Asthma Flashcards

Question

Antichols

Answer 1

antihistamines, antipsychotics, antidepresssants, antiparkinsonian

Answer 2

``` Red as a beet Dry as a bone Blind as a bat Mad as a hatter Hot as a hare Flushing, dry skin and membranes, mydriasis (dilation), fever, altered LOC, tachycardia ```

Answer 3

Amitriptyline (elavil) Amoxapine (asendin) Clomipramine (anafranil) Doxepin (sinequan)

Answer 4

Inhibit Norepi, serotonin reuptake Antichols Direct alpha-adrenergic block Inhibits K+ channels in myocardium and Na+ in brain and myocardium

Answer 5

Delerium, coma, seziures, resp depression, sinus tach, long PRI QRS and QT, heart blocks, hypotension, ventricular arrhythmias, blurred vision, mydriasis

Answer 6

ABCs BGL, IVs Heart blocks, long PRI, wide QRS, Brugada pattern (incomplete RBBB with ST elevation V1, V3) bradycardia, ventricular dysrhythms including PMVT Wide QRS key for tx w/ bicarb

Answer 7

no more than 40mL/kg Bicarb 1-2mEq/kg for refract hypotension and initial seizure Seizures tx with benzos (remember check monitor for dysrhythmia that looks like a seizure) Torsades 2g mag in 50mL over 5 GCS less than 8 consider advanced airway as it predicts cardiotoxicity and or seizures Pressors for refract hypotension, nor epi if not then epi

Answer 8

Bicarb, benzos, mag, pressors, intubation

Answer 9

``` Not effective for Cyanide Mineral acids Caustic alkalis Ethanol Methanol Organic solvents NG/OG or orally ```

Answer 10

Corrosive agent or petroleum distillate (may cause vomiting) | Dose 1gm/kg PO NG, OG same for peds

Answer 11

Cholinesterase inhibitors prevent ACh from reuptake. Similar effects as organophosphate, S&S depend on if its muscarinic or nicotinic

Answer 12

Miosis (constricted)/dim vision Tight chest Muscular weakness, cramps diarrhea, breathing difficulty and convulsions

Answer 13

``` Bradycardia/bronchospasm Miosis (constrict) Salivation/sweating Lacrimation Urination Defication GI upset Emesis ```

Answer 14

``` Acephate (orthene) Chlorphoxim (baythion-C) Chlorpyifos (dursban, lorsban) Diazinon Dimethoate (cygon, defend) Ethoprop (mocap) Fenitrothion (sumithion) Fenthion (baytex) Malathion (cythion) Naled (Dibrome) Terbufos (counter) ```

Answer 15

Decontaminate, assist ventilations, monitor for tordsades, | atropine 2-4mg q 1-5, watch for non cardiogenic pulmonary edema, avoid succ's/prolonged paralysis

Answer 16

2mg q 5 until reversal of symptoms

Answer 17

Antidote only for organophosphate. Binds to site different than organophosphate and boots it off. Must be given early

Answer 18

Intracranial hemorrhage possible from HTN Aortic dissection possible Sodium channel blockade with some Benzos, fluid, maybe beta blockers, maybe bicarb, and ice to groin, neck, axilla

Answer 19

Thought to be because beta block blocks beta 2 (peripheral vasodilation) but A1 is still hit. LITFL says minor increase in BP, minor drop in heart rate, safe to give

Answer 20

Cocaine blocks sodium channels like TCA. Tx wide QRS with bicarb

Answer 21

0.4mg q 2 max 1.6 0.8mg q 5 max 3.2 2mg intranasal (1mg/nare) q3-5 max 4mg

Answer 22

IV or IM 0.1mg/kg max 2mg single dose, max total 10mg (same for intranasal but max 2mg)

Answer 23

Decreased LOC, delirium, slurred speech, combative, coma, resp depression, apnea, hypotension, bradycardia, diaphoresis, hypothermia, nystagmus

Answer 24

Flumazenil, selective competitive GABA receptor antagonist

Answer 25

Bicarb. Alkalization of urine enhances elimnation of phenobarb and other long acting barbs via ion trapping.

