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Pharmacology Flashcards

1
Q

ACE Inhibitor

A
  • Management of heart failure; Decreases BP; Decreases cardiac remodeling
  • angioedema (benadryl)
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2
Q

Albumin

A
  • Tx of low protein / patients with extravasation of fluid to the third spaces (think post burn or post resuscitation from sepsis)
  • increases the oncotic pressure and draws fluid back into the vasculature and out of interstitial spaces
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3
Q

Amiodarone

A

ACLS Dosage:
- VTach without pulse/V-fib = 300 mg IV/IO; 150 mg IV/IO
- VTach with a pulse: 150 mg
- Cardiac Phase - 3 / Class III drug

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4
Q

Atropine

A
  • Management of organophosphate poisoning
  • Management of symptomatic bradycardia
  • Pre-tx for RSI with pediatric pts (<5 yrs)
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5
Q

Betamethasone / Dexamethasone

A
  • Steroid to assist with fetal lung development in premature infants
  • Given via IV to mother for pre-term labor
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6
Q

Calcium Chloride

A
  • For magnesium toxicity
  • For EKG changes in presence of crush injury
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7
Q

Cerebryx (Fosphenytoin)

A
  • Second line seizure therapy (if benzos are not working)
  • Given for prophylactic seizure tx in TBI pts
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8
Q

Crofab

A
  • Admin for snake envenomation with acute symptoms of neurological dysfunction or tissue compromise
  • Multiple vials over hours are needed for complete tx
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9
Q

Cyanokit (Hydroxocobalamin)
(amyl nitrate/sodium nitrate/sodium thianosulfate)

A
  • admin when exposed to cyanide (fire or Nipride infusion without protective bag)
  • Sx of cyanide toxicity inc: tachycardia and hypertension with presence of toxicity pathology
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10
Q

Dantrolene

A
  • antidote for malignant hyperthermia
  • sx onset after paralytic is administered (inhaled anesthetics or Anectine)
  • S/S inc: increased ETCO2, increased HR, increased temp
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11
Q

DDAVP (Desmopressin)

A
  • Tx diabetes insipidus by working on the hypothalamus
  • Therapeutic levels are present when pt has a decrease in urine output back to 30-50 ml/hr (adults)
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12
Q

Demerol

A
  • Pain mgmt
  • Not utilized with most RSI protocols
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13
Q

Diazoxide

A
  • tx: hypoglycemia caused by pancreas cancer, surgery, or other conditions.
  • works by preventing release of insulin from the pancreas
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14
Q

Dilantin (Phenytoin)

A
  • Second line seizure therapy when benzos are not controlling seizures
  • Prophylactic seizure tx in TBI pts
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15
Q

Dobutamine

A
  • Vasopressor therapy
  • Seen with cardiogenic shock patients as it increases SV
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16
Q

Dopamine

A
  • Tx hypotension
  • Caution with pts with increased lactate or cardiac dysfunction due to causing lg increase in O2 demand due to increased HR
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17
Q

Epinephrine

A
  • ACLS protocols (epi every 3-5 min; IV/IO)
  • Admin for catecholamine dependent pts that are hypotensive prior to RSI
  • Admin for hypotension (push dose pressor for adults)
    – 1cc of 1:10,000 Epi and mix with 9 cc NS
    – Admin 0.5-2.0 mL per dose which is 5-20 mcg.
    – Need more than 3? consider Epi infusion at 2-10 mcg/min
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18
Q

Etomidate

A
  • sedative for RSI admin at 0.3 mg/kg
  • can only utilize 1x, due to adrenal suppression
  • contraindicated in septic pts or anyone with adrenal insufficiency
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19
Q

Fentanyl

A
  • Tx: pain mgmt and post RSI to assist with discomfort
  • Pt intubated? admin with sedation as well
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20
Q

Heparin

A
  • Admin in central lines to keep them from occlusion
  • Prior to using central line that was d/c, withdraw 10-20 mL of blood from the line and discard
  • Also admin to AMI pts in the cath lab, or during the clotting stages of DIC
  • reversal: protamine
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21
Q

Hydralazine

A
  • Admin for hypertension
  • Can be given to OB pts for pre-eclampsia tx of HTN while Mag Sulfate is being set up
  • Also seen with acute HTN
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22
Q

Indomethacin

A
  • Given in NICU for a pt with a fetal duct that is open and the presence of a ductal dependent cardiac lesion that is not present.
  • When the doc wants to close the duct, Indomethacin is admin.
  • NSAID - decreases the prostaglandin synthesis and allows the ducts to close (prostaglandins keep ducts open)
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23
Q

Integrillin

A
  • Admin for NSTEMI pts or pts in the cath lab to decrease clotting size from extending (attempting to decrease the extension of the MI)
24
Q

