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AZDHS Profiles > Other Drug Profiles > Flashcards

Other Drug Profiles Flashcards

1
Q

Bumetanide Name/class

A

Bumetanide

Brand: Bumex

Class: Loop diuretic

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2
Q

Bumetanide MOA

A

Inhibits electrolyte reabsorption in the ascending loop of Henle leading to diuresis

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3
Q

Bumetanide Indications

A

Pulmomary Edema

CHF

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4
Q

Bumetanide Contraindications

A

Anuria
Electrolyte deficiencies
Hepatic coma
CAUTION in: hepatic cirrhosis, ascites, gout, furosemide allergy

Note: high dose or frequent admin (particular elderly) can cause profound diuresis, hypovolemia, and circulatory collapse with development of thrombi and emboli. may also precipitate HypoK induced digitalis toxicity

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5
Q

Bumetanide Adverse Reactions

A

Dizziness, headache, muscle cramps
Hypotension
EKG changes associated with HypoK, Na, Ca, and Mg
N/V, diarrhea, dry mouth, ringing in ears

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6
Q

Bumetanide Incompatability/nteraction

A

NSAIDS reduce diuretic effect
May increase blood lithium poisoning resulting in lithium poisoning
Potentiates effets of various anntHTN drugs

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7
Q

Bumetanide Dose (ad)

A

0.5 - 1 mg IV slow push over 1-2 mins or IM

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8
Q

Activated Charcoal Name/Class

A

Activated Charcoal

Brand: Insta char, Actidose aqua

Class: Adsorbent

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9
Q

Activated Charcoal MOA

A

Pharmacological: Physical binding of toxins from GI tract

Clinical Effects: Prevents/Reduces systemic absorption of toxins

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10
Q

Activated Charcoal Indications

A

Oral ingestion of toxic substances

Pre-lavage of oral ingestion of toxic substances

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11
Q

Activated Charcoal Contraindications

A

Ingestion of caustics, hydrocarbons
Comatose Pts
Simultaneous admin of other oral drugs

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12
Q

Activated Charcoal Adverse Reactions

A

Emesis

May worsen poison induced ileus

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13
Q

Activated Charcoal incompatabilities/interactions

A

Ineffective for Iron, Lithium, heavy metals, and other ions
May reduce effectiveness of other treatments (mucomyst) in pure acetaminophen
Bonds with whatever it is mixed with, flavoring reduces effectiveness

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14
Q

Activated Charcoal Dose (ad and ped)

A

Adult: 30-60 gm (1-2 gm/kg) 1 part charcoal to 4 parts water to mix

Peds: 0.5-1 gm (15-30gm)

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15
Q

Dextrose 50% Name/class

A

Dextrose 50%, D50W

Class: Carbohydrate, hypoglycemic

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16
Q

Dextrose 50% MOA

A

Pharmocologic: Aerobic metabolic substrate (ATP Production)

Clinical effects: reverses CNS effects of hypoglycemia through elevevating BGL, provides short term osmotic diueresis

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17
Q

Dextrose 50% Indications

A

Known hypoglycemia
ALOC/Seizures of unknown etiology
HyperK

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18
Q

Dextrose 50% Contraindications

A 
Known thiamine deficient
DTs (use thiamine in known alcoholic with this)
Head injury (unless documented hypoglycemia)
Intracranial hemorrhage (relative)
Severe pain (paradoxical excitement may occur)
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19
Q

Dextrose 50% adverse reactions

A

Cerebral edema in children when given undiluted IV
Worsening elevated ICP or Cerebral edema from trauma or CVA
Sclerosing effect on peripheral veins

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20
Q

Dextrose 50% Incompatabilities/interactions

A

Sodium Bicarb

Diazepam will precipitate if given concurrently without flushing

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21
Q

Dextrose 50% Dose (as and ped)

A

Adult:
Hypoglycemia/ALOC/Seizure of unknown etiology: 25-100 mL (12.5-50 gm, 1/2 - 2 Amps ) IV

