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Weapons Specialist > Medications > Flashcards

Medications Flashcards

1
Q

What class is Acetaminphen (Tylenol)

A

CNS agent - Non-narcotci, analgesic, antipyretic

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2
Q

What are analgesics?

A

Analgesics are medicines that are used to relieve pain. They are also known as painkillers or pain relievers. Technically, the term analgesic refers to a medication that provides relief from pain without putting you to sleep or making you lose consciousness.

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3
Q

TCCC indications for Acetaminophen (Tylenol)

A

For mild to moderate pain management for a casualty that is still able to fight. Part of the combat wound medication pack (CWMP)

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4
Q

Dose for Acetaminophen (Tylenol)

A

325–650 mg PO q4–6h (max: 4 g/d)

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5
Q

Onset/Peak/Duration of Acetaminophen (Tylenol)

A

Onset Varies / Peak 1-3 hours / Duration 3-4 hours

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6
Q

Contraindications of Acetaminophen (tylenol)

A

Acetaminophen hypersensitivity; use with alcohol; pregnancy category B

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7
Q

Adverse/side effects of acetaminophen (Tylenol)

A

Negligible with recommended dose; rash; acute poisoning: anorexia, nausea, vomiting, dizziness, lethargy, diaphoresis, chills, epigastric or abdominal pain, diarrhea; hepatotoxicity: elevation of liver function tests; hypoglycemia, hepatic coma, acute renal failure; chronic ingestion: neutropenia, pancytopenia, leukopenia, thrombocytopenic purpura, renal damage

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8
Q

Acetaminophen (Tylenol) interactions

A

Cholestyramine may decrease absorption; barbiturates, carbamazepine, phenytoin, rifampin, and excessive alcohol use may increase potential for hepatotoxicity

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9
Q

K-9 Dosage for acetaminophen (Tylenol)

A

DO NOT GIVE

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10
Q

Mission impact on giving Acetaminophen (Tylenol)?

A

None to minimal mission impact

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11
Q

What class is Ertapenem (Invanz)

A

Antimicrobial – antibiotic, carbapenem, beta-lactam

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12
Q

TCCC indications for Ertapenem

A

Recommended for all open combat wounds if unable to take PO meds

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13
Q

Dose for Ertapenem?

A

1 gram IV/IM q24h

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14
Q

Administration instructions for Ertapenem

A

For IV reconstitute with 10mL NS; for IM 3.2mL 1.0% lidocaine without epinephrine

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15
Q

Contraindications for Ertapenem

A

Carbapenem, beta-lactam, or amide-type local anesthetic (ie. Lidocaine) hypersensitivity; pregnancy cat B

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16
Q

Adverse/Side Effects for Ertapenem?

A

Injection site phlebitis or thrombosis; asthenia, fatigue, death, fever, leg pain, anxiety, altered mental status, dizziness, headache, insomnia; chest pain, hypo- or hypertension, tachycardia, edema; abdominal pain, diarrhea, acid reflux, constipation, dyspepsia, nausea, vomiting, increased LFTs; cough, dyspnea, pharyngitis, rales, rhonchi, respiratory distress; erythema, pruritus, rash

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17
Q

Ertapenem Interactions

A

Probenecid decreases renal excretion

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18
Q

Ertapenem Mission Impact

A

GROUNDING medication for personnel on flight status

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19
Q

What class is Fentanyl?

A

CNS agent - potent narcotic (opiate) agonist

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20
Q

TCCC Indications for Fentanyl

A

For moderate to severe pain management for a casualty that IS NOT in shock or respiratory distress and IS NOT at significant risk of developing either condition.

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21
Q

Fentanyl Dose

A

800 mcg oral transmucossally, reassess in 15 min, add a second lozenge in other cheek as necessary.

