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P2 Exams > Trauma Meds > Flashcards

Trauma Meds Flashcards

1
Q

Acetaminophen) Dynamics:
Indications:
Contra:
Dose:

A

= Nonopioid Analgesic/Antipyretic Fever,
= pain management
= AMS
= IV/IO: 1 gram over 10 - 15 minutes, PO: 15 mg/kg

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2
Q

Bohr Effect:
Influences by:
What does it do to hemoglobin:

A

= Acid> Hemoglobin droping oxy off in body
= + CO2, +temp, -pH+ BPG 2,3 in body
= -oxy affinity

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3
Q

Diazepam) Dynamics:
Indications:
Contra:
Dose:

A

= Benzodiazepine. Binds w/ GABA receptors causing an influx of Cl
= Tcardia due to stimulant OD, Substained seizures. Anxiety. Sedation.
= Hypersensitivity
= 2.5-10 mg in 2.5 mg increments slow IV/IO/IM

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4
Q

Diazepam) Dynamics:
Indications:
Contra:
Dose:

A

= Benzodiazepine Binds with GABA receptors causing an influx of Cl
= TachyC from stimulant OD, Sustained seizure, Anxiety, Sedation,
= Hypersensitivity
= 2.5-10 mg in 2.5 mg increments slow IV/IO/IM.

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5
Q

Etomidate) Dynamics:

Indications:
Contra:
Dose:

A

= Nonbarbiturate, nonbenzodiazepine sedative Interacts w/ GABA receptors. Anesthetic w/o analgesic.
= Sedation / SFI/RSI
= Hypersensitivity
= 0.2-0.4 mg/kg (limit to 1 dose). Onset 30 secs Duration: 5-10 mins

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6
Q

Ketamine) dynamics:
Indications:
Contraindications:
(Pain Management) Adult & Pediatric Dose:
Dissociation dose:

A

= + sympathetic response, Sedative-hypnotic & analgesic med
= Moderate to severe pain ØSFI/RSI
= History of hypersensitivity to the med, Hypertension
= 0.2mg/kg/1-2mins w/ max single dose 20mg(.5mg/kg IN/M)
= 1-2mg/kg ((0.5 mg/kg IN/IM)

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7
Q

Ketamine) Sedation Dose:
Analgesia/Pain Dose:

A

= 1-2 mg/kg Onset: 30-60 secs, Lasts: 10-20 mins
= 0.2 mg/kg IV/IO (max single dose 20mg) 0.5 mg/kg IM/IN (if no IV/IO)

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8
Q

Ketorolac (Toradol) Dynamics:
Indications:
Contra:
Dose:

A

= Anti-inflammatory & antipyretic through inhibition of prostaglandins
= Mild-moderate pain, Fever, Inflammation, Renal calculi
= Hypersensitivity, Bronchospasm, Angioedema
= 15mg IV, 30mgIM

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9
Q

Levalbuterol (Xopenex) Dynamics:
Indications:
Contra:
Dose:

A

= ß Agonist w/ preference for ß2 receptors. Has <effects on heart vs. Albuterol
=Bronchospasm, Allergies/anaphylaxis, Hyperkalemia
=Hypersensitivity
= 0.63 mg/3 mL via SVN

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10
Q

Levalbuterol /Xopenex) Indications:
Contra:

A

= Bronchospasm, Allergies/anaphylaxis, Hyperkalemia
= Hypersensitivity

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11
Q

Lorazepam) Dynamics:
Indications:
Contra:
Dose:

A

= Benzodiazepines, Binds w/ GABA receptors causing an influx of Cl
= Sustained seizures, anxiety, sedation, chemical restraint
= Hypersensitivity
= 2-4 mg (may repeat to a max dose of 8 mg)

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12
Q

Methylene Blue) Dynamics:
Indications:
Contra:
Dose:

A

= Water soluable thiazine dye helps metHb to hemoglobin conversion
= Methemoglobinemia (metHb), Nitrate OD/poisoning
= Hypersensitivity
= 1 mg/kg IV/IO over 5-30 minutes.

