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ADVANCE EMT CARDIAC > MED QUIZ 5 > Flashcards

MED QUIZ 5 Flashcards

Diphenhydramine, Epi, Oxymetazoline, Pseudoephedrine, Terbutaline

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1
Q

DIPHENHYDRAMINE - AKA

A

BENADRYL

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2
Q

DIPHENHYDRAMINE - CLASS

A

ANTIHISTAMINE

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3
Q

DIPHENHYDRAMINE - MOA

A

blocks histamine receptors (endogenous chemical causes allergic symptoms)

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4
Q

DIPHENHYDRAMINE - INDICATIONS

A

ALLERGIC REACTION/ANAPHYLAXIS

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5
Q

DIPHENHYDRAMINE - CONTRAINDIATIONS

A

NARROW-ANGLE GLAUCOMA (EYE PRESSURE iris blocks the eye’s drainage angle, preventing fluid from draining normally)
INFANTS

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6
Q

DIPHENHYDRAMINE - ADVERSE REACTIONS/SE

A
  1. CNS: downiness, sedation, seizure, dizziness, headache, blurred vision, paradoxical CNS excitement in children (excitation, agitation, or insomnia instead of drowsiness)
  2. RESPIRATORY: wheezing, thickening of bronchial secretions
  3. CV: palpations, hypotension, arrhythmias
  4. GI/GU: dry mouth, diarrhea, N/V
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7
Q

DIPHENHYDRAMINE - DRUG INTERACTIONS

A

POTENTIATES EFFECTS OF ALC AND OTHER ANTICHOLINERGICS

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8
Q

DIPHENHYDRAMINE - DOSAGE ADMINISTRATION ADULT NAT

A

50 mg IV/IO/IM/PO

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9
Q

DIPHENHYDRAMINE - DOSAGE ADMINISTRATION PEDI NAT

A

1 mg/kg IV/IO/IM/PO

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10
Q

DIPHENHYDRAMINE - DOSAGE ADMINISTRATION ADULT RI

A

ALLERGIC REACTION (mild severity):
50 mg PO/IV/IM

ALLERGIC REACTION (moderate severity):
50 mg IV/IM
(AND IM EPI [no cardiac history] AND [ALBUTEROL +/- IPRATROPIUM] AND METHYLPREDNISOLONE IV ..OR HYDORCORTISONE IV

ALLERGIC REACTION (severe symptoms):
50 mg IV/IM
(AND [NS 500mL] AND [ALBUTEROL] AND [METHYLPREDNISOLONE IV ..OR HYDORCORTISONE IV] AND [GLUCAGON])

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11
Q

DIPHENHYDRAMINE - DOSAGE ADMINISTRATION PEDI RI

A

ALLERGIC REACTION (mild severity):
1 mg/kg PO/IV/IM (MAX 50 mg)

ALLERGIC REACTION (moderate severity):
1 mg/kg IV/IM (MAX 50 mg)
(AND IM EPI [no cardiac history] AND [ALBUTEROL +/- IPRATROPIUM] AND METHYLPREDNISOLONE IV ..OR HYDORCORTISONE IV

ALLERGIC REACTION (severe symptoms):
1 mg/kg IV/IM (MAX 50 mg)
(AND [NS 20 mL/kg bolus, MAX 60ml/kg] AND [ALBUTEROL +/- IPRATROPIUM] AND [METHYLPREDNISOLONE IV ..OR HYDORCORTISONE IV])

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12
Q

DIPHENHYDRAMINE - DURATION OF ACTION

A

onset: 15-30 min
peak: 1 hr
duration: 3-12 hrs

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13
Q

DIPHENHYDRAMINE - SPECIAL CONSIDERATIONSOS

A
  1. IF USED IN ANAPHYLAXIS MUST BE USED WITH EPI & CORTICOSTERIODS
  2. SAME DOSE USED FOR DYSTONIC REACTIONS [spasmodic or sustained involuntary contractions of muscles] TO ANTI-PSYCHOTIC DRUGS (eg. Haldol, Thorazine, Prolixin)
  3. Diphenhydramine helps rash and itch, steroids take time for effects to be seen
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14
Q

OXYMETAZOLINE - AKA

A
  1. AFRIN
  2. ZYCAM
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15
Q

OXYMETAZOLINE - CLASS

A
  1. ADRENERGIC RECEPTOR AGONIST
  2. DECONGESTANT
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16
Q

OXYMETAZOLINE - MOA

A

AGONIST AT ALPHA-1 AND ALPHA-2 RECEPTORS CAUSING LOCALIZED VASOCONSTRICTION OF NASAL MUCOSA VASCULATURE

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17
Q

OXYMETAZOLINE - INDICATIONS

A

EPISTAXIS (NOSE BLEEDS)

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18
Q

OXYMETAZOLINE - CONTRAINDICATIONS

A
  1. known hypersensitivity
  2. coronary artery disease
  3. SEVERE HYPERTENSION (Diastolic BP > 110)
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19
Q

OXYMETAZOLINE - ADVERSE/SE

A
  1. CNS: headache, dizziness
  2. CV: hypertension, arrhythmias
  3. OTHER: temporary burning, stinging of nasal mucosa, sneezing
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20
Q

OXYMETAZOLINE - DRUG INTERACTIONS

A

USE W/ CAUTION PTS ON MAOIs MONOAMINE OXIDASE INHIBITORS

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21
Q

OXYMETAZOLINE - DOSAGE ADMINISTRATION ADULT NAT

A

2 sprays to affected nostril

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22
Q

OXYMETAZOLINE - DOSAGE ADMINISTRATION PEDI NAT

A

2 sprays of affected nostril

23
Q

OXYMETAZOLINE - DOSAGE ADMINISTRATION ADULT RI

A

EXPISTAXIS:
if compressing does not work, have pt blow nose & suction active bleeding before giving 2 sprays of OXYMETAZOLINE to affected nostril/s- follow with direct pressure

