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PCP BC Drug Knowledge Prep > Medications > Flashcards

Medications Flashcards

1
Q

What are the indications for Acetaminophen?

A

mild to moderate pain

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2
Q

What are the contraindications for Acetaminophen?

A

-Hypersensitivity to acetaminophen or any component of the formulation

-Severe alcoholic hepatitis or liver dysfunction with active alcohol consumption

-Acute liver injury

-Acetaminophen-induced liver disease

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3
Q

What is the dosage of Acetaminophen for an Adult?

A

500-1,000 mg PO (specifically, 15 mg/kg to a maximum of 1,000 mg)

May repeat once after 4 hours

24-hour maximum: 3 g (3,000 mg) - In patients with suspected or known liver dysfunction (e.g., advanced chronic liver disease or cirrhosis), the 24-hour maximum should be lowered to 1-2 g (1,000 mg - 2,000 mg)

May be used concurrently with ibuprofen for analgesia

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4
Q

What is the dosage for Acetaminophen for a Pediatric Patient?

A

Follow weight-based dosing

–> < 30 kg: 15 mg/kg PO (use liquid preparation)

–> 30-50 kg: 500 mg PO (may use liquid preparation or tablets, depending on patient ability)

and –> > 50 kg: 500-1,000 mg PO

-May repeat once after 4 hours
-24-hour maximum: 75 mg/kg or 1 g (1,000 mg)
-Do not exceed 5 doses in 24-hours in patients < 12 years of age

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5
Q

What are the indications for ASA?

A

Chest pain or signs and symptoms consistent with cardiac ischemia

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6
Q

What are the contraindications for ASA?

A

-Hypersensitivity to ASA or drug components

-Patients who have experienced bronchospasm or other respiratory reaction precipitated by ASA or nonsteroidal anti-inflammatory drugs

-Active or recent bleeding of any kind, including head injury or peptic ulcer disease

-Pediatric patients with signs and symptoms consistent with viral illnesses (due to Reye’s Syndrome

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7
Q

What is the adult dosage for ASA?

A

162 mg PO chewed and swallowed

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8
Q

What is the pediatric dosage for ASA?

A

CliniCall consultation required prior to pediatric administration.

Chest pain in children is unlikely to be the result of ischemia; ASA is therefore not indicated unless there are rare, specific histories of disease.

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9
Q

What type of drug is ASA? - i.e. classification

A

Antiplatelet

Antithrombotic

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10
Q

What are the indications for dextrose, D10W?

A

Suspected or known hypoglycemia

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11
Q

What are the contraindications for dextrose, D10W?

A

None noted

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12
Q

What is the adult dosing of dextrose, D10W?

A

PCP: Suspected or known hypoglycemia

10-25 g IV (equivalent to 100-250 mL of D10W solution)

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13
Q

What is the pediatric dosing for dextrose, D10W?

A

Use weight based dosing

***note IV’s can only be initiated on pediatric patients 12 and over

5 mL/kg D10W IV
May repeat once

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14
Q

What are the inidications for Gravol (DimenhydriNATE)?

A

PCP: Prevention or control of nausea caused by motion sickness

PCP: Relief of moderate to severe nausea and vomiting

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15
Q

What are the contraindications for Gravol (DimenhydriNATE)?

A

Known sensitivity to dimenhydrinate, diphenhydramine, or caffeine derivatives

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16
Q

What is the adult dosing of Gravol (DimenhydriNATE)?

A

PCP: Nausea relief

  • 25-50 mg IV/IM
    OR
  • 12.5 mg IV/IM in elderly or frail patients

May repeat dose once after 4-6 hours if required

Give IM dose as direct injection; IV dose should be diluted with saline; administer medication at rate of 25 mg/min

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17
Q

What is the pediatric dosing of Gravol (DimenhydriNATE)?

A

PCP: Nausea relief

-1.25 mg/kg IV/IM; maximum single dose of 25 mg

May repeat dose once after 4-6 hours if required

Maximum total daily dose 5 mg/kg/day

Note: not authorized for patients < 12 years of age by PCP

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18
Q

What are the inidication for Epi (EPINEPHrine)?

A

PCP: Anaphylaxis

PCP: Severe bronchospasm

PCP: Severe croup

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19
Q

What are the contraindications for Epi (EPINEPHrine)?

A

There are no absolute contraindications to EPINEPHrine use in life-threatening situations such as anaphylaxis

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20
Q

What are the adult doses of Epi (EPINEPHrine)?

