Obj. 34-40 misc. drugs & fluids

Question 1

What is the clinical usefulness of magnesium sulfate?

Answer 1

1. torsades de pointes
2. life-threatening asthma exacerbation
3. arrhythmias caused by hypomag

Question 2

What is the clinical usefulness of morphine?

Answer 2

1. relief of PAIN, including due to MI

2. relief of DYSPNEA due to LV failure and pulmonary edema

Question 3

What is the clinical usefulness of sodium bicarbonate?

Answer 3

1. metabolic acidosis
2. hyperkalemia
3. OD of TCAs, aspirin

Question 4

What is the clinical usefulness of calcium chloride?

Answer 4

1. hypocalcemia
2. emergent treatment of severe hypermag, severe hyperkalemia
3. CCB or BB overdose

Question 5

Naloxone can be repeated every 2-3 minutes.

T/F

Answer 5

True

Question 6

What is flumazenil used for?

Answer 6

reverses benzo sedation

Question 7

What is ondansetron used for?

Answer 7

anti-nausea, esp. associated with radiation therapy, surgery, chemotherapy

Question 8

What is a relative contraindication for ondansetron?

Answer 8

long QT

Question 9

Name 3 examples of crystalloid fluids.

Answer 9

~normal saline
~lactated ringer
~dextrose

Question 10

Name 3 examples of colloid fluids.

Answer 10

~whole blood
~platelets, RBCs
~fresh frozen plasma

Question 11

What is the general difference between crystalloids and colloids?

Answer 11

~crystalloids contain small molecules that cross cell membranes, so crystalloids expand the EXTRAVASCULAR volume
~colloids contain large molecules that cannot cross cell membranes, so they expand the INTRAVASCULAR volume (blood circulation)

Question 12

What’s an example of a hypotonic solution and when is it used?

Answer 12

1/2 normal saline - hypernatremia

Question 13

What are 2 examples of an isotonic solution and when are they used?

Answer 13

~normal saline 0.9%, LR: fluid replacement/resuscitation

~dextrose: hypernatremia

Question 14

What’s an example of a hypertonic solution and when is it used?

Answer 14

~3.5%, 5% saline: hyponatremia

~7.5% saline: closed head injuries, to decrease intracranial pressure

Question 15

What is the preferred volume expander in cases of emergency blood loss?

Answer 15

~isotonic crystalloid solutions

Question 16

For every 1 unit of blood loss, how much isotonic crystalloid solution is required to restore intravascular volume?

Answer 16

3 units

Question 17

For giving blood products, what is the preferred blood to be given?

Answer 17

In descending preference order:

1. type & cross matched
2. type-specific
3. O negative