Other Drugs Flashcards

1
Q

Activated Charcoal

A

Name/Class: ACTIVATED CHARCOAL (Actidose) / Absorbent

Description: Is a specially prepared charcoal that will adsorb and bind toxins from the gastrointestinal tract.

Indications: Acute ingested poisoning

Precautions: Administer only after emesis or in those cases where emesis is contraindicated.
Dosage/Route: 1G/Kg mixed with at least 6 to 8 oz of water, then PO or via an NG tube

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2
Q

Alteplase Recombinant (tPA) (activase)/Thrombolytic

A

Name/Class: ALTEPLASE RECOMBINANT (tPA) (Activase)/Thrombolytic

Description: Recombinant DNA–derived form of human tPA promotes thrombolysis by forming plasmin. Plasmin, in turn, degrades fibrin and fibrinogen and, ultimately, the clot.

Indications: To thrombolyse in acute myocardial infarction, acute ischemic stroke, and
pulmonary embolism.

Contraindications: Active internal bleeding, suspected aortic dissection, traumatic CPR, recent hemmorhagic stroke (6 months), intracranial or intraspinal surgery or trauma (2 month), pregnancy, uncontrolled hypertension, or hypersensitivity to thrombolytics.

Precautions: Recent major surgery, cerebral vascular disease, recent GI or GU bleeding, recent trauma, hypertension, patient > 75 years, current oral anticoagulants, or hemorrhagic
ophthalmic conditions.

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3
Q

Benzocaine Spray (Hurricane)

A

Name/Class: BENZOCAINE SPRAY (Hurricane) Topical anesthetic

Description: Stabilizes neuronal membrane, which blocks the initiation and conduction of nerve impulses

Indications: Used as a lubricant and topical anesthetic to facilitate passage of diagnostic and treatment devices. Suppresses the pharyngeal and tracheal gag reflex.

Dosage/Route: 0.5-1 second spray, repeat as needed.

Pedi: 0.25-0.5 second spray, repeat at needed

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4
Q

Bumetanide (Bumex)

A

Name/Class: BUMETANIDE (Bumex) Loop diuretic

Description: A potent loop diuretic with a rapid onset and short duration of action. Inhibits the reabsorption of sodium and chloride in the ascending limb of the loop of Henle.

Indications: Pulmonary edema, congestive heart failure

Contraindications: Hypersensitivity to bumetanide or sulfonamides, hypotension, anuria, electrolyte deficiencies, hepatic coma. Use caution: hepatic cirrhosis, ascites, disbetes, hypersensitivity to furosemide.

Dosage/Route: 0.5-1.0 mg IV slowly over 1 to 2 minutes, or IM.

Pedi: Safety and effectiveness in pediatric is not established

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5
Q

Calcium Chloride

A

Name/Class: CALCIUM CHLORIDE (Calcium Chloride)/Electrolyte

Description: Calcium chloride increases myocardial contractile force and increases ventricular automaticity.

Indications: Hyperkalemia, hypocalcemia, hypermagnesemia, and calcium channel blocker toxicity.

Contraindications: Ventricular fibrillation, hypercalcemia, and possible digitalis toxicity.

Precautions: It may precipitate toxicity in patients taking digoxin. Ensure the IV line is in a large vein and flushed before using and after calcium.

Dosage/Route: 5-10cc of (10% solution / 1Gram –10cc)/10 min, as needed or 6-8mg/Kg .

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6
Q

Amyl Nitrite

1 part of cyanide kit

A

Name/Class: AMYL NITRITE Antidote, cyanide poisoning adjunct

Description: Converts hemoglobin to methemogolobin, which reacts with cyanide and chemically binds with it, preventing any toxic effects.

Indications: Cyanide poisoning

Contraindications: None in the emergency setting

Precautions: Headache, dizziness, weakness, increased ICP, shortness of breath, orthostatic hypotension, tachycardia

Dosage/Route: 1-2 ampules crushed and inhaled for 30 seconds of each minute until sodium nitrite is prepared of administer for 30-60 seconds every 5 minutes until patient is conscious.

