Pharmacology Flashcards
Define Pharmacodynamics
The study of how a medication alters a function or process within the body
Define pharmacokinetics
The action of the body on a medication.
Endogenous chemicals
Produced from within the body
Exogenous chemicals
Produced outside the body
Agonist medications
Initiate or alter a cellular activity by attaching to receptor sites, prompting a cell response
Antagonist medications
Prevent endogenous or exogenous agonist chemicals from reaching cell receptor sites and initiating or altering a particular cellular activity.
Affinity
The ability of a medication to bind with a particular receptor site
LR
Other name
Hartmann
LR
Mechanism
Replace water and electrolytes
LR
Indicate
Hypovolemic shock
TKO line
Hypoperfusion
LR
Contra
Don’t use in pt w renal failure or heart failure
LR
Side affects
Rare
LR
Drug interactions
Few in emergency setting
LR
Adult dose
Hypovolemic shock- titrate to CTC response
Hypoperfusion- 20ml/kg over 15 min
LR
Pediatric dose
Hypovolemic shock- titrate to CTC response
Hypoperfusion- 20ml/kg over 15 min (neonate- 10ml/kg over 5-10 min)
LR
Duration
Short term therapy
0.9% Sodium Chloride
Other names
Normal Saline
NS
NS
Class
Isotonic crystalloid solution
NS
Mechanism
Replace water and electrolytes
LR
Class
Isotonic crystalloid sol
NS
Indication
Hypovolemia
TKO line
Heat problems
DKA
Fresh water drowning
NS
Contra
Do not use in pt with renal and heart failure
NS
Side effects
Rare
NS
Drug interactions
Few in emergency setting
NS
Adult and Ped dose
Situational
NS
Duration
Short term therapy
Nitroglycerin
Other names
Nitrostat
Nitrobid
Tridil
Nitro
Class
Vasodilator
Nitro
Mechanism
Relax the smooth muscle of the vessels, bronchial, uterine, and intestine
Dilate peripheral vessels
Decrease preload/ after load which decreases the myocardial ox demand
Nitro
Indication
Acute angina pectoris
Ischemic angina
HTN
Heart failure
Pulmonary edema
Nitro
Contra
Hypotension
Hypovolemia
ICH
Pericardial tamponade
Severe Brady or tachycardia
RV infarct
ED meds within 24 hours
Nitro
Side effects
Headache
Dizziness
Weakness
Reflex tachycardia
Syncope
Hypotension
N/v
Dry mouth
Muscle twitch
Diaphoresis
Nitro
Drug interactions
Additive effect with other vasodilation meds
Incompatible with other IV drugs
Nitro
Adult dose
0.4 SL q 3-5 min up to 3 doses
IV infusion: begin at 10mcg/min, increase by 10 mcg q 3-5 min. Titrate prn up to 200mcg/min
Nitro
Ped doses
Not recommended
Nitro
Duration
Onset: 1-3 min
Peak: 5-10 min
Duration: 20-30 min
Nitro
Consider
Pregnancy caution C
Rule out RV infarct w right sided ekg if an interior MI is noted
FDA Preg category A
No evidence of risk to baby
FDA preg category B
No human trials but animal fetus had no risk/ harm
FDA preg category C
Animal studies showed adverse affects on fetus however situational use may warrant for a mother to have medication based on a benefit to risk analysis
FDA preg category D
Positive evidence of human fetal risk but the med still may be given to mom based on a benefit to risk analysis
FDA preg category X
Studies show that these medications have serious fetal risks that clearly outweigh the benefit
FDA preg category N
FDA has not classified the drug
Epi
Class
Sympathomimetic
Epi
Mechanism
Agonist of:
Alpha (vasoconstrict)
beta1 (positive inotrope, chronotrope, dromotrope)
Beta2 (relax and dilated smooth muscle vasculature)
Blocks histamine receptor
Epi 1:10
Indication
Cardiac arrest (asystole, PEA, pulses Vtach, Vfib)
Symptomatic bradycardia alt to dopamine
Hypotension from Hypovolemia
Epi contra
None in emergency
10 rights
Pt
Med
Dose
Route
Time
Documentation
Assessment
To refuse
Evaluation
Pt education
Epi side effect
Nervous
Restless
Headache
Tremor
Pulmonary edema
Dysthymia
Chest pain
Hypertension
Tachycardia
N/V
Epi 1:10 adult dose
1 mg IV/IO q 3-5 min
2-2.5 mg in 10mL NS via ET tube
Push dose- 2-10 mcg/min titrated
Epi 1:10 ped dose
0.01 mg/kg IV/IO q 3-5 min for cardiac arrest and symptomatic bradycardia
Push dose- 1mcg/kg q 2-5 min IV/IO
Epi duration
Onset- immediate
Peak- minutes
Duration- several minutes
Epi considerations
Preg caution C
Contraindicated in active labor
Could cause syncope with asthma kid
May increase myocardial ox demand
Epi push dose indication
Severe Hypotension and Bradycardia
(Not due to Hypovolemic shock)
Epi 1:1 indication
Anaphylaxis
Asthma
Epi
Drug interactions
Potentiates other sympathomimetic
Deactivated by alkaline solutions
MAOI might potentiate Epi
Beta blocker may blunt Epi effects
Epi 1:1
Adult dose
0.3-0.5 IM
Epi 1:1
Ped dose
Anaphylaxis/ asthma 0.01 mg/kg IM up to 0.3 mg
Stridor 0.25-0.5 mg/kg in 3mL nebulized
Aspirin
Other names
Acetylsalicylic acid
ASA
ASA
Class
Platelet inhibitor
Anti inflammatory
ASA
Mechanism
Prevents thromboxane A2 formation (stopping platelet aggregation)
Antipyretic
Analgesics
ASA
Indication
Acute chest pain
ACS
ASA
Contra
Hs
Acute ulcer disease
Asthma
ASA
Side effects
Bronchospasm
Anaphylaxis
Wheezing
Prolonged bleeding
GI bleeding
Epigastric distress
N/V
Reye syndrome
ASA
Side effects
Bronchospasm
Anaphylaxis
Wheezing
Prolonged bleeding
GI bleeding
Epigastric distress
N/V
Reye syndrome
ASA
Drug interactions
Caution with NSAID allergy
ASA
Adult dose
160-325 mg PO chew
ASA
Ped dose
Not recommended
ASA
Duration
Onset 5-30 min
Peak 1-3 hours
Duration 3-6 hours
ASA
Considerations
Preg caution D
Administer ASAP for ACS
Nitropaste
Other name
Nitrobid ointment
Nitropaste
Adult dose
1/2 - 1/3 inch (30-50mg)
Cover with wrap and secure with tape
Max 5 inch line per application
Nitropaste
Ped dose
Not recommended
Ondansetron HCL
Other name
Zofran
Zofran
Class
Serotonin receptors agonist
Antiemetic
Zofran
Mechanism
Blocks serotonin action
(Serotonin naturally causes N/V)
Zofran
Indication
Prevent and control N/V
Zofran
Contra
HS
Zofran
Side effect
Headache
Malaise
Wheezing
Bronchospasm
Afib
Abnormal EKG
Prolonged QT interval
ST segment depression
2nd degree AV block
Constipation
Diarrhea
Hives
Skin rash
Drug interaction
Not recommend if pt take apomorphine, mesoridazine, thioridazine
Zofran
Adult dose
4mg IM/IV/PO/SL May repeat once after 10 min
Acute motion sickness- repeat every 6 hours
Zofran
Ped dose
6 months- 14 years
0.15 mg/kg IV/PO Mac of 4 mg
Zofran
Duration
Onset 30 min
Peak 2 hours
Duration 3-6 hours
Zofran
Consideration
Preg caution B
How do we carry Zofran
Vial of 4mg/2ml
Or 4mg tablets SL
How is Nitropaste Carried
30g of 2% ointment
How is nitro carried
0.4 mg nitro per spray SL
0.4 mg tablets SL
50mg/10ml iv infusion
How do we carry Epi
1mg/10ml preloaded syringe
1mg/1ml vial
How do we carry ASA
81 mg chewable tablets