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pharmpharm(from shared med emerg doc) Flashcards

1
Q

What is the class of Oxygen?

A

Medical Gas

Oxygen is used in various medical scenarios to increase oxygen saturation in the blood.

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2
Q

What is the dose of Oxygen for non-rebreather masks?

A

10-15 lpm NRB (60%-90%)

Non-rebreather masks are used for patients requiring high concentrations of oxygen.

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3
Q

What is the primary mechanism of action (MOA) of Oxygen?

A

Increases the amount of oxygen available to the body’s tissues and saturation in the blood.

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4
Q

List the indications for administering Oxygen.

A
  • Hypoxia
  • Cardiac Arrest
  • Angina
  • Stroke
  • Respiratory distress
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5
Q

What is a contraindication for Oxygen therapy?

A

Severe COPD (hypoxic drive vs hypercarbia drive)

In patients with severe COPD, the drive to breathe may depend on low oxygen levels.

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6
Q

What is the class of Normal Saline?

A

Isotonic Solution

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7
Q

What is the dose range for Normal Saline?

A

250cc, 500cc, 1000cc IV, IO

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8
Q

What is the primary MOA of Normal Saline?

A

Provides fluid resuscitation and restores blood volume.

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9
Q

What is the indication for using Normal Saline?

A

Fluid Resuscitation & Therapy

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10
Q

What is a contraindication for Normal Saline?

A

Heart and kidney failure

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11
Q

What class of medication is Aspirin?

A

NSAID (Non-steroidal anti-inflammatory drugs)

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12
Q

What is the usual dose of Aspirin?

A

81mg x 4 = 324mg chew

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13
Q

What is the MOA of Aspirin?

A

Prevents platelets from clumping together (blood = slippery)

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14
Q

List the indications for Aspirin.

A
  • Angina
  • Suspected MI
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15
Q

What is a contraindication for Aspirin?

A

Ulcer and Asthma

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16
Q

What class of medication is Nitroglycerin?

A

Vasodilator

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17
Q

What is the dose of Nitroglycerin?

A

0.4mg SL q 3-5min

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18
Q

What is the primary MOA of Nitroglycerin?

A

Vasodilation (coronary arteries), relaxation and dilation of coronary arteries, reducing myocardial oxygen demand and improving blood flow to the heart muscle.

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19
Q

List the indications for Nitroglycerin.

A
  • Angina
  • ACS
  • Heart failure with pulmonary edema
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20
Q

What is a contraindication for Nitroglycerin?

A

ED drugs

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21
Q

What class of medication is Atropine?

A

Parasympatholytic, anticholinergic

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22
Q

What is the dose of Atropine?

A

1mg IVP (max 3 doses)

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23
Q

What is the MOA of Atropine?

A

Competes with acetylcholine at receptors on the AV and SA node, enhances SA node automaticity, and AV conduction, increases HR, CO.

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24
Q

What is the primary indication for Atropine?

A

1st line treatment for sinus bradycardia

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25
Q

What is a contraindication for Atropine?

A

Acute MI

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26
Q

What class of medication is Clopidogrel (Plavix)?

A

Antiplatelet

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27
Q

What is the dose of Clopidogrel?

A

300-600mg loading dose

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28
Q

What is the MOA of Clopidogrel?

A

Block ADP binding site (makes it slippery)

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29
Q

List the indications for Clopidogrel.

A
  • Angina
  • Suspected STEMI
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30
Q

What is a contraindication for Clopidogrel?

A

Increased risk of bleeding

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31
Q

What class of medication is Epinephrine?

A

Catecholamine, Sympathomimetic, bronchodilator, vasopressor

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32
Q

What is the dose of Epinephrine?

A

2-10mcg/min (titrate to patient response)

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33
Q

What is the MOA of Epinephrine?

A

Alpha/Beta agonism increases inotropy, chronotropy, systemic vascular resistance.

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34
Q

List the indications for Epinephrine.

A
  • 1st line treatment for cardiac arrest
  • Treatment of severe symptomatic hypotensive sinus bradycardia
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35
Q

What is a contraindication for Epinephrine?

A

Active arrhythmias with a pulse

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36
Q

What class of medication is Heparin?

A

Anticoagulant

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37
Q

What is the dose of Heparin?

A

60u/kg up to 4,000U

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38
Q

What is the MOA of Heparin?

A

Anticoagulant, prevents conversion of fibrinogen to fibrin.

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39
Q

List the indications for Heparin.

A
  • Acute STEMI
  • ACS
  • DVT
  • PE
  • Ischemic stroke
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40
Q

What is a contraindication for Heparin?

A

Active bleeding

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41
Q

What class of medication is Dopamine?

A

Inotropic agent, vasopressor, adrenergic.

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42
Q

What is the dose range for Dopamine?

A
  • 1-3 mcg/kg/min for Dopaminergic effect
  • 3-10 mcg/kg/min for Beta 1 & 2 and Dopaminergic effect
  • 10+ mcg/kg/min for Alpha, Beta 1, Beta 2, and Dopaminergic effect
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43
Q

What is the MOA of Dopamine?

A

Stimulates both alpha and beta-adrenergic receptors, increases HR, CO.

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44
Q

List the indications for Dopamine.

A
  • 2nd line drug for symptomatic bradycardia
  • Use for hypertension SBP <70-100 with signs of shock
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45
Q

What is a contraindication for Dopamine?

A

Tachycardia

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46
Q

What class of medication is Furosemide (Lasix)?

A

Loop diuretic

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47
Q

What is the dosing for Furosemide in emergencies?

A

Begin with 40 mg IV, IO.

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48
Q

What is the MOA of Furosemide?

A

Inhibits the absorption of sodium and chloride ions and water in the loop of Henle, increasing urine production.

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49
Q

List the indications for Furosemide.

A
  • Pulmonary edema
  • CHF
  • Hypertensive emergency
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50
Q

What is a contraindication for Furosemide?

A

Known sensitivity to sulfonamides or furosemide.

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51
Q

What class of medication is Procainamide?

A

Antiarrhythmic, Class IA

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52
Q

What is the dose of Procainamide?

A

20mg/min IV infusion (max 17mg/kg)

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53
Q

What is the MOA of Procainamide?

A

Blocks the influx of sodium through membrane pores, suppressing atrial and ventricular arrhythmias.

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54
Q

List the indications for Procainamide.

A
  • A-fib with RVR in WPW syndrome
  • V-Tach
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55
Q

What is a contraindication for Procainamide?

A

AV block, QT prolongation, torsades de pointes.

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56
Q

What class of medication is Lidocaine?

A

Class 1b Antiarrhythmic (Sodium Channel Blocker)

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57
Q

What is the dose of Lidocaine for cardiac arrest?

A

1 - 1.5mg/kg IV (cardiac arrest)

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58
Q

What is the MOA of Lidocaine?

A

Blocks sodium channels, decreasing slope of phase 0 of depolarization.

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59
Q

List the indications for Lidocaine.

A
  • V-Tach
  • V-Fib
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60
Q

What is a contraindication for Lidocaine?

A

Normally not given to patients who are awake.

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61
Q

What class of medication is Metoprolol?

A

Class II antiarrhythmic (Beta-Blocker)

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62
Q

What is the dose of Metoprolol?

A

5mg IV q 5min slow over 2min (max 3 doses)

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63
Q

What is the MOA of Metoprolol?

A

Decreased HR, cardiac contractility, BP, and myocardial O2 demand.

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64
Q

List the indications for Metoprolol.

A
  • ACS
  • Hypertension
  • SVT
  • Atrial Flutter
  • AFib
  • Thyrotoxicosis
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65
Q

What is a contraindication for Metoprolol?

A

Pulmonary edema, cardiogenic shock, hypotension, or bradycardia.

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66
Q

What class of medication is Amiodarone?

A

Class III Antiarrhythmic, Potassium Channel Blocker

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67
Q

What is the dose of Amiodarone for V-Tach with pulse?

A

150mg over 10min

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68
Q

What is the MOA of Amiodarone?

A

Blocks sodium, potassium, and calcium channels, prolonging cardiac action potential and repolarization.

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69
Q

List the indications for Amiodarone.

A
  • V-Tach with pulse
  • Cardiac Arrest
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70
Q

What is a contraindication for Amiodarone?

A

Hypersensitivity

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71
Q

What class of medication is Diltiazem?

A

Calcium channel blocker (Class IV antiarrhythmic)

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72
Q

What is the dose of Diltiazem?

A

15-20 mg (0.25 mg/kg) over 2 min SLOW IV PUSH

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73
Q

What is the MOA of Diltiazem?