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7
Q

Sodium Nitrate

1 Part of cyanide kit

A

Name/Class: SODIUM NITRATE Antidote cyanide poisoning adjunct

Description: Reacts with hemoglobin to form methemoglobin, which reacts with cyanide and chemically binds with it to prevent toxic effect.

Indications: Cyanide poisoning

Contraindications: None in the emergency setting

Precautions/Side Effects: Hypotension, tachycardia, fainting, nausea, vomiting

Dosage/Route: 300 mg (10 mL of a 3% solutions) slow IV push over 5 minutes or dilute 300 mg in 100 mL of saline and infuse slowly

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8
Q

Sodium Thiosulfate

1 part of cyanide kit

A

Name/Class: SODIUM THIOSULFATE Cyanide antidote

Description: Converts cyanide to the less toxic thiocyanate, which is then excreted in the urine.

Indications: Cyanide poisoning

Dosage/Route: 12.5g (50 mL of a 25% solution) IV/IO slow push over 10 minutes.

Pedi: 400 mg/kg (1.65 mL/kg of a 25% solution) IV/IO slow push.

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9
Q

DEXAMETHASONE (Decadron)

A

Name/Class: DEXAMETHASONE (Decadron)/Steroid

Description: Dexamethasone is a long-acting synthetic adrenocorticoid with intense anti-inflammatory activity. It prevents the accumulation of inflammation generating cells at the sites of
infection or injury.

Indications: Anaphylaxis, asthma, COPD, spinal cord edema.

Contraindications: No absolute contraindications in the emergency setting.

Relative contraindications: systemic fungal infections, acute infections, tuberculosis, varicella, or vaccinia or live virus vaccinations.

Precautions: Herpes simplex, keratitis, myasthenia gravis, hepatic or renal impairment, diabetes, CHF,
seizures, psychic disorders, hypothyroidism, and GI ulceration.

Dosage/Route: 4 to 24 mg IV/IM

Pedi: 0.5 to 1 mg/kg.

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10
Q

DIPHENHYDRAMINE (Benadryl)

A

Name/Class: DIPHENHYDRAMINE (Benadryl)/Antihistamine

Description: Diphenhydramine blocks histamine release, thereby reducing bronchoconstriction,
vasodilatation, and edema.

Indications: Anaphylaxis, allergic reactions, and dystonic reactions.

Contraindications: Asthma and other lower respiratory diseases.

Precautions: May induce hypotension, headache, palpitations, tachycardia, sedation, drowsiness, and/or disturbed coordination.

Dosage/Route: 25 to 50 mg IV/IM.

Pedi: 1-2mg/kg

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11
Q

Dextrose 50% in water (D50W)

A

Name/Class: DEXTROSE 50% IN WATER (D50W)/Carbohydrate

Description: Dextrose is a simple sugar that the body can rapidly metabolize to create energy.

Indications: Hypoglycemia

Contraindications: None in hypoglycemia.

Precautions: Increased ICP. Determine blood glucose level before administration. Ensure good venous access.

Dosage/Route: 25g D50W (50 mL) IV.

Pedi: 2 –4 mL/kg of a 25% solution IV (Over 1 Year) 10% solution for under 1 Year

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12
Q

Diazepam (Valium)

A

Name/Class: DIAZEPAM (Valium)/Antianxiety, Hypnotic, Anticonvulsant, Sedative

Description: Diazepam is a benzodiazepine sedative and skeletal muscle relaxant that reduces tremors, induces amnesia, and reduces the incidence and recurrence of seizures. It relaxes muscle spasms in orthopedic injuries and produces amnesia for painful procedures (cardioversion).

Indications: Major motor seizures, status epilepticus, premedication before cardioversion, muscle tremors due to injury, and acute anxiety.

Contraindications:, shock, coma, acute alcoholism, depressed vital signs, obstetric patients, neonates.

