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CAL-Jac Paramedic Program > Pharmacokinetics and Pharmacodynamics > Flashcards

Pharmacokinetics and Pharmacodynamics Flashcards

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1
Q

What class of drug is most commonly used to treat bronchospasms?

A

sympathomimetics

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2
Q

What is the danger of pt taking over the counter antihistamines with a history of cardiovascular disease?

A

hypertension

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3
Q

Patients taking ACE inhibitors medication may experience?

A

chronic, dry cough

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4
Q

Most common side effect of sympathomimetics?

A

tachycardia

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5
Q

stimulation of alpha-2 receptors suppresses the release of what?

A

norepinephrine

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6
Q

Sublingual nitroglycerin has what type of onset and bioavailability?

A

sublingual route has a rapid onset but low bioavailability

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7
Q

Ipratropium bromide (Atrovent) causes bronchodilation antagonzing which receptors?

A

antagonizing muscarinic receptors

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8
Q

ACE inhibitor medications lower the blood pressure by blocking?

A

Blocking the conversion of Angiotensin I to Angiotensin II

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9
Q

What is the most commonly prescribed diuretic that inhibits sodium transport within the distal tubule of the kidney

A

Thiazide

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10
Q

What does alpha 1 receptor do?

A

constrict blood vessels

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11
Q

What does alpha 2 receptor do?

A

smooth muscle contraction, inhibit insulin, introduction of glucagon, suppresses norepinephrine

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12
Q

What does beta I receptor do?

A

inotropy, chronotropy, dromotropy

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13
Q

What does cholinergic mean?

A

Acetylcholine (neurotransmitter) meaning parasympathetic

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14
Q

dromotropy

A

refers to the strength of conduction of electrical impulses

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15
Q

chronotropy

A

heart rate

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16
Q

Which catecholamine has less vasoconstriction than epinephrine or norepinephrine?

A

Dopamine

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17
Q

What is the most common dose of dopamine used in the field?

A

5-10 mcg/kg/min

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18
Q

Can dopamine and dobutamine treat hypovolemic shock?

A

NO

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19
Q

What can you treat with dopamine and dobutamine?

A

hypotension or shock

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20
Q

What is the agonist affect of nicotinic?

A

Allow acetylcholine to stimulate muscle contractions

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21
Q

Which medication can not be given to pregnant women unless absolutely necessary?

A

hydralazine (vasodilator used to treat hypertension)

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22
Q

Calcium increases what property of the heart?

A

The strength of the heart’s contraction = contractility

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23
Q

Calcium ____ coronary arteries and peripheral arterioles.

A

vasoconstricts

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24
Q

Which node fires first?

A

SA node

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25
Q

After the SA node fires, which node fires next?

A

AV node

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26
Q

What are abnormal pacemaker sites within the heart (outside the SA node)?

A

ectopic foci

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27
Q

What is a premature ventricular contraction?

A

A single impulse that originates at the right ventricle

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28
Q

To fix slower rhythms, you need?

A

calcium

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29
Q

How do you fix faster rhythms?

A

sodium and potassium

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30
Q

What is outside of the cell? Sodium or potassium?

A

Sodium

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31
Q

What is inside of the cell? Sodium or potassium?

A

Potassium

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32
Q

The Vagus nerve releases which neurotransmitter?

A

ACH

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33
Q

What is an indication for class I, sodium channel blockers?

A

ventricular dysrhythmias

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34
Q

What does Class IB agents do?

A

slow conductions through the ventricles, increase v-fib threshold, reduce automaticity/ectopic foci

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35
Q

What is needed to treat Torsades de Pointes?

A

Magnesium- bc a magnesium deficiency is what causes Torsades de Pointes.

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36
Q

What is one example of a Class IB Agent?

A

Lidocaine (Xylocaine)

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37
Q

Beta 1 receptors in the heart attach to which channels?

A

calcium

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38
Q

What is used to treat HTN, angina, supraventricular tachycardia?