HyperK: 50gm IV in conjunction with CaCl and bicarb

Peds:
0.5 - 1gm of D10, slow over 20 min period

(dilute D50 to a 1:4 solution by wasting 50mL of D50 and adding 50 mL to 250 mL NS

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22
Q

Diphenhydramine Name/Class

A

Diphenhydramine

Brand: Benadryl

Class: antihistamine/anticholinergic

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23
Q

Diphenhydramine MOA

A

Blocks cellular histamine receptors, does not block histamine release (epi does) resulting in decreased capillary permeability/vasodilation, and prevention of bronchspasm
Has some anticholinergic effects

24
Q

Diphenhydramine Indications

A

Anaphylaxis (2nd line)
Dystonic reactions (extrapyramidal/phenothiazine reactions)
Antiemetic

25
Q

Diphenhydramine Contraindications

A

Newborn/premature infants and nursing mothers

Caution: acute narrow angle glaucoma, stenosing or obstructive GI tract disease, bronchial asthma, hyperthyroidism, CV disease, age above 60 (consider benefit vs risk in all of these)

26
Q

Diphenhydramine Adverse reactions

A

CV: Hypotension, palpations, arrhythmias, hemolytic anemia
Resp: anaphylaxis, thickening of bronchial secretions, tightness in chest, wheezing, nasal stuffiness
CNS: sedation, visual disturbance, seizures
GU/GI: urinary frequency or retention, vomiting

27
Q

Diphenhydramine Incompatability/interactions

A

Additive effects with alcohol and other CN depressants

MAO inhibitors prolong/intensify anticholinergic effects (drying)

28
Q

Diphenhydramine Dose (ad and ped)

A

Adult:
Anaphylaxis: 25-50 mg slow V or deep IM
Dystonic/antiemetic: 10-50 mg IV or deep IM, titrated

Ped:
1 - 1.25 mg/kg slow IV or deep IM

29
Q

Epitifibatide Name/Class

A

Epitifibatide

Brand: Integrellin

Class: Antiplatelet Agent, aggregation inhibitor

30
Q

Epitifibatide MOA

A

Reversibly bind with glycoprotein IIb/IIIa to inhibit finl common pathway for aggregation

The blockade intereferes with binding of fibrinogen, von Willebrand factors, and other modulators, thus, preventing aggregation.

31
Q

Epitifibatide Indications

A

Infusion during interfacility transport only
Treatment of acute coronary syndrome, Percutaneous Transluminal coronary angioplasty (PTCA) or atherectomy
Heparin should be concurrently administered

32
Q

Epitifibatide Contraindications

A 
Active internal bleeding or GI/GU bleed within 30 days
CVA with current deficit in past 2 years
Bleeding diathesis
Concurrent use of Warfarin in past 7 days
Thrombocytopenia
Trauma or major surgery in past 6 weeks
Intracranial neoplasm
Arteriovenous malformation, anuerysm, or evidence of aortic dissection
Uncontrolled HTN (sys >200, Dia >120)
History of vascullitis
Other GP IIb/IIIa inhibitors
Acute pericarditis
33
Q

Epitifibatide Adverse Reactions

A

Bleeding, major bleeds have occured in those >65 y/o, <75kg, prior GI disease, and those on thrombolytics and heparin
Hemorrhagic stroke/ intracranial breathing
Thrombocytopenia
CV: bradycardia, dissection of coronary artery, edema, swelling, vasovagal reaction
CNS: dizziness, sweating, pain (leg and pelvic)

34
Q

Epitifibatide interactions/incompatabilities

A

Hemostatic meds, thrombolytics, anticoagulants, ASA other NSAIDS, dipyradimole, ticlopidine, clopidogrel
Furosemide in the same IV tubing

35
Q

Epitifibatide Dose (ad)

A

Acute Coronary Syndrome:
Loading dose of 180 mcg/kg, then infuse at 2mcg/min for 72 hours
PTCA intervention:
Loading dose of 135 mcg/kg, infusion of 0.5 mcg/min for 20-24 hrs

