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Paramedic Drugs
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483
Pharmacology
Undergraduate 1
10/26/2013

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Term
Trade Name for Streptokinase
Definition
Streptase
Term
Streptokinase--drug class
Definition
Fibrinolytic (thrombolytic enzyme)
Term
Streptokinase--Mechanism of Action
Definition
Converts plasminogen to plasmin, which acts on fibrin, hence dissolving blood clots.
Term
Streptokinase--Contraindications
Definition
-Active internal bleeding
-Cerebrovascular accident w/in 2 mos
-Intracranial or intraspinal surgery
-Intracranial neoplasm
-Sever uncontrolled hypertension
Term
Streptokinase--Indications
Definition
-AMI
-Pulmonary Embolism
-DVT (deep venous thrombosis)
-Arterial Thrombosis
-Embolism
Term
Streptokinase--Precautions
Definition
May cause bleeding
Term
Streptokinase--Available Forms
Definition
IV, Intracoronary
Term
Streptokinase--Dosage Adult, AMI
Definition
IV-infuse 1.5 mil units w/in 60 mins
Intracoronary-20k units by bolus, followed by 2k/min for 60 min
Term
Streptokinase--Dosage Adult, Embolism/Thrombosis
Definition
IV-loading dose 250k units infused in peripheral vein over 30 min, followed by 100k units/hr for 24hr (embolism), 72hr (DVT), and 24-72hr for arterial thrombosis/embolism.
Term
Streptokinase--Pediatric Dosage
Definition
Safety and efficacy not established.
Term
Streptokinase--Side Effects
Definition
-Blurred vision
-Confusion
-Dizziness, lightheadedness, faintness
-Fever
-Sweating
-Unusual Fatigue
Term
Streptokinase--Interactions
Definition
-Anticoagulants
-Agents that alter platelet function (aspirin, NSAIDs)
-Other thrombolytics
-Agents that alter coagulation
Term
Glucagon MOA
Definition
Causes the breakdown of glycogen to glucose at alpha cells of the pancreas.
Term
Indications for glucagon use.
Definition
-Hypoglycemia
-Beta blocker overdose
-Calcium channel overdose
-Esophageal spasm
Term
Contraindications for glucagon use.
Definition
-Hypersensitivity
-Pheochromocytoma (tumor of the adrenal glands
Term
Actions of glucagon
Definition
-Converts glycogen to glucose
-Positive inotrope
-Decreases renal vascular resistance
-Relaxes GI tract muscle
Term
Glucagon, adult dose
Definition
0.5-1 mg, can repeat 1x @ 15 min
(2-5 mg for non-diabetic treatments)
Term
Glucagon, pediatric dose
Definition
0.5 mg, usually not recommended
Term
Side-effects of glucagon admin.
Definition
Allergic rxns, can make the pt hypotensive
Term
How does glucagon come prepared?
Definition
Comes in one unit of powder with 1 mL of diluting solution that must be reconstituted.
Term
Dextrose MOA
Definition
Prompts the pancreas to release insulin, which drives glucose and K+ into cells.
Term
Indications for dextrose use.
Definition
-Documented hypoglycemia
-Hyperkalemia
Term
Contraindications for dextrose use.
Definition
Suspected brain bleed (CVA), TBI or delirium tremors.
Term
Actions of dextrose.
Definition
Raises blood glucose levels and lowers serum K+ levels.
Term
Dextrose, adult dosage
Definition
12.5-25 mg is normal field dose, textbook is 0.5-1 mg/kg.
Term
Dextrose, pediatric dosage
Definition
0.5 g/kg
-If wt greater than 15 kg, use D25 or D50
-If wt less than 15 kg, use D10 or D25
Term
Dextrose, neonate dosage
Definition
2.4 mL/kg of D10
Term
Posssible side effects of dextrose use.
Definition
Tissue necrosis
Term
How does dextrose come prepared?
Definition
D50--25 g/50 mL
D25--2.5g/10 mL
D10--25 g/250 mL
Term
Diazepam is commonly known as...
Definition
Valium
Term
Diazepam MOA
Definition
Works via facilitation of the action of GABA, an inhibitory neurotransmitter of the CNS.
Term
Indications for diazepam use.
Definition
-Anxiety/sedation
-Acute alcohol withdrawal
-Muscle spasms
-Active seizures
-Post-intubation
-Cardio-pacing
-Vertigo
Term
Contraindications for diazepam use.
Definition
-CNS depression
-NAG
-Hypersensitivity
-Ped pts under 2
Term
Actions of diazepam.
Definition
-Anticonvulsant
-Sedative
-Anxiolytic
-Amnesic
Term
Diazepam dosage, adults.
Definition
-Seizures, 5-10 mg, max 20 mg
-Anxiety 2-10 mg
Term
Diazepam dosage, pediatrics.
Definition
0.05-0.3 mg/kg, max of 10 mg, if wt less than 5 kg, max dose of 5 mg.
Term
Side effects of diazepam admin.
Definition
-Respiratory depression
-Hypotension
-Sedation
Term
How does diazepam come prepared?
Definition
PFS of 10 mg/2 mL
Term
Lorazepam is commonly referred to as...
Definition
Ativan
Term
Lorazepam MOA
Definition
Potentiates GABA
Term
Indications for lorazepam admin.
Definition
-Major motor seizures
-Persistent or recurrent seizure activity
-Sedation
-Anxiety
Term
Contraindicaitons for lorazepam use.
Definition
-Hypersensitivity
-NAG
-Hypotension
-Respiratory failure
Term
Lorazepam actions...
Definition
-Anti-convulsant
-Anxiolytic
-Sedative
-Anesthetic
Term
Lorazepam, adult dosage.
Definition
Term
Lorazepam, pediatric dosage.
Definition
Dilute 1:1 with NS and give IV, IM or IO at 0.1 mg/kg to a max dose of 2 mg.
Term
This is the preferred drug for treatment of pediatric seizures.
Definition
Lorazepam
Term
What are the side-effects of lorazepam?
Definition
-Drowsiness
-Hypotension
-Respiratory depression
-Apnea
Term
How does lorazepam come prepared?
Definition
2 mg in vials or PFS
Term
Midazolam is commonly known as...
Definition
Versed
Term
MOA of midazolam.
Definition
Potentiates GABA
Term
Indications for medazolam use.
Definition
-Sedation prior to cardioversion/ET
-Maintenance sedation in mech. ventilated pt
-Seizure control
Term
Contraindications for medazolam use.
Definition
-Shock
-Coma
-Hypersensitivity
-Pregnancy
-NAG
Term
Actions of medazolam.
Definition
-Anxiolytic
-Anticonvulsant
-Amnesiac
-Relaxant
Term
Medazolam, adult dosage.
Definition
0.1 mg/kg with max single dose of 5 mg and max total dose of 10 mg
-Can readmin after 5 mins
Term
Medazolam, pediatric dosage
Definition
Same as medazolam adult dosage
Term
Side effects of medazolam admin.
Definition
-Apnea
-Paradoxical CNS stimulant
-Hypotension
Term
How does medazolam come prepped?
