Special Considerations Flashcards
Acetaminophen/ APAP (Special Considerations)
This is not a non-steroidal anti-inflammatory drug (NSAID)
The drug can cause acute liver failure and death when taken as an overdose
Consider decreased dosages for elderly patients and patients with liver disease due to their slow metabolic function
Peak effect- 30 to 60 minutes
Duration- 4 to 6 hours
Acetylsalicylic acid/ASA (Special considerations)
The drug may increase adverse reactions and side effects when administered with anti-inflammatory and anticoagulant drugs such as warfarin (Coumadin)
Peak effect- 1 to 2 hours
Duration- 4 to 6 hours
Activated Charcoal (Special Considerations)
If aspirated, the drug can cause serious pulmonary complications
Peak effect- variable
Duration- variable
Adenosine (Special Considerations)
Constant monitoring of patient’s cardiac rhythm is required during administration of the drug
Half-life is 6-10 seconds
Peak effect- 20 to 30 seconds
Duration- 30 seconds
Albuterol Sulfate (Special Considerations)
Drug may be used in conjunction with Ipratropium bromide (Atrovent)
Peak effect- 1 to 1.5 hours
Duration- 3 to 6 hours
Amiodarone (Special Considerations)
Peak effect- 10 minutes
Duration- variable
Atropine Sulfate (Special Considerations)
Consider transcutaneous pacing for bradydysrhythmias refractory to administration of the drug
Bumetanide (Special considerations)
Bumetanide 1.0 mg has the diuretic potency of furosemide 40 mg
Peak effect- 15 to 30 minutes
Duration- 3 to 4 hours
Calcium Chloride (Special Considerations)
Drug may be used as a pretreatment to the administration of diltiazem (Cardizem)
Drug may cause bradydysrhythmias with a patient prescribe digoxin (Lanoxin)
Peak effect- variable
Duration- variable
Calcium Gluconate 2.5% Topical Gel (Special considerations)
Peak effect- variable
Duration- variable
Calcium Gluconate (Special Considerations)
Peak- immediate
Duration- 30 to 120 minutes
Dexamethasone (Special Considerations)
Peak effect- 6 to 12 hours
Duration- 24 to 72 hours
Dextrose 50% (Special Considerations)
Drug may be used in conjunction with thiamine (Vitamin B1) for a patient with malnutrition or alcohol abuse
Check the blood glucose level before administering the drug
Check the blood glucose level after each additional dosage of the drug
Peak effect- variable
Duration- Variable
Diazepam (Special Considerations)
Peak effect IV/IO- 15 minutes
Duration IV/IO- 15 to 60 minutes
Peak effect IM- 30 to 45 minutes
Duration IM- 15 to 60 minutes
Peak effect Rectal for PEDS- variable
Duration Rectal for PEDS- Variable
Efficiency of rectal to adults has not been established
Diltiazem (Special Considerations)
Consider decreasing the dosage for elderly patients
Consider pretreatment with calcium chloride
Peak effect- 7 minutes
Duration- 1 to 3 hours
An infusion pump should be used to administer
Diphenhydramine (Special Considerations)
Peak effect- 1 hour
Duration- 6 to 8 hours
Dopamine (Special Considerations)
Peak- 5 to 10 minutes
Duration- variable
An infusion pump should be use to administer the drug when possible
Epinephrine (Special Considerations)
Drug can increase adverse reactions and side effects when administered with another Sympathomimetic drug
Peak IV/IO/ET- less than 5 minutes
Duration IV/IO/ET- 5 to 10 minutes
Peak effect IM- less than 20 minutes
Duration IM- 20 to 30 minutes
An infusion pump should be used to administer the drug when possible
Etomidate (Special Considerations)
Peak effect- less than 1 minute
Duration- 3 to 5 minutes
Fentanyl (Special Considerations)
Peak effect- 3 to 5 minutes
Duration- 30 to 60 minutes
Fentanyl 100 mcg is equivalent in analgesia to morphine 10 mg
Furosemide (Special Considerations)
Peak effect- 20 to 30 minutes
Duration- 3 to 6 hours
Glucagon (Special Considerations)
Check the blood glucose level before administering the drug
Check the blood glucose level after each additional dosage of the drug
Peak effect- 30 minutes
Duration- 1 to 2 hours
Drug may be used in conjunction with dextrose 50%
Drug may be used in conjunction with thiamine (Vitamin B1) for a patient with malnutrition or alcohol abuse
Hydroxocobalamin (Special Considerations)
Peak effect- variable
Duration- variable
Ibuprofen (Special Considerations)
Peak effect- 30 to 60 minutes
Duration- 4 to 6 hours
Ipratropium Bromide (Special Considerations)
Drug may be used in conjunction with Albuterol (Proventil)
Peak effect- 1.5 to 2 hours
Duration- 4 to 6 hours
Ketamine (Special Considerations)
Peak effect IV/IO- 15 minutes
Duration IV/IO- 15 to 60 minutes
Peak effect IM- 30 to 45 minutes
Duration IM- 15 to 60 minutes