36
Q

Fentanyl Citrate Name/Class

A

Fentanyl Citrate

Brand: Fentora

Class: Narcotic agonist, narcotic analgesic

37
Q

Fentanyl Citrate MOA

A

Acts on pain receptors in the brain to elevate pain threshold
Depresses CNS, brainstem respiratory centers, and responsiveness to PaCO2
Increases venous capacitance and vasodilates arterioles, reducing reload and afterload

38
Q

Fentanyl Citrate Indications

A

Analgesia, especially in those with burns, trauma, MI, and renal colic
Adjunct to sedation in post intubation state
Adjunct to sedation in post RSI or medication assisted intubation

39
Q

Fentanyl Citrate Contraindications

A

Elevated ICP
Head in jury with ALOC
Relative: Asthma, abdominal pain

40
Q

Fentanyl Citrate Adverse reactions

A

MS: muscle rigidity (particularly respiratory muscles)
CV: bradydysrhthymias, tachydysthrythmias, hyoptension, orthostatic hypotension
Respiratory depression/arrest
CNS: Excessive sedation, seizures leading to coma or arrest, dizziness, blurred vision
GI: N/V
Derm: Histamine release may cause local or generalized urticaria, diaphoresis

41
Q

Fentanyl Citrate Dose (ad and ped)

A 
Adult:
IV/IO 25-50 mcg/kg (0.5 - 1 mL of 50 mcg/mL concentration) slow push to desired effect
IM: same as IV, slower onset
IN: 25-50 mcg
MAX DOSE 200  mcg

Peds:
IV/IO: 1-2 mcg/kg (0.02-0.04 mL/kg) slow push
IM: same as IV
IN: 1-2 mcg/kg

42
Q

Furosemide Names/Class

A

Furosemide

Brand: Lasix

Class: loop diuretic

43
Q

Furosemide MOA

A

Pharmacologic: inhibits electrolyte reabsorption in ascending loop of Henle, promotes excretion of Na, K and Cl. Vasodilation increases venous capacitance and decreases afterload
Clinical: diueresis

44
Q

Furosemide Indications

A

Pulmonary Edema

CHF

45
Q

Furosemide Contraindications

A

Anuria
Hypovolemia
Hypotension

46
Q

Furosemide Adverse reactions

A

Exacerbate hypovolemia
Hyperglycemia
HypoK
May decrease response to pressors

47
Q

Furosemide Incompatabilities/interactions

A

Increased effects with other antihypertensives

48
Q

Furosemide Dose (ad and ped)

A

Adult:
Already on furosemide: initial dose of 2 times the daily dose, may double in 20 mins with no effect
Not on furosemide: 0.5-1 mg/kg to a max of 2 mg/kg (usually 20-40 mg) IV slow push

Ped: 1 mg/kg IV slow push

49
Q

Glucagon Name/Class

A

Glucagon

Brand: Glucagen

Class: pancreatic hormone, polypeptide, hyperglycemia agent

50
Q

Glucagon MOA

A

Pharmacological: acts on liver glycogen to convert it to glucose, counteracts effects of insulin, relaxes GI smooth muscle causing increased dilation/motility, cardiac inotrope
Clinical: may reverse hypoglycemia is PT has liver stores, withing 4-8 minutes

51
Q

Glucagon Indications

A

Symptomatic hypoglycemia when IV access is delayed

Beta blocker poisioning

52
Q

Glucagon Contraindications

A

Pheochromocytoma

Insulinoma

53
Q

Glucagon Adverse reactions

A

N/V
Generalized allergic reaction (made from beef/pork pancreas)
Palpitations, HTN, tachycardia

54
Q

Glucagon Incompatabilites/Interactions

A

UNKNOWN

55
Q

Glucagon Dose (ad and ped)

A

Adult and Children over 20kg:
1 mg IM, may repeat in 7-10 mins

Children <20kg:
0.5 mg IM or dose equivalent to 20-30 ug, may repeat in 7-10 mins

56
Q

Hemostatic Agents Name/Class

A

Hemostatic Agents (Kaolin, Chitosan)

Brand: Quikclot

Class: Hemostatic agent

AZDHS Profiles (3 decks)

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