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WMFR Field Instruction > Medication Exam > Flashcards

Medication Exam Flashcards

1
Q

Acetaminophen

A

Indications:
Mild, moderate, severe pain.

Contraindications:
Allergic, chronic liver disease, therapeutic dose in last 6 hours or 3gm+ in last 24 hours.

  • *Dose:**
  • *1000mg** PO
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2
Q

Adenosine

A

Adenocard

Indications:
Narrow complex SVT

Contraindications:
Irregular/wide tachycardia, heart transplants

  • *Dose:**
  • *12 mg** IV bolus, 12 mg IV bolus for second dose
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3
Q

Albuterol

A

Proventil

Indications:
Bronchospasms, known or suspected hyperkalemia with peak T waves/wide QRS

RELATIVE Contraindication:
Sever tachycardia

  • *Dose:**
  • *2.5mg in 3cc**, 3 total dosages.
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4
Q

Amiodarone

A

Cordarone

Indications:
Pulseless arrest patients with recurrent/refractory VFib/VTach, Wide complex tachycardia not immediately requiring cardioversion.

Contraindications:
2nd or 3rd degree AV heart blocks
Cardiogenic shock

Dosages:
PULSELSS VTACH/VFIB = 300mg then 150mg if shock refractory

SYMPTOMATIC VTACH and undifferentiated wide complex tach w/pulse = 150 mg over 10 minutes.

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5
Q

Aspirin

A

Indications:
Suspected acute coronary syndrome

Contraindications:
ACTIVE GI bleed
Aspirin allergy

  • *Dose:**
  • *324 mg** PO
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6
Q

Atropine Sulfate

A

Indications:
Symptomatic Bradycardia
2nd and 3rd degree heart blocks
Organophosphate poisoning

Contraindications:
PRECAUTIONS ONLY
Should not be used w/o medical control for stable bradycardia
Closed angle glaucoma

Dosages:
Unstable bradycardia = 1.0 mg IV/IO, repeat 3-5 minutes max 3 mg

Poisoning = 40 kg and up 2mg IV/IM

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7
Q

Calcium Gluconate

A

Indications:
Adult pulseless arrest associated with:
-known hyperK+
-Renal failure
-CCB overdose
CCB overdose with hypotension and bradycardia
Crush injury w/HyperK+
Renal failure with known or suspected hyper K

Contraindications:
Known hypercalcemia
Suspected digoxin toxicity

Dose:
Pulseless arrest = 3gm slow IV

Renal failure w/known or suspected hyper K = 3 gm IV/IO over 5 mine

CCB overdose w/shock = 3 gm IV/IO over 5 min, 3 total doses CONTACT BASE

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8
Q

Dextrose 10%

A

Indications:
Hypoglycemia
Unconscious or AMS w/unknown etiology

Contraindications:
NONE

  • *Does:**
  • *25gm** (250mL of 10% IV solution)
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9
Q

Versed

A

Midazolam

  • *Indication:**
  • Status epilepticus
  • Sedation of the severely agitated/combative patient
  • Sedation for cardioversion or TCP
  • Severe pain (back spasms) in adults that is uncontrolled by fentanyl CALL IN ONLY
  • *Contraindication:**
  • Hypotension
  • Respiratory depression

Dosages:
Seizure or sedation for cardioversion
- 2mg IV/IO
2 times total, 5 minutes apart.
-10mg IN/IM
2 times total, 5 minutes apart
CONTACT BASE for more than 2 doses.

Mildly combative (RASS +3)
-**5mg** x2 IN/IM, give second dose after 5 min. OR SWITCH TO VERSED

Extreme combative (RASS +4)

  • *-10mg** x1 IM
  • *CONTACT BASE FOR ADDITIONAL**
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10
Q

Diphenhydramine

A

Benadryl

  • *Indications:**
  • Allergic reaction
  • Dystonic medication reactions or akathisia (inability to remain still, psychomotor restlessness)
  • *Contraindications:**
  • *PRECAUTIONS ONLY**
  • Asthma or COPD as it thickens bronchial secretions
  • Narrow-angle glaucoma
  • ½ dose for patients 65+
  • *Dose:**
  • *50mg** IV/IO/IM
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11
Q

Droperidol

A
  • *Indications:**
  • Sedation of severely agitated or combative patient
  • Nausea/vomiting
  • Combative head injury
  • *Contraindications:**
  • Suspected MI
  • BP less that 100
  • Respiratory/CNS depression
  • Pregnancy