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22
Q

Fentanyl Administration instructions

A

Document AVPU prior to administration. Place lozenge between the cheek and gum; do not chew lozenge. Recommend taping lozenge-on-a-stick to casualty’s finger as an added safety OR utilizing a safety pin and rubber band to attach the lozenge (under tension) to the patient’s uniform or plate carrier. Monitor for respiratory depression. Administer Nalaxone as reversal if needed. Be prepared to provide ventilatory support with a BVM.

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23
Q

Fentanyl Contraindications

A

MAOIs(anti-depressants); myasthenia gravis(disorder that causes weakness to skeletal muscles); pregnancy category C

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24
Q

Fentanyl Adverse/Side Effects

A

Sedation, euphoria, dizziness, diaphoresis, delirium, convulsions; bradycardia, hypotension, circulatory depression, cardiac arrest; miosis, blurred vision; nausea, vomiting, constipation, ileus; muscle and thoracic muscle rigidity; urinary retention, rash; laryngospasm, bronchoconstriction, respiratory depression or arrest

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25
Fentanyl Interactions
Alcohol and other CNS depressants potentiate effects; MAOIs may precipitate hypertensive crisis
26
Fentanyl mission impact
Casualty weapons, communications and sensitive equipment should be secured. GROUNDING medication for personnel on flight status.
27
What class is Ketamine?
Nonbarbiturate anesthetic, dissociative
28
what are nonbarbiturates?
Nonbarbiturate sedatives are medications derived from certain other compounds which have potent sedative properties like barbiturates. These sedatives have a rapid onset and very short duration of action, ideal for deep sedation during short procedures, in combination with analgesics.
29
TCCC Indications of Ketamine
For moderate to severe pain management for a casualty that IS in hemorrhagic shock or respiratory distress or is at significant risk of developing either condition. Also a useful adjunct to reduce the amount of opioids required to manage pain.
30
Ketamine Dose
50 - 100 mg IM or IN, Repeat doses q30min prn IM or IN (max: 4 g/d) OR 20 mg slow IV or IO, Repeat doses q20min prn IV or IO (max: 4g/d)
31
Ketamine Onset/Duratoin
IM – Onset in 3-4 minutes / Duration 12-25 minutes IV – Onset in 30 seconds / Duration 5-10 minutes
32
Ketamine administration Instructions
Document AVPU prior to administration. IV Ketamine should be administered slowly over 1 minute. End points: Control of pain or development of nystagmus (rhythmic bac-and-forth movement of eyes). Be prepared to suction as Ketamine can increase secretions. Be prepared to provide ventilatory support with a BVM.
33
Ketamine contraindications
Head injury (may worsen severe TBI)(somewhat debunct), Hypersensitivity to ketamine, Pregnancy Category B
34
Ketamine Adverse/side effects
Hypertension, Respiratory Depression, Emergence Reactions (delirium, hallucinations, confusion), Increased Intra-cranial pressure, Increased intra-ocular pressure
35
Ketamine Interactions
Effects of ketamine are increased when combined with other analgesics or muscle relaxants
36
Ketamine Mission Impact
Casualty weapons, communications and sensitive equipment should be secured. GROUNDING medication for personnel on flight status.
37
What class is Meloxicam (Mobic)
NSAID; COX2 Inhibitor, anti-inflammatory, analgesic, antipyretic
38
TCCC indications for Meloxicam (Mobic)
For mild to moderate pain management for a casualty that is still able to fight as a component of the Combat Wound Medication Pack (CWMP)
39
Meloxicam (mobic) dose?
7.5-15mg PO daily
40
Meloxicam (Mobic) contraindications
NSAID or salicylate hypersensitivity; rhinitis, urticaria, angioedema, asthma; severe renal or hepatic disease; pregnancy category C (1st/2nd trimester) and category D (3rd trimester)
