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Pharm Flashcards

1
Q

Class of Adenosine

A

Antiarrhythmic and endogenous nucleoside

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2
Q

Adenosine Dosage

A

Adult:
Initial - 6mg rapid IV push
Follow up - 12mg rapid push

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3
Q

Amiodarone Class

A

Class III Antiarrythmic - Lengthens cardiac action potential and slows conduction prolonging refractoriness by blocking K+ channels

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4
Q

Amiodarone Dosage

A

Adult: VF or PVT - 300mg IV push repeat of 150mg after 10 min.
Unstable VT - 150mg over 10 min
Stable Monomorph WCT - 150mg over 10 min.

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5
Q

Atropine Class

A

Anticholinergic and Antimuscarinic

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6
Q

Atropine Indications

A 
Restore rhythm in bradydysrythmia
Sinus brady with hemo compromise
Brady second to AV block
Organophosphate poisoning
Palliative control of secretions
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7
Q

Atropine Dosage

A

Bradycardia - 0.6mg IV (max dose 0.04mg/kg)
Organophosphate poisoning - 1-2mg repeat q 30s- 5min.
Secretion - 0.6mg IM

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8
Q

Atropine Contraindications

A 
Hypersensitivity
Tachycardia
Narrow-angle glaucoma
Thyrotoxicosis
Prostatic hypertropy
Myasthena Gravis
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9
Q

Atropine MOA

A

Antagonizes ACh at muscarinic M2 receptors producing parasympatholytic effects

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10
Q

Amiodarone MOA

A

Class III antiarrhythmic, poses characteristics of all classes. Blocks Na channels, antagonizes beta receptors, produces negative chronotropic effects in nodal tissue, lengthens action potential, and slows conduction and prolongs refractoriness by blocking K channels

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11
Q

Calcium Chloride Classification

A

Electrolyte

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12
Q

CaCl Indications

A
  • Cardiac arrest due to hyperkalemia
  • Hyperkalemia with cardiotoxicity
  • Ca channel OD with symptomatic bradycardia and hemodynamic instability
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13
Q

Calcium Chloride Dose

A

Adult dose: - 1g over 3 min. can repeat once after 10 minutes
Peds dose:
CA - 20mg/kg over 3 minutes
other causes 10mg/kg over 15 minutes

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14
Q

CaCl Contraindications

A

Hypersensitivity
Primary or secondary hypercalcemia
Tissue irritation may occur
Extravasation causes necrosis

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15
Q

Epinephrine Indications

A 
Anaphylaxis
Severe Bronchospasm
Severe croup
Cardiac Arrest
Peri Arrest Hypotension
Significant bradycardia
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16
Q

Epinephrine dosage in Arrest

A

Adult: 1mg IV/IO q 3-5 min max- 3-4 doses
Peds: 0.01mg/kg IV/IO q 3-5 min. max. 3-4 doses

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17
Q

Epinephrine - Peri Arrest Hypotension Dosage

A

Adult - 10mcg IV/IO slow push q2-3

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18
Q

Epi Dosage Adult Bradycardia

A

2-10 mcg/minute IV/IO infusion

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19
Q

Epinephrine MOA

A

Acts on alpha and beta receptors. Alpha effects - vasoconstriction, reduces vascular permeability
Beta effects - bronchial smooth muscle relaxation, increased HR, increased cardiac contractility

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20
Q

Epinephrine Pre-arrest anaphylaxis

A

Adult: 50-100mcg IV/IO
Peds: 5mcg/kg IV/IO

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21
Q

Fentanyl Dose Adult

A

Initial loading dose 0.5-1.0 mcg/kg max. 100mcg q5minutes up to 300mcg
Maintenance - 50mcg/kg q 10min max. 250mcg/hr

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22
Q

Fentanyl Onset

A

IV- Immediate

IM - 7-15 minutes

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23
Q

Ipatropium class

A

anticholinergic bronchodilator

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24
Q

Ipratropium Dose

A

160mcg (8x20mcg)

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25
Q

Ketamine Indications

A

Analgesia, Induction, Sedation, Procedural Sedation, Severe agitation

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26
Q

Ketamine Analgesia Dose

A 
IV
Analgesia - 0.3mg/kg slow push
repeat @ 5min. 0.15mg/kg
Max. 0.6 mg/kg in 45 minutes
IM
0.5mg/kg
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27
Q

Ketamine Procedural Sedation Dose

A

0.1-0.5mg/kg slow IV Push q 60 seconds to effect

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28
Q

Ketamine MOA

A

Ketamine is a non-competitive NMDA receptor antagonist that blocks glutamate. Low doses produce analgesia and modulate central sensitization, hyperalgesia, and opioid tolerance. Reduces polysynaptic spinal reflexes.

29
Q

Lidocaine MOA

A

As a sodium channel blocker, lidocaine decreases the duration of the action potential by shortening the period of repolarization.

30
Q

Magnesium Sulfate MOA

A

The precise mechanism of action of magnesium sulfate is not entirely clear. It appears to alter membrane potential, slowing conduction and relaxing smooth muscle.

31
Q

Midazolam MOA

A

Like other benzodiazepines, MIDAZOLam intensifies the activity of gamma aminobutyric acid, the major inhibitory neurotransmitter in the central nervous system. This action is believed to result in hyperpolarization of neuronal cells, which then take longer to reach threshold and depolarize.

