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Pharmacology 2 Flashcards

1
Q

Diphenhydramine

A

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

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2
Q

Where are H1 receptor sites

A

Smooth muscle, bronchi

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3
Q

Where are H2 receptor sites

A

Stomach mucosa, and responsible for secretion of gastric acids

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4
Q

When histamines are released what happens

A

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

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5
Q

Ketamine

A 
KETALAR
CLASS: anesthetic
MOA: dissociative anesthesia; dissociates CNS from outside stimuli
INDICATIONS: Agitated delirum
DOSE: IM
MFD 4mg/kg
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6
Q

Promethazine

A

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

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7
Q

Famotidine

A

MOA

Dose: 20mg. Or 2.0mg/kg

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8
Q

Epineprhine

A

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

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9
Q

Vasopressin

A

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

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10
Q

Isuproterenol

A

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

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11
Q

Norepinephrine

A

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

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12
Q

Dopamine

A

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

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13
Q

Atropine

A

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

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14
Q

Adenosine

A

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

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15
Q

Digitalis

A

No dose

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16
Q

Isuprel

A

No dose

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17
Q

Lidocaine

A

MOA anesthetic-quiets ventricles

NO DOSE

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18
Q

Mag sulfate

A

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

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19
Q

Norepinephrine

A

MOA : sympathomimetic - pressor

Alpha and beta stimulator

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20
Q

Amiodarone

A

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

Pulse: 150 mg in 100ml D5W

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21
Q

Calcium chloride

A

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

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22
Q

Diltiazem

A

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

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23
Q

sodium bicard

A

1 meq/kg IV

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24
Q

Procainamide

A

20 mg/min IV

50 mg/min IV URGENT situations

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25
Q

Promethazine

A

Antihistamine, GI agent

DOSE: 25 mg Allergy

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26
Q

Verapamil

A

Calcuim Channel Blocker

DOSE: 5mg IV—-2.5 mg at a time

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27
Q

What drug is used for Torsades de pointes and dose

A

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

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28
Q

What drug is used for Eclapmsia

A

Mag sulfate-lowers BP–2-4 grams

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29
Q

What drug/drugs could we use for hyperkalemia

A

Sodium Bicarb and Calcium chloride

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30
Q

What drugs

A

1

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31
Q

test

A

test

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32
Q

what does Ispurel do directly to BP

A

lower it and causes hypotension

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33
Q

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

A

verapimil diltrazem

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34
Q

what are other names for verapamil and diltiazem

A

verap (isoptim, calan, verelan)

dilt (cardizem)

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35
Q

what are the actions of verapimil and diltiazem

A

negative chronotrope(av)
negative inotrope
coronary and vaso dilation

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36
Q

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

A

both are negative inotrope: decreases force of heart

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37
Q

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

A

if adenosine doesn’t work

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38
Q

calcium channel blockers are contradicted in what tachy rhythms

A

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

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39
Q

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

A

IV Beta blocker

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40
Q

Decribe the first and second dose of dilt

A

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

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41
Q

describe the first and second dose of verapamil

A

initial dose 5mg repeat dose 5-10 mg

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42
Q

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

A

vagal maneuvers

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43
Q

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

A

cardio version

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44
Q

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

A

calcium chloride

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45
Q

what is dose of calcium chloride?

A

500-1000 mg

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46
Q

administer verapmil with extreme caution if at all to patient on

A

digoxin or digitulis

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47
Q

what is a non-overdose indication of calcium chloride

A

give to patient with suspected hyperkalinia helps stabalize myocordid cell

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48
Q

what does bicarb do?

A

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

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49
Q

what mus patient be doing when giving bicarb

A

breathing or vic ett

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50
Q

what is dose of bicarb?

A

1 meq/kg

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51
Q

never mix bicarb with____?

A

calcium catecholamines

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52
Q

what overdose would bicarb help with?

A

cyclic antidepressants

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53
Q

what are indications for Magnesium Sulfate

A

torsade de pointes, Eclampsia, Asthma

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54
Q

what is the dose of mag when treating torsade de pointes

A

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

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55
Q

what are two actions of mag that help treat Eclampsia

A

smooth muscle relaxer=vasodilation

CNS depressant

56
Q

what are two main actions of adenosine

A

negative chronotrope, weak bronchoconstrictor

57
Q

what are top 3 side effects of adenosine

A

flushing, dypnea, chest pressure

58
Q

what is dosing of adenosine in clude max

A

.6mg Rapid 1.0mL saline flush

(repeat) 12mg Rapid, 12mg Rapit total of 30 mg

59
Q

list 4 steps of administrate for adenosine to be most effective

A

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

60
Q

describe how adenosine is beneficial in A-fib/Aflut

A

may help to diagnose but will not treat

61
Q

what are the symptomatic NS actions of amidoarone

A

Alpha Blocker-Vasodilation

Beta Blocker- Negative Chronotrope, Negative inotrope

62
Q

What channels does iF affect

A

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

63
Q

what two PNB rhythms may receive amiodarone

A

V-tach, V-Fib

64
Q

what are side effects of amiodarone

A

hypotension-Alpha blocker
Brady- Beta blocker
AV block
TDP

65
Q

amidodarone dose in PNB

A

300mg iv, 150mg in 3-5 min

66
Q

amiodarone dose in tachy with a pulse

A

150mg in 100mL D5W over 10 min

67
Q

procanamide should be given until…?

A

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

68
Q

procainamide decreases excitability in what part of the heart

A

ventricles, atria, purkinje fibers

69
Q

do NOT use procainamide in what vent rhythm

A

torsades

70
Q

what action does lido have that amiodarone nor procainamide have

A

helps decrease ICP and is an anestheic

71
Q

list the CNS side effects of lido

A

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

72
Q

what are the endogenous catecholamides

A

Epi nor epi dopmine

73
Q

what are some indications for using a beta blocker

A

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

74
Q

what can you treat a beta blocker overdose with

A

glucagon

75
Q

list the antidysrhythmic drugs

A

adenosine, amiodarone, pigoxin, lidocaine, procainamidl, verapamil

76
Q

list the sympathomimetic drugs

A

dopamine, isoproterenol (isuprel), epi, nor epi

77
Q

list the calcium channel blocker

A

diltiazem, verapamile

78
Q

list some electrolyte drugs

A

calcium chloride, mag sulfate, sodium bicarb

79
Q

the dopaminergic effects occur mainly at what rate?

A

1-4 mg/kg/min

80
Q

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

A

primarily beta, some vasoconstriction, more closer to 10

81
Q

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

A

predomiraley alpha with substantial vasoconstriction

82
Q

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

A

20,30,40

83
Q

what cardiac arrest drugs can be admin. through the ett

A

Epi vasopressin, also used to be lido and atrophine

84
Q

indications for vasopressin

A

cardiac arrest

85
Q

dose of vasopressin..can you repeat dose?

A

no and 40 units, 2 vials

86
Q

how is vasopressin different from other pressors

A

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

87
Q

what are the signs and symptoms of symptomatic brady?

A 
chest pain (ischemic) 
hypotension
signs of shock
altered IOC
acute heart failure
88
Q

first line drug for symptomatic brady is and why?

A

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

89
Q

what is first line non drug for symptom brady

A

trancutaneous pacing

90
Q

describe atrophine using ANS words

A 
parasympatholytic
parasympathetic blocking
vagolytic
anticholinergic
positive chronotrope
91
Q

what is non-cardiac use for atropine

A

organophosphate poison

92
Q

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

A

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

93
Q

what is max doses of atropine

A

3mg and .04mg/kg

94
Q

what side affect of atropine can interfere with assesment

A

dilated pupils

95
Q

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

A

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

96
Q

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

A

isuprel

97
Q

using ANS terms describe isuprel

A

pure beta and positive chronotrope and positive inotrope

sympathomimetic, catecholamine

98
Q

list 4 steps of administrate for adenosine to be most effective

A

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

99
Q

describe how adenosine is beneficial in A-fib/Aflut

A

may help to diagnose but will not treat

100
Q

what are the symptomatic NS actions of amidoarone

A

Alpha Blocker-Vasodilation

Beta Blocker-Chronotrope, Negative inotrope

101
Q

What channels do Amiodarone affect

A

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

102
Q

what two PNB rhythms may receive amiodarone

A

V-tach, V-Fib

103
Q

what are side effects of amiodarone

A

hypotension-Alpha blocker
Brady- Beta blocker
AV block
TDP

104
Q

amidodarone dose in PNB

A

300mg iv, 150mg in 3-5 min

105
Q

amiodarone dose in tachy with a pulse

A

150mg in 100mL D5W over 10 min

106
Q

procanamide should be given until…?

A

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

107
Q

procainamide decreases excitability in what part of the heart

A

ventricles, atria, purkinje fibers

108
Q

do NOT use procainamide in what vent rhythm

A

torsades

109
Q

what action does lido have that amiodarone nor procainamide have

A

helps decrease ICP and is an anestheic

110
Q

list the CNS side effects of lido

A

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

111
Q

what are the endogenous catecholamides

A

Epi, nor epi ,dopmine

112
Q

what are some indications for using a beta blocker

A

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

113
Q

what can you treat a beta blocker overdose with

A

glucagon

114
Q

list the antidysrhythmic drugs

A

adenosine, amiodarone, digoxin, lidocaine, procainamidl, verapamil

115
Q

list the sympathomimetic drugs

A

dopamine, isoproterenol (isuprel), epi, nor epi

116
Q

list the calcium channel blockers

A

diltiazem, verapamile

117
Q

list some electrolyte drugs

A

calcium chloride, mag sulfate, sodium bicarb

118
Q

the dopaminergic effects occur mainly at what rate?

A

1-4 mg/kg/min

119
Q

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

A

primarily beta, some vasoconstriction, more closer to 10

120
Q

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

A

predomiraley alpha with substantial vasoconstriction

121
Q

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

A

20,30,40

122
Q

what cardiac arrest drugs can be admin. through the ett

A

Epi vasopressin, also used to be lido and atrophine

123
Q

indications for vasopressin

A

cardiac arrest

124
Q

dose of vasopressin..can you repeat dose?

A

no and 40 units, 2 vials

125
Q

how is vasopressin different from other pressors

A

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

126
Q

what are the signs and symptoms of symptomatic brady?

A 
chest pain (ischemic) 
hypotension
signs of shock
altered IOC
acute heart failure
127
Q

first line drug for symptomatic brady is and why?

A

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

128
Q

what is first line non drug for symptom brady

A

trancutaneous pacing

129
Q

describe atrophine using ANS words

A 
parasympatholytic
parasympathetic blocking
vagolytic
anticholinergic
tchrontrope
130
Q

what is non-cardiac use for atropine

A

organophosphate poison

131
Q

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

A

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

132
Q

what is max doses of atropine

A

3mg and .04mg/kg

133
Q

what side affect of atropine can interfere with assesment

A

dilated pupils

134
Q

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

A

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

135
Q

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

A

isuprel

136
Q

using ANS terms describe isuprel

A

pure beta and chronotrope and inotrope

sympathomimetic, catecholamine

paramedic (9 decks)

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