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Pharmacy Phriday > Nausea and Vomiting > Flashcards

Nausea and Vomiting Flashcards

1
Q

….. is the preferred antiemetic in our protocols that can be found within the retitled Nausea/Vomiting Protocol and is also cited in various other locations in the protocols where nausea and vomiting are of concern.

A

Zofran

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2
Q

Zofran is a rapid-acting ….. which essentially means it blocks the vomiting impulse from being sent to the brain and thus suppresses nausea and vomiting.

A

serotonin receptor antagonist

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3
Q

n/v can lead to very serious illnesses or complications. Some of these may include dehydration and ….., aspiration, or other airway compromises.

A

electrolyte imbalances

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4
Q

n/v can lead to very serious illnesses or complications. Some of these may include dehydration and electrolyte imbalances, aspiration, or other airway compromises. N/V can worsen a ….. or cause ….. that is controlled to start bleeding again.

A

hemorrhagic stroke

intracranial hemorrhage

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5
Q

Zofran is provided and approved for administration by paramedics in the IV/IM form as a …..

A

4mg/2ml vial.

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6
Q

Zofran

Adult dosing is….. initially that can be repeated in 10 minutes if needed, to a maximum dose of …..

A

4 mg

8 mg

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7
Q

Zofran

Adult dosing is 4 mg initially that can be repeated in ….. if needed, to a maximum dose of 8 mg

A

10 minutes

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8
Q

Zofran is provided and approved for administration by paramedics in the ….. form as a 4mg/2ml vial.

A

IV/IM

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9
Q

Zofran
In the pediatric patient ….. old, the dosing of the IV/IM solution is 0.15 mg/kg that can be repeated in 10 minutes if needed, to a maximum dose of 4 mg.

A

> 1 year

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10
Q

Zofran
In the pediatric patient >1 year old, the dosing of the IV/IM solution is ….. that can be repeated in 10 minutes if needed, to a maximum dose of 4 mg.

A

0.15 mg/kg

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11
Q

Zofran
In the pediatric patient >1 year old, the dosing of the IV/IM solution is 0.15 mg/kg that can be repeated in ….. if needed, to a maximum dose of 4 mg.

A

10 minutes

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12
Q

Zofran
In the pediatric patient >1 year old, the dosing of the IV/IM solution is 0.15 mg/kg that can be repeated in 10 minutes if needed, to a maximum dose of ……

A

4 mg

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13
Q

Zofran
In the pediatric patient >1 year old, the dosing of the ….. solution is 0.15 mg/kg that can be repeated in 10 minutes if needed, to a maximum dose of 4 mg.

A

IV/IM

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14
Q

The ODT (Oral Dissolving Tablet) form can only be used in the pediatric patient if they are over …..in weight and at least 12 years of age.

A

40 kg

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15
Q

The ODT (Oral Dissolving Tablet) form can only be used in the pediatric patient if they are over 40 kg in weight and at least ….. of age.

A

12 years

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16
Q

Zofran
In the pediatric patient >1 year old, the dosing of the IV/IM solution is 0.15 mg/kg that can be repeated in 10 minutes if needed, to a maximum dose of 4 mg. This solution can also be administered…… in a child >1 year of age by drawing up the medication, removing the needle, and using the syringe to “shoot” it past their tongue.

A

PO

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17
Q

Zofran
In the pediatric patient >1 year old, the dosing of the IV/IM solution is 0.15 mg/kg that can be repeated in 10 minutes if needed, to a maximum dose of 4 mg. This solution can also be administered PO in a child >1 year of age by drawing up the medication, removing the needle, and using the syringe to ……

A

“shoot” it past their tongue

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18
Q

Zofran
In the pediatric patient >1 year old, the dosing of the IV/IM solution is 0.15 mg/kg that can be repeated in 10 minutes if needed, to a maximum dose of 4 mg. This solution can also be administered PO in a child ….. of age by drawing up the medication, removing the needle, and using the syringe to “shoot” it past their tongue.

A

> 1 year

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19
Q

Zofran

A slow IV push, over ….. minutes, will help reduce the risk of any unwanted side effects.

A

2

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20
Q

Zofran Oral Dissolving Tablet
Place the tablet ….. the patient’s tongue. The tablet will rapidly dissolve, and the patient can then swallow their saliva. No water is needed.

A

on

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21
Q

The list of contraindications for the use of Zofran has changed within the 2022 UH protocols. Other than a known allergy and ….., the presence of a prolonged QT interval of greater than 500 ms or 2.5 large boxes on the ECG is also listed as a contraindication

A

liver disease (the medication is metabolized in the liver)

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22
Q

The list of contraindications for the use of Zofran has changed within the 2022 UH protocols. Other than a known allergy and liver disease (the medication is metabolized in the liver), the presence of a ….. of greater than 500 ms or 2.5 large boxes on the ECG is also listed as a contraindication.

A

prolonged QT interval

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23
Q

The list of contraindications for the use of Zofran has changed within the 2022 UH protocols. Other than a known allergy and liver disease (the medication is metabolized in the liver), the presence of a prolonged QT interval of greater than ….. on the ECG is also listed as a contraindication.

A

500 ms or 2.5 large boxes

24
Q

Though a rare occurrence, serious cardiac arrhythmias including ….. can occur following the administration of Zofran. Thus, many sources recommend EKG monitoring before, during, and after the administration of Zofran.

A

Torsades de Pointes

25
Q

Other concerns listed within the protocol as precautions and side effects are also rare but include Zofran’s use in pregnancy (Zofran is a Category……); GI changes; headaches; and fatigue and general weakness.

