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Pharmacology > Quiz 11/20 > Flashcards

Quiz 11/20 Flashcards

1
Q

Morphine Sulfate: Class

A

Narcotic analgesic

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1
Q

Epinephrine: Class

A

sympathomimetic

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1
Q

epinephrine: pharmacokinetics

A

onset: IV immediate onset: IM 5 to 10 minutes onset: SQ 6 to 15 minutes

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1
Q

lorazepam (Ativan): side effects

A

Hypotension, respiratory depression

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1
Q

midazolam (Versed): precautions

A

monitor respiratory status

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2
Q

diazepam (Valium): side effects

A

hypotension, respiratory depression

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3
Q

Morphine Sulfate: Pharmacokinetics

A

Onset: less than five minutes IV; 10 to 30 minutes IM.

Duration: 4 to 6 hours.

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3
Q

epinephrine: interactions

A

sodium bicarbonate can deactivate catecholamines. MAO inhibitors potentiate the effects of epinephrine (Marplan, Eutonyl, Parnate, Nardil)

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4
Q

dopamine: dosage

A

2-20mcg/kg/minute IV infusion.

Improve cardiac output (beta):5-10 mcg/kg/minute.

Increase peripheral vascular resistance (Alpha): 10-20 mcg/kg/minute.

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5
Q

Naloxone Hydrochloride: Contraindications

A

None

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7
Q

diazepam (Valium): class

A

benzodiazepines, anticonvulsant, sedative, hypnotic

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8
Q

Morphine Sulfate: Contraindications

A

Head injury and /or decreased mental status, hypotension, abdominal pain associated with trauma (some EMS systems don’t permit use of morphine in undiagnosed abdominal pain of any origin.

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10
Q

Diazapam (Valium): Dosage

A

5-15 mg IV

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11
Q

lorazepam (Ativan): interactions

A

Effects are additive when used with other CNS depressants, for example, alcohol

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13
Q

Morphine Sulfate: Notes

A

Patients with allergy to sulfa are not allergic to MS. Morphine is the standard which all other analgesics are compared. 60 mg oral MS is same as 10 mg IV MS. MS is a schedule II narcotic.

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14
Q

Lorazepam (Ativan): class

A

benzodiazepine, anticonvulsant, sedative, hypnotic

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15
Q

Naloxone Hydrochloride: Pharmacokinetics

A

Onset: 1-2 minutes IV, 2-5 minutes IM.

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15
Q

Lorazepam (Ativan): Indications

A

Major motor seizures, premedication for cardioversion ot TCP, sedation associated with intubation, muscle spasms, acute anxiety, agitation (amphetamine or cocaine OD)

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15
Q

Lorazapam (Ativan): pharmacokinetics

A

Onset: 1-2 min IV; 15 min IM
Duration: 30-60 min IV, IM

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15
Q

midazolam (Versed): interactions

A

Effects are additive when used with other CNS depressants, for example, alcohol.

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17
Q

Morphine Sulfate: Indications

A

Pain, cardiac pain refractory to NTG, burns, acute pulmonary edema.

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17
Q

Dopamine: precautions

A

extravasation will cause tissue necrosis

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18
Q

dopamine: side effects

A

increased myocardial oxygen demand, ischemia, tachydysrhythmias.

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19
Q

Naloxone Hydrochloride: Interactions

A

None

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19
Q

diazepam (Valium): mechanism of action

A

Enhances action of GABA, an inhibitory
neurotransmitter, which inhibits spread of electrical
activity from irritable focus during seizures, calms CNS.
Also a muscle relaxant.

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20
Q

Naloxone Hydrochloride: Indications

A

Symptomatic opiate overdose (respiratory depression), Clonidine overdose.

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20
Q

epinephrine: side effects

A

increased myocardial oxygen demand, ischemia, tachydysrhythmias, and anxiety.

21
Q

Naloxone Hydrochloride: Dosage

A

0.1 - 2 mg(IV, IM, SQ, ETT, nasal), repeated to a max of 8 mg. Naloxone is shorter acting than most opiates, repeated doses may be required.

23
Q

epinephrine: side effects

A

increased myocardial oxygen demand, ischemia, tachydysrhythmias, and anxiety.

24
Q

Morphine Sulfate: Dosage

A

2-5 mg slow IV push, titrated to effect. Max dose usually not to exceed 20 mg without OLMC approval. MS can be given IM.

25
Q

Morphine Sulfate: Precautions

A

Consider calling OLMC in the setting of multi-systems trauma. May cause N&V if given rapidly.

26
Q

midazolam (Versed): side effects

A

Laryngospasm, bronchospasm, respiratory depression, drowsiness, amnesia, altered mental status

27
Q

Naloxone Hydrochloride: Mechanism of action

A

Competitively displaces opioid analgesics from their receptor sites, reversing their effects. Respiratory depression, sedation, papillary miosis, and euphoric effects will be reversed.

28
Q

epinephrine: dosage

A

Cardiac arrest: 1 mg/3-5 minutes IV (1:10,000)

Bradycardia: 2-10 mcg/minute

Anaphylaxis: 0.3–0.5 mg IM every 5–15 minutes (1:1000), 0.3-0.5 mg 3-5 minutes slow IV (1:10000).

Croup 0.5 mL via nebulizer (2.25% racemic epinephrine added to 3 mL saline)

29
Q

Naloxone Hydrochloride: Class

A

Opiate antagonist

31
Q

diazepam (Valium): precautions

A

Cannot be given IM. If possible use large vein and give slowly because of possible venous irritation. Monitor respiratory status

32
Q

Morphine Sulfate: Mechanism of action

A

Combines with opioid receptors in the brain. Peripheral vasodialation of the veins and arteries resulting in decreased preload (not usually altering heart rate or blood pressure at usual doses).

33
Q

Dopamine: indications

A

1 Significantly symptomatic hypotension (most commonly septic or cardiogenic shock). With the possible exception of cardiogenic shock, fluid resuscitation mast be attempted before the administration of dopamine.in the prehospital setting, dopamine is not used for shock in the setting of trauma.

34
Q

epinephrine: indications

A

cardiac arrest: asystole and V-fib/tach without a pulse, PEA.also used in bradycardia (as a drip medicine only), anaphylaxis bronchospasm/constriction, and croup (racemic)

35
Q

Diazapam (Valium): Contraindications

A

Hypotension, head injury and/or decreased mental status unless being given during RSI

37
Q

lorazepam (Ativan): mechanism of action

A

Enhances action of GABA, and inhibitory neurotransmitter, inhibits spread of electrical activity from irritable focus during seizures, calmes CNS. Also a muscle relaxant.

39
Q

Naloxone Hydrochloride: Side effects

A

Nausea, vomiting (if administered rapidly). Narcotic withdrawal symptoms: dizziness, hypertension, tachycardia, sweating, nervousness, abdominal cramps, headache, weakness, joint and muscle pain, insomnia, and untreated pain.

40
Q

Diazapam (Valium): Indications

A

Major motor seizures, premedication for cardioversion ot TCP, sedation associated with intubation, muscle spasms, acute anxiety, agitation (amphetamine or cocaine OD)

40
Q

Lorazepam (Ativan): Dosage

A

0.05mg/kg IV, max is generally 4mg

41
Q

dopamine: mechanism of action

A

dopamine stimulates alpha and beta-1, and dopaminergic receptors. It also acts indirectly by causing release of norepinephrine from storage sites in the sympathetic nerve endings.the effects of dopamine are dose-related. At low doses, beta-1 and dopaminergic receptors are stimulated. At high doses out for the effects predominate.

41
Q

diazepam (Valium):pharmacokinetics

A

Onset: 2-4 minutes
Duration: 30-90 minutes

42
Q

epinephrine: mechanism of action

A

Epinephrine stimulates alpha and beta adrenergic receptors. Because of these effects the drug causes: peripheral vasoconstriction, increased inotropic, chronotropic, and dromatropic responses; and bronchodilation. Inhibits mast cell degranulation.

44
Q

Dopamine: interactions

A

sodium bicarbonate can deactivate catecholamines. MAO inhibitors potentiate the effects of dopamine (Marplan, Eutonyl, Parnate, Nardil)

45
Q

midazolam (Versed): mechanism of action

A

Enhances action of GABA, an inhibitory neurotransmitter; inhibits spread of electrical activity from irritable focus during seizures, calms CNS. Also a muscle relaxant.

46
Q

Midazolam (Versed): Dosage

A

RSI: 0.1mg/kg IV, Max 10mg

Other sedation, seizure: 2.5mg-10mg IV/IM

48
Q

Morphine Sulfate: Interactions

A

Potentiates other CNS depressants. Use caution with patients who have been drinking alcohol.

50
Q

Dopamine: pharmacokinetics

A

IV drip administration has a rapid onset and will last as long as the drug is being infused.

52
Q

Lorazepam (Ativan): Contraindications

A

Hypotension, head injury and/or decreased mental status unless being given during RSI

53
Q

Midazolam (Versed): Indications

A

Major motor seizures, premedication for cardioversion ot TCP, sedation associated with intubation, muscle spasms, acute anxiety, agitation (amphetamine or cocaine OD)

54
Q

epinephrine: contraindications

A

none when used in emergency situations, however in patients with a pulse, use caution if they have underlying cardiovascular disease, hypertension, or tachydysrhythmias.

55
Q

dopamine: class

A

sympathomimetic, vasopressin

56
Q

midazolam (Versed): class

A

benzodiazepine, anticonvulsant, sedative, hypnotic

57
Q

diazepam (Valium): interactions

A

Effects are additive when used with other CNS depressants, for example, alcohol

58
Q

dopamine: contraindications

A

pheochromocytoma, uncorrected tachydysrhythmia (except sinus tachycardia).

59
Q

Naloxone Hydrochloride: Precautions

A

Can precipitate severe withdrawal symptoms in individuals physically dependent on opioids. Use repeated small doses (0.1-0.2 mg IV) in patients taking chronic narcotics. Consider physical restraints (and your personal safety) prior to, or concurrent with naloxone hydrochloride administration. may precipitate seizures in the neonate.

60
Q

Morphine Sulfate: Side effects

A

Respiratory depression, hypotension, decreased mental status, histamine release.

61
Q

Dopamine: how supplied

A

prefilled syringes and ampoules of either 400 or 800 mg. Premix bags with either 400 or 800 mg in 250 to 500 mL. Concentrations of mixtures vary, but most commonly are 1600 mcg/mL

62
Q

midazolam (Versed): pharmacokinetics

A

Onset: 1-2 min IV; 15 min IM
Duration: 30-60 min IV, IM

64
Q

Midazolam: Contraindications

A

Hypotension, head injury and/or decreased mental status unless being given during RSI.

65
Q

Naloxone Hydrochloride: Notes

A

Larger doses may be required to reverse the effects of synthetic narcotics (propoxyphene, buprenorphine, butorphanol, nalbuphine, or pentazocine). Not useful in cardiac arrest even if cardiac arrest was a result of respiratory arrest caused by narcotic overdose. Naloxone will not restart an arrested heart.

Pharmacology (24 decks)

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