Pharmacology 2 Flashcards by shannon smith

Diphenhydramine

BENADRYL
CLASS:antihistamine
MOA: prevent histamine from reaching the receptor sites
INDICATIONS: reduce bronchi spaz,rashes,hives associated with allergic reactions
CONTRAINDICATIONS: severe asthmatic or COPD
ADVERSE: hypotension,reflex tachy,sedation,thick secretions
DOSE: 25-50 mg IV ,IM

How well did you know this?

Not at all

Perfectly

Where are H1 receptor sites

Smooth muscle, bronchi

How well did you know this?

Not at all

Perfectly

Where are H2 receptor sites

Stomach mucosa, and responsible for secretion of gastric acids

How well did you know this?

Not at all

Perfectly

When histamines are released what happens

Widening of capillaries, decreased BP, increased gastric juice,tightening if bronchi muscles, increased mucus production-due to decrease in capillary membrane

How well did you know this?

Not at all

Perfectly

Ketamine

KETALAR
CLASS: anesthetic
MOA: dissociative anesthesia; dissociates CNS from outside stimuli
INDICATIONS: Agitated delirum
DOSE: IM
MFD 4mg/kg

How well did you know this?

Not at all

Perfectly

Promethazine

PHENERGAN
MOA: blocks H1 receptors (smooth Muscle) without blocking the secretions of histamine.
INDICATIONS: allergy, motion sickness, nausea & vomiting, sedation
DOSE: 25 mg IM or IV

How well did you know this?

Not at all

Perfectly

Famotidine

MOA

Dose: 20mg. Or 2.0mg/kg

How well did you know this?

Not at all

Perfectly

Epineprhine

ADRENALIN
MOA: Sympathomimetic-alpha and beta stimulating
Alpha:vasoconstriction
Beta 1:increase heart rate- positive chronotrope- Increases strength of contraction-positive inotrope
Beta 2: relaxes bronchiolar smooth muscle
INCREASES CARDIAC OUTPUT
INDICATIONS: PNB, Hypotension, Shock, Asthma, Allergic reaction
DOSE;1:10,000= 1mg in arrest
0.3-0.5 mg 1:1000 allergic
1mg in 250 ml NS - infusion

How well did you know this?

Not at all

Perfectly

Vasopressin

MOA: High doses acts as a non-adrenergic peripheral VASOCONSTRICTOR-direct stimulation of smooth muscle
INDICATIONS: ventricular fibrillation, pulseless vent tachy, Asystole, PEA
MAy replace EPI in either first or second dose.
DOSE: 40 Units

How well did you know this?

Not at all

Perfectly

Isuproterenol

ISUPREL
MOA: Sympatohmimetic
Beta only
BETA 1 Positive chronotrope-rate SA & AV–positive inotrope-force
BETA 2: basodilation of renal, skeletal and mesenteric circulation–relax bronchiolar smooth muscle
INDICATIONS: Symptomatic Bradycardia with pulses–NEVER FIRST LINE

How well did you know this?

Not at all

Perfectly

Norepinephrine

LEVOPHED
MOA: sympathomimetic-pressor-alpha and beta stimulating.
ALPHA-peripheral vasoconstriction-increases BP
BETA 1 ONLY- increases strentgh of contraction-positive inotrope
INDICATIONS: severe hypotension

How well did you know this?

Not at all

Perfectly

Dopamine

DOPASTAT
MOA: sympathomimetic-alpha and beta stimulating-PRESSOR
ALPHA: peripheral vasoconstriction-increases BP
BETA 1: increases heart rate-positive chronotrope-increases strength of contraction-positive inotrope
INDICATIONS: Hypotension, Shock
DOSE:traditional range-2-20 mcg/kg/min– 400mg/250 ml NS

How well did you know this?

Not at all

Perfectly

Atropine

ALWAYS FIRST LINE FOR SYMPTOMATIC BRADY
MOA: Parasympatholytic-beta blocker
reduces vagal tone. Positive chronotrope-increases rate of discharge of SA node.
Increases rate of impulse conduction of AV node
INDICATIONS: Symptomatic Bradycardia-with pulses
Hypotension, altered mental status, signs of shock
DOSE: 0.5mg IV bolus–3 mg total

How well did you know this?

Not at all

Perfectly

Adenosine

ADENOCARD
MOA: Negative Chronotrope-decreases heartrate. Depresses conduction through AV node to interrupt re-entry. Depresses sinus node Activity
INDICATIONS: Stable SVT with narrow QRS
DOSE: 6 mg initial rapid IV, 12 mg second, total 30 mg..follow with 20 ml saline flush

How well did you know this?

Not at all

Perfectly

Digitalis

No dose

How well did you know this?

Not at all

Perfectly

Isuprel

No dose

How well did you know this?

Not at all

Perfectly

Lidocaine

MOA anesthetic-quiets ventricles

NO DOSE

How well did you know this?

Not at all

Perfectly

Mag sulfate

MOA stabilize cell membranes
DOSE: torsdes de pointes pulseless 1-2gr in 10ml D5W
Pulse: 1-2gr in 50-100ml D5

How well did you know this?

Not at all

Perfectly

Norepinephrine

MOA : sympathomimetic - pressor

Alpha and beta stimulator

How well did you know this?

Not at all

Perfectly

Amiodarone

MOA: anti arrhythmic
DOSE: pulseless vtach 1st 300mg iv. 2nd 150mg iv

Pulse: 150 mg in 100ml D5W

How well did you know this?

Not at all

Perfectly

Calcium chloride

MOA: positive inotrope / positive inotrope
DOSE: 500-1000mg

How well did you know this?

Not at all

Perfectly

Diltiazem

MOA: calcium channel blocker
DOSE: iv 0.25 mg/kg
**15 min repeat dose 0.35mg/kg

How well did you know this?

Not at all

Perfectly

sodium bicard

1 meq/kg IV

How well did you know this?

Not at all

Perfectly

Procainamide

20 mg/min IV

50 mg/min IV URGENT situations

How well did you know this?

Not at all

Perfectly

Promethazine

Antihistamine, GI agent | DOSE: 25 mg Allergy

Verapamil

Calcuim Channel Blocker | DOSE: 5mg IV----2.5 mg at a time

What drug is used for Torsades de pointes and dose

Mag Sulfate pulseless 1-2 g in 10 ml D5W pulse 1-2 g in 50-100 ml D5W

What drug is used for Eclapmsia

Mag sulfate-lowers BP--2-4 grams

What drug/drugs could we use for hyperkalemia

Sodium Bicarb and Calcium chloride

What drugs

test

what does Ispurel do directly to BP

lower it and causes hypotension

what drug can be given to A Fib of 220 to slow HR

verapimil diltrazem

what are other names for verapamil and diltiazem

verap (isoptim, calan, verelan) | dilt (cardizem)

what are the actions of verapimil and diltiazem

negative chronotrope(av) negative inotrope coronary and vaso dilation

why would calcium channel blocker cause congestive heart failure or make worse

both are negative inotrope: decreases force of heart

you would administer dilt/verap to narrow QRS tachy only in what situation

if adenosine doesn't work

calcium channel blockers are contradicted in what tachy rhythms

WPW in A-fib, V-tach, wide QRS of unknown origin

if a pt. recieves _____ you can not five a calcium channel blocker

IV Beta blocker

Decribe the first and second dose of dilt

.25 mg/kg over 2 min and .35 mg/kg over 2 min

describe the first and second dose of verapamil

initial dose 5mg repeat dose 5-10 mg

what can be tried 1st instead of CCB in a stable patient

vagal maneuvers

patient in A-fib, hypoterisve and deteriorating rapidly what do you do

cardio version

you have overdosed your patient of verapmil, what drug can you give to prevent toxic effects

calcium chloride

what is dose of calcium chloride?

500-1000 mg

administer verapmil with extreme caution if at all to patient on

digoxin or digitulis

what is a non-overdose indication of calcium chloride

give to patient with suspected hyperkalinia helps stabalize myocordid cell

what does bicarb do?

decreases acid by combining with H+ and then eliminates CO2 with ventilation

what mus patient be doing when giving bicarb

breathing or vic ett

what is dose of bicarb?

1 meq/kg

never mix bicarb with____?

calcium catecholamines

what overdose would bicarb help with?

cyclic antidepressants

what are indications for Magnesium Sulfate

torsade de pointes, Eclampsia, Asthma

what is the dose of mag when treating torsade de pointes

pulseles: 1-2g in 10ml D5W, 1-2g in 50 -100 D5W

what are two actions of mag that help treat Eclampsia

smooth muscle relaxer=vasodilation | CNS depressant

what are two main actions of adenosine

negative chronotrope, weak bronchoconstrictor

what are top 3 side effects of adenosine

flushing, dypnea, chest pressure

what is dosing of adenosine in clude max

.6mg Rapid 1.0mL saline flush | (repeat) 12mg Rapid, 12mg Rapit total of 30 mg

list 4 steps of administrate for adenosine to be most effective

central circ IV, give as close to site as possible, inject rapid, flush needed

describe how adenosine is beneficial in A-fib/Aflut

may help to diagnose but will not treat

what are the symptomatic NS actions of amidoarone

Alpha Blocker-Vasodilation | Beta Blocker- Negative Chronotrope, Negative inotrope

What channels does iF affect

Sodium channels, potassium, calcium -Slow conduction through vents slow HR - increases AV node conduction, increases refrat

what two PNB rhythms may receive amiodarone

V-tach, V-Fib

what are side effects of amiodarone

hypotension-Alpha blocker Brady- Beta blocker AV block TDP

amidodarone dose in PNB

300mg iv, 150mg in 3-5 min

amiodarone dose in tachy with a pulse

150mg in 100mL D5W over 10 min

procanamide should be given until...?

dysrhythmia is suppressed QRS duration increased by 750% hypotension total dose of 17mg/kg

procainamide decreases excitability in what part of the heart

ventricles, atria, purkinje fibers

do NOT use procainamide in what vent rhythm

torsades

what action does lido have that amiodarone nor procainamide have

helps decrease ICP and is an anestheic

list the CNS side effects of lido

altered LOC, slurred speech, visual disturbances, muscle twitching, seizures

what are the endogenous catecholamides

Epi nor epi dopmine

what are some indications for using a beta blocker

reduce angina and v-fib, SUT's, hypertension, migraine, profuse sweating tremors

what can you treat a beta blocker overdose with

glucagon

list the antidysrhythmic drugs

adenosine, amiodarone, pigoxin, lidocaine, procainamidl, verapamil

list the sympathomimetic drugs

dopamine, isoproterenol (isuprel), epi, nor epi

list the calcium channel blocker

diltiazem, verapamile

list some electrolyte drugs

calcium chloride, mag sulfate, sodium bicarb

the dopaminergic effects occur mainly at what rate?

1-4 mg/kg/min

describe what happens when dopamine is infused at 5-10mcg/kg/min

primarily beta, some vasoconstriction, more closer to 10

10-20 mcg/kg/min of dopamine results in...?

predomiraley alpha with substantial vasoconstriction

finish this at 10 mcg/kg/min you run dopamine at...?

20,30,40

what cardiac arrest drugs can be admin. through the ett

Epi vasopressin, also used to be lido and atrophine

indications for vasopressin

cardiac arrest

dose of vasopressin..can you repeat dose?

no and 40 units, 2 vials

how is vasopressin different from other pressors

bolus only in units, long half life 10-20 mins, not as irritating/stimulating to the heart not alpha or ans

what are the signs and symptoms of symptomatic brady?

``` chest pain (ischemic) hypotension signs of shock altered IOC acute heart failure ```

first line drug for symptomatic brady is and why?

atrophine: only action is to increase heart rate- no other demand on heart-

what is first line non drug for symptom brady

trancutaneous pacing

describe atrophine using ANS words

``` parasympatholytic parasympathetic blocking vagolytic anticholinergic positive chronotrope ```

what is non-cardiac use for atropine

organophosphate poison

what is dose of atropine..what happens if you give a less amount of dose

Brady- .5mg IV max 3mg, it will slow heart rate

what is max doses of atropine

3mg and .04mg/kg

what side affect of atropine can interfere with assesment

dilated pupils

atropine may not work in sympt. Brady if the patient is...?

hypotnesive, can't get where needs to go or heart can't respond

another and chronotrope you could after atropite, dopamine, epi, and a TCP is...?

isuprel

using ANS terms describe isuprel

pure beta and positive chronotrope and positive inotrope | sympathomimetic, catecholamine

list 4 steps of administrate for adenosine to be most effective

central circ IV, give as close to site as possible, inject rapid, flush needed

describe how adenosine is beneficial in A-fib/Aflut

may help to diagnose but will not treat

what are the symptomatic NS actions of amidoarone

Alpha Blocker-Vasodilation | Beta Blocker-Chronotrope, Negative inotrope

What channels do Amiodarone affect

Sodium channels, potassium, calcium -Slow conduction through vents slow HR - increases AV node conduction, increases refrat

what two PNB rhythms may receive amiodarone

V-tach, V-Fib

what are side effects of amiodarone

hypotension-Alpha blocker Brady- Beta blocker AV block TDP

amidodarone dose in PNB

300mg iv, 150mg in 3-5 min

amiodarone dose in tachy with a pulse

150mg in 100mL D5W over 10 min

procanamide should be given until...?

dysrhythmia is suppressed QRS duration increased by 750% hypotension total dose of 17mg/kg

procainamide decreases excitability in what part of the heart

ventricles, atria, purkinje fibers

do NOT use procainamide in what vent rhythm

torsades

what action does lido have that amiodarone nor procainamide have

helps decrease ICP and is an anestheic

list the CNS side effects of lido

altered LOC, slurred speech, visual disturbances, muscle twitching, seizures

what are the endogenous catecholamides

Epi, nor epi ,dopmine

what are some indications for using a beta blocker

reduce angina and v-fib, SVT's, hypertension, migraine, profuse sweating tremors

what can you treat a beta blocker overdose with

glucagon

list the antidysrhythmic drugs

adenosine, amiodarone, digoxin, lidocaine, procainamidl, verapamil

list the sympathomimetic drugs

dopamine, isoproterenol (isuprel), epi, nor epi

list the calcium channel blockers

diltiazem, verapamile

list some electrolyte drugs

calcium chloride, mag sulfate, sodium bicarb

the dopaminergic effects occur mainly at what rate?

1-4 mg/kg/min

decribe what happens when dopamine is infused at 5-10mcg/kg/min

primarily beta, some vasoconstriction, more closer to 10

10-20 mcg/kg/min of dopamine results in...?

predomiraley alpha with substantial vasoconstriction

finish this at 10 mcg/kg/min you run dopamine at...?

20,30,40

what cardiac arrest drugs can be admin. through the ett

Epi vasopressin, also used to be lido and atrophine

indications for vasopressin

cardiac arrest

dose of vasopressin..can you repeat dose?

no and 40 units, 2 vials

how is vasopressin different from other pressors

bolus only in units, long half life 10-20 mins, not as irritating/stimulating to the heart not alpha or ans

what are the signs and symptoms of symptomatic brady?

``` chest pain (ischemic) hypotension signs of shock altered IOC acute heart failure ```

first line drug for symptomatic brady is and why?

atrophine: only action is to increase heart rate- no other demand on heart-

what is first line non drug for symptom brady

trancutaneous pacing

describe atrophine using ANS words

``` parasympatholytic parasympathetic blocking vagolytic anticholinergic tchrontrope ```

what is non-cardiac use for atropine

organophosphate poison

what is dose of atropine..what happens if you give a less amount of dose

Brady- .5mg IV max 3mg, it will slow heart rate

what is max doses of atropine

3mg and .04mg/kg

what side affect of atropine can interfere with assesment

dilated pupils

atropine may not work in sympt. Brady if the patient is...?

hypotnesive, can't get where needs to go or heart can't respond

another pos chronotrope you could after atropite, dopamine, epi, and a TCP is...?

isuprel

using ANS terms describe isuprel

pure beta and chronotrope and inotrope | sympathomimetic, catecholamine