A

beta blockers

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39
Q

Used to treat tachydysrhythmias brought on by the sympathetic nervous system

A

beta blockers

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40
Q

Class III

A

potassium channel blockers

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41
Q

Do potassium channel blockers shorten or extend the refractory period

A

Prolongs repolarization which extends refractory period

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42
Q

What can be used to treat all tachydysrhythmias?

A

potassium channel blockers

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43
Q

What is the most common potassium channel blocker?

A

Amiodarone

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44
Q

Class IV

A

Calcium channel blockers

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45
Q

Prime side effects of calcium channel blockers

A

hypotension and bradycardia- slows does the heart because its decreasing the automaticity

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46
Q

Calcium channel blocker medications

A

Verapamil, Diltiazem, Nifedipine

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47
Q

Adenosine does what to the heart’s conductivity?

A

Decreases conduction velocity through the AV junction

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48
Q

Adenosine is not effective on?

A

A-fib(above the ventricle), A-flutter or ventricular dysrthmias

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49
Q

Where does Adenosine work?

A

The AV junction

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50
Q

Can adenosine be used to treat SVT?

A

yes

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51
Q

How does Diogoxin work?

A

Increases intracellular calcium which increases cardiac output and contractility. It also decreases AV conduction velocity.

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52
Q

Common agents for sedative hypnotics

A

eptimodate, fentanyl, midazolam

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53
Q

What is an analgesic?

A

decrease in perception of pain (not sensation)

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54
Q

What two classes of analgestic?

A

Opioid and non-opioids

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55
Q

What is an agonist?

A

binds to the receptor site and causes the expected response

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56
Q

What is an antagonist

A

binds to the receptor site and does not initiate the expected response (blocks the site)

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57
Q

A generic reference to morphine-like drugs/actions?

A

Opiates

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58
Q

What do opiods do?

A

Acts on endorphin receptors to decrease the ability to propagate pain impulses (Mu, Kappa, Sigma)

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59
Q

What do Sigma receptors cause?

A

AMS, hallucinations and delium

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60
Q

Examples of agonist-antagonist

A

nalbuphine (Nubaine), butorphanol (Stadol)

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61
Q

Example of pure opioid antagonist

A

naloxone(Narcan)

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62
Q

What is the cardiac load on analgesias?

A

Lowers preload and afterload

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63
Q

Miosis

A

excessive pupil constriction

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64
Q

Examples of adjunct medications/drugs that potentiate with opioids

A

caffeine, antihistamines, benzos

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65
Q

Naloxone is used for what type of overdose?

A

Treat heroin and opioid overdoses

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66
Q

Indication for Narcan(Naloxone)

A

Respiratory rate less than 8

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67
Q

Examples of Non steroidal anti-inflammatory drugs

A

Acetaminophen (Tylenol), Ibuprofen, Naproxen, Toradol(ketorolac), Salicylates (Aspirin)

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68
Q

How does Tylenol work?

A

Inhibits the synthesis of CNS prostaglandins (inflammatory response) and inhibits leukocyes migration and release of lysosomes

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69
Q

What is Ketorolac (Tordol)?

A

Anti-inflammatory effects are caused by decreased prostaglandin. Pain management related to decreased inflammation. Antipyretic

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70
Q

How can Ketorolac be given for vomiting pt?

A

IM or IV

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71
Q

What does Asprin inhibit the synthesis of?

A

inhibits the synthesis of cyclooxygenase(COX)

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72
Q

Aspirin effects

A

Bad:GI ulceration, increase bleeding, decrease renal elimination, decrease uterine contractions during labor

Good: pain relief, fever, inflammation

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73
Q

What decreases the neural impulses and loss of sensation?

A

anesthetics

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74
Q

Conscious sedation is also known as?

A

neuroleptanesthesia

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75
Q

How do local anesthetics affect?

A

affect on area around injection like lidocaine accompanies by epinephrine

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76
Q

Three examples of gas anesthetics

A

nitrous oxide(Notronox), halothane, Ether

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77
Q

Barbiturates do what?

