Medications Mod IV

Question 1

Calcium Chloride

Class, MoA, Adverse Eff

Answer 1

Class: Electrolyte
MoA:
▪Increase cardiac contractile state and ventricular automaticity.
▪ Is useful in reversing cardiac arrhythmias due to hyperkalemia. (Often seen in renal dialysis
patients)
Adverse Effects:
Bradycardia, Hypotension

Question 2

Dextrose 50%

Class, Pharma

Answer 2

Class:
Hyperglycemic Agent, Monosaccharide

Pharma:
Restores circulating blood sugar and is rapidly utilized following IV Injection

Question 3

Glucagon

Class, MoA,

Answer 3

Class:
Hyperglycemic Agent, Pancreatic Hormone

MoA:
Hormone synthesized by the pancreas, Increases Blood glucose concentration by releasing glycogen stores in the liver and skeletal muscles.

Question 4

Sodium Bicarbonate

Class, Pharma, Adv Effects

Answer 4

Class:
Alkalinizing Agent

Pharma:
Rapid onset of action in the blood
Delayed onset of action in the tissues.

Adverse Effects:
Worsened intracellular acidosis due to Carbon Dioxide formation, May precipitate congestive heart failure, Metabolic Alkalosis, Acute Hypokalemia, Exacerbation of Central Venous acidosis

Question 5

Thiamine

Class, MoA, Adverse Eff

Answer 5

Class:
Vitamin B1

MoA:
Combines with ATP to form co-enzyme essential for normal metabolism - converting sugar to energy

Question 6

Ketorolac (Toradol)

Class, MoA, Adverse Eff

Answer 6

Class:
Nonsteroidal Anti Inflammatory

MoA:
Exhibits peripherally acting nonnarcotic analgesic activity by inhibiting prostaglandin

Adv Effects:
Edema, Sedation, Bleeding, Rash, Nausea, Headache

Question 7

Calcium Chloride

Indications, Contraindications, Dosages

Answer 7

Indications
Hyperkalemia
Hypocalcemia
Treat adverse effects of Calcium Channel Blocker Overdose
Hypermagnesemia 
Crush Syndrome

Question 8

Dextrose
Indications
Contraindications

Answer 8

Indications:
Correction of altered mental status due to hypoglycemia

Contraindications:
Known hyperglycemia, Intracranial Hemorrhage, CVA (Unless hypoglycemic, consider smaller dose increments)

Question 9

Dextrose

Dosage

Answer 9

Adult:
D50W 25g IV (IO as last resort)
D10W 100ML bolus then reassess

Question 10

Glucagon
Indications
Contraindications

Answer 10

Indications:
Unconscious patients who are highly suspected of being hypoglycemic where IV access is unobtainable.
Calcium channel blocker OD unresponsive to Ca Chloride
Bradycardia secondary to beta blocker OD, not responsive to atropine
Steakhouse syndrome
Bronchospasm secondary to choking

Contraindications:
None

Question 11

Glucagon

Dosage

Answer 11

Dosage:

Hypoglycemia- Administer 1mg IM

Question 12

Sodium Bicarb

Indications, Contraindications

Answer 12

Indications:
Used in cardiac arrest only after more definitive treatments
Hyperkalemia
Tricyclic and phenobarbital OD, Prophylaxis prior to release of crush injuries
Metabolic Acidosis

Contraindications
Pre Existing alkalosis

Question 13

Sodium Bicarb Dosage

Answer 13

1 mEq / Kg IV/IO
Crush Injuries:
Maintenance infusion 50mEq/250 cc D5W (1ML/MIN)

Question 14

Thiamine

Indications, Contraindications, Adverse Effects

Answer 14

Indications:
Malnourished or alcoholic hypoglycemic patients

Contraindications:
None

Adverse Effects:
Tachycardia, Palpatations, Nervousness, Tremors, Dizziness, Nausea, Vomiting

Question 15

Thiamine

Dosage

Answer 15

100 mg IM or Slow IV/IO

Question 16

Ketorolac (Toradol)

Indications Contraindications

Answer 16

Indications:
Management of moderate to severe pain. Patient with a history of narcotic medication abuse, Musculoskeletal pain of spasm.

Contraindications:
Allergies to ASA or other NSAIDS
Bleeding disorders, renal failure / dialysis. Active peptic ulcers, Head Trauma, History of cerebral hemorrhage, Pregnancy

Question 17

Ketorolac (Toradol)

Dosages

Answer 17

Adult:

30mg Slow IV/IO/I,

Question 18

Calcium Chloride Dosage

Answer 18

• Dosage:
▪ Adult:
• Administer 2 g – 4 g slow IV/IO at a rate of 100 mg/min. May be repeated as needed at 10-minute intervals.
• Cardiac arrest doses may be given over 2 minutes

Question 19

Calcium Chloride

Adverse Effects

Answer 19

Bradycardia may occur with rapid injection.

Syncope, cardiac arrest, arrhythmia, bradycardia Hypotension, particularly if administered quickly