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13
Q

Midazolam (Versed) Dynamics:
Indications:
Contra:
Seizures Dose:
RSI Dose:

A

= Benzodiazepine, binds w/ GABA receptors causing an influx of Cl
= Active seizures, Chemical restraint, Anxiety, RSI/SFI, Sedation
= Hypersensitivity
= 0.2 mg/kg in 2 mg increments IV/IO (max 10 mg). 5 mg IM/IN
= 0.1-0.3 mg/kg slow IV/IO (max 10 mg) Onset: 2-5 mins. Duration: 15-30 mins.

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14
Q

Morphine) Analgesia dose:

A

= Analgesia: 2-10 mg up to max 20 mg

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15
Q

Morphine) Dynamics:

indications:
Contra:
Analgesia:
STEMI:
NSTEMI-ACS:

A

= Narcotic (Schedule II Opioid) Analgesia & sedation via binding to opiate receptor
= Ischemic chest pain not relieved by Nitroglycerin
= Hypersensitivity. Uncorrected hypotension (<90 SBP)
= 2-10 mg up to max 20 mg.
= 2-4mg slow IV/O, may admin 2nd dose 2-8mg IV/IO q5-15 mins
= 0.1 mg/kg slow IV/IO or IM up to 10 mg

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16
Q

Norepinephrine) Dynamics:
Indications:
Contra:
Dose:

A

= αß adrenergic agonist (α > ß effects)
= Normovolemic hypoBP, Sepsis, Cardiogenic shock
= Shouldn’t use in hypovol/ til’ vol/ replacement occurred
= 0.1-0.5 mcg/kg/min IV/IO infusion

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17
Q

Ondansetron (Zofran) Dynamics:
Indications:
Contra:
Dose:

A

= Selective serotonin 5-HT3 receptor blocker
= Prevention & control of Nausea and/or vomiting
= Hypersensitivity, QT prolonged
= 4-8 mg IV slow push, IM, PO.

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18
Q

(Propofol/ Diprivan) Class:
Dose:

A

= Sedative
= 1-2 mg//kg IV/IO Onset: <1min, Lasts: 5-10mins

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19
Q

Sodium Bicarbonate 8.4%) Dynamics:

Indications:

Contra:
Suspected acidosis Dose:
Hyperkalemia Dose:

A

= Alkalinizing Agent. Increases plasma bicarbonate, buffers excess hydrogen ion concertration, raises blood pH & reverses clinical manifestations of acidosis.
= Suspected hyperkalemia, suspected bicarbonateresponsive acidosis (DKA, OD on TCA’s, Aspirin or Cocaine)
= Patients in cardiac arrest
= 1 mEq/kg, Hyperkalemia:
= 50 mEq IV bolus.

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20
Q

Norepinephrine) Dynamics:
Indications:
Contra:
Dose:

A

= αß adrenergic agonist (α > ß effects)
= Normovolemic hypoBP, Sepsis, Cardiogenic shock
= Shouldn’t use in hypovol/ til’ vol/ replacement occurred
= 0.1-0.5 mcg/kg/min IV/IO infusion

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21
Q

Tranexamic Acid (TXA) Dynamics:
Indications:
Contra:
Dose:

A

= Binds to plasminogen, blocking plasminogen fibrin interactions (fibrinolysis)
= Sig/ hemorrhage, either in/external (after external hemorrhage is controlled)
= SP 3 hrs past injury, allergy/Sensitivity, Suspected thromboembolism
1 gram over 10 minutes (mix in 50 mL bag of
NS), Followed by 1 gram over 8 hours (500 mL
bag NS).

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22
Q

Succinylcholine) Dynamics
Indications:
Contra:
Dose:

A

= Depolarizing neuromuscular blocker. Binds to Ach recptors
= DSI/RSI
= Hyperkalemia(burns, crush injury), Increased ICP, Severe trauma
= 1-1.5 mg/kg IV/IO. TTP: 45-60 seconds. DOP: 5-10 mins.