41
Adverse/side effects of Meloxicam (Mobic)
Edema, flu-like syndrome, pain; abdominal pain, diarrhea, dyspepsia, flatulence, nausea, constipation, ulceration, GI bleed; anemia; arthralgia; dizziness, headache, insomnia; pharyngitis, upper respiratory tract infection, cough; rash, pruritus; urinary frequency, UTI
42
Meloxicam (Mobic) interactions
May decrease effect of ACE inhibitors and diuretics; may increase lithium levels and toxicity; aspirin may increase GI bleed risk; warfarin and herbals (feverfew, garlic, ginger, ginkgo) may increase bleeding.
43
Mission impact of Meloxicam (Mobic)
None to minimal
44
k9 dosage of meloxicam (mobic)
DO NOT GIVE
45
What class is Morphine Sulfate (MSO4)?
CNS agent - narcotic (opiate) agonist; analgesic
46
TCCC indications for Morphine
Alternative to OTFC moderate to severe pain management for a casualty that IS NOT in shock or respiratory distress and IS NOT at significant risk of developing either condition.
47
Morphine Dose?
5 mg IV/IO, Reassess in 10 min, repeat dose every 10 min as necessary to control severe pain.
48
Onset/Peak/Duration of Morphine?
IV – Onset in 5-20 minutes / Peak in 20 minutes / Duration 4-5 hours
49
Morphine administration instructions
Document AVPU prior to administration. Monitor for respiratory depression. Administer Nalaxone as reversal if needed. Be prepared to provide ventilatory support with a BVM.
50
Contraindications for Morphine
Opiate hypersensitivity; increased ICP; seizures; acute alcoholism; acute bronchial asthma, chronic pulmonary disease, severe respiratory depression; chemical-irritant induced pulmonary edema; BPH; diarrhea due to poisoning until toxic material has been eliminated; undiagnosed acute abdominal conditions; following biliary tract surgery and surgical anastomosis; pancreatitis; acute ulcerative colitis; severe liver or renal insufficiency; hypothyroidism; pregnancy category B
51
Adverse/Side effects of Morphine
Pruritus, rash, urticaria, edema, anaphylactoid reaction; sweating, skeletal muscle flaccidity; cold, clammy skin, hypothermia; euphoria, insomnia, disorientation, visual disturbances, dysphoria, paradoxic CNS stimulation (restlessness, tremor, delirium, insomnia), convulsions; decreased cough reflex, drowsiness, dizziness, deep sleep, coma; miosis; bradycardia, palpitations, syncope; flushing of face, neck, and upper thorax; orthostatic hypotension, cardiac arrest; constipation, anorexia, dry mouth, biliary colic, nausea, vomiting, elevated LFTs; urinary retention or urgency, dysuria, oliguria, reduced libido or potency; severe respiratory depression or arrest; pulmonary edema
52
Morphine Interactions
CNS depressants, sedatives, barbiturates, alcohol, benzodiazepines, and TCAs potentiate CNS depressant effects; MAOIs may precipitate hypertensive crisis; phenothiazines may antagonize analgesia; herbals (Kava-kava, valerian, St. John's wort) may increase sedation.
53
Mission impact of Moprhine
Casualty weapons, communications and sensitive equipment should be secured. GROUNDING medication for personnel on flight status.
54
what class is Moxifloxacin (Avelox)
Anitmicrobial - antibiotic; fluoroquinolone
55
TCCC indications for Moxifloxacin (Avelox)
Recommended for all open combat wounds if unable to take PO meds as a component of the Combat Wound Medication Pack (CWMP)
56
Dose of Moxifloxacin (Avelox)
400mg PO qd
57
Onset/Peak/Durations of Moxifloxacin (Avelox)
Onset Varies / Peak 1-3 hours / Duration 3-4 hours
58
Contraindications of Moxifloxacin (Avelox)
Quinolone hypersensitivity; hepatic insufficiency; syphilis; arrhythmias; myocardial ischemia or infarction; QTc prolongation, hypokalemia, or those receiving Class IA or Class III antiarrhythmic drugs; pregnancy category C.
59
