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ASSOCIATES IN EMERGENCY CARE 24-25 > MODULE 2 MEDICATIONS > Flashcards

MODULE 2 MEDICATIONS Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

d

ASPIRIN

CLASSIFICATION

A
  • Antiplatetlet
  • Antipyretic
  • Anti-Inflammatory
  • Analgesic
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2
Q

ASPIRIN
DOSAGE

ADULT

A
  • 81mg - 324mg (1 - 4 pills)
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3
Q

ASPIRIN

INDICATION

A
  • Chestpain of suspected cardiac origin
  • Acuted cornonary syndromes (with or without suspected chest pain
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4
Q

ASPIRIN

CONTRADICTION

A
  • Allergy to Asprin
  • Any bleeding disorders
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5
Q

ASPIRIN

ADVERSE EFFECTS

A
  • Allergic reaction
  • Bleeding
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6
Q

ASPIRIN

MECHANISM OF ACTION

A
  • Prevents formation of Thromboxane A2, inhibitiung the clotting caseade4 by decreasing platelet aggregation
  • Prolongs bleeding times
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7
Q

DIPHENHYDRANMINE HYDROCHLORIDE

CLASSIFICATION

A
  • Antihistamine
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8
Q

DIPHENHYDRANMINE HYDROCHLORIDE

INDICATIONS

A
  • Allergic reactions
  • Anaphyaxis
  • Dystonic reatctions (Extrapyramidal symptoms)
  • Chemical restraint
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9
Q

DIPHENHYDRANMINE HYDROCHLORIDE
ADULT

DOSAGE

A
  • 25 - 50 mg IV/IO/IM
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10
Q

DIPHENHYDRANMINE HYDROCHLORIDE

DOSAGE
PEDIATRIC

A
  • 1mg/kg IV/IO/IM
  • MAX SINGLE DOSE 25mg
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11
Q

DIPHENHYDRANMINE HYDROCHLORIDE

CONTRAINDICATIONS

A
  • Know allergy to Diphenhydranmine
  • Acute Ashtma exacerbation
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12
Q

DIPHENHYDRANMINE HYDROCHLORIDE

ADVERSE EFFECTS

A
  • Drowsiness
  • Loss of coordination
  • Blurred vision
  • Headache
  • Hypotension
  • Tachycardia
  • Palpitations
  • Thickening of pronchial secertions leading to chest tighttness and wheezing
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13
Q

DIPHENHYDRANMINE HYDROCHLORIDE

MECHANISM OF ACTION

A
  • H1 Receptor antagonist blocking histamine from binding, reducing allergic, and anaphylactic response and allergy cascade
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14
Q

DIPHENHYDRANMINE HYDROCHLORIDE

PHARMACOKINETICS

A
  • Effect begins within 1-5 minutes of IV dose
  • Peak effect 1 to 4 hours
  • metabolized by the liver
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15
Q

EPINEPHRINE 1:1000/1:10000

CLASSIFICATION

A
  • Adrenergic Catecholamine
  • Sympathomimetic (Vasopressor)
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16
Q

EPINEPHRINE 1:1000/1:10000

DOSAGE
CARDIAC ARREST

A
  • ADULT
    • 1mg (1:10,000) IVP every 3 - 5 min
  • PEDIACTRIC
    • 0.01 mg/kg (0.1ml/kg) (1:10,000) IV/IO every 3 - 5 min
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17
Q

EPINEPHRINE 1:1000/1:10000

DOSAGE
ROSC

A
  • 0.1 - 0.5 mcg/kg/min
    • Standard concentration = 1mg EPI/250ml NS
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18
Q

EPINEPHRINE 1:1000/1:10000
SYMPTOMATIC BRADYCARDIA (UNSTABLE)

DOSAGE

A
  • ADULT
    • 2 - 10 mcg/min, mix 1 mg EPI in 250ml D5W
  • PEDIATRIC
      • 0.01 mg/kg (1:10,000) IO/IV, every 3-5 min
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19
Q

