Pharmacology

Question 1

Acetylsalicylic Acid (ASA)

Answer 1

Class: NSAID
Action: Platelet inhibition
Dose:
- Non-traumatic CP and suspected ACS: 81 mg x 4; chew and swallow
- STEMI: 81 mg x 4; chew and swallow
Contraindications: Allergy to ASA
Adverse Reactions: none

Question 2

Bronchodilator Metered Dose Inhaler

Answer 2

Class: sympathomimetic
Action: bronchodilator
Dose: Assist pt w/ administering own MDI
Contraindications: sensitivity to drug
Adverse Reactions: tachycardia; palpitations; anxiousness; headache

Question 3

Epinephrine Auto-Injector

Answer 3

Class: sympathomimetic
Action: bronchodilation; positive chronotrope; positive inotrope
Dose: assist pt w/ administering own auto-injector
Contraindications: none
Adverse Reactions: palpitations due to tachycardia or ectopic beats may produce arrhythmia if cardiac disease present; elevated BP; headache; anxiousness

Question 4

Oral Glucose

Answer 4

Class: carbohydrate
Action: quick infusion of sugar into blood for metabolism
Dose:
- AMS/Syncope: 15g PO
- PEDS AMS/Syncope: up to 15g PO
- PEDS Shock: up to 15g PO
Contraindications: none
Adverse Reactions: none

Question 5

Naloxone Hydrochloride (Narcan)

Answer 5

Class: narcotic antagonist
Action: reverse the effects of narcotics
Dose:
-AMS; Syncope; OD; Poisoning : 2-4mg IN; may repeat
- PEDS AMS: 0.1mg/kg IN; max single dose of 2mg; total dose 10mg
- PEDS OD/Poisoning: 2-3mg IN
Contraindications: hypersensitivity to the drug; intubated pt; newly born during initial resuscitation
Adverse Reaction: rapid administration causes projectile vomiting

Question 6

Nitroglycerin

Answer 6

Class: vasodilator
Action: dilates systemic arteries and veins; reduces preload and afterload
Dose:
- Non-traumatic CP: 0.4 mg SL; may repeat q 5 min x 2
- PE/CHF: 0.4 mg SL; may repeat q 5 min if HR > 60 and systolic BP >100 mm Hg
- STEMI: 0.4 mg SL; repeat q 5 mins x 2
Contraindications: hypotension; ED medications w/in 48 hours; hypersensitivity to nitrates or nitrites
Adverse Reaction: hypotension

Question 7

Oxymetazoline 0.05% Spray (Afrin)

Answer 7

Class: sympathomimetic
Action: direct local vasoconstriction
Dose:
- Epistaxis/PEDS epistaxis: 2 sprays each nostril, follow w/ direct pressure
Contraindications: MAOI use within 14 days
Adverse reactions: none

Question 8

Phenylephrine (Neo-Synephrine)

Answer 8

Class: sympathomimetic
Action: direct local vasoconstriction
Dose:
- Epistaxis/PEDS epistaxis: 2 sprays each nostril; follow w/ direct pressure
Contraindications: ventricular tachycardia; severe CAD; head injury w/ AMS
Adverse Reaction: none

Question 9

General key procedure considerations for medication administration

Answer 9

a. inquire about allergies and previous medication sections
b. check and recheck medications
c. solution clarity and expiration date
d. right drug
right patient
right dose
right time
right route
right documentation
e. dispose of syringe and other material in proper container