Definition
Vial, PFS, or tubex of 5 mg/5 mL
Term
Haloperidol is commonly called...
Definition
Haldol
Term
MOA of haloperidol
Definition
Binds to dopamine 1 and dopamine 2 receptors
Term
Indications for use of haloperidol.
Definition
-Acute psychosis (delusions and hallucinations
-Acute mania
-Delirium (typically drug induced)
-Irretractable hiccups
Term
Contraindications for use of haloperidol.
Definition
-Parkinson's
-CNS depression
-NAG
-Anticholinergic syndrome
-PCP overdose
Term
Actions of haloperidol.
Definition
-Antipsychotic
-Antiemetic (rare use)
Term
Haloperidol, adult dosage.
Definition
5-10 mg for psychosis
0.5-2 mg for nausea
Can repeat every 30 min
Term
Haloperidol, pediatric dosage.
Definition
0.5-1 mng
Term
Side effects of haloperidol admin?
Definition
-Hypotension
-Muscle stiffness
-Headache
-EPR
-Pneumonia (chronic use)
Term
How does haloperidol come prepared?
Definition
5 mg/1 mL vial or 10 mg/1 mL vial
Term
Trade name for Ipratroprium
Definition
Atrovent, Combivent
Term
Ipratroprium (class)
Definition
Anticholinergic
Term
Indications for ipratroprium.
Definition
-Bronchial asthma
-Bronchospasm in acute exacerbation of COPD
-Bronchospasm in anaphylaxis, burns, and toxic inhalations
Term
Contraindications of ipratroprium.
Definition
Pts with peanut and soybean allergies
Term
Ipratroprium forms available.
Definition
Vial (solution)
Term
How does ipratroprium come prepared?
Definition
0.02% solution containing 2.5 mL
Term
Routes for ipratroprium admin.
Definition
Inhalation
Term
What is the adult dosage for ipratropium?
Definition
0.5 mg with O2 flow at 8 LPM via nebulizer, not to be repeated
Term
You've already administered a dose of ipratroprium, and the Pt requires additional Rx, what should you do?
Definition
Administer albuterol via nebulizer (NOT another dose of ipratroprium)
Term
What is the pediatric dose of ipratroprium?
Definition
Same as adults
Term
Ipratroprium onset.
Definition
5-15 min
Term
Ipratroprium duration.
Definition
4-6 hr
Term
Ipratroprium side-effects.
Definition
-Palpitations
-Cough, dry mouth
-Blurred vision
-Anxiety, nervousness
-Dizziness
-HA
-Rash
-NV
Term
Etomidate trade name.
Definition
Amidate
Term
Etomidate (class)
Definition
Anesthetic, non-narcotic sedative/hypnotic
Term
MOA of Etomidate
Definition
Increases the number or GABA receptors and works partially by depressing the reticular activating system
Term
Actions of Etomidate
Definition
-Sedative
-Amnesic
Term
Indications for etomidate.
Definition
Sedation for intubation and cardioversion.
Term
Contraindications for etomidate.
Definition
-Hypersensitivity
-Active labor in pregnant Pts
-Septic shock
-Pts < 2 y/o
Term
Precautions for etomidate use.
Definition
-Elderly pts
-Pts < 10 y/o
-Renal/hepatic failure
Term
Forms available of etomidate.
Definition
Vial (solution)
Term
How does etomidate come prepared?
Definition
20, 30, or 40 mg/mL
Term
Routes for etomidate admin.
Definition
IV, IM, IO
Term
What is the adult dosage of etomidate?
Definition
0.15-0.3 mg/kg slow push over 30-60 sec, MTD 0.6 mg/kg
-Use 0.15 for cardioversion
-Use 0.3 for intubation
Term
What is the pediatric dosage of etomidate?
Definition
Only Pts over 2 y/o, same as adults
Term
Onset of etomidate.
Definition
30 sec
Term
Duration of etomidate.
Definition
3-5 min
Term
Side-effects of etomidate.
Definition
-Dyspnea
-Dysrhythmias
-Hypotension
-HTN
-Temporary involuntary muscle mvmts
-Laryngospasm
Term
Etomidate interactions.
Definition
-CNS depressants
-Anti-HTN agents
Term
What is the trade name for succinylcholine?
Definition
Anectine
Term
Succinylcholine (class)
Definition
Depolarizing neuromuscular blocker
Term
Succ MOA.
Definition
Inhibits transmission of nerve impulses by binding with cholinergic receptor sites, antagonizing action of ACh.
Term
Succ actions.
Definition
-Persistent depolarization of the neuromuscular junction
-Mimics ACh w/o being hydrolyzed by acetylcholinesterase
Term
Precautions for succ use.
Definition
-Cardiac disease
-Dehydration
-Respiratory disease
-NAG
Term
Succ comes in a...(forms available)
Definition
Vial
Term
How does succ come prepared?
Definition
20 mg/mL in 10 mL vials
Term
Routes for succ admin.
Definition
IV, IM, IO
Term
Adult dosage for succ.
Definition
1-2 mg/kg rapid push, rpt 1x if needed
Term
Pediatric dosage for succ.
Definition
Same as adults
Term
Infant dosage for succ.
Definition
2 mg/kg
Term
Onset of succ.
Definition
-IV, 30-60 sec
-IM, 2-3 min
Term
Duration of succ.
Definition
-IV, 3-5 min
-IM, 10-30 min
Term
What are the side-effects of succ?
Definition
-Sinus arrest
-Hypotension
-Increased IOP
-Prolonged apnea
-Bronchospasm
-Vomiting/aspiration
Term
What are the signs of succ toxicity?
Definition
-Cardiac arrest
-Ventricular dysrhythmia
-Hyperkalemia
-Apnea
Term
Succ is incompatible with...
Definition
-Alkaline solutions
Term
The effects of succ are enhanced by...
Definition
-Lidocaine
-Procainamide
-Beta blockers
-Magnesium sulfate
-Other neuromuscular blockers
Term
What is the trade name of vecuronium?
Definition
Non-curon
Term
What class does vecuronium belong to?
Definition
Non-depolarizing neuromuscular blocking agent
Term
What is the MOA of vecuronium?
Definition
Produces skeletal muscle paralysis via competition with ACh for cholinergic receptor sites and binding with nicotinic receptors.
Term
Is vecuronium an agonist?
Definition
No
Term
Does vecuronium effect consciousness?
Definition
No
Term
Indications for vecuronium use.
Definition
Facilitation of intubation and maintenance of paralysis following RSI.
Term
Precautions when using vecuronium.
Definition
-Pregnancy
-Malignant hyperthermia
-Cardiac/hepatic disease
-NAG
-Elderly or debilitated Pts
-Dehydration
-Electrolyte or pH imbalance
-Neuromuscular disease
Term
Vecuronium forms available.
Definition
1 unit pwdr, with 1 unit diluting solution (aka, a vial requiring the addition of saline).
Term
What is the route for vecuronium admin?
Definition
IV
Term
What is the adult dosage of vec?
Definition
0.1 mg/kg, rpt PNR
Term
What is the ped dosage of vec?
Definition
Same as adults
Term
This is a special consideration when administering vecuronium.
