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Protocol > Medications > Flashcards

Medications Flashcards

1
Q

Classification of acetaminophen

A

anti-pyretic and analgesic

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2
Q
  1. Action of acetaminophen

2. Onset and duration of onset

A

Fever reducer, pain blocker

10-30 min, 3-4 hrs

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3
Q

Indication of acetaminophen

A

Fever

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4
Q

Contraindication of acetaminophen

A

Hypersensitivity

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5
Q

Caution of acetaminophen

A

Anemia, Liver disease, renal disease

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6
Q

Dosage of acetaminophen

A

Pediatric 15mg/kg oral or rectal

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7
Q

Adverse reaction of acetaminophen

A

Nausea, vomiting, rash

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8
Q

Acetaminophen protocol reference

A

Medical emergencies, febrile pediatric patient

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9
Q

Classification of activated charcoal

A

Gastric decontaminant, absorbent

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10
Q
  1. Action of activated charcoal

2. Onset and duration of activated charcoal

A
  1. Adheres to meds and prohibits absorption in the GI tract

2. Immediate, Unknown

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11
Q
  1. Indication of activated charcoal

2. Contraindication

A
  1. Poisoning, overdose, consult poison control prior to administration
  2. DLOC, Ingestion of meds that may lead to abrupt DLOC
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12
Q

Caution of activated charcoal

A

Renders ipecac inactive, May give ipecac prior to but not after charcoal, Ingestion of corrosives, Fluid and electrolyte abnormalities, Fecal impaction, If gastric lavage is considered

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13
Q

Dosage of activated charcoal

A

Adult and pediatric 1gm/kg oral

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14
Q

Adverse reaction of activated charcoal

A

Nausea vomiting, black stools, diarrhea, cramping, bloating, constipation

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15
Q

Reference in protocol of activated charcoal

A

Medical Emergencies

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16
Q

Classification of Adenosine

A

Antiarrhythmic

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17
Q
  1. Action of Adenosine

2. Onset and Duration of Adenosine

A
  1. Slows conduction of AV node, may inhibit reentry pathways

2. Immediate, Less than 1 min

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18
Q
  1. Indication of Adenosine

2. Contraindication

A
  1. Conversion of paroxysmal SVT to sinus rhythm, Wolf-Parkinson-White Syndrome with narrow QRS complex
  2. 2nd & 3rd degree heart block, sick sinus syndrome unless pt has pacemaker, hypersensitivity
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19
Q

Caution of Adenosine

A

May produce transient 1st, 2nd, &3rd degree blocks or systole for 10-15 sec
Asystolic pause longer in pts. on Tegretol or Persantine
Pts. on theophyllines or caffeine may require higher dose
Asthma pts may experience bronchiospasm
May be used with wide QRS complex SVT at direction of base station, but may cause acceleration of the rate

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20
Q

Dosage of Adenosine

A

Adult: 6mg rapid IV push. If no response in 1-2 min give 12mg. Rapid push followed by 20ml NaCl bolus and elevate extremity.
Pediatric: .1mg/kg up to 6mg. If no response within 1-2 min, .2mg/kg up to 12mg rapid IV push
IV in AC with 18g or >

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21
Q

Adverse reaction of Adenosine

A

Common but transient asystole, bradycardia, hypotension, Cpx, flushing, dyspnea, numbness, tingling in arms, sweating, palpation, nausea

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22
Q

Reference in protocol of Adenosine

A

Cardiac emergencies and pediatric cardiac arrest guide

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23
Q

Classification of Afrin

A

Adrenergic sympathomimetic

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24
Q
  1. Onset of Afrin

2. Duration of Afrin

A
  1. < 5 min

2. < 12 hrs

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25
Q
  1. Indication of Afrin

2. Contraindication of Afrin

A
  1. Prep for nasotracheal intubation, control epistaxsis

2. hypersensitivity

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26
Q

Caution of Afrin

A

children < 6 years

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27
Q

Dosage of Afrin

A

2-3 sprays in each nostril

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28
Q

Adverse Reaction of Afrin

A

Headache, drowsiness, Insomnia, Palpitations, Hypertension, rebound congestion
Burning stinging sneezing if exceed dosage

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29
Q

Reference in Protocol of Afrin

A

General Principles (nasal intubation)

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30
Q

Classification of Albuterol

A

Bronchodilator, beta-2 selective, sympathetic agonist

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31
Q

Action of Albuterol

A

Relax bronchial and uterine smooth muscle by acting on beta adrenergic receptors
Causes K+ influx into the cell