A

Produce anesthesia and hypnosis but no pain relief; used for RSI

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78
Q

Onset and duration of barbiturates?

A

20-60 seconds, duration if 5 minutes

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79
Q

What are the three classes of sedative-hypnotic drugs?

A

Alcohol, Benzos, Barbiturates

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80
Q

Benzos promote which receptors?

A

Promote the effectiveness of GABA receptors

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81
Q

What part of the brain has a high concentration of benzo receptors?

A

amygdala (emotion center)

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82
Q

Examples of non-benzo benzos?

A

Zolpidem

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83
Q

Do barbiturates have a higher or lower respiratory depression than benzos?

A

high

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84
Q

Is there an antagonist for barbiturates?

A

No

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85
Q

Which barbiturate can be used for anti-seizures?

A

Phenobarbital(Luminal)

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86
Q

Magnesium sulfate

A

Blocks neurotransmission by decreasing ACH at motor nerve terminals

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87
Q

100gm of Thorazine is equivalent to what amount of Haldol?

A

2mg of Haldol

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88
Q

What is a treatment for extrapyramidal symptom?

A

Benadryl

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89
Q

TCAS block the reuptake of what?
Tricyclic antidepressants

A

Blocks the reuptake of NE and serotonin

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90
Q

What is the antidote for Tricyclic antidepressants

A

sodium bicarbonate

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91
Q

Most common side effects of SSRI’s

A

nausea, insomnia, sexual dysfunction

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92
Q

Common MAO medications

A

Nardil, Parnate, Marplan

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93
Q

What is the Mechanism of action for amphetamines?

A

Promote the release of norepinephrine and dopamine

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94
Q

Indications for Amphetamines

A

diet suppresion, decrease in fatigue, increase concentraion

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95
Q

Side effects of amphetamines

A

psychosis, insomnia, convulsion, hypertension, tachycardia

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96
Q

Mimics the effect of ACH causing depolarization, then paralysis

A

succinylcholine

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97
Q

What do alpha agonists do?

A

increase BP and constrict blood vessels

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98
Q

Parasympatholytic/anti-cholinezgic effects include?

A

drying and bronchodilation

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99
Q

Muscarinic effects can be blocked with what?

A

Atropine

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100
Q

Anticholinergics black ACH at what receptor sites?

A

muscarinic receptors

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101
Q

How long does Atropine last?

A

3-5 minutes

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102
Q

What is Myasthenia gravis?

A

autoimmune disorder that destroys nicotinic fibers and causes muscle weakness

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103
Q

What is used to block adrenergics?

A

beta blockers and alpha blockers

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104
Q

What reacts directly on alpha and beta receptors?

A

catecholamines

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105
Q

What are the three naturally occurring catecholamines?

A

epi, norepinephrine, dopamine

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106
Q

Is dopamine is dose dependant?

A

yes

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107
Q

What are beta blockers used for?

A

HTN, SVT, Angina, tachy-dysrhythmias

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108
Q

Prolonged repolarization with potassium channel blockers extends what?

A

refractory period

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109
Q

What Class III dysrhythmic can be used on all tachydysrhythmias?

A

potassium channel blockers

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110
Q

What is one example of an off-label medication in EMS?

A

IV Tranexamic Acid

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111
Q

What is one controversial Schedule I controlled substance?

A

Marijuana

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112
Q

What classification of medication has a high abuse potential but has legitimate medical purposes?

A

Schedule II

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113
Q

What classification of medication is likely to be be carried and administered by medics?

A

Schedule II(Fentanyl and Morphine Sulfate) and Schedule 4 such as Midazolam(Versed), diazepam(Valium) and lorazepam(Ativan)

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114
Q

Which classification of medication requires locked storage, record keeping and waste protocols?

A

Schedule 2-5

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115
Q

Which classification of medication is not recognized for medical purposes?

A

Schedule 1

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116
Q

Which classification of medication is has high abuse potential?

A

Schedule 1

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117
Q

Heroin, Marijuana, LSD and Peyote are what type of classification?

