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Pharmacology > Medications > Flashcards

Medications Flashcards

1
Q

Acetaminophen Trade Names

A

Tylonol, Tempra

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2
Q

Acetaminophen AHS Protocols - Adult

A

-Pain management
-Antipyretic therapy; greater than 38° C
-Headache

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3
Q

Acetaminophen AHS Protocols - Pediatric

A

-Pain management
-Antipyretic therapy; greater than 38° C

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4
Q

Acetaminophen Classification

A

-Non-Opioid analgesic
-Antipyretic

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5
Q

Acetaminophen Mechanism Of Action

A

-Inhibits the synthesis of prostaglandins that may serve as mediators of pain and fever; does not have any significant anti-inflammatory properties.
-Inhibits prostaglandin synthesis in the central nervous system by blocking pain impulse generation.
-Acts on the hypothalamic heat regulating canter to produce peripheral vasodilation resulting in increased blood flow through the skin, sweating, and heat loss.

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6
Q

Acetaminophen Indications

A

-Mild pain management
-Reduction of fever

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7
Q

Acetaminophen Contraindications

A

-Hypersensitivity to alcohol, aspartame, saccharin, sugar, FDC yellow dye #5 (food colouring)
-Active liver disease / hepatic impairment

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8
Q

Acetaminophen Dosage - Adult

A

975mg PO, No repeat dose

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9
Q

Acetaminophen Dosage - Pediatric

A

15mg/kg PO, max dose of 975mg

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10
Q

Acetaminophen Side Effects

A

-Renal failure due to high doses / chronic use

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11
Q

Acetaminophen Pharmacokinetics

A

Onset - 15-30 minutes
Duration - 4-6 hours

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12
Q

Acetaminophen EMS Considerations

A

-Do not administer if the patient has taken the maximum dose of 975mg witching 4 hours.
-If the patient has received less than 975mg witching 4 hours, administer remaining medication to obtain max dose of 975mg.
-Ensure to document patient’s temperature prior to administration.

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13
Q

Acetylsalicylic Acid Trade Names

A

-ASA
-Aspirin
-Bufferin

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14
Q

Acetylsalicylic Acid AHS Protocols

A

Acute Coronary Syndrome (suspected)

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15
Q

Acetylsalicylic Acid Classifications

A

-Antiplatelet
-Analgesic
-Antipyretic
-Non-steroidal anti-inflammatory drug (NSAID)

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16
Q

Acetylsalicylic Acid Mechanism Of Action

A

-Blocks the formation of thromboxane A2, which is responsible for platelets aggregating and arteries constricting.
-Producing analgesia and has anti-inflammatory, and antipyretic effects by inhibiting the production of prostaglandins.

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17
Q

Acetylsalicylic Acid Indications

A

-Antiplatelet therapy in Acute Coronary Syndrome

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18
Q

Acetylsalicylic Acid Contraindications

A

-Hypersensitivity to salicylates / NSAIDs
-Unconscious / unable to follow commands
-Active ulcer disease / GI hemorrhage
-Bleeding disorders
-Pregnancy (especially 3rd trimester)
-Children under 15 years of age
-ASA induced asthma

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19
Q

Acetylsalicylic Acid Dosage

A

160mg - 162mg PO chewed, total max in 24 hours

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20
Q

Acetylsalicylic Acid Side Effects

A

-GI irritation
-Nausea / vomiting
-Tinnitus
-Increased risk of bleeding

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21
Q

Acetylsalicylic Acid Pharmacokinetics

A

Onset - 1-2 hours
Duration - 4-5 hours

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22
Q

Acetylsalicylic Acid EMS Considerations

A

-Withhold EMS dose if it is confirmed that patient took ASA properly previous to arrival of EMS.
-ASA must still be administered even if patient has taken their daily dose or are on blood thinners.
-Patients taking anticoagulant therapy, ASA may potentiate the effect.
-Diabetics taking ASA and oral hypoglycemic or insulin should be closely monitored for hypoglycemia.

