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Drug Quiz 7 Flashcards

(62 cards)

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1
Q

Aspirin

A

Platelet aggregation inhibitor

Anti-inflammatory

Salicylate

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2
Q

Aspirin MOA 1/3

A

Inhibits platelet aggregation by blocking the formation of THROMBOXANE A2–>

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3
Q

Aspirin MOA 2/3

A

THROMBOXANE A2 causes
Platelet aggregation AND
Arterial contraction

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4
Q

Aspirin MOA 3/3

A

COX inhibitor—> INHIBITS ProstaGLANDIN

Synthesis and REDUCES spread of INFLAMMATION

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5
Q

Aspirin Pharmacokinetics

A

OoA: 5-30 min
PE: 15-120 min
DoE: 1-4 Hrs
HL: 15-20 min

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6
Q

Aspirin—> Indications/ Field Use

A

CHEST PAIN

             SUGGESTIVE of AMI/ACS
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7
Q

Aspirin Contraindications

A

Active GI Bleeding

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8
Q

Aspirin

Side Effects/Adverse Reactions x6

A 
GI Bleeding 
Prolonged Bleeding 
Heartburn 
Nausea
Vomiting 
Wheezing
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9
Q

Aspirin Dose

A

Chest Pain (AMI/ACS)

Adult: 324mg PO
81mg Baby ASA tablets preferred as it can be
——————————-chewed or swallowed.

Pedi: NOT RECOMMENDED

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10
Q

Aspirin Precautions

A

If PT takes DAILY ASA, may supplement HOME dose IF taken within 24hrs.

CAN cause GI UPSET.

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11
Q

Aspirin Drug-Drug Interactions

A

ENHANCED side effects w/other Anti-inflammatory AGENTS.

DECREASED ABSORPTION w/ concurrent administration of ANTACIDS.

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12
Q

Epinephrine drug class

A

SympathoMIMETIC

Sympathetic AGONIST

CateCHOLAmine

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13
Q

Epinephrine MOA 1/3

A

A1 AGONIST—->

2nd MSSGR release of Ca2+ in VSMC—>
PERIPHERAL VasoCONSTRIction—>
INCREASED SVR—>
INCREASED BP.

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14
Q

Epinephrine MOA 2/3

A

B1 AGONIST—>

INCREASED intraCELLULAR Ca2+ in Cardiac cells->
POSITIVE INOtropy, CHRONOtropy, DROMOtropy.

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15
Q

Epinephrine MOA 3/3

A 
B2 AGONIST—>
BRONChial SMOOth MUScle RELAxation—>
BRONCODILATION
BLOCKS RELEAse of Ca2+ in and SUBSEQUENT 
DESTRUCTION of MAST cells.
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16
Q

Epinephrine pharmacokinetics IV

A

OoA: <2min
PE: <5min
DoE: 5-10min
HL: 5 min

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17
Q

Epinephrine Pharmacokinetics IM

A

OoA: 3-10min
PE: 20 min
DoE: 20-30min
HL:

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18
Q

Epinephrine indications/field use.

A

Cardiac Arrest
Anaphylaxis/SRAD/Asthma
SymptBradycardia/HypoTN/RefractAnaphy

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19
Q

Epinephrine contraindications

A

TACHYDYSRHYTHMIAS

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20
Q

Epinephrine side effects/adverse reactions

A 
Anxiety
Dysrhythmias
Dizziness 
Headache 
Nausea
Tremulousness
Vomiting
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21
Q

Epinephrine DOSE for Cardiac Arrest

A

ADULT: 1mg rapid IV IO (1:10,000) q 3-5min

PEDI: 0.01mg/kg rapid IV IO (1:10,000) q 3-5min

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22
Q

Epinephrine dose Asthma/Anaphylaxis

A

ADULT: 0.3mg IM (1:1000)q 5 min x 3doses

PEDI: 0.01mg/kg IM (1:1000) q 5min (Max 0.3mg)
until S/S resolve

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23
Q

Epinephrine dose for

Refractory Anaphylaxis/HYPOTENSION

A

ADULT: 2-10 ug/min IV IO INFUSION

PEDI: 0.1-2 ug/kg/min IV IO INFUSION
max 10ug/min

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24
Q

Epinephrine dose for Bradycardia

A

ADULT: 2-10 ug/min IV IO INFUSION

PEDI: 0.01 mg/kg IV IO (1:10,000) q 3-5min

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25
Epinephrine precautions
LEADS to INCREASED myocardial O2 demand. AfTER 3 Doses of (1:1000) for ANAPHYLAXIS consider REFRACTORY ANAPHYLAXIS and ADMINISTER INFUSION.
26
Epinephrine Drug-Drug interaction
pH DEPENDENT, DEACTIVATED by ALKALINE solutions, EFFECTS intensified w/pt’s taking ANTIDEPRESSANTS, REACTS w/ CaCl2 and NaHCO3 to form precipitate in IV tubing.
27
FENTANYL CITRATE (Sublimaze) Drug class
OPIOID ANALGESIC
28
FENTANYL CITRATE MOA
Opiate R-AGONIST—> HYPERPOLARIZATION of InterNEURONS + DECREASED release of NEUROTRANSMITTERS responsible for the transmission of PAIN IMPULSES to the THALAMUS and CEREBRAL Cