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Emergency Care > Medications > Flashcards

Medications Flashcards

0
Q

What is the dose of Benadryl that you would give to a patient having a mild allergic reaction (diphenhydramine)?

A

25-50 mg IV/IO/IM/PO

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1
Q

What is the indication for Benadryl (diphenhydramine)?

A

Allergic reaction

Pediatric allergic Rxn

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2
Q

What is a contraindication for Benadryl (diphenhydramine)?

A

Asthma
Infants less than 3 months
Narrow angle glaucoma
Prostatic Hypertrophy

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3
Q

What dose of diphenhydramine (Benadryl) would you give to a pediatric patient experiencing a mild allergic rxn?

A

1mg/kg IV/IO/IM

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4
Q

What is the generic name for Zofran?

A

Ondansetron

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5
Q

What is the trade name for ondansatron?

A

Zofran

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6
Q

What is the action of Zofran (ondansetron)?

A

Zofran (ondansetron) antagonizes serotonin receptors.

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7
Q

What are the indications for the use of Zofran (ondansetron)?

A

Abdominal pain
Vomiting & diarrhea
Pediatric vomiting & diarrhea

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8
Q

What are the contraindications for the use of Zofran (ondansetron)?

A

Hypersensitivity

Concomitant use of apomorphine

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9
Q

What are the side effects of Zofran (ondansetron)?

A

Headache

Drowsiness

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10
Q

What is the adult dose/route of Zofran (ondansetron)?

A

ABDOMINAL PAIN — 4mg IV/IM/IO/ODT may repeat in 15 minutes

VOMITING/DIARRHEA — 4mg IV/IO/ODT may repeat in 15

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11
Q

What is the pediatric dose/route of Zofran (ondansetron)?

A

Serious S/S — no: 0.2mg/kg PO/ODT (max. 4mg)
Yes: 0.2mg/kg ODT -or-
0.15mg/kg IV/IO

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12
Q

What are any special considerations for the use of Zofran (ondansetron)?z

A

It prolongs the QT interval

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13
Q

What pregnancy category is Zofran (ondansetron)?

A

Pregnancy category B

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14
Q

What is the trade name for promethazine?

A

Phenergan

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15
Q

What is the generic name for Phenergan?

A

promethazine

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16
Q

What class of medication is Zofran (ondansetron)?

A

Antiemetic

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17
Q

What is an antiemetic?

A

a drug that prevents vomiting

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18
Q

What is the class of Phenergan (promethazine)?

A

It is an antihistamine and a antiemetic drug

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19
Q

What is the action of Phenergan (promethazine)?

A

It blocks H1 receptors

Possesses anticholinergic properties

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20
Q

What are the indications for Phenergan (promethazine)?

A

Abdominal pain

Vomiting & diarrhea

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21
Q

What are the contraindications of Phenergan (promethazine)?

A

Children < 2

Lactating women

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22
Q

What are the side effects of Phenergan (promethazine)?

A

Sedation
Respiratory depression
Induced asthma

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23
Q

What is the adult dose/route for Phenergan (promethazine)?

A

12.5mg IV/IO/IM repeat x 1 (as needed)

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24
Q

What is the pediatric dose/route for Phenergan (promethazine)?

A

None

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25
Q

What are any special considerations for the use of Phenergan (promethazine)?

A

Choose lower dose if reaction is suspected (ie. Age > 60)

When giving IV dilute with 10mL of NaCl & PUSH SLOWLY

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26
Q

What pregnancy category is Phenergan (promethazine)?

A

Pregnancy category C

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27
Q

What is the trade name for albuterol?

A

Proventil

Ventolin

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28
Q

What is the generic name for Ventolin and Proventil?

A

albuterol

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29
Q

What class of medication is albuterol?

A

Sympathomimetic

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30
Q

What is the action of albuterol (ALS)?

A

Bronchodilation

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31
Q

What are the indications for albuterol?

A

Allergic Rxn/anaphylaxis
Adult COPD/Asthma
Ped. Allergic Reaction
Ped. Respiratory Distress

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32
Q

What is the contraindication for albuterol?

A

Hypersensitivity

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33
Q

What are the side effects of albuterol?