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32
Q
  1. Onset of Albuterol

2. Duration of Albuterol

A
  1. 5-15 min

2. 3-6 hrs

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33
Q
  1. Indication of Albuterol

2. Contraindication of Albuterol

A
  1. Wheezing, allergic reaction, asthma
    Suspected Hyperkalemia
    Crush Injury Syndrome
  2. Hypersensitivity
34
Q

Caution of Albuterol

A 
Cardiovascular disease
Rx tricyclics
Elderly require lower dose
Monitor HR
Lung sounds before and after
Beta-blockers may blunt effect
35
Q

Dosage and administration of Albuterol

A

Adult: 2.5mg in 3ml NS SVN continuously
Pediatric: < 6 mo. 1.25mg in 3 ml NS SVN continuously, >6 mo. 2.5mg in 3 ml NS SVN

If assisting with inhaler instruct pt. to clear throat, exhale fully, put mouthpiece in place and inhale deeply.

36
Q

Adverse Reaction of Albuterol

A

Tremor, Nervousness, Dizzy, Headache, Tachycardia, Palpitations, Hypertension, Nausea, Vomiting, Ventricular Arrhythmias

37
Q

Reference in Protocol of Albuterol

A

Shock (anaphylactic), Respiratory (diff breath), Medical (renal dialysis-hyperkalemia), Environmental (toxic inhalations and allergic reactions), Traumatic (crush injury syndrome)

38
Q

Classification of Amiodarone

A

Antiarrhythmic

39
Q

Action of Amiodarone

A

Rate control in a variety of atrial and ventricular tachyarrythmias

40
Q
  1. Onset of Amiodarone

2. Duration of Amiodarone

A
  1. Immediate

2. up to 40 days

41
Q
  1. Indication of Amiodarone

2. Contraindication of Amiodarone

A
  1. Shock Refractory/VF pulseless VT
    - Polymorphic VT/wide complex tachycardia of unknown origin
    - Control of hemodynamically stable VT when cardioversion is unsuccessful
    - Acceptable for termination of ectopic or multifocal atrial tachycardia with preserved LV function
    - Used for rate control in treatment of a fib or flutter when other testaments are unsuccessful
  2. Hypersensitivity
    - Cardiogenic shock with marked sinus bradycardia, 2nd or 3rd degree AV block unless a pacemaker is available
42
Q

Caution of Amiodarone

A
  • May produce vasodilation and hypotension
  • May have negative inotropic effects and prolong QT interval
  • Renal failure, terminal elimination is long (1/2 life up to 40 days)
43
Q

Dosage and Administration of Amiodarone

A
  1. Cardiac Arrest:
    a. 300mg IV/IO push, consider repeating 150mg in 3-5 min.
    b. max dose 2.2g IV/IO in 24 hrs
    c. Pediatric: 5mg/kg IV/IO push, up to max of 300mg, may repeat up to daily dose of 15mg/kg
  2. Wide Complex Tachycardia
    a. Rapid infusion of 150mg IV/IO over 10 min
    b. May repeat every 10 min as needed
44
Q

Adverse reaction of Amiodarone

A

Vasodilation, Hypotension, Bradycardia

45
Q

Reference in Protocol of Amiodarone

A

Cardiac Emergencies (see AHA handbook)

46
Q

Classification of Aspirin

A

Non steroidal anti-inflammatory

47
Q

Action of Aspirin

A

Inhibits platelet aggregation in pts. with suspected MI

48
Q
  1. Onset of Aspirin

2. Duration of Aspirin

A
  1. 5-30 min

2. Decreasing by 1/7th over 7 days

49
Q
  1. Indication of Aspirin

2. Contraindication of Aspirin

A
  1. Suspected ischemic chest Px
  2. Allergy to salicylates
    - active ulcer disease
    - asthma
    - hemorrhagic stroke
50
Q

Caution of Aspirin

A

Pts. taking anticoagulation therapy

51
Q

Dosage and administration of Aspirin

A

Adult: 162mg if already taking ASA, 324mg if not already taking ASA
Pediatric: Contact MBCH

52
Q

Adverse Reaction of Aspirin

A

Hypersensitivty

53
Q

Reference in Protocol of Aspirin

A

Cardiac Emergencies (Chest discomfort and possible ACS, AHA handbook)

54
Q

Atropine Classification

A

Parasympathetic blocker, anticholinergic

55
Q

Atropine Action

A 
Cardiac:
1. Chronotropic effect of Increase SA node rate by blocking vagus nerve
2. Positive inotropic effect in AV Node
Non-Cardiac:
1. decrease body secretions
2. dilate pupils and eye paralysis
3. Decrease bladder tone and increase urinary retention
4. CNS Stimulant
56
Q