Definition
Maintenance dose may be higher, and may last 1.5 times longer.
Term
What is the onset of vec?
Definition
1 min
Term
What is the duration of vec?
Definition
30-60 min
Term
What are the side-effects of vec?
Definition
-Bronchospasm
-Dysrhythmias
-HTN or hypotension
Term
Interaction concerns of vecuronium.
Definition
-Opiates or antiarrhythmics can potentiate effects
Term
What is the trade name of ondansetron?
Definition
Zofran
Term
What class of drugs does ondansetron belong to?
Definition
Anti-emetic, selective serotonin receptor antagonist
Term
Ondansetron MOA
Definition
Reduces the activity of the vagus nerve and blocks serotonin receptors in the chemoreceptor trigger zone.
Term
Does ondansetron help with vomiting caused by motion sickness?
Definition
No
Term
What are the indications for ondansetron use?
Definition
Moderate to severe nausea
Term
Contraindications of ondansetron use.
Definition
-Prolonged QT syndrome
-Concurrent use of apomorphine/Apokyn (an anti-parkansonian drug)
Term
What are the precautions for ondansetron use?
Definition
-Not well studied in children under 2
-Use w/ caution in Pts concurrently using drugs which effect QT interval
-Use with caution in Pts w/ hepatic impairment (consider prolonging dosage intervals/decreasing dose)
Term
Ondansetron is available in what forms?
Definition
-4 mg/2 mL vial
-4 or 8 mg ODT or tablet
Term
Routes of ondansetron admin.
Definition
IV, IO, IM
Term
What's the adult dosage of ondansetron?
Definition
-IV/IO/IM, 4 mg, rpt once in 15 min PRN (admin over 30 sec at least, preferably 2-5 min)
-8 mg PO (tablet or ODT)
Term
What's the ped dosage of ondansetron?
Definition
In peds 2 or older
-IV/IO/IM-0.1 mg/kg with a MSD of 4 mg
-Call med control to rpt
Term
What is the onset of ondansetron?
Definition
10-30 min
Term
What is the duration of ondansetron?
Definition
2-4 hr
Term
What are the side-effects of ondansetron?
Definition
-Sedation
-Hypotension
-Tachycardia
-Angina
-EPS
-Torsades
-Constipation
Term
What are the drug interactions associated with ondansetron?
Definition
-Additive effects w/ meds that prolong QT intervals, and CNS depressants
Term
What class of drug is morphine sulfate?
Definition
Opioid
Term
MOA of morphine sulfate.
Definition
Targets and binds to Mu, Kappa, and Delta opioid receptors, and is a GABA agonist.
Term
Morphine actions.
Definition
-Analgesic
-Miosis
-Minimal amnesic
Term
Indications for morphine use.
Definition
-Moderate to severe chronic pain
-Acute pain
-Pacing
Term
Contraindications for morphine use.
Definition
-Hypotension
-Hypovolemia
-Breastfeeding mother
-Allergy (morphine)
-Pt taking muscle relaxants (reduce dosage)
-Addiction
-Head injuries/brain disorders
-Multisystem trauma
Term
Precautions for morphine use.
Definition
-Depression of respiratory or circulatory system
-NV, vomiting, constipation, dizziness, sedation, anxiety, euphoria
-Seizures
-Cirrhosis/decreased renal function
-Cool/clammy skin
-Any CNS depressant
Term
What are the available forms of morphine?
Definition
Tablets, suppositories, solution
Term
What are the routes of morphine admin?
Definition
Rectal, Oral, IV
Term
What is the adult dosage for morphine admin?
Definition
-Pain, 2-4 mg slow IV over 1-5 min ever 5-30 min, titrate to effect
-STEMI-2-4 mg IV, may give additional doses at 2-8 mg IV at 5-15 min intervals
-Non-STEMI 1-5 mg IV only if symptoms are not relieved by nitrates or if symptoms reoccur
Term
What is the ped dosage for morphine?
Definition
0.1-0.2 mg/kg dose IV, MTD 15 mg
Term
Onset of morphine.
Definition
1-2 min depending on route
Term
Duration of morphine.
Definition
2-7 hr
Term
What are the side-effects of morphine?
Definition
-NV
-Constipation
-Lightheadedness
-Dizziness
Term
Drug interactions of morphine.
Definition
-CNS Depressants
-OTC cough syrups/cold meds
-Psychiatric drugs
Term
Trade name of nitrous oxide.
Definition
Nitronox
Term
Nitrous oxide is what class of drug?
Definition
Anesthetic gas, analgesic
Term
MOA of nitrous oxide.
Definition
Potentiates GABA (analgesic is unknown but thought to cause a release of endorphins that stimulate opioid receptors)
Term
What are the actions of morphine?
Definition
-Anxiolytic
-Anesthetic
Term
What are the indications for nitrous oxide use?
Definition
-Musculoskeletal pain
-Kidney stones
-Burns
-Severe anxiety
-Suspected ischemic chest pain
Term
Contraindications of nitrous oxide use.
Definition
-ETOH or med intox
-Head injury with AMS
-COPD
-Pneumothorax
-Shock
-ABD pain/distention with a bowel obstruction
-Significant respiratory compromise
Term
Precautions to consider when using nitrous oxide.
Definition
Use in well ventilated areas, and it may not work at low temps.
Term
NO is available in what forms?
Definition
50/50 blend of oxygen and NO
Term
How is NO administered?
Definition
Inhalation
Term
How is NO administered?
Definition
Self-administered until pain is relieved or Pt drops the regulator (same for peds)
Term
What is the onset/duration of NO?
Definition
2-5 min (same for both)
Term
What are the side effects of NO?
Definition
-Dizziness
-AMS
-Hallucinations
-NV
-Diffusional hypoxia
Term
Signs of NO toxicity.
Definition
Long term provider use may cause fetal abnormalities, memory/cognition loss, loss of manual dexterity, and liver/renal dysfunction.
Term
NO interacts with...
Definition
-ETOH
-CNS Depressants
Term
The trade name for fentanyl citrate.
Definition
Sublimaze
Term
Fentanyl belongs to what class of drug?
Definition
Opiate analgesic (type II narcotic)
Term
MOA of fentanyl
Definition
CNS depressant, opiate receptor agonist, and depresses responsiveness to alpha-adrenergic drugs.
Term
Actions of fentanyl
Definition
-Analgesic
-Vasodilator (decreases venous return)
Term
Indications for fentanyl use.
Definition
-Moderate-severe pain
-Adjunct for intubation
Term
Contraindications for fentanyl use.
Definition
-Hypovolemia
-Hypotension
-Head injury
-MAOIs in last 14 days
-Myasthensia gravis
Term
Precautions for fentanyl use.
Definition
Admin slowly (pushing too fast can cause chest wall rigidity which can cause difficulty breathing and an inability to ventilate with an adjunct
Term
Fentanyl is available in what forms?
Definition
Ampules
Term
How does fentanyl come prepared?
Definition
Ampules of 50 mcg/mL, diluted to a volume of 5 cc using D5W or NS, then slowly infused over a min
Term
Routes of fentanyl admin.
