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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
Q

Dopamine interactions

A

Drug interactions: Alkaline solutions; MAOIs; TCAs; beta blockers

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26
Q

Dopamine Dosage and Administration

A

Adult: IV/IO infusion at 5–20 mcg/kg/min, slowly titrated to patient response
Pediatric: Safety and effectiveness not established

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27
Q

Dopamine Duration of Action

A

Duration of action
Onset: Within 5 min
Peak effect: 5–10 min
Duration: < 10 min

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28
Q

Dopamine Special Considerations

A

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

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29
Q

lorazepam Adult Dosage

A

Adult: Anxiety/sedation: 0.1 mg/kg IV slowly over 2 min or 4 mg IM; Heat exposure: 1 mg IV/IO or 2mg IM; Chemical restraint: 2 mg IV or 4 mg IM

30
Q

Lorazepam Pediatric

A

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
Q

Lorazepam Duration of action

A

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
Q

Lorazepam Special Considerations

A

Special considerations
Pregnancy safety: Category D
Monitor respiratory rate and BP; have advanced airway equipment readily available

33
Q

Lorazepam Class

A

Class: Benzodiazepine, sedative-hypnotic, anticonvulsant; Schedule IV drug

34
Q

Lorazepam Indications

A

Indications: Uncontrolled shivering associated with heat exposure, active seizures, anxiety/sedation, chemical restraint

34
Q

Lorazepam MOA

A

Mechanism of action: Anxiolytic, anticonvulsant, and sedative effect; suppresses seizure activity; inhibits GABA receptors

34
Q

Lorazepam Contraindications

A

Contraindications: Hypersensitivity, neurologic or respiratory depression, glaucoma, sleep apnea, shock, suspected drug abuse

35
Q

Lorazepam Adverse/Side Effects

A

Adverse/side effects: Dizziness, drowsiness, CNS depression, apnea, hypotension, bradycardia

36
Q

Lorazepam Drug interactions

A

Drug interactions: Other CNS depressants

37
Q

Sodium Bicarbonate Class

A

Class: Systemic hydrogen ion buffer, alkalizing agent

38
Q

Sodium Bicarbonate MOA

A

Mechanism of action: Corrects metabolic acidosis; increases blood/urinary pH

39
Q

Sodium Bicarbonate indications:

A

Indications: Cardiac arrest with hyperkalemia or TCA overdose, QRS prolongation in TCA overdose, crush syndrome

40
Q

Sodium Bicarbonate Contraindications

A

Contraindications: Hypersensitivity, metabolic or respiratory alkalosis, hypokalemia, hypernatremia, hypocalcemia; use caution with heart failure and renal disease

41
Q

Sodium Bicarbonate Adverse Side effects

A

Adverse/side effects: Electrolyte imbalance, heart failure, and pulmonary edema; tremors, twitching, and seizures

42
Q

Sodium Bicarbonate Drug Interactions

A

Drug interactions: Amphetamines; benzodiazepines and TCAs; sympathomimetics

43
Q

Sodium Bicarbonate Adult Dosage

A

Adult: 1 mEq/kg slow IV/IO push

44
Q

Sodium Bicarbonate Pediatric

A

Pediatric: 1 mEq/kg slow IV/IO push

45
Q

Sodium Bicarbonate Duration of action

A

Duration of action
Onset: Seconds
Peak effect: < 15 min
Duration: 1–2 hours

46
Q

Sodium Bicarbonate Special Considerations

A

Special considerations
Pregnancy safety: Category C
Monitor closely for signs and symptoms of fluid overload.
Ensure patient has adequate airway and ventilatory support

47
Q

Morphine Class

A

Class: Opioid analgesic; Schedule II drug

48
Q

Morphine MOA

A

Mechanism of action: Alleviates pain, suppresses fear and anxiety

49
Q

Morphine indications

A

Indications: Acute pain

50
Q

Morphine Contraindications

A

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
Q

Morphine Adverse/Side Effects

A

Adverse/side effects: Confusion, sedation, headache, CNS or respiratory depression, apnea, bronchospasm, dyspnea, hypotension, orthostatic hypotension, syncope, bradycardia, tachycardia, nausea, vomiting, dry mouth

52
Q

Morphine Drug interactions

A

Drug interactions: Other CNS depressants; MAOIs

53
Q

Morphine Dosage Adult

A

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
Q

Morphine Dosage Pediatric

A

Pediatric: 0.1–0.2 mg/kg per dose IV/IO/ IM

55
Q

Morphine Duration of Action

A

Duration of action
Onset: Immediate
Peak effect: 20 min
Duration: 2–4 hours

56
Q

Morphine Special Considerations

A

Special considerations
Pregnancy safety: Category C
Use with caution in older patients and patients with asthma or susceptible to CNS depression

57
Q

Rocuronium Class

A

Class Paralytic (Non Depolarizing)

58
Q

Rocuronium MOA

A

Prevents Neuromuscular activity by blocking the effect of acetylcholine. at the myoneural junction. Used as a paralytiv during RSI

59
Q

Rocuronium indications

A

RSI

60
Q

Rocuronium Adverse Reactions

A

Hypotension, Bradycardia

61
Q

Rocuronium Dosage

A

1mg/kg IV/IO

62
Q

Rocuronium Special Considerations

A

Have Back-up airways available during RSI. Cardiac Monitoring, heart ratem and blood pressure. ETCO2 Continuously Reassessments.

63
Q

Ondansetron (Zofran) Class:

A

Class: Selective serotonin receptor (5-HT3) antagonist, antiemetic

64
Q

Ondansetron MOA

A

Mechanism of action: Blocks action of serotonin

65
Q

Ondansetron Indications

A

Indications: Nausea or vomiting

66
Q

Ondansetron Contraindications

A

Contraindications: Hypersensitivity, QT syndrome, coadministration with apomorphine

67
Q

Ondansetron Adverse/side effects:

A

Adverse/side effects: Headache, malaise, syncope, wheezing, bronchospasm, dysrhythmias, ECG changes, palpitations, constipation, diarrhea, hives, skin rash, serotonin syndrome

68
Q

Ondansetron Drug interactions:

A

Drug interactions: Other drugs that prolong the QT interval

CCAC Pharmacology (12 decks)

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