effectiveness
DEXTROSE - DOSAGE ADMINISTRATION NATIONAL (ADULT+PEDI)
Adult: 12.5-25 gm slow IV/IO push. May repeat x1 in 5 min if BGL < 60 mg/dl
Pedi: 0.5 gm/kg slow IV push. May repeat in 1x in 5 min if BGL < 60 mg/dl
DEXTROSE - DOSAGE ADMINISRATION RI (ADULT+PEDI)
Adult: D10W 250 ml (25g) IV over 5 minutes, may repeat in 5 minutes if bG <60 mg/dl.
Pedi: D10W 5 ml/kg over 5 minutes, may repeat in 5 minutes if bG <60 mg/dl.
DEXTROSE - DURATION OF ACTION
Onset: < 1 min
Peak: variable
Duration: variable
DEXTROSE - SPECIAL CONSIDERATIONS
Administer thiamine prior to dextrose in known or suspected alcoholic or malnourished pts
Don’t administer to pt with known CVA unless hypoglycemia documented
EPINEPHRINE (NON-CARDIAC) - AKA
Adrenalin
EPINEPHRINE (NON-CARDIAC) - CLASS
Sympathomimetic
EPINEPHRINE (NON-CARDIAC) - MOA
Bronchodilation, vasoconstriction, increased heart rate/contraction strength
EPINEPHRINE (NON-CARDIAC) - INDICATIONS
- ALLERGIC REACTION
- SEVERE ASTHMA NOT RESPONDING TO OTHER THERAPIES
- CROUP
EPINEPHRINE (NON-CARDIAC) - CONTRAINDICATIONS
- Hypertension
- Hypothermia
- Pulmonary edema
- Myocardial ischemia
- Hypovolemic shock
EPINEPHRINE (NON-CARDIAC) - ADVERSE REACTIONS/SE
- CNS: nervousness, restlessness, headache, tremor
- CV: arrhythmias, chest pain, hypertension, tachycardia
- GI/GU: N/V
EPINEPHRINE (NON-CARDIAC) - DRUG INTERACTIONS
Potentiates other sympathomimetics