A

Schedule 1

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118
Q

How does Amio work within the cardiac cycle?

A

Prolongs phase 3 of the cardiac action potential cycle

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119
Q

What is the generic name for Atrovent?

A

Ipratropium Bromide

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120
Q

What is the effect of Adenosine?

A

Slows AV conduction time

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121
Q

What is the direct effect of glucagon?

A

mobilizes glycoygen storages

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122
Q

What is the effect of sodium bicarbonate on Ph blood level?

A

Increases blood Ph level

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123
Q

What is the effect of diphenhydramine?

A

Blocks histamine release by competing with H-1 receptors

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124
Q

How long should you administer Adenosine in duration?

A

1-3 seconds

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125
Q

What sign or symptom should you anticipate when administering magnesium sulfate?

A

hypercarbia

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126
Q

What is the effect of diltiazem(calcium channel blocker)?

A

Increases intracellular calcium

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127
Q

What is the mechanism of action for an analgestic?

A

increases the pain threshold in the CNS

128
Q

What is the mechanism of action for an antipyretic?

A

blocks protaglandins in the hypothalamic thermoregulatory center of the brain

129
Q

What produces endogenous pyrogens that increase prostalgandin in CSF?

A

leukocytes

130
Q

What is the onset time for Acetaminophen?

A

30-60 minutes

131
Q

What is the duration for Acetaminophen?

A

3-4hours

132
Q

How do you treat for an acetaminophen overdose within 1 hour?

A

activated charcoal within 1 hour

133
Q

How do you treat for an acetaminophen overdose over an hour?

A

Acetyllcysteine (Mucomyst)

134
Q

Pediatric dose for Acetaminophen?

A

15mg/kg every 4-6 hours

135
Q

Adult dose for Acetaminophen PR every 4-6 hours?

A

650mg

136
Q

ADult dose for Acetaminophen PO every 4-6 hours?

A

325-650mg

137
Q

What is the class for Acetazolamide?

A

carbonic anhydrase inhibitor

138
Q

What is the indication for Acetazolamide?

A

prevention and treatment of acute mountain sickness

139
Q

What does Acetazolamide cause the kidneys to secrete when the person is hyperventilating?

A

bicarbonate (alkaline)

140
Q

What is tinnitus? (*side effect of Acetazolamide)

A

ringing, humming or buzzing in both ears

141
Q

What is the adult dose for Acetazolamide?

A

500mg - 1g per day in divided dose

142
Q

What is the pediatric dose for Acetazolamide?

A

500mg per day in divide dose

143
Q

What form of medication is wax like that dissolves in the rectum or other body cavity

A

suppository

144
Q

What form of medication is a sterile solution for direct injection into a body cavity, tissue or organ?

A

Parenteral solution

145
Q

What are two examples of parenteral solution?

A

Fentanyl(Sublimaze) and Epinephrine

146
Q

The stem “pril” signifies

A

ACE Inhibitor Medication Class

147
Q

Cardiac medication digoxin is given based on the pt’s _______ body weight?

A

ideal body weight

148
Q

Antidysrhythmic, Lidocaine, is administered based on the pt’s ______ body weight?

A

actual body weight

149
Q

Which patients are disproportionately susceptible to paradoxical medication reactions- opposite to the intended effects of the medication?

A

Pt’s at extreme ages- infants and pt’s older that 65yr

150
Q

Barbiturates can cause unexpected _____ in older patients.

A

excitement or agitation

151
Q

Barbiturates can cause unexpected ___________ in children?

A

excitement or agitation

152
Q

Fever suppresses the function of the ____________ in the liver

A

Cytochrome P-450

153
Q

______________impairs effectiveness of medications used in traditional cardiac ALS.

A

hypotension

154
Q

Patients with primary pulmonary hypertension experience acute decompensation when they receive _______ ___________.