A 
Tremors
Paradoxical bronchospasm 
Dizziness
Nausea
Angioedema
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34
Q

What is the adult dose of abuterol?

A

2.5-5.0mg NEB +/- 0.5mg ipratropium repeat x 3 as needed

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35
Q

What’s is the pediatric dose of albuterol?

A

Allergic Rxn (mod/severe) 2.5-5.0mg NEB +/- 0.5mg ipratropium repeat x 3 as needed

Stridor 1.25-5.0mg NEB

Wheezing
(greater than or equal to 12 mo.) 1.25-5.0mg NEB repeat x 3 as needed
(less than 12 mo.) 1.25-2.5mg NEB repeat x 3 as needed

MAY BE USED IN CONJUNCTION WITH ATROVENT

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36
Q

What are the special considerations for albuterol?

A

Use with caution in patients with cardiovascular disease

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37
Q

What pregnancy category is albuterol?

A

C

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38
Q

What is the generic name of Xopenex?

A

Levalbuterol HCL

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39
Q

What is the trade name of levalbuterol HCL?

A

Xopenex

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40
Q

What class of medication is Xopenex?

A

Beta 2 agonist

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41
Q

What is the action of levalbuterol (Xopenex)?

A

Activates beta 2 adrenergic receptors on bronchial smooth muscles (bronchodilator)

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42
Q

What are the indications for levalbuterol (Xopenex)?

A

Allergic Rxn/Anaphylaxis
Adult COPD/Asthma
Ped. Allergic Rxn
Ped Respiratory distress

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43
Q

What are the contraindications of levalbuterol (Xopenex)?

A

Hypersensitivity

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44
Q

What are the side effects of levalbuterol (Xopenex)?

A

Nervousness
Tremors
Tachycardia

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45
Q

What is the adult dosage of levalbuterol (Xopenex)?

A

Adults & adolescents 12 years or > 0.63mg/3mL NEB

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46
Q

What is the Ped dosage of levalbuterol (Xopenex)?

A

(6-11 years) 0.31mg/3mL

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47
Q

What is the pregnancy category for levalbuterol (Xopenex)?

A

C

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48
Q

How long does levalbuterol (Xopenex) last in the system?

A

8 hrs

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49
Q

What is the generic name for Atrovent?

A

Ipratropium

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50
Q

What is the trade name for ipratropium?

A

Atrovent

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51
Q

What class of medication is Atrovent (ipratropium)?

A

Anticholinergic (parasympathetic)

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52
Q

What is the action of Atrovent (ipratropium)?

A

Bronchodilation (antagonizes action of acetylcholine)

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53
Q

What are the indications for Atrovent (ipratropium)?

A

Adult COPD/Asthma
Allergic Reaction/Anaphylaxis
Pediatric Allergic Reaction
Pediatric Respiratory Distress

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54
Q

What are the contraindications of Atrovent (ipratropium)?

A

Hypersensitivity to: Atrovent, atropine, soy, peanuts

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55
Q

What are the side effects of Atrovent (ipratropium)?

A

Dizziness/palpitation
Bronchitis
Angioedema
Paradoxical bronchospasms

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56
Q

What are the adult dosages of Atrovent (ipratropium)?

A

Allergic Reaction/Anaphylaxis – 0.5mg (500mcg) repeat x 3 as needed

Adult COPD/Asthma - 0.5mg repeat x 3 as needed (may be used in conjunction with Albuterol)

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57
Q

What is the pediatric dosage of Arrovent (ipratropium)?

A

Allergic Rxn — 0.5mg repeat x 3 as needed

Respiratory Distress — 0.5mg repeat x 3 as needed

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58
Q

What pregnancy category is Atrovent (ipratropium)?

A

B

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59
Q

What is the generic name for Solu-Medrol?

A

Methylprednisolone

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60
Q

What is the trade name for methylprednisolone?

A

Soul-Medrol

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61
Q

What class of medication is Solu-Medrol (methylprednisolone)?

A

Corticosteroid

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62
Q

What is the action of Solu-Medrol (methylprednisolone)?