Ketamine

A
  • Utilized for sedation with RSI at 2 mg/kg
  • IV infusion to maintain sedation post intubation at 0.75-1 mg/kg/hr to achieve RASS -4 to -5
  • Also used for procedural sedation and pain mgmt refractory to Fentanyl
25
Labetalol
- beta-blocker admin for hypertension - admin 20 mg, then repeat at 40 mg after 5 mins, and then repeat at 80 mg after 5 mins. Continue at 80 mg per dose to a max total of 300 mg.
26
Levothyroxine
- Admin for hypothyroidism with lvls of T3/T4 are decreased and pt is symptomatic with bradycardia, decreased RR, declining LOC.
27
Lidocaine
- ACLS guidelines
28
Magnesium Sulfate
- Smooth muscle relaxer - Admin for pre-term labor, tachysystole, pre-eclampsia, and severe asthma
29
Mannitol
- Osmotic diuretic used to treat increased ICP with head injuries - Admin to decrease CSF to decrease ICP in attempt to prevent herniation - Given as SIVP at 1 mg/kg
30
Methergine
- Admin to mothers post-delivery with post-partum hemorrhage (blood loss >500mL during and after delivery)
31
Milrinone
- Primarily used with pediatric heart failure with decreased cardiac output - Works on RV (and LV) to increase cardiac SV and thus increases CO treating hypotension
32
Mucomyst (N-acetylcysteine)
- Admin for Tylenol OD - Inhaled med
33
Neostigmine (Prostigmin)
- Cholinesterase inhibitor - Blocks acetylcholinesterase / increases the amount of acetylcholine present - Stimulates both muscarinic and nicotinic receptors - Admin for pts with muscular disorders like myasthenia gravis or reversal of non-depolarizing NMB agents (paralytics) during surgery - Does NOT cross the BBB
34
Phyostigmine
- Cholinesterase inhibitor - Blocks acetylcholinesterase / increases the amount of acetylcholine present - Crosses the BBB - Tx: anticholinergic syndrome (cx by atropine, jimson weed, diarrhea meds OD, GHB, etc) - S/S of anticholinergic syndrome are increased temp without sweating, tachycardia, agitation progressing to delirium
35
Neosynephrine (Phenlyephrine)
- Tx: hypotension as an infusion or a push dose pressor therapy - For PDP - take 10 mg Neosynephrine and place in 250 mL NS. Take out 10 mL of the solution and admin 0.5-2 mL or 50-200 mcg/dose.
36
Nicardipine (Cardene)
- Calcium channel blocker - Admin for hypertension - Works quickly, but effects rapidly subside when infusion is stopped
37
Nimodipine
- Admin for subarachnoid hemorrhage - Pts to decrease vasospasms, which -- if present -- cause significant sequelae due to decrease blood supply; and, therefore, decrease oxygenation to that brain area.
38
Nipride (Nitroprusside)
- Admin for HTN - Needs protective black bag over the infusion IV bag or light will react with the med and cx a chemical reaction to cyanide. Observed as increased BP and HR with potential decreased LOC during infusion
39
Nitric Oxide
- Admin for persistent pulmonary HTN where the pulmonary resistance is 2/3 or higher the systemic vascular resistance - Inhaled and is a pulmonary vasodilator at 10-20 ppm - When doses are >60-80 ppm, can see systemic vasodilation and may need to be admin with a vasopressor to increase SVR while decreasing PVR
40
Norepinephrine
- admin for severe hypotension, as an infusion - not available as a push dose pressor - first line pressor in presence of distributive shock (sepsis/SCI) due to a strong alpha effect leading to profound vasoconstriction, but no increase in HR - good for pts who are O2 demand intensive, as it does not increase demand substantially since there is not an increase in HR
41
Octreotide (Sandostatin)
- Admin to decrease portal hypertension by dilating the portal vein - used with pts whom have esophageal varices so the blood can return the normal flow from the esophagus to the liver via decreased portal pressure
42
Oxytocin (Pitocin)
- admin for EMS and HEMS to stimulate uterine contraction after delivery to treat post-partum hemorrhage - Admin in hospital to induce labor/increase the strength and regularity of contractions - If being admin to pt and they are noted to have >5 contractions in 10 mins (tachysystole), then the infusion of oxytocin should be stopped / rate decreased
43
Phenobarbital
- Third line med to tx seizures - Can induce coma with med to prevent seizure activity
44
Prostaglandin E1 (PGE1)
- Admin for NICU pts with congenital heart defects that are ductal dependent lesions; keeps ducts open so the blood can mix - used to get the pt to definitive care (or until surgical intervention is performed to repair the defect)
45
Rhogam
- admin to women of child-bearing age when they are Rh- for their blood typing and they are either given blood products which are Rh+ or they deliver a baby, suffer a trauma while pregnant, or have a miscarriage.
46
Rocuronium
- Dosage: 1 mg/kg - Non-depolarizing paralytic - Duration of action 20-30 mins - Reversal agent = Neostigmine
47
Romazicon
- Reversal agent for benzodiazepine OD
48
Sodium Bicarb
- Admin to tx acidosis - Admin for increased ICP due to head injury - Tx crush injury
49
Succinylcholine
- Dose: 1-1.5 mg/kg - Depolarizing paralytic (+fasiculations) - Contraindicated with hyperkalemia, myasthenia gravis, burns > 24 hours, renal failure without dialysis, penetrating eye injury, etc. - Caution for malignant hyperthermia - Reversed with Dantrolene
50
Terbutaline
- Admin at 0.25 mg SQ - Smooth muscle relaxer used to tx pre-term labor and severe asthma attacks. - Caution with simultaneous admin with Mag Sulfate (can cause pulmonary edema)
51
Tridil
- Nitroglycerin admin IV for pts with AMI
52
Tranexamic Acid
- Admin for pts with severe hemorrhage to prevent the breakdown of clots already formed by the pt - Dose: 1 g in 100mL over 10 mins; then 1g in 500 mL over 8 hours and admin at 62.5 mL/hr
53
Vasopressin (ADH)
- Admin for hypotension esp in septic and GI hemorrhage pts
54
Vecuronium
- Non-depolarizing paralytic - Duration of action about 45 mins - Not often used in EMS unless airway already estb and prolonged paralysis desired (ex: ARDS pt in 2:1 ratio who requires sedation and paralysis to tolerate vent settings that treat their severe hypoxemia)
55
Versed
- Benzo - admin for sedation post intubation or seizure mgmt - admin for combative pts on PCP, bath salts, etc.

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