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Fire Protocol > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Adenosine Action

A

endongenous nucleotide: slows conduction through the AV node; blocks reentrant pathways in SVT

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2
Q

Adenosine Indication

A

SVT

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3
Q

Adenosine Contraindications

A

2nd or 3rd degree AV blocks; atrial flutter; atrial fibrillation, ventricular tachycardia, wolf-Parkinson-white syndrome, hypersensitivity; may cause bronchoconstriction.

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4
Q

Adenosine side effects

A

facial flushing, pain palpitations, headache, dyspnea, vertigo, nausea, metallic taste

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5
Q

Adenosine Dose and administration

Pediatric dose: use tape

A

6 mg rapid IVP, 20 mL saline flush/proximal IV;

If no conversion after 1-2 minutes repeat dose of 12 mg rapid IVP followed by 20 mL flush

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6
Q

Albuterol action

A

sympathomimetic bronchodilator, acts selectively on beta-2 receptors to relax bronchial smooth muscle tissue

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7
Q

Albuterol indications

A

bronchospasm secondary to asthma or exacerbation due to COPD

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8
Q

Albuterol contraindications

A

hypertension, hypersensitivity, tachycardia secondary to digitalis toxicity

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9
Q

Albuterol precautions

A

patients with cardiovascular disease or CHF

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10
Q

Albuterol side effects

A

headache, hypertension, drowsiness, vertigo, dysrhythmias, nausea

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11
Q

Albuterol dosage & administration

A

2.5 mg with 3-6 mL NS with O2 set to 6LPM; may repeat if no adverse effects or treatment not working

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12
Q

DuoNeb substance

A

3 mg of albuterol sulfate equal to 2.5 albuterol base; 0.5 mg Ipratropium in isotonic sterile sodium chloride

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13
Q

DuoNeb action

A

maximize response in treatment for patients with severe COPD symptoms; producing greater bronchodilation effects.

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14
Q

DuoNeb indications

A

treatment of bronchospasm associated with asthma, COPD, respiratory distress, drowning, allergic reaction,
toxic inhalation

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15
Q

DuoNeb side effects

A

headaches, tachycardia, palpitations, dizziness, nausea, dry mouth, *occasionally can make breathing worse immediately after treatment

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16
Q

DuoNeb contraindications

A

hypersensitivity to any of its components including atropine

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17
Q

DuoNeb precautions

A

cardiovascular disorders, especially coronary insufficiency, cardiac arrythmias, and hypertension, convulsive disorders, use in pregnancy only if benefit outweigh the risks.

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18
Q

DuoNeb dosage and administration

A

3 mL vial, may repeat 2X if wheezing persists

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19
Q

Amiodarone action

A

antiarrythmic medication; calcium, potassium and sodium channel blocker; negative chronotropic, negative dromotropic, and vasodilator.

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20
Q

Amiodarone Indications

A

shock refractory V-fib; shock refractory pulseless V-tach;
hemodynamically unstable V-tach refractory to treatment; control of hemodynamically stable VT; use as adjunct to cardioversion of SVT and PSVT;

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21
Q

Amiodarone Contraindications

A

hypersensitivity, cardiogenic shock, sinus bradycardia, high degree AV block.

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22
Q

Amiodarone Incompatibilities

A

do not mix with sodium bicarbonate

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23
Q

Amiodarone side effects

A

bradycardia, nausea, AV block, vasodilation and hypotension

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24
Q

Amiodarone dosage and administration

A

cardiac arrest: 300 mg then 150 mg after 3-5 min; followed by a 20-30 mL flush. SLOW DRAW from vial with large bore needle.

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25
Q

Amiodarone dosage for ventricular ectopy:

A

VT with pulse and unstable PSVT administer 150 mg in 100 mL of D5W over 10 minutes: 40 mL per hour

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26
Q

Aspirin action

A

interferes with platelet aggregation and is known as an anti-platelet medication.

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27
Q

Aspirin Indication

A

MI patients, reduction of death chance with past MI hx., unstable angina, cardiac related chest pain.

