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Paramedic Drug Week 06 > Paramedic Drugs Week 6 > Flashcards

Paramedic Drugs Week 6 Flashcards

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1
Q

Fentanyl Citrate

Class

A

Narcotic Analgesic

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2
Q

Fentanyl Citrate
Sublimaze

Mechanism of Action
Opioid

A

Agonist against the body’s opioid receptor

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3
Q

Fentanyl Citrate
Sublimaze

Mechanism of Action
GI System

A

Increases tone and decrease smooth muscle of the GI Tract

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4
Q

Fentanyl Citrate
Sublimaze

Indications

A

Severe pain

Adjunct to RSI

Maintenance of Analgesia

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5
Q

Fentanyl Citrate
Sublimaze

Contraindications

A

Myasthenia Gravis

Children under the age of 2

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6
Q

Fentanyl Citrate
Sublimaze

Adverse Reactions

A

Bradycardia

Seizures

Diaphoresis

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7
Q

Fentanyl Citrate
Sublimaze

Drug Interactions

A

May interact with alcohol or CNS Depressants

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8
Q

Fentanyl Citrate
Sublimaze

Dosage and Administration
Adult

A

25 - 100mcg IV, IN, IO, IM

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9
Q

Fentanyl Citrate
Sublimaze

Dosage and Administration
Pediatric

A

2-12 years old

1-2mcg per kg per dose

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10
Q

Fentanyl Citrate
Sublimaze

Onset Intravenous

A

Immediate onset IV

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11
Q

Fentanyl Citrate
Sublimaze

Onset IM

A

7-15 minutes

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12
Q

Fentanyl Citrate
Sublimaze

Peak Effect IV

A

Peak Effect 3-5 minutes

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13
Q

Fentanyl Citrate
Sublimaze

Peak Effect IM

A

Peak Effect IM

30 Minutes

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14
Q

Fentanyl Citrate
Sublimaze

Special Considerations

A

May cause life threatening hypoventilation

Have Narcan Available

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15
Q

Alteplase (rTAP, Activase)

Class

A

Fibrinolytic

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16
Q

Alteplase (rTAP, Activase)

Mechanism of Action

A

Alteplase is an enzyme that converts plasminogen to the enzyme plasmin.

When administered, it binds to the fibrin in a clot and converts the plasminogen into plasmin.

The plasmin then digests the fibrin and fibrinogen, causing the clot(s) to dissolve.

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17
Q

Alteplase (rTAP, Activase)

Indications

A

Acute Coronary Sydrome

Acute Ischemic Stroke

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18
Q

Alteplase (rTAP, Activase)

Adverse Reactions

A 
Bleeding
Allergic reaction and/or anaphylaxis (rare)
fever
Nausea
Vomiting
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19
Q

Alteplase (rTAP, Activase)

Drug Interactions

A

Always use extreme caution in patients on anticoagulation therapy

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20
Q

Alteplase (rTAP, Activase)

Dosage and Administration

Pediatric

A

Not Recommended

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21
Q

Alteplase (rTAP, Activase)

Dosage and Administration

Adult

A

Total dose is 100mg

A loading dose of 15mg is admin as an iv bolus over 1-2 minutes.

Followed by an infusion of 0.75 mg/ kg (up to 50mg) OV over 30 minutes

Then an infusion of 0.5 mg/kg (up to 35mg) IV over 60 minutes

Must be admin via IV pump and carefully monitored

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22
Q

Alteplase (rTAP, Activase)

Onset

A

Onset

Immediate

23
Q

Alteplase (rTAP, Activase)

Peak Effect

A

Peak Effect

Within 45 minutes

24
Q

Alteplase (rTAP, Activase)

Duration

A

Duration

6-8 hours

25
Q

Alteplase (rTAP, Activase)

Special Considerations

A

Anaphylaxis can occur with alteplase, but is very rare due to the recombinant DNA technology used to produce it.

Emergency equipment should be readily available.

Reperfusion arrhythmias are common once the occluded artery is opened.

Anti arrhythmic medications should be also available

26
Q

Mannitol

(Osmotrol)

Class

A

Osmotic Diuretic

27
Q

Mannitol

(Osmotrol)

Mechanism of Action

A

Decreases cellular edema

Increases urinary output

28
Q

Mannitol

(Osmotrol)

Indications

A

Acute cerebral edema

Blood transfusion reactions

29
Q

Mannitol

(Osmotrol)

Contraindication

A

Pulmonary edema

Dehydrated patients

Hypersensitivity

30
Q

Mannitol

(Osmotrol)

Adverse Reactions

A

Pulmonary Congestion

Sodium depletion

Transient volume overload

31
Q

Mannitol

(Osmotrol)

Drug Interactions

A

May enhance digitalis toxicity

32
Q

Mannitol

Osmotrol
Dosage and Administration
Adult

A

Adult:

1.5 to 2 g/kg iv slow push or infusion

33
Q

Mannitol

Osmotrol
Dosage and Administration
Pediatric

A

0.25 to .5 g/kg iv over 60 minutes

34
Q

Mannitol

(Osmotrol)

Onset

A

Onset:

15 Minutes after start of infusion

35
Q

Mannitol

(Osmotrol)

peak effect

A

Peak Effect

30 to 60 minutes

36
Q

Mannitol

(Osmotrol)

Duration

A

Duration:

3-8 hours after discontinued

37
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

Any prior intracranial hemorrhage

A

Absolute

37
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

Known structural cerebral vascular lesion

A

Absolute

37
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

Known malignant intracranial neoplasm

A

Absolute

38
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

Ischemic stroke within 3 months (except acute ischemic stroke within 3 hours

A

Absolute

39
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

Suspected aortic aneurysm

A

Absolute

40
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

Active bleeding or bleeding disorder (except menstrual)

A

Absolute

41
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

Significant closed head or facial trauma within 3 months

A

Absolute

42
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

History of chronic, severe or uncontrolled hypertension

A

Relative

43
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

Sever in controlled hypertension on presentation SBP >180 or DBP >110

A

Relative

44
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

History of prior ischemic stroke >3months

A

Relative

45
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

Dementia or other known intracranial pathology not specifically covered in the contraindications

A

Relative

46
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

Traumatic or prolonged CPR >10 minutes

A

Relative

47
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

Major surgery < 3 weeks

A

Relative

48
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

Recent Internal Bleeding (within 2-4 weeks)

A

Relative

49
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

Noncompressible vascular puncture

A

Relative

50
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

Pregnancy

A

Relative

51
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

Active Peptic Ulcer

A

Relative

52
Q

Alteplase (rTAP, Activase)

Relative or Absolute Contraindication

Current use of anticoagulants

A

Relative

Paramedic Drug Week 06 (1 decks)

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