Adverse/Side effects of Moxifloxacin (Avelox)
Dizziness, headache, peripheral neuropathy, nausea, diarrhea, abdominal pain, vomiting, taste perversion, abnormal LFTs, dyspepsia, tendon rupture.
60
Moxifloxacin (Avelox) Interactions
Iron, zinc, antacids, aluminum, magnesium, calcium, sucralfate decrease absorption; atenolol, cisapride, erythromycin, antipsychotics, TCAs, quinidine, procainamide, amiodarone, sotalol may prolong QTC interval; may cause false positive on opiate screening tests.
61
Moxifloxacin (Avelox) Mission Impact
GROUNDING medication for personnel on flight status.
62
What class is Naloxone (Narcan)
CNS agent - Narcotic (Opiate) Antagonists
63
TCCC indications for Naloxone (Narcan)
For narcotic opiate overdose and reversal of effects, including respiratory depression, sedation, and hypotension.
64
Dose for Naloxone (Narcan)
0.4–2.0 mg IV, repeat q2–3min up to 10 mg prn
65
Onset/Peak/Duration of Naloxone (Narcan)
IV – Onset in 1-2 minutes / Peak in 5-15 minutes / Duration 45 minutes or longer IM – Onset in 2-5 minutes / Peak in 5-15 minutes / Duration 45 minutes or longer
66
Administration instructions of Naloxone (Narcan)
Have available when administering opioids. Titrate to effect to manage negative opioid effects, but use caution that pain is still managed.
67
Contraindications of Naloxone (Narcan)
Non-opioid drug respiratory depression; pregnancy category B
68
Adverse/Side effects of naloxone (Narcan)
Analgesia reversal, tremors, hyperventilation, drowsiness, sweating; increased BP, tachycardia; nausea, vomiting.
69
Naloxone (Narcan) Interactions
Reverses analgesic effects of narcotic (opiate) agonists and agonist-antagonists.
70
Mission impact of Naloxone (Narcan)
GROUNDING medication for personnel on flight status
71
What class is Ondanestron (Zofran) Tablet and Injection?
GI agent – 5-HT3 antagonist, antiemetic
72
TCCC Indications for Ondanestron (Zofran) Tablet and Injection
For prevention and management of nausea and vomiting associated with pain management medications
73
Dose of Ondanestron (Zofran) Tablet and Injections
tablet - 4 mg ODT PO q8h PRN (max: 8 mg in an 8 hour period) Injection - 4 mg q8h PRN (max: 8 mg in an 8 hour period)
74
Contraindications of Ondanestron (Zofran) Tablet and injection
Hypersensitivity to ondansetron; pregnancy category B
75
Adverse/Side effects to ondanestron (Zofran) Tablet and injection
Dizziness, light-headedness, headache, sedation; diarrhea, constipation, dry mouth
76
Ondanestron (Zofran) Interactions tablet and injection
Rifampin may decrease ondansetron levels
77
Mission impact of Ondanestron (Zofran) Tablet and Injection
GROUNDING medication for personnel on flight status
78
What class is TXA
Antifibrinolytic
79
TCCC Indications for TXA
For patients anticipated to need significant blood transfusion; hemorrhagic shock, one or more major amputations, penetrating torso trauma, or evidence of severe bleeding.
80
Dose for TXA
1 gram in separate 100cc of NS or LR slow IV push over 10 min. Do not administer in same bag as blood products or Hextend. Administer a second infusion of 1 gram after 500cc fluid challenge.
81
Administration Instruction of TXA
Administer as soon as possible but not later than 3 hours after injury. Ensure documentation on casualty card and/or attach/write on patient’s chest wall.
82
Contraindications for TXA
subarachnoid hemorrhage, active intravascular clotting, Pregnancy Category B.
83
Adverse/Side effects of TXA
Blurred vision or impaired color vision. Gastrointestinal disturbances (nausea, vomiting, diarrhea) may occur but disappear when the dosage is reduced. Hypotension has been observed when intravenous injection is too rapid. To avoid this response, the solution should not be injected more rapidly than 100mg per minute.

Weapons Specialist (3 decks)

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