A

Reduces pulmonary inflammation & mucous production

Reverses capillary permeability

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63
Q

What are the indications for Solu-Medrol (methylprednisolone)?

A

Adult COPD/Asthma
Allergic Rxn/Anaphylaxis
Ped Allergic Rxn
Ped respiratory distress

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64
Q

What are the contraindications for Solu-Medrol (methylprednisolone)?

A

Hypersensitivity

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65
Q

What are the side effects for Solu-Medrol (methylprednisolone)?

A

Rare prehospital

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66
Q

What is the adult dose of Solu-Medrol?

A

Mod/severe allergic Rxn - 125mg IV/IO

COPD/Asthma - 125mg IV/IO

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67
Q

What is the ped dosage of Solu-Medrol (methylprednisolone)?

A

Allergic Rxn (mod/severe) - 2mg/kg IV/IO max. 125mg

Respiratory Distress - stridor - 2mg/kg IV/IO max. 125mg
Wheezing - 12 mo. or greater? Yes - 2mg/kg IV/IO (max 125mg)
No - 1st episode? None
2nd or more? 2mg/kg IV/IO max. 125mg

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68
Q

What are the special considerations for Solu-Medrol (methylprednisolone)?

A

IM dosing only if indicated by local protocol

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69
Q

What pregnancy category is Solu-Medrol (methylprednisolone)?

A

C

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70
Q

What is the pregnancy category for nalaxone?

A

C

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71
Q

What are any special consideration for nalaxone?

A

May induce withdrawals

Use cautiously in drug-dependent adults/newborns

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72
Q

What is the pediatric dose of nalaxone?

A

0.1mg/kg IV/IO/IM/IN/ETT max. 2mg

Titrated to effect
Adequate oxygenation/ventilation
Not to be given to restore consciousness

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73
Q

What is the adult dose of nalaxone?

A

0.4-2mg IV/IO/IM/IN/ETT

Titrated to effect
Adequate ventilation/oxygenation
Not to be given to restore consciousness

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74
Q

What are the side effects for nalaxone?

A

Nausea/vomiting

Drowsiness

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75
Q

What are the contraindications of nalaxone?

A

Hypersensitivity

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76
Q

What is the indications for nalaxone?

A

Overdose/toxic ingestion

Pediatric overdose/toxic ingestion

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77
Q

Naloxone is generic for ?

A

Narcan

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78
Q

What is the class for Narcan ( Naloxone)?

A

Narcotic antagonist

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79
Q

What action does Narcan provide (Naloxone)?

A

Binds opioid receptors and blocks the effects of narcotics

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80
Q

What are the indications for Narcan( Naloxone)?

A 
#31 overdose/toxic ingestion
#60 ped overdose/toxic ingestion
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81
Q

What are the contraindications for Narcan (Naloxone)?

A

hypersensitivity

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82
Q

What are the side effects for Narcan ? (Naloxone)

A

Nausea

Drowsiness

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83
Q

What is the adult Dosage for Narcan ( Naloxone)?

A

0.4 -2mg IV/ IO/ IM/ IN/ ETT

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84
Q

What is the dosage for Peds for Narcan( Naloxone)?

A

0.1 mg/kg IV/ IO/ IM/ IN/ ETT

Max 2mg

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85
Q

What pregnancy category is Narcan (Naloxone)?

A

C

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86
Q

What is the trade name for glucagon?

A

Glucogen

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87
Q

What is the generic name for Glucogen?

A

glucagon

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88
Q

What is the class for Glucogen (glucagon)?

A

Antihypoglycemic agent

Hormone

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89
Q

What is the action of Glucogen (glucagon)?

A

Causes the breakdown of glycogen to glucose
Increases chronotropy
Increases inotropy

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90
Q

What are the indications for Glucogen (glucagon)?

A

Diabetic adult
Overdose/toxic ingestion
Ped. Diabetic
Ped. Overdose/toxic ingestion

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91
Q

What are the contraindications of Glucogen (glucagon)?

A

Patients with inadequate glucogen stores
Malnutrition
Alcoholic
Diabetic

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92
Q

What are the side effects of Glucogen (glucagon)?

A

Rare in emergency setting

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93
Q

What is the dosage for Glucogen (glucagon)?

A

Diabetic — Blood sugar less than or equal to 69mg/dl and symptomatic:
1-2mg IM repeat in 15 minutes if needed

OD/TI — 2mg IV/IO may repeat in 15 minutes

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94
Q

What is the pediatric dose of Glucogen (glucagon)?

A

Diabetic — blood sugar less than or equal to 69mg/dl & symptomatic
0.1mg/kg IM may repeat every 15 minutes as needed MAX 1mg

OD/TI — beta blocker OD
0.1mg/kg IV/IO/IM max. 2mg

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95
Q

What are the special considerations for the use of Glucogen (glucagon)?

A

Use with caution in patients with heart/renal diseases.

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96
Q

What pregnancy category is Glucagen (glucagon)?

A

B

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97
Q

What is the trade name for dextrose 50%?

A

D50

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98
Q

What is the trade name for d50?

A

Dextrose 50%

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99
Q

What class is dextrose 50% (d50)?

A

Carbohydrate

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100
Q

What is the action of dextrose 50% (d50)?

A

Increases circulating glucose

Transient osmotic diuretic

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101
Q

What are the indications for the use of dextrose 50 (d50)?

A

Adult diabetic

Pediatric diabetic

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102
Q

What are the contraindications for dextrose (d50)?

A

None in the emergency setting

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103
Q

What is the dose of dextrose (d50)?3

A

Awake/Alert/symptomatic BS 69mg/dl or less
12.5g IV/IO (after considering oral glucose)

ALOC BS 69mg/dl or less
12.5-25g IV/IO
Repeat every 5 minutes until BS is greater than or equal to 70mg/dl

104
Q

What are the side effects of dextrose 50% (d50)?

A

Extravasation
Phlebitis
Hyperglycemia

105
Q

What is the pediatric dose of dextrose (d50)?

A

Awake/alert/symptomatic
BS 69mg/dl or less
Consider oral glucose

ALOC BS 69mg/dl or less

Less than 1month —D10 6ml/kg IV/IO repeat as needed
1month— 2 years D25 4ml/kg IV/IO Repeat as needed
Older than 2 years D50 2ml/kg IV/IO max 25g per dose repeat as needed

Repeat every 5 mins until BS is higher than 70mg/dl

106
Q

What are special considerations for the use of dextrose 50% (d50)?

A

Consider d50 for any pt with ALOC/AMS

107
Q

what pregnancy category is dextrose (d50)?

108
Q

What is the trade name for thiamine?

109
Q

What is the generic name for Betaxin?

110
Q

What class of medication is thiamine?

A

vitamin (B1)

111
Q

What action is thiamine (Betaxin)?

A

assists in carbohydrate metabolism

112
Q

What are the indications of thiamine (Betaxin)?

A

DTs
Malnutrition
Coma of unknown origin

113
Q

What are contraindications for thiamine (Betaxin)?

A

Hypersensitivity

114
Q

What are the side effects of thiamine (Betaxin)?

A

Hypotensive (from rapid push)

N/V

115
Q

What is the dose of thiamine (Betaxin)?

A

100mg slow IVP

116
Q

What is the pregnancy category for thiamine (Betaxin)?

117
Q

What is the action of nalaxone?

A

It binds to opioid receptors and blocks the effects of narcotics

118
Q

What class of medication is nalaxone?

A

Narcotic antagonist

119
Q

What is the trade name for nalaxone?

120
Q

What is the generic name for Narcan?

121
Q

What is the dose of diphenhydramine (Benadryl) that you would give to an adult have a Moderate/severe allergic Rxn?

A

25-50mg IV/IO/IM (if not already given PO)

121
Q

What are the side effects for the administration of diphenhydramine?

A

Drowsiness/sedation
Anxiety/tremors
Thickens bronchial secretions

121
Q

What dose of Benadryl would you give to a pediatric patient experiencing a moderate/severe allergic rxn?

A

1mg/kg IV/IO/IM (if not given PO)

121
Q

What are the special considerations for the administration of Benadryl?

A

Peds OD: hallucinations, convulsions, death

121
Q

What class of medication is Benadryl?

