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PARAMEDIC STUDY > Pharm List > Flashcards

Pharm List Flashcards

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1
Q

Brand Name Acetaminophen

A

Tylenol and Tempra

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2
Q

Classification of Acetaminophen

A

-Analgesic
-Antipytretic

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3
Q

Mechanism of Action

A

-Inhibits the prostaglandin synthesis which produces analgesic effect.
-Acts on the hypothalamic heat regulating center.

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4
Q

Indications for Acetaminophen

A

-Treatment of mild pain
-Reduced fevers due to infection

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5
Q

Contraindications for Acetaminophen

A

-Hypersensitivity
-Liver disease
-Major burns

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6
Q

What is the dosages for acetaminophen?

A

Adult: 500-1000mg q 4-6 h prn PO
Pediatric: 10-15mg/kg q 4-6 h prn PO

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7
Q

What are the side effects of acetaminophen?

A

None if given proper dose

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8
Q

What are the precaution(s) for acetaminophen?

A

Acetaminophen is commonly seen in overdoses and may cause severe hepatic damage.

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9
Q

Brand names for Acetylsalicylic Acid

A

-ASA
-Asprin

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10
Q

What are the classifications of Acetylsalicylic?

A

-Anti-platelet
-NSAID (non-steroidal inflammatory drug

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11
Q

What is the mechanism of action for Acetylsalicylic Acid?

A

Inactivates the cyclooxyrgenase (COX) enzyme which decreases the production of prostaglandins in the tissue, blocking the pain receptors sensitivity and decrease inflammation. Due to this inactivation of COX, thrombin A2 production is also inhibited, which is responsible for platelet aggregation.

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12
Q

what are the indication(s) for Acetylsalicylic acid?

A

-Acute Coronary Syndrome

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13
Q

What are the contraindications for acetylsalicylic acid?

A

-GI bleed
-Asthmatic sensitive to ASA
-Hypersensitivity

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14
Q

What is the dosage for acetylsalicylic acid?

A

-160-325mg PO (chewed)

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15
Q

What are the side effects for acetylsalicylic acid?

A

-Indigestion
-Gastric bleeding
-Urticaria
-Anaphylaxis
-Nausea
-Vomiting

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16
Q

What are the precaution(s) for acetylsalicylic acid?

A

-Patients on other platelet inhibitors

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17
Q

What is the classification(s) for D50W?

A

-Carbohydrate

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18
Q

What is the mechanism of action for D50W?

A

-Increases blood glucoses levels.
-Hypertonic solution producing a transient movement from interstitial spaces into the venous system.

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19
Q

What is the indication(s) for D50W?

A

-Hypoglycaemia

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20
Q

What are the contraindication(s) for D50W?

A

-Hyperglycaemia

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21
Q

What is the dosages for D50W?

A

-Adult: 25g IVP, may repeat once
-Peds: 0.5-1g/kg slow IVP, dilute 1:1 with sterile water forming D25W (NS can be used if sterile not available)

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22
Q

What are the side effects of D50W?

A

-Phlebitis
-Tissue necrosis (if infiltration occurs)
-rebound hyperglycaemia

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23
Q

What are the precautions for D50W?

A

-Tissue necrosis if infiltration occurs
-May precipitate sever neurological symptoms in alcoholics (thiamine should be considered prior to administration)
-Patients with increased intracranial pressure, may worsen cerebral edema

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24
Q

What is the brand name for Dimenhydrainate?

A

Gravol

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25
Q

What are are the classifications for dimenhydrainate?

A

-Antiemetic
-Antihistamine
-Anticholinergic

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26
Q

What is the mechanism of action for dimenhydrainate?

A

-Blocks histamine and Ach raptors in vomiting centres as well as blocks the pathways between the inner ear and the vomiting centre that case nausea and vomiting.
-Similar chemical composition to that of diphenhydramine

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27
Q

What are the indications for dimenhydrainate?

A

-Nausea and vomiting may be associated with Ménière’s disease
-Relief of prevention of motion sickness and Vertigo

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28
Q

What are the contraindication(s) for for dimenhydrainate?

A

-None

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29
Q

What are the dosages for dimenhydrainate?

A

-Adult: 25-100mg IM q 4h PRN
12.5-50mg IV q 4h PRN
-Peds: 1.0mg/kg IV/IM max of 25mg

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30
Q

What are the side effects of dimenhydrainate?

A

-CNS depression
-Headache
-Anti-muscanrinic (blurred vision, dry mouth,urinary retention, constipation)
-Thickened bronchial secretions
-Paradoxical excitation can occur in children

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31
Q

What are the precaution(s) for dimenhydrainate?

