Paramedic Drug Week 16

Question 1

Labetalol (Normodyne, Trandate)

Class

Answer 1

Selective alpha (a1) and non-selective beta(b1-b2)-adrenergic blocker

Question 2

Labetalol (Normodyne, Trandate)

Mechanism of Actions

Answer 2

Reduces blood pressure without reflex tachycardia; total peripheral resistance is reduced without significant alteration in cardiac output

Question 3

Labetalol (Normodyne, Trandate)

Indications

Answer 3

Moderate to severe hypertension

Question 4

Labetalol (Normodyne, Trandate)

Contraindications

Answer 4

bradycardia, bronchial asthma, cardiogenic shock, CHF,

second- or third-degree AV block

Question 5

Labetalol (Normodyne, Trandate)

Adverse Reactions

Answer 5

Headache, dizziness, dyspnea, hypotension, ventricular arrhythmias

Question 6

Labetalol (Normodyne, Trandate)

Drug Interactions

Answer 6

Trandate may block bronchodilator effects of beta-adrenergic agonists. NTG may augment hypotensive effects of Labetalol.

Question 7

Labetalol (Normodyne, Trandate)

Adult IVP Dosage

Answer 7

5-20 mg Slow IVP over 2 min, can give additional dosages of 10-
40 mg at 10 minute intervals.

Question 8

Labetalol (Normodyne, Trandate)

Adult Infusion Dosage

Answer 8

Infusion: 2 mg/min titrated to acceptable

supine blood pressure

Question 9

Labetalol (Normodyne, Trandate)

Pediatric

Answer 9

Safety has not been established

Question 10

Labetalol (Normodyne, Trandate)

Onset

Answer 10

Less than 5 Minutes

Question 11

Labetalol (Normodyne, Trandate)

Peak Effect

Answer 11

Variable

Question 12

Labetalol (Normodyne, Trandate)

Duration

Answer 12

3-6 hours

Question 13

Labetalol (Normodyne, Trandate)

Special Considerations

Answer 13

Continuous monitoring of BP, pulse rate, and ECG. Observe for signs of CHF, bradycardia, and bronchospasm.

Question 14

Labetalol (Normodyne, Trandate)
Special Considerations
Body Position

Answer 14

Should only be administered when the patient is supine.

Question 15

Furosemide (Lasix)

Class

Answer 15

Loop diuretic

Question 16

Furosemide (Lasix)

Mechanism of Action

Answer 16

Inhibits electrolyte reabsorption and promotes excretion of sodium, potassium, and chloride.

Question 17

Furosemide (Lasix)

Indications

Answer 17

CHF, pulmonary edema, and hypertensive crisis.

Question 18

Furosemide (Lasix)

Contraindications

Answer 18

Hypovolemia, anuria, hypotension (relative

contraindication), hypersensitivity, and hepatic coma.

Question 19

Furosemide (Lasix)

Adverse Reactions

Answer 19

May exacerbate hypovolemia, hypokalemia, ECG changes, dry mouth, hypochloremia, hyponatremia, and hyperglycemia (due to hemoconcentration).

Question 20

Furosemide (Lasix)

Drug Interactions

Answer 20

Lithium toxicity may be potentiated by sodium depletion. Digitalis toxicity may be potentiated by potassium depletion.

Question 21

Furosemide (Lasix)

Adult Dosage

Answer 21

0.5 – 1 mg/kg injected IV over 1 – 2 minutes. If no response, double the dose to 2 mg/kg over 1 – 2 minutes.

Question 22

Furosemide (Lasix)

Pediatric Dosage

Answer 22

1 mg/kg/dose IV or IO

Question 23

Furosemide (Lasix)

Onset

Answer 23

5 Minutes

Question 24

Furosemide (Lasix)

Peak Effect

Answer 24

20 - 60 Minutes

Question 25

Furosemide (Lasix) | Duration

Answer 25

4 - 6 Hours

Question 26

Furosemide (Lasix) | Special Considerations

Answer 26

Ototoxicity and deafness can occur with rapid administration.

Question 27

Nifedipine (Procardia) | Class

Answer 27

Calcium channel blocker

Question 28

Nifedipine (Procardia) | Mechanism of Action

Answer 28

Inhibits movement of calcium ions across cell membranes; arterial and venous vasodilator; reduces preload and afterload; prevents coronary artery spasm and decreases total peripheral resistance; reduces myocardial oxygen demand; does not prolong AV nodal conduction.

Question 29

Nifedipine (Procardia) | Indications

Answer 29

Hypertensive crisis, angina pectoris, pulmonary edema

Question 30

Nifedipine (Procardia) | Contraindications

Answer 30

Compensatory hypertension, hypotension, and | hypersensitivity

Question 31

Nifedipine (Procardia) | Adverse Reactions

Answer 31

Hypotension, CHF, headache, dizziness, lightheadedness, nausea, vomiting, muscle cramps, peripheral edema, and myocardial infarction.

Question 32

Nifedipine (Procardia) | Drug Interactions

Answer 32

Beta-blockers and theophylline may potentiate the effects. Antihypertensives may potentiate hypotensive effects.

Question 33

Nifedipine (Procardia) | Adult Dosage

Answer 33

10 mg SL, may repeat in 30 minutes

Question 34

Nifedipine (Procardia) | Pediatric Dosage

Answer 34

0.25 - 0.4 mg/kg

Question 35

Nifedipine (Procardia) | Onset

Answer 35

15-30 minutes

Question 36

Nifedipine (Procardia) | Peak Effect

Answer 36

1-3 hours

Question 37

Nifedipine (Procardia) | Duration

Answer 37

6-8 hours

Question 38

Nifedipine (Procardia) | Special Consideration

Answer 38

Use with caution in the geriatric population, may cause hypotension or angina.