A

Antihistamine

121
Q

What is the action of diphenhydramine?

A

Blocks H1 receptors

Possesses anticholinergic and antiemetic properties

121
Q

What pregnancy category is Benadryl?

121
Q

What class of medication is epi?

A

Sympathomimetic

121
Q

What is the action of epi?

A

Vasoconstriction/relaxes bronchiole smooth muscles

126
Q

What are the side effects for epi?

A

Anxiety/palpitations

Headaches

128
Q

What are the contraindications for the use of epinephrine?

130
Q

You responded to a call for a 25y/o patient experiencing wheezing. Your protocol calls for the administration of epinephrine. What dose/route could you administer?

A

0.3-0.5mg IM

131
Q

You have been dispatched to a 6 y/o allergic reaction. Your protocol suggests the administration of epinephrine. How much and by what route could you administer this medication?

A

0.01mg/kg IM
MAX 0.3mg
Repeat in 5 min if no improvement

132
Q

You are responding to a 19 y/o patient with stridor. Your protocols suggests the administration of epi. What dose/route could you administer?

A

1mg in 2mL of NS NEB

134
Q

What is the dosage of epi for a pediatric patient experiencing wheezing?

A

If they are less than 12 months and it is their first time, 1mg in 2mL of NS NEB

135
Q

Your 45 y/o patient is experiencing wheezing as a result of his COPD. Your protocol calls for the administration of epi. What dose/route could you administer this epinephrine?

A

0.3-0.5mg IM

137
Q

You respond to a 5 y/o patient experiencing stridor. Your local protocol suggests the administration of epinephrine. What dose/route could you administer?

A

1mg in 2mL of NS NEB
may repeat once

-or-

0.01mg/kg IM
Max 0.3mg

138
Q

What is the action of fentanyl?

A

It binds to opioid receptors and produces an analgesic effect

138
Q

Your patient is having an moderate/severe allergic reaction. What dose range of epinephrine would you consider?

A

0.3-0.5mg IM

Repeat in 5 minutes if no improvement

139
Q

What pregnancy category is epinephrine?

140
Q

What are special considerations for the use of epinephrine?

A

Any patient 50 years or older
Any patient with cardiac disease
Any patient on: digitoxin or beta blockers
If the patient has a HR of 150 or greater, administer half the dose (0.15-0.25mg)
Epi 1:1000 May be administered IV (consult med control)

141
Q

What are contraindications for the use of fentanyl (sublimaze)?

A

Hypersensitivity

Known intolerance to opioids

141
Q

What are the side effects for the use of fentanyl?

A

Respiratory depression/apnea
Muscle rigidity
Bradycardia

142
Q

What is the generic name of fentanyl?

143
Q

Fentanyl (sublimaze) is in what class of medication?

A

opioid analgesic

144
Q

What are special considerations for the use of fentanyl (sublimaze)?

A

Avoid use if SBP

145
Q

You are about to perform RSI on your patient. How much fentanyl will you administer?

A

50-75mcg IV/IO
repeat 25mcg every 20 minutes as needed
Max 200mcg

146
Q

What are the indications for the use of fentanyl (sublimaze)?

A

Airway RSI
Adult Pain Control
Pediatric Pain Control

147
Q

What pregnancy category is fentanyl?

148
Q

How much fentanyl will you administer to a pediatric patient experiencing pain?

A

1mcg/kg IV/IM/IN
may repeat 0.5mcg every 5 minutes as needed
Max 2mcg/kg

149
Q

What is the generic name for atropine?

150
Q

What class of medication is atropine?

A

Anticholinergic (parasympatholytic)

151
Q

What is the action of atropine?

A

Blocks acetylcholine

Increases heart rate

152
Q

What are the indications for the use of atropine?

A

Bradycardia, Pulse Present
Pediatric bradycardia
WMP nerve agent

153
Q

What are the contraindications for the use of atropine?

A

High degree heart block

Pts predisposed to narrow angle glaucoma

154
Q

What are the side effects of atropine?

A

V-fib
SVT
Dizziness
N/V

155
Q

Your patient is bradycardic, how much atropine will administer?

