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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
What is the pediatric dose/route for Phenergan (promethazine)?
None
25
What are any special considerations for the use of Phenergan (promethazine)?
Choose lower dose if reaction is suspected (ie. Age > 60) | When giving IV dilute with 10mL of NaCl & PUSH SLOWLY
26
What pregnancy category is Phenergan (promethazine)?
Pregnancy category C
27
What is the trade name for albuterol?
Proventil | Ventolin
28
What is the generic name for Ventolin and Proventil?
albuterol
29
What class of medication is albuterol?
Sympathomimetic
30
What is the action of albuterol (ALS)?
Bronchodilation
31
What are the indications for albuterol?
Allergic Rxn/anaphylaxis Adult COPD/Asthma Ped. Allergic Reaction Ped. Respiratory Distress
32
What is the contraindication for albuterol?
Hypersensitivity
33
What are the side effects of albuterol?
``` Tremors Paradoxical bronchospasm Dizziness Nausea Angioedema ```
34
What is the adult dose of abuterol?
2.5-5.0mg NEB +/- 0.5mg ipratropium repeat x 3 as needed
35
What's is the pediatric dose of albuterol?
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
36
What are the special considerations for albuterol?
Use with caution in patients with cardiovascular disease
37
What pregnancy category is albuterol?
C
38
What is the generic name of Xopenex?
Levalbuterol HCL
39
What is the trade name of levalbuterol HCL?
Xopenex
40
What class of medication is Xopenex?
Beta 2 agonist
41
What is the action of levalbuterol (Xopenex)?
Activates beta 2 adrenergic receptors on bronchial smooth muscles (bronchodilator)
42
What are the indications for levalbuterol (Xopenex)?
Allergic Rxn/Anaphylaxis Adult COPD/Asthma Ped. Allergic Rxn Ped Respiratory distress
43
What are the contraindications of levalbuterol (Xopenex)?
Hypersensitivity
44
What are the side effects of levalbuterol (Xopenex)?
Nervousness Tremors Tachycardia
45
What is the adult dosage of levalbuterol (Xopenex)?
Adults & adolescents 12 years or > 0.63mg/3mL NEB
46
What is the Ped dosage of levalbuterol (Xopenex)?
(6-11 years) 0.31mg/3mL
47
What is the pregnancy category for levalbuterol (Xopenex)?
C
48
How long does levalbuterol (Xopenex) last in the system?
8 hrs
49
What is the generic name for Atrovent?
Ipratropium
50
What is the trade name for ipratropium?
Atrovent
51
What class of medication is Atrovent (ipratropium)?
Anticholinergic (parasympathetic)
52
What is the action of Atrovent (ipratropium)?
Bronchodilation (antagonizes action of acetylcholine)
53
What are the indications for Atrovent (ipratropium)?
Adult COPD/Asthma Allergic Reaction/Anaphylaxis Pediatric Allergic Reaction Pediatric Respiratory Distress
54
What are the contraindications of Atrovent (ipratropium)?
Hypersensitivity to: Atrovent, atropine, soy, peanuts
55
What are the side effects of Atrovent (ipratropium)?
Dizziness/palpitation Bronchitis Angioedema Paradoxical bronchospasms
56
What are the adult dosages of Atrovent (ipratropium)?
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)
57
What is the pediatric dosage of Arrovent (ipratropium)?
Allergic Rxn — 0.5mg repeat x 3 as needed Respiratory Distress — 0.5mg repeat x 3 as needed
58
What pregnancy category is Atrovent (ipratropium)?
B
59
What is the generic name for Solu-Medrol?
Methylprednisolone
60
What is the trade name for methylprednisolone?
Soul-Medrol
61
What class of medication is Solu-Medrol (methylprednisolone)?
Corticosteroid
62
What is the action of Solu-Medrol (methylprednisolone)?
Reduces pulmonary inflammation & mucous production Reverses capillary permeability
63
What are the indications for Solu-Medrol (methylprednisolone)?
Adult COPD/Asthma Allergic Rxn/Anaphylaxis Ped Allergic Rxn Ped respiratory distress
64
What are the contraindications for Solu-Medrol (methylprednisolone)?
Hypersensitivity
65
What are the side effects for Solu-Medrol (methylprednisolone)?
Rare prehospital
66
What is the adult dose of Solu-Medrol?
Mod/severe allergic Rxn - 125mg IV/IO | COPD/Asthma - 125mg IV/IO
67
What is the ped dosage of Solu-Medrol (methylprednisolone)?
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
68
What are the special considerations for Solu-Medrol (methylprednisolone)?
