Chapter 12 Med.'s-name, class, actions

Question 1

Adenosine

Answer 1

Class: Antiarrhythmic
Actions: Slow AV conduction
Indications: 
1. PSVT
 2. Wide complex Tach's of uncertain type refractory to Lidocaine

Question 2

Activated Charcoal

Answer 2

Class: Adsorbent 
Actions: Adsorbs toxins by binding to them to prevent absorption 
Indications:
1. Poisoning following emesis
 2.Emesis contraindicated

Question 3

Metaproterenol (Alupent)

Answer 3

Class: Sympathomimetic (Beta 2 selective)
Action: 
1. Bronchodilation 
2. Increases heart rate
Indications: 
1. Asthma 
2. Bronchospasm with COPD

Question 4

Aminophylline

Answer 4

Class: Xanthine bronchodilator
Actions: 
1. Smooth muscle relaxent: Bronchodilation & Vasodilation indirectly results in increased coronary blood flow 
2. increased diaphragmatic constrictions 
3. Mild diuresis
 4. increased cardiac output, chronotropic & inotropic 
5. stimulates resp. drive 
6. CNS stimulant
Indications: 
1. Acute Asthma 
2. Decompensated COPD
 3. CHF 
4. Pulmonary edema 
5. Bronchoconstriction in anaphylaxis

Question 5

Aspirin

Answer 5

Class: platelet inhibitor/ antiinflammatory
Actions: Blocks platelet aggregation
Indications: acute chest pain suggestive of MI

Question 6

Atropine

Answer 6

Class: Parasympatholytic (anticholinergic)
Actions:
1.Blocks acetylcholine receptors (decreases parasympathetic tone and thus increases heart rate)
2. Decreases gastrointestinal secretios
Indications:
1. Symptomatic bradycardia (PVC’s, Hypotension, or decreased LOC)
2. Asystole & symptomatic heart blocks
3. Organophosphate poisoning

Question 7

Ipratopium Bromide

Answer 7

Class: Anticholinergic (parasympatholytic)
Action: 
1.Bronchodilation
2. Dries respiratory tract secretions
Indications:
1. Bronchial asthma
2. Bronchospasm associated with COPD

Question 8

Terbutaline

Answer 8

Class: Sympathomimetic (adrenergic) & tocolytic
Actions: 
1. Beta 2 selective: bronchodilator
2. Beta 1 Chronotropic 
3. Relaxes Uterine Muscles to suppress contractions
Indications:
1. Bronchial Asthma 
2. Bronchospasm with COPD
3. Preterm labor

Question 9

Calcium Chloride 10%

Answer 9

Class: Electrlyte
Actions: Increases cardiac contractility
Indications: 
1. acute hyperkalemia
2. acute hypocalcemia
3. calcium channel blocker overdose
4. antidote to madnesium sulfate OD

Question 10

Diltiazem (cardizem)

Answer 10

Class: calcium channel blocker
Actions:
1. Vascular dialation
2. slows conduction through AV node
3. Slows rapid Ventricular rate associated with A-Fib and A-Flutter
4. Dilates coronary arteries (negative inotrope)
Indications:
1. Rapid Ventricular Rates in: A-fib and A- flutter
PSVT refractory to Adenosine
2. Angina

Question 11

Amiodarone

Answer 11

Class: III antiarrhythmic
Action: prolongs action potential duration in all cardiac tissues
Indications:
1. pulseless VT & V-Fib
2. Tachycardias refractory to digoxin
3. Polymorphic Ventricular Tachycardia
4. Wide complex tachycardias of unknown etiology

Question 12

Diazepam (Valium)

Answer 12

Class: Sedative hypnotic
Action: 
1. Anticonvulsant
2. Skeletal muscle relaxant
3. Sedative
4. General CNS depressant
Indications:
1. Generalized seizures
2. Statues epilepticus
3. Premedication
4. Skeletal muscle relaxent

Question 13

Phenytoin (Dilantin)

Answer 13

Class: Anticonvulsant
Action: 
1. Decreases neuron excitability thru increasing sodium efflux from neurons
Indications: 
1. Status Epilepticus
2. Digitalis induced dysrhythmias

Question 14

Digitalis (lanoxin or digoxin)

Answer 14

Class: Cardiac Glycoside
Actions: 
1. increases cardiac contractile force
2. increases cardiac output
3. reduces edema associated with CHF
4. Slows AV junction
Indications:
1.CHF
2. Rapid A-fib & A- flutter

Question 15

Diphenhydramine (benadryl)

Answer 15

Class: antihistamine
Actions: 
1. Blocks histamine receptors
2. Has some sedative effects
Indications: 
1. Anaphylaxis in conjunction with Epi
2. Allergic reactions
3. Dystonic reactions (extrapyramidal effects: uncontrolled muscle twitching) due to Phenothiazines (Thorazine, compazine, antipsychotics, narcotic potentiators and antiemetics)

Question 16

50% Dextrose

Answer 16

Class: Carbohydrate
Action: elevates blood glucose level
Indications: 
1. hypoglycemia
2. Coma of unknown origin

Question 17

Dopamine (Intropin)

Answer 17

Class: Sympathomimetic
Actions:
1. Increases cardiac contractility
2. Causes peripheral vasoconstriction
3. Increase chronotropic and inotropic effects
4. dilation of mesentaeric & renal arteries promoting urination (reason why Dop. is preferred over NorEpi)
5. Low does action 10mcg/kg/min Alpha Effects
Indications
1.Cardiogenic shock
2. Hypovolemic shock refractory to fluid resuscitation
3. Hypotensin secondary to bradycardia post resuscitation

Question 18

Epinephrine 1:1000

Answer 18

Class: Sympathomimetic
Action: 
1. Alpha: vasoconstriction: improves coronary blood flow and supports BP in anaphylactic shock
2. Beta 1: inotropic and chronotropic effects
3. Beta 2: Bronchodilation
Indications:
1. Bronchial asthma
2. Exacerbation of COPD
3. Allergic reaction

Question 19

Epinephrine 1: 10,000

Answer 19

Class: Sympathomimetic
Actions:
1. Alpha: vasoconstriction: improves coronary blood flow and supports BP in anaphylactic shock
2. Beta 1: chronotropic effects, lowers defibrillation threshold, inotropic effects: increase myocardial contractility
3. Beta 2: Bronchodilation

Question 20

Etomidate (amidate)

Answer 20

Class: Benzodiazepine (sedative/ Hypnotic)
Action:
1. Rapid induction of anesthesia with minimal cardiovascular and respiratory effects
2. does not cause histamine release as do other barbiturates On set:10-20 sec Duration: 3-5 mins
Indications: RSI

Question 21

Fentanyl (sublimaze)

Answer 21

Class: Narcotic analgesic
Action: 
1. CNS depressant
2. Decreases sensitivity to pain
Indications: 
1. Acute pain
2. Premedication for RSI

Question 22

Furosemide (lasix)

Answer 22

Class: Diuretic
Action: 
1. Inhibits reabsorbtion of NaCl
2. Promotes promt diuresis
3. Vasodilation
Indications: 
1.CHF
2. Pulmonary edema

Question 23

Glucose

Answer 23

Class: Carbohydrate
Action: Increases blood sugar levels
Indications: 
1. Altered mental status
2. History of diabetes controlled by medication

Question 24

Glucagon

Answer 24

Class: Hormone (antihypoglycemic agent)
Action:
1. causes breakdown of glycogen to glucose
2. inhibits glycogen synthesis
3. elevates blood glucose level 
4. increases cardiac contractility force
5. increases heart rate
Indications: hypoglycemia

Question 25

Lidocaine

Answer 25

``` Class: IB Antiarrhythmic Action: 1. suppress ventricular ectopy 2. increase ventricular force threshold 3. reduce electrical impulse through heart Indications: 1. Malignant PVC's -a. >6/min b. MI c. Couplets/Salvos or runs of VT d. R-on-T phenomenon e. Multifocal f. Symptomatic 2. VT, VF 3. Wide complex tachycardias of unknown origin ```

Question 26

Magnesium Sulfate

Answer 26

``` Class: Anticonvulsant Actions: 1. CNS depressant 2. Anticonvulsant 3. stabalize muscle cell membrane by interacting with Na/K pumps 4. Smooth muscle relaxent (vaso & bronchodilation) Indications: 1. Eclampsia (toxemia of Pregnancy) 2. Torsades de Pointes 3. Severe refractory pulsess VF/VT 4. Post MI for postphylaxia of arrhythmias 5. Management of acute asthma attacks ```

Question 27

Racemic Epi (Phenylephrin Hydrochloride)

Answer 27

Class: Sympathomimetic (adrenergic) Actions: 1. Beta 2: bronchodilation: PRIMARY 2. Beta 1: Positive Chronotrope& Inotrope Indications: Croup (laryngothracheobronchitis)

Question 28

Morphine Sulfate

Answer 28

``` Class: Narcotic (opiate) Actions: 1. CNS depressant 2. Analgesic 4. Decrease myocardial O2 demand Indications: 1. severe pain 2. Pulmonary edema ```

Question 29

Naloxone (narcan)

Answer 29

Class: Narcotic Antagonist (Opiate) Actions: Reverses effects of narcotics by competing for opiate receptors Indications: 1. Narcotic overdoses including: Morphine, Methadone, Dilaudid, Herion, Fentanyl, Demerol, Paregoric, Percodan, Tylox, Nubain, Stadol, Talwin, and Darvon 2. alcoholic coma 3. To rule out narcotic in coma of unknown origin

Question 30

Nitroglycerin

Answer 30

