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CCAC Pharmacology > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

Ketamine Class

A

Class: Analgesic, general anesthetic, dissociative anesthetic; Schedule III drug

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2
Q

Ketamine Mech. Of Action

A

Mechanism of action: Blocks pain receptors, minimizes spinal cord activity

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3
Q

Ketamine indications:

A

Indications: Procedural sedation, agitated/violent behavior, pain control

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4
Q

Ketamine Contraindications

A

Contraindications: Hypersensitivity, infants younger than 3 months, pregnancy, angina, heart failure, hyperthyroidism, schizophrenia, hazardous hypertension; head trauma, intracranial mass lesions, intracranial bleeding, or hydrocephalus

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5
Q

Ketamine Adverse/side effects:

A

Adverse/side effects: Hypertension, hallucinations, nausea/vomiting, nystagmus, bronchodilation, tachycardia, increased secretions, hypersalivation, laryngospasm, respiratory depression, elevations in BP and heart rate

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6
Q

Ketamine Drug interactions:

A

Drug interactions: Alcohol, cannabis, opioids, barbiturates, and nondepolarizing neuromuscular blockers

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7
Q

Ketamine Adult Dosage

A

Adult: Procedural sedation: 1–2 mg/kg IV push over 1–2 min; Moderate discomfort: 0.5 mg/kg IN; Severe discomfort: 0.25 mg/kg IM/IV/IO; Chemical restraint: 2 mg/kg IV or 4 mg/kg IM

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8
Q

Ketamine Pediatric

A

Pediatric: Procedural sedation: 1–2 mg/kg IV/IO push over 1–2min; Chemical restraint: 1 mg/kg IV or 3mg/kg IM

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9
Q

Ketamine Duration of Action

A

Onset: 30 seconds
Peak effect: 30 seconds–5 min
Duration: 10–15 min

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10
Q

Ketamine Special considerations

A

Pregnancy safety: Not classified
Shorting acting and less toxic than PCP

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11
Q

Epinephrine Class

A

Class: Sympathomimetic, sympathetic agonist

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12
Q

Epinephrine Mechanism of action

A

Strong alpha adrenergic, strong beta-1, and moderate beta-2 effect
Vasoconstriction increased HR/BP increased Contractility. Bronchodilator.

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13
Q

Epinephrine indications

A

Indications: Cardiac arrest, bradycardia, shock, anaphylaxis, severe refractory wheezing, croup/bronchiolitis

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14
Q

Epinephrine Contraindications

A

Contraindications: Hypersensitivity, coronary insufficiency, cardiac dilation

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15
Q

Epinephrine Adverse Side Effects.

A

Adverse/side effects: Nervousness, restlessness, headache, tremor, dysrhythmias, chest pain, increased myocardial oxygen demand, hypertension, palpitations, nausea, vomiting

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16
Q

Epinephrine Interactions

A

Drug interactions: Other sympathomimetics; alkaline solutions; MAOIs and antidepressants; beta blockers

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17
Q

Epinephrine Dose Adult

A

Adult:
Cardiac Arrest 1:10,000 1mg IV/IO 3-5 Minutes
Anaphylaxis: 1:1000 0.3 mg IM in anterolateral thigh
5mg Nebulizer (Stridor)

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18
Q

Epinephrine Dose Peds.

A

1:10,000 Cardiac Arrest 0.01 mg/kg
1:1,000 Anaphylaxis 0.01 mg/kg
Croup/Stridor 5cc 1:1,000 Via hand held neb.