IM dosing only if indicated by local protocol
69
What pregnancy category is Solu-Medrol (methylprednisolone)?
C
70
What is the pregnancy category for nalaxone?
C
71
What are any special consideration for nalaxone?
May induce withdrawals | Use cautiously in drug-dependent adults/newborns
72
What is the pediatric dose of nalaxone?
0.1mg/kg IV/IO/IM/IN/ETT max. 2mg Titrated to effect Adequate oxygenation/ventilation Not to be given to restore consciousness
73
What is the adult dose of nalaxone?
0.4-2mg IV/IO/IM/IN/ETT Titrated to effect Adequate ventilation/oxygenation Not to be given to restore consciousness
74
What are the side effects for nalaxone?
Nausea/vomiting | Drowsiness
75
What are the contraindications of nalaxone?
Hypersensitivity
76
What is the indications for nalaxone?
Overdose/toxic ingestion | Pediatric overdose/toxic ingestion
77
Naloxone is generic for ?
Narcan
78
What is the class for Narcan ( Naloxone)?
Narcotic antagonist
79
What action does Narcan provide (Naloxone)?
Binds opioid receptors and blocks the effects of narcotics
80
What are the indications for Narcan( Naloxone)?
``` #31 overdose/toxic ingestion #60 ped overdose/toxic ingestion ```
81
What are the contraindications for Narcan (Naloxone)?
hypersensitivity
82
What are the side effects for Narcan ? (Naloxone)
Nausea | Drowsiness
83
What is the adult Dosage for Narcan ( Naloxone)?
0.4 -2mg IV/ IO/ IM/ IN/ ETT
84
What is the dosage for Peds for Narcan( Naloxone)?
0.1 mg/kg IV/ IO/ IM/ IN/ ETT Max 2mg
85
What pregnancy category is Narcan (Naloxone)?
C
86
What is the trade name for glucagon?
Glucogen
87
What is the generic name for Glucogen?
glucagon
88
What is the class for Glucogen (glucagon)?
Antihypoglycemic agent | Hormone
89
What is the action of Glucogen (glucagon)?
Causes the breakdown of glycogen to glucose Increases chronotropy Increases inotropy
90
What are the indications for Glucogen (glucagon)?
Diabetic adult Overdose/toxic ingestion Ped. Diabetic Ped. Overdose/toxic ingestion
91
What are the contraindications of Glucogen (glucagon)?
Patients with inadequate glucogen stores Malnutrition Alcoholic Diabetic
92
What are the side effects of Glucogen (glucagon)?
Rare in emergency setting
93
What is the dosage for Glucogen (glucagon)?
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
94
What is the pediatric dose of Glucogen (glucagon)?
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
95
What are the special considerations for the use of Glucogen (glucagon)?
Use with caution in patients with heart/renal diseases.
96
What pregnancy category is Glucagen (glucagon)?
B
97
What is the trade name for dextrose 50%?
D50
98
What is the trade name for d50?
Dextrose 50%
99
What class is dextrose 50% (d50)?
Carbohydrate
100
What is the action of dextrose 50% (d50)?
Increases circulating glucose | Transient osmotic diuretic
101
What are the indications for the use of dextrose 50 (d50)?
Adult diabetic | Pediatric diabetic
102
What are the contraindications for dextrose (d50)?
None in the emergency setting
103
What is the dose of dextrose (d50)?3
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
What are the side effects of dextrose 50% (d50)?
Extravasation Phlebitis Hyperglycemia
105
What is the pediatric dose of dextrose (d50)?
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
What are special considerations for the use of dextrose 50% (d50)?
Consider d50 for any pt with ALOC/AMS
107
what pregnancy category is dextrose (d50)?
C
108
What is the trade name for thiamine?
Betaxin
109
What is the generic name for Betaxin?
thiamine
110
What class of medication is thiamine?
vitamin (B1)
111
What action is thiamine (Betaxin)?
assists in carbohydrate metabolism
112
What are the indications of thiamine (Betaxin)?
DTs Malnutrition Coma of unknown origin
113
What are contraindications for thiamine (Betaxin)?
Hypersensitivity
114
What are the side effects of thiamine (Betaxin)?
Hypotensive (from rapid push) | N/V
115
What is the dose of thiamine (Betaxin)?
100mg slow IVP
116
What is the pregnancy category for thiamine (Betaxin)?
A
117
What is the action of nalaxone?
It binds to opioid receptors and blocks the effects of narcotics
118
What class of medication is nalaxone?
Narcotic antagonist
119
What is the trade name for nalaxone?
Narcan
120
What is the generic name for Narcan?