A

B medication indicating no animal studies have shown fetal risk and no controlled studies in pregnant women have been completed

26
Q

Other concerns listed within the protocol as precautions and side effects are also rare but include Zofran’s use in pregnancy (Zofran is a Category B medication indicating no animal studies have shown fetal risk and no controlled studies in pregnant women have been completed); …..; headaches; and fatigue and general weakness.

A

GI changes

27
Q

Other concerns listed within the protocol as precautions and side effects are also rare but include Zofran’s use in pregnancy (Zofran is a Category B medication indicating no animal studies have shown fetal risk and no controlled studies in pregnant women have been completed); GI changes;…..; and fatigue and general weakness.

A

headaches

28
Q

Generic name for Zofran

A

Ondansetron

29
Q

Zofran Contraindications

A

Known hypersensitivity
Severe liver disease
QT interval greater than 500ms (2.5 large EKG boxes)

30
Q

zofran precautions

A

pregnancy

may prolong QT interval when used with another QT prolonging agent

31
Q

Zofran Side Effects

A

Constipation, Diarrhea

Increased liver enzymes

headache

fatigue and malaise

32
Q

Adult dose Zofran

A

4mg IM or IV

may repeat in 10 minutes - Max 8 Mg

33
Q

Zofran ODT dose

A

4mg ODT

may repeat in 10 minutes - Max 8 MG

34
Q

Peds Zofran Dose

A
  1. 15 mg / kg IM or IV >1 year old
  2. 15 mg / kg PO (injectable liquid NOT ODT) > 1 year old

May repeat in 10 minutes - Max 4 mg

35
Q

Peds Zofran ODT dose

A

if > 40 kg AND > 12 years old

4mg ODT

36
Q

In cases when Zofran is not available, the suggested alternative is now …….

A

Reglan.

37
Q

Reglan is an antiemetic (though a different class than Zofran, often used to treat ……..

A

gastric reflux and nausea/vomiting (n/v)

38
Q

Reglan is an…….(though a different class than Zofran, often used to treat gastric reflux and nausea/vomiting (n/v).

A

antiemetic

39
Q

Reglan enhances the effects of the neurotransmitter acetylcholine (ACH) on the ….. which causes increased gastric motility and emptying of the stomach.

A

upper GI tract

40
Q

Reglan enhances the effects of the neurotransmitter ….. on the upper GI tract which causes increased gastric motility and emptying of the stomach.

A

acetylcholine (ACH)

41
Q

Reglan enhances the effects of the neurotransmitter acetylcholine (ACH) on the upper GI tract which causes increased gastric motility and emptying of the stomach. In addition, it is also a …….

A

dopamine antagonist (blocks dopamine receptors).

42
Q

Dopamine is one of the neurotransmitters released by ….. that can cause n/v, and blocking the receptor sites will reduce n/v.

A

GI irritation

43
Q

…..is one of the neurotransmitters released by GI irritation that can cause n/v, and blocking the receptor sites will reduce n/v.

A

Dopamine

44
Q

Dopamine also plays other roles in the brain, controlling ….. to name a few.

A

motor and cognitive function

45
Q

Reglan’s effect in blocking dopamine can also affect these other functions of dopamine causing altered levels of consciousness, impaired mental and physical abilities, and …..

A

extrapyramidal symptoms (EPS).

46
Q

Reglan’s effect in blocking dopamine can also affect these other functions of dopamine causing ….., and extrapyramidal symptoms (EPS).

A

altered levels of consciousness, impaired mental and physical abilities

47
Q

….. are involuntary muscle movements, often around the face.

A

EPS symptoms

48
Q

contraindications to Reglan’s use are

A

altered levels of consciousness, impaired mental and physical abilities, and extrapyramidal symptoms (EPS).

when a patient is suspected of having a GI bleed, obstruction, or perforation.

history of epilepsy due to Reglan’s effect on lowering the seizure threshold resulting in longer and more frequent seizures for the patient

the presence of QT prolongation greater than 500 ms (2.5 large EKG boxes)

49
Q

Of all the side effects, the most concerning are the extrapyramidal reactions that are more likely to occur in diabetics, children, seniors, and those already taking anti-psychotic medications. In cases where EPS does occur, the provider is directed to administer ……

A

Benadryl

50
Q

The dosing of Reglan under the UH protocols is ….. given IV and should be given as a slow push, over 1-2 minutes.

A

10 mg

51
Q

The dosing of Reglan under the UH protocols is 10 mg given IV and should be given as a …..

A

slow push, over 1-2 minutes

52
Q

The dosing of Reglan under the UH protocols is 10 mg given… (Answer what route)… and should be given as a slow push, over 1-2 minutes

A

IV

53
Q

Reglan is a fast-acting medication with an onset of about….. via the IV route with a duration of 1-3 hours.

A

1-3 minutes

54
Q

Reglan is a fast-acting medication with an onset of about 1-3 minutes via the IV route with a duration of…..

A

1-3 hours.

55
Q

Repeat dose of Reglan is …..

A

There is no repeat dose recommended.

56
Q

Reglan is a medication only given by the paramedic provider and only to an ….. Pediatric dosing is not recommended in the pre-hospital setting.

A

adult patient.

57
Q

Reglan is a medication only given by the paramedic provider and only to an adult patient. Pediatric dosing is …..

A

not recommended in the pre-hospital setting.

Pharmacy Phriday (2 decks)

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