A

-Pneumonia
-Asthmatic attack
-Dilute with NS prior to IV administration to avoid vein irritation

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32
Q

What is the brand name for diphenhydramine?

A

-Benadryl

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33
Q

What are the classification(s) for diphenhydramine?

A

-Antihistamine
-Anticholingeric

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34
Q

What is the mechanism of action for diphenhydramine?

A

-Competes for free histamine for binding and blocks H1 receptors.
-Antagonizes the effects of histamine (HA) receptors, leading to a reduction of the negative symptoms brought on by histamines.
-CNS depressant
-Has antiemetic properties (H2 histamine receptors in the Gi system)

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35
Q

What are the indication(s)for diphenhydramine?

A

-Allergic and anaphylactic reactions involving respiratory difficulties, edema or severe itching.

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36
Q

what are the contraindication(s) for diphenhydramine?

A

-Hypersensitiviy

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37
Q

What is the dosages for diphenhydramine?

A

-Adult: 25-50mg IV, IM
-Peds: 1-2 mg/kg IV, IM (max 50mg)

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38
Q

What are the side effect(s) of diphenhydramine?

A

-Drowsiness
-Dizziness
-Headaches
-Excitable state
-Thickening of bronchial secretions
-Chest tightness
-Reflex tachycardia
-Hypotension

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39
Q

What are the precaution(s) for diphenhydramine?

A

-The sedative effects of Benadryl can be potentiated by the administration of CNS depressants, other antihistamines, narcotic and alcohol.
-Acute asthma as it may thicken secretions.

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40
Q

What is the generic name for Epinephrine?

A

-Adrenaline

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41
Q

What are the classification(s) for epinephrine?

A

-Sympathomimetic
-Adrenergic

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42
Q

What is the mechanism of action for epinephrine?

A

-Stimulates alpha and beta receptors:
>Increases heart rate
>Increases AV conduction
>Increases force of myocardial contractility
>Increases vasoconstriction (increases SVR)
-Relaxes bronchial smooth muscle (⬇️A/V resistance)
-Increases coronary and cerebral blood flow

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43
Q

What are the indication(s) for epinephrine?

A

-Anaphylaxis
-Near death asthma
-Croup/Stridor (nebulized)

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44
Q

What are the contraindication(s) for epinephrine?

A

-Hypersensitivity
-No indications

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45
Q

What are the dosage(s) for epinephrine?

A

-Adult:
>Asthma/Anaphylaxis: 0.3-0.5mg IM/SQ 1:1,000
-Peds:
>Asthma/Anaphylaxis: 0.02mg/kg
>Croup/Stridor: (see chart) 0.5mg/kg 1:1,000 to a max of 5.0mg mixed with NaCl 0.9% to make 5.0ml of solution

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46
Q

What are the side effect(s) of epinephrine?

A

-Anxiety
-Headache
-HTN
-Cardiac dysrhythmias
-Tremors
-Chest pain
-Nausea/vomiting

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47
Q

What are the precaution(s) for epinephrine?

A

-Cardiovascular disease
-Elderly patients
-Hypertension
-Pregnancy

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48
Q

What is are the classification(s) of Glucagon?

A

-Anti-hypoglycemic

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49
Q

What is the mechanism of action for glucagon?

A

-Stimulates the release of glycogen (glucongenesis) from the liver, for glycogenolysis (⬆️blood glucose levels)
-Smooth muscle relaxation

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50
Q

What the indication(s) for epinephrine?

A

-Hypoglycemia (BGL < 4.0mmol/L and unable to take oral glucose or IV D50)

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51
Q

What are the contraindication(s) for epinephrine?

A

-Hypersensitivity
-Pheochromocytoma

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52
Q

What are the dosages for epinephrine?

A

Adult: 1mg IM, SQ may repeat in 20 minutes required
Peds: 0.5mg IM, SQ (<20kg)

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53
Q

What are the side effect(s) for epinephrine?

A

-Nausea/Vomiting
-Rebound hyperglycemia
-Hypotension
-Tachycardia

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54
Q

What are the precaution(s) of epinephrine?

A

-Effectiveonly if there are sufficient stores of glycogen within the liver.
-Use with caution in patients with cardiovascular or renal diesease.

55
Q

What is the brand name for Glucose?

A

-Insta-glucose

56
Q

What are the classification(s) for glucose?

A

-Sugar

57
Q

What is the mechanism of action for glucose?