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23
Q

Vecuronium) Dynamics:
Indications:
Contra:
Dose:

A

= Nondepolarizing neuromuscular blocker Binds to ACh receptors
= DSI/RSI
= Hypersensitivity
= 0.1-0.2 mg/kg IV/IO. TTP: 1-3 mins DOP: 45-90mins

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24
Q

Rocuronium) Dynamics:
Indications:
Contra:
Dose:

A

= Nondepolarizing neuromuscular blocker Binds to ACh receptors
= DSI/RSI
= Hypersensitivity
= 0.6-1.2 mg/kg. TTP: 60-90 seconds. DOP: 45-120 minutes

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25
Q

Methylene Blue) Dose:

A

= 1 mg/kg IV/IO over 5-30 mins

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26
Q

Lorazepam) Dynamics:
Indications:
Contra:
Dose:

A

= Benzo Binds w/ GABA receptors causing an influx of Cl
= Sustained seizures, anxiety, sedation, chem restraint
= Hypersensitivity
= 2-4 mg (may repeat to a max dose of 8 mg)

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27
Q

Hydroxocobalamin) Dynamics:
Indications:
Contra:
Dose:

A

Binds with cyanide to form nontoxic
cyanacobalamin (Vitamin B12), preventing its
toxic effects.
Suspected cyanide poisoning Hypersensitivity 5 grams IV/IO over 15 minutes. May repeat a
2nd 5 gram dose for a max of 10 grams

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28
Q

Fentanyl) Dynamics:
Indications:
Contra:
Dose:

A

=Synthetic Narcotic (Schedule II Opioid)
= Analgesia & sedation via binding to opiate receptor, sig/ more potent than morphine (100 mcg = 10 mg of Morphine)
= Moderate-Severe pain
= Hypersensitivity, SBP<90
=1mcg/kg to a max dose 100 mcg (IV/IO/IM/) may repeat PRN in 5-10
= 1mcg/kg IN may repeat PRN 5-10mins (Max 1mL PRN if admin/ed IN)

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29
Q

Fentanyl) 1.
2 dynamics:
3 Indications:
4 Contraindications:
5 Adverse Effects:
6 Adult & Pediatric Dose same:

A

1 = quicker but <duration vs Morphine & Schedule II Narcotic
2= Narcotic (opioid) 10x more potent than morphine
3= Moderate to severe pain & Anesthetic
4= Known hypersensitivity to med & SBP<90
5= HypoBP, N/V, Cramps, CHEST WALL RIGIDITY, Resp/depres
6= 1 mcg/kg max of 100 mcg (IV/O& IM/N) may PRN in 5-10 mins w/ Max of 1mL if IN

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30
Q

Haldane Effect:
Influences by:
What does it do to the hemoglobin?

A

= Alk> Hemoglobin Loves oxy in Lungs
= -CO2, -temp, +pH -BPG 2,3, in Lungs,
= +oxy affinity

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31
Q

If you were administering isotonic crystalloid solutions, how much would move out of the intravascular compartment within 1 hour?

A

2/3s would move out

32
Q

Morphine) 1
2 Pharmacodynamics:
3 Indications:
4 Contraindications:
5 Adverse Effects:
6 Adult Dose:
7 Pediatric Dose:

A

1= (not same as Morphine Sulfate)
2= Narc (opioid) Schedule II & releases histamine
3= Moderate to severe pain
4= SBP< 90, Known hypersensitivity
5= HypoBP, Syncope, Tachy/BradyC, Resp/Depres/Apnea , N/V
6= 2-10mg or 0.1 mg/kg to max dose 20 mg
7= 0.1 mg/kg IV/IO (slow) or IM up to 10 mg

33
Q

Oxy Dissociation Curve:
Bohr Effect:
Haldane Effect:

A

= H-globin “Train” taking & dropping oxy
= Acidotic with R-shift of hemoglobin w/ decrease oxy affinity
= Alkalotic w/ L-shift Loves oxy in Lungs

34
Q

Rocuronium) Dynamics
Indications:
Contra:
Dose:

A

= Nondepolarizing neuromuscular blocker. Binds to ACh receptors
=DSI/RSI
= Hypersensitivity
= 0.6-1.2 mg/kg. TTP: 60-90 secs. DOP: 45-120 mins

35
Q

Vecuronium) Dynamics:
Indications:
Contra:
Dose:

A

= Nondepolarizing neuromuscular blocker. Binds to ACh receptors
= DSI/RSI
= Hypersensitivity
= 0.1-0.2 mg/kg IV/IO. TTP: 1-3 mins. DOP: 45-90 mins.