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19
Q

Epinephrine Considerations

A

Special considerations
Pregnancy safety: Category C
Carefully document dosage, concentration, route, time of administration, and patient response
Administer ASAP in cardiac arrest associated with PEA or asystole

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20
Q

Dopamine (Intropin) Class

A

Class: Endogenous catecholamine, adrenergic, vasopressor, inotropic agent

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21
Q

Dopamine MOA

A

Mechanism of action: Immediate metabolic precursor to norepinephrine with mixed alpha adrenergic, beta adrenergic, and dopaminergic effects that are dose-dependent

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22
Q

Dopamine indications

A

Refractory cardiogenic or distributive shock, hypotension with low cardiac output states, second-line drug for symptomatic bradycardia

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23
Q

Dopamine Contraindications

A

Hypersensitivity, hypovolemia, pheochromocytoma, uncorrected tachydysrhythmias, VF

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24
Q

Dopamine Adverse Side Effects:

A

Adverse/side effects: Headache, anxiety, dyspnea, dysrhythmias, hypotension, hypertension, palpitations, chest pain, nausea, vomiting

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25
Dopamine interactions
Drug interactions: Alkaline solutions; MAOIs; TCAs; beta blockers
26
Dopamine Dosage and Administration
Adult: IV/IO infusion at 5–20 mcg/kg/min, slowly titrated to patient response Pediatric: Safety and effectiveness not established
27
Dopamine Duration of Action
Duration of action Onset: Within 5 min Peak effect: 5–10 min Duration: < 10 min
28
Dopamine Special Considerations
Special considerations Pregnancy safety: Category C Correct hypovolemia before administering; administer via infusion pump Extravasation may cause necrosis and sloughing of surrounding tissue Slow or stop infusion if tachydysrhythmias or increased ventricular ectopy is observed
29
lorazepam Adult Dosage
Adult: Anxiety/sedation: 0.1 mg/kg IV slowly over 2 min or 4 mg IM; Heat exposure: 1 mg IV/IO or 2 mg IM; Chemical restraint: 2 mg IV or 4 mg IM
30
Lorazepam Pediatric
Pediatric: Seizures: 0.1 mg/kg IV/IO slowly over 2 min; Heat exposure: 0.1 mg/kg IV/IM/IO; Chemical restraint: 0.05 mg/kg IV/IM
31
Lorazepam Duration of action
Onset: 2–5 min IV; 15–30 min IM Peak effect: Less than 15 min IV, 2–3 hours IM Duration: 6–8 hours
32
Lorazepam Special Considerations
Special considerations Pregnancy safety: Category D Monitor respiratory rate and BP; have advanced airway equipment readily available
33
Lorazepam Class
Class: Benzodiazepine, sedative-hypnotic, anticonvulsant; Schedule IV drug
34
Lorazepam Indications
Indications: Uncontrolled shivering associated with heat exposure, active seizures, anxiety/sedation, chemical restraint
34
Lorazepam MOA
Mechanism of action: Anxiolytic, anticonvulsant, and sedative effect; suppresses seizure activity; inhibits GABA receptors
34
Lorazepam Contraindications
Contraindications: Hypersensitivity, neurologic or respiratory depression, glaucoma, sleep apnea, shock, suspected drug abuse
35
Lorazepam Adverse/Side Effects
Adverse/side effects: Dizziness, drowsiness, CNS depression, apnea, hypotension, bradycardia
36
Lorazepam Drug interactions
Drug interactions: Other CNS depressants
37
Sodium Bicarbonate Class
Class: Systemic hydrogen ion buffer, alkalizing agent
38
Sodium Bicarbonate MOA
Mechanism of action: Corrects metabolic acidosis; increases blood/urinary pH
39
Sodium Bicarbonate indications:
Indications: Cardiac arrest with hyperkalemia or TCA overdose, QRS prolongation in TCA overdose, crush syndrome
40
Sodium Bicarbonate Contraindications
Contraindications: Hypersensitivity, metabolic or respiratory alkalosis, hypokalemia, hypernatremia, hypocalcemia; use caution with heart failure and renal disease
41
Sodium Bicarbonate Adverse Side effects
Adverse/side effects: Electrolyte imbalance, heart failure, and pulmonary edema; tremors, twitching, and seizures
42
Sodium Bicarbonate Drug Interactions
Drug interactions: Amphetamines; benzodiazepines and TCAs; sympathomimetics
43
Sodium Bicarbonate Adult Dosage
Adult: 1 mEq/kg slow IV/IO push
44
Sodium Bicarbonate Pediatric
Pediatric: 1 mEq/kg slow IV/IO push
45
Sodium Bicarbonate Duration of action
Duration of action Onset: Seconds Peak effect: < 15 min Duration: 1–2 hours
46
Sodium Bicarbonate Special Considerations
Special considerations Pregnancy safety: Category C Monitor closely for signs and symptoms of fluid overload. Ensure patient has adequate airway and ventilatory support
47
Morphine Class
Class: Opioid analgesic; Schedule II drug
48
Morphine MOA
Mechanism of action: Alleviates pain, suppresses fear and anxiety
49
Morphine indications
Indications: Acute pain
50
Morphine Contraindications
Contraindications: Hypersensitivity, MAOI in past 14 days, paralytic ileus, diarrhea, heart failure, head injuries, brain tumors, delirium tremens, seizure disorders, premature birth, bronchial asthma, upper airway obstruction, GCS <15, hypotension, hypoventilation
51
Morphine Adverse/Side Effects
Adverse/side effects: Confusion, sedation, headache, CNS or respiratory depression, apnea, bronchospasm, dyspnea, hypotension, orthostatic hypotension, syncope, bradycardia, tachycardia, nausea, vomiting, dry mouth
52
Morphine Drug interactions
Drug interactions: Other CNS depressants; MAOIs
53
Morphine Dosage Adult
i. Moderate discomfort: 0.1 mg/kg IM (maximum dose: 15 mg) ii. Severe to excruciating discomfort: 0.1 mg/kg slow IV/IO (maximum dose: 10 mg) iii. STEMI: Initial dose: 2 to 4 mg slow IV (over 1 to 5 minutes) Repeat dose: 2 to 8 mg at 5- to 15-minute intervals iv. NSTEMI/unstable angina: 1 to 5 mg slow IV push only if symptoms are not relieved by nitrates, provided additional therapy is used to manage the underlying ischemia
54
Morphine Dosage Pediatric
Pediatric: 0.1–0.2 mg/kg per dose IV/IO/ IM
55
Morphine Duration of Action
Duration of action Onset: Immediate Peak effect: 20 min Duration: 2–4 hours
56
Morphine Special Considerations
Special considerations Pregnancy safety: Category C Use with caution in older patients and patients with asthma or susceptible to CNS depression
57
Rocuronium Class
Class Paralytic (Non Depolarizing)
58
Rocuronium MOA
Prevents Neuromuscular activity by blocking the effect of acetylcholine. at the myoneural junction. Used as a paralytiv during RSI
59
Rocuronium indications
RSI
60
Rocuronium Adverse Reactions
Hypotension, Bradycardia
61
Rocuronium Dosage
1mg/kg IV/IO
62
Rocuronium Special Considerations
Have Back-up airways available during RSI. Cardiac Monitoring, heart ratem and blood pressure. ETCO2 Continuously Reassessments.
63
Ondansetron (Zofran) Class:
Class: Selective serotonin receptor (5-HT3) antagonist, antiemetic
64
Ondansetron MOA
Mechanism of action: Blocks action of serotonin
65
Ondansetron Indications
Indications: Nausea or vomiting
66
Ondansetron Contraindications
Contraindications: Hypersensitivity, QT syndrome, coadministration with apomorphine
67
Ondansetron Adverse/side effects:
Adverse/side effects: Headache, malaise, syncope, wheezing, bronchospasm, dysrhythmias, ECG changes, palpitations, constipation, diarrhea, hives, skin rash, serotonin syndrome
68
Ondansetron Drug interactions:
Drug interactions: Other drugs that prolong the QT interval

CCAC Pharmacology (12 decks)

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