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AZ Drug Profiles > AZ Drug Profile > Flashcards

AZ Drug Profile Flashcards

1
Q

Acetylsalicylic Acid (Aspirin, ASA) Class

A

Analgesic, antipyretic, anti-inflammatory

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2
Q

Aspirin MOA

A

In small doses aspirin blocks thromboxane A2, a potent platelet aggregate and vasoconstrictor

Decreased platelet aggregate

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3
Q

Aspirin Indications

A

Chest pain or other S/S suggestive of acute MI

ECG changes suggestive acute MI

Unstable Angina

Pain, discomfort, fever, in adult only

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4
Q

Aspirin Contraindications

A

Bleeding Ulcer, hemorrhagic states, hemophilia

Known hypersensitivity to salicylates or other non-steroidal anti-inflammatories that has led to hypotension and/or bronchospasm

Children and adolescents

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5
Q

Aspirin Adverse reactions

A

Use with caution if history of asthma, anaphylactic reactions have occurred

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6
Q

Aspirin Adult Dosages

A

Cardiac: 160-325 mg (2-4 pediatric chewable tabs), chew or swallow

Pain/discomfort/fever: 325 mg po

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7
Q

Adenosine Class

A

Antiarrhythmic, endogenous nucleoside

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8
Q

Adenosine MOA

A

Slows conduction time thru AV node; can interrupt re-entrant pathways through the AV node

Slows sinus rate

Larger doses increase BP by decreasing peripheral resistance

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9
Q

Adenosine Indications

A

Conversion of supraventricular tachycardias with no known atrial fibrillation or atrial flutter

Undifferentiated regular monomorphic wide-complex tachycardia

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10
Q

Adenosine Contraindications

A

Sick sinus syndrome, 2nd or 3rd degree AV block, except in pt with functioning ventricular pacemaker

Use cautiously in pts with known asthma

Pts on theophylline and related methylxanthines

Pts on dipyridamole or carbamazepine

Cardiac transplant patients are more sensitive to adenosine and require a small dose

Known a-fib or a-flutter

Pregnancy

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11
Q

Adenosine Incompatibilities

A

Adenosine is not blocked by Atropine

Theophylline and related methylxanthines in therapeutic concentrations decrease effectiveness

Dipryidamole and carbamazepine block uptake and potentiate effects

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12
Q

Adenosine Dosage

A

Adult: 6 mg IV fast push, follow with 20 mL flush, repeat in 1-2 min at 12mg

Pediatric: Initial: 0.1 mg/kg as a rapid IV bolus, 2-3 ml normal saline flush, repeat double dose 0.2 mg/kg

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13
Q

Albuterol Sulfate Class

A

Sympathomimetic, bronchodilator

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14
Q

Albuterol MOA

A

Beta agonist (primarily B2), relaxes bronchial smooth muscle, resulting in bronchodilation; relaxes vascular and uterine smooth muscle, decreases airway resistance

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15
Q

Albuterol Indications

A

Treatment of bronchospasm

Treatment of hyperkalemia

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16
Q

Albuterol Contraindications

A

Synergistic with other sympathomimetics

Use caution in patients with diabetes, hyperthyroidism, and cerebrovascular disease

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17
Q

Amiodarone Class

A

Antiarrhythmic Agent

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18
Q

Amiodarone MOA

A
  • Multiple effects on sodium, potassium and calcium channels
  • Prolongs action potential, refractory period
  • Ventricular automaticity (potassium channel blockade)
  • Slows membrane depolarization and impulse conduction (sodium channel blockade)

-Negative chronotropic activity in nodal tissue, rate reduction, and antisympathetic
activity

-Dilates coronary arteries due to calcium channel and alpha-adrenergic blocking action

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19
Q

Amiodarone Indications

A

-Treatment of: defibrillation-refractory VF/pulseless VT, polymorphic VT, and wide
complex tachycardia of uncertain origin

  • Control hemodynamically stable ventricular tachycardia when cardioversion
    unsuccessful.

