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Stuff I should know. Maybe. > Medications > Flashcards

Medications Flashcards

1
Q

Norepinephrine dose

A

.1 mcg/kg/min IV

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2
Q

Norepinephrine therapeutic effect

A

increases BP and cardiac output

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3
Q

Norepinephrine mechanism

A

Stimulates alpha adrenergic receptors located mainly in blood vessels
Causes constriction of both capacitance and resistance of blood vessels
Minor beta adrenergic activity that includes myocardial stimulation

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4
Q

How long is norepinephrine active in the blood

A

1-2 minutes

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5
Q

Norepinephrine contraindication

A

Vascular, mesenteric or peripheral thrombosis

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6
Q

Norepinephrine side effects

A

anxiety, dizziness, h/a, dyspnea, arrhythmias, chest pain, htn, bradycardia, metabolic acidosis

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7
Q

Norepinephrine nursing instructions for frequency of monitoring

A

check bp every 2-3 minutes until stabilized and every 5 mins after. continuously check ecg

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8
Q

Norepinephrine toxicity treatment

A

discontinue norepi and administer fluid and electrolyte replacement therapy. and phentolamine (alpha adrenergic blocking agent)

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9
Q

Norepinephrine what to correct before initiation

A

volume depeletion

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10
Q

Norepinephrine continuous infusion instructions

A

dilute 4 mg in 1000 ml of d5w or d5/.9% saline. this creates 4 mcg/ml

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11
Q

Norepinephrine how to stop

A

discontinue gradually.

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12
Q

Midazolam indication

A

reduce anxiety, preop sedation, anti seizure

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13
Q

Midazolam mechanism

A

acts at different levels within the CNS to produce generalized CNS depression. Mediated by GABA, an inhibatory neurotransmitter

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14
Q

Midazolam therapeutic effect

A

induce short term sedation

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15
Q

Midazolam half lfie

A

3-7 hours in children

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16
Q

Midazolam time to start working

A

15 mins im, peaks in 30-60 mins

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17
Q

Midazolam side effects

A

agitation, drowsiness, excess sedation, headache, respiratory depression, bronchospasm, coughing, cardiac arrest, arrhythmias

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18
Q

Midazolam drug drug interaction

A

alcohol, opioid analgesics, sedatives (dec midazolam dose by 50% if given in conjunction with these drugs)

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19
Q

Midazolam metabolism

A

P450 enyzme

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20
Q

Midazolam dose PO 6months to 16 years for conscious sedation

A

.25-.5mg/kg

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21
Q

Midazolam dose IM for conscious sedation

A

.1-.15 mg/kg

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22
Q

Midazolam dose for status epilepticus kids >2mos IV

A

.15mg/kg load followed by a continuous infusion of 1 mcg/kg/min. titrate dose upward q5min until seizure controlled 1-18 mcg/kg/min

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23
Q

Midazolam nursing instructions for monitoring

A

monitor level of sedation and level of consciousness during and throughout for 2-6 hours after administration

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24
Q

What to monitor specifically in midazolam administration

A

BP, pulse, respiration continuously during iv admin

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25
Q

Midazolam rescue drug

A

flumazenil (romazicon)

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26
Q

How to administer midazolam IV

A

administer undiluted or diluted with D5W .9% NaCl.
Undiluted concentration of 1 mg/ml or 5mg/ml.
Diluted: .02-3mg/ml

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27
Q

Midazolam IV rate

A

2-5 min. titrate dose to patient response

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28
Q

Midazolam continuous IV instructions

A

dilute with .9% NaCl or D5W. get a concentration of .5-1mg/mL

29
Q

Midazolam intranasal route, 6 mo and older dose

A

0.2 mg/kg intranasally x1; Max: 10 mg/dose; Info: may repeat dose x1 after 5-15min

30
Q

Acetaminophen indication

A

mild pain, fever

31
Q

Acetaminophen mechanism

A

inhibits synthesis of prostaglandins that may serve as mediators of pain and fever in the CNS. Has no significant anti inflammatory properties

32
Q

Acetaminophen therapeutic effect

A

analgesia

33
Q

Acetaminophen half life

A

1-3 hours

34
Q

Acetaminophen onset for po and iv

A

PO onset in .5-1 hr peaks in 1-3 hours and lasts 3-8 hours

IV onset in 30 mins peaks in 30 minutes and lasts 4-6 hours`

35
Q

Acetaminophen contraindication

A

alcohol. use cautiously in patients with hepatic disease

36
Q

Acetaminophen side effects

A

agitation, anxiety, headache, fatigue, insomnia, atlectasis, dyspnea, htn, vomiting.