A

-Provides glucose content for regular cell metabolism.
-Usually absorbed through mucus membranes.

58
Q

What are the indication(s) for glucose?

A

-BGL < 4.0mmol/L in a conscious patient who can maintain their own airway.
-Confusion with recorded BGL < 4.0mmol/L (an altered LOC)

59
Q

What is the dosage(s) for glucose?

A

-1 tube (15g) orally/ buccaneers PRN

60
Q

What are the side effect(s)? Of glucose?

A

-None

61
Q

What are the precaution(s) for glucose?

A

-None

62
Q

What are the brand names for Ibuprofen?

A

-Advil
-Motrin

63
Q

What are the classification(s) for ibuprofen?

A

-NSAID (non steroidal anti inflammatory)

64
Q

What is the mechanism of action for ibuprofen?

A

-Decreases inflammation, pain and fever through inhibition of cyclooxyrgenase (COX) activity and prostaglandin synthesis.

65
Q

What are the indication(s) for ibuprofen?

A

-Treatment of mild to moderate pain.
-Reduction in fever.
-Anti-inflammatory.

66
Q

What are the contraindication(s) of ibuprofen?

A

-Hypersensitivity
-ASA induced asthma
-Late pregnancy (3rd trimester)
-CVA if TBI in previous 24 hours
-Major burns
-Renal failure or solitary kidney
-Age under 6 months

67
Q

What are the dosage(s) for ibuprofen?

A

-Adults: 200-600mg PO q 6-8 h
-Ped: (>6 months): 7.5mg/kg PO 6-8 h

68
Q

What are the side effect(s) of ibuprofen?

A

-Dizziness
-Drowsiness
-Light headedness
-Peripheral edema
-Diarrhea
-Nausea/vomiting

69
Q

What are the precaution(s) for ibuprofen?

A

-Renal impairment
-History of GI bleeds
-CHF
-Elderly patients (>65)

70
Q

What is the brand name for Ipratropium Bromide?

A

-Atrovent

71
Q

What is the classification(s) for Ipratropium Bromide?

A

-Anticholinergic

72
Q

What is the mechanism of action for Ipratropium bromide?

A

-Causes bronchodilation by competitive inhibition of cholinergic receptors on bronchial smooth muscle.
-Blocks the action of acetylcholine, which inhibits parasympathetic stimulation, thus decreasing bronchial secretions.
-Dries respiratory tract secretions

73
Q

What are the indication(s) for Ipratropium bromide?

A

-Bronchial asthma
-Bronchospasm associated with COPD

74
Q

What are the contraindication(s) for Ipratropium bromide?

A

-Known hypersensitivity
-Is not indicated for acute treatment of bronchospasm for which rapid response is required
-Ischemic chest pain
-Acute narrow angle glaucoma

75
Q

what are the dosages for Ipratropium bromide?

A

-Adults:
>250-500 mcg mixed with Ventolin q 20 minutes x 3
>2-4 puffs q 20 minutes x3
-Peds:
>125-250 mcg mixed with Ventolin and/or NS to minimum of 2cc
>1-2 puffs

76
Q

What are the side effect(s) of Ipratropium bromide?

A

-Palpitations
-Anxiety
-Dizziness
-Headache
-Nervousness
-Rash
-Nausea/Vomiting

77
Q

What are the precaution(s) for Ipratropium bromide?

A

-Narrow angle glaucoma and patients with BPH and or bladder-neck obstruction.

78
Q

What is the brand name for ketorolac?

A

Toradol

79
Q

What are the classification(s) for ketorolac?

A

-Nonsteroidal Anti-inflammatory

80
Q

What is the mechanism of action for ketorolac?

A

-Inhibits prostaglandin synthesis producing peripherally mediated analgesic, anti-inflammatory, and antipyretic effects.
-At analgesic doses little anti inflammatory or antipyretic seen.
-Acts peripherally verse narcotics, which acts upon the CNS therefore, no CNS depression.

81
Q

What are the indication(s) for ketorolac?

A

-Treatment of moderate to severe pain (major burns, CA pain, renal colic, neck/back)

82
Q

What are the contraindication(s) for ketorolac?

A

-Hypersensitivity to ASA or NSAID.
-Asthmatics due to bronchospactic activity.
-Renal impairment.
-Pt’s at risk for bleeding as ketorolac inhibits platelet function thereby increasing bleeding time for:
>Trauma/GI bleed
>CVA/TBI < 24hrs

83
Q

What is the dosages for ketorolac?

