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My P1 Drug Cards > Medical Emergencies > Flashcards

Medical Emergencies Flashcards

1
Q

Diphenhydramine (Benadryl) Class

A

Antihistamine

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2
Q

Diphenhydramine (Benadryl) Actions

A

blocks histamine receptors

has some sedative effects

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3
Q

Diphenhydramine (Benadryl) Indications

A

Anaphylaxis / allergic reactions / dystonic reactions due to phenothiazines

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4
Q

Diphenhydramine (Benadryl) Contraindications

A

Asthma / nursing mothers

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5
Q

Diphenhydramine (Benadryl) Precautions / Side Effects

A

Prec: hypotension

SE: sedation / dries bronchial secretions / blurred vision / headache / palpitations

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6
Q

Diphenhydramine (Benadryl) Dose

A

Adult: 25-50mg/slow IV push or deep IM
Pedi: 2-5mg/kg

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7
Q

D50W Class

A

Carbohydrate

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8
Q

D50W Action

A

elevates blood glucose level rapidly

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9
Q

D50W Indications

A

hypoglcemia

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10
Q

D50W Contraindications

A

none in an emergency setting

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11
Q

D50W Precautions / Side Effects

A

Prec: blood sample should be drawn before administration

SE: local venous irritation

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12
Q

D50W Dose

A

Adult: 25g(50mL)/IV

Pedi: 0.5g/kg slow IV; dilute 1:1 with sterile water to form a 25% solution

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13
Q

Glucagon Class

A

Hormone (antihypoglycemic agent)

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14
Q

Glucagon Actions

A 
Causes breakdown of glycogen to glucose
inhibits glycogen synthesis
elevates blood glucose level
increases cardiac contractile force
increases heart rate
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15
Q

Glucagon Indications

A

Hypoglycemia

Beta-blocker OD

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16
Q

Glucagon Contraindications

A

hypersensitivity

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17
Q

Glucagon Precautions / Side Effects

A

Prec: effective only if there are sufficient stores of glycogen within the liver / use with caution in pts with cardiovascular or renal disease / draw blood for glucose test before administration

SE: few in emergency situation

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18
Q

Glucagon Dose

A

Adult: 0.25-0.5units/IV or 1.0mg/IM
Peds: 0.03mg/kg

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19
Q

Sodium Bicarbonate Class

A

Alkalinizing agent

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20
Q

Sodium Bicarbonate Actions

A

combines with excessive acids to form a weak volatile acid

increases pH

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21
Q

Sodium Bicarbonate Indications

A

TCA overdose

severe acidosis refractory to hyperventilation

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22
Q

Sodium Bicarbonate Contraindications

A

Alkalotic states

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23
Q

Sodium Bicarbonate Precautions / Side Effects

A

Prec: correct dose is essential to avoid overcompensation of pH / can deactivate catecholamines / can precipitate with calcium / delivers large sodium load

SE: Alkalosis

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24
Q

Sodium Bicarbonate Dose

A

Adult: 1mEq/kg initially followed by 0.5mEq/kg every 10 min as indicated by blood gas studies

Peds: 1mEq/kg initially followed by 0.5mEq/kg every 10 min

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25
Q

Methylprednisone (Solu-Medrol) Class

A

Steroid

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26
Q

Methylprednisone (Solu-Medrol) Actions

A

anti-inflammatory

suppresses immune response (especially in allergic reactions)

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27
Q

Methylprednisone (Solu-Medrol) Indications

A

severe anaphylaxis
asthma
COPD

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28
Q

Methylprednisone (Solu-Medrol) Contraindications

A

none in emergency setting

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29
Q

Methylprednisone (Solu-Medrol) Precautions / Side Effects

A

Prec: must be reconstituted and used promptly / onset of action may be 2-6hrs, thus should not be expected to be of use in the critical first hour following an anaphylactic reaction

SE: gastrointestinal bleeding / prolonged wound healing / suppression of natural steroids

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30
Q

Methylprednisone (Solu-Medrol) Dose

A

Adult: 125-250mg/IV/IM
Peds: 30mg/kg/IV/IM

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31
Q

Dexamethasone (Decadron, Hexadrol) Class

A

Steroid

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32
Q

Dexamethasone (Decadron, Hexadrol) Actions

A

possibly decreases cerebral edema
anti-inflammatory
suppresses immune response (especially in allergic reactions)