EPINEPHRINE 1:1000/1:10000

DOSAGE
ANAPHYLACTIC SHOCK / ASTHMA

A
  • ADULT
    • 0.3 - 0.5 mg (1:1,000) SQ/IM
  • PEDIATRIC
      • 0.01 mg/kg (1:10,000) SQ/IM… MAX SINGLE DOSE 0.3mg
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20
Q

EPINEPHRINE 1:1000/1:10000
ANAPHYLACTIC SHOCK / ASTHMA WITH LIFE THREATENING MANIFESTATIONS

DOSAGE

A
  • Concider 0.1mg (1:10,000) Slow IV/IO Infusion over 5 min
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21
Q

EPINEPHRINE 1:1000/1:10000
CROUP

DOSAGE

A
  • PEDIATRIC
    • 1:1,000 3mg Via nebulizer: Dilute in 3ml normal saline
      If no improvement, repeat initial dose ONCE
22
Q

EPINEPHRINE 1:1000/1:10000

INDICATIONS

A
  • Cardiac arrest
  • Anaphylaxis
  • Bronchial sthma
  • Respiratory stridor (suspected croup)
  • Symptomatic Bradycardia
  • Return Of Spontaneous Circulation (ROSC)
23
Q

EPINEPHRINE 1:1000/1:10000

CONTRAINDICATIONS

A
  • Hypertension
  • None in cardiac arrest settings
24
Q

EPINEPHRINE 1:1000/1:10000

ADVERSE EFFECTS

A
  • Tachydysrhythmias (supraventricular and ventricular)
  • Hypertension
  • Headache
  • Nervousness
  • Tremors/Shakes
  • May endude early labor in pregnant women
  • Rebound edma in croup patients, 20 - 30 min after administration
25
Q

EPINEPHRINE 1:1000/1:10000

MECHANISM OF ACTION

A
  • Administration of Epinephen causes “Fight or Flight” response
  • Alpha - Peripherial vasoconstriction
  • Beta 1- Increases inotropy, chronotropy, dromotropy, & automaticity
  • Beta 2 - Bronchodialation and skeletal muscle vasodialtion
26
Q

EPINEPHRINE 1:1000/1:10000

PHARMACOKINETICS

A
  • IV administation has VERY RAPID onset of action
  • Rapidly inactivated by liver
  • Subcutaneous administation slower due to local vasoconstriction
  • Epi has vasoconstriction properties in respiratory tract, which result in reduction of mucosal and submucosal edema
27
Q

EPINEPHRINE 1:1000/1:10000

PEARLS

A
  • Do not mix with Sodium Bicarbonate or Furosemide as this deactivates Epinephrine
  • Epi causes dramatic increase in myocardial oxygen demand
  • IV Epi should be reserved for cardiac arrest and for impending cardiac arrest due to anaphylaxis
28
Q

FUROSEMIDE

CLASSIFICATION

A

Loop diuretic

29
Q

FUROSEMIDE

DOSAGE

A
  • 0.5 - 1 mg/kg IV/IO
  • 40 mg if taking Lasix
  • 80 mg if NOT taking Lasix
30
Q

FUROSEMIDE

INDICATIONS

A
  • CHF
  • Pulmonary edema
31
Q

FUROSEMIDE

CONTRAINDICATION

A
  • Hypovolemia / Dehydration
  • Hypokalemia / Electrolyte depletion
32
Q

FUROSEMIDE

ADVERSE EFFECTS

A
  • Hypotension
  • Electrolyte imbalances
33
Q

FUROSEMIDE

MECHANISM OF ACTION

A
  • Inhibits the reabsorbtion of Sodium Chloride in the Loop of Henle abnd proximal tubule of the nephron in the kidneys.
  • Water follows salt…. water is not reabsorbed and is then excreted into the bladder and is released as urine
34
Q