A

-Adults: 30-60mg IM/IV q 4-6 h max, 120mg/day
-Peds > 6 months: 0.5mg/kg IM/IV q 4-6 h, max 30mg/dose and 0.5mg/kg/day

84
Q

what are the side effect(s) for ketorolac?

A

-Dizziness
-Headache
-Drowsiness
-Bronchospasm
-Heartburn
-Nausea
-Diarrhea
-Renal failure
-Edema
-Rash

85
Q

What are the precaution(s) for ketorolac?

A

-HTN, CHF, Elderly.
-Hepatic insufficiency.
-GI tract irritation and hemorrhage with long term use.

86
Q

What is the brand name for metoclopramide?

A

-Maxeran

87
Q

What is the classification(s) for metoclopramide?

A

-Antiemetic

88
Q

What is the mechanism of action for metoclopramide?

A

-Antagonizes central and peripheral dopamine receptors, as well as 5HT4 receptors agonistic properties, which raises the threshold of activity in the chemoreceptor trigger zone,resulting in antiemetic effects.
-Increases the amplitude and tone of gastric contractions, increases peristalsis and causes accelerated gastric emptying and intestinal transit.

89
Q

What are the indication(s) for metoclopramide?

A

-Treatment of nausea and vomiting
-Migraines headaches

90
Q

What are the contraindication(s) for metoclopramide?

A

-Hypersensitivity
-GI hemorrhage, mechanical obstruction or perforation
-Pheochromocytoma (my cause HTN crisis)
-Seizure disorder
-Patients receiving medication s that put them at risk for extrapyramidal such as haloperidol and fluphenazine.

91
Q

what are the dosages for metoclopramide?

A

-Adults: 10mg IV/IM/SQ q 4-6 h
-Peds: 0.15mg/kg IM/IV max 10mg

92
Q

What are the side effect(s) of metoclopramide?

A

-Drowsiness
-Fatigue
-Sedation
-Dizziness
-Mental depression
-Hypertension
-Hypotension
-Tachycardia
-Bradycardia
-Diarrhea

93
Q

What are the precaution(s) for metoclopramide?

A

-Hx of epilepsy or Parkinson’s disease (potential for exacerbation of their conditions).
-Anticholinergic drugs antagonize the effects of Maxeran on GI motility.
-Sedative effects of the drug can be potentiated by other CNS depressants.
-May cause extra pyramidal symptoms, treat with 50mg diphenhydramine.

94
Q

What is the brand name for Naloxone?

A

-Narcan

95
Q

What are the classification(s) for naloxone?

A

-Narcotic antagonist

96
Q

What is the mechanism of action for naloxone?

A

-Displaces opioids from receptors, reversing effects of the narcotic overdose.

97
Q

What are the indication(s) for naloxone?

A

-Decreased LOC and respiratory depression in a suspected opioid overdose.

98
Q

What are the contraindication(s) for naloxone?

A

-Allergy of known sensitivity.

99
Q

What are the dosages for naloxone?

A

-Adult: 0.4-2.0mg IV/IN/IM/SC q 2-3 mins PRN
-Peds: 0.1mg/kg IV/IN/IM/SC q 2-3 mins PRN , max 2.0mg per dose

100
Q

What are the side effect(s) of naloxone?

A

-Seizures
-Dizziness
-Headaches
-Tremulousness
-Tachycardia
-Hypotension
-Hypertension
-Nausea/Vomiting

101
Q

What are the precaution(s) for naloxone?

A

-Use cautiously in patients dependent on opioids, acute withdrawal may occur.
-Cardiac collapse in patients postoperative with cardiac dysfunction, or patients on cardio toxic medications.
-Administer cautiously as patients may expire next withdrawl symptoms or aggressive behaviour.

102
Q

What is the brand name for nitroglycerin?

A

-Nitro-Dur

103
Q

What are the classification(s) for Nitroglycerin?

A

-Anti-angina
-Vascular smooth muscle relaxer
-Vasodilator

104
Q

What is the mechanism of action for nitroglycerin?

A

-relaxes vascular smooth muscles, there by dilating the veins and arterioles (at higher doses), causing blood pooling, which reduces the preload thus decreasing workload of the heart muscles
-Reduces left ventricular systolic wall tension, which decreases after load.

105
Q

What’s are the indication(s) for nitroglycerin?

A

-Possible ischemia due to ACS (acute coronary syndrome):
>Unstable angina
>AMI (Acute myocardial infarction)
-Pulmonary edema/CHF

106
Q

What are the contraindication(s) for nitroglycerin?