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33
Q

Dexamethasone (Decadron, Hexadrol) Indications

A

Anaphylaxis (after epinephrine and diphenhydramine)
asthma
COPD

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34
Q

Dexamethasone (Decadron, Hexadrol) Contraindications

A

none in emergency setting

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35
Q

Dexamethasone (Decadron, Hexadrol) Precautions / Side Effects

A

Prec: protect from heat / onset may be 2-6hrs thus should not be considered to be of use in the critical first hour following an anaphylactic reaction

SE: gastrointestinal bleeding / prolonged wound healing

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36
Q

Dexamethasone (Decadron, Hexadrol) Dose

A

Adult: 4-24mg/IV/IM
Peds: 0.2-0.5mg/kg/IV/IM

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37
Q

Midazolam (Versed) Class

A

tranquilizer (benzodiazepine)

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38
Q

Midazolam (Versed) Actions

A

hypnotic

sedative

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39
Q

Midazolam (Versed) Indications

A

premedication before cardioversion

acute anxiety states

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40
Q

Midazolam (Versed) Contraindications

A

hypersensitivity
narrow angle glaucoma
shock

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41
Q

Midazolam (Versed) Precautions / Side Effects

A

Prec: emergency resuscitative equipment must be available / flumazenil (Romazicon) should be available / dilute with normal saline of D5W prior to IV administration / respiratory depression more common with midazolam than other benzodiazepines

SE: drowsiness / hypotension / amnesia / respiratory depression/apnea

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42
Q

Midazolam (Versed) Dose

A

Adult: 1.0-2.5mg/IV
Peds: 0.03mg/kg
Routes: IV, oral, intranasal

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43
Q

Diazepam (Valium) Class

A

Tranquilizer (benzodiazepine)

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44
Q

Diazepam (Valium) Actions

A

anticonvulsant
skeletal muscle relaxant
sedative

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45
Q

Diazepam (Valium) Indications

A 
major motor seizures
status epilepticus
premedication before cardioversion
skeletal muscle relaxant
acute anxiety states
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46
Q

Diazepam (Valium) Contraindications

A

hypersensitivity

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47
Q

Diazepam (Valium) Precautions / Side Effects

A

Prec: local venous irritation / short duration of effect / do not mix with other medication because of possible precipitation problems / Flumazenil (Romazicon) should be available

SE: drowsiness / hypotension / respiratory depression/apnea

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48
Q

Diazepam (Valium) Dose

A

Adult Status epilepticus: 5-10mg/IV
Adult Acute Anxiety: 2-10mg/IM/IV
Adult Premedication before cardioversion: 5-15mg/IV

Peds Status Epilepticus: 0.1-0.2mg/kg

Routes: IV care must be taken not to administer faster than 1mL/min / IM / rectal

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49
Q

Promethazine (Phenergan) Class

A

Phenothiazine antihistamine (H1 Antagonist)

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50
Q

Promethazine (Phenergan) Actions

A

mild anticholinergic activity
antiemetic
potentiates actions of analgesics

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51
Q

Promethazine (Phenergan) Indications

A

Nausea and vomiting
motion sickness
to potentiate the effects of analgesics
sedation

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52
Q

Promethazine (Phenergan) Contraindications

A

comatose states

pts who have received a large amount of depressants (including alcohol)

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53
Q

Promethazine (Phenergan) Precautions / Side Effects

A

Prec: avoid accidental intraarterial injection / extravasation can cause tissue damage

SE: may impair mental/physical ability / drowsiness

54
Q

Promethazine (Phenergan) Dose

A

Adult: 25-75mcg/kg as needed
Peds: 1mg/kg IV

Route: IV/PO

55
Q

Thiamine (Vitamin B1) Class

56
Q

Thiamine (Vitamin B1) Action

A

allows normal breakdown of glucose

57
Q

Thiamine (Vitamin B1) Indications

A

Coma of unknown origin
Alcoholism
Delirium tremens

58
Q

Thiamine (Vitamin B1) Contraindications

A

none in emergency setting

59
Q

Thiamine (Vitamin B1) Precautions / Side Effects

A

Prec: rare anaphylactic reactions have been reported / should not be used as part of a “coma cocktail”

SE: rare, if any

60
Q

Thiamine (Vitamin B1) Dose

A

Adult: 100mg/IV/IM

Ped: rarely indicated

61
Q

Succinylcholine (Anectine) Class

A

Depolarizing neuromuscular blocking agent (paralytic)

62
Q

Succinylcholine (Anectine) Action

A

skeletal muscle relaxant / paralyzes skeletal muscles, including respiratory muscles