A

Calcium channel blockade inhibits calcium transport into the cell, decreasing SA and AV node conduction.

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74
Q

List the indications for Diltiazem.

A
  • Ventricular rate control in rapid AFib and A-flutter
  • Second line after adenosine for narrow complex SVT
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75
Q

What is a contraindication for Diltiazem?

A

It may cause hypotension. Do not give to a hypotensive patient.

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76
Q

What class of medication is Adenosine?

A

Antiarrhythmic (regular)

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77
Q

What is the dose of Adenosine?

A

6mg Rapid IVP (IO) followed by 20cc NS flush

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78
Q

What is the MOA of Adenosine?

A

Slows the conduction of the electrical impulses of the AV node, causes transient asystole.

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79
Q

What is the indication for Adenosine?

A

SVT (AVNRT)

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80
Q

What is a contraindication for Adenosine?

A

Sick sinus syndrome, 2nd or 3rd-degree heart block.

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81
Q

What class of medication is Etomidate (Amidate)?

A

Anesthetic induction agent, Sedative, Hypnotic

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82
Q

What is the dose of Etomidate?

A

0.2 to 0.6 mg/kg slow IV, IO (over 30 to 60 seconds)

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83
Q

What is the MOA of Etomidate?

A

Enhances the activity of the GABA receptors in the central nervous system.

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84
Q

List the indications for Etomidate.

A
  • Procedural Sedation
  • Induction for rapid sequence intubation
  • Induction of anesthesia
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85
Q

What is a contraindication for Etomidate?

A

Hypersensitivity

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86
Q

What class of medication is Ketamine?

A

Analgesic, Sedative

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87
Q

What is the dose of Ketamine for RSI?

A

1.5mg/kg

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88
Q

What is the MOA of Ketamine?

A

NMDA Receptor stimulator.

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89
Q

List the indications for Ketamine.

A
  • Pain and anesthesia for procedures of short duration
  • RSI Induction agent
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90
Q

What is a contraindication for Ketamine?

A

Hypoglycemia or known sensitivity.

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91
Q

What class of medication is Versed (Midazolam)?

A

Benzodiazepine

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92
Q

What is the dose of Versed?

A

0.2-0.3mg/kg

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93
Q

What is the MOA of Versed?

A

Binds to drug-specific receptors of the GABA complex, increasing the frequency of chloride channel openings.

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94
Q

List the indications for Versed.

A

To promote amnesia and sedation.

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95
Q

What is a contraindication for Versed?

A

Use caution in volume-depleted or hemodynamically compromised PTs.

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96
Q

What class of medication is Fentanyl?

A

Opioid Analgesic

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97
Q

What is the dose of Fentanyl?

A

50-100mcg/min (max total 300mcg)

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98
Q

What is the MOA of Fentanyl?

A

Binds to mu-opioid receptors in the central nervous system, leading to analgesic and sedative effects.

99
Q

List the indications for Fentanyl.

A
  • Moderate to severe pain
  • Procedural sedation
100
Q

What is a contraindication for Fentanyl?

A

Hypersensitivity

101
Q

What class of medication is Propofol?

A

Anesthetic

102
Q

What is the dose of Propofol?

103
Q

What is the MOA of Propofol?

A

Enhances GABA activity at the GABA receptor complex.

104
Q

List the indications for Propofol.

A

Induction agent of choice for pregnant PTs.

105
Q

What is a contraindication for Propofol?

A

No absolute contraindications. Use caution in PTs with egg allergy.

106
Q

What class of medication is Morphine?

A

Opioid Analgesic

107
Q

What is the dose of Morphine?

108
Q

What is the MOA of Morphine?

A

Binds to mu-opioid receptors in the CNS, producing analgesic and sedative effects.

109
Q

List the indications for Morphine.

A
  • Moderate to severe pain
  • Chest pain associated with ACS
  • Angina
  • Congestive heart failure
  • Pulmonary edema
110
Q

What is a contraindication for Morphine?

A

Hypotension

111
Q

What class of medication is Succinylcholine?

A

Depolarizing neuromuscular blocker

112
Q

What is the dose of Succinylcholine?

A

2mg/kg rapid onset

113
Q

What is the MOA of Succinylcholine?

A

Competes with ACH receptors of the motor end plates on the muscle cells, resulting in paralysis.

