meds and treatment Flashcards
succinylcholine action
short acting motor nerve depolarizer, skeletal muscle relaxant. Binds to cholinergic receptors in the motor neuron end-plate to cause muscle depolarization followed by paralysis.
succinylcholine indications
use after induction of anesthesia to produce skeletal muscle paralysis. when ETT is indicated and muscle tone or seizure activity prevents it. Pt. who exhibits high probability of airway compromise during transport.
succinylcholine contraindications
crush injury, kidney failure: hyperkalemia. hx. of glaucoma and malignant hyperthermia.
side effects of sodium bicarbonate
seizures, metabolic alkalosis, electrolyte imbalance
Naloxane with severe respiratory depression dosage
<6 breaths a minute at 2 mg
amiodarone contraindications
cardiogenic shock, sinus bradycardia, high degree AV block
Etomidate properties
a hypnotic drug without analgesic properties or muscle relaxing properties. Will usually cause myoclonus on injection.
Pacing protocol amperage
Set amperage at lowest setting; gradually increase the amperage until patient demonstrates electrical capture on EKG and mechanical capture as evidenced by pulses simultaneous with paced beat. Set amperage approximately 5 milliamps above capture point.
Ativan (lorazepam) when pacing
Conscious patients requiring pacing may be given Ativan 0.05 mg / kg, IV push. Titrate to patient comfort, up to a maximum dose of 4 mg or a systolic blood pressure of > 100 mm/Hg.
Atropine contraindications
tachycardia, narrow angle glaucoma, myasthenia gravis
ketamine properties
rapid acting general anesthetic producing a disassociative state characterized by profound analgesia; with cardiovascular and respiratory stimulation.
Labetalol preeclampsia
gestational age >20 weeks, elevated BP 160/110, S&S such as edema, visual disturbance, headache and epigastric pain: labetalol 10 mg IVP every 10 minutes until BP is <130/100
Magnesium sulfate pregnant female
consult medical control for <20 weeks gestation or postpartum: 4 grams IV in 100 mL D5W over 15 minutes with SEIZURE ACTIVITY
Calcium Chloride Action
an essential electrolyte for functional integrity of the nervous and muscular system, cardiac contractility and coagulation of blood.
Syncope possible causes
subarachnoid bleed, acute coronary syndrome, aortic dissection, leaking aortic aneurysm, ruptured ectopic pregnancy.
Glucose over 200 (hyperglycemic) with signs of DKA or dehydration
administer 500 mL bolus NS
Atropine dose
0.5 mg rapid IV push; repeat every 3-5 minutes; max dose 3 mg: Pediatric 0.02 mg/kg max 0.5 mg (minimum dose 0.1 mg)
Abdominal pain
male > 30 ALS; female > 45 ALS possible CAD
TFR 365
hard copy patient care report
snake bite
immobilize the limb: ALS; keep limb below level of the heart and use pain control protocol
Sodium bicarbonate
alkalizing agent raises metabolic pH. use with OD in cocaine, tricyclic antidepressants, aspirin or diphenhydramine. 1 mEq/kg q 10 min @ 0.5 mEq/kg. 25 mEq for crush injuries.
tachycardia > 100 BPM
labetalol 5 mg over 1-2 minutes max of 20 mg. may repeat dose after 5 minutes. 5 mg, 5 min; 10 mg, 10 min.
DO NOT use in hypotension syst. < 100 or signs of hypoperfusion.
if cooling causes shivering
Lorazepam 2 mg IV/IM
Diltiazem (cardizem) action
calcium channel blocker: inhibits transport of calcium; causes systemic vasodilation decreasing blood pressure.