Precautions: Psychoses, depression, myasthenia gravis, Due to a short half-life of the drug, seizure activity may recur.

Dosage/Route: Seizures: 5 to 10 mg IV/IM.

Acute anxiety: 2 to 5 mg IV/IM.

Pedi: 0.5 to 2 mg IV/PR.

Premedication: 5 to 15 mg IV.

Pedi: 0.2 to 0.5 mg/kg IV.

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13
Q

Flumazenil (Romazicon)

A

Name/Class: FLUMAZENIL (Romazicon)/Benzodiazepine Antagonist

Description: Flumazenil is a benzodiazepine antagonist used to reverse the sedative, recall, and psychomotor effects of diazepam, midazolam, and the other benzodiazepines.

Indications: Respiratory depression secondary to the benzodiazepines.

Contraindications: Hypersensitivity to flumazenil or benzodiazepines; those patients who take medication for status epilepticus or seizures; seizure-prone patients during labor and delivery; tricyclic antidepressant overdose.

Precautions: Hepatic impairment, elderly, pregnancy, nursing mothers, head injury, alcohol and drug dependency and physical dependence on benzodiazepines.

Dosage/Route: 0.2 mg IV over 30 sec/min, up to 1 mg.

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14
Q

Glucagon (GlucaGen)

A

Name/Class: GLUCAGON (GlucaGen)/Hormone, Anti-hypoglycemic

Description: Glucagon is a protein secreted by pancreatic cells that causes a breakdown of stored glycogen into glucose.

Indications: Hypoglycemia without IV access and to reverse beta-blocker and Calcium Channel Blocker overdose.

Contraindications: None

Precautions: Cardiovascular or renal impairment. Effective only if there are sufficient stores of glycogen in the liver.

Dosage/Route: Hypoglycemia: 1 mg IM repeat q10 to 20 min.

Pedi: 0.1 mg/kg IM/SC/IV for child < 10 kg;

Beta-blocker overdose / Calcium Channel Blocker

OD: 3mg IV over 1 min.

Pedi: 50 to 150 mcg/kg IV over 1 min.

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15
Q

Haloperidol (Haldol)

A

Name/Class: HALOPERIDOL (Haldol)/Antipsychotic

Description: Haloperidol is believed to block dopamine receptors in the brain associated with mood and behavior,is a potent antiemetic, and impairs temperature regulation.

Indications: Acute psychotic episodes.

Contraindications: Parkinson’s disease, seizure disorders, coma, alcohol depression, CNS depression, and thyrotoxicosis, and with other sedatives.

Precautions: Orthostatic Hypotension

Dosage/Route: 2 to 5 mg IM. Normally mixed with Benadryl to avoid EPS Reactions

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16
Q

Hydroxocobalamin

A

Name/Class: HYDROXOCOBALAMIN (Cyanokit) Antidote, cyanide poisoning adjunct

Description: Binds with cyanide to form nontoxic cyanocobalamin, preventing its toxic effects; excreted renally
Indications: Treatment of known or suspected cyanide poisioning.

Contraindications: None is the emergency setting

Precautions/Side Effects: Hypertension, allergic reactions, GI bleeding, nausea, vomiting, dyspepsia, dyspnea, dizziness, headache, injection site reactions.

Dosage/Route: 5 g IV infusion over 15 minutes at a rate of 15 mL/min.

Pedi: 70 mg/kg IV one time, may be repeated one time at the same dose.

17
Q

Labetalol (Normodyne, Trandate)

A

Name/Class: LABETALOL (Normodyne, Trandate) Selective alpha and nonselective beta-adrenergic blocker, antihypertensive

Description: Blood pressure reduction without reflex tachycardia; total peripheral resistance reduced without significant alteration in cardiac output.

Indications: Moderate to sever hypertension.

Contraindications: Bronchial asthma, congestive heart failure, cardiogenic shock, second- and third-degree heart block, bradycardia

Dosage/Route: 10- 20 mg IV push over 1-2 minutes.