Definition
IV
Term
What is the adult dosage of fentanyl?
Definition
1 mcg/kg with MSD of 100 mcg
Term
What is the pediatric dose of fentanyl?
Definition
Ped must be over 2, then 1 mcg/kg with max dose of 100 mcg
Term
What is the onset of fentanyl?
Definition
-IV/IO/IN 1-3 min
-IM 10-20 min
-Peak effect at 30 min-1 hr
Term
Duration of fentanyl.
Definition
1-2 hr
Term
What are the side effects of fentanyl?
Definition
-Euphoria
-Dizziness
-Hallucinations
-Hypotension
-ALOC
-Seizure
Term
What are the signs of fentanyl toxicity?
Definition
-Respiratory depression
-Muscle rigidity
-Apnea
Term
What are the interaction concerns of fentanyl admin?
Definition
-CNS Depressants
-DO NOT mix in-line with Heprin
Term
What is the trade name of albuterol sulfate?
Definition
Ventolin
Term
What class of drug does albuterol belong to?
Definition
Beta2 Blocker, Sympathomimetic
Term
Albuterol MOA
Definition
Acts selectively on Beta2 receptor sites in the lungs.
Term
Actions of Albuterol.
Definition
-Relaxes bronchiole smooth muscle
-Somewhat stimulates CNS/heart
-Increases diuresis and gastric acid secretion
-Reuptake of K+ inside the cell
Term
Indications for use of albuterol.
Definition
-Bronchial asthma
-Bronchospasm
-Hyperkalemia (incl. crushing/compartment syndrome)
Term
What are the contraindications for albuterol use?
Definition
Tachydysrhythmias
Term
What are the precautions of albuterol admin?
Definition
-Geriatric Pts
-HTN
-Diabetes
-Always have an EKG in place to monitor the heart
Term
Albuterol forms available.
Definition
Solutions, mist, aerosol for inhalation
Term
How does albuterol come prepared?
Definition
MDIs, solutions for nebulizers
Term
How is albuterol admin'd?
Definition
Inhalation, ETT
Term
What is the adult dose of albuterol?
Definition
Bronchospasm
-MDI: 1-2 inhalations, 1 min ea, rpt @ 15 min PRN
-Nebulizer: 2.5 mg w/ O2 @ 8 LPM, rpt PRN
Hyperkalemia
-ETT: 4 unit doses 10 mg directly down ETT followed by hyperventilation
-Nebulizer: 10 mg w/ O2 @ 8 LPM
Term
What is the ped dose of albuterol?
Definition
Same as adults
Term
What is the onset of albuterol?
Definition
5-15 min after inhalation
Term
What is the duration of albuterol?
Definition
3-4 hr
Term
What are the side-effects of albuterol?
Definition
-Palpitations/tachycardia
-Anxiety/nervousness
-Dizziness
-Tremors
-HA
-NV
-HTN
-Dysrhythmias
-Chest pain
Term
What are the signs of albuterol toxicity?
Definition
-Seizures
-Nausea
-Chest pain
-Fast, irregular pounding heart
-Excessive tiredness
-Uncontrollable shaking
Term
What are the interaction concerns of albuterol?
Definition
-Antagonistic effects on beta blockers
-Additive effects on sympathomimetics (MAOIs, TCAs, etc.)
Term
Trade name for Ipratroprium
Definition
Atrovent, Combivent
Term
Ipratroprium (class)
Definition
Anticholinergic
Term
Indications for ipratroprium.
Definition
-Bronchial asthma
-Bronchospasm in acute exacerbation of COPD
-Bronchospasm in anaphylaxis, burns, and toxic inhalations
Term
Contraindications of ipratroprium.
Definition
Pts with peanut and soybean allergies
Term
Ipratroprium forms available.
Definition
Vial (solution)
Term
How does ipratroprium come prepared?
Definition
0.02% solution containing 2.5 mL
Term
Routes for ipratroprium admin.
Definition
Inhalation
Term
What is the adult dosage for ipratropium?
Definition
0.5 mg with O2 flow at 8 LPM via nebulizer, not to be repeated
Term
You've already administered a dose of ipratroprium, and the Pt requires additional Rx, what should you do?
Definition
Administer albuterol via nebulizer (NOT another dose of ipratroprium)
Term
What is the pediatric dose of ipratroprium?
Definition
Same as adults
Term
Ipratroprium onset.
Definition
5-15 min
Term
Ipratroprium duration.
Definition
4-6 hr
Term
Ipratroprium side-effects.
Definition
-Palpitations
-Cough, dry mouth
-Blurred vision
-Anxiety, nervousness
-Dizziness
-HA
-Rash
-NV
Term
Etomidate trade name.
Definition
Amidate
Term
Etomidate (class)
Definition
Anesthetic, non-narcotic sedative/hypnotic
Term
MOA of Etomidate
Definition
Increases the number or GABA receptors and works partially by depressing the reticular activating system
Term
Actions of Etomidate
Definition
-Sedative
-Amnesic
Term
Indications for etomidate.
Definition
Sedation for intubation and cardioversion.
Term
Contraindications for etomidate.
Definition
-Hypersensitivity
-Active labor in pregnant Pts
-Septic shock
-Pts < 2 y/o
Term
Precautions for etomidate use.
Definition
-Elderly pts
-Pts < 10 y/o
-Renal/hepatic failure
Term
Forms available of etomidate.
Definition
Vial (solution)
Term
How does etomidate come prepared?
Definition
20, 30, or 40 mg/mL
Term
Routes for etomidate admin.
Definition
IV, IM, IO
Term
What is the adult dosage of etomidate?
Definition
0.15-0.3 mg/kg slow push over 30-60 sec, MTD 0.6 mg/kg
-Use 0.15 for cardioversion
-Use 0.3 for intubation
Term
What is the pediatric dosage of etomidate?
Definition
Only Pts over 2 y/o, same as adults
Term
Onset of etomidate.
Definition
30 sec
Term
Duration of etomidate.
Definition
3-5 min
Term
Side-effects of etomidate.
Definition
-Dyspnea
-Dysrhythmias
-Hypotension
-HTN
-Temporary involuntary muscle mvmts
-Laryngospasm
Term
Etomidate interactions.
Definition
-CNS depressants
-Anti-HTN agents
Term
What is the trade name for succinylcholine?
Definition
Anectine
Term
Succinylcholine (class)
Definition
Depolarizing neuromuscular blocker
Term
Succ MOA.
Definition
Inhibits transmission of nerve impulses by binding with cholinergic receptor sites, antagonizing action of ACh.
Term
Succ actions.
Definition
-Persistent depolarization of the neuromuscular junction
-Mimics ACh w/o being hydrolyzed by acetylcholinesterase
Term
Precautions for succ use.
Definition
-Cardiac disease
-Dehydration
-Respiratory disease
-NAG
Term
Succ comes in a...(forms available)
Definition
Vial
Term
How does succ come prepared?
Definition
20 mg/mL in 10 mL vials
Term
Routes for succ admin.
Definition
IV, IM, IO
Term
Adult dosage for succ.