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28
Q

Aspirin contraindications

A

hypersensitivity and hx of gastric or intestinal ulcers

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29
Q

Aspirin precautions

A

patients taking diabetic medications, or medications for anticoagulation or gout

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30
Q

Aspirin side effects

A

anaphylaxis, GI bleeding if preexisting conditions exist

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31
Q

Dosage and administration

A

324 mg chewable aspirin

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32
Q

Atropine Action

A

parasympatholytic drug inhibits actions of acetacholine: dilates pupils, relaxes bronchioles, increases heart rate, creates positive chronotropic and dromotropic effects

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33
Q

Atropine Indications

A

symptomatic bradycardia, organophosphate poisoning

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34
Q

Atropine contraindications

A

tachycardia, narrow angle glaucoma, myasthenia gravis

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35
Q

Atropine side effects

A

palpitations, paradoxical bradycardia from too slow of administration, headache, tachycardia, dry mouth, vertigo

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36
Q

Atropine dosage and administration

A

0.5 mg IV push rapid. repeat every 3-5 minutes. Max dose 3 mg

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37
Q

Atropine pediatric dose

A

0.02 mg/kg, minimum dose 0.1 mg - max 0.5 mg. May repeat for a second dose

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38
Q

Calcium chloride action

A

essential electrolyte for functional integrity of the nervous and muscular system, cardiac contractility and blood coagulation.

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39
Q

Calcium chloride indications

A

hypocalcemia, hyperkalemia, calcium channel blocker toxicity, magnesium sulfate OD, cardiac resuscitation.

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40
Q

Calcium chloride contraindications

A

VF during arrest, hypercalcemia, calcium chloride precipitates on contact with sodium bicarb.

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41
Q

calcium chloride side effects

A

bradycardia, hypotension

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42
Q

Calcium chloride dosage and administration

A

1 gram IV/IO slowly; Pediatric 20 mg/kg slowly

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43
Q

Dextrose Action

A

carbohydrate, Monosaccharide, is a hypertonic solution which increases blood glucose levels intravenously.

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44
Q

Dextrose indications

A

hypoglycemia, Altered level of consciousness, coma or seizure of unknown etiology

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45
Q

Dextrose precautions

A

patients with CVA and intra-cerebral hemorrhage

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46
Q

Dextrose side-effects

A

warm, painful burning sensation from administration of the medication; thrombophlebitis, sclerosis of the vein

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47
Q

Dextrose dosage and adminstration

A

25 grams slow IV push with 18 gauge (250 mL of 10% solution) - may discontinue without full infusion if patient awakens and can swallow oral glucose. Repeat in 10 minutes if BLGL less than 60

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48
Q

Dextrose pediatric dose and administration

A

0.5 grams/kg (5mL/kg of 10% solution) max 10 grams;

if patient less than 20 kg use a syringe for accurate dosing

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49
Q

Diazepam (valium) Action

A

sedative-hypnotic benzodiazepine. Acts on the limbic, thalamic and hypothalamic regions of the CNS to potentiate the effects of inhibitory neurotransmitters. Raises the SEIZURE threshold and produces sedation and amnesia.

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50
Q

Diazepam Indications

A

Seizure control, acute anxiety, muscle relaxant, pre-medication prior to cardioversion.

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51
Q

Diazepam side effects

A

hypotension, respiratory depression, ataxia (impaired balance and coordination), confusion, nausea, CNS depression.

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52
Q

Diazepam contraindications

A

respiratory depression, substance abuse of CNS depressants, hypersensitivity.

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53
Q

Diazepam (valium) precautions

A

Patients with renal or hepatic insufficiency. smaller doses usually required for the elderly.

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54
Q

Diazepam dosage and adminstration

A

5 mg IV/IO or MAD; repeat as needed after 5 min - up to 10 mg.

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55
Q

Diazepam pediatric dosage and adminstration

A

0.2 mg/kg IV/IO or MAD (maximum 5 mg) repeat after 5 minutes if necessary up to MAX 10 mg.

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56
Q

Diltiazem (cardizem) action

A

Calcium channel blocker inhibits transport of calcium into myocardial and vascular smooth muscle cells. causes systemic vasodilation, decreasing BP and coronary vasodilation.

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57
Q

Diltiazem indications

A

management of SVT; rapid ventricular rates in atrial fibrillation or flutter.