-Adjunct to cardioversion of SVT and PSVT.
Rate control in atrial fibrillation or flutter

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20
Q

Amiodarone Contraindications

A
  • Bradycardia
  • Second or third degree heart block unless a functioning pacemaker is present
  • Cardiogenic shock
  • Hypotension
  • Pulmonary congestion
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21
Q

Amiodarone Incompatibilities

A

-Beta blockers, calcium channel blockers, and other antiarrhythmics are additive and can
be proarrhythmic when given in combination with Amiodarone due to similar
mechanisms of action

-Amiodarone precipitates at certain concentrations when mixed at a Y-site with sodium
bicarbonate, furosemide, and heparin.

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22
Q

Amiodarone Dosage

A

VF/Pulseless VT
300 mg IV push over 30 – 60 seconds, may repeat in 3-5 minutes with 150 mg IV push

Wide-Complex Tachycardias, Atrial Flutter, Atrial Fibrillation, SVT with
cardioversion
150 mg IV over 10 minutes (mix in 50 mL bag of D5W) may repeat every 10 minutes

Maintenance Infusion Post Resuscitation/Conversion
After successful defibrillation, follow with up to 1mg/min IV infusion for 6 hours, then
up to 0.5 mg/min IV infusion for up to 18 hours, maximum daily dose is 2.2 grams
Mix 450 mg in 250 mL of D5W (special polyolefin bag), concentration 1.8 mg/mL, and
run at 33.3 mL/hr for 1 mg/min or 16.7 mL/hr for 0.5 mg/min

For Other Maintenance infusion
Rates range from 0.5 mg/min to 1mg/min. Maximum daily dose is 2.2 grams

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23
Q

Amiodarone Pediatric Dosage

A

VF/Pulseless VT
5 mg/kg IV push (max 300 mg single dose), may repeat every 5 minutes two times to a
total maximum of 15 mg/kg/day

Probable VT with pulse
5 mg/kg IV administered over 20 minutes may repeat two more times to a total of 15
mg/kg/day

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24
Q

Albuterol Incompatibilites

A

Tricyclic antidepressants (TCA’s) and monoamine oxidase (MAO) inhibitors

Other sympathomimetics (relative)

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25
Q

Albuterol Dosages

A

Adult:
2.5 mg of premixed solution via SVN with a mouth piece,
or in-line with a ventilatory device

Ped:
2.5 mg of premixed solution via SVN with a mouth piece,
or in-line with a ventilatory device
May administer up to 5mg per dose according to medical control preference

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26
Q

Bumetanide Class

A

Loop Diuretic

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27
Q

Bumetanide MOA

A

Inhibits electrolyte reabsorption in the ascending loop of Henle leading to diuresis

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28
Q

Bumetanide Indications

A

Pulmonary Edema

CHF

29
Q

Bumetanide Contraindications

A 
Hypersensitivity
Anuria
Electrolyte deficiencies
Hepatic coma
Cautious use: hepatic cirrhosis, ascites, history of gout, hypersensitivity to furosemide
30
Q

Bumetanide Incompatibilities

A

NSAIDs reduce diuretic effect

May increase blood levels of lithium increasing risk of lithium poisoning

Potentiates effects of various antihypertensive drugs

31
Q

Bumetanide Dosages:

A

0.5 to 1.0 mg IV slowly over 1-2 min

Not safe for peds

32
Q

Calcium Chloride Class

A

Electrolyte

33
Q

Calcium Chloride MOA

A

Increases extracellular and intracellular calcium levels

Stimulates release of catecholamines

Increases cardiac contractile state (positive inotropic effect)

May enhance ventricular automaticity

Inhibits the effects of adenosine on mast cells

34
Q

Calcium Chloride Indications

A

Acute hypocalcemia

Calcium channel blocker OD

Acute hyperkalemia (known or suspected)

Hypermagnesemia (Magnesium OD)

