Week 2 Drugs (Atropine, Calcium Chloride, Dexamethasone, Dextrose)

Question 1

Atropine Sulfate
Pharmacology and Actions

Answer 1

• Blocks action of acetylcholine at muscarinic receptor sites
• Blocks parasympathetic response allowing sympathetic to take over
• Positive chronotropic properties with little to no inotropic effects (increases HR, increases AV node conduction)
• Atropine reverses muscarinic effects of cholinergic poisoning by reversing bronchorrea and bronchoconstriction and drying you out

Question 2

Calcium Chloride
Pharmacology and Actions

Answer 2

• Increases extracellular and intracellular calcium levels
• Stimulates release of catecholamines
• Increase cardiac contractile state (pos inotropic)
• Essential to transmission of nerve impulses, contraction of cardiac, smooth and skeletal muscles
• Stabilizing effect on myocardial cell membranes in hyperkalemia

Question 3

Dexamethasone
Pharmacology and actions

Answer 3

• Improve lung function and myocardial performance
• Stabilization of lysosomal and cell membranes, inhibition of granulocyte aggregation
• Inhibition of prostaglandin and leukotriene production, increase in surfactant production, decrease in pulmonary edema, relaxation of bronchospasm

Question 4

Dextrose
Pharmacology and Actions

Answer 4

• Rapidly increases blood sugar

Question 5

Atropine Sulfate
Indications

Answer 5

• Symptomatic Bradycardia
• Nerve agent toxicity

Question 6

Calcium Chloride
Indications

Answer 6

• Suspected hyperkalemia
• Antidote for calcium channel blocker overdose

Question 7

Dexamethasone
Indications

Answer 7

• Reactive airway disease: acute bronchial asthma
• Anaphylaxis

Question 8

Dextrose
Indications

Answer 8

• Hypoglycemia

Question 9

Atropine Sulfate
Contraindications

Answer 9

• Bradycardia without cardiopulmonary compromise
• Allergy

Question 10

Calcium Chloride
Contraindications

Answer 10

• Do not use in suspected digoxin toxicity
• Hypercalcemia
• Suspected severe hypokalemia (life-threatening cardiac arrythmias may occur)
• Allergy

Question 11

Dexamethasone
Contraindications

Answer 11

• Systemic fungal infections
• Preterm infants
• Allergy

Question 12

Dextrose
Contraindications

Answer 12

• None in prehospital setting
• Allergy

Question 13

Atropine Sulfate
Precautions and Side Effects

Answer 13

• Avoid in hypothermic bradycardia
• Paradoxical bradycardia occurs in doses less than 0.5mg
• Use caution when administering to pediatric pts

Question 14

Calcium Chloride
Precautions and Side Effects

Answer 14

• May cause discomfort at injection site
• Will precipitate when mixed with sodium bicarbonate

Question 15

Dexamethasone
Precautions and Side Effects

Answer 15

• If given IV/IO should be given as slow IV push
• Sodium and fluid retention, potassium loss, hypokalemic alkalosis, hyperglycemia, HTN, convulsions and myocardial rupture following recent MI

Question 16

Dextrose
Precautions and Side Effects

Answer 16

• Extravasation of dextrose cause tissue necrosis
• If extravasation occurs, stop administering dextrose, notify receiving hospital and document
• If there is evidence of malnutrition or alcohol abuse, thiamine, if available, should precede dextrose

Question 17

Atropine Sulfate
Administration

Answer 17

Route: IV/IO/IM
Onset: immediate
Peak Effect: 2-4 mins
Duration: 4 hrs

Question 18

Calcium Chloride
Administration

Answer 18

Route: IV/IO
Onset: immediate
Peak Effect: unknown
Duration: variable

Question 19

Dexamethasone
Administration

Answer 19

Route: IV/IO
Onset: 4-8 hours
Peak Effect: 6-12 hrs
Duration: 24-72 hrs

Question 20

Dextrose
Administration

Answer 20

Route: IV/IO
Onset: Less than 1 minute
Peak Effect: variable
Duration: variable