18
Q

Lorazepam (Ativan)

A

Name/Class: LORAZEPAM (Ativan)/Sedative

Description: Lorazepam is the most potent benzodiazepine available. It has strong antianxiety, sedative, hypnotic, and skeletal muscle relaxant properties, and a relatively short half-life.

Indications: Sedation for cardioversion and status epilepticus.

Contraindications: Sensitivity to benzodiazepines.
Precautions: Narrow-angle glaucoma, depression or psychosis, coma, shock, acute alcohol intoxication, renal or hepatic impairment, organic brain syndrome, myasthenia gravis, GI disorders, elderly, debilitated, limited pulmonary reserve.

Dosage/Route: Sedation: 2 to 4 mg IM, 0.5 to 2 mg IV.

Pedi: 0.03 to 0.5 mg/kg IV/IM/PR up to 4 mg.

Status epilepticus: 2 mg slow IV/PR (2 mg/min).

Pedi: 0.1 mg/kg slow IV/PR (2 to 5 min).

19
Q

Magnesium Sulfate

A

Name/Class: MAGNESIUM SULFATE (Magnesium)/Electrolyte

Description: Magnesium sulfate is an electrolyte that acts as a calcium channel blocker, acting as a CNS depressant and anticonvulsant. It also depresses the function of smooth, skeletal, and cardiac muscles.

Indications: Refractory ventricular fibrillation and pulseless ventricular tachycardia (especially torsade depointes), AMI, eclamptic seizures, Asthma, COPD

Contraindications: Heart block, myocardial damage, shock, persistent hypertension, and hypocalcemia.

Precautions: CNS depressants, or neuromuscular blocking agents.

Dosage/Route: Ventricular fibrillation: 1 to 2 g IV over 2 min.

Torsade de pointes: 1 to 2 g IV .

Asthma / COPD: 1-2 Grams over 10 minutes (Mix in 50cc NS)

Eclampsia: 2 to 6 g IV/IM over 15-30 mins (Mix in 50cc NS)

20
Q

Mannitol (Osmitrol)

A

Name/Class: MANNITOL (Osmitrol)/Osmotic Diuretic

Description: Mannitol is an osmotic diuretic that draws water into the intravascular space through its hypertonic effects, then causes diuresis.

Indications: Cerebral edema.

Contraindications: Hypersensitivity, pulmonary edema or severe dehydration

Precautions: Must give slow with filter tubing

Dosage/Route: 1.5 to 2 g/kg slow IV.

Pedi: 0.25 to 0.5 g/kg over 60 min.

21
Q

METOCLOPRAMIDE (Reglan)/Antiemetic

A

Name/Class: METOCLOPRAMIDE (Reglan)/Antiemetic

Description: Metoclopramide is a dopamine antagonist similar to procainamide but with few
antidysrhythmic or anesthetic properties. Its antiemetic properties stem from rapid gastric emptying and desensitization of the vomiting reflex.

Indications: Nausea and vomiting.

Contraindications: Hypersensitivity, seizure disorders, GI obstruction or perforation, and breast cancer.

Precautions: CHF, hypokalemia, renal impairment, GI hemorrhage, intermittent porphyria.

Dosage/Route: 10 IM or slow IV (over 2 to 4 min).

Pedi: 1 to 2 mg/kg/dose.

22
Q

Milrinone (Primacor)

A

Name/Class: MILRINONE (Primacor) / Cardiac Inotrope, Vasodilator

Description: Milrinone is related to amrinone and increases the strength of cardiac contraction without Increasing rate, increasing cardiac output without increasing oxygen demand.

Indications: CHF, or pediatric septic shock.

Contraindications: Hypersensitivity

Precautions: Elderly, pregnancy, and nursing mothers

Dosage/Route: CHF: 50mcg/kg IV over 10 min, then drip of 0.375 to 0.75mcg/kg/min.

Pedi: 50-75mcg/kg IV

23
Q

Naloxone (Narcan)

A

Name/Class: NALOXONE (Narcan)/Narcotic Antagonist

Description: Naloxone is a pure narcotic antagonist that blocks the effects of both natural and synthetic narcotics and may reverse respiratory depression.