Definition
1-2 mg/kg rapid push, rpt 1x if needed
Term
Pediatric dosage for succ.
Definition
Same as adults
Term
Infant dosage for succ.
Definition
2 mg/kg
Term
Onset of succ.
Definition
-IV, 30-60 sec
-IM, 2-3 min
Term
Duration of succ.
Definition
-IV, 3-5 min
-IM, 10-30 min
Term
What are the side-effects of succ?
Definition
-Sinus arrest
-Hypotension
-Increased IOP
-Prolonged apnea
-Bronchospasm
-Vomiting/aspiration
Term
What are the signs of succ toxicity?
Definition
-Cardiac arrest
-Ventricular dysrhythmia
-Hyperkalemia
-Apnea
Term
Succ is incompatible with...
Definition
-Alkaline solutions
Term
The effects of succ are enhanced by...
Definition
-Lidocaine
-Procainamide
-Beta blockers
-Magnesium sulfate
-Other neuromuscular blockers
Term
What is the trade name of vecuronium?
Definition
Non-curon
Term
What class does vecuronium belong to?
Definition
Non-depolarizing neuromuscular blocking agent
Term
What is the MOA of vecuronium?
Definition
Produces skeletal muscle paralysis via competition with ACh for cholinergic receptor sites and binding with nicotinic receptors.
Term
Is vecuronium an agonist?
Definition
No
Term
Does vecuronium effect consciousness?
Definition
No
Term
Indications for vecuronium use.
Definition
Facilitation of intubation and maintenance of paralysis following RSI.
Term
Precautions when using vecuronium.
Definition
-Pregnancy
-Malignant hyperthermia
-Cardiac/hepatic disease
-NAG
-Elderly or debilitated Pts
-Dehydration
-Electrolyte or pH imbalance
-Neuromuscular disease
Term
Vecuronium forms available.
Definition
1 unit pwdr, with 1 unit diluting solution (aka, a vial requiring the addition of saline).
Term
What is the route for vecuronium admin?
Definition
IV
Term
What is the adult dosage of vec?
Definition
0.1 mg/kg, rpt PNR
Term
What is the ped dosage of vec?
Definition
Same as adults
Term
This is a special consideration when administering vecuronium.
Definition
Maintenance dose may be higher, and may last 1.5 times longer.
Term
What is the onset of vec?
Definition
1 min
Term
What is the duration of vec?
Definition
30-60 min
Term
What are the side-effects of vec?
Definition
-Bronchospasm
-Dysrhythmias
-HTN or hypotension
Term
Interaction concerns of vecuronium.
Definition
-Opiates or antiarrhythmics can potentiate effects
Term
What is the trade name of ondansetron?
Definition
Zofran
Term
What class of drugs does ondansetron belong to?
Definition
Anti-emetic, selective serotonin receptor antagonist
Term
Ondansetron MOA
Definition
Reduces the activity of the vagus nerve and blocks serotonin receptors in the chemoreceptor trigger zone.
Term
Does ondansetron help with vomiting caused by motion sickness?
Definition
No
Term
What are the indications for ondansetron use?
Definition
Moderate to severe nausea
Term
Contraindications of ondansetron use.
Definition
-Prolonged QT syndrome
-Concurrent use of apomorphine/Apokyn (an anti-parkansonian drug)
Term
What are the precautions for ondansetron use?
Definition
-Not well studied in children under 2
-Use w/ caution in Pts concurrently using drugs which effect QT interval
-Use with caution in Pts w/ hepatic impairment (consider prolonging dosage intervals/decreasing dose)
Term
Ondansetron is available in what forms?
Definition
-4 mg/2 mL vial
-4 or 8 mg ODT or tablet
Term
Routes of ondansetron admin.
Definition
IV, IO, IM
Term
What's the adult dosage of ondansetron?
Definition
-IV/IO/IM, 4 mg, rpt once in 15 min PRN (admin over 30 sec at least, preferably 2-5 min)
-8 mg PO (tablet or ODT)
Term
What's the ped dosage of ondansetron?
Definition
In peds 2 or older
-IV/IO/IM-0.1 mg/kg with a MSD of 4 mg
-Call med control to rpt
Term
What is the onset of ondansetron?
Definition
10-30 min
Term
What is the duration of ondansetron?
Definition
2-4 hr
Term
What are the side-effects of ondansetron?
Definition
-Sedation
-Hypotension
-Tachycardia
-Angina
-EPS
-Torsades
-Constipation
Term
What are the drug interactions associated with ondansetron?
Definition
-Additive effects w/ meds that prolong QT intervals, and CNS depressants
Term
What class of drug is morphine sulfate?
Definition
Opioid
Term
MOA of morphine sulfate.
Definition
Targets and binds to Mu, Kappa, and Delta opioid receptors, and is a GABA agonist.
Term
Morphine actions.
Definition
-Analgesic
-Miosis
-Minimal amnesic
Term
Indications for morphine use.
Definition
-Moderate to severe chronic pain
-Acute pain
-Pacing
Term
Contraindications for morphine use.
Definition
-Hypotension
-Hypovolemia
-Breastfeeding mother
-Allergy (morphine)
-Pt taking muscle relaxants (reduce dosage)
-Addiction
-Head injuries/brain disorders
-Multisystem trauma
Term
Precautions for morphine use.
Definition
-Depression of respiratory or circulatory system
-NV, vomiting, constipation, dizziness, sedation, anxiety, euphoria
-Seizures
-Cirrhosis/decreased renal function
-Cool/clammy skin
-Any CNS depressant
Term
What are the available forms of morphine?
Definition
Tablets, suppositories, solution
Term
What are the routes of morphine admin?
Definition
Rectal, Oral, IV
Term
What is the adult dosage for morphine admin?
Definition
-Pain, 2-4 mg slow IV over 1-5 min ever 5-30 min, titrate to effect
-STEMI-2-4 mg IV, may give additional doses at 2-8 mg IV at 5-15 min intervals
-Non-STEMI 1-5 mg IV only if symptoms are not relieved by nitrates or if symptoms reoccur
Term
What is the ped dosage for morphine?
Definition
0.1-0.2 mg/kg dose IV, MTD 15 mg
Term
Onset of morphine.
Definition
1-2 min depending on route
Term
Duration of morphine.
Definition
2-7 hr
Term
What are the side-effects of morphine?
Definition
-NV
-Constipation
-Lightheadedness
-Dizziness
Term
Drug interactions of morphine.
Definition
-CNS Depressants
-OTC cough syrups/cold meds
-Psychiatric drugs
Term
Trade name of nitrous oxide.
Definition
Nitronox
Term
Nitrous oxide is what class of drug?
Definition
Anesthetic gas, analgesic
Term
MOA of nitrous oxide.
Definition
Potentiates GABA (analgesic is unknown but thought to cause a release of endorphins that stimulate opioid receptors)
Term
What are the actions of morphine?
Definition
-Anxiolytic
-Anesthetic
Term
What are the indications for nitrous oxide use?
Definition
-Musculoskeletal pain
-Kidney stones
-Burns
-Severe anxiety
-Suspected ischemic chest pain
Term
Contraindications of nitrous oxide use.