DIVING EMERGENCIES (“ear or sinus squeeze”) [sinus pressure, pain, or nasal bleeding+ N/V+ hearing loss + rupture eardrum] :
2 sprays to each nostril
(AND PSEUDOEPHEDRINE AND ANALGESIA)

24
Q

OXYMETAZOLINE - DOSAGE ADMINISTRATION PEDI RI

A

same

25
Q

OXYMETAZOLINE - DURATION OF ACTION

A

onset: <10 min
peak: variable
duration: up to 12 hrs

26
Q

OXYMETAZOLINE - SPECIAL CONSIDERATIONS

A

FOLLOW ADMINISTERATION WITH DIRECT PRESSURE TO NOSTRIS

27
Q

PSEUDOEPHEDRINE - AKA

A
  1. SUDAFED
28
Q

PSEUDOEPHEDRINE - CLASS

A
  1. ADRENERGIC RECEPTOR AGONIST
  2. DECONGESTANT
29
Q

PSEUDOEPHEDRINE - MOA

A
  1. agonist of alpha receptors causing localized vasoconstriction of nasal mucosa vasculature AND bronchial vasculature
  2. AIDS in release of air pressure in sinuses and middle ear
30
Q

PSEUDOEPHEDRINE - INDICATIONS

A

DIVING-ASSOCIATED EAR OF SINUS SQUEEZE

31
Q

PSEUDOEPHEDRINE - CONTRAINDICATIONS

A
  1. known hypersensitivity
  2. HYPERTENSION
  3. benign prostatic hyperplasia (prostate enlargement)
  4. GLAUCOMA
32
Q

PSEUDOEPHEDRINE - ADVERSE REACTIONS/SE

A
  1. anxiety, restlessness, insomnia
  2. tachycardia, hypertension, arrhythmias
33
Q

PSEUDOEPHEDRINE - DRUG INTERACTIONS

A

AVOID IN PTS ON MAOIs MONOAMINE OXIDASE INHIBITORS

34
Q

PSEUDOEPHEDRINE -DOSADE ADMINISTRATION ADULT NAT

A

30 mg PO

35
Q

PSEUDOEPHEDRINE -DOSADE ADMINISTRATION PEDI NAT

A

NOT RECOMMENDED

36
Q

PSEUDOEPHEDRINE -DOSADE ADMINISTRATION ADULT RI

A

DIVING EMERGENCIES (“ear of sinus squeeze”):
30 mg PO
(AND OXYMETAZOLINE AND ANALGESIA)

37
Q

PSEUDOEPHEDRINE -DOSADE ADMINISTRATION PEDI RI

A

NOT RECOMMENDED

38
Q

PSEUDOEPHEDRINE - DURATION OF ACTION

A

onset: 30 min
peak: 1-2 hrs
duration: 3-8 hrs

39
Q

PSEUDOEPHEDRINE - SPECIAL CONSIDERATIONS

A

Sinus and middle ear squeeze is an increase in air pressure resulting from a rapid ascent from a dive and may cause barotrauma

40
Q

TERBUTALINE - AKA

A

BRETHINE

41
Q

TERBUTALINE - CLASS

A
  1. SYMPATHOMIMETIC
  2. BRONCHODILATOR
42
Q

TERBUTALINE - MOA

A
  1. selective beta2 agonist which stimulates the sympathomimetic NS
  2. results in smooth muscle relaxation in the bronchial tree and peripheral vasculature
43
Q

TERBUTALINE - INDICATIONS

A

BRONCHOSPASM UNRESPONSIVE TO NEBULIZED INTERVENTIONS (COPD/ASTHMA/RAD ETC.)

44
Q

TERBUTALINE - CONTRAINDICATIONS

A
  1. hypersensitivity
  2. tachyarrhythmias
45
Q

TERBUTALINE - ADVERSE REACTIONS/SE

A
  1. CNS: CNS stimulation, headache, seizure, restlessness, apprehension
  2. CV: tachycardia, palpations, ST wave changes, PAC’s, PAC’s, chest pain
  3. OTHER: tremors
46
Q

TERBUTALINE - DRUG INTERACTIONS

A
  1. cardiovascular effect exacerbated by other sympathomimetics
  2. beta blockers may antagonize terbutaline
47
Q

TERBUTALINE - DOSAGE AND ADMINISTRATION ADULT NAT

A

0.25 mg IM (may repeat every 15 min x2)

48
Q

TERBUTALINE - DOSAGE AND ADMINISTRATION PEDI NAT

A

NOT RECOMMENDED

49
Q

TERBUTALINE - DOSAGE AND ADMINISTRATION ADULT RI

A

N/A NOT IN RI PROTOCOL

50
Q

TERBUTALINE - DOSAGE AND ADMINISTRATION PEDI RI

A

N/A

51
Q

TERBUTALINE - DURATION OF ACTION

A

Onset: 5-10 min
Peak: variable
Duration: 1.5-4 hrs

52
Q

TERBUTALINE - SPECIAL CONSIDERATIONS

A
  1. MOA similar to albuterol except for route (IM)
  2. unlike albuterol Terbutaline is a second-line agent bc higher risk of side effects
53
Q
A

ADVANCE EMT CARDIAC (5 decks)

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