Week Two Medications Special Considerations

Question 1

activated charcoal
(Special considerations)

Answer 1

– Shake vigorously before use
– Contact medical control before
administering in cases of
acetaminophen OD
– Charcoal aspiration can produce an
unmanageable airway.
– Aspiration of emesis containing
charcoal can induce fatal pneumonitis
– Use caution in patients with abdominal
pain of unknown origin
– Do not use charcoal with sorbitol additive
in pediatrics

Question 2

atropine sulfate
(Special considerations)

Answer 2

– Paradoxical bradycardia can occur
with doses less than 0.1 mg
– Ineffective in hypothermic bradycardia
and patients with AV blocks or heart
transplants
– Use with caution in myocardial ischemia

Question 3

dextrose
(Special considerations)

Answer 3

– For children younger than 8 years, do not
use concentrations higher than D25.
– Co-administer thiamine to alcoholic or
malnourished patients to prevent
Wernicke’s encephalopathy
– Do not administer to known stroke unless
hypoglycemia is documented
– Extravasation may lead to severe tissue
necrosis - aspirate the syringe during
administration to ensure IV patency and
use a large vein.

Question 4

diphenhydramine hydrochloride
(Special Considerations)

Answer 4

– Pregnancy Safety: Category B
– Increases effectiveness of epinephrine
– Can be given with any H2-blocking
antihistamine

Question 5

glucagon
(Special Considerations)

Answer 5

– Pregnancy Safety: Category B
– Ineffective if glycogen stores are depleted
– Not recommended for use in lactating
mothers