Answer 26

protip, oil of wintergreen is high in salicylates | Elimination mostly hepatic but renal excretion becomes important

Answer 27

Acute is around 150mg/kg More commonly chronic, vague symptoms and insidious onset. Commonly in oldies as they can't excrete as much as they take in Diagnosis on presence of salicylate ingestion + mixed metabolic anion gap acidosis and no other explanation

Answer 28

Hyperventilation as they directly stimulate resp center, resp alkalosis may be first sign. Increased resps means fluid lossess Metabolic acidosis from compensation of resp alkalosis and impaired glucose metabolism As acidosis builds, more drug moved intracellulary, toxicity worsens Anion gap positive acidosis

Answer 29

Cerebral and pulmonary edema, poorly understood why, possibly increased cap perm Hypovolemia and hypokalemia from large amounts of fluid losses (vomiting, diarrhea) Tachycardia, arrhythmias Hypoglycemia May need tubing Tinnitus

Answer 30

Fluid, control hyperthermia, tx hypoglycemia, benzos if seizing, bicarb considered. Activated charcoal if ingestion has been within 60 minutes

Answer 31

Rapidly absorbed, peaks at 2 hours, steady state at 4 hours Metabolized CYP3A4 and 2E1 into NAPQI (n-acetyl-p-benzoquinonimine) which is highly toxic Glutathione in liver normally deactivates it, OD uses up all the glutathione

Answer 32

N/V Diaphoresis pallor lethargy malaise RUQ pain liver enlargement hypoglycemia Elevated AST, ALT, bilirubin

Answer 33

ABCs, BGL N-acetylcysteine, hepatoxicity risk at 8 hours post ingestion typically

Answer 34

Replenishes stores of glutathione

Answer 35

150mg/kg in 200mL of D5 over 15-60 minutes Then 50ml/kg in 500mL of D5 over 4 hours Then 100mg/kg in 1000mL over 16 hours

Answer 36

7000mg single ingestion, 150mg/kg (wiki says 10000 and 200mg/kg)

Answer 37

Propranolol most common, its non selective and has membrane-stabilizing effects responsible for CNS depression, seizures, prolonged QRS (sodium channel blockade)

Answer 38

Blocks 1 - reduced hrt rate, BP, myocardial contractility and MVO2 Blocks 2 - inhibits relaxation of smooth muscle in vessels, bronchi and GI system and genitourinary Also inhibits glycogenolysis and gluconeogenesis which may result in hypoglycemia

Answer 39

Heart blocks, bradycardia, conduction delays, bronchospasm (if underlying airway disease) decreased LOC (lipid soluble ones like propranolol and acebutolol)

Answer 40

Glucagon increases cAMP, often will cause nausea and vomiting consider prophylatic ondanstron Insulin increases CO also through non-alpa and non-beta receptor methods CaCl regulates action potential excitation threshold 8-16mg/kg (100-1000gm)

Answer 41

``` Tx with heart block protocol Tx hypoglycemia 20mL/kg IV/IO map 65 max 40mL/kg Glucagon 2mg SIVP q 10 max of 6mg Zofran 4mg Calcium chloride for refractory hypotension, 1g SIVP q 10 max 3g Wide QRS bicarb 1mEq/kg q 5 max 2 mEq/kg STILL hypotensive, OLMC for norepi 0.1mcg/kg/min titrate to effect 0.3mcg/kg/min max ```

Answer 42

Verpamil, Isoptin, Nifedipine, Adalat, Diltziazem

Answer 43

``` Peripheral vasodilation Negative chronotropy (rate) Negative intotropy (contractility) Negative dromotropy (conduction) ```

Answer 44

Decreased LOC, hypotension, bradycardia, various degrees of heart block, seizures, hyperglycemia

Answer 45

``` Calcium chloride - overwhelms CCB Insulin - increased CO ithout A/B receptors TCP (brady cardia with SBP under 90) Glucagon Pressors ```

Answer 46

For pacing too 0.05mg/kg max 2.5mg versed + 1mcg/kg fentanyl max 100 0.5mg/kg ketamine instead if SBP under 100 (consider half dose if pt over 65)

Answer 47

``` Tachyarrythmias + heart blocks Head, irritability, psychosis Yellow-green vision Anorexia, N/V Palpitations, syncope, dyspnea Atrial tach with block, junctional tach, ectopy ```

Answer 48

Inhibition of Na+/K+ ATPase pump which raises intracellular Ca2+ and Na+ plus loss of K+ which increases force of myocardial contraction (inotropic effect) Dig also increases automaticity of purkinje but slows AV conduction

Answer 49

Fluid Atropine/TCP bradycardia No calcium for hyperK (relative contra, give digibind first) Digibind (digoxin immunie fab) 400mg IV over 15 minutes 800mg RIVP if cardiac arrest

Answer 50

In antifreeze, small amounts can lead to severe tox, kids sometimes drink as its sweet and fluorescent

Answer 51

Windshield washer fluid, small amounts can lead to tox

Answer 52

Stopped at slide 64

Asthma Flashcards

(76 cards)