Definition
-ETOH or med intox
-Head injury with AMS
-COPD
-Pneumothorax
-Shock
-ABD pain/distention with a bowel obstruction
-Significant respiratory compromise
Term
Precautions to consider when using nitrous oxide.
Definition
Use in well ventilated areas, and it may not work at low temps.
Term
NO is available in what forms?
Definition
50/50 blend of oxygen and NO
Term
How is NO administered?
Definition
Inhalation
Term
How is NO administered?
Definition
Self-administered until pain is relieved or Pt drops the regulator (same for peds)
Term
What is the onset/duration of NO?
Definition
2-5 min (same for both)
Term
What are the side effects of NO?
Definition
-Dizziness
-AMS
-Hallucinations
-NV
-Diffusional hypoxia
Term
Signs of NO toxicity.
Definition
Long term provider use may cause fetal abnormalities, memory/cognition loss, loss of manual dexterity, and liver/renal dysfunction.
Term
NO interacts with...
Definition
-ETOH
-CNS Depressants
Term
The trade name for fentanyl citrate.
Definition
Sublimaze
Term
Fentanyl belongs to what class of drug?
Definition
Opiate analgesic (type II narcotic)
Term
MOA of fentanyl
Definition
CNS depressant, opiate receptor agonist, and depresses responsiveness to alpha-adrenergic drugs.
Term
Actions of fentanyl
Definition
-Analgesic
-Vasodilator (decreases venous return)
Term
Indications for fentanyl use.
Definition
-Moderate-severe pain
-Adjunct for intubation
Term
Contraindications for fentanyl use.
Definition
-Hypovolemia
-Hypotension
-Head injury
-MAOIs in last 14 days
-Myasthensia gravis
Term
Precautions for fentanyl use.
Definition
Admin slowly (pushing too fast can cause chest wall rigidity which can cause difficulty breathing and an inability to ventilate with an adjunct
Term
Fentanyl is available in what forms?
Definition
Ampules
Term
How does fentanyl come prepared?
Definition
Ampules of 50 mcg/mL, diluted to a volume of 5 cc using D5W or NS, then slowly infused over a min
Term
Routes of fentanyl admin.
Definition
IV
Term
What is the adult dosage of fentanyl?
Definition
1 mcg/kg with MSD of 100 mcg
Term
What is the pediatric dose of fentanyl?
Definition
Ped must be over 2, then 1 mcg/kg with max dose of 100 mcg
Term
What is the onset of fentanyl?
Definition
-IV/IO/IN 1-3 min
-IM 10-20 min
-Peak effect at 30 min-1 hr
Term
Duration of fentanyl.
Definition
1-2 hr
Term
What are the side effects of fentanyl?
Definition
-Euphoria
-Dizziness
-Hallucinations
-Hypotension
-ALOC
-Seizure
Term
What are the signs of fentanyl toxicity?
Definition
-Respiratory depression
-Muscle rigidity
-Apnea
Term
What are the interaction concerns of fentanyl admin?
Definition
-CNS Depressants
-DO NOT mix in-line with Heprin
Term
What is the trade name of albuterol sulfate?
Definition
Ventolin
Term
What class of drug does albuterol belong to?
Definition
Beta2 Blocker, Sympathomimetic
Term
Albuterol MOA
Definition
Acts selectively on Beta2 receptor sites in the lungs.
Term
Actions of Albuterol.
Definition
-Relaxes bronchiole smooth muscle
-Somewhat stimulates CNS/heart
-Increases diuresis and gastric acid secretion
-Reuptake of K+ inside the cell
Term
Indications for use of albuterol.
Definition
-Bronchial asthma
-Bronchospasm
-Hyperkalemia (incl. crushing/compartment syndrome)
Term
What are the contraindications for albuterol use?
Definition
Tachydysrhythmias
Term
What are the precautions of albuterol admin?
Definition
-Geriatric Pts
-HTN
-Diabetes
-Always have an EKG in place to monitor the heart
Term
Albuterol forms available.
Definition
Solutions, mist, aerosol for inhalation
Term
How does albuterol come prepared?
Definition
MDIs, solutions for nebulizers
Term
How is albuterol admin'd?
Definition
Inhalation, ETT
Term
What is the adult dose of albuterol?
Definition
Bronchospasm
-MDI: 1-2 inhalations, 1 min ea, rpt @ 15 min PRN
-Nebulizer: 2.5 mg w/ O2 @ 8 LPM, rpt PRN
Hyperkalemia
-ETT: 4 unit doses 10 mg directly down ETT followed by hyperventilation
-Nebulizer: 10 mg w/ O2 @ 8 LPM
Term
What is the ped dose of albuterol?
Definition
Same as adults
Term
What is the onset of albuterol?
Definition
5-15 min after inhalation
Term
What is the duration of albuterol?
Definition
3-4 hr
Term
What are the side-effects of albuterol?
Definition
-Palpitations/tachycardia
-Anxiety/nervousness
-Dizziness
-Tremors
-HA
-NV
-HTN
-Dysrhythmias
-Chest pain
Term
What are the signs of albuterol toxicity?
Definition
-Seizures
-Nausea
-Chest pain
-Fast, irregular pounding heart
-Excessive tiredness
-Uncontrollable shaking
Term
What are the interaction concerns of albuterol?
Definition
-Antagonistic effects on beta blockers
-Additive effects on sympathomimetics (MAOIs, TCAs, etc.)
Term
Ipratropium is used for...
Definition
Bronchodilation.
Term
Etomidate is used for...
Definition
Sedation.
Term
Succinylcholine is used as a...
Definition
Paralytic
Term
Vecuronium is used as a...
Definition
Paralytic
Term
Ondansetron is used as an...
Definition
Anti-emetic
Term
Mag Sulfate is used as an...
Definition
Antidysrhythmic and anticonvulsant
Term
Furosemide is used as a...
Definition
Diuretic
Term
Promethazine is used as an...
Definition
Antiemetic
Term
Morphine Sulfate is used as an...
Definition
Analgesic
Term
Nitrous oxide is used as an...
Definition
Analgesic
Term
Fentanyl is used as an...
Definition
Analgesic
Term
Albuterol is used as a...
Definition
Bronchodilator
Term
Trade names of Magnesium Sulfate.
Definition
Mag, Mag Sulfate, MgSO4, Mg++
Term
MOA of Mag Sulfate
Definition
-Ca++ Channel blocker
-Reduces ACh release at myoneural junctions
-Increases membrane stability and decreases ventricular excitability
Term
Actions of Mag Sulfate
Definition
-Increases RMP
-Increase absolute refractory period
-Decreases QT interval
-Relaxes smooth muscle during bronchospasm
-Reduces SA node impulse formation
-Reduces striated muscle contractions
-Decreases neuronal excitability
Term
Indications for Mag Sulfate admin
Definition
-Hypomagnesia
-Refractory Torsades, VTach, VFib
-Ventricular ectopy
-Preeclampsia/eclampsia seizure prevention/Rx
-Status asthmaticus that doesn't respond to Beta-agonists/anticholinergics
Term
This is the Rx of choice for torsades.