A

PCP: Anaphylaxis
- 0.5 mg IM every 5 minutes; may repeat up to 3 times

PCP: Severe bronchospasm with impending respiratory arrest
- CliniCall consultation recommended prior to administration.
0.5 mg IM every 5-20 minutes

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21
Q

What are the pediatric doses of Epi (EPINEPHrine)?

A

PCP: Anaphylaxis
- 0.01 mg/kg IM to a maximum of 0.5 mg; may repeat up to 3 times

PCP: Severe bronchospasm with impending respiratory arrest
- CliniCall consultation required prior to administration.
- 0.01 mg/kg IM to a maximum of 0.5 mg

PCP: Severe croup
- 5 mg by nebulizer mask
- CliniCall consultation recommended to discuss care planning options.
- If under 1 year of age: 0.5 mg/kg to a maximum of 5 mg
- Total volume of fluid in nebulizer mask should be 5 mL
- Requires additional training

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22
Q

What are the indications for Glucagon?

A

PCP: Suspected or confirmed hypoglycemia where IV access is unavailable

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23
Q

What are the contraindications for Glucagon?

A

Hypersensitivity

Pheochromocytoma (Pheochromocytoma is a type of neuroendocrine tumor that grows from cells called chromaffin cells - tumor on the adrenal gland that is non cancerous)

24
Q

What is the adult dosing of Glucagon?

A

PCP: Suspected or confirmed hypoglycemia where IV access in unavailable

1 mg IM/SC

25
Q

What is the pediatric dosing of Glucagon?

A

Follow weight-based dosing

PCP: Suspected or confirmed hypoglycemia where IV access is unavailable

If < 25 kg: 0.5 mg IM/SC

OR

If ≥ 25 kg: 1 mg IM/SC

26
Q

What are the indications for Oral Glucose?

A

Known or suspected hypoglycemia in a conscious patient where there is no risk of aspiration or choking

27
Q

What are the contraindications for Oral Glucose Gel?

A

None

28
Q

What is the adult dosing of Oral Glucose Gel?

A

15 g glucose PO (equivalent to one 38 g tube or 32 ml pouch)

Repeat at 5 minutes as necessary; no limit

29
Q

What is the Pediatric dosing of Oral Glucose Gel?

A

15 g glucose (equivalent to one 38 g tube or 32 ml pouch)

Pediatrics may require a smaller dose depending on age

Repeat at 5 minutes if necessary; 30 g glucose max

30
Q

What are the indications for Ibuprofen (Advil)?

A

Mild to moderate pain

31
Q

What are the contraindications for Ibuprofen (Advil)?

A

-Hypersensitivity to ibuprofen or other nonsteroidal anti-inflammatory drugs

-Active GI hemorrhage or ulcers

-Pregnancy (first, second, or third trimesters)

32
Q

What is the adult doing of Ibuprofen (Advil)?

A

300-400 mg PO; may repeat every 4-6 hours; maximum daily dose 1,200 mg/day

33
Q

What is the pediatric dosing of Ibuprofen (Advil)?

A

Follow weight-based dosing

10 mg/kg PO; may repeat once after 6 hours; maximum daily dose 40 mg/kg/day

34
Q

What are the indications for Narcan (Naloxone)?

A

Reversal of respiratory depression caused by suspected narcotic intoxication

35
Q

What are the contraindications for Narcan (Naloxone)?

A

Allergy or known hypersensitivity to naloxone

Neonates

36
Q

What is the adult dosing for Narcan (Naloxone)?

A

Naloxone IM/IV every 3 minutes as required; maximum 4 doses

First dose:0.4 mg IM/IV

Second dose: 0.4 mg IM/IV if required

Third dose: 0.8 mg IM/IV if required

Fourth dose: 2 mg IM/IV if required (IV preferred)

CliniCall consultation required prior to administration of further doses

37
Q

What is the pediatric dose for Narcan (Naloxone)?

A

Never administer naloxone to neonates

Follow weight-based dosing for Reversal of respiratory depression caused by suspected narcotic intoxication

0.1 mg/kg (to maximum of 2 mg per dose); repeat every 3 minutes; maximum 4 doses

Higher dose for pediatric patients as they are unlikely to experience withdrawal

38
Q

What is the pediatric dosing of Nitro?

A

Nitro is not authorized for use in pediatrics

39
Q

What is the adult dosing of Nitro?

A

PCP: Relief from chest pain suggestive of acute coronary syndrome

CliniCall consultation required prior to administration if the patient has no prior prescription for nitroglycerin or if more than 3 doses are required.