Dose:
Sedation mildly combative
-5mg IV/IM x2

Hyperactive delirium
-10mg IM CONTACT BASE FOR MORE

N/V
-1.25mg slow IV/IO push

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12
Q

Epinephrine

A

Adrenalin

  • *Indications:**
  • Pulseless arrest
  • Anaphylaxis
  • Asthma
  • Bradycardia w/poor perfusion

Contraindications:
NONE

Dose:
Pulseless arrest
- 1mg 1:10,000 IV/IO repeat 3-5 minutes

Bradycardia w/poor perfusion
-Vasopressor infusion

Asthma
-0.3 mg 1:1,000 IM repeated once

Systemic allergic reaction
-0.3 mg 1:1,000 IM repeated once

Anaphylaxis, (hypotensive)
-Vasopressor infusion

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13
Q

Fentanyl

A

Indications:
Hemodynamically stable patients with moderate to severe pain, trauma or medical

  • *Contraindications:**
  • Hypotension, hemodynamically unstable, shock
  • Respiratory depression
  • Start low and titrate in the elderly

Dose:
IV/IO/IM = 1 - 2 mcg/kg max 3 mcg/kg

IN = 1-2 mcg/kg repeat after 5 minutes, max dose of 3

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14
Q

Glucagon

A
  • *Indication:**
  • AMS where hypoglycemia is suspected and no IV access
  • Hypotension, bradycardia from beta blocker or calcium channel blocker OD

Contraindications:
NONE

Dose:
Hypoglycemia - 1mg IM
BB or CCB OD - CONTACT BASE 2 mg IV

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15
Q

Ipatropium Bromide

A

Atrovent

Indications:
Bronchospasm

Contraindications:
Children under 2
Soy/peanut allergy is in propellent of MDI

  • *Dose:**
  • *0.5 mg** in 2.5cc neb
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16
Q

Lidocaine

A

Indications:
Analgesic for IO insertion

contraindication:
NONE

  • *Dose:**
  • *0.5mg/kg** IV/IM
17
Q

Ketamine

A

Indications:
Pain management

RELATIVE contraindication:
Penetrating eye trauma

  • *Dose:**
    0. 25 mg/kg IV/IM
18
Q

Magnesium sulfate

A
  • *Indications**
  • *Antiarrythmic** - TDP with prolonged QT
  • *Respiratory -** Severe bronchospasm unresponsive to AA neb, IM epi.
  • *OB -** Eclampsia >20 weeks or post partum w/seizures

Contraindications:
NONE

Dose:
TDP - 2gm IV bolus
Bronchospasm - 2gm IV bolus over 2 min
Eclampsia - 2 gm IV bolus slowly
Mix 4gm in 50cc over 15-30 min.

19
Q

Methylprednisolone

A

Solumedrol

  • *Indications:**
  • Anaphalyxis
  • Severe asthma
  • COPD
  • Suspected addisonian crisis
  • *Contraindication**
  • Evidence of severe active GI bleeding
  • *Dose**
  • *- 125 mg** IV/IO over 2 min
20
Q

Naloxone

A

Narcan

  • *Indications:**
  • Reversal of suspected opioid induced CNS or respiratory depression

-Coma of unknown etiology w/respiratory depression

Contraindications:
NONE

Dose:
0.5 mg IV/IO/IM/IN
Titrate to desired effect up to 2mg

21
Q

Nitroglycerin

A
  • *Indications**
  • Pain or discomfort due to suspected ACS
  • Pulmonary edema due to CHF
  • *Contraindications**
  • Suspected right ventricular STEMI
  • Hypotension SBP < 100
  • Recent use of ED meds
  • *Dose:**
  • *CP -** 0.4mg SL every 5 minutes
  • *Pulmonary Edema** - 0.4 mg every 5 minutes PRN titrated to symptoms or BP
22
Q

Ondansetron

A

Zofran

Indications:
Nausea and Vomiting

Contraindications:
NONE. but used in caution in first trimester of pregnancy and reserved for only those patients with severe dehydration and intractable vomiting

Dose:
4mg IV/IM/PO/ODT

23
Q

Racemic Epinephrine

A

Indications:
Stridor at rest

Contraindications:
NONE

  • *Dose:**
    0. 5ml mixed in 3 cc saline neb
24
Q

Sodium Bicarbonate

A

Indications:

  • TCA OD with arrhythmia, widened QRS complex or hypotension
  • Suspected Hyper K cardiac arrest (dialysis patient)
  • Crush or suspension injury with known or suspected hyper K

Contraindication

  • Metabolic and respiratory alkalosis
  • Hypocalcemia
  • Hypokalemia

Dose
-1 meq/kg slow IV push, repeated x2 q 5 minutes if needed.

WMFR Field Instruction (2 decks)

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