114
Q

List the indications for Succinylcholine.

A

To induce paralysis for the facilitation of ET intubation.

115
Q

What is a contraindication for Succinylcholine?

A

Malignant hyperthermia, burns, trauma.

116
Q

What class of medication is Rocuronium?

A

Non-depolarizing NM blocker

117
Q

What is the dose of Rocuronium?

A

1.5mg/kg IV/IO push

118
Q

What is the MOA of Rocuronium?

A

Competitive NMBA, Non-depolarizing.

119
Q

List the indications for Rocuronium.

A

Provides skeletal muscle relaxation to facilitate ET intubation.

120
Q

What is a contraindication for Rocuronium?

A

Known sensitivity to bromides.

121
Q

What class of medication is Vecuronium?

A

Non-depolarizing NMBA

122
Q

What is the dose of Vecuronium?

123
Q

What is the MOA of Vecuronium?

A

Antagonizes the action of acetylcholine at the neuromuscular junction.

124
Q

What is the dose for Succinylcholine?

A

1.5mg/kg IV/IO push

Onset: 40sec, Duration: 40-60min

125
Q

What is the mechanism of action (MOA) of Succinylcholine?

A

Competitive NMBA, Non-depolarizing

126
Q

What are the indications for Succinylcholine?

A

Provides skeletal muscle relaxation to facilitate ET intubation

127
Q

What is a contraindication for Succinylcholine?

A

Known sensitivity to bromides

128
Q

What is the class of Vecuronium?

A

Non-depolarizing NMBA

129
Q

What is the dose for Vecuronium?

130
Q

What is the onset time for Vecuronium?

A

1-2 minutes

131
Q

What is the duration of action for Vecuronium?

A

25-30 minutes

132
Q

What is the MOA of Vecuronium?

A

Antagonizes ACH receptors at the neuromuscular end plates, inducing paralysis

133
Q

What are the indications for Vecuronium?

A

NMB for ET intubation

134
Q

What is the class of Diazepam (Valium)?

135
Q

What is the dose range for Diazepam?

A

2-5 mg IV/IM

136
Q

What is the onset time for Diazepam?

A

1-5 minutes

137
Q

What is the duration of action for Diazepam?

A

15-60 minutes

138
Q

What is the MOA of Diazepam?

A

Benzodiazepine that depresses CNS and has anticonvulsant properties

139
Q

What are the indications for Diazepam?

A

Post-intubation sedation

140
Q

What is a contraindication for Diazepam?

A

Inadequate pulmonary function, hypotension, and apnea

141
Q

What is the class of Albuterol?

A

Adrenergic Bronchodilator

142
Q

What is the dose for Albuterol via nebulizer?

A

2.5mg Nebulizer for COPD/Asthma

143
Q

What is the duration of action for Albuterol?

144
Q

What is the MOA of Albuterol?

A

Relaxes airways and smooth muscles, causing Bronchodilation by binding to Beta 2 adrenergic receptors

145
Q

What are the indications for Albuterol?

A

COPD, Asthma

146
Q

What is a contraindication for Albuterol?

A

Known hypersensitivity

147
Q

What is the class of Dexamethasone?

A

Corticosteroid

148
Q

What is the dose for Dexamethasone?

A

0.6mg/kg up to 10mg IV

149
Q

What is the MOA of Dexamethasone?

A

Suppresses inflammation and immune response

150
Q

What are the indications for Dexamethasone?

A

Anaphylaxis, Asthma

151
Q

What is a contraindication for Dexamethasone?

A

Untreated infections

152
Q

What is the class of Diphenhydramine (Benadryl)?

A

Antihistamine

153
Q

What is the dose range for Diphenhydramine?

A

25-50mg IV/IM

154
Q

What is the MOA of Diphenhydramine?

A

Antagonizes histamine effects

155
Q

What are the indications for Diphenhydramine?

A

Allergic reaction

156
Q

What is a contraindication for Diphenhydramine?

A

Known hypersensitivity

157
Q

What is the class of Epinephrine?

A

Bronchodilator

158
Q

What is the dose range for Epinephrine in anaphylaxis?

A

0.3-0.5mg SQ/IM of epi 1:1,000

159
Q

What is the MOA of Epinephrine?

A

Beta-2 adrenergic effects causing bronchodilation

160
Q

What are the indications for Epinephrine?