  • 0.4 mg SL every 3-5 minutes
  • Verify systolic blood pressure prior to administering each dose; systolic blood pressure must be ≥ 110 mmHg
  • Heart rate must be between 50 and 150 beats/minute
40
Q

What are the contraindications for Nitro?

A
  • Known allergy or hypersensitivity to nitroglycerin
  • Use of Viagra (sildenafil) or Levitra (vardenafil) within the previous 24 hours
  • Use of Cialis (tadalafil) within the previous 48 hours
  • Severe anemia
  • Restrictive pericarditis or pericardial tamponade
  • Documented right sided acute myocardial infarction
  • Hypotension or uncorrected hypovolemia
  • Systolic blood pressure < 110 mmHg - for EMRs and PCPs
  • Heart Rate <50 or >150 - for EMRs and PCPs
41
Q

What are the indications for Nitro?

A

Relief from chest pain suggestive of acute coronary syndrome

42
Q

What are in indications for Entonox?

A

Self-administered relief from moderate to severe pain

Includes pain caused by extremity injuries, burns, or other injuries or clinical conditions not including inhalation injuries

43
Q

What are the contraindications for Entonox?

A

Traumatic or spontaneous pneumothorax
Air embolism or decompression sickness following a recent SCUBA dive
Bullous emphysema
Gross abdominal distension
Altered mental status or an inability to comply with instructions
Inhalation injury (i.e., smoke or chemicals)
Nitroglycerin use within five minutes prior to administration of nitrous oxide

Consider the use of the mnemonic CDCPAIN:

C - Ability to Comply
D - Decompression sickness
C - Altered level of Consciousness
P - Pneumothorax
A - Air embolism
I - Inhalation injury
N - Nitroglycerin use within five minutes

44
Q

What is the adult dose of Entonox?

A

Self-administered to effect

Discontinue if any of the following start and are bad - Lightheadedness, dizziness, numbness in lips, sedation, drowsiness, disorientation
Nausea and/or vomiting

45
Q

What is the pediatric dosing for Entonox?

A

Self-administered to effect

Discontinue if any of the following start and are bad - Lightheadedness, dizziness, numbness in lips, sedation, drowsiness, disorientation
Nausea and/or vomiting

46
Q

What are the cautions of using Entonox?

A

SADMC

Shock
Abdominal distension
Depressant drugs
Maxillofacial injuries
COPD

47
Q

What are the indications for Ventolin (Salbutamol)?

A

Bronchospasm

48
Q

What are the contraindications for Ventolin (Salbutamol)?

A

-Known hypersensitivity to salbutamol

-Hemodynamically significant tachycardia

49
Q

What is the adult dosing of Ventolin (Salbutamol)?

A

Bronchospasm

5 mg nebulized; repeat doses back to back as necessary - NB: nebulized medication therapy not authorized during Covid

4 x 100 mcg via metered dose inhaler; repeat as required

50
Q

What is the pediatric dosing of Ventolin (Salbutamol)?

A

For bronchospasms - Via metered dose inhaler

< 10 kg: not indicated

10-20 kg: 5 x 100 mcg per course; may repeat up to 3 times

> 20 kg: 10 x 100 mcg per course; may repeat up to 3 times

51
Q

What are the adverse effects of Ventolin (Salbutamol)?

A

-Restlessness, weakness, vertigo, apprehensiveness
-Nausea and vomiting
-Tachycardia or other dysrhythmias
-Paradoxical worsening of respiratory distress
-Cough
-Pulmonary edema
-Sweating, pallor, flushing
-Tremors

52
Q

When would you discontinue Ventolin?

A

Discontinue administration if signs of toxicity develop:

heart rate > 150/minute (> 200/minute in pediatrics);
severe tremors
ventricular arrhythmias.

53
Q

What are the indications for TXA?

A

PCP: Signs of shock or hypoperfusion, in association with an injury suggestive of occult or ongoing hemorrhage

54
Q

What are the contraindications for TXA?

A
  • Hypersensitivity to tranexamic acid
  • Gastrointestinal hemorrhage
  • Time since injury to administration > 3 hours
  • Age < 12 years (PCP) or < 1 year (ACP)
55
Q

What is the adult dosing of TXA?

A

Signs of shock or hypoperfusion in association with an injury suggestive of occult or ongoing hemorrhage

1 g IV over 10 minutes (via infusion) which is 1 drop per second over 10 mins

AND

Signs of shock or hypoperfusion in maternal vaginal bleeding >20 weeks or postpartum hemorrhage

1 g IV over 10 minutes (via infusion) but CliniCall consultation required prior to administration of tranexamic acid

PCP BC Drug Knowledge Prep (1 decks)

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