Medical Drugs Flashcards
D10 Class
Hypertonic Dextrose containing solution
D10 Mechanism of Action
10% dextrose in water provies nutrients in the form of dextrose as well as free water
D10 Indications
Neonatal resuscitation, hypoglycemia
D10 Contraindications
D10W should not be used as a hypovolemic volume replacement
D10 Adverse reactions and side effects
Rare in the therapeutic dosages
D10 Drug Interactions
Should not be used with phenytoin(Dilantin) or amiodarone(Inocor)
D10 Dosage and Administration for Neonates
a 10% dextrose solution may be given as an IV boilus(2mL/kg) if the newborns blood glucose level is less than 40 mg/dL and the infant is symptomatic, with a recheck of the blood glucose in about 30 minutes. IV administration of dextrose often needs to be followed by a 10% dextrose infusion run at 60 to 100 mL/kg/d. Infusion of dextrose is based on the newborns gestational age (60 mL/kg per day for a full term newborn; adjusted upward based on the recommendations of the referring hospital for premature newborns)
D10 Duration of action
Short term therapy
D10 Special considerations
None
D50 Class
Carbohydrate, antihypoglycemic
D50 Mechanism of action
Rapidly increases serum glucose levels. short term osmotic diuresis
D50 Indications
Hypoglycemia, altered level of consciousness, coma of unknown origin, seizure of unknown origin, status epilepticus
D50 Contraindications
Intracranial hemorrhage
D50 Adverse reactions and side effects
Extravasation leads to tissue necrosis. Cerebral hemorrhage; cerebral ischemia; pulmonary edema; warmth, pain, burning from IV infusion; hyperglycemia
D50 Drug Interactions
Sodium Bicarbonate, warfarin(Coumadin)
D50 Dosage and administration adult
25g slow IV push.
D50 Duration of action
onset: Less than 1 minute
peak: variable
duration: variable
Diphenhydramine (Benadryl) Class
Antihistamine (H1 blocker)
Diphenhydramine (Benadryl) Mechanism of action
Blocks H1 histamine receptors in the respiratory tract, blood vessels, and GI smooth muscle; decreases motion sickness. Reverse extrapyramidal reactions.
Diphenhydramine (Benadryl) Indications
Symptomatic relief of allergies, allergic reactions, and anaphylaxis. Blood administration reactions; used for motion sickness and relief of acute dystonic reactions caused by phenothiazines; may be useful in phenothiazine overdoses.
Diphenhydramine (Benadryl) Contraindications
Hypersensitivity to antihistamines, newborns or premature infants, breastfeeding. Use with caution in infants, children, and older adults and in patients with asthma, narrow angle glaucoma, or patients taking MAOIs
Diphenhydramine (Benadryl) Adverse Reactions and Side Effects
Drowsiness, sedation, seizures, dizziness, headache, blurred vision, wheezing, thickening of bronchial secretions, palpitations, hypotension, dysrhythmias, dry mouth, diarhea, nausea, vomiting. Hallucinations, confusion, and paradoxical CNS excitation can occur in children.
Diphenhydramine (Benadryl) Drug Interactions
Potentiates effects of alcohol and other CNS depressants. MAOI’s prolong and intensify the anticholinergic(drying) effects of diphenhydramine.
Diphenhydramine (Benadryl) Adult Dosage and Administration
25 to 50 mg IM, IV, PO.
Diphenhydramine (Benadryl) Pediatric Dosage and Administration
1 to 2 mg/kg IV, IO slowly, or IM. If PO 5 mg/kg per 24 hours.
Diphenhydramine (Benadryl) Duration of action
onset: 15 to 30 minutes
peak: 1 hour
duration: 3 to 12 hours
Diphenhydramine (Benadryl) Pregnancy safety Category
B
Diphenhydramine (Benadryl) Special considerations
Diphenhydramine (Benadryl) increases the effectiveness of epinephrine and is often used in conjunction with it, as in anaphylaxis.
Flumazenil (Romazicon) Class
Benzodiazepine antagonist, antidote
Flumazenil (Romazicon) Mechanism of action
antagonizes the action of benzodiazepines on the CNS, reversing the sedative effects
Flumazenil (Romazicon) Indications
Reversal of respiratory depression and sedative effects from pure benzodiazepine overdose.
Flumazenil (Romazicon) Contraindications
Hypersensitivity, tricyclic antidepressant overdose, seizure prone patients, coma of unknown etiology
Flumazenil (Romazicon) Adverse reactions and side effects
Seizures, dizziness, agitation, confusion, headache, visual disturbances, dysrhythmias, chest pain, hypertension, nausea, vomiting, vomiting, hiccups, rigors, shivering, pain at the injection site.