Pre-treatment for IV calcium channel blocker administration

35
Q

Calcium Chloride Contraindications

A

Hypercalcemia

Concurrent Digoxin therapy

36
Q

Calcium Chloride Adult Dosages

A

Hypocalcemia, calcium channel blocker OD, hyperkalemia and hypermagnesemia:
5-10 ml (0.5-1 Gm) of 10% calcium chloride. May repeat in 10 minutes

Pre-treatment for IV calcium channel blocker administration: 3 ml of 10% calcium
chloride. May be repeated once

37
Q

Calcium Chloride Ped Dosage

A

Hypocalcemia, calcium channel blocker OD hyperkalemia and hypermagnesemia:
0.2 - 0.25 ml/kg of a 10% solution infused slowly. Should not be repeated without
documented calcium deficiency

38
Q

Succinylcholine Class

A

Ultra-short-acting depolarizing-type skeletal muscle relaxant

39
Q

Succinylcholine MOA

A

Combines with cholinergic receptors of the motor end plate to produce depolarization

Hydrolyzed by acetylcholinesterase

40
Q

Succinylcholine Indications

A

Endotracheal intubation requiring paralysis (RSI) by a qualified Paramedic with
authorization from the Paramedic’s administrative medical director

41
Q

Succinylcholine Contraindications

A

Muscle disorders

Personal or family history of malignant hyperthermia

History of hyperkalemia

Burn injured patients*

Ocular injuries

Patients in whom successful endotracheal intubation is doubtful

42
Q

Succinylcholine Incompatibilities

A

Beta-blockers, procainamide, lithium, and quinidine prolong the effects

43
Q

Succinylcholine Dosage

A

Adult: 0.6-2 mg/kg IV push, may repeat once in 2-3 minutes if inadequate response to initial
dose to achieve paralysis

Ped: 1-2 mg/kg IV push, may repeat once in 2-3 minutes if inadequate response to initial dose to
achieve paralysis

44
Q

Glucagon Class

A

Pancreatic hormone, polypeptide, hyperglycemic agent

45
Q

Glucagon MOA

A

Acts only on liver glycogen, converting it to glucose.
Counteracts the
effect of insulin.

Relaxes GI smooth muscle causing dilation and decreased motility.

Cardiac inotrope

May reverse hypoglycemia (if patient has glycogen stored in liver)
within 4-8 minutes

46
Q

Glucagon Indications

A

Symptomatic hypoglycemia when IV access is delayed.

Beta blocker poisoning

47
Q

Glucagon Contraindications

A

Known hypersensitivity

Pheochromocytoma

Insulinoma

Should not be routinely used to replace dextrose when IV access has been obtained

48
Q

Glucagon Dosage

A

Adult: Hypoglycemia: 1 mg IM, may repeat 7-10 min

Ped: Hypoglycemia 0.5 mg IM or a dose equivalent to 20-30 mcg/kg

49
Q

Dopamine Class:

A

Sympathomimetic

50
Q

Dopamine MOA:

A

2-10 g/kg/min, affects Beta1 Cardio Shock

1-2 megs/kg affects Dope receptors

51
Q

Dopamine Indications:

A

Symptomatic brady (2nd line drug to Atropine)

Hemodynamically significant hypotension in the absence of hypovolemia

Cardiogenic/Septic Shock ONLY after fluid administration; assess breath sounds first

52
Q

Dopamine Contrindications:

A 
Pheochromocytoma
Hypersensitivity
Hypovolemic Shock
MAO inhibitors (Marplan, Nardil, Parnate)
Tachy-arrythmias / V-Fib
53
Q

Dopamine Incompatibilities:

A

Incompatible in ant alkaline solution

On-board MAO inhibitors will cause hypertensive crisis

54
Q

Dopamine Dosages:

A

Adult: Range (2-20 g/kg/min)
Prep: add 400mg/250 ml NS or Dextrose = 1600 g/ml
Brady: start at 5 g/kg/min
BP 70 start at 2.5 g/kg/min

