Pharmacology Flashcards
Glucagon
Class - Hormone
Action - Elevates blood glucose levels through conversion of glycogen to glucose
Indications - Hypoglycemia, beta-blocker OD
Contraindications - Hypersensitivity
Dose - 0.25 - 0.5u IV / 1mg IM
Adverse affect - few in emergency setting
*Less effective in pts with decreased glycogen stores
Ondansetron (Zofran)
Class - serotonin antagonist Action - Selectively blocks serotonin receptors Indications - Nausea, vomiting Contraindications - Hypersensitivity Dose - 4-8mg IV, IM, PO Adverse affect - dizziness, lightheaded
Nitro Paste
Class - nitrate
Action - relaxes vascular smooth muscle causing vasodilation, decreased cardiac work and improved coronary blood flow
Indications - Chest pain, CHF
Contraindications - Hypotension, increased ICP
Dose - 0.5-1” transdermal
Adverse affect - headache, dizziness, weakness, tachycardia, hypotension
*Do not get paste on your finger as this may cause headache.
**Monitor BP closely
Diphenhydramine (Benadryl)
Class - Antihistamine
Action - Blocks H1 & H2 histamine receptors
Indications - Allergies, anaphylaxis, Parkinson’s disease, extrapyramidal reactions
Contraindications - hypersensitivity, glaucoma, pregnancy
Dose - 25-50mg IV, IM, IO, PO
Adverse Affect - Drowsiness, dizziness, dry mouth
*If given IM, give deep in muscle
Nitroglycerin
Class - Nitrate
Action - Relaxes vascular smooth muscle causing vasodilation, decreased cardiac work and improved coronary blood flow
Indications - Chest pain, CHF
Contraindications - Hypotension, increased ICP
Dose - 0.4mg SL tablet or spray
Adverse affect - Headache, dizziness, weakness, tachycardia, hypotension
*Tablets will lose effectiveness when exposed to air/sun
**Monitor BP closely
Albuterol
Class - B-agonist
Action - B-agonist with preference for B2 adrenergic receptors
Indications - Bronchospasm, anaphylaxix, hyperkalemiz
Contraindications - hypersensitivity
Dose - 2.5 mg Neb, 90 mcg MDI (inhalation)
Adverse Affect - Palpitations, anxiety, headache, dizziness, tachycardia
**Monitory heart rate & SPO2
Epinephrine
Class - Sympathetic agonist
Action - Adrenergic agonist
Indications - Cardiac arrest, sympathetic bradycardia, normovolemic hypotension, anaphylaxis, severe bronchospasm
Contraindications - Few in the emergency setting
Dose - Cardiac arrest: 1mg (1:10,000)
Anaphylaxis/Asthma 0.01mg/kg IM (1:1000)
max dose 0.5 mg
Adverse Affect - Palpitations, anxiety, headache, dizziness, hypertension, can worsen cardiac ischemia
Atropine
Class - Anticholinergic (parasympatholytic)
Action - Selectively blocks receptors inhibiting parasympathetic stimulation
Indications - Bradycardia, antidote for organophosphate poisoning, premedication for RSI
Contraindications - Hypersensitivity
Dose - 0.5 - 2mg IV, IO
Adverse Affect - Blurred vision, dry mouth, dilated pupils, confusion
**Organophosphate poisonings may require higher doses
Ipratropium (Atrovent)
Class - Anticholinergic (parasympatholytic)
Action - Selectively blocks receptors inhibiting parasympathetic stimulation
Indications - Bronchospasm associated with obstructive lung disease (asthma, COPD)
Contraindicaions - Hypersensitivity
Dose - 500mcg inhalation
Adverse Affect - Blurred vision, dry mouth, dilated pupils, cough, confusion
*Typically administered with beta agonist (albuterol)
Aspirin
Class - NSAID
Action - Platelet inhibitor and anti-inflammatory
Indications - Chest pain when acute myocardial infarction is suspected, mild to moderate pain, fever, platelet aggregation inhibitor
Contraindications - hypersensitivity, bronchospasm, angioedema, patients receiving MAOIs
Dose - 324mg PO (not indicated for pediatrics)
Adverse Affect - Heartburn, wheezing, nausea, vomiting, GI bleed, allergic reaction
*Commonly causes gastric upset
Naloxone (Narcan)
Class - Opiate antagonist
Action - Opioid antagonist w/o opiate agonist properties (it has no activity when given in the absence of an opiate agonist)
Indications - Partial reversal of opiate drug effects, opiate OD
Contraindications - Hypersensitivity
Dose - 0.4 - 2 mg IV, IO, SQ, IN, Neb
Adverse Affect - Fever, chills, nausea, vomiting, diarrhea, opiate withdrawal
**Administer enough to reverse respiratory depression and avoid full narcotic withdrawal syndrome
Acetaminophen (Tylenol)
Class - Non-narcotic analgesic, antipyretic
Action - Exact mechanism uncertain but is thought to reduce the production of prostaglandins (reduce swelling and inflammation
Indications - Mild - moderate pain, fever
Contraindications - hypersensitivity, alcoholism, chronic liver disease, head injury, hypotension, previously taken the med, inability to swallow, respiratory distress, persistent vomiting
Dose - 15mg/kg not to exceed 650mg PO
Adverse Affect - Not clinically significant
*Can be liver toxic, use minimal dose necessary
Ibuprofen (Advil, Motrin)
Class - NSAID
Action - Anti-inflammatory and antipyretic through inhibition of prostaglandins
Indications - Mild - moderate pain, fever, inflammation
Contraindications - hypersensitivity, bronchospasm, angioedema
Dose - 10mg/kg not to exceed 800mg PO
Adverse Affect - Nausea, vomiting, GI bleed, allergic reaction
*Commonly causes gastric upset
Dextrose
Class - Carbohydrate, Hypertonic solution
Action - A monosaccharide, which provides calories for metabolic needs, spares body proteins and loss of electrolytes. Readily excreted by kidneys producing diuresis. Hypertonic solution
Indication - Hypoglycemia
Contraindication - Intracranial or intraspinal hemorrhage, DTs with dehydration, blood glucose >60mg/dl
Dose - 8 yrs & up50cc of 50% solution; 25mg IV or if conscious 25gm PO; Pediatric 2-4 ml/kg slow IV of 25% solution; Newborn 4ml/kg of 12.5%solution dilute with D50 4:1 with NS
Adverse Affects - Thrombosis, sclerosing if given in peripheral vein, tissue irritation/necrosis if infiltration
*May cause Wernicke-Korsakoff syndrome in acute alcohol intoxication, prevent with Thiamine 100mg IM or IV, Check glucose level before and after administering