Flumazenil (Romazicon) Drug Interactions
Toxic effects of mixed drug overdose (especially tricyclics)
Flumazenil (Romazicon) Adult Dosage and Administration
First dose: 0.2 mg IV/IO over 15 seconds
Second dose: 0.3 mg may be given over 30 seconds;if no response give third dose.
Third dose: 0.5 mg IV/IO over 30 seconds; if no response repeat dose until adequate response or 3mg has been given.
Flumazenil (Romazicon) Pediatric Dosage and Administration
Not recommended
Flumazenil (Romazicon) Duration of action
onset: 1 to 2 minutes
peak: related to plasma concentration on benzodiazepines
duration: related to plasma concentration of benzodiazepines
Flumazenil (Romazicon) Pregnancy Safety category
C
Flumazenil (Romazicon) Special Considerations
Be prepared to manage seizures in patients who are physically dependent on benzodiazapines or who have ingested larger doses of other drugs. Flumazenil may precipitate withdrawal syndromes in patients dependent on benzodiazepines. Monitor patients for resedation and respiratory depression; be prepared to assist ventilations. Not recommended in combined drug overdoses, especially with TCAs; may result in death. Controversial use in unknown overdose or polysubstance overdose.
Glucagon (GlucaGen) Class
Hyperglycemic agent, pancreatic hormone, insulin antagonist
Glucagon (GlucaGen) Mechanism of Action
Increases blood glucose level by stimulating glycogenolysis. Unknown mechanism of stabilizing cardiac rhythm in beta blocker overdose. Minimal Positive inotropic and chronotropic response. Decreases GI motility and secretions
Glucagon (GlucaGen) Indications
Altered level of conciousness when hypoglycemia is suspected. May be used as a reversal agent in beta blocker and calcium channel blocker overdoses.
Glucagon (GlucaGen) Contraindications
Hyperglycemia, hypersensitivity
Glucagon (GlucaGen) Adverse Reactions and Side Effects
Dizziness, headache, hypertension, tachycardia, nausea, vomiting, rebound hypoglycemia
Glucagon (GlucaGen) Drug Interactions
Incompatible in solution with most other substances. No significant drug interactions with other emergency medications.
Glucagon (GlucaGen) Adult Dosage and Administration
Hypoglycemia: 1mg IM/IN, may repeat in 7 to 10 minutes.
Calcium channel blocker or beta blocker overdose: 3 to 10 mg IV slowly over 3 to 5 minutes initially, followed by a 3 to 5 mg/h infusion as necessary.
Glucagon (GlucaGen) Pediatric Dosage and Administration
Hypoglycemia: 1 mg IM/IN if 20 kg or greater (or 5 years or more); 0.5 mg IM/IN if less than 20 kg or younger than 5 years.
Calcium Channel or beta blocker toxicity: 0.05 to 0.15 mg/kg IV/IO over 3 to 5 minutes initially, followed by a 0.05 to 0.10 mg/kg per hour infusion as necessary.
Glucagon (GlucaGen) Duration of Action
onset: 1 minute
peak: 5 to 20 minutes
duration: 60 to 90 minutes
Glucagon (GlucaGen) Pregancy safety category
B
Glucagon (GlucaGen) Special Considerations
Ineffective if glycogen stores depleted. Should always be used in conjunction with D50 whenever possible. If patient does not respond to second dose of glucagon, D50 must be administered. Requres reconstitution with the supplied solution.
Haloperidol Lactate (Haldol) Class
Tranquilizer, antipsychotic
Haloperidol Lactate (Haldol) Mechanism of Action
Inhibits CNS catecholamine receptors: strong antidopaminergic and weak anticholinergic. Acts on CNS to depress subcortical areas, midbrain, and ascending reticular activating system in the brain.
Haloperidol Lactate (Haldol) Indications
Acute psychotic episodes
Haloperidol Lactate (Haldol) Contraindications
Parkinson disease, depressed mental status, agitation secondary to shock and hypoxia, hypersensitivity
Haloperidol Lactate (Haldol) Adverse Reactions and Side Effects
Seizures, sedation, confusion, restlessness, extrapyramidal reactions, dystonia, respiratory depression, hypotension, QT prolongation, sudden cardiac death, constipation, dry mouth, nausea, vomiting, drooling, blurred vision.
Haloperidol Lactate (Haldol) Drug Interactions
Enhanced CNS depression and hypotension in combination with alcohol. Antagonized amphetamines and epinephrine. Other CNS depressants may potentiate effects
Haloperidol Lactate (Haldol) Adult dosage and administrations
2 to 5 mg IM only ever 30 to 60 minutes until sedation is achieved
Haloperidol Lactate (Haldol) Pediatric Dosage and Administration
Not recommended