Indications: Narcotic and synthetic narcotic overdose, coma of unknown origin.
Contraindications: Hypersensitivity to the drug, non–narcotic-induced respiratory depression.

Precautions: Possible dependency (including newborns). It also has a half-life that is shorter than that of most narcotics; hence the patient may return to the overdose state.

Dosage/Route: 0.4 to 2 mg IV/IM/IN repeated/2 to 3 min as needed up to 10 mg.

Pedi: 0.01 mg IV/IM repeated/2 to 3 min as needed up to 10 mg.

24
Q

Norepinephrine Bitrate (Levophed)

A

Name/Class: NOREPINEPHRINE BITARTRATE (Levophed) Sympathomimetic, vasopressor

Description: Potent alpha-agonist resulting in intense perpipheral vasoconstriction, positive chronotropic and increased inotropic effect (from 10% beta effect) with increased cardiac output. Alpha-adrenergic activity resulting in peripheral vasoconstriction and beta-adrenergic activity leading to inotropic stimulation of the heart and coronary artery vasodilation.

Indications: Cardiogenic shock, unresponsive to fluid resuscitation, significant hypotensive (<70 mm Hg) sates

Contraindications: Hypotensive patients with hypovolemia, pregnancy (relative)

Precautions/Side Effects: Bradycardia, hypertension, dysrhythmias, chest pain, peripheral cyanosis, tissue necrosis from extravasation.

Dosage/Route: 0.1-0.5 ug/kg/min titrated to response (average dose for 70 kg patient 7-35 ug/min).

Pedi: Begin at 0.1-2 ug/kg/min IV infusion, adjust rate to achieve desired change in blood pressure and systemic perfusion. Titrated to patient response.

25
Q

OXYTOCIN (Pitocin)

A

Name/Class: OXYTOCIN (Pitocin)/Hormone

Description: Oxytocin is a naturally occurring hormone that causes the uterus to contract, thereby inducing labor, encouraging delivery of the placenta, and controlling postpartum hemorrhage.

Indications: Severe postpartum hemorrhage.

Contraindications: Hypersensitivity, prehospital administration before delivery of the infant or infants.

Precautions: Before delivery may induce uterine rupture and fetal dysrhythmias, hypertension, intracranial bleeding, or asphyxia. Uterine tone, ECG, and vital signs should be monitored during administration.

Dosage/Route: 3 to 10 units IM after delivery of the placenta. 10 to 20 units in 1,000 mL of D5W or NS IV titrated to effect.

26
Q

PHENYTOIN (Dilantin)

A

Name/Class: PHENYTOIN (Dilantin)/Anticonvulsant

Description: Phenytoin is a derivative related to phenobarbital that reduces the spread of electrical discharges in the motor cortex and inhibits seizures. It also has antidysrhythmic properties that counteract the effects of digitalis.

Indications: Seizures, status epilepticus, or cardiac dysrhythmias secondary to digitalis toxicity.

Contraindications: seizures due to hypoglycemia, sinus bradycardia, heart block, and Adams-Stokes syndrome.

Precautions: Hepatic or renal impairment, alcoholism, cardiogenic shock, elderly, bradycardia, or respiratory depression.

Dosage/Route: Seizures, status epilepticus: 10 to 15 mg/kg slow IV no more than 50mg/min

Pedi: 8 to 10 mg/kg slow IV.

Dysrhythmias: 100 mg slow IV (over 5 min) to a maximum 1,000 mg.

Pedi: 3 to 5 mg/kg slow IV.

27
Q

PROCHLORPERAZINE ( COMPAZINE)

A

Name/Class: PROCHLORPERAZINE ( COMPAZINE) Antiemetic

Description: Prochlorperazine is a phenothiazine derivative similar to chlorpromazine with potent
antiemetic properties and fewer sedative, hypotensive, and anticholinergic effects.

Indications: Severe nausea and vomiting or acute psychosis.
.