Nalaxone
121
What is the dose of diphenhydramine (Benadryl) that you would give to an adult have a Moderate/severe allergic Rxn?
25-50mg IV/IO/IM (if not already given PO)
121
What are the side effects for the administration of diphenhydramine?
Drowsiness/sedation Anxiety/tremors Thickens bronchial secretions
121
What dose of Benadryl would you give to a pediatric patient experiencing a moderate/severe allergic rxn?
1mg/kg IV/IO/IM (if not given PO)
121
What are the special considerations for the administration of Benadryl?
Peds OD: hallucinations, convulsions, death
121
What class of medication is Benadryl?
Antihistamine
121
What is the action of diphenhydramine?
Blocks H1 receptors | Possesses anticholinergic and antiemetic properties
121
What pregnancy category is Benadryl?
B
121
What class of medication is epi?
Sympathomimetic
121
What is the action of epi?
Vasoconstriction/relaxes bronchiole smooth muscles
126
What are the side effects for epi?
Anxiety/palpitations | Headaches
128
What are the contraindications for the use of epinephrine?
None
130
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?
0.3-0.5mg IM
131
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?
0.01mg/kg IM MAX 0.3mg Repeat in 5 min if no improvement
132
You are responding to a 19 y/o patient with stridor. Your protocols suggests the administration of epi. What dose/route could you administer?
1mg in 2mL of NS NEB
134
What is the dosage of epi for a pediatric patient experiencing wheezing?
If they are less than 12 months and it is their first time, 1mg in 2mL of NS NEB
135
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?
0.3-0.5mg IM
137
You respond to a 5 y/o patient experiencing stridor. Your local protocol suggests the administration of epinephrine. What dose/route could you administer?
1mg in 2mL of NS NEB may repeat once -or- 0.01mg/kg IM Max 0.3mg
138
What is the action of fentanyl?
It binds to opioid receptors and produces an analgesic effect
138
Your patient is having an moderate/severe allergic reaction. What dose range of epinephrine would you consider?
0.3-0.5mg IM | Repeat in 5 minutes if no improvement
139
What pregnancy category is epinephrine?
C
140
What are special considerations for the use of epinephrine?
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
What are contraindications for the use of fentanyl (sublimaze)?
Hypersensitivity | Known intolerance to opioids
141
What are the side effects for the use of fentanyl?
Respiratory depression/apnea Muscle rigidity Bradycardia
142
What is the generic name of fentanyl?
Sublimaze
143
Fentanyl (sublimaze) is in what class of medication?
opioid analgesic
144
What are special considerations for the use of fentanyl (sublimaze)?
Avoid use if SBP
145
You are about to perform RSI on your patient. How much fentanyl will you administer?
50-75mcg IV/IO repeat 25mcg every 20 minutes as needed Max 200mcg
146
What are the indications for the use of fentanyl (sublimaze)?
Airway RSI Adult Pain Control Pediatric Pain Control
147
What pregnancy category is fentanyl?
C
148
How much fentanyl will you administer to a pediatric patient experiencing pain?
1mcg/kg IV/IM/IN may repeat 0.5mcg every 5 minutes as needed Max 2mcg/kg
149
What is the generic name for atropine?
Atropen
150
What class of medication is atropine?
Anticholinergic (parasympatholytic)
151
What is the action of atropine?
Blocks acetylcholine | Increases heart rate
152
What are the indications for the use of atropine?
Bradycardia, Pulse Present Pediatric bradycardia WMP nerve agent
153
What are the contraindications for the use of atropine?
High degree heart block | Pts predisposed to narrow angle glaucoma
154
What are the side effects of atropine?
V-fib SVT Dizziness N/V
155
Your patient is bradycardic, how much atropine will administer?
0.5-1mg IV every 3-5 minutes (max. 3mg) | ET max. 6mg
156
What is the organophosphate dose of atropine?
1-2mg IV/IO
157
Your pediatric patient you just intubated has become bradycardic. How much atropine will you administer?
0.02mg/kg IV/IO (max. 1mg) may repeat in 3-5 minutes
158
What is the pediatric organophosphate dose?
0.05mg/kg IV/IO
159
What are special considerations for the use of atropine?
May be given other route per med control | For ET dose, double the dose
160
What is the pregnancy category of atropine?
C
161
What is the trade name for lidocaine?
Xylocaine
162
What class of medication is lidocaine (xylocaine)?
Anesthetic | Antiarrythmic med
163
What is the action of lidocaine (xylocaine)?
Stabilizes neuronal membrane by inhibiting ionic fluxes
164
What are the indications for the use of lidocaine (xylocaine)?