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58
Q

Diltiazem contraindications

A

2nd or 3rd degree AV block; myocardial infarction, WPW syndrome, Sick sinus syndrome, hypotension <90 mmhg systolic, pulmonary congestion

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59
Q

Diltiazem precautions

A

patients with renal or hepatic insufficiency or CHF, geriatric, pregnant with lactation, children, hx of serious ventricular dysrhythmias

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60
Q

Diltiazem side effects

A

epitaxis, CHF, chest pain, syncope, dyspnea, bradycardia, palpations, tachycardia, diaphoresis, hyperglycemia

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61
Q

Diltiazem dosage and administration

A

0.25 mg IV over 2 minutes, max 20 mg - may repeat in 15 minutes if first does ineffective; consider vagal maneuvers as first line treatment for regular, narrow complex tachycardias suggestive of SVT.

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62
Q

Diphenhydramine action

A

antihistamine, blocks effects of allergic reactions inhibits motions sickness and causes mild sedation.

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63
Q

Diphenhydramine indications

A

anaphylaxis, extrapyramidal reaction to phenothiazine medications (anti-psychotics), mild to moderate allergic reactions

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64
Q

Diphenhydramine contraindications

A

asthma (relative), narrow angle glaucoma, patients taking MAO inhibitors.

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65
Q

Diphenhydramine precautions

A

pregnant patients, may have additive effects when used with CNS depressant medications.

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66
Q

Diphenhyramine side effects

A

drowsiness, palpitations, urinary retention, drying of bronchial secretions, dry mouth

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67
Q

Diphenhydramine dosage and administration

A

1 mg/kg max 50 mg IV or IM if no IV access. for Dystonic reactions give 25-50 mg IV/IM

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68
Q

Epinephrine action

A

endogenous catecholamine with beta 1 and beta 2 vasoconstriction and bronchodilation effects; Alpha 1 effects - peripheral vasocontriction. Increasing cerebral and coronary perfusion and increased automaticity with increase in myocardial O2 demand.

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69
Q

Epinephrine Indication

A

cardiac arrest, acute bronchospasm from asthma or COPD, Anaphylaxis.

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70
Q

Epinephrine contraindication

A

no known contras in cardiac arrest.

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71
Q

Epinephrine precautions

A

hyperthyroidism, diabetes mellitus, glaucoma, may exacerbate hypertension or angina, SVT, CHF, is unstable in alkaline solutions.

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72
Q

Epinephrine side effects

A

headache, palpitations, dizziness, tachycardia, N&V, anxiety

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73
Q

Epinephrine dosage and administration CODE

A

1 mg IV/IO 1:10,000 push for cardiac arrest every 3-5 minutes; can be given via ETT at 2-2.5 times the dose diluted in 10 mL of NS - Pediatric 0.01 mg/kg cardiac arrest

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74
Q

Epinephrine dosage and administration ANAPHYLAXIS

A

0.3 mg of 1:1,000 IM adult; 0.15 mg IM pedi: may repeat if signs and symptoms of shock persist

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75
Q

Epinephrine dosage and administration SEVERE SOB

A

ADULT: 0.3 mg 1:1,000 IM ; discuss prior to use with patient over 55 or using beta blockers

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76
Q

Etomidate Action

A

hypnotic drug without analgesic or muscle relaxing properties. Can cause myoclonus upon injection. Usually given with neuromuscular blocking agents and/or analgesics.

77
Q

Etomidate indications

A

Induction PRIOR to neuromuscular blocking agents and/or analgesics. (RSI)

78
Q

Etomidate contraindications

A

pregnancy or lactation, patients under 3 months of age

79
Q

Etomidate precautions

A

patients with hepatic and/or renal insufficiency

80
Q

Etomidate side effects/adverse effects

A

transient venous pain at injection site; transient muscle skeletal spasms/twitching

81
Q

Etomidate complications

A

anticipate that the patient will awaken and will be left without residual analgesia; medicate with additional narcotics and neuromuscular blockers as needed.

82
Q

Etomidate dosage and administration

A

Adult and Pedi: 0.3 mg/kg IV; Onset within 1 minute, duration 5 minutes. Patient will awaken fully within 7-14 minutes.

83
Q

Fentanyl (sublimaze) action

A

opioid analgesic, binds to opiate receptors in the CNS altering its response and perception to pain. May produce CNS and/or respiratory depression in higher doses.