36
Q

Water is contained in what 3 compartments in the human body? What are the percentages?

A

60% of body weight is water 45%=intracellular & 15% extracellular (outside cell)
Interstitial 10.5%
Intravascular 4.5%

37
Q

Hydrostatic pressure in the vascular system & what creates it?

Oncotic pressure in the vascular system and what creates it?

A

=Pressure from heart in blood vessels & forces water to cross the capillary membrane into the interstitial space.
=Pulling water back into the blood vessels by the presence of large proteins in the blood (pulling back in)

38
Q

Parkland Burn Form for:
form:

A

= (BSA >20% only 2 & 3 degree burns)
= 4 mL x BSA x Weight (kg) = ½ 1st 8 Hrs & ½ next 16Hrs

39
Q

Any eye trauma PT:
Zofran contra=

A

= vomiting &/ B/c +ocular pressure
= prolonged QT

40
Q

Morphine & fent drop BP by:

A

= body releasing Histamines

41
Q

Stridor w/ inhalation burns:

Bad Airway burns might might need:

A

= AKA “crowing” larynx last defense against heat then swells 2/3s so intubate asap bc only worsens (Press chest & follow bubbles)
= Might need to nasal endotracheal intubation w/ BAAM & Endotrol tube (ET w/ trigger) BAAM> High=inhale &Low=exhale

42
Q

Albuterol) bronchospasm=
Hyperkalemic=

A

2.5mg/3mg via SVN→ repeat 15-20mins as needed
10-20mg via LVN over 15 mins→ repeat as needed

43
Q

Calcium Chloride) standard dose:
Hypotension after Diltiazem admin:

A

=0.5-1gram slow IV over 3-5mins
=following admin/ of Diltiazem: 250-500mg

44
Q

Fentanyl):
IN route:

A

=1mcg/kg to max of 100mcg (IV/IO/IN) → may repeat PRN in 5-10mins
=Max of 1mL per nare admin/ed IN

45
Q

Fentanyl) Dose:
PTs w/ elevated ICP, IC-hemorrhage, cardiac ischemia, or aortic dissection:

A

= 1mcg/kg w/ (max 100mcg)(IV/O,IN) may repeat PRN in 5-10mins
Max of 1mL per nare if admin/ed IN
= 2-3 mcg/kg IV <sympathetic response (Raised HR & BP) to intubate

46
Q

(Sodium Bicarb) Suspected Acidosis:
Hyperkalemia:

A

= 1 mEq/kg IV Bolus
= 50 mEq IV Bolus

47
Q

Morphine) Analgesia:
STEMI:
NSTEMI-ACS:

A

= 2-10 mg up to max 20 mg.
= 2-4mg slow IV/O, may admin 2nd dose 2-8mg IV/IO q5-15 mins
= 0.1 mg/kg slow IV/IO or IM up to 10 mg

48
Q

Hydroxocobalamin)

A

= 5Gs IV/O over 15 mins. May repeat 2nd 5G dose (max 10G)

49
Q

ketamine) Sedation Dose:
Pain dose:

A

= Sedation: 1-2 mg/kg Onset: 30-60 secs, Duration: 10-20 mins
= Pain: 0.2 mg/kg IV/IO (max single dose 20 mg), 0.5 mg/kg IM/IN (if no IV/IO)

50
Q

Methylene Blue)

A

= 1 mg/kg IV/IO over 5-30 mins

51
Q

(Sedative meds) 1.
2.
3.
4.
5.
6.

A
  1. Etomidate (Amidate)
  2. Midazolam (Versed)
  3. Ketamine (Ketalar)
  4. Propofol (Diprivan)
  5. Lorazepam (Ativan)
  6. Diazepam (Valium)
52
Q

(Paralytic/ Neuromuscular blocking meds) 1.
2.
3.