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23
Q

Dextrose in Water Trade Names

A

-D10W
-D25W
-D50W

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24
Q

Dextrose in Water AHS Protocol - Adult

A

-Head injury
-Hypoglycemia
-Stroke

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25
Q

Dextrose in Water AHS Protocols - Pediatric

A

-Hypoglycemia (D10W; D25W)
-Head injury (D25W)

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26
Q

Dextrose in Water Classification

A

-Caloric agent

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27
Q

Dextrose in Water Mechanism Of Action

A

-Increases blood sugar levels to normal cases on hypoglycemia.
-Hypertonic solution producing a transient movement of water from interstitial spaces into the venous system (osmotic diuretic).

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28
Q

Dextrose in Water Indications

A

-Severe, symptomatic hypoglycemia from any cause.
-Head injury with symptomatic hypoglycemia (half dose).
-Stroke with symptomatic hypoglycemia (half dose).

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29
Q

Dextrose in Water Contraindications

A

-Allergy to corn or corn products
-Hyperglycemia
-Hypersensitivity to dextrose solution
-Intracranial hemorrhage (half dose)

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30
Q

Dextrose in Water Dosage - Adult; Symptomatic Hypoglycemia

A

25g D50W SIVP / IO q 5 min prn, titrate to BGL >/= 4.0mmol/L or patient improvement
Max 50g

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31
Q

Dextrose in Water Dosage - Adult; Suspected Stroke

A

12.5g D50W SIVP / IO q 5 min prn, titrate BGL = 3.0mmol/L or patient improvement
Max 50g

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32
Q

Dextrose in Water Dosage - Adult; Suspected Head Injury

A

12.5g D50W SIVP / IO q 5 min prn, titrate BGL = 4.0mmol/L or patient improvement
Max 50g

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33
Q

Dextrose in Water Dosage - Pediatric; Less than 10kg

A

0.5g/kg D10W SIVP / IO q 5 min prn, titrate to BGL 4.0mmol/L or patient improvement

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34
Q

Dextrose in Water Dosage - Pediatric; More than 10kg / less than 40kg

A

0.5g/kg D25W SIVP / IO to a single max dose of 12.5g q 5 min, titrate BGL 4.0mmol/L or patient improvement

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35
Q

Dextrose in Water Dosage - Pediatric; More than / Equal to 40kg

A

12.5g D50W SIVP / IO q 5 min prn, single max dose, titrate BGL 4.0 mmol/L or patient improvement

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36
Q

Dextrose in Water - Create D10W

A

-Remove 40mL D50W preload, replace with 40mL of normal saline
-New concentration of 5g/50mL = 100mg/mL
((0.5g X kg) X 50mL) divided by 5g

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37
Q

Dextrose in Water - Create D25W

A

-Remove 25mL from the D50W preload, replace with 25mL of normal saline.
-New concentration of 12.5g/50mL = 250mg/mL
((0.5g X kg) X 50mL) divided by 12.5g

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38
Q

Dextrose in Water Side Effects

A

-Rebound hyperglycemia
-May aggravate hypertension / CHF
-May cause neurological symptoms in an alcoholic patient
-Werkinick’s encephalopathy / Korsakoff’s syndrome

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39
Q

Dextrose in Water Pharmacokinetics

A

Onset - <1 minutes
Duration - Varies

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40
Q

Dextrose in Water EMS Considerations

A

-Tissue necrosis if infiltration occurs, to avoid; give 1/2 the total volume and check IV patency before administering the rest.
-Utilize a large bore catheter in a large vein.
-D50W has a short duration of action, therefore follow drug administration with an oral complex carbohydrate (toast, pasta, sandwich).
-Increased intracellular glucose levels in the setting of cerebral ischemia and hypoxia result in increased intracellular acidosis due to anaerobic metabolism of glucose and subsequent neuronal death.