84
Q

Fentanyl indications

A

pain control; sedation of the intubated patient

85
Q

Fentanyl contraindications

A

patients currently taking MAO inhibitors; hypotension; inferior myocardial wall infarct on EKG

86
Q

Fentanyl use with PRECAUTION

A

head injury, COPD injury, Respiratory difficulty

87
Q

Fentanyl side effects

A

apnea, laryngospasm, hypotension, respiratory depression, N&V, bradycardia

88
Q

Fentanyl dosage and administration

A

50-100 mcg, IV push slowly over 1-2 minutes or IM injection, may repeat every 5 minutes to a total of three doses or a maximum cumulative dose of 250 mcg.

89
Q

Fentanyl dosage and administration PEDI

A

0.5 mcg/kg IV push slowly over 1-2 minutes; not to exceed 100 mcg. 1.5 mcg/kg MAD if IV inaccessible; may repeat every 5 minutes up to 3 times to a total dose of 250 mcg - recheck pain score and HR, RR, and BP

90
Q

Fentanyl sedation in patient with advanced airway

A

100 to 250 mcg IV, may repeat to a cumulative dose of 250 mcg. Discuss with medical control if more needed.

91
Q

Glucagon action

A

Increases blood glucose secondary to glycogenesis, which is the breakdown of glycogen to glucose in the liver. Action in hypoglycemia in hypoglycemia relies on the presence of adequate liver glycogen stores.

92
Q

Glucagon Indications

A

Hypoglycemia with inability to obtain IV access

93
Q

Glucagon contraindications

A

hypersensitivity; depleted glycogen stores in liver (starvation states)

94
Q

Glucagon precautions

A

cardiac disease, malnutrition, children

95
Q

Glucagon side effects

A

N&V, tachycardia, decreased gastric motility, sudden transient hypertension

96
Q

Glucagon dosage and administration

A

adults and children >25 kg 1 mg IM; children <25 kg 0.5 mg IM, may repeat every 10 minutes for persistent hypoglycemia up to 1.5 mg.

97
Q

Glucagon NOTE:

A

patient usually awakens from hypoglycemic state within 15 to 20 minutes after admin of glucagon. Give carbs PO ASAP after patient able to swallow.

98
Q

Oral Glucose Action

A

after absorption in the GI tract, glucose is distributed in the tissues and provides a prompt increase in circulating blood sugar.

99
Q

Oral glucose indications

A

hypoglycemia

100
Q

Oral glucose side effects

A

nausea

101
Q

Oral glucose precautions

A

AMS may impair ability to follow directions, make sure patient can swallow, must be swallowed.

102
Q

Oral glucose dosage and administration

A

15 grams PO for patients who can swallow; pediatric 5 to 15 grams PO for patients who can swallow

103
Q

Haloperidol (haldol) Action

A

Anti-psychotic; precise action has not been established ; has effects on dopamine and seritonin receptors. blocking dopamine D2 receptors in the brain. When 72% of dopamine receptors are blocked, this drug achieves its maximal effect.

104
Q

Haldol inidications

A

prompt control of acute agitated delirium with moderate to severe symptoms; preferentially used in the setting of an acute psychiatric episode.

105
Q

Haldol side effects

A

tachycardia, hypertension, diaphoresis, blurred vision, nausea and vomiting.

106
Q

Haldol contraindications

A

severe, toxic CNS depression (DRUNK patients) or comatose states, hypersensitivity, known prolonged QT

107
Q

haldol precautions

A

caution for patients with severe cardiovascular disorder; history of seizures: may lower convulsion threshold; use caution with patients over 50; will make the effects of alcohol and CNS depressants worse.

108
Q

Haldol dosage and administration

A

5 mg IV/IM; may repeat once in 10 minutes

109
Q

hydroxcobalamin (cyanokit) action

A

ability to detoxify cyanide

110
Q

Cyanokit indications

A

known or suspected cyanide poisoning: can present after breathing smoke from a house or industrial fire, breathing or swallowing cyanide, skin exposure to cyanide.

111
Q

cyanokit side/adverse effects

A

anaphylaxis, edema, skin and urine redness, eye swelling, irritation and redness. liver damage

112
Q

cyanokit incompatibilities

A

do not administer through same IV line as sodium nitrate, propofol, diazepam, nitro blood products: GET TWO IV ACCESS LINES

113
Q

cyanokit dosage and administration

A

5 grams in one vial ADD 200 mL of 0.9% NS to vial using the transfer spike, fill to line and keep upright. Rock and rotate vial for 60 seconds to mix. Infuse the vial using vented IV tubing. Infuse over 15 minutes.