A

vasopressors

155
Q

-azole

A

antifungals

156
Q

-ane

A

general anesthetics

157
Q

-ase

A

thrombolytics(clot-blusters)

158
Q

-azosin

A

alpha blockers (adrenergic antagonist)

159
Q

-barbital

A

barbiturates

160
Q

-caine

A

local anesthetics

161
Q

-ciclovir

A

anti-virals

162
Q

-curonium

A

neuromuscular blocker

163
Q

-dipine

A

calcium channel blockers

164
Q

-ine

A

stimulants

165
Q

-lam/ -pam

A

benzodiazepines

166
Q

-lol

A

beta blockers (adrenergic antagonists)

167
Q

-lone

A

corticosteroids

168
Q

-micin/-mycin

A

antibiotics

169
Q

-prazole

A

proton pump inhibitors (anti-ulcers)

170
Q

-pril

A

ACE inhibitor (antihypertensives)

171
Q

-profen

A

NSAID (antiinflammatory)

172
Q

-setron

A

5-HT3 Receptor Antagonists (antiemetics)

173
Q

-sone

A

corticosteriods

174
Q

-stigmine

A

Cholinergics

175
Q

-stine

A

Anti-tumor

176
Q

-terol

A

Bronchodilators

177
Q

-thiazide

A

Potassium-losing diuretics

178
Q

-tidine

A

H2 receptor antagonists (anit-ulcers)

179
Q

-triptan

A

anti-migraines

180
Q

-triptline

A

(anti-depressants) tricyclics

181
Q

-vastatin

A

antilipemics (anti-cholesterol)

182
Q

-zine

A

phenothiazines (antipsychotics, antiemetics)

183
Q

-zoine

A

nasal decongestants

184
Q

A non proprietary name of abbreviation of the chemical name

A

GEneric name

185
Q

Name given to the drug by the pharmaceuticals companies that make the drug

A

Tradename/brand name

186
Q

What are the 6 rights of medication administration?

A

Right drug
Right dose
Right time
Right route
Right patient
Right documentation

187
Q

What describes the attraction between a drug and a receptor?

A

Affinity

188
Q

Do drugs with a low affinity require a higher or lower concentration of the drug to get a response?

A

Higher

189
Q

What is the amount of drug that is required to produce a therapeutic response?

A

Drug potency

190
Q

What is the amount of drug that produces a response in 50% of people taking it?

A

Effective Dose

191
Q

What is the amount of the drug that produces adverse effects in 50% if the people taking it?

A

Toxic dose

192
Q

What is the ratio between in the Margin of safety?

A

Toxic Dose and the Effective Dose

193
Q

What is it called when a reaction to a drug has significantly different response that what was expected?

A

Idiosyncrasy

194
Q

What is the enhancement of one’s drug’s effect by another drug?

A

Potentiation

195
Q

Opium, Morphine and Methadone are examples of what type of drug schedule?

A

Schedule II

196
Q

Codeine, amphetamines, phenobarbital are examples of what type of drug schedule?

A

Schedule III

197
Q

What is the study of metabolism and action of drugs?

A

Pharmacokinetics

198
Q

What are the key organs in biotransformation, process of drugs being inactivated and eliminated from the body?

A

LIver, lungs, kidneys, intestines

199
Q

When medication is administered through IV, what percentage of bioavailability does it have?

A

100%

200
Q

Drug induced movement disorders caused by antipsychotics, which include side effects like uncontrollable movements, tremors, muscle contractions are called what?

A

Extrapyramidal Symptoms

201
Q

List the most effective routes of administration to the least effect route:

A

IV - INH- Intraperitoneal - IM - PO - Topical

202
Q

What type of medication is mixed with a liquid, usually water, cannot dissolve and requires to be shaken for even distribution?

A

Suspension

203
Q

What type of medication is a mixture of two liquid components?

A

Emulsion

204
Q

Nerve fibers that secrete norepinephrine are called what?

A

adrenergic nerve

205
Q

Nerve fibers that secrete acetylcholine are called?

A

cholinergic nerve fibers

206
Q

Which drugs mimic catecholamines or the release of norepinephrine causing a sympathetic response are called what?