MORPHINE SULFATE

CLASSIFICATION

A
  • Narcotic analgesic
35
Q

MORPHINE SULFATE
ACUTE MYOCARDIAL INFARCTION/ PULMONARY EDEMA

DOSAGE

A
  • 2 - 10 mg IV/IO/IM for pain not relieved by Nirtoglycerin
36
Q

MORPHINE SULFATE
BURN INJURY

DOSAGE

A
  • 2 - 20 mg IV/IO/IM
37
Q

MORPHINE SULFATE
ISOLATED INJURIES

DOSAGE

A
  • 2 - 10 mg IV/IO/IM
  • Additional 2 - 10 mg UP TO 20 mg or until pain is relieved
38
Q

MORPHINE SULFATE
ISOLATED INJURIES
PEDIATRIC

DOSAGE

A
  • 0.1 mg/kg IV/IM
  • Systolic BP must be over 100 mmHG
  • MAX TOTAL DOSE 10mg
39
Q

MORPHINE SULFATE

INDICATIONS

A
  • Acute Myocardial Infarction
  • Isolated injuries
  • Pulmonary edema/CHF
  • Burns
40
Q

MORPHINE SULFATE

CONTRAINDICATIONS

A
  • Head injury
  • Multiple system trauma (Relative)
  • COPD with compromised respiratory effort
  • Hypotension
  • Sensitivity to Morphine, Codeine, Percodan
41
Q

MORPHINE SULFATE

ADVERSE EFFECTS

A
  • Increased vagal tone due to suppresion of sympathetic pathways (slowed heart rate)
  • Respiratoty depression / arrest
  • Altered mental status
  • Nausea
  • Vomiting
  • Bronchospasm
  • itch
42
Q

MORPHINE SULFATE

MECHANISM OF ACTION

A
  • Decreases pain perception and anxiety
  • Decreases respiratory effort
  • Causes peripheral dialation which decreases preload
  • Decreases left ventricular afterload
43
Q

MORPHINE SULFATE

PHARMACOKINETICS

A
  • Binds with opiate receptors in the CNS, altering perception to pain
  • Onset of actions < 5 min after administration. Effects last 4 - 5 hrs
  • Casuses peripheral arterial & venous vasodilation
44
Q

NITROGLYCERIN

CLASSIFICATION

A
  • Nitrate
  • Vasodilator
45
Q

NITROGLYCERIN
CHEST PAIN

DOSAGE

A
  • 0.4 mg SL (Sublingual) every 3 - 5 min
  • MAX DOSE 1.2 mg
46
Q

NITROGLYCERIN
PULMONARY EDEMA / CHF

DOSAGE

A
  • 0.4 mg SL (Sublingual) repeat 3 - 5 min if symptoms persist
  • 1 inch Nitro paste to chest wall
    *** If hypotension occurs due to administration, wipe site with gauze
47
Q

NITROGLYCERIN

INDICATIONS

A
  • Treatment of angina
  • Congestive heart failure
  • Acute pulmonary edema
  • Symptomatic hypertensive crisis
48
Q

NITROGLYCERIN

CONTRAINDICATIONS

A
  • Known hypersensitivity
  • Pediatrics under 12 y/o
  • Viagra/Levitra/Cialis ingestion in the last 24hrs
  • Asymptomatic Hypertension
  • BP below 90 mmHg
  • Right side MI (Positive ST segment elevation V4R)
49
Q

NITROGLYCERIN

ADVERSE EFFECTS

A
  • Headache
  • Hypotension
  • Nausea & Vomiting
  • Dizziness
  • Decreased LOC
50
Q

NITROGLYCERIN

MECHANISM OF ACTION

A
  • Vasodilator - effect on veins more than arteries
  • Decrease right heart return (preload) by venous pooling, thereby decreasing myocardial workload and oxygen consumption
51
Q

NITROGLYCERIN

PHARMACOKINETICS

A
  • Absorbed through oral mucosa or scin
  • Antianginal and vasodilatory effects within 1-2 min after administation
  • Half-life is 1 - 4 min. Duration is less than 5 min.

ASSOCIATES IN EMERGENCY CARE 24-25 (5 decks)

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