A

0.5-1mg IV every 3-5 minutes (max. 3mg)

ET max. 6mg

156
Q

What is the organophosphate dose of atropine?

A

1-2mg IV/IO

157
Q

Your pediatric patient you just intubated has become bradycardic. How much atropine will you administer?

A

0.02mg/kg IV/IO (max. 1mg) may repeat in 3-5 minutes

158
Q

What is the pediatric organophosphate dose?

A

0.05mg/kg IV/IO

159
Q

What are special considerations for the use of atropine?

A

May be given other route per med control

For ET dose, double the dose

160
Q

What is the pregnancy category of atropine?

161
Q

What is the trade name for lidocaine?

162
Q

What class of medication is lidocaine (xylocaine)?

A

Anesthetic

Antiarrythmic med

163
Q

What is the action of lidocaine (xylocaine)?

A

Stabilizes neuronal membrane by inhibiting ionic fluxes

164
Q

What are the indications for the use of lidocaine (xylocaine)?

A

Airway, RSI
VF, pulseless VT
Ped VF pulseless VT

165
Q

What are contraindications for the use of lidocaine?

A

WPW syndrome
2nd or 3rd degree heart block
Hypersensitivity to corn products

166
Q

What are the side effects of lidocaine?

A

Dizziness

N/V

167
Q

You are preparing to intubate your 25 y/o trauma patient. What is the dose/route of lidocaine you could give him to prevent his ICP?

A

1.5mg IV/IO bolus; 3mg ETT (max. 3mg/kg)

168
Q

You have a pulseless VT pediatric patient. What dose/route could you administer your lidocaine?

A

1mg/kg IV/IO (max. 100mg) may repeat 0.5mg/kg

Max 3mg/kg

169
Q

What are special considerations for the use of lidocaine?

A

Use with caution in hypotensive pts

170
Q

What pregnancy category is lidocaine?

171
Q

What is the trade name for midazolam?

172
Q

What class is Versed (midazolam)?

A

Benzodiazepine

173
Q

What is the action of midazolam (versed)?

A

Sedative

Hypnotic

174
Q

What are the indications for the use of midazolam (versed)?

A

Seizures
Pediatric seizures
Behavior emergencies

175
Q

What are the contraindications for the use of versed?

A

Hypersensitivity
Shock
Narrow angle glaucoma
Acute alcohol intoxication

176
Q

What are the side effects for the use of versed?

A

Respiratory depression

Apnea

177
Q

What are the special considerations for the use of versed?

A

Do not delay IM administration for IV/IO Access
Titrate slowly
May dilute to facilitate slower administration
Schedule IV control

178
Q

What pregnancy category is versed?

179
Q

What is the adult dose of versed?

A

0.5-2.5mg IV/IO
5mg IM
2mg IN
May repeat every 3-5 minutes (max 5mg)

180
Q

What is the pediatric dose of versed?

A
  1. 1-0.2mg/kg IV/IO (max 2mg)
  2. 2mg/kg IN (max 2mg)
  3. 2mg/kg IM (max 10mg)
181
Q

What is the trade name for recuronium?

182
Q

What class of medication is recuronium?

A

Nondepolarizing neuromuscular blocking agent

183
Q

What is the action of recuronium?

184
Q

What are the indications for the use of recuronium?

A

Airway RSI

185
Q

What are the contraindications for the use of recuronium?

A

Hypersensitivity

186
Q

What are the side effects for the use of recuronium?

A

N/V

Prolonged skeletal muscle weakness/atropy

187
Q

What is the adult dose of recuronium?

A

1mg/kg IV/IO may repeat x 1

188
Q

What is the pediatric dose of recuronium?

189
Q

What pregnancy category is recuronium?

190
Q

What are the special considerations for the use of recuronium?

A

Onset is longer than succinylcholine. May take up to 3-5 minutes
Only use is succinylcholine is contraindicated

191
Q

What is the trade name for etomidate?

192
Q

What class is etomidate (amidate)?

A

Anesthetic agent

193
Q

What is the action for etomidate (amidate)?

A

Sedative :

Hypnotic

194
Q

What are the indications for etomidate (amidate)?