63
Q

Succinylcholine (Anectine) Indications

A

to achieve paralysis to facilitate endotracheal intubation

64
Q

Succinylcholine (Anectine) Contraindications

A

known hypersensitivity

65
Q

Succinylcholine (Anectine) Precautions / Side Effects

A

Prec: do not administer unless person skilled in ET are present / ET equipment must be available / O and resuscitative meds must be available / paralysis occurs within 1min and lasts for approx. 8min

SE: prolonged paralysis / hypotension / bradycardia

66
Q

Succinylcholine (Anectine) Dose

A

Adult: 1-1.5mg/kg/IV (40-100mg)

Ped: 1mg/kg/IV

67
Q

Rocuronium Class

A

Nondepolarizing neuromuscular blocker (paralytic)

68
Q

Rocuronium Action

A

Prevents neuromuscular transmission by blocking the effect of acetylcholine / skeletal muscle paralysis

69
Q

Rocuronium Indication

A

Induction of skeletal muscle paralysis

70
Q

Rocuronium Contraindication

A

hypersensitivity

71
Q

Rocuronium Precautions / Side Effects

A

Prec: underlying cardiovascular disease / dehydration/electrolyte abnormalities

SE: bronchospasm

72
Q

Rocuronium Dose

A

Adult: Initial RSI induction 600mcg/kg
Maintenance dose 100-200mcg/kg continuous infusion IV/IV drip

Ped: Initial RSI induction 600mcg/kg
Maintenance dose 75-125mcg/kg continuous IV infusion

73
Q

Vecuronium (Norcuron) Class

A

Non depolarizing neuromuscular blocking agent

74
Q

Vecuronium (Norcuron) Action

A

Skeletal muscle relaxant

paralyzes skeletal muscles including respiratory muscles

75
Q

Vecuronium (Norcuron) Indications

A

to achieve paralysis to facilitate endotracheal intubation

76
Q

Vecuronium (Norcuron) Contraindications

A

known hypersensitivity

77
Q

Vecuronium (Norcuron) Precautions / Side Effects

A

Prec: ETI will be required after administration
paralysis occurs within 1min and lasts for approx 30min

SE: prolonged paralysis / hypotension / bradycardia

78
Q

Vecuronium (Norcuron) dose

A

Adult: 0.08-0.1 mg/kg/IV/IO
Ped: 0.1 mg/kg/IV/IO

79
Q

Ketamine (Ketalar) Class

A

Sedative/hypnotic and analgesic

80
Q

Ketamine (Ketalar) Action

A

causes dissociative state

81
Q

Ketamine (Ketalar) Indications

A

induction agent for RSI

82
Q

Ketamine (Ketalar) Contraindications

A

Hypersensitivity

Significantly elevated BP

83
Q

Ketamine (Ketalar) Precautions / Side Effects

A

Prec: hallucinations can occur / emergency airway and resuscitation equipment/med must be available

SE: hallucinations / increased skeletal muscle tone

84
Q

Insulin (Humilin, Novolin, Iletin) Class

A

Hormone (hypoglycemic agent)

85
Q

Insulin (Humilin, Novolin, Iletin) Actions

A

Causes uptake of glucose by the cells
Decreases BGL
Promotes glucose storage

86
Q

Insulin (Humilin, Novolin, Iletin) Indications

A

Elevated BGL

DKA

87
Q

Insulin (Humilin, Novolin, Iletin) Contraindications

A

Avoid overcompensation of BGL; if possible administration should wait until the pt is in the ED

88
Q

Insulin (Humilin, Novolin, Iletin) Precautions / Side Effects

A

Prec: excessive dose may induce hypoglycemia / glucose should be available

SE: few in emergency situation

89
Q

Insulin (Humilin, Novolin, Iletin) Dose

A

Adult: 10-25 units IV followed by infusions of 0.1units/kg/hr
Ped: based on BGL

90
Q

Epi 1:1000 Class

A

Sympathomimetic

91
Q

Epi 1:1000 Action

A

Bronchodilation

92
Q

Epi 1:1000 Indications

A

Bronchial asthma
Exacerbation of COPD
Allergic reactions
Pediatric cardiac arrest (after initial epinephrine dosage)

93
Q

Epi 1:1000 Contraindications

A

underlying cardiovascular disease
hypertension
pregnancy
tachy-arrhythmias

94
Q

Epi 1:1000 Precautions / Side Effects

A

Prec: protect from light / BP, pulse, ECG must be constantly monitored

SE: palpitations/tachycardia / anxiousness / headache / tremors

95
Q

Epi 1:1000 Dose

A

Adult: 0.3-0.5mg/IM

Ped: 0.01mg/kg/IM up to 0.3mg

96
Q

Oxytocin (Pitocin) Class

A

Hormone (oxytocic)