A

Adrenergics

207
Q

What do adrenergics cause in the lungs?

A

bronchial dilation

208
Q

What do adrenergics cause in the pupils?

A

Pupils will dilate

209
Q

What do adrenergics cause to the rate of the heart?

A

Increase the contractile force and heart rate

210
Q

Which type of drugs inhibit the activity of the sympathetic nervous system?

A

Sympatholytics

211
Q

What schedule of medication is Xanax, Valium, Ativan under?

A

Schedule IV

212
Q

What is another word for mechanism of action?

A

pharmacodynamics

213
Q

What level of evidence does Class I indicate?

A

Strong evidence supporting the use of medication for the condition

214
Q

What level of evidence does Class IIb indicate?

A

Weak evidence

215
Q

What level of evidence does Class IIa indicate?

A

moderate evidence

216
Q

What level of evidence does Class III no benefit indicate?

A

the benefit equals the risk and intervention should not be performed

217
Q

What level of evidence does Class III harm indicate?

A

strong evidence that the risk is greater than the benefit, intervention should not be performed

218
Q

What class of drug is hydrocodone?

A

Schedule III

219
Q

What kind of antagonist temporarily bind with cellular receptor sites to displace agonist chemicals?

A

competitive antagonists

220
Q

What type of antagonist permanently binds with receptor sites and prevent the activation by agonist chemicals?

A

Noncompetative antagonists

221
Q

What are two examples of a noncompetitive antagonists?

A

Ketamine and Aspirin

222
Q

Which partial agonist binds to mu opioid receptors which minimizes opioid physical dependence but still produces analgesia; used to treat addiction.

A

Buprenorphine( Buprenex, Subutex)

223
Q

What kind of agents bind with heavy metals in the body to create a compound that can be eliminated?

A

chelating agent

224
Q

When bicarbonate ions bind with excess hydrogen ions from sodium bicarbonate, does it increase or decrease the blood ph?

A

Increase pH

225
Q

A chemical that increases urinary output?

A

diuretic

226
Q

What is the effect of diltiazem?

A

(Calcium channel blocker) Decreases intracellular calcium which leads to reduction in muscle contractions.

227
Q

What is the Brand name for Sildenafil?

A

Viagra

228
Q

What is the first line drug for a pulseless ventricular tachycardia?

A

Epinephrine

229
Q

What is the antidote for benzodiazepine overdose?

A

Flumazenil

230
Q

What is the primary neurotransmitter in the parasympathetic nervous system?

A

Acetlycholine

231
Q

What is the primary effect of Adenosine?

A

Slows AV node conduction time

232
Q

Muscarinic effects can be blocked with what medication?

A

Atropine

233
Q

Which sympatholytics block adrenergic effects?

A

Beta blocker and Alpha blockers

234
Q

Which medication is similar to Dopamine but it doesn’t increase HR as much and better for pt’s who are already tachycardic?

A

Dobutamine

235
Q

What is the indication for sodium channel blockers?

A

Ventricular dysrhythmias

236
Q

What is the MOA for Class IA agents?

A

slow conduction through the ventricles (widens QT intervals)

237
Q

What does Class Ib Agents do the v-fib threshold?

A

Increase

238
Q

Where do Beta1 receptors in the heart attach to?

A

Calcium channels

239
Q

What is the indication for Class II Beta Blockers?

A

tachydysrhythmias caused by sympathetic stimulation, HTV, SVT, angina

240
Q

These blockers prolong repolarization which extend refractory periods…

A

Potassium channel blockers

241
Q

These blockers are similar as Beta Blockers but are useful in breaking slow SVT, A-fib, and A-flutter

A

Calcium Channel Blockers

242
Q

Verapamil, Diltiazem and Nifedipine are what type of medication?

A

Calcium Channel Blockers

243
Q

Which medication can be used for CHF, A-fib and A-flutter?

A

Cardiac Glycocides

244
Q

What can be used for stable A-fib as a diagnostic to rule out PSVT?