A

Anaphylaxis, Severe Asthma

161
Q

What is a contraindication for Epinephrine?

A

Known hypersensitivity

162
Q

What is the class of Ipratropium Bromide (Atrovent)?

A

Anticholinergic Bronchodilator

163
Q

What is the dose for Ipratropium Bromide?

A

0.5mg Nebulized

164
Q

What is the MOA of Ipratropium Bromide?

A

Inhibits bronchial secretions and constriction by blocking parasympathetic response

165
Q

What are the indications for Ipratropium Bromide?

A

Asthma/COPD

166
Q

What is a contraindication for Ipratropium Bromide?

A

Known hypersensitivity

167
Q

What is the class of Magnesium Sulfate?

A

Electrolyte

168
Q

What is the dose range for Magnesium Sulfate?

A

1.2-2g over 20 mins

169
Q

What is the MOA of Magnesium Sulfate?

A

Smooth muscle relaxant, bronchodilator

170
Q

What are the indications for Magnesium Sulfate?

A

Asthma exacerbation

171
Q

What is a contraindication for Magnesium Sulfate?

A

Known hypersensitivity

172
Q

What is the class of Methylprednisolone (Solu-Medrol)?

A

Corticosteroid

173
Q

What is the dose for Methylprednisolone?

A

2mg/kg IV/IM or 125mg IV/IM

174
Q

What is the MOA of Methylprednisolone?

A

Suppresses inflammation and immune response

175
Q

What are the indications for Methylprednisolone?

A

Severe asthma

176
Q

What is a contraindication for Methylprednisolone?

A

Known hypersensitivity

177
Q

What is the class of Epinephrine in cardiac arrest?

A

Catecholamine, adrenergic agent, vasopressor, bronchodilator

178
Q

What is the dose for Epinephrine in cardiac arrest?

A

1mg (1:10,000) IV/IO q3-5mins

179
Q

What is the MOA of Epinephrine in cardiac arrest?

A

Beta 1 & 2 agonist, Alpha 1 agonist

180
Q

What are the indications for Epinephrine in cardiac arrest?

A

Cardiac arrest or symptomatic bradycardia

181
Q

What is a contraindication for Epinephrine in cardiac arrest?

A

Known hypersensitivity or cardiac arrhythmias

182
Q

What is the class of Amiodarone?

A

Class III antiarrhythmic

183
Q

What is the dose for Amiodarone in V-Fib/pV-Tach?

A

300mg IV/IO followed by 150mg IV/IO

184
Q

What is the MOA of Amiodarone?

A

Prolongs action potential and refractory period; slows sinus rate

185
Q

What are the indications for Amiodarone?

A

Ventricular fibrillation/ventricular tachycardia

186
Q

What is a contraindication for Amiodarone?

A

Known hypersensitivity

187
Q

What is the class of Lidocaine?

A

Class IB antiarrhythmic

188
Q

What is the dose for Lidocaine in cardiac arrest?

A

1-1.5 mg/kg IV/IO

189
Q

What is the MOA of Lidocaine?

A

Suppresses automaticity and spontaneous depolarization of ventricles

190
Q

What are the indications for Lidocaine?

A

Alternative to amiodarone in VF/VT cardiac arrest

191
Q

What is a contraindication for Lidocaine?

A

3rd degree AV block

192
Q

What is the class of Magnesium?

A

Mineral/Electrolyte

193
Q

What is the dose for Magnesium in TdP?

A

1-2g IV/IO diluted in 10mL of D5 or NS

194
Q

What is the MOA of Magnesium?

A

Essential for the activity of many enzymes

195
Q

What are the indications for Magnesium?

A

Polymorphic V-Tach with Torsades de Pointes

196
Q

What is a contraindication for Magnesium?

A

Heart block

197
Q

What is the class of Calcium Chloride?

A

Electrolyte, positive inotrope

198
Q

What is the dose for Calcium Chloride?

A

500-1000mg IV/IO for hyperkalemia

199
Q

What is the MOA of Calcium Chloride?

A

Returns Ca++ levels to normal for optimal nerve and muscle function

200
Q

What are the indications for Calcium Chloride?

A

Hyperkalemia, Hypocalcemia, Calcium channel blocker overdose

201
Q

What is the class of Sodium Bicarbonate?