A
  1. Succinylcholine (Anectine)
  2. Rocuronium (Norcuron)
  3. Vecuronium (Zemuron)
53
Q

(Etomidate/ Amidate) class
Dose:

A

= Sedative
= 0.2-0.4 mg/kg IV/IO

54
Q

(Etomidate/ Amidate) Onset:
Duration:

A

= 30 sec
= 5-10 mins

55
Q

(Etomidate/ Amidate) Advan:
Disadv:

A

= Little effect on B/P. decreases ICP
= Suppresses cortisol, not good for head -injured patients long term.

56
Q

(Midazolam/ Versed) Class:
Dose:

A

= Sedative
= 0.1-0.3 mg/kg IV/IO

57
Q

(Midazolam/ Versed) Onset:
Duration:

A

= 2-5 mins
= 15-30 mins

58
Q

(Midazolam/ Versed) Advan:
Disadv:

A

= Excellent amnesia effects, good sedative
= Hypotension

59
Q

(Ketamine/ Ketalar) Class:
Dose:

A

= Sedative
= 1-2 mg/kg IV/IO

60
Q

(Ketamine/ Ketalar) Onset:
Duration:

A

= 30-60 secs
= 10-20mins

61
Q

(Ketamine/ Ketalar) Advan:
Disadv:

A

= Decreases bronchospasm, little hypotension, amnesia.
= Increases ICP, Hypertension, Tcardia, Laryngospasm, Hallucinations

62
Q

(Propofol/ Diprivan) Class:
Dose:

A

= Sedative
= 1-2 mg//kg IV/IO

63
Q

(Propofol/ Diprivan) Onset:
Duration:

A

= < 1 min
= 5-10mins

64
Q

(Propofol/ Diprivan) Advan:
Disadv:

A

= Rapid onset, good sedative effects
= significant hypotension

65
Q

(Lorazepam/Ativan) class:
Dose:

A

= Sedative
= 0.05 mg/kg IV/IO

66
Q

(Succinylcholine/ Anectine) Class:
Dose:

A

= Depolarizing Neuromuscular Blocker paralytic
= 1-1.5 mg/kg IV/IO

67
Q

(Succinylcholine/ Anectine) TTP:
DOP:

A

= 45-60 secs
= 5-10 mins

68
Q

(Succinylcholine/ Anectine) Contra:
Effects:

A

= Hyper/K, Neuro/M disease, Crush injury, Burns, raised ICP, trauma
= Hyper/K, Muscle fasciculations, Bradycardia, Prolonged paralysis, Malignant hyperthermia, Increased ICP

69
Q

(Rocuronium/ Norcuron) Class:
Dose:

A

= Nondepolarizing Neuromuscular Blocker paralytic
= 0.6-1.2 mg/kg IV/IO (If succinylcholine is contraindicated)

70
Q

(Rocuronium/ Norcuron) TTP:
DOP:

A

= 60-90 secs
= 45-120 mins

71
Q

(Rocuronium/ Norcuron) Contra:
Effects:

A

= Hypersensitivity
= Minimal cardiovascular side effects, Skeletal muscle weakness, Malignant hyperthermia

72
Q

(Vecuronium/ Zemuron) Class:
Dose:

A

= Nondepolarizing Neuromuscular Blocker Paralytic
= 0.1 -0.2 mg/kg IV/IO

73
Q

(Vecuronium/ Zemuron) TTP:
DOP:

A

= 1-3 mins
= 45-90 mins

74
Q

(Vecuronium/ Zemuron) Contra:
Effects:

A

= hypersensitivity
= Minimal cardiovascular side effects, Skeletal muscle weakness, Malignant hyperthermia

75
Q

(Diazepam/ Valium) class:
pharmacodynamics:

A

= benzodiazepine (Sedative)
= binds w/ GABA receptors causing a influx of chloride

76
Q

(Diazepam/ Valium) indications:
Contraindications:

A

= Tcardia from stimulant OD, Sustained seizures, Anxiety, Sedation
= hypersensitivity

77
Q

(Diazepam/ Valium) effects:
dose:

A

= Resp/depress/, N/V, Sedation/amnesia
= 2.5-10mg in 2.5mg increments slow IV/IO/IM

P2 Exams (9 decks)

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