Definition
Magnesium Sulfate
Term
Contraindications of Mag sulfate admin.
Definition
-Heart block
-MI
-Hypermagnesemia
Term
Mag sulfate precautions.
Definition
-Renal insufficiency
-Concurrent use w/ nifedepine in Rx of maternal HTN may harm the fetus
Term
Mag sulfate is available in what form?
Definition
Diluted in water for injection
Term
How does mag sulfate come prepared?
Definition
4 g/100 mL, 20 g/500 mL, 40 g/1000 mL, 2 g/50 mL, and 4 g/50 mL NOTICE GRAMS MATT YOU TWIT!!!
Term
Routes of mag sulfate admin.
Definition
IV, IM
Term
What is the adult dosage of mag sulfate for torsades, VTach, VFib, or bronchospasm?
Definition
IV, 2 g diluted in 20 mL, administered over 5 min
-NOT FASTER THAN 1 g/min
Term
What is the dosage of mag sulfate for preeclampsia?
Definition
IV, 4 g diluted in 100 mL, administered over 20 min
-NOT FASTER THAN 1 g/min
Term
What is the maintenance infusion dose of mag sulfate for preeclampsia?
Definition
10 g/250 mL NS run at 50 mL/hr
Term
What is the mag sulfate dose for eclamptic seizures?
Definition
IV, 4 g diluted in 100 mL, administered over 5 min, rpt as needed.
-DO NOT GIVE FASTER THAN 1 g/min
Term
What is the pediatric dosage of mag sulfate for Torsades, Vtach, Vfib, and bronchospasm?
Definition
IV, 25-50 mg/kg in 100 mL, administered over 2-5 min with max dose of 2 g
-DO NOT GIVE FASTER THAN 1 g/min
Term
What is the onset of mag sulfate?
Definition
-IV, immediate
-IM, 3-4 min
Term
What is the duration of mag sulfate?
Definition
-IV, 30-60 min
-IM, 3-4 hr
Term
What are the side effects of mag sulfate (9)?
Definition
-Flushing/sweating
-Itching/rash
-Hypothermia
-Drowsiness
-Respiratory depression
-Bradycardia/AV block
-Absence of knee jerk
-Flaccid paralysis
-HypoTN, diaphoresis
Term
Signs of mag sulfate toxicity.
Definition
-Respiratory failure
-Cardiac arrest
-Circulatory collapse
-Complete heart block
Term
Drug interactions of mag sulfate.
Definition
-Incompatible with alcohol, salicylates, and sodium bicarb
-Additive effects w/ CNS depressants
Term
This is an analagesic, commonly known as morphine.
Definition
Morphine Sulfate
Term
This is an analgesic, commonly known as nitronox.
Definition
Nitrous Oxide
Term
This is an analgesic, commonly known as sublimaze.
Definition
Fentanyl
Term
This is used for Rx of bronchospasm and hyperkalemia, commonly known as Ventolin.
Definition
Albuterol
Term
Used to Rx bronchospasm, this drug is commonly known as Atrovent or Combivent.
Definition
Ipratropium
Term
This anesthetic is commonly known as Amidate.
Definition
Etomidate
Term
This paralytic is commonly knownn as Anectine.
Definition
Succinycholine
Term
This paralytic is commonly known as Non-curon.
Definition
Vecuronium
Term
This anitconvulsant/antidysrhythmic is commonly known as Mg++, MgSO4, or Mag.
Definition
Magnesium Sulfate
Term
This diuretic is commonly known as Lasix.
Definition
Furosemide
Term
This antiemetic is commonly known as Phenergan.
Definition
Promethazine
Term
Morphine dose for pain.
Definition
2-4 mg slow IV push over 1-5 min every 5-30 min (titrate to effect)
Term
Morphine dose for STEMI.
Definition
2-4 mg IV, may rpt 2-8 mg at 5-15 min intervals
Term
Morphine dose for Non-STEMI.
Definition
1-5 mg IV (only if not relieved by nitrates or symptoms come back)
Term
Morphine pediatric dose.
Definition
0.1-0.2 mg/kg IV, MTD 15 mg
Term
Nitrous oxide dose for pain.
Definition
Self administered until the Pt drops the mask or pain is relieved.
Term
Fentanyl pain dosage.
Definition
1 mcg/kg with MSD of 100 mcg
Term
Albuterol bronchospasm MDI dose.
Definition
1-2 inhalations over 1 min, rpt 15 min PRN.
Term
Albuterol bronchospasm nebulizer dose.
Definition
2.5 mg via neb w/ O2 at 8 lpm
Term
Albuterol hyperkalemia ETT dose.
Definition
4 unit doses of 10 mg followed by hyperventilation.
Term
Albuterol hyperkalemia nebulizer dose.
Definition
10 mg w/ O2 at 8 lpm
Term
Ipratropium nebulizer dose.
Definition
0.5 mg w/ O2 at 8 lpm (DO NOT RPT)
Term
Etomidate cardioversion dose.
Definition
0.15 mg/kg slow push
Term
Etomidate intubation dose.
Definition
0.3 mg/kg slow push
Term
Succinylcholine adult dose.
Definition
1-2 mg/kg rapid push, rpt 1x if needed
Term
Succinycholine pediatric dose.
Definition
Same as adults, but infants get 2 mg/kg.
Term
Vecuronium dose.
Definition
0.1 mg/kg, rpt PNR
Term
Ondansetron adult IV/IO/IM dosing.
Definition
4 mg slow push, may rpt 1x at 15 min
Term
Ondansetron oral med dosing.
Definition
8 mg ODT or tablet
Term
Ondansetron pediatric dosing.
Definition
IV/IO/IM, 0.1 mg/kg with MD of 4 mg (contact med control to repeat)
Term
Magnesium sulfate Vtach, Vfib, Torsades and bronchospasm dosing.
Definition

Bronchospasm: IV, 2 g diluted in 20 mL, delivered over 2 min

 

Refractory vent. rhythms: IV, 2 g diluted in 20 mL, delivered over 5 min

Term
Magnesium sulfate preeclampsia dose.
Definition
IV, 4 g diluted in 100 mL, delivered over 20 min
Term
Magnesium sulfate preeclampsia maintenance dose.
Definition
IV, 10 g diluted in 250 mL NS, ran at 50 mL/hr drip rate.
Term
Mag sulfate eclamptic seizure dosing.
Definition
IV, 4 g diluted in 100 mL over 5 min (< 1 g/min)
Term
Pediatric dose of mag sulfate.
Definition
IV, 25-50 mg/kg in 100 mL over 2-5 min, MD of 2 g
Term
Furosemide adult dose.
Definition
20-40 mg
Term
Furosemide peds dose.
Definition
0.5-2 mg/kg
Term
Promethazine adult dose.
Definition
IV, 12.5 mg slow push
IM, 25 mg
Term
Promethazine pediatric dose.
Definition
0.25-0.5 mg/kg
Term
Oxytocin IM dosage.
Definition
10 units
Term
Oxytocin IV dosage.
Definition
10-40 units in 250-1000 mL over 15 min
Term
What is the preferred delivery method of oxytocin.
Definition
IM
Term
Trade name for this drug is Valium.
Definition
Diazepam
Term
Commonly called Valium, you would use this drug as an anticonvulsant, sedative, anxiolytic or amnesic.
Definition
Diazepam
Term
Diazepam adult seizure dose.
Definition
5-10 mg, MD of 20 mg
Term
Diazepam adult anxiety dose.
Definition
2-10 mg
Term
Diazepam pediatric dose.
Definition
0.05-0.3 mg/kg MD of 10 mg (if Pt < 5 yr, MD is 5 mg)
Term
Adult dosage of dextrose.
Definition
12.5-25 g
Term
Pediatric dosage of dextrose.
Definition
0.5 g/kg (if Pt weighs more than 15 kg, use D25 or 50, if weighs less, use D10 or 25)
Term
Neonate dosage of dextrose.
Definition
2.4 mL/kg of D10
Term
Adult dose of glucagon in Rx of diabetic emergency.
Definition
0.5-1 mg, can rpt 1x at 15 min
Term
Adult dose of glucagon in Rx of non-diabetic emergency.
Definition
2-5 mg
Term
Pediatric dose of glucagon.
Definition
0.5 mg, but not recommended
Term
Adult dose of Haldol for psychosis.
Definition
5-10 mg, can rpt every 30-60 min
Term
Adult dose of Haldol for nausea.
Definition
0.5-2 mg
Term
Pediatic dose of Haldol.
Definition
0.5-1 mg
Term
Trade name Versed, this drug can be used as an anxiolytic, sedative, anticonvulsant or amnesic.
Definition
Midazolam
Term
Adult dose of midazolam.
Definition
0.1 mg/kg with MSD of 5 mg, and MTD of 10 mg. Can rpt after 5-10 min
Term
Pediatric dose of midazolam.
Definition
Same as adult
Term
Commonly known as Ativan, this drug can be used as an anticonvulsant, anxiolytic, or a sedative.
Definition
Lorazepam
Term
Adult dosage of Lorazepam.
Definition
1-2 mg, MSD of 2 mg, and MTD of 4 mg
Term
Pediatric dosage of lorazepam (the preferred drug for pediatric seizure Rx).
Definition
0.1 mg/kg, MD of 2 mg
Term
Furosemide trade name.
Definition
Lasix
Term
Furosemide drug class.
Definition
Sulfonamide Type Loop Diuretic
Term
Furosemide MOA.
Definition
-Inhibits reabsorption of sodium and chloride
-Increases excretion of K+, H+, Ca++, magnesium, bicarb, ammonium and phosphate
-Decreases peripheral vascular resistance and preload
Term
T or F, Furosemide is considered a 2nd line drug.
Definition
True
Term
Lasix (furosemide) indications.
Definition
-Pulmonary edema
-CHF
-HTN crisis
Term
Contraindications of furosemide use.
Definition
-Hypovolemia
-Dehydration
-Hypokalemia
-Hypersensitivity to sulfonamides
Term
Precautions of Lasix use.
Definition
-Diabetes
-Renal disease
-Hepatic disease
-Anuria
-May cause electrolyte imbalances
Term
Furosemide forms available.
Definition
PFS, Tablet, IV, IM
Term
How does furosemide come prepared?
Definition
IV Bolus
Term
What are the routes of furosemide admin?
Definition
IV, IO, IM, Oral
Term
What is the adult dose of Lasix/furosemide?
Definition
20-40 mg
Term
What is the pediatric dose of furosemide?
Definition
IV/IM 0.5-2 mg/kg
Term
Furosemide onset
Definition
15-30 min
Term
Furosemide duration.
Definition
6-8 hr
Term
Side effects of furosemide.
Definition
-Hearing loss
-Tinnitis
-Hypovolemia
-Hypotension
-Hypokalemia
-Hyperglycemia
-Electrolyte imbalances
-Hyperuricemia
-Weakness
-Dizziness
-Pulmonary HTN
Term
Furosemide interactions.
Definition
-Incompatible with any drug in syringe
-Additive effects on antihypertensives, nitrates, and other diuretics
Term
Promethazine trade name.
Definition
Phenergan
Term
Drug class of Phenergan/promethazine.
Definition
Antiemetic
Antivertigo
Term
MOA of promethazine/phenergan.
Definition
-Blocks histamine release by Vagus nerve
-Blocks serotonin release in the chemoreceptor trigger zone
Term
Actions of promethazine.
Definition
-Antiemetic
-Antihistamine
Term
Indications for Phenergan use.
Definition
-Prolonged nausea/vomiting
-Vertigo
Term
Contraindications for promethazine admin.
Definition
-Intoxication
-Other CNS Depressants
-Less than full mental status
Term
Precautions for promethazine use.
Definition
-Pts w/ Hx of bladder or prostate problems
-Seizure disorders
-Peptic ulcers
-Intestinal obstruction
-Rapid push may cause tissue necrosis
Term
Promethazine forms available.
Definition
25 mg/mL ampule
Term
Routes of promethazine admin.
Definition
IV, IM
Term
Adult dosage promethazine, IV.
Definition
12.5 mg slow push (w/ flush wide open)
Term
Adult dosage promethazine, IM.
Definition
25 mg deep IM
Term
Pediatric dose of promethazine.
Definition
0.25-0.5 mg/kg slow IV push or deep IM
Term
Promethazine onset.
Definition
IV 3-5 min
IM 20 min
Term
Promethazine duration.
Definition
4-6 hr
Term
Side effects of promethazine use.
Definition
-Dizziness
-Seizure
-Stiff muscles
-Hypotension
-Drowsiness
-Loss of bladder control
Term
Signs of promethazine toxicity.
Definition
-EPR
-Profound hypoTN
-Unconsciousness
-Sudden death
Term
Trade name of oxytocin.
Definition
Pitocin
Term
Oxytocin/Pitocin belongs to what drug class?
Definition
Uterine stimulant hormone
Term
Site of action, Oxytocin.
Definition
Uterine and mammary smooth muscle myofibrils.
Term
Actions of oxytocin.
Definition
-Stimulates uterine contraction
-Enhances lactation
Term
Indications for oxytocin.
Definition
-Control post-partum bleeding
-Induction/stimulation of labor
Term
Contraindications for oxytocin.
Definition
-Prior to delivery of placenta or all of the fetus
-Cephalopelvic disproportion
-Fetal distress w/o imminent delivery
-Hyperactive or hypnotic uterus
Term
How does oxytocin come prepared?
Definition
10 unit/mL
Term
Routes for oxytocin admin.
Definition
IV
IM
Term
Dose of oxytocin.
Definition
-For post-partum bleeding, 10 unit IM preferred
-IV, 10-40 units in 250-1000 mL over 15 min
Term
Onset of oxytocin.
Definition
1-6 min
Term
Duration of oxytocin.
Definition
-IV, 30 min
-IM, 2.5 hr
Term
Side effects of oxytocin.
Definition
-Tachycardia
-HA
-PVC
-HypoTN
-Chest pain
Term
Oxytocin toxicity.
Definition
Water intox leading to seizure, coma or death.
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