Airway, RSI VF, pulseless VT Ped VF pulseless VT
165
What are contraindications for the use of lidocaine?
WPW syndrome 2nd or 3rd degree heart block Hypersensitivity to corn products
166
What are the side effects of lidocaine?
Dizziness | N/V
167
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?
1.5mg IV/IO bolus; 3mg ETT (max. 3mg/kg)
168
You have a pulseless VT pediatric patient. What dose/route could you administer your lidocaine?
1mg/kg IV/IO (max. 100mg) may repeat 0.5mg/kg | Max 3mg/kg
169
What are special considerations for the use of lidocaine?
Use with caution in hypotensive pts
170
What pregnancy category is lidocaine?
B
171
What is the trade name for midazolam?
Versed
172
What class is Versed (midazolam)?
Benzodiazepine
173
What is the action of midazolam (versed)?
Sedative | Hypnotic
174
What are the indications for the use of midazolam (versed)?
Seizures Pediatric seizures Behavior emergencies
175
What are the contraindications for the use of versed?
Hypersensitivity Shock Narrow angle glaucoma Acute alcohol intoxication
176
What are the side effects for the use of versed?
Respiratory depression | Apnea
177
What are the special considerations for the use of versed?
Do not delay IM administration for IV/IO Access Titrate slowly May dilute to facilitate slower administration Schedule IV control
178
What pregnancy category is versed?
D
179
What is the adult dose of versed?
0.5-2.5mg IV/IO 5mg IM 2mg IN May repeat every 3-5 minutes (max 5mg)
180
What is the pediatric dose of versed?
0. 1-0.2mg/kg IV/IO (max 2mg) 0. 2mg/kg IN (max 2mg) 0. 2mg/kg IM (max 10mg)
181
What is the trade name for recuronium?
Zemuron
182
What class of medication is recuronium?
Nondepolarizing neuromuscular blocking agent
183
What is the action of recuronium?
Paralytic
184
What are the indications for the use of recuronium?
Airway RSI
185
What are the contraindications for the use of recuronium?
Hypersensitivity
186
What are the side effects for the use of recuronium?
N/V | Prolonged skeletal muscle weakness/atropy
187
What is the adult dose of recuronium?
1mg/kg IV/IO may repeat x 1
188
What is the pediatric dose of recuronium?
None
189
What pregnancy category is recuronium?
C
190
What are the special considerations for the use of recuronium?
Onset is longer than succinylcholine. May take up to 3-5 minutes Only use is succinylcholine is contraindicated
191
What is the trade name for etomidate?
Amidate
192
What class is etomidate (amidate)?
Anesthetic agent
193
What is the action for etomidate (amidate)?
Sedative : Hypnotic
194
What are the indications for etomidate (amidate)?
Airway RSI | Induced hypothermia
195
What are the contraindications for etomidate (amidate)?
Hypersensitivity | Patients less than 10 years
196
What are the side effects for etomidate (amidate)?
Adrenal suppression Injection site pain Tonic skeletal muscle movements
197
What is the adult dose for etomidate (amidate)?
0.3mg/kg IV/IO | Usual does 20mg
198
What is the pediatric dose for etomidate (amidate)?
None
199
What are the special considerations for etomidate (amidate)?
Use with caution in hypotensive patients and patients where respirations are suppressed
200
What is the pregnancy category etomidate (amidate)?
C
201
What is the trade name for Succinylcholine?
Quelcin
202
What class is succinylcholine (quelicin)?
Paralytic
203
What is the action for succinylcholine (quelicin)?
Airway RSI
204
What are the contraindications for succinylcholine (quelicin)?
Burns less than 24 hours Chronic neuromuscular disease ESRD
205
What are the side effects for succinylcholine (quelicin)?
Apnea Hyperkalemia Anaphylaxis Malignant Hypothermia
206
What is the adult dose/route of succinylcholine (quelicin)?
1.5mg/kg IV/IO may repeat x1
207
What is the pediatric dose for succinylcholine (quelicin)?
None
208
What are the special considerations for succinylcholine (quelicin)?
Consider premeditating with atropine | Premeditating with lidocaine may blunt any increase in ICP
209
What is the pregnancy category succinylcholine (quelicin)?
C
210
What is the tear name for Vecuronium bromide?
Norcuiron
211
What class is vercuronium bromide ( norcuiron)?
Paralytic
212
What is the action for vercuronium bromide ( norcuiron)?
Neuromuscular blocking agent
213
What is the indications for vercuronium bromide ( norcuiron)?
Airway RSI Post Resuscitation Induced hypothermia
214
What are the contraindications vercuronium bromide ( norcuiron)?