Peds: 2-20 g/kg/min for circulatory shock or shock unresponsive to fluid administration
Prep: 6 x body weight in kg = mg added to NS to make 100ml

55
Q

Lidocaine Class:

A

anti-arrhythmic, local anesthetic

56
Q

Lidocaine MOA:

A

Decreases automaticity
Terminates re-entry
Increases VF threshold

57
Q

Lidocaine Indications

A

Suppression of ventricular arrhythmias (Vtach, Vfib, PVCs)

Prophylaxis against recurrence after conversion from vtach or vfib

Pain management after IO insertion in conscious patients

58
Q

Lidocaine Contraindications

A

Known hypersensitivity/allergy

Use extreme caution in patients with conduction disturbance

Do not treat ectopic beats if heart rate is

59
Q

Lidocaine Adult Dosages

A

VF/pVT: Initial Bolus of 1.0-1.5 mg/kg every 3-5 minutes. Total 3 mg/kg

Cardiac Arrest: 1.5mg/kg

Antidysrhythmic: Initial boluses 0.5-0.75mg/kg up to 1.0-1.5mg/kg additional bolus at 0.5-0.75 mg/kg every 5-10 minutes. Total dose 3 mg/kg

Maintenance infusion: 2-4mg/min

IO pain management: 20-40mg

60
Q

Lidocaine Pediatric Dosages

A

VF/pVT: 1 mg/kg may repeat 1 time in 3-5 minutes

ROSC: 20-50 mcg/kg/min

IO Pain Management: 0.1 mg/kg not to exceed adult dosage

61
Q

Atropine Class:

A

Anti-cholinergic
Anti-arrhythmic
Anti-spasmatic antidote
Anti-muscarinic

62
Q

Atropine MOA:

A

Block the action of ACh as a competitive antagonist at muscarinic receptor sites of smooth muscles

Blocks parasympathetic response to the Vagus nerve, allowing sympathetic response to take over, resulting in increased cardiac output and drying of secretions

63
Q

Atropine Indications:

A

Symptomatic bradycardia causing severe hypotension

Chest pain

ALOC

Systole (after epi) monitored Pt only

PEA w/ actual or red bradycardia (after epi) monitored Pt only

Acetylcholinesterase inhibitor poisoning (organophosphate, carbamate, cholinergic poisoning)

64
Q

Atropine Contraindications:

A

Hypersensitivity

Belladonna alkaloid allergy

Glaucoma, adhesions of iris & lens

Tachycardia; Mobitz type II block, 3rd degree heart blocks

Obstructive GI disease; paralytic, ulcerative colitis

Hepatic or Renal disease; obstructive uropathy

Myasthenia gravis (except to treat acetylcholinesterase inhibitor)

65
Q

Atropine Bradycardia Dosages

A

Adult: IV/IO – 0.5 mg every 5 minutes. Do NOT exceed a total dose of 3 mg or 0.04mg/kg

Peds: IV/IO – 0.02 mg/kg (minimum of 0.1 mg), repeat every 5 minutes to a max total dose of 1 mg in children and 2 mg in adolescents

66
Q

Atropine Organophosphate Dosage

A

Adult: IV/IO – Initially: 1-5 mg. Doses should be doubled every 5 minutes until signs of muscarinic excess abate

Peds:IV/IO – 0.03-0.05 mg/kg every 10 to 20 minutes until cholinergic symptoms minimize, then every 1 to 4 hours for at least 24 hours

67
Q

Ipratropium Bromide Class

A

Anticholinergic

Bronchodilator

68
Q

Ipratropium Bromide MOA

A

Anticholinergic (parasympatholytic) agent, antagonizes the action of acetylcholine

69
Q

Ipratropium Bromide Indications

A

Tx of bronchospasm associated with COPD, alone or in combination with other bronchodilators

AZ Drug Profiles (1 decks)

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