97
Q

Oxytocin (Pitocin) Action

A

causes uterine contraction
causes lactation
slows postpartum vaginal bleeding

98
Q

Oxytocin (Pitocin) Indications

A

postpartum vaginal bleeding

99
Q

Oxytocin (Pitocin) Contraindications

A

any condition other than postpartum bleeding

Cesarean section

100
Q

Oxytocin (Pitocin) Precautions / Side Effects

A

Prec: ensure the placenta has delivered and that there is not another fetus before administering
OD can cause uterine rupture
Hypertension

SE: anaphylaxis / cardiac arrhythmias

101
Q

Oxytocin (Pitocin) Dose

A

10-20units/IV in 500mL of D5W administered according to uterine response
3-10units/IM

102
Q

Metoclopramide (Reglan) Class

A

Antiemetic

103
Q

Metoclopramide (Reglan) Actions

A

antiemetic

reduces gastro-esophageal reflux

104
Q

Metoclopramide (Reglan) Indications

A

N/V

Gastro-esophageal reflux

105
Q

Metoclopramide (Reglan) Contraindications

A

GI hemorrhage
Bowel obstruction/perforation
Hx of hypersensitivity

106
Q

Metoclopramide (Reglan) Precautions / Side Effects

A

Prec: extrapyramidal (dystonic) symptoms have been reported

SE: may impair mental and physical ability / drowsiness

107
Q

Metoclopramide (Reglan) Dose

A

10-20mg/IM
10mg/IV/1-2min

Peds: rarely used

108
Q

Droperidol (Inapsine) Class

A

Butyrophenone antipsychotic/antiemetic

109
Q

Droperidol (Inapsine) Actions

A

antagonizes the effects of medications that act on the chemoreceptor trigger zone (CTZ)

reduces anxiety and produces sedation

110
Q

Droperidol (Inapsine) Indications

A

Acute psychosis

N/V

111
Q

Droperidol (Inapsine) Contraindications

A

hypersensitivity

112
Q

Droperidol (Inapsine) Precautions / Side Effects

A

Prec: “black box” warning for “QT” interval prolongation
Use with caution in the elderly, debilitated, or poor-risk pts
Monitor vitals and ECG

SE: drowsiness; EPS symptoms (dystonia); dizziness; restlessness; hypotension; tachycardia

113
Q

Droperidol (Inapsine) Dose

A

Adult: 2.5-10mg/IV

Ped: 0.088-0.165mg/kg/IV (children >2yrs)

114
Q

Ketorolac (Toradol) Class

A

NSAID agent

115
Q

Ketorolac (Toradol) Actions

A

anti inflammatory

analgesic (peripherally acting)

116
Q

Ketorolac (Toradol) Indications

A

mild to moderate pain

117
Q

Ketorolac (Toradol) Contraindications

A

hypersensitivity

allergy to Aspirin

118
Q

Ketorolac (Toradol) Precautions / Side Effects

A

Prec: GI irritation or hemorrhage can occur

SE: edema; rash; heartburn

119
Q

Ketorolac (Toradol) Dose

A

Adult: 15-30mg/IV / 30-60mg/IM

Ped: 0.5mg/kg (max of 30mg)

120
Q

Acetaminophen (Tylenol) Class

A

Non-narcotic analgesic / antipyretic

121
Q

Acetaminophen (Tylenol) Actions

A

inhibits cyclooxygenase

122
Q

Acetaminophen (Tylenol) Indications

A

mild to moderate pain

fever

123
Q

Acetaminophen (Tylenol) Contraindications

A

hypersensitivity

124
Q

Acetaminophen (Tylenol) Precautions / Side Effects

A

Prec: use with caution in children <3yrs and in pts with known liver disease

SE: minimal within recommended dosage range

125
Q

Acetaminophen (Tylenol) Dose

A

Adult: 325-650mg/PO every 4-6hrs (up to 1gram for antipyretic)

Ped: 10-15mg/kg/PO every 4-6hrs

126
Q

Ibuprofen (Motrin, Advil) Class

127
Q

Ibuprofen (Motrin, Advil) Action

A

anti-inflammatory

prostaglandin inhibitor

128
Q

Ibuprofen (Motrin, Advil) Indications

A

Mild to moderate pain

Fever

129
Q

Ibuprofen (Motrin, Advil) Contraindications

A

hypersensitivity

pts taking other NSAIDs

130
Q

Ibuprofen (Motrin, Advil) Precautions / Side Effects

A

Prec: GI bleeding / upset stomach

SE: heartburn; N/V; wheezing

My P1 Drug Cards (3 decks)

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