37
Q

Acetaminophen PO dose >12 years old

A

325-650 mg q4-6 hours or 1g 3-4 times daily

38
Q

Acetaminophen PO dose kids 1-12 years

A

10-15mg/kg/dose q4-6 hours

39
Q

Acetaminophen IV dose >13 years

A

1000mg q 6hrs or 650 mg q4hr not exceed 4g/day

40
Q

Acetaminophen IV dose 2-12 years

A

15mg/kg q6hr or 12.5 mg/kg q4hr not to exceed 75 mg/kg/day

41
Q

Acetaminophen nursing, when to recheck patient

A

30-60 minutes after administration.

42
Q

Acetaminophen toxicity treatment

A

acetylcysteine

43
Q

Acetaminophen IV infusion rate

A

infuse over 15 minutes. no need to dilute

44
Q

Morphine indication

A

severe pain and pulmonary edema

45
Q

Morphine mechanism

A

binds to opiate receptors in the CNS to alter perception of and response to painful stimuli. it also causes CNS depression.

46
Q

Morphine therapeutic effect

A

decrease severity of pain.

47
Q

Morphine onset

A

PO onset=unknown
IM onset=10-30 mins, peaks in 30-60
IV onset=rapid and peaks in 20 mins

48
Q

Morphine contraindication

A

avoid in patients w hypersensitivity or who have had alcohol

49
Q

Morphine: when to use cautiously

A

in patients with head trauma, increased ICP, renal or hepatic disease.

50
Q

Morphine adverse effects

A

confusion, sedation, dizziness, hallucinations, headache, unusual dreams, blurry vision, respiratory depression, hypotension, constipation

51
Q

Morphine drug drug interaction

A

Use cautiously in patients receiving MAO inhibitors within 14 days prior

52
Q

Morphine dose for PO

A

.2-.5 mg/kg/dose q4-6 hours as needed

53
Q

Morphine dose for IV kids <50kg

A

.05-.2 mg/kg/ q3-4hr. maximum 15mg/dose

54
Q

Morphine dose IV > 50 kg

A

initial 4-10 mg q3-4 hr. For very severe pain additional smaller doses may be given every 3-4 hours.

55
Q

Morphine dose for continuous administration

A

.01-.04 mg/kg/hr. If cancer or sickle cell pain, can give .02-2.6 mg/kg/hr

56
Q

Morphine: what to assess for after administration

A

type, location, and intensity of pain prior to and 1 hr following administration.

57
Q

Morphine: how to titrate up

A

increase doses 25-50% until patients pain is decreased by 50%.

58
Q

Morphine: for pts on continuous drip, when can boluses be given?

A

every 15-30 min as needed for pain. The bolus amount is set to the amount of drug infused each hour by continuous infusion.

59
Q

Morphine what to assess for

A

bp, respiratory rate, level of consciousness. if respiratory rate is <10/min, assess level of sedation. physical stimulation may be enough to prevent significant hypoventilation.

60
Q

Morphine, when to give laxatives

A

after 2-3 days of opioid administration.

61
Q

Morphine toxicity treatment

A

naloxone (narcan) dilute .4mg of naloxone in 10ml of .9% nacal and administer .5ml (.02mg) by direct iv push every 2 minutes. if less than 40Kg administer .1mg in 10ml (0.5mcg/kg)

62
Q

Morphine direct IV administration

A

dilute with at least 5ml of sterile water or .9% NaCl for injection. concentration of .5-5 mg/ml. Administer 2.5-15 mg over 5 min

63
Q

Epinephrine indications

A

cardiac arrest (aystole and pulseless electrical activity) and in bradycardia and hypotension.

64
Q

Epinephrine effects

A

It increases heart rate, myocardial contractility, systemic vascular resistance and cardiac automaticity. SE=causes inc myocardial demand

65
Q

Epinephrine IV dose

A

0.01mg/kg (0.1 mL/kg) 1:10,000 concentration every 3-5 minutes

66
Q

Atropine effects

A

a parasympathetic drug that inhibits vagal activity, accelerates sinoatrial pacemakers, and enhances atrioventricular conduction.

67
Q

Atropine indication

A

indicated for symptomatic bradycardia due to increased vagal tone, cholinergic drug toxicity, or AV heart block.

68
Q

Atropine dose

A

0.02 mg/kg IV

Stuff I should know. Maybe. (20 decks)

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