Pharm 21-27 (Fentanyl, Morphine, Ketamine, Glucagon, Haldol, Nitrous Oxide, Thiamine) Flashcards
Fentanyl (Sublimaze): Class?
Synthetic Opioid analgesic
Fentanyl (Sublimaze): Action?
Combines with the receptor sites in the brain to produce potent analgesic effects
Fentanyl (Sublimaze): Indications? (2)
Pain and sedation
Fentanyl (Sublimaze): Contraindications? (6)
1.Hypersensitivity to opiates 2.Hypotension 3.Cardiac dysrhythmias 4.Respiratory depression 5.Head injury 6.Myasthenia gravis
Fentanyl (Sublimaze): Onset/Duration?
Onset 1-2 min IV
Duration 30-60 min
Fentanyl (Sublimaze): Dose/Route?
Adult: 0.5 – 2 mcg/kg slow IV/IO/IM/IN over 2 mins, q 5 min, max single dose of 100 mcg, max total dose of 300 mcg.
Peds: 0.5 – 1 mcg/kg IV/IN over 2 mins, q 5 min, max single dose of 100 mcg, max total dose of 3 mcg/kg.
Fentanyl (Sublimaze): Side effects? (5)
- Nausea/Vomiting 2.Respiratory depression 3.Hypotension or hypertension 4.Bradycardia 5.Rigidity of chest wall muscles
Fentanyl (Sublimaze): Notes?
None
Morphine Sulfate (Astramorph): Class?
Opioid analgesic
Morphine Sulfate (Astramorph): Action?
Morphine is a natural opioid analgesic. Morphine also causes venous dilation and decreased venous return to the heart thus reducing myocardial oxygen demand. Morphine also causes euphoria, central nervous system depression and sedation.
Morphine Sulfate (Astramorph): Indications? (3)
1.Acute pain 2.Chest pain associated with ACS 3.Pulmonary edema
Morphine Sulfate (Astramorph): Contraindications? (9)
1.Hypersensitivity to narcotics 2.CNS depression 3.Respiratory depression 4.Hypotension 5.Hypovolemia 6.Head injury 7.Increased ICP 8.Pts that took MAO inhibitors in last 14 days 9.Caution with pt’s with RV infraction/MI
Morphine Sulfate (Astramorph): Onset/Duration?
Onset: 5-10 min
Duration: 4-5 hrs
Morphine Sulfate (Astramorph): Dose/Route?
Adult: 2-5 mg IV/IO repeat every 10 min as needed
Peds: 0.1 mg/kg IV/IO, every 10 min up to 5 mg max single dose, max total dose of 15 mg
Morphine Sulfate (Astramorph): Side effects? (4)
1.Hypotension 2.CNS depression 3.Respiratory depression 4.Tachycardia
Morphine Sulfate (Astramorph): Notes?
CNS depressants and Phenothiazines may potentiate morphine. Use Narcan for Morphine overdoses.
Ketamine (Ketalar): Class?
Nonbarbiturate anesthetic
Ketamine (Ketalar): Action?
Acts on the limbic system and cortex to block afferent transmission of impulses associated with pain perception. It produces short-acting amnesia without muscular relaxation. A derivative of phencyclidine (PCP).
Ketamine (Ketalar): Indications? (2)
- Pain 2.Sedation and sometimes used as an adjunct to nitrous oxide
Ketamine (Ketalar): Contraindications? (5)
1.Stroke 2.Hypersensitivity 3.Severe hypertension 4.Cardiac instability 5.Caution with schizophrenia.
Ketamine (Ketalar): Onset/Duration?
Onset: 30 sec
Duration: 5-10 min up to 1-2 hours
Ketamine (Ketalar): Dose/Route?
Adult: Sedation - 1-2 mg/kg IV over 1 min or 4 mg/kg IM.
Pain – 0.3 mg/kg IV/IO/IM/IN
Peds > 2 y/o: 1-2 mg/kg IV over 1 min.
Pain – 0.3 mg/kg IV/IO/IM/IN