Medications review Flashcards
Acetaminophen (Tylenol)
Indications
Contraindications
Adult dose/Ped dose
Side effects
Mechanism of action
- Indications:
Mild to moderate pain, fever reducer (no anti-inflammatory effects)
- Contraindications:
Hypersensitivity to acetaminophen, sever hepatic impairment, severe active hepatic disease
- Adult dose/Ped dose:
Adult: 1000 mg PO every 4-6 hours (dont exceed 4g in 24 hours)
Ped: 10-15 mg/kg every 4-6 hours (dont exceed 5 doses /24 hours)
- Side effects:
rash, hives, angioedema
- Mechanism:
unknown
Albuterol
Indications
Contraindications
Adult dose/Ped dose
Side effects
Mechanism of action:
- Indications:
Treatment of bronchospasm in PT with reversible obstructive airway disease (COPD, asthma)
Prevention of exercise-induced bronchospasm
- Contraindications:
Known prior hypersensitivity to albuterol. Tachycardia, dysrhythmias (especially from digitalis) synergistic with other sympathomimetics
- Adult dose/Ped dose:
Adult dose: 2.5 mg dilute with 0.5 mL normal saline in nebulizer and administer over 10-15 minutes.
MDI: 1-2 inhalations (90-180mcg)
Ped dose:
<20 kg: 1.25 mg/dose via handheld nebulizer
>20 kg: 2.5 mg/dose via nebulizer over 20 minutes. Repeat every 20 minutes
Side effects:
(often dose related) headache, fatigue, light-headedness, irritability, restlessness, aggressive behavior, pulmonary edema, hoarseness, nasal congestion, increased sputum, hypertension, tachycardia, dysrhythmias, chest pain, palpitations, nausea/vomiting, dry mouth, epigastric pain, and tremors
mechanism of action:
Selective beta-2 agonist that stimulates adrenergic receptors of the sympathomimetic nervous system. Results in smooth-muscle relaxation in the bronchial tree & peripheral vasculature
Aspirin
Indications
Contraindications
Adult dose/Ped dose
Side effects
Mechanism of action:
- Indications
New onset chest discomfort suggestive of ACS
- Contraindications
Hypersensitivity. Relatively contraindicated in PT with active ulcer disease or asthma
- Adult dose/Ped dose
Adult dose: 160 mg to 325 mg PO. Chewing is preferred
Ped dose: Not recommended
- Side effects
Bronchospasm, anaphylaxis, wheezing in allergic PT’s, prolonged bleeding, GI bleeding, epigastric distress, nausea, vomiting, heartburn, Reye syndrome
- Mechanism of action:
Prevents formation of thromboxane A2, which causes platelets to clump together (aggregate) and form plugs that cause obstruction or constriction, has antipyretic and analgesic properties
Epinephrine
Indications
Contraindications
Adult dose/Ped dose
Side effects
Mechanism of action:
- Indications
Cardiac arrest (asystole, PEA, VF, and pulseless VT), Symptomatic bradycardia as ALT. infusion to Dopamine, hypotension from shock other then hypovolemia, allergic reaction, anaphylaxis , asthma
- Contraindications
none in emergency setting
- Adult dose/Ped dose
Adult dose:
Allergic reaction/Asthma: 0.3-0.5 mg IM (0.3-0.5 mL of 1 mg)
Ped Dose:
Anaphylaxis: 0.1 mg (0.1 mL of 1mg) IM
- Side effects:
Nervousness, restlessness, headache, tremor, pulmonary edema, myocardia ischemia, hypovolemic shock
- Mechanism of action:
Direct-acting alpha and beta agonist
Alpha: vasoconstriction
Beta 1: positive inotropic, chronotropic, and dromotropic effects
Beta 2: bronchia smooth muscle relation and dilation of skeletal vasculature, Blocks histamine receptors
Ipratropium
Indications
Contraindications
Adult dose/Ped dose
Side effects
Mechanism of action:
- Indications
Persistent bronchospasm, COPD exacerbation
- Contraindications
Hypersensitivity to Ipratropium, atropine, alkaloids, peanuts
- Adult dose/Ped dose
Adult dose:
250-500 mcg via inhalation w/ nebulizer every 20 minutes up to 3x
Ped dose:
same
- Side effects
Headache, dizziness, nervousness, fatigue, tremor, blurred vision, cough, dyspnea, worsening COPD, symptoms, tachycardia, palpitations, flushing, MI, dry mouth, nausea/vomiting, GI distress
- Mechanism of action:
Inhibits interaction of aCH at receptor sites of bronchial smooth muscle, resulting in decreased cyclic guanosine monophosphate and bronchodilation
Naloxone
Indications
Contraindications
Adult dose/Ped dose
Side effects
Mechanism of action:
- Indications
Opiate overdose, complete or partial reversal of CNS & respiratory depression induced by opioids
Narcotic agonist for the following:
Morphine, heroin, Hydromorphone (Dilaudid), methadone, meperidine (demerol), paregoric, Fentanyl (sublimaze), oxycodone, codeine, propoxyphene
- Contraindications
Use with caution in narcotic-dependent PT’s. use with caution in neonates of narcotic-addicted mothers
- Adult dose/Ped dose
Adult dose:
0.4-2 mg IM/IV/IO
(2 mg recommended)
repeat every 5 minutes to max dose of 10 mg
Nasal : 1 spray (1 ml) in each nostril to = 2 mg
Ped dose:
0.1 mg dose IVIO/IM/ET every 2 minutes as needed
(2 mg recommended single dose)
If not response in 10 minutes, administer additional 0.1 mg per dose
- Side effects
Restlessness, seizures, dyspnea, pulmonary edema, tachycardia, hypertension dysthymias, cardiac arrest, nausea/vomiting, withdrawal symptoms in opioid-addicted PT’s, diaphoresis
- Mechanism of action:
Competitive inhibition at narcotic receptor sites. Reverses respiratory depression secondary to opiate drugs. Completely inhibit the effect of morphine
Nitroglycerin
Indications
Contraindications
Adult dose/Ped dose
Side effects
Mechanism of action:
- Indications
Acute angina pectoris, ischemic chest pain, hypertension, heart failure, pulmonary edema
- Contraindications
PT Has systolic BP below 90 mmHg or 30 mmHg lower then the baseline BP
HR is <50 bpm or >100 bpm
PT has suspected head injury
PT is infant or child
Max doses of three have been given
PT has taken Tadafil (Cialis), Vardenafil (Levitra) or sildenafil (Viagra) w/in 24 hours
- Adult dose/Ped dose
Adult dose: 0.4 mg Tablet or 1x spray under the tongue; may repeat in 3-5 minutes of max 3 doses
Ped Dose: Not recommended
- Side effects
- Mechanism of action:
Dilates blood vessels
Decreases workload of the heart
Decreases cardiac oxygen demand
Oral glucose
Indications
Contraindications
Adult dose/Ped dose
Side effects
Mechanism of action:
- Indications
(conscious PT’s with suspected hypoglycemia)
AMS, History of diabetes or BGL of >70 mg/dl, ability to swallow medication
- Contraindications
BGL above 70 mg/dl, unresponsive or unable to swallow
- Adult dose/Ped dose
Adult dose:
one whole tube
Ped dose:
0.5 -1 g PO with intact gag reflex and ability to manage own secretions
- Side effects:
nausea, vomiting
- Mechanism of action:
After absorption in GI tract, glucose is distributed to tissues providing an increase in circulating blood glucose levels
Oxygen
Indications
Contraindications
Adult dose/Ped dose
Side effects
Mechanism of action:
- Indications:
Confirmed or expected hypoxemia, ischemic chest pain, respiratory insufficiency, prophylactically during air transport, confirmed or suspected carbon monoxide poisoning, all other causes of decreased tissue oxygenation, decreased level of consciousness
- Contraindications:
Certain PT with COPD, decreased respiratory drive in COPD PT’s, dry mucous membranes
- Adult dose/Ped dose
Adult dose:
10-15 Lpm via NRM
Ped dose:
same
- Side effects
Decreased level of consciousness (COPD PT’s)
- Mechanism of action:
Reverse hypoxemia
