Pharmocolgoy

Question 1

Oxygen

Answer 1

• Indications:
-dyspnea/SOB, or
-Medical pt. SpO2 < 94% goal, or
-Trauma pt. SpO2 < 95% or greater
goal, or
-COPD pt. SpO2 < 88-92% goal, or
-pregnant pt.

•Contraindications:
-No dyspnea/SOB & SPO2 @ goal
-Newborn requiring BVM: room air
only

•Action: enables aerobic metabolism

•Dose:
-NC: 1-6lpm
-SVN:6-10lpm
-NRB: 8-15lpm
-BVM: 15lpm
-CPAP: manufacturers
recommendation

•Route: inhaled

•Side effects:
-dry mouth

Question 2

Albuterol

Answer 2

•Indications: Asthma with wheezing

•Contradictions:
-known sensitivity
-Not responsive enough to use SVN
or MDI

•Action:Beta 2 agonist —>
bronchodilation

•Dose:
-SVN: 2.5mg in 3 cc of NS with O2 at
6-10 lpm
-MDI: one puff ( after shake x30 secs)

•Route: inhaled via SVN or MDI

•Side Effects:
-Anxious/ jittery
-Increased HR

Question 3

Aspirin

Answer 3

•Indications: cardiac ischemia

•Contraindications:
-Active bleed
-Unable to control airway or chew/
swallow

•Action: anti-platelet (NOT
anticoagulant)

•Dose: 160-325mg

•Route: PO (oral) or, chew pill

•Side Effects:
-gastric irritation
-taste

Question 4

Nitroglycerin

Answer 4

•Indications: pain/discomfort due to
cardiac ischemia

•Contrindications:
-SBP < 90 mmHg
-ED med use within 48 hours
-SBP drops 30 mmHg below baseline
-unable to control airway (pill form)

•Action: vasodilation—> decrease
preload/afterload —> decreases
workload

•Dose:
-0.4mg pill/ spray
-Repeat q 5 mins with continued CP &
no contraindication
- Max 3 doses

•Route: SL pill / spray

•Side Effects:
-Decrease BP
-HA
-stinging under tongue

Question 5

Glucagon

Answer 5

•Indications: (must have ALL three)
-AMS &
-BGL < 70 mg/dl, &
-Unable to swallow

•Contraindications: none with all three
of above indications

•Action: Increases BGL by releasing
glycogen stores in liver; onset 13-16
mins

•Dose:
-1 mg per nostril with max volume
0.5 ml per spray: 2 mg total
-Follow up with oral glucose PRN

•Route: IN (Intranasal) spray

•Side Effects: nasal drainage

Question 6

Oral Glucose

Answer 6

•Indications: (Must have ALL three)
-AMS, &
-BGL < 70 mg/dl, &
-Able to swallow

•Contraindications: (must have only
one)
-BGL > 70 mg/dl or
-Unresponsive
-Unable to swallow

•Action: Increase BGL

•Dose: one tube

•Route: PO (oral)

•Side effects
- bad taste
-High BGL

Question 7

Epinephrine

Answer 7

•Indications: Anaphylaxis

•Contraindications: none in presence
of anaphylaxis

•Action:
-Alpha 1: vasoconstriction
-Alpha 2: check on vasoconstriction
-Beta 1: increased HR & stroke
volume
-Beta 2: bronchodilation

•Dose:
-0.3 mg via adult auto-injector; onset
<1 min, last 15-20mins
-0.15 mg via pedi- injector

•Route: IM auto-injector

•Side effects:
-Increased HR
-N/V
-Anxious/jittery

Question 8

Naloxone Hydrochloride (Narcan)

Answer 8

•Indications: ( must have both)
-Known/ suspected opioid OD, &
-Respiratory depression requiring
BVM

•Contraindications:none in presence
of suspected opioid OD with
respiratory depression

•Action: competitive opioid antagonist
binds to opioid receptor sites.

•Dose:
- 1mg per nostril with max volume
0.5 ml per spray: 2mg total
-Repeat q 5 minutes PRN

•Route: IN (intranasal ) spray

•Side Effects:
-possible of acute opioid withdrawal
resulting in agitated patient.
-vomiting