A

Alkalizing agent

202
Q

What is the dose for Sodium Bicarbonate?

A

1mEq/kg IV bolus

203
Q

What is the MOA of Sodium Bicarbonate?

A

Acts as a buffer to hydrogen ions, reducing acidosis

204
Q

What are the indications for Sodium Bicarbonate?

A

Hyperkalemia, acidosis, prolonged downtime

205
Q

What is a contraindication for Sodium Bicarbonate?

A

Lack of effective ventilation

206
Q

What is the class of Lorazepam (Ativan)?

A

Benzodiazepine, Schedule C-IV

207
Q

What is the dose for Lorazepam?

A

1-2mg IV/IM

208
Q

What is the MOA of Lorazepam?

A

Enhances effects of GABA, leading to sedation and anticonvulsant activity

209
Q

What are the indications for Lorazepam?

A

Pre-procedure sedation induction, Anxiety, Status Epilepticus

210
Q

What is a contraindication for Lorazepam?

A

Known sensitivity to lorazepam or benzodiazepines

211
Q

What is the class of Midazolam (Versed)?

A

Benzodiazepine, Schedule C-IV

212
Q

What is the dose for Midazolam?

A

5-10mg IV/IM

213
Q

What is the MOA of Midazolam?

A

Enhances effects of GABA, producing CNS depression

214
Q

What are the indications for Midazolam?

A

Sedation, Anxiety, Skeletal muscle relaxation

215
Q

What is a contraindication for Midazolam?

A

Acute-angle glaucoma, pregnant women

216
Q

What is the class of Meperidine hydrochloride (Demerol)?

A

Opioid analgesic; synthetic opioid; Schedule II drug

217
Q

What is the dose for Meperidine?

A

50 to 100 mg IM or 25 to 50 mg slowly IV/IO

218
Q

What is the MOA of Meperidine?

A

Synthetic opioid analgesic that acts similarly to morphine

219
Q

What are the indications for Meperidine?

A

Analgesia for moderate to severe pain

220
Q

What is a contraindication for Meperidine?

A

Known hypersensitivity, diarrhea caused by poisoning

221
Q

What is the class of Morphine?

A

Opioid Analgesic

222
Q

What is the dose for Morphine?

223
Q

What is the MOA of Morphine?

A

Binds to mu-opioid receptors in the CNS, producing analgesic effects

224
Q

What are the indications for Morphine?

A

Moderate to severe pain, including chest pain associated with ACS

225
Q

What is the class of Ketorolac (Toradol)?

A

NSAID, nonopioid analgesic

226
Q

What is the dose for Ketorolac?

A

30-60 mg IM or 15 mg IVP

227
Q

What is the MOA of Ketorolac?

A

Inhibits prostaglandin synthesis

228
Q

What are the indications for Ketorolac?

A

Acute management of moderate to severe pain

229
Q

What is a contraindication for Ketorolac?

A

NSAID or ASA allergy

230
Q

What is the class of Fentanyl?

A

Opioid Analgesic

231
Q

What is the dose for Fentanyl?

A

50-100mcg/min (max total 300mcg)

232
Q

What is the MOA of Fentanyl?

A

Binds to mu-opioid receptors, increasing potassium efflux and decreasing calcium influx

233
Q

What are the indications for Fentanyl?

A

Moderate to severe pain, Procedural sedation

234
Q

What is the class of Ondansetron (Zofran)?

A

Selective serotonin receptor (5-HT3) antagonist, antiemetic

235
Q

What is the dose for Ondansetron?

A

4 mg IV/SL or orally

236
Q

What is the MOA of Ondansetron?

A

Blocks the action of serotonin, preventing nausea and vomiting

237
Q

What are the indications for Ondansetron?

A

Prevention and control of nausea or vomiting

238
Q

What is a contraindication for Ondansetron?

A

Known hypersensitivity to ondansetron

239
Q

What is the class of Promethazine (Phenergan)?

A

Phenothiazine, antiemetic, antihistamine

240
Q

What is the dose for Promethazine?

A

12.5 to 25 mg deep IM

241
Q

What is the MOA of Promethazine?

A

H1 receptor antagonist; blocks action of histamine

242
Q

What are the indications for Promethazine?

A

Nausea and vomiting

243
Q

What is a contraindication for Promethazine?

A

Known hypersensitivity to promethazine

TCC pm pharm (4 decks)

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