A

Airway RSI

Induced hypothermia

195
Q

What are the contraindications for etomidate (amidate)?

A

Hypersensitivity

Patients less than 10 years

196
Q

What are the side effects for etomidate (amidate)?

A

Adrenal suppression
Injection site pain
Tonic skeletal muscle movements

197
Q

What is the adult dose for etomidate (amidate)?

A

0.3mg/kg IV/IO

Usual does 20mg

198
Q

What is the pediatric dose for etomidate (amidate)?

199
Q

What are the special considerations for etomidate (amidate)?

A

Use with caution in hypotensive patients and patients where respirations are suppressed

200
Q

What is the pregnancy category etomidate (amidate)?

201
Q

What is the trade name for Succinylcholine?

202
Q

What class is succinylcholine (quelicin)?

203
Q

What is the action for succinylcholine (quelicin)?

A

Airway RSI

204
Q

What are the contraindications for succinylcholine (quelicin)?

A

Burns less than 24 hours
Chronic neuromuscular disease
ESRD

205
Q

What are the side effects for succinylcholine (quelicin)?

A

Apnea
Hyperkalemia
Anaphylaxis
Malignant Hypothermia

206
Q

What is the adult dose/route of succinylcholine (quelicin)?

A

1.5mg/kg IV/IO may repeat x1

207
Q

What is the pediatric dose for succinylcholine (quelicin)?

208
Q

What are the special considerations for succinylcholine (quelicin)?

A

Consider premeditating with atropine

Premeditating with lidocaine may blunt any increase in ICP

209
Q

What is the pregnancy category succinylcholine (quelicin)?

210
Q

What is the tear name for Vecuronium bromide?

211
Q

What class is vercuronium bromide ( norcuiron)?

212
Q

What is the action for vercuronium bromide ( norcuiron)?

A

Neuromuscular blocking agent

213
Q

What is the indications for vercuronium bromide ( norcuiron)?

A

Airway RSI
Post Resuscitation
Induced hypothermia

214
Q

What are the contraindications vercuronium bromide ( norcuiron)?

A

Patients with chronic neuromuscular disease

215
Q

What are the side effects vercuronium bromide ( norcuiron)?

A

Apnea
Muscular skeletal weakness/prolonged atrophy
Hypotension/tachycardia
Bronchospasm

216
Q

What is the adult dose for vercuronium bromide ( norcuiron)?

A

10mg (0.1mg/kg) IV/IO (If needed for patients movement)
10mg IV/IO (If needed)
10mg IV/IO (If needed x 1 dose)

217
Q

What is the pediatric dose for vercuronium bromide ( norcuiron)?

218
Q

What are the special considerations for vercuronium bromide ( norcuiron)?

A

Paralytic therapy should be started after sedation
Use with caution in patients with poor renal function
Ongoing sedation should be maintained and monitored periodically

219
Q

What is the pregnancy category for vercuronium bromide ( norcuiron)?

220
Q

What is the trade name for Oxymetazoline HCL?

221
Q

What class is Oxymetazoline ( Afrin)?

A

Sympathamimetic

222
Q

What is the action for Oxymetazoline (Afrin)?

A

Antagonizes a1 and a2 adrenergic receptors

Vaso Constriction

223
Q

What are the indications for Oxymetazoline (Afrin)?

A

Epistaxis

Nasotracheal intubation

224
Q

What are the contraindications for Oxymetazoline (Afrin)?

A

Hypersensitivity

Significant hypertension

225
Q

What are the side effects for Oxymetazoline (Afrin)?

A

Trembling
Nervousness
Headache,dizziness,drowsiness
Blurred vision

226
Q

What is the adult dose for Oxymetazoline (Afrin)?

A

2 sprays in affected nostrils

227
Q

What is the pediatric dose for Oxymetazoline (Afrin)?

A

1 - 2 sprays in affected nostrils

228
Q

What are the special considerations for Oxymetazoline (Afrin)?

A

Use with caution in patients with narrow angle glaucoma

Use with caution in lactating women

229
Q

What is the pregnancy category for Oxymetazoline (Afrin)?

230
Q

What is the trade name for Vasopressin?

231
Q

What are the protocols that warrant the use of vasopressin?