A

Adenosine

245
Q

What medication can be used to treat for A-fib, chest pain and high blood pressure?

A

Cardizem (Diltiazem) - Calcium Channel Blocker

246
Q

What is a depolarizing neuromuscular blocking agent used for RSI?

A

Succinylcholine (Anectine)

247
Q

How much is in a micro-drip tubing set?

A

60 gtts/mL

248
Q

How much is in a macro-drip tubing set?

A

10 gtts/mL

249
Q

For refractory V-fib or pulseless v-tach, how much Amiodarone is given?

A

300mg rapid IV/IO push

250
Q

Are antidysrhythmics indicated for hemodynamic stable patients?

A

No

251
Q

What is the correct dose and concentration of epi for a non-traumatic cardiac arrest?

A

0.1mg/mL or 10ML(1mg) every 3-5min

252
Q

What are side effects of Atropine Sulfate?

A

thirst, dry mouth, pupil dilation, urinary retention (think anticholinergic)

253
Q

What is the initial dose of Diltiazem to treat rapid ventricular rates with A-fib and A-Tach?

A

0.25mg/kg for IV

254
Q

Does Nitro increase or decrease preload and afterload?

A

decrease

255
Q

Are PVC’s routinely treated with antidysrhythmics?

A

No

256
Q

What is the life saving drug for hyperkalemia?

A

Calcium

257
Q

Peaked T waves, absent P waves and widened QRS complexes are signs of?

A

hyperkalemia

258
Q

Inward sodium channels close the cell begins to repolarize during what phase?

A

Phase 1

259
Q

-tan

A

ARBs (antihypertensive)

260
Q

What is used to increase the heart rate by opposing the vagus nerve when it causes bradycardia?

A

Atropine Sulfate

261
Q

What medication increases myocardial oxygen demand?

A

Atropine

262
Q

What is the state of being insensible to pain while still conscious?

A

analgesia

263
Q

A medication that causes the inability to feel sensation

A

anesthetic

264
Q

The percentage of the unchanged medication that reaches systemic circulation.

A

bioavailability

265
Q

Medications that bind with heavy metals in the body and create a compound that can be eliminated; used incases of ingestion or poisoning

A

chelating agents

266
Q

Paralytic agents that act at the neuromuscular junction by binding with nicotinic receptors on muscles, causing fasciculations and preventing activation by acetylcholine

A

competitive depolarizing

267
Q

Drugs used in the treatment of heart failure and certain atrial dysrhythmias

A

digitalis preparations

268
Q

Aspirin blocks the formations of ….?

A

Thromboxane A2

269
Q

Can Aspirin be used to dissolve existing thrombuses?

A

No, it can only be used to prevent existing throbuses from

270
Q

What is an inotropic medication that increases cardiac contractility to improve perfusion?

A

Dopamine

271
Q

Can PVC’s be treated with antidysrhythmics?

A

No

272
Q

Digoxin is prescribed for patients with…?

A

heart failure, Afib, A-flutter

273
Q

The mu opioid receptor complicates therapy for pain because it can cause….?

A

respiratory depression, dependence and constipation

274
Q

What are three reasons to consider IO route?

A

Shock, seizures, cardiac arrest

275
Q

What might happen if fluid leaks from an IO infusion outside the bone?

A

compartment syndrome

276
Q

Where does medication undergo first-pass metabolism?

A

the liver

277
Q

Where is the buccal region located?

A

between the gum and cheeks

278
Q

Intranasal medication require how much more times the dose of IV medication?

A

2-2.5 times

279
Q

Which 5 medications can be given IN?

A

Narcan, Versed, GlucaGen, Tordol (Ketorolac), Romazicon (Flumazenil), Fentanyl(Sublimaze)

280
Q

What are the sites for IO medications?

A

proximal tibia, femur, distal tibia(medial malleolus), proximal humerus, sternum

281
Q

Which opioid analgesic can cause hypotension?

A

Morphine

282
Q

Which prehospital medications are known to cause fetal harm?