28
Q

PROMETHAZINE (Phenergan)

A

Name/Class: PROMETHAZINE (Phenergan)/Antiemetic

Description: Promethazine is an anticholinergic agent that enhances the effects of analgesics and is a potent antiemetic.

Indications: Nausea and vomiting, motion sickness, to enhance the effects of analgesics, and to induce sedation.

Contraindications: None

Precautions: Hepatic, respiratory, or cardiac impairment, asthma, hypertension,
elderly, or debilitated patients.

Dosage/Route: 12.5 to 25 mg IV/IM/PR.

Pedi: 0.5 mg/kg IV/IM/PR.

29
Q

Timoptic

A

Name/Class: Timoptic /Beta Blocker

Description: Timoptic is a non-selective beta-adrenergic receptor blocking agent

Indications: HTN, MI, elevated ocular pressure

Contraindications: asthma, severe COPD, sinus brady, 2nd or 3rd degree AV block, cardiogenic shock

Precautions: Readily absorbed

Dosage/Route: ophthalmic: one drop per eye BID

30
Q

SODIUM BICARBONATE (NaHCO3)

A

Name/Class: SODIUM BICARBONATE (NaHCO3)/Alkalizing Agent

Description: Sodium bicarbonate provides vascular bicarbonate to assist the buffer system in reducing the effects of metabolic acidosis and in the treatment of some overdoses.

Indications: Tricyclic antidepressant and barbiturate overdose, refractory acidosis, or hyperkalemia.

Contraindications: None when used in severe hypoxia or late cardiac arrest.

Precautions: May cause alkalosis if given in too large a quantity. It may also deactivate vasopressors and may precipitate with calcium chloride.

Dosage/Route: 1 mEq/kg IV, then 0.5 mEq/kg/10 min.

Pedi: same as adult (may be given IO).

31
Q

Thiamine

A

Name/Class: THIAMINE/Vitamin

Description: Thiamine is vitamin B1, which is required to convert glucose into energy. It is not manufactured by the body and must be constantly provided from ingested foods.

Indications: Coma of unknown origin, chronic alcoholism with associated coma, and delirium tremens.

Contraindications: None.

Precautions: Known hypersensitivity to the drug.

Dosage/Route: 100mg IV/IM.

Pedi: 10 to 25 mg IV/IM.

32
Q

Zofran

A

Name/Class: Zofran /Antiemetic

Description:: selective blocking agent of the serotonin 5-HT3 receptor type

Indications: Prevention of nausea and intractible vomiting .

Contraindications: None

Precautions: may mask a progressive ileus and/or gastric distension, Long QT syndrome

Dosage/Route: 4mg IVP or single 4-mg tablet ODT

33
Q

PLASMA PROTEIN FRACTION (Plasmanate)

A

Name/Class: PLASMA PROTEIN FRACTION (Plasmanate) Natural colloid

Description: Plasmanate is a protein-containing colloid that remains in the intravascular compartment. It increases intravascular by attracting water from other fluid compartments by virtue of its colloid osmotic pressure.

Indications: Hypovolemic shock, especially burn shock; hypoproteinemia (low-protein states)

34
Q

Dextran

A

Name/Class: DEXTRAN Artificial colloid

Description: Dextran is a sugar-containing colloid used as an intravascular volume expander. It remains in the intravascular compartment for approximately 12 hours. It increases intravascular volume by attracting water from other fluid compartments by virtue of its colloid osmotic pressure.

Indications: Hypovolemic shock.

35
Q

HETASTRACH (Hespan)

A

Name/Class: HETASTRACH (Hespan) Artificial colloid

Description: Hetastarch is a starch-containing colloid used as an intravascular volume expander. Following administration, the plasma volume is expanded slightly in excess of the volume of hetastarch administered. This effect has been observed for up to 24 to 36 hours. Hetastarch increases intravascular volume by virtue of its colloid osmotic pressure.

Indications: Hypovolemic shock, especially burn shock; septic shock