A

Asystole, PEA, and V-Fib

232
Q

What class of medication is vasopressin?

A

Nonadrenergic vasoconstrictor

Posterior pituitary hormone (ADH)

233
Q

What is the mechanism of action of vasopressin?

A

Vasoconstrictor.
Targets the V1 receptors in the smooth muscle of vessels
Targets the V2 receptors in the kidney promoting fluid absorption

234
Q

What are the indications for the use of vasopressin?

A

V Fib
Pulseless V Tach
Asystole
PEA

235
Q

What are the contraindications of the use of vasopressin?

A

None in cardiac arrest

Responsive patients with cardiac disease

236
Q

What are the side effects of vasopressin?

A 
Cardiac ischemia
Angina
Headache
Vertigo
Diaphoresis
237
Q

What is the adult dose of vasopressin?

A

40 units IV/IO (may be used to replace 1st or 2nd dose of epinephrine)

238
Q

What is the pediatric dose of vasopressin?

239
Q

What pregnancy category of vasopressin?

240
Q

What are any special considerations for the use of vasopressin?

A

EMS will only use for patients without a pulse

241
Q

What is the trade name for dopamine?

242
Q

What are the protocols associated with the use of dopamine?

A 
Bradycardia
Hypotension
Post Resuscitation
PEA
Pediatric Hypotension
243
Q

What class of medication is dopamine?

A

Adrenergic agonist
Inotropic
Vasopressin
Natural catecholamine

244
Q

At what dose does dopamine stimulate dopaminergic receptors dilating renal, mesenteric, and cerebral arteries?

A

1-2mcg/kg/min

245
Q

At what dose does dopamine act on beta receptors increasing Inotropy and chronotropy?

A

2-10mcg/kg/min

246
Q

At what dose does dopamine act on alpha and beta receptors beginning vasoconstriction of peripheral arteries and veins?

A

10-20mcg/kg/min

247
Q

On what dose does dopamine act on alpha receptors only and mimic the effects of norepinephrine?

A

> 20mg/kg/min

248
Q

What receptors does dopamine act on?

A

Alpha, beta1, and dopaminergic receptors.

249
Q

What are the mechanisms of action of dopamine?

A

Stimulates alpha, beta1, and dopaminergic receptors.

Does not increase oxygen demand as much as epinephrine.

Has greater effect on systolic pressure than diastolic pressure (widening the pulse pressure)

250
Q

What are the indications for the use of dopamine?

A

Hypotension and/or bradycardia associated with:
•cardiogenic shock
•septic shock
•neurogenic shock
•anaphylaxis shock after epi 1:1000 had been given

Hypotension after return of spontaneous circulation following cardiac arrest

Symptomatic bradycardia unresponsive to atropine

For the correction of hemodynamic imbalances present during shock due to:
        •MI
        •Trauma
        •Endotoxic septicemia
        •Open Heart Surgery 
        •Renal failure
        •Chronic cardiac decomp. (CHF)
251
Q

What are the contraindications for the use of dopamine?

A
  • Hypovolemia (without fluid replacement)
  • Patients with known pheochromocytoma (adrenal tumor)
  • V-Tach, V-Fib, or other ventricular arrhythmias
  • Known hypersensitivity (including sulfites)
252
Q

What are the side effects of dopamine?

A 
Nervousness
Headache
Dysrrhythmias
Palpitations
Chest pain 
Dyspnea
N/V 
Tachycardia 
Skin &amp; soft tissue necrosis
Severe hypertension (excessive vasoconstriction)
Cardiac conduction abnormalities
Anxiety
253
Q

What is the dose for the use of dopamine? (Adult& Ped)

A

2-20mcg/kg/min tot rate to systolic BP of 90mmHg

Titrate to systolic BP appropriate for age

254
Q

What are any special considerations for the use of dopamine?

A

Dopamine is deactivated by alkaline solutions (do not administer in same line)

Can worsen SVT and ventricle arrhythmias

Dosage of >20mcg/kg/min cause necrosis (by squeezing down on vessles)

Onset

255
Q

What pregnancy class is dopamine?

Emergency Care (8 decks)

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