Patients with chronic neuromuscular disease
215
What are the side effects vercuronium bromide ( norcuiron)?
Apnea Muscular skeletal weakness/prolonged atrophy Hypotension/tachycardia Bronchospasm
216
What is the adult dose for vercuronium bromide ( norcuiron)?
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
What is the pediatric dose for vercuronium bromide ( norcuiron)?
None
218
What are the special considerations for vercuronium bromide ( norcuiron)?
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
What is the pregnancy category for vercuronium bromide ( norcuiron)?
C
220
What is the trade name for Oxymetazoline HCL?
Afrin
221
What class is Oxymetazoline ( Afrin)?
Sympathamimetic
222
What is the action for Oxymetazoline (Afrin)?
Antagonizes a1 and a2 adrenergic receptors | Vaso Constriction
223
What are the indications for Oxymetazoline (Afrin)?
Epistaxis | Nasotracheal intubation
224
What are the contraindications for Oxymetazoline (Afrin)?
Hypersensitivity | Significant hypertension
225
What are the side effects for Oxymetazoline (Afrin)?
Trembling Nervousness Headache,dizziness,drowsiness Blurred vision
226
What is the adult dose for Oxymetazoline (Afrin)?
2 sprays in affected nostrils
227
What is the pediatric dose for Oxymetazoline (Afrin)?
1 - 2 sprays in affected nostrils
228
What are the special considerations for Oxymetazoline (Afrin)?
Use with caution in patients with narrow angle glaucoma | Use with caution in lactating women
229
What is the pregnancy category for Oxymetazoline (Afrin)?
C
230
What is the trade name for Vasopressin?
Pitressin
231
What are the protocols that warrant the use of vasopressin?
Asystole, PEA, and V-Fib
232
What class of medication is vasopressin?
Nonadrenergic vasoconstrictor | Posterior pituitary hormone (ADH)
233
What is the mechanism of action of vasopressin?
Vasoconstrictor. Targets the V1 receptors in the smooth muscle of vessels Targets the V2 receptors in the kidney promoting fluid absorption
234
What are the indications for the use of vasopressin?
V Fib Pulseless V Tach Asystole PEA
235
What are the contraindications of the use of vasopressin?
None in cardiac arrest | Responsive patients with cardiac disease
236
What are the side effects of vasopressin?
``` Cardiac ischemia Angina Headache Vertigo Diaphoresis ```
237
What is the adult dose of vasopressin?
40 units IV/IO (may be used to replace 1st or 2nd dose of epinephrine)
238
What is the pediatric dose of vasopressin?
None
239
What pregnancy category of vasopressin?
C
240
What are any special considerations for the use of vasopressin?
EMS will only use for patients without a pulse
241
What is the trade name for dopamine?
Intropin
242
What are the protocols associated with the use of dopamine?
``` Bradycardia Hypotension Post Resuscitation PEA Pediatric Hypotension ```
243
What class of medication is dopamine?
Adrenergic agonist Inotropic Vasopressin Natural catecholamine
244
At what dose does dopamine stimulate dopaminergic receptors dilating renal, mesenteric, and cerebral arteries?
1-2mcg/kg/min
245
At what dose does dopamine act on beta receptors increasing Inotropy and chronotropy?
2-10mcg/kg/min
246
At what dose does dopamine act on alpha and beta receptors beginning vasoconstriction of peripheral arteries and veins?
10-20mcg/kg/min
247
On what dose does dopamine act on alpha receptors only and mimic the effects of norepinephrine?
>20mg/kg/min
248
What receptors does dopamine act on?
Alpha, beta1, and dopaminergic receptors.
249
What are the mechanisms of action of dopamine?
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
What are the indications for the use of dopamine?
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
What are the contraindications for the use of dopamine?
- Hypovolemia (without fluid replacement) - Patients with known pheochromocytoma (adrenal tumor) - V-Tach, V-Fib, or other ventricular arrhythmias - Known hypersensitivity (including sulfites)
252
What are the side effects of dopamine?
``` Nervousness Headache Dysrrhythmias Palpitations Chest pain Dyspnea N/V Tachycardia Skin & soft tissue necrosis Severe hypertension (excessive vasoconstriction) Cardiac conduction abnormalities Anxiety ```
253
What is the dose for the use of dopamine? (Adult& Ped)
2-20mcg/kg/min tot rate to systolic BP of 90mmHg Titrate to systolic BP appropriate for age
254
What are any special considerations for the use of dopamine?
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
What pregnancy class is dopamine?
C

Emergency Care (8 decks)

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