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41
Q

Dimenhydrinate Trade Name

A

Gravol

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42
Q

Dimenhydrinate AHS Protocols

A

Nausea / vomiting

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43
Q

Dimenhydrinate Classification

A

Antiemetic

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44
Q

Dimenhydrinate Mechanism Of Action

A

-Depresses vestibular (equilibrium) function by inhibiting histamine H1 receptors
-Sedative effects due to inhibition of histamine

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45
Q

Dimenhydrinate Indications

A

Nausea / vomiting associated with motion sickness and vertigo

46
Q

Dimenhydrinate Contraindications

A

-Hypersensitivity to Dimenhydrinate and Diphenhydramine or propylene glycol (food additive)
-Narrow angle glaucoma
-Patients who have ingested large quantities of depressants including alcohol

47
Q

Dimenhydrinate Dosage

A

50mg SIVP / IM q 4 hours
25mg SIVP / IM for patients over 65 years, no repeat dose

48
Q

Dimenhydrinate Side Effects

A

-Drowsiness
-Sedative effect

49
Q

Dimenhydrinate Pharmacokinetics

A

Onset- IV immediate; IM 20-30 minutes
Duration- 3-6 hours

50
Q

Dimenhydrinate EMS Considerations

A

-Generally administered in 10mL syringe with normal saline for IV administration
-Preferred antiemetic for nausea / vomiting associated with vertigo, motion sickness, narcotic side effect, pregnancy

51
Q

Diphenhydramine Trade Name

52
Q

Diphenhydramine AHS Protocols - Adult

A

-Allergic reaction
-Anaphylaxis

53
Q

Diphenhydramine AHS Protocols - Pediatric

A

-Allergic reaction
-Anaphylaxis

54
Q

Diphenhydramine Classification

A

Antihistamine

55
Q

Diphenhydramine Mechanism Of Action

A

-Competes with histamine for H1 receptor sites on effector cells. They thereby prevent, but do not reverse responses mediated by histamine alone.
-Does not inhibit histamine release

56
Q

Diphenhydramine Indications

A

-Allergic reactions
-Adjunct to epinephrine (used after epinephrine deployed) in the management of anaphylaxis
-Management of drug induced extrapyramidal symptoms

57
Q

Diphenhydramine Contraindications

A

-Hypersensitivity to Diphenhydramine and Dimenhydrinate
-Avoid antihistamine n nursing mothers and / or in neonates (less than 28 days) unless life threatening anaphylaxis / allergy

58
Q

Diphenhydramine Dosage - Adults

A
  • (Elixer) 50mg PO, no repeat dose
    -1mg/kg SIVP / IM / IO, 50mg, no repeat dose
59
Q

Diphenhydramine Dosage - Pediatrics

A

-(Elixer) 1mg/kg PO, 50mg max dose, no repeat dose
-1mg/kg SIVP / IM / IO, 50mg max dose, no repeat dose

60
Q

Diphenhydramine Side Effects

A

-Dry mouth / throat
-Blurred vision
-Hypotension
-Thickening of bronchial secretions
-Bronchospasm

61
Q

Diphenhydramine Pharmacokinetics

A

Onset - 15 minutes PO, 5-10 minutes IM / IV
Peak effects - 1-4 hours

62
Q

Diphenhydramine EMS Considerations

A

-Diphenhydramine is not recommended in neonates due to increased susceptibility to anticholinergic effects however should be administered judiciously in setting of anaphylaxis

63
Q

Epinephrine 1mg/mL (1:1000) Trade Name

A

Adrenaline

64
Q

Epinephrine 1mg/mL (1:1000) AHS Protocols - Adult

A

Anaphylaxis

65
Q

Epinephrine 1mg/mL (1:1000) AHS Protocols - Pediatric

A

Anaphylaxis

66
Q

Epinephrine 1mg/mL (1:1000) Classifications

A

Sympathomimetic, endogenous catecolamine

67
Q

Epinephrine 1mg/mL (1:1000) Mechanism Of Action

A

-Inhibits the release of histamine associated with allergic and anaphylactic reactions.
- Alpha 1 agonist - peripheral vasoconstriction improving coronary and cerebral perfusion.
-Beta 1 agonist - positive chronotripic, inotropic, dromotropic properties, increases automaticity in the heart.
-Beta 2 agonist - bronchodilation - adrenergic receptors in the lungs to relax bronchial smooth muscle.