Atropine 1.Onset 2.Duration

A
  1. Immediate IV

2. 4 Hrs

57
Q

Atropine Indication

A
  1. Bradycardia with HYPOTN, AMS, PVC, Cpx,
  2. 2nd, 3rd heart block, asystole but not very effective
  3. Organophosphate, Nerve agent poisoning
  4. Pre-medication for pediatric intubations
58
Q

Atropine Contraindication

A
  1. Afib/flutter
  2. HR>60
  3. Bradycardia due to ICP (stroke/trauma)
59
Q

Atropine Use with Caution

A
  1. Do not mix with sodium bicarb

2. Be certain bradycardia not due to hypoxia or ICP

60
Q

Atropine Dosage and Administration

A
  1. Bradycardia
    Adult: .5mg IV every 3-5 min as needed, not to exceed .04mg/kg, ET 1mg diluted in 10ml NS
    Ped: .02mg/kg, min = 0.1mg, max single dose = 0.5mg, max total dose = 1mg
    Adolescent single dose = 1mg, max total = 2mg
    ET = .05mg/kg in 5ml NS
  2. Poisoning
    Adult: 1mg every 1 min until Sy clear, up to 10mg, If using MARK1 kit give up to 3 sets of meds
    Ped: <12yo .5mg IV/IO every 1 min. until Sy clear, max total 10mg.
    RSI = .02mg/kg, min dose = .1mg, max dose = .5mg
61
Q

Atropine Adverse Reaction

A

Cardiac: tachy, palpitations, V-Fib

Non Cardiac: Dry mouth, diplopia, restless, irritability, AMS, injection site px

62
Q

Atropine Reference

A

Cardiac
Environmental
RSI
Pediatric Cardiac Arrest Guide

63
Q

Calcium Chloride Classification

A

Electrolyte

64
Q

Calcium Chloride Action

A
  1. Regulate cell permeability to sodium and potassium

2. Increases force of myocardial and muscle contraction

65
Q

Calcium Chloride 1. Onset 2. Duration

A
  1. Immediate

2. 30min-2hrs

66
Q

Calcium Chloride Indication

A
  1. bradycardia 2nd to dialysis and hyperkalemia with peaked T-waves, prolonged QRS, low P-waves
  2. Calcium channel block or beta blocker OD
  3. Antidote for Mag Sulfate
  4. Crush Injury Syndrome
67
Q

Calcium Chloride Contraindication

A
  1. V-fib
  2. Digitalis intoxication
  3. Hypercalcemia
68
Q

Calcium Chloride Use with Caution

A

Extravasation

Flush line prior to giving in conjunction with sodium bicarb

69
Q

Calcium Chloride Dosage and Administration

A

Adult: 500-1000mg (5-10ml) IV/IO
Ped: 20mg/kg IV/IO Push Slowly

70
Q

Calcium Chloride Adverse Reaction

A

Bradycardia, Asystole, V-fib

71
Q

Calcium Chloride Reference

A

Cardiac
Medical (Renal)
Trauma (Crush)

72
Q

Diltiazem Classification

A

Calcium Channel Blocker

73
Q

Diltiazem Action

A

Slows AV node conduction

74
Q

Diltiazem 1.Onset 2.Duration

A
  1. 3 min

2. 1-3 hrs

75
Q

Diltiazem Indication

A
  1. Symptomatic A-fib/flutter

2. PSVT (narrow complex)

76
Q

Diltiazem Contraindication

A
  1. Sick Sinus Syndrome
  2. 2nd or 3rd degree block
  3. A-fib w/ WPW or short PR syndrome
  4. SBP <90
  5. Cardiogenic Shock
  6. Wide Complex Tachycardia
  7. Avoid use on patients taking beta blockers
77
Q

Diltiazem Use with Caution

A

Hypotension, impaired renal and hepatic function

78
Q

Diltiazem Dosage and Administration

A

Adult: initial dose- 15-20mg IV over 2 min. Second dose after 15 min, if needed is 20-25mg IV over 2 min.
Ped: Contact MBCH

79
Q

Diltiazem Adverse Reaction

A

Bradycardia, Cpx, Syncope, Ventricular Arrhythmia, V-fib, dizzy, HA, dry mouth

80
Q

Diltiazem Reference

A

Cardiac

Protocol (1 decks)

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