A

Aspirin and Benzos (diazepam, midazolam)

283
Q

Is Lidocaine administered based on pt’s ideal weight or actual?

A

Actual weight

284
Q

A fever is known to suppress the function of the _______ system in the liver, which decreases the rate of metabolism of certain medications.

A

cytochrome P-450

285
Q

hypotension may occur with a dobutamine infusion because?

A

it decreases afterload

286
Q

As a medication undergoes biotransformation, it becomes?

A

metabolite

287
Q

What is a another name for adverse effects, clinical changes not desired and cause some degree of harm?

A

untoward effects

288
Q

Promethazine(Phenergan) is an antiemetic that may cause?

A

hemodynamic and ECG changes

289
Q

In first order elimination, where the plasma levels directly influence the rate of elimination, the more substance in the plasma, the more _______exists.

A

elimination

290
Q

What is the time needed in an average person for the metabolism or elimination of 50% of the substance in the plasma?

A

half-life

291
Q

What is the half-life of Aspirin?

A

15-20 minutes

292
Q

What is the half-life of Klonopin (Clonazepam)?

A

19-50hrs

293
Q

Dopamine is commonly used for?

A

non hypovolemic hypotension

294
Q

first-pass metabolism of a medication occurs when?

A

bioavailability of a medication is reduced before it reaches the circulation

295
Q

Antibiotics and antiseizure medications can cause Stevens-Johnsons syndrome which causes?

A

fatal reactions that mimics a burn

296
Q

What is an example of summation/addition medication interactions where two medications with similar effects combine to produce an effect equal to the sum?

A

Tylenol and Advil which are both antipyretics.

297
Q

What medication can be used to treat tricyclic antidepressant overdose with widening QRS interval, hypotension and arrhythmias?

A

sodium bicarbonate

298
Q

When promethazine(Phenergan) is used with codeine to increase effects over one medication alone; this is an example of?

A

potentiation - one medication enhancing the presence of another, which does not produce the same effect

299
Q

Which cardiac glycoside decreases heart rate and improves contractility?

A

Digoxin (Lanoxin)

300
Q

Calcium Channel blockers common indication includes?

A

reduction of heart rate and BP

301
Q

which alpha receptor inhibits insulin release and suppresses norepinephrine release?

A

Alpha 2

302
Q

Glucagon is used in the treatment of beta-blocker overdose because it?

A

produces positive inotropic and chronotropic effects

303
Q

IV calcium can be used as an antidote to treat?

A

Magnesium Sulfate overdose

304
Q

What do alpha adrenergic receptors do?

A

lower blood pressure

305
Q

Which medication can be used to reduce cerebral edema?

A

Mannitol

306
Q

Which catecholamine stimulates the alpha receptors?

A

Norepinephrine

307
Q

Which medication is needed when acetylcholinesterase is inhibited and acetylcholine increases?

A

Atropine

308
Q

In up to 60% of all patients, morphine sulfate have the side effect of?

A

nausea and vomiting, fentanyl is referred

309
Q

an example of a nondepolarizing paralytic is?

A

Rocuronium - fast onset, longer duration and less side effects than Succ

310
Q

what is an example of a competitive depolarizing paralytic is?

A

Succinylcholine - binds with nicotinic receptors to prevent additional activation of ACh

311
Q

What is a life-threatening side effect of Succ?

A

Hyperthermia with metabolic acidosis and muscle rigidity

312
Q

What is the main effect of dobutamine?

A

increases inotropy

313
Q

What is the effect of Nitroglycerin in cardiac related chest pain?

A

decreases preload and coronary vasodilation

314
Q

What medication is used to decrease gastric acid secretion?

A

histamine-2 receptor antagonist

315
Q

The renin-angiotensin system functions by?

A

vasoconstriction, fluid retention for hypotension or hypoperfusion

316
Q

The vagus nerve releases _______, which acts on the ____________receptors.

A

ACh, muscarinic

317
Q
A

CAL-Jac Paramedic Program (8 decks)

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