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Paramedic AEC > Module V Medications > Flashcards

Module V Medications Flashcards

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1
Q

Fentanyl Citrate
(Sublimaze)
Class, MoA, Pharma

A

Classification:
Narcotic Analgesic
MoA:
A dose of 100mcg is approximately equivalent in analgesic activity to 10mg of morphine or 75mg of meperidine.

Pharma:
Onset of Action almost immediately when given IV. Peak Respiratory depressant effect occurs in 5-15 min.

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2
Q

Fentanyl Citrate
(Sublimaze)
Indications, Contraindications, Adverse Eff

A

Indications:

  • Analgesic Requirement of short duration
  • Sedation Maintenance for RSI

Contraindications:

  • Myasthenia Gravis
  • Hypotension
  • Head Injury

Adverse Effects:

  • Respiratory Depression, Apnea, Rigidity, and Hypercapnia may not be resolvable with Naloxone.
  • Increased effects in the elderly and debilitated patients.
  • Bradycardia resolvable with atropine.
  • Extrapyramidal symptoms resolvable with Diphenhydramine.
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3
Q

Fentanyl Citrate
(Sublimaze)
Dosages, Pearl

A

Adult
-50-100mcg slow IV, IO, IM, or IN. For severe burns, max dose of 200mcg.
Pediatric
-1-2mcg/kg Slow IV, IO, IM, or IN when patients SBP is less than 90mmHg. May repeat dose once after 5 minutes to reach desired effects. Max total dose 100mcg.

Pearl

  • May cause chest wall rigidity, seizures, and hypotension if administration too rapid.
  • EtCO2 must be monitored once the patient is compliant.
  • Document witnessed waste of unused medication.
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4
Q

Flumazenil
(Romazicon)
Class, MoA

A

Classification
-Benzodiazepine Atagonist
MoA
-Competes with benzodiazepines at the receptor sites, reversing the sedative effects of Benzodiazepines.

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5
Q

Flumazenil
(Romazicon)
Indications, Contraindications, Adverse Effects

A 
Indications
-Benzodiazepine over sedation
Contraindications
-TCA OD
-Seizures
-Known Benzo Dependence
Adverse Effects
-Seizure
-Dizziness
-Nausea / Vomitting
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6
Q

Flumazenil
(Romazicon)
Dosages, Pearls

A 
Dosages
-.2mg IV/IO over 15 seconds
wait 45 seconds between doses, repeat until desired effect or 1mg max. 
PEARLS
-Reversal of Benzo may cause seizures.
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7
Q

Midazolam
(Versed)
Classification, MoA,

A

Classification:

  • Sedative Hypnotic
  • Anxiolytic
  • Benzodiazepine Anticonvulsant

MoA
Short acting benzo with sedative, hypnotic, and amnestic properties

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8
Q

Midazolam
(Versed)
Indications, Contraindications, Adverse Effects

A

Indications

  • Sedation of intubated patients
  • Seizures
  • Combative Patients
  • RSI
  • Sedation prior to cardioversion

Contraindications

  • Hypotension
  • Acute, Narrow angle glaucoma

Adverse Effects

  • Respiratory Depression
  • Apnea
  • Hypotension
  • Amnesia
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9
Q

Midazolam
(Versed)
Dosages

A

Dosages
-Adult
1-5mg Slow IV/IO or .01-.02mg/kg IM/IN max of 5mg Single Dose
-Pediatric
0.05-0.1mg/kg slow IV/IO or .1-.2mg/kg IM/IN (Max of 2mg single dose)

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10
Q

Racemic Epinephrine

Classification, MoA

A 
Classification
-Sympathomimetic Agonist
MoA
-Causes vasoconstriction to reduce swelling of the upper airway
-Relief of Bronchospasm
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11
Q

Racemic Epinephrine

Indications, Contraindications, Adverse Effects

A

Indications

  • Croup
  • Bronchiolitis
  • Smoke Inhalation that causes stridor
  • Bronchial Asthma refractory to first line medications in patients greater than 4 years old.

Contraindications
- Known hypersensitivity

Adverse Effects

  • Tachydysrhythmias
  • Hypertension
  • Headache
  • Nervousness
  • Rebound Edema may occur 20-30 minutes after administration to croup patients
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12
Q

Racemic Epinephrine

Dosages

A

5kg and over
0.5ml diluted in 3ml nebulized
less than 5kg
0.25ml diluted in 3ml nebulized

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13
Q

Diazepam
(Valium)
Classification, Pharma

A

Classification

  • Sedative Hypnotic
  • Benzodiazepine

Pharma
-Short acting Benzodiazepine with sedative hypnotic and amnestic properties.

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14
Q

Diazepam
(Valium)
Indications, Contraindications, Adverse Effects

A 
Indications
-Sedation of Intubated patients with ventilatory difficulty secondary to bucking or combativeness. 
-Seizures
-Combative Patients
-Pre Medications prior to TCP / Cardioversion
Contraindications
-Hypotension
-Respiratory Depression

Adverse Effects

  • Respiratory Depression
  • Apnea
  • Hypotension
  • Amnesia
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15
Q

Diazepam
(Valium)
Dosages

A 
Dosages
Adult
-RSI/Sedation
2-5mg IV/IO every 10-15 min
-Behavioral Emergency
2-5 mg IV/IO/IM
-Seizures
2-5mg slow IV/IO/IM

Pediatric
0.05-0.1mg/kg slow IV/IO or 0.1-0.2mg/kg IM/IN
Give Prophylactically when administering Ketamine for RSI to prevent emergence reaction: 0.02mg/kg IV

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