68
Q

Epinephrine 1mg/mL (1:1000) Indication

A

Analphylaxis

69
Q

Epinephrine 1mg/mL (1:1000) Contraindications

A

-None in emergent situations
-Hypersensitivity to epinephrine

70
Q

Epinephrine 1mg/mL (1:1000) Dosage - Adult

A

0.3mg (1mg/mL) IM q 5 prn, max 0.9mg

71
Q

Epinephrine 1mg/mL (1:1000) Dosage - Pediatric; Less than 30kg

A

0.15mg IM q 5 min, total max 0.45mg
Vastus lateralis for injection

72
Q

Epinephrine 1mg/mL (1:1000) Dosage - Pediatric; More than / Equal to 30kg

A

0.3mg IM q 5 min, total max 0.9mg
Vastus lateralis for injection

73
Q

Epinephrine 1mg/mL (1:1000) Side Effects

A

-Palpitation
-Tremors
-Nervousness
-Dizziness
-Anxiety
-Headache
-Hypertension
-Tachycardia

74
Q

Epinephrine 1mg/mL (1:1000) Pharmacokinetics

A

Onset - 5-10 minutes (IM)
Peak effects - 20 minutes

75
Q

Epinephrine 1mg/mL (1:1000) EMS Considerations

A

-All patients receiving this medication must be cardiac monitored.
-Do not administer 1mg/mL solution by direct IV.
-Epinephrine in pregnancy can cause fetal hypoxia.
-Ensure patient is in recumbent position prior to administration of epinephrine.

76
Q

Glucagon AHS Protocols - Adult

A

Hypoglycemia

77
Q

Glucagon AHS Protocols - Pediatric

A

Hypoglycemia

78
Q

Glucagon Classification

79
Q

Glucagon Mechanism Of Action

A

-Causes an increase in blood glucose by stimulating glucagen breakdown in the liver, converting glucagen to glucose.

80
Q

Glucagon Indications

A

-Confirmed hypoglycemia in which an IV cannot be established

81
Q

Glucagon Contraindications

A

-Hypersensitivity to glucagon, beef, or pork proteins
-Pheochromocytoma
-Hyperglycemia

82
Q

Glucagon Dosage - Adult

A

1mg IM q 15 prn, total max 2mg

83
Q

Glucagon Dosage - Pediatric; Less than 20kg

A

0.5mg IM q 15 min prn, total max 1mg

84
Q

Glucagon Dosage - Pediatric; More than 20kg

A

1mg IM q 15 min prn, total max

85
Q

Glucagon Side Effects

A

-Dizziness
-Headache
-Hypertension
-Tachycardia
-Rebound hyperglycemia

86
Q

Glucagon Pharmacokinetics

A

Onset - 5- 15 minutes (IM)

87
Q

Glucagon EMS Considerations

A

-Use of glucagon in patients with pheochromocytoma can cause the tumour to release catecholamines resulting in hypertensive crisis.
-D50W is the drug of choice in hypoglycemia.
-Effective only if there are sufficient stores of glycogen within the liver.
-A complex carbohydrate must be given after administration of medication to prevent relapse after hypoglycemia is corrected (toast, pasta, sandwich).

88
Q

Ibuprofen Trade Names

A

-Advil
-Motrin

89
Q

Ibuprofen AHS Protocols - Adult

A

-Pain Management
-Antipyretic therapy; greater than 38° C
-Headache

90
Q

Ibuprofen AHS Protocols - Pediatric

A

-Pain management
-Antipyretic therapy; greater than 38° C

91
Q

Ibuprofen Classifications

A

-Non-steroidal anti-inflammatory drug (NSAID)
-Non-opioid analgesic

92
Q

Ibuprofen Mechanism Of Action

A

-Inhibits prostaglandin synthesis, decreasing pain and inflammation through non-selective, reversible inhibition of cyclooxygenase enzymes, COX-1 and COX-2

93
Q

Ibuprofen Indications

A

-Treatment of mild pain associated with arthritis, pain in muscles, joints, or bones.
-Reduction of fever for adults or children over 6 months old.
-Dysmenorrhea or headaches