114
Q

Ketamine action

A

Rapid acting general anesthetic: producing a dissociate state characterized by profound analgesia with cardiovascular and respiratory stimulation with an occasional transient and minimal respiratory depression.

115
Q

Ketamine indications

A

Induction or agitated delirium

116
Q

ketamine side effects

A

hypertension, tachycardia, laryngospasm, respiratory depression, N&V

117
Q

ketamine contraindications

A

patients in whom a significant rise in BP would cause serious problems. Hemorrhagic stroke; BP > 240/120, children less than 3 months old.

118
Q

ketamine dosage and administration

A

2 mg/kg IV or IM. Use only in extreme cases of excited delirium and SAME dose for INDUCTION; 30 to 40% of patients treated with ketamine may require intubation in the ER for sedation and respiratory depression.

119
Q

Labetalol Action (Normodyne)

A

Adrenergic blocking agent with selective alpha and non-selective beta adrenergic blocking actions: lowering blood pressure without reflexive tachycardia.

120
Q

Labetalol Indications

A

acutely symptomatic hypertension 220/120; may be used in presence of CVA symptoms. May be used for sinus tachycardia in the setting of chest pain. Pregnant patient or recently delivered (fewer than 6 weeks) hypertensive patient: greater than 140 systolic or 100 diastolic. Especially if acutely symptomatic for preeclampsia or eclampsia.

121
Q

Labetalol contraindications

A

high degree AV block, cardiogenic shock, bradycardia, hypotension.

122
Q

Labeatlol precautions

A

heart failure, liver disease, diabetes, asthma

123
Q

labetalol side effects/adverse effects

A

postural hypotension, diaphoresis, vertigo, N&V

124
Q

Labetalol dosage and administration hypertension

A

10 mg IV over 1-2 minutes; may be repeated in 10 minutes if no change in blood pressure. The goal is to lower blood pressure but not more than 25%.

125
Q

Labetalol pre-eclampsia/eclampsia

A

10 mg IV over 1-2 minutes; may repeat in 10 minutes if no change. Lower BP to less than 130 over 100

126
Q

Labetalol sinus tachycardia dose

A

5 mg IV over 1-2 minutes wait for response; repeat in 5 minutes if no change. another 5 mg but no more than 20 mg. maximum effect usually occurs within 5 min.

127
Q

Labetalol notes

A

patient BP should always be closely monitored; and in SUPINE position

128
Q

Lorazepam action

A

Benzodiazepine with anti-anxiety, sedative and anti-convulsant effects.

129
Q

Lorazepam indication

A

continuous or multiple seizures; shivering or seizure activity with rapid cooling of hypothermic patients.

130
Q

Lorazepam contraindications

A

hypersensitivity to glycols or benzyl alcohol, acute narrow angle glaucoma or COPD

131
Q

Lorazepam side effects

A

respiratory depression, drowsiness or confusion, headache, ekg changes or tachycardia

132
Q

Lorazepam dosage and administration

A

> 18 years of age: 2-4 mg IV, IO slow push; may repeat if needed after 5 minutes. <18 years of age: 0.1 mg/kg but not more than 4 mg. For cooling due to hyperthermia 2 mg

133
Q

Magnesium sulfate action

A

Depresses cardiac muscle and nerve junctions, depresses the CNS,

134
Q

Magnesium sulfate indications

A

cardiac arrest if torsade de pointes or hypomagnesemia is present; seizure for eclampsia, bronchospasm due to COPD or status asthmaticus

135
Q

mag sulfate contraindications

A

symptomatic heart block, use with caution in patients with renal impairment.

136
Q

Mag sulfate adverse effects

A

bradycardia, paralysis, severe diaphoresis, hypothermia

137
Q

Mag sulfate dose and admin

A

respiratory distress: 2 grams mixed in 100 mL bag D5W over 10-20 minutes. Eclampsia: 4 grams mixed in 100 mL D5W over 15 minutes.

138
Q

Methlyprednisolone action

A

potent anti-inflammatory glucocorticoid steroid. Can control severe inflammatory conditions such as anaphylaxis and allergic reactions; exacberations of COPD and asthma. Onset of about 1 hour and last up to 12 hours.