A

-Hypotension (<90mmHg)
-Severe bradycardia/tachycardia (<50 or >150 bpm)
-Increase ICP(intracranial pressure) or intracranial dysfunction medications.
-Patients taking erectile dysfunction medications:
>Viagra within 24 hours
>Cialis, Levitin, staxyn within 36 hours

107
Q

What is the dosage for Nitroglycerin?

A

-0.4mg SL q 5 min

108
Q

What are the side effect(s) of nitroglycerin?

A

-Headaches
-Hypotension
-Bradycardia
-Postural syncope
-Weakness
-Dizziness
-Nausea/Vomiting
-Reflex tachycardia

109
Q

What are the precaution(s) for nitroglycerin?

A

-administration to right ventricular infarction patients, due to preload dependency, can result in hypotension.

110
Q

What are the brand name(s) for nitrous oxide?

A

-Nitronox
-Entonox

111
Q

What are the classification(s) for nitrous oxide?

A

-Analgesic gas

112
Q

What is the mechanism of action for nitrous oxide?

A

-Blended mixture of 50% o2 and 50% N2O that has potent analgesic effects.
-CNS depressant with analgesic properties
-Effects last only 2-5 minutes after administration ceases.

113
Q

What are the indication(s) for nitrous oxide?

A

-Acute pain associated with MSK injury, ACS, renal colic perinatal, burns and ABD pain.
-Temporary relief of mild to moderate pain from painful procedures such as splinting.
-Acute anxiety

114
Q

What are the contraindication(s) for nitrous oxide?

A

-Patient cannot comprehend verbal instructions or who are intoxicated
-Gas trapping conditions:
>possible bowel obstruction
>air embolism
>pneumothorax
>middle ear infection
>decompression sickness
-COPD or signs of respiratory distress including SaO2 <90%
-Head injury
-Altered LOC

115
Q

What is the dosage for nitrous oxide?

A

-Self-administered

116
Q

What are the side effect(s)of nitrous oxide?

A

-Dizziness
-Light headedness
-Altered mental status
-Hallucinations
-Apnea
-Nausea/Vomiting

117
Q

What are the precaution(s) for nitrous oxide?

A

-Use in well ventilated area (inhalation by provider is possible)
-Anytime > 50% oxygen is required
-Gases may separate at -6 degrees Celsius

118
Q

What is the brand name for salbutamol
?

A

-Ventolin

119
Q

What is the classification for salbutamol?

A

-Bronchodilator
-Sympathomimetic B2 agonist

120
Q

What is the mechanism of action for salbutamol?

A

-Selective B2 stimulation allows for smooth muscle relaxation of the bronchioles. Also has some B1 affects causing an increase in HR.

121
Q

What are the indication(s) for salbutamol?

A

-Bronchoconstriction (wheeze) with SOB.

122
Q

What are the contraindication(s) for salbutamol?

A

-Hypersensitivity
-Ischemic chest pain (relative)

123
Q

What are they dosage for salbutamol?

A

-Adults:
>5.0mg aerosol
>400-600 mcg (4-6 puffs) via MDI (1 poufs q 30 sec)
-Peds (10-30kg):
>2.5mg Aerosol
>200-300 mcg (2-3 puffs) via MDI (1 puff q 30 sec)
-Infant (<10kg):
>1.25mg via Aerosol

124
Q

What are the side effect(s) for salbutamol?

A

-Hypertension
-Tachycardia
-Muscle cramps
-Dry nose and throat
-Headache

125
Q

What are the precaution(s) for salbutamol?

A

-Pt’s with pulmonary edema (cardiac in origin)

126
Q

What is the brand name for tetracaine?

A

-Tetcaine

127
Q

What is the classification for tetracaine?

A

-Topical anesthetic

128
Q

What is the mechanism of action for tetracaine?

A

-Topical ophthalmic anesthetic to allow for flushing of an eye by removing the blink reflex.

129
Q

What are the indication(s) for tetracaine?

A

-To facilitate eye flushing

130
Q

What are the contraindication(s) for tetracaine?

A

-Hypersensitivity to local anesthetic s (Caine family)
-Possible penetrating eye injury

131
Q

What is the dosage for tetracaine?

A

-2-3 drops in affected eye
-Once treatment is done, moist gauze should be placed over eye until blink reflex returns

132
Q

What are the side effects of tetracaine?

A

-May briefly increase irritation

133
Q

What are the precaution(s) for tetracaine?

A

-May cause blurred vision

PARAMEDIC STUDY (2 decks)

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