32
Q

Phenylephrine MOA

A

Agonizes alpha-adrenergic receptors producing arterial vasoconstriction.

33
Q

Amiodarone Indications

A

VF. pVT, unstable VT, Recurrent VT following cardioversion

34
Q

Amiodarone Contraindications

A

Hypersensitivity
Cardiogenic Shock
Marked Sinus Bradycardia
Second and Third degree block

35
Q

Adenosine contraindications

A

Hypersensitivity

2nd and 3rd degree AV block or sick sinus without a pacemaker

36
Q

Adenosine Pharmacokinetics

A

Onset - immediate
Peak - immediate
Duration <10s

37
Q

Adenosine Indications

A

Conversion and termination of SVT

38
Q

Amiodarone Phamacokinetics

A

2-2-2
Onset - 2 minutes
Peak - 20 minutes
Duration 2 hours

39
Q

Atropine Pharmacokinetics

A

Onset - <2 minutes
Peak - 2-4 min IV
Duration 2-6 hours

40
Q

Calcium Chloride Pharmacokinetics

A

Onset 5-15 minutes

Duration - Dose-dependent may persist up to 4 hrs

41
Q

Calcium Chloride MOA

A

Essential for nerve conductions, muscle contraction and coagulation. Administered to improve myocardial contractility and ventricular automaticity

In hyperkalemia causes an increase in threshold potential and restoration of gradient between resting potential and threshold potential

42
Q

Epinephrine Pharmacokinetics

A

Onset - 30s IV; 30-90s IM
Peak - 3-5min IV; 4-10min IM
Duration - 5-10 min

43
Q

Fentanyl Contraindications

A 
Hypersensitivity
Myasthenia gravis
Pre-existing resp depression
Acute Asthma
Upper airway obstruction
44
Q

Fentanyl Pharmacokinetics

A

Onset - Immediate (IV); 7-15 min(IM)
Peak - <5min(IV); 2min (IN); 1-2 hrs (IM)
Duration 30-60 min(IV); 1-2 hrs(IM)

45
Q

Fentanyl Indications

A

Moderate or severe pain

Adjunct to awake intubation

46
Q

Fentanyl MOA

A

Inhibits ascending pain pathways in CNS, alters pain perception by binding to operate receptors producing analgesia and euphoria

47
Q

Ipatropium Contraindications

A

Hypersensitivity

48
Q

Ipatropium Indications

A

Severe bronchospasm

49
Q

Ipatropium Pharmacokinetics

A

Onset 3-5 minutes
Peak - 1.5 -2 hrs
Duration - 6 hrs

50
Q

Ketamine Contraindications

A

Hypersensitivity
Unable to manage adverse effects
Conditions where elevated BP may be harmful
Age <6 months

51
Q

Ketamine Pharmacokinetics

A

Onset - 30s

Duration - 5-10 minutes with recovery 1-2 hrs

52
Q

Ketamine Induction dose

A

Shock index >1 1mg/kg

Shock index <1 2mg/kg

53
Q

Lidocaine contraindications

A

Hypersensitivity
Third degree AV block
Vent escape rhythm
WPW

54
Q

Lidocaine Pharmacokinetics

A

Onset - 45-90 s
Peak - 5-10 min
Duration - 10 - 20 min (IV)

55
Q

Lidocaine Indications

A

Control of ventricular arrhythmias

Local anesthesia during IO or awake intubation

56
Q

Magnesium Sulfate Contraindications

A

Hypersensitivity

Second or third degree AV block

57
Q

Magnesium Sulfate Pharmacokinetics

A

Onset 1-2 minutes
Peak <5 min
Duration- 30 min as anticonvulsant

58
Q

Magnesium Sulfate Indications

A

VF or VT refractory to first line treatment
Recurrent intermittent episodes of WCT
Torsades
Bronchospasm in acute asthma refractory to bronchodilators
Seizures in pregnancy with associate HTN

59
Q

Midazolam Contraindications

A 
DLOC
Hypotension
Shock
Hypersensitivity
Acute narrow angle glaucoma
60
Q

Midazolam indications

A

Sedation of agitated pt
Control of seizures
Anesthesia maintenance

61
Q

Nitro contraindications

A 
Hypersensitivity
Use of sildenafil or vardenafil within 24 hours
Use of tadalafil within 48 hours
Severe anemia
Tamponade or restrictive pericarditis
Right sided MI
Hypotension
62
Q

Nitro Pharmacokinetics

A

Onset - 30s-2 min (SL)
Peak - 5-10 min (SL)
Duration 15-30 min

63
Q

Phenylephrine Contraindications

A

Hypersensitivity
Hypersensitivity to sulfites
Severe HTN or VTach
Pheochromocytoma

64
Q

Sodium Bicarbonate Contraindications

A

Suspected metabolic alkalosis

Hx of excessive vomiting (excessive Cl- loss)

65
Q

Sodium Bicarb dosage

A

1mEq/kg repeat half dose q 10-15min

66
Q

Sodium Bicarb MOA

A

Buffers or neutralizes excess acid raising pH

67
Q

Sodium Bicarb Pharmacokinetics

A

Onset 1-2 minutes
Peak 30 min
Duration 1-2 hrs

68
Q

Sodium Bicarb Indications

A

Known or suspected hyperkalemia
TCA or Salicylate OD
Suspected or confirmed metabolic acidosis
Pretreatment prior to weight release in crush injury

Term 1 (5 decks)

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