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pharm Flashcards

1
Q

What is the classification of Acetaminiphen?

A

Analgesic
Antipyretic (ALS)

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2
Q

Contraindication for acetaminophen? (4)

A

-hypersensitivity
-alcoholic hepatitis or liver dysfunction
-acute liver injury
-acetaminophen induced liver disease

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3
Q

Adult dose acetaminophen

A

500- 1 g
repeat after 4 hours to a
max dose of 3g in 24 hours

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4
Q

Acetaminophen Pediatric dose for under 30 kg

A

15mg/kg PO

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5
Q

Acetaminophen Pediatric dose for 30-50 kg:

A

500 mg PO

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6
Q

Acetaminophen Pediatric dose for over 50 kg

A

500-1g, to make 24 hour dose of 75 mg/kg (do not exceed 5 doses in 24 hrs in ped under 12 years)

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7
Q

Acetaminophen liquid formula?

A

80mg/ml

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8
Q

Mechanism of action of acetaminophen?

A

inhibits prostaglanding synthetase in the CNS reducing pain and pyrexia

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9
Q

Pharmocokinetics of Acetaminophen PO?
Onset:
Peak:
Duration:

A

onset: 30 min
Peak: 1-3 hours
duration: 4 hours

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10
Q

Pharmocokinetics of Acetaminophen IV?
Onset:
Peak:
Duration:

A

Onset: 15 minutes
peak: 1 hour
duration: 4-6 hours (analgesia) and over 6 hours of antipyresis

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11
Q

what is a toxic dose of acetaminophen

A

after a single dose of more than 7.5 g in adults of 150mg/kg pediatrics

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12
Q

Classification of ASA

A

Antiplatelet and antithrombotic

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13
Q
A
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14
Q

mechanism of action for ASA

A

it inhibits the formation of thromboxane A2, which is a potent platelet aggregator and vasoconstrictor. The platelet effects are irreversible and last for the life of the platelet (7-10 days)

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15
Q

Adenosine classification

A

antiarrhythmic and endogenous nucleoside

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16
Q

Indications for Adenosine

A

Conversion of SVT

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17
Q

Contraindicated (3 things)

A

1-Hypersensitivity
2- second/third degree heart block
3- sick sinus syndrome (print rhythm) in patients without artificial pacemaker

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18
Q

Adenosine dosage:

A

inital dose of 6 mg, followed by 12 mg rapid IV push

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19
Q

Mechanism of action for adenosine

A

slows the conduction of the electrical impulses through the AV node

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20
Q

Pharmocokinetics of adenosine

A

onset: rapid
peak: rapid
duration: 10 seconds or less

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21
Q

adverse effects of Adenosine

A

lightheadedness, flushing, SOB, chest pressure and nausea- usually self limiting

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22
Q

Warnings/precautions for Adenosine (2 things)

A
  • rare cases of VF associated with adenosine in patients taking digoxin, or digoxin and verapamil- consider clinicall to discuss
    -may worsem bronchoconstriction in pts with COPD/Asthma
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23
Q

Amiodarone classification

A

anti-arrhythmic

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24
Q

Amiodarone indications

A

1- VFIB
2- pulseless vtac
3- unstable vtac
4- recurrent VTAC following cardioversion

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25
Q

Amiodarone dosages for VFIB/VTAC

A

300 mg IV push, followed by 150 mg IV after 10 minutes if VF/pVT persists

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26
Q

Amiodarone dosage for unstable vtac and recurrant vtac following cardioversion?

A

150mg IV over 10 minutes

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27
Q

Amiodarone used in stable monomorphic WCT or symptomatic runs of WCT?

A

Yes, 150 mg over 10 minutes- BUT YOU MUST CALL CLINICALL

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28
Q

Amiodarone for pediatrics?

A

not established- call clinicall for tx plan

29
Q

Describe the mechanism of action for Amiodarone in regards to its characteristics of all 4 Vaughn-Williams classes of anti-arrhythmics

A

1) Blocks NA channels in heart,
2)antagonizes beta adrenoreceptors to inhibit sympathetic activity,
3) produces negative chronotropic effects in nodal tissues
4) lengthens cardiac action potential, 5) also slows conduction and prolongs refractoriness by blocking potassium channels.

30
Q

pharmacokinetics of amiodarone?

A

Onset: 2 minutes
Peak: 20 minutes
duration: 2 hours

31
Q

Adverse Effects:

A
  • hypotension (if this happens during an infusion, just slow the rate)
    -nausea and bradycardia
    -QT prolongation
32
Q

Drug interactions with Amiodarone?

A

be careful as they may potentiate the effects of beta blockers, calcium channel blockers or digoxin and should be used with caution

33
Q

Atropine classification

A

anticholinergic
antimuscarinic

34
Q

Atropine indications (5)

A

1- restoration of bradydysrhythmias
2-Sinus brady less than 50 with hemodynamic compromise
3- bradycardia secondary to AV node blocks
4- treatment for ogranophosphate poisoning
5- Control of secretions in palliative care

35
Q

Contraindications to Atropine (6 things)

A

1- hypersensitivity
2-tachycardia
3-narrow-angle glaucoma
4- thyrotoxicosis
5- prostate hypertrophy
6- myasthenia gravis

36
Q

Atropine dosage for bradycardia?

A

.6mg IV push to max dose of .04mg/kg or 3 mg in most patients

37
Q

Atropine dosage for organophosphate toxicity

A

1-2 mg Im/IV repeat 5-60 minutes until symptoms resolve

38
Q

Atropine dosage for secretions in palliative care

39
Q

If atropine is given too slow, or underdosed, what are the potential outcomes?

A

Paradoxical slowing of HR

40
Q

Can pediatrics have atropine?

A

yes- follow weight based tx- .02mg/kg

41
Q

Indications for calcium chloride (3)

A

1- Cardiac arrest due to suspected hyperkalemia (renal failure, DKA)
2- suspected hyperkalemia with cardiovascular toxicity (wide QRS, peaked T, hemodynamic instability)
3- Calcium channel blocker OD with sympathetic bradycarida or hemodynamic instability

42
Q

Contraindication for Calcium Chloride

A

hypersensitivity
primary or secondary hypercalcemia

43
Q

Calcium chloride adult dosages

A

1-2g IV over 10 minutes
can repeat once in 10 minutes if indications are still present

44
Q

Calcium chloride for pediatric dosing

A

20mg/kg over 3 minutes, max single dose of 1 g
-can repeat once in 10 minutes if indications are still present

45
Q

What is the mechanism of action for Calcium Chloride?

A

nerve conduction, muscle contraction, renal function and coagulation- administration of calcium in prehospital is intended to improve mycardial contractility and ventricular automaticity

46
Q

Pharmocokinetics of clacium chloride

A

IV- 5-15 minutes
duration- dose dependent (can be up to 4 hours)

47
Q

Adverse effects of calcium chloride

A

-tissue irritation (most common side of effect of calcium administration)
-hypotension- cardiac arrhythmias, and cardiac arrest may occur if calcium is given too quickly
-calcium chloride may precipitate or worsen acidosis, cor pulmonale, or renal and respiratory disease

48
Q

Dexamethasone classifications

A

anti-inflammatory agen, systemic corticosteroid

49
Q

Dexamethasone contraindications

A
  • systemic fungal infections
    -hypersensitivity to dexamethasone or other cortiscosteroids
50
Q

Dose for Dexamethasone

A

8mg Iv/IO/IM/PO (PO preferred)

51
Q

Pediatric dose for dexamethasone

A

.6mg/kg to max of 16 mg

52
Q

mechanism of action for dexamthasone

A

suppresses neurtrophil migration, decreasing production of inflammatory mediators and reversng capillary permeability

53
Q

Dopamine classification and indications

A

sympathomimetic alpha and beta agonist
dopaminergic agonist
indicated for CCP for symptomatic hypotension in the absense of hypovolemia

54
Q

Dopamine dosages (based on dopaminergic, beta and alpha effects)

A

2 mcg/kg/min for dopaminergic effects
5-10 mcg/kg/min IV beta effects
10-20 mcg/kg alpha effects
-for hemodynamic unstable patients dose range is 5-20 mcg/kg/min

55
Q

EPI dose for anaphylaxis

56
Q

EPI dose for anaphylaxis

A

50-100mcg IV

57
Q

Cardiac Arrest Epi dose

A

1 mg q 2-4 minutes

58
Q

peri-arrest hypotension epi dose

A

10mcg/ IV q 2-3 minutes

59
Q

Brady cardia Epi dose?

A

2-10mcg/minute Iv/Io infusion

60
Q

Pediatric Epi dose anaphylaxis

61
Q

Pediatric bronchospasm with impending arrest Epi dose

A

.01 mg/kg up to max .5mg

62
Q

Pediatric croup Epi dose over 1 year

A

5mg nebulizer

63
Q

under 1 year epi dose nebulized for croupe dosage?

A

.5mg/kg to max of 5mg

64
Q

Pediatric Cardiac arrest Epi dosage

A

.01mg/kg IV

65
Q

Pediatric pre-arrrest anaphylaxis Epi dosage

A

5mcg/kg/IV

66
Q

Pediatric peri-intubation resusitation dose for Epi

67
Q

Pharmocokinetics of EPI

A

onset: 30-90 second IM, 30 secs IV
peak: 4-10 min IM, 3-5 min IV
Duration: 5-10 min (IM/IV)

68
Q

Diphenhydramine contraindications?

A

-allergy to
-neonates
-premature infants

ALS (3 decks)

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