94
Q

Ibuprofen Contraindications

A

-Hypersensitivity to NSAIDs / salicylates
-Suspected intracranial bleeding
-Sub-arachnoid hemorrhage (indicated by sudden onset / most severe headache ever)
-Ibuprofen induced asthma
-Renal disease, except renal colic
-Diagnosis of crohns / ulcerative colitis / IBD
- Patient currently taking oral anticoagulants
-Patient undergoing chemotherapy
-Pregnancy

95
Q

Ibuprofen Dosage - Adult

A

400mg PO - No repeat dose

96
Q

Ibuprofen Dosage - Pediatric

A

10mg/kg PO - max dose 400mg

97
Q

Ibuprofen Side Effects

A

-Mild hypertension
-GI irritation
-Nausea / vomiting
-Constipation
-Tinnitus
-Increased risk of bleeding

98
Q

Ibuprofen Pharmacokinetics

A

Onset - 30 mins
Duration - 4-8 hours

99
Q

Ibuprofen EMS Considerations

A

-Do not administer if the patient has taken maximum dose writhing 6 hours.
-If patient has received less than ten maximum dose of 400mg within 6 hours, administer remaining medication up to the maximum dose of 400mg.
-Works well with pain associated with renal colic, dental, muscoskeletal.
-Cautious use with patients who have past medical history of: recent trauma / suspected subarachnoid hemorrhage, renal impairment, GI bleed, CHF, elderly over 65yrs, chronic alcoholics; can cause bleeding

100
Q

Ipratropium Bromide Trade Name

101
Q

Ipratropium Bromide AHS Protocols - Adult

A

Bronchospasm

102
Q

Ipratropium Bromide AHS Protocols - Pediatric

A

Bronchospasm

103
Q

Ipratropium Bromide Classification

A

Anticholinergic Bronchodilator

104
Q

Ipratropium Bromide Mechanism Of Action

A

-Derivative of atropine.
-Exerts anticholinergic action in the bronchioles thereby inhibiting bronchoconstriction.
-Blocks increased mucus secretions.

105
Q

Ipratropium Bromide Indications

A

-Bronchospasm (used with salbutamol)
-Anaphylaxis (used with salbutamol)

106
Q

Ipratropium Bromide Contraindictions

A

-Hypersensitivity
-Hypersensitivity to atropine

107
Q

Ipratropium Bromide Dosage - Adult

A

-MDI with spacer 1 puff (20mcg/puff) q 30-60 seconds prn, max 15 puffs
-500mcg q 5 minutes via nebulizer, max 1500mcg

108
Q

Ipratropium Bromide Dosage - Pediatric; Less than 20kg

A

-1 puff (20mcg/puff) MDI with spacer q 30-60 seconds, max 12 puffs
-250mcg via nebulizer prn, max 750mcg

109
Q

Ipratropium Bromide Dosage - Pediatric; More than / Equal to 20kg

A

-1 puff (20mcg/puff) MDI with spacer q 30-60 seconds, max 15 puffs
-500mcg via nebulizer, max 1500mcg

110
Q

Ipratropium Bromide Side Effects

A

-Dry mouth / throat
-Headache
-Cough
Palpitations
-Tremors
-Dizziness

111
Q

Ipratropium Bromide Pharmacokinetics

A

Onset - 5-15 minutes
Peak - 1-2 hours

112
Q

Ipratropium Bromide EMS Considerations

A

-Invert canister 3 times prior to administration.
-Depress canister to prime prior to administration directed to the floor.
-Direct patient to inhale slowly while administering and hold their breath for 5-10 seconds if possible, repeat 1-2 times to inhale any remaining medication in chamber before removing from mouth.
-MDI needs 30 seconds minimum recharge time between puffs.
-Alternate single puffs with salbutamol during recharge period.
-Nebulizer administration - usually combined with salbutamol to create combivent.
-Nebulizer administration - use non-humidified O2 source at 6-8LPM.
_Enhanced by other anticholinergic drugs.

Pharmacology (11 decks)

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