Paramedic Drug Week 8

Question 1

Succinylcholine (Anectine)

CLASS

Answer 1

Depolarizing neuromuscular blocker, paralyzing agent

Question 2

Succinylcholine (Anectine)

MECHANISM OF ACTION

Answer 2

Bind to the receptors of acetylcholine.

Question 3

Succinylcholine (Anectine)

INDICATIONS

Answer 3

To facilitate intubation, to terminate laryngospasm, to promote muscle relaxation, and to facilitate electroconvulsive shock therapy.

Question 4

Succinylcholine (Anectine)

CONTRAINDICATIONS

Answer 4

Acute narrow angle glaucoma, penetrating eye injuries, inability to control airway or support ventilations with oxygen and positive pressure.

Question 5

Succinylcholine (Anectine)

SIDE EFFECTS

Answer 5

Apnea, malignant hyperthermia, arrhythmias, bradycardia, hypertension, hypotension, cardiac arrest, hyperkalemia, increased intraocular pressure, fasciculations, exacerbation of hyperkalemia in trauma patients

Question 6

Succinylcholine (Anectine)

DRUG INTERACTIONS

Answer 6

Effects potentiated by oxytocin, beta-blockers, and organophosphates.

Diazepam may reduce duration of action.

Question 7

Succinylcholine (Anectine)

ADULT DOSE

Answer 7

1 -2 mg/kg rapid IV; repeat once if needed

Question 8

Succinylcholine (Anectine)

PEDIATRIC DOSE

Answer 8

1 – 1.5 mg/kg dose rapid IV/IO; repeat once if needed

Question 9

Succinylcholine (Anectine)

ONSET

Answer 9

1 MINUTE

Question 10

Succinylcholine (Anectine)

PEAK EFFECT

Answer 10

1-3 MINUTES

Question 11

Succinylcholine (Anectine)

DURATION

Answer 11

5 MINUTES

Question 12

Succinylcholine (Anectine)

SPECIAL CONSIDERATIONS

Answer 12

If the patient is conscious, explain the side effects prior to administration. Consider premedication with atropine, particularly in pediatric patients. Premedication with lidocaine may blunt any increase in intracranial pressure during intubation. Diazepam or midazolam should be used in any conscious patient undergoing neuromuscular blockade.

Question 13

Pancuronium (Pavulon)

CLASS

Answer 13

Nondepolarizing neuromuscular blocker/paralytic

Question 14

Pancuronium (Pavulon)

MECHANISM OF ACTION

Answer 14

Binds to the receptor for acetylcholine at the neuromuscular junction.

Question 15

Pancuronium (Pavulon)

INDICATIONS

Answer 15

Induction or maintenance of paralysis after intubation to assist ventilations.

Question 16

Pancuronium (Pavulon)

CONTRAINDICATIONS

Answer 16

Hypersensitivity, inability to control airway and support ventilations with oxygen and positive pressure, neuromuscular disease (myasthenia gravis), hepatic or renal failure.

Question 17

Pancuronium (Pavulon)

SIDE EFFECTS

Answer 17

Apnea, weakness, salivation, PVCs, tachycardia; transient hypotension, increased BP; pain, burning at the injection site.

Question 18

Pancuronium (Pavulon)

DRUG INTERACTIONS

Answer 18

Positive chronotropic drugs may potentiate tachycardia.

Question 19

Pancuronium (Pavulon)

ADULT DOSE

Answer 19

0.04-0.1 mg/kg slow IV; repeat every 30 – 60 minutes PRN.

Question 20

Pancuronium (Pavulon)

PEDIATRIC DOSE

Answer 20

0.1 mg/kg slow IV, IO

Question 21

Pancuronium (Pavulon)

ONSET

Answer 21

30 SECONDS

Question 22

Pancuronium (Pavulon)

PEAK EFFECT

Answer 22

3-5 MINUTES

Question 23

Pancuronium (Pavulon)

DURATION

Answer 23

45-60 MINUTES

Question 24

Pancuronium (Pavulon)

SPECIAL CONSIDERATIONS

Answer 24

Pancuronium has no effect on consciousness or pain.

Will not stop neuronal seizure activity.

Pulse rate and cardiac output are increased.

Decrease doses in patients with renal disease.

Question 25

Ketamine (Ketalar) | CLASS

Answer 25

Ultra-Short-acting nonbarbiturate hypnotic agent (dissociative anesthetic)

Question 26

Ketamine (Ketalar) | MECHANISM OF ACTION

Answer 26

It interrupts the pathways within the cortex and limbic system, prompting the release of endogenous catecholamines.

Question 27

Ketamine (Ketalar) | INDICATIONS

Answer 27

Anesthetic agent, airway maintenance, chemical restraint

Question 28

Ketamine (Ketalar) | CONTRAINDICATIONS

Answer 28

Infants younger than 3 months and patients with established | psychosis

Question 29

Ketamine (Ketalar) | SIDE EFFECTS

Answer 29

Hallucinations, HTN, increased ICP, tremors.

Question 30

Ketamine (Ketalar) | DRUG INTERACTIONS

Answer 30

Incompatible with diazepam and barbiturates.

Question 31

Ketamine (Ketalar) | ADULT OPTIMAL DOSE

Answer 31

1.5 mg/kg IV

Question 32

Ketamine (Ketalar) | ADULT IM DOSE

Answer 32

4-5 mg/kg IM

Question 33

Ketamine (Ketalar) | PEDIATRIC DOSE

Answer 33

0.5 - 3.0 MG IV/IM

Question 34

Ketamine (Ketalar) | ONSET IV

Answer 34

60-90 SECONDS

Question 35

Ketamine (Ketalar) | ONSET IM

Answer 35

1-2 MINUTES

Question 36

Ketamine (Ketalar) | DURATION IV-IO

Answer 36

10- 15 MINUTES

Question 37

Ketamine (Ketalar) | DURATION IM

Answer 37

15-20 MINUTES

Question 38

Ketamine (Ketalar) | SPECIAL CONSIDERATIONS

Answer 38

Consider premedication with benzodiazepines to prevent emergence reactions. Ketamine may be the preferred induction agent in a patient with respiratory failure.