139
Q

Methylprednisolone indication

A

Acute bronchospasm (asthma or COPD); allergic reactions including anaphylaxis.

140
Q

Solumedrol contraindications

A

systemic fungal infections; use with caution if tuberculosis, or patients who have received steroids in last 24 hours.

141
Q

Solumedrol side effects

A

nervousness, dizziness, headache, may raise glucose serum levels.

142
Q

Solumedrol dosage and administration

A

125 mg IV preferred or IM PEDI: 2 mg/kg IV max 125 mg

143
Q

Midazolam (versed) Action

A

short-acting benzodiazapine; Produces generalized CNS depression.

144
Q

Midazolam indications

A

sedative for agitation or post intubation AND treatment of seizure

145
Q

Midazolam contraindications

A

known hypersensitivity to benzos, hypotension/shock, respiratory distress

146
Q

Midazolam precautions

A

pulmonary disease, CHF, renal or hepatic impairment, geriatric or debilitated patients

147
Q

Midazolam side effects

A

agitation, excess sedation, bronchospasm, N&V, respiratory depression, cough

148
Q

Midazolam dosage and admin

A

post-intubation or pre-treatment for cardioversion: 2-4 mg IV/IO; Agitated delirium 5-10 mg IV/IM or 10 mg IN with 5 mg for each nostril per MAD.

149
Q

Midazolam dosage pediatric

A

<50kg use 5 mg Versed with MAD: 2.5 mg each nostril; sedation post-intubation or pre cardioversion use 0.1 mg/kg IV/IO max 2 mg; agitated delirium: 5-10 mg IV/IO or 10 mg MAD; SEIZURE preferred if no IV use 0.2 mg/kg with max of 10 mg total. ONSET 1.5 to 5 minutes

150
Q

Naloxone (narcan) Action

A

synthetic opioid antagonist; competes at opiate receptor sites resulting in reversal of respiratory depression, sedation and pupil miosis.

151
Q

Naloxone Indication

A

Acute CNS depression; decreased Level of consciousness due to opiate OD or unknown etiology

152
Q

Naloxone contraindication

A

none known

153
Q

Naloxone precautions

A

known opiate abusers, narcotic dependent - may cause severe withdrawal effects; pre-existing cardiac disease, patients who have received cardio-toxic drugs.

154
Q

Naoloxone side effects

A

tachycardia, hypertension, hypotension, N&V

155
Q

Naloxone dose and admin

A

0.5 mg IV, IM, IN, IO. May be given in one 2 mg dose or in increments of 0.5 up to four times. depending on clinical presentation. FOR SEVERE RESPIRATORY DEPRESSION ADMINISTER 2 mg. Use ENTIRE 4 mg of nasal MAD when administering narcan. PEDI: 0.1 mg/kg

156
Q

Nitroglycerin Action

A

peripheral vasodilator: reduces preload, decreasing myocardial 02 demand.

157
Q

Nitroglycerin indication

A

Ischemic chest pain, HTN, acute pulmonary edema possibly secondary to CHF

158
Q

Nitro contraindications

A

Hypotension, head injury or possibility of intracranial hemorrhage, use of viagra or levitra in 24 hourse or cialis in 48 hours. Right ventricular infarct (preload)

159
Q

Nitro precautions

A

patients with glaucoma as it may increase intraocular pressure.

160
Q

Nitro side effects

A

headaches, hypotension, vomiting, diaphoresis, syncope, tachycardia

161
Q

Nitro dose and admin

A

0.4 mg tablet SL or 0.4 mg metered dose SL spray every 3-5 minutes up to 3 times

162
Q

Norepinephrine action

A

sympathomimetic drug acts as a peripheral vasoconstrictor (alpha adrenergic)/inotropic stimulator/dilator of the coronary arteries (beta adrenergic); has a rapid onset and lasts 1-2 minutes, should be given as a continuous infusion.

163
Q

Norepinephrine indication

A

bradycardia with a pulse, hypotension in cardiogenic shock to maintain a SBP of 90 or greater; treatment of hypotension refractory to fluid challenge

164
Q

Norepinephrine contraindication

A

Relative: patients with shock from hemorrhage, or other causes of hypovolemia (patient needs fluid replacement), do not use in patient who is severely tachycardic, or in any patient with good perfusion. MUST use 18G catheter and AC location with PATENT IV

165
Q

Norepinephrine side effects

A

tachycardia, HTN

166
Q

Norepinephrine dose and admin

A

4 mL from 250 bag of D5W and inject the 4mg/4mL of Norepi to make an infusion of 16mcg/mL. 60 gtts/min or 1 drop every second. To titrate give 1 drop every two seconds for 8 mcg a minute. RECHECK vitals every 2 minutes while setting drip and every 5 minutes thereafter. MONITOR for tachycardia and/or HTN.