Duration Rectal-Variable
Lidocaine (Special Considerations)
Consider decreased dosages for elderly patient and patients with liver disease due to their slower metabolic function
Peak effect- 5 to 10 minutes
Duration- 10 to 20 minutes
An infusion pump should be used to administer the drug when possible
Lorazepam (Special Considerations)
Drug may produce longer periods of sedation with elderly patients
Peak effect IV/IO- less than 15 minutes
Duration IV/IO- 6 to 8 hours
Peak effect IM- 2 to 3 hours
Duration IM- 6 to 8 hours
Magnesium Sulfate (Special Considerations)
Peak- Variable
Duration- 1 hour
An infusion pump should be used to administer the drug when possible
Methylprednisolone (Special Considerations)
Peak effect- 8 hours
Duration- 18 to 36 hours
Midazolam (Special Considerations)
Consider decreased dosages for elderly patients and patients with liver and kidney disease due to slower metabolic function
Peak effect IV/IO-3 to 5 minutes
Duration IV/IO- less than 2 hours
Peak effect IM- 30 to 60 minutes
Duration IM- 1 to 6 hours
Morphine Sulfate (Special Considerations)
Peak IV/IO- 20 minutes
Duration IV/IO- 2 to 4 hours
Peak Effect IM - 30 to 60 minutes
Duration IM- 4 to 5 hours
Respiratory arrest/ depression can be reverse by naloxone (Narcan)
Drug can cross the placenta barrier
Naloxone (special considerations)
Peak effect IV/IO- less than 2 minutes
Duration IV/IO- 20 minutes to 2 hours
Peak IM/IN- 2 to 10 minutes
Duration IM/IN- 20 minutes to 2 hours
Peak IN- 20 minutes
Duration IN- 30 to 90 minutes
Nitroglycerin (Special Considerations)
Peak effect- 5 to 10 minutes
Duration- 20 to 30 minutes
Nitrous Oxide 50% (Special Considerations)
The patient must hold the mask to their face while inhaling the drug
Peak effect- 1 minute
Duration- 1 to 5 minutes
Norepinephrine (Special Considerations)
Drug can increase adverse reactions and side effects when administered with another Sympathomimetic drug
Peak effect- less than 1 minute
Duration- 1 to 2 minutes
An infusion pump should be used to administer drug
Ondansetron (Special Considerations)
Peak effect- 1.5 to 2 hours
Duration- 3 to 8 hours
Oral Glucose (Special Considerations)
Check the blood glucose level before administering the drug
Check the blood glucose level after each additional dosage of the drug
Peak effect- variable
Duration- variable
Oxygen (Special Considerations)
In emergency setting, administration of oxygen does not have a significant depressive respiratory effect on the patient with a cardiovascular condition or chronic pulmonary disease, including emphysema
Peak effect- variable
Duration- variable
Oxytocin (Special Considerations)
Peak effect of infusion- variable
Duration of infusion- 1 hour after discontinued
Peak effect IM- variable
Duration IM- 2 to 3 hours
An infusion pump should be used to administer the drug when possible
Phenylephrine Nasal Spray 0.5% (Special Considerations)
Drug is used in conjunction with a properly-sized nasotracheal tube and lubrication
Peak effect - 30 minutes
Duration- 30 minutes to 4 hours
Pradlidoxime Chloride (2-Pam) (Special Considerations)
Drug may be used in conjunction with atropine sulfate
Peak effect- 10 to 20 minutes
Proparacaine Ophthalmic solution 0.5% (Special Considerations)
Peak effect- 30 to 2 minutes
Duration- 5 to 10 minutes
Racemic Epinephrine (Special Considerations)
Drug can increase adverse reactions and side effects when administered with another Sympathomimetic drug
Peak- 5 to 15 minutes
Duration- 1 to 3 hours
Rocuronium (Special Considerations)
Peak effect- 1 to 3 minutes
Duration- 30 to 60 minutes
Sodium Bicarbonate 7.5-8.4% (Special Considerations)
Drug must be used in conjunction with effect ventilation
Peak effect- less than 15 minutes
Duration- 1 to 2 hours
Succinylcholine (Special Considerations)
Peak effect- 1 to 3 minutes
Duration- 7 to 10 minutes
Tetracaine (Special Considerations)
Peak effect- 15 to 30 seconds
Duration- 10 to 20 minutes
Thiamine (Special Considerations)
Drug may be administered prior to dextrose 50%
Drug should be administered before dextrose 50% or glucagon to a patient with malnutrition or alcohol abuse
Peak effect- 3 to 5 days
Duration- variable
Vasopressin (Special Considerations)
Peak effect- 15 minutes
Duration- 30 to 60 minutes
Used to replace either 1st or 2nd dose of epinephrine
Verapamil (Special Considerations)
Administer drug over 3 minutes to elderly patients
Peak effect- 1 to 5 minutes
Duration- 1 to 6 hours
0.9% sodium chloride solution (special considerations)
None
Lactated Ringer’s solution (special considerations)
None
Dextrose 5% in water (Special considerations)
None