``` Class: Antianginal Actions: 1. Smooth muscle relaxant 2. reduces cardiac work 3. Dilates coronary arteries 4. Dilates systemic arteries Indications: 1. Angina pectoris 2. Chest pain associated with MI 3. Hypertension (Sys. >200 OR Dias >100) 4. CHF ```

Question 31

Nitrous Oxide

Answer 31

Class: Gas/Analgesic Actions: CNS depressant Indications: 1.Musculskeletal pain especially fractures 2. Burns 3. Suspected ischemic chest pain 4. Severe anxiety including hyperventilation

Question 32

Vecuronium

Answer 32

Class: Nondepolarizing neuromuscular blocker Actions: 1. Comperes with acetylcholine for cholinergic receptor sites on the postjunctional membrane 2. paralysis of skeleral muscles 3. Onset 1 min Duration 25-30 mins Indications: RSI

Question 33

Norepinephrine

Answer 33

``` Class: Sympathomimetic Actions: 1. Causes peripheral vasoconstriction 2. Alpha sympathomimetic 3. Mild Beta effects: Increase inotropic effects 4. Increase myocardial O2 demand Indications: 1. Hypotension refractory to other sympathomimetics 2. Neurogenic shock 3. Cardiogenic shock ```

Question 34

Promethazine

Answer 34

``` Class: antihistamine (H1 antagonist) Actions: 1. Mild anticholinergic activity 2. Antiemetic 3. Potentiates actions of analgesics Indications: 1. Nausea & vomiting 2. Motion sickness 3. To potentiate the effects of analgesics 4. Sedation ```

Question 35

Procainamide

Answer 35

``` Class: IA antiarrhythmic Actions: Slows conduction through myocardium by increasing electrical threshold of ventricle, Bundle of His & perkinje system Indications: 1. PVC's refractory to lidocaine 2. VF or VT refractory to lidocaine 3. Wide complex tachycardia ```

Question 36

Sodium Bicarbonate

Answer 36

``` Class: Alkalinizing agent Actions: 1.Neutralizes excess acids 2. Increases pH Indications: 1. Metabolic Acidosis a) Poisoning: Ethylene Glycol OR Tricyclics b) Post Resuscitation 2. Hyperkalemia 3. Promote excreation of Barbiturates 4. Promotes excreation of myoglobin after crush injury or electrocution 5. Status asthmatics 6. Prolonged CPR 7. Severe acidosis refractory to hyperventilation ```

Question 37

Methylprednisolone (Solu-Medrol)

Answer 37

``` Class: Steriod Actions: 1. Anti-inflammatory 2. Suppresses immune response (allergic reactions) Indications: 1. Severr Anaphylaxis 2. Asthma/COPD 3. Possibly effective as an adjunctive agent in the management of spinal cord injury ```

Question 38

Succinylcholine

Answer 38

``` Class: depolarizing neuromusclar blocker Actions: 1. Depolarizes skeletal muscle 2. Onset: 60-90 sec 3. Duration 4-5 mins Indications: RSI ```

Question 39

Thiamine (B1)

Answer 39

Class: vitamin Actions: assists in converting glucose into energy Indications: 1. Coma of unknown origin 2. Chronic Alcoholism with associated coma 3. Delirium tremens 4. Precursor of D50 to prevent Wernicke's Encephalopathy (proplem with neurotransmitters in brain which results in retained altered LOC) in alcoholics 5. Beriberi (Thiamine deficiency)

Question 40

Vasopressin (ADH)

Answer 40

``` Class: Anti-diuretic hormone Actions: 1. Vasoconstriction 2. Contraction of smooth muscles of the gut Indications: 1. VF/ Pulseless VT 2. Slow or stop GI bleeding 3. Diabetes insipidus ```

Question 41

Midazolam (Versed)

Answer 41

``` Class: Tranquilizer Actions: Sedative/hypnotic Indications: 1. Premedication prior to cardioversion 2. Premedication prior to RSI 3. Acute anxiety states ```

Question 42

Lactated Ringer's (LR)

Answer 42

Class: Isotonic Crystalloid solution Replaces water and electrolytes Indications: Hypovolemic shock, Burns, TKO IV

Question 43

5% Dextrose in water (D5W)

Answer 43

Class: Hypotonic dextrose- containing solution Hypotonic, it prevents circulatory overload in patients with CHF and renal failure Actions: provides nutrients in the form of dextrose and free water Indications: 1. IV access for emergency drugs 2. For dilution of concentrated drugs for IV infusion

Question 44

.9% sodium chloride (normal saline)

Answer 44

``` Class: Isotonic Crystalloid solution Replaces water and electrolytes Indications: 1. Heat related problems 2. Freshwater drowning 3. Hypovolemia 4. Diabetic ketoacidosis 5. TKO IV ```