Precautions and Side Effects Flashcards
1
Q
Albuterol Sulfate (3)
A
- May cause dizziness, anxiety, palpitations, headache, sweating, and muscle tremors
- Clinically significant arrhythmias may occur especially in patients with underlying cardiovascular disorders
- Relative contraindication include symptomatic tachycardia, tachyarrhythmias, or anginal chest pain
2
Q
Epinephrine (2)
A
- May produce tachycardia and other dysrhythmias
- Excessive use may cause bronchospasm
3
Q
Ipratropium Bromide (2)
A
- Use with caution in patients with narrow angle glaucoma
- Side effects may include palpitations, dizziness, anxiety, headache, eye pain, urinary retention, and anxiety
4
Q
Magnesium Sulfate (2)
A
- May cause hypotension and respiratory depression in large doses
- Caution with use in patients with renal insufficiency or chronic renal failure/dialysis
5
Q
Methylprednisolone (none)
A
none
6
Q
Morphine Sulfate (4)
A
- Morphine causes neurologic and respiratory depression. Respiratory depression may be worse in patients with underlying lung disease or concomitant use of other depressant drugs such as benzos or alcohol
- Can be reversed with naloxone
- Check and document vital signs and patient response after each dose
- When given to treat pain, the goal is reduction of pain not total elimination of pain
7
Q
Naloxone (5)
A
- May precipitate acute withdrawal symptoms in patients who chronically use opioids
- Agitation, tachycardia, pulmonary edema, nausea, vomitting, and seizures (in neonates)
- Be prepared to restrain the patient as they may become violent with reverse of narcotic effect
- Duration of some narcotics is longer than naloxone
- Repeated doses may be required for some opioid toxicities
8
Q
Nitroglycerin (4)
A
- Generalized vasodilation may cause profound hypotension and reflex tachycardia
- May cause profound hypotension in patients taking medication for ED
- Common side effects include throbbing headache, flushing, dizziness and burning under the tongue
- Causes generalized smooth muscle relaxation, may be effective in relieving chest pain caused by esophageal spasm
9
Q
Phenylephrine (2)
A
- Each bottle is single patient use only
- Hypertension, palpitations, tremors
10
Q
Succinylcholine (2)
A
- Use with caution in patients with anticipated difficult airway
- Has no effect on consciousness– sedatives should be used in conjunction
11
Q
Midazolam (3)
A
- More potential than other IV benzos to cause respiratory depression. Patient should be monitored closely
- Most likely to produce respiratory depression in patients who have taken other depressant drugs, especially alcohol and barbitruates, or when given rapidly
- Elderly patients may have more profound respiratory and/or CNS depression, half dose should be administered
12
Q
Etomidate (1)
A
- Not intended for prolonged infusion due to suppression of cortisol and aldosterone production
13
Q
Ketamine (6)
A
- Transient periods of apnea (1-2 min) have occurred with IV ketamine administration, especially with rapid infusion
- May cause laryngospasm
- May cause hypersalivation, increased airway secretions
- May cause emergence reaction
- May cause nystagmus
- Use with caution in patients with schizophrenia
14
Q
Diphenhydramine (3)
A
- Usually causes sedation, however it may paradoxically cause excitation in children
- May have additive sedation effect with alcohol or other CNS depressants
- May cause hypotension when given IV
15
Q
Dexamethasone (2)
A
- If given IV should be given as slow IV push
- Sodium retention, fluid retention, potassium loss, hypokalemic alkalosis, hypertension, convulsions, hyperglycemia, myocardial rupture following recent myocardial infarction
16
Q
Acetaminophen (5)
A
- Nausea/vomiting
- Rash
- Headache
- Anemia
- Thrombocytopenia
17
Q
Vasopressin (5)
A
- Arrhythmia
- Bradycardia
- Limb ischemia
- Hyponatremia
- Mesenteric ischemia
18
Q
Lidocaine (2)
A
- At higher doses may cause CNS stimulation, seizure, depression, and respiratory failure
- Toxicity is more likely in elderly patients with CHF or impaired liver function
19
Q
Atropine (2)
A
- Avoid in hypothermic bradycardia
- Paradoxical bradycardia may result from doses less than 0.5mg, use in caution in pediatric patients
20
Q
Adenosine (3)
A
- May cause brief asystole, dizziness, facial flushing, headache, nausea, and transient shortness of breath
- IV adenosine has been shown to produce bronchospasm in asthmatic patients
- If pt becomes hemodynamically unstable, cardioversion should occur
21
Q
Amiodarone (1)
A
- May cause hypotension and bradycardia
22
Q
Sodium bicarbonate (1)
A
- May result in metabolic alkalosis, which may be difficult to reverse
23
Q
Aspirin (2)
A
- May cause GI discomfort and nausea
- May cause wheezing
24
Q
Fentanyl (3)
A
- Causes neurologic and respiratory depression (worse with alcohol or benzos). Resp. support must be available
- Can be reverse with naloxone
- Goal is reduction of pain, not total elimination
25
Q
Calcium chloride
A
- May cause discomfort at injection site
- Will precipitate if mixed with sodium bicarbonate
26
Q
Dopamine (5)
A
- May induce tachyarrhythmias
- High does (10mcg/kg) may cause peripheral vasoconstriction
- Will be inactivated in alkaline solutions (sodium bicarb)
- Treat hypovolemia with fluids before dopamine
- Best administered by infusion pump
27
Q
Norepinephrine (4)
A
- Ensure adequate fluid replacement before starting
- Administer through largest vein possible to reduce risk of tissue necrosis if extravasation
- Monitor BP closely
- Must be administered via infusion pump
28
Q
Verapamil (7)
A
- Dizziness
- Headache
- Nausea and vomitting
- Hypotension
- Bradycardia
- Complete AV block
- Peripheral edema
29
Q
Diltiazem (3)
A
- Prolongation of AV node conduction may result in 2nd or 3rd degree block
- Should not be administered to compromised myocardium
- Use caution when giving to hypotensive patients
30
Q
A
