Pharm 16-20 (Diphenhydramine, Ondansetron ODT + IV, Midazolam, Diazepam, Lorazepam)

Question 1

Diphenhydramine (Benadryl): Class?

Answer 1

Antihistamine

Question 2

Diphenhydramine (Benadryl): Action?

Answer 2

Blocks histamine H1 receptor sites thereby inhibiting actions of histamine release

Question 3

Diphenhydramine (Benadryl): Indication? (3)

Answer 3

1. Allergic reactions 2.anaphylaxis 3.acute extrapyramidal reaction (dystonia)

Question 4

Diphenhydramine (Benadryl): Contraindication? (3)

Answer 4

1. Hypersensitivity 2. pt’s taking MAO inhibitors 3. caution with glaucoma

Question 5

Diphenhydramine (Benadryl): Onset/Duration?

Answer 5

Onset: 5-15 min with max effects in 1-3 hrs
Duration: 6-12 hrs

Question 6

Diphenhydramine (Benadryl): Dose/Route?

Answer 6

Adult: 25-50mg IV/IM/PO with a max of 400 mg/day
Peds: 1 mg/kg IV/IM/PO with a max of 300 mg/day

Question 7

Diphenhydramine (Benadryl): Side Effects? (7)

Answer 7

1.Drowsiness 2. Disturbed coordination 3.Dry mouth/throat 4.Thickening of bronchial secretions 5.palpitations 6.hypotension 7.tachycardia or bradycardia

Question 8

Diphenhydramine (Benadryl): Notes?

Answer 8

Use with caution in CNS depressed pts and pts with lower respiratory tract diseases such as asthma.

Question 9

Ondansetron (Zofran): Class?

Answer 9

Antiemetic

Question 10

Ondansetron (Zofran): Action?

Answer 10

First selective serotonin blocking agent to be marketed. Blocks the serotonin 5-HT3 receptors that are found centrally in the chemoreceptor trigger zone and peripherally at the vagal nerve terminals in the intestines which in turn minimizes nausea and vomiting.

Question 11

Ondansetron (Zofran): Indication?

Answer 11

Nausea and vomiting

Question 12

Ondansetron (Zofran): Contraindication? (3)

Answer 12

1.Hypersensitivity 2.GI obstruction 3.Use caution with liver disease pt’s. (For patient’s with PKU, do not give orally)

Question 13

Ondansetron (Zofran): Onset/Duration?

Answer 13

Onset: 15-30 min
Duration: 3-6 hr

Question 14

Ondansetron (Zofran): Dose/Route?

Answer 14

Adult: 4 mg IV/IO/IM
Peds: 0.15 mg/kg IV/IO/IM
ODT: 4mg (dissolves)

Question 15

Ondansetron (Zofran): Side effects? (7)

Answer 15

1.Headache 2.Dizziness 3.Drowsiness 4.Hiccups 5.Chills 6.Pruritus 7.ECG irregularities (rare)

Question 16

Ondansetron (Zofran): Notes?

Answer 16

None

Question 17

Midazolam (Versed): Class?

Answer 17

Benzodiazepine

Question 18

Midazolam (Versed): Action?

Answer 18

Increases the activity of the inhibitory neurotransmitter GABA, thereby producing a sedative effect, relaxing skeletal muscles, and raising the seizure threshold.

Question 19

Midazolam (Versed): Indication?

Answer 19

1.Seizures and anxiety 2.Premedication for intubation, cardioversion or conscious sedation procedures

Question 20

Midazolam (Versed): Contraindication? (5)

Answer 20

1.Hypersensitivity 2.Shock 3.Respiratory depression 4.Depressed VS 5.Use caution with CNS depressants including barbiturates, alcohol, and narcotics and glaucoma

Question 21

Midazolam (Versed): Onset/Duration?

Answer 21

Onset: 1-3 min IV
Duration: 2-6 hours IV

Question 22

Midazolam (Versed): Dose/Route?

Answer 22

Adult: 2-10 mg IV(5mg)/IO/IM(10mg)/IN, every 5 min up to 10 mg max total dose.
Peds: 0.2 mg/kg IV/IO/IM/IN, every 5 min up to 5 mg max single dose.

Question 23

Midazolam (Versed): Side effects?

Answer 23

1. Hypotension 2.Respiratory depression or arrest 3.CNS depression 4.Oversedation 5.Hiccups 6.Blurred vision

Question 24

Midazolam (Versed): Notes?

Answer 24

May be given IM since Midazolam is water based. Should be given with analgesic for painful procedures

Question 25

Diazepam (Valium): Class?

Answer 25

Benzodiazepine

Question 26

Diazepam (Valium): Action?

Answer 26

Increases the activity of the inhibitory neurotransmitter GABA, thereby producing a sedative effect, relaxing skeletal muscles, and raising the seizure threshold.

Question 27

Diazepam (Valium): Indications?

Answer 27

1.Seizure activity 2.Acute anxiety 3.Acute alcohol withdrawal 4.Skeletal muscle relaxation 5.Sedation for pacing

Question 28

Diazepam (Valium): Contraindications? (6)

Answer 28

1.Hypersensitivity 2.Respiratory depression 3.Head injury w/ CNS depression 4.Shock 5.Coma 6.Use with caution in pts with acute substance abuse.

Question 29

Diazepam (Valium): Onset/Duration?

Answer 29

Onset: 1-5 min IV and 15-30 min IM
Duration: 15-60 min IV and 15-60 min IM

Question 30

Diazepam (Valium): Dose/Route?

Answer 30

Adult: Seizures – 5 to 10 mg IV over 2 mins every 10-15 min as needed & a max of 30 mg. Premedication for pacing – 5-15 mg IV.

Peds: Ages 30 days to 5 yrs – 0.2-0.5 mg slow IV push over 2 mins every 2-5 min to a max of 5 mg. Peds 5 yrs or older – 1 mg slow IV push over 2 mins every 2-5 min with a max of 10 mg.

Question 31

Diazepam (Valium): Side effects? (8)

Answer 31

1.Respiratory depression 2.Hypotension 3.Altered LOC 4.Amnesia 5.confusion 6.Nausea 7.Vomiting 8.Blurred vision

Question 32

Diazepam (Valium): Notes?

Answer 32

None

Question 33

Lorazepam (Ativan): Class?

Answer 33

Benzodiazepine

Question 34

Lorazepam (Ativan): Action?

Answer 34

Increases the activity of the inhibitory neurotransmitter GABA, thereby producing a sedative effect, relaxing skeletal muscles, and raising the seizure threshold

Question 35

Lorazepam (Ativan): Indication? (4)

Answer 35

1.Seizures 2.Agitation 3.Anxiety 4.Alcohol withdrawal

Question 36

Lorazepam (Ativan): Contraindication?

Answer 36

1.Hypersensitivity 2.Hypotension 3.Respiratory depression 4.CNS depression.

Question 37

Lorazepam (Ativan): Onset/Duration?

Answer 37

Onset: 2-10 min IV
Duration: 6-8 hrs

Question 38

Lorazepam (Ativan): Dose/Route?

Answer 38

Adult: 1-4 mg IM/IV, every 15-20 min up to 8 mg max total dose.

Peds: 0.1 mg/kg IV/IO/IM/PR/IN over 2 min, can be repeated once in 5-10 min up to 4mg

Question 39

Lorazepam (Ativan): Side effects? (6)

Answer 39

1.Hypotension 2.Tachycardia 3.Bradycardia 4.CNS depression 5.Respiratory depression 6.blurred vision

Question 40

Lorazepam (Ativan): Notes?

Answer 40

None