167
Q

Ondansetron (Zofran)

A

anti-emetic blocks effects of serotonin in the vagal nerve terminals and in the CNS

168
Q

Zofran indications

A

prevention and treatment of N&V

169
Q

Zofran contraindications

A

hypersensitivity

170
Q

Zofran precautions

A

liver impairment not to exceed 8 mg; pregnant or lactating females and children less than 3 years old

171
Q

Zofran side effects

A

headache, dizzy, drowsy, fatigue

172
Q

Zofran dose and admin

A

4 mg IV or IM administer over at least 30 seconds preferably over 2 - 5 minutes. Peak effect in 15 to 30 minutes with a duration of 4 hours; 0.1 mg/kg for children fewer than 40 kg

173
Q

Rocuronium (Zemuron) Action

A

non-depolarizing, neuromuscular blocker that competitively blocks acetylcholine receptors without stimulation

174
Q

Rocuronium Indications

A

use for skeletal muscle paralysis following an induction agent such as etomidate and ketamine or fetanyl in rapid sequence intubation. paralysis may also facilitate chest wall for good bag compliance in mechanical ventilation.

175
Q

Rocuronium side effects

A

transient HTN

176
Q

Rocuronium contraindications

A

known hypersensitivity to bromides USE caution in patients with liver disease - the duration of action in these patients can be 1.5 times longer.

177
Q

Rocuronium dose and admin

A

1 mg/kg IV ONSET of action about 45 to 60 seconds and lasts up to 25 to 70 minutes. Use plenty of hypnotic to endure the length of paralysis.

178
Q

Sodium bicarbonate action

A

alkalizing agent which raises blood pH

179
Q

Sodium bicarb indications

A

OD of antidepressants, aspirin, cocaine or benadryl; prolonged resuscitation with adequate ventilation, ROSC after long arrest interval. Severe acidosis, hyperkalemia, pretreatment prior to trapped extremity with a serious crush injury.

180
Q

Sodium bicarb contraindications

A

metabolic and respiratory alkalosis, hypocalcemia, hypokalemia - Infiltration can cause necrosis

181
Q

Sodium bicarb side effects

A

metabolic alkalosis, seizures, electrolyte imbalance

182
Q

Sodium bicarb dose and admin

A

1 mEq/kg IV or IO bolus - may repeat after 10 minutes maximum of 2 doses. PRE-TREATMENT in a CRUSH INJURY - 25 mEq IV/IO prior to the release of the trapped extremity; these patients may require a 2nd dose of 25 mEq if symptomatic of hyperkalemia.

183
Q

Succinylcholine (Anectine) Action

A

short acting, motor nerve depolarizing and skeletal muscle tissue relaxant. It binds to cholinergic receptors in the motor neuron end plate ultimately causing MUSCLE PARALYSIS.

184
Q

Succinylcholine Indication

A

Used after induction of anesthesia to produce paralysis. Achieves temporary paralysis for intubation where muscle tone and/or seizure activity prevent it.

185
Q

Succinylcholine contraindication

A

known hypersensitivity, penetrating eye injuries, hx of glaucoma, and malignant hyperthermia (use ROX)

186
Q

Succinylcholine side effects

A

hypotension, hypertension, ventricular disrhythmias, tachycardia, cardiac arrest. Increases intraocular and intracranial pressure with a repeat dose and child uner 5 years old.

187
Q

Succinylcholine dose and adminstration

A

1.5 mg/kg IV/IO push, in extreme necessity deep IM injection of 3-4 mg/kg; total dose NOT to exceed 150 mg, however paralytics are preferred IV push.

188
Q

Succinylcholine NOTE

A

after IV, complete paralysis is obtained within 1 minute and persists for approximately 2-4 minutes; effects will fade within 4-10 minutes. IM EFFECTS take up to 3 minutes onset and the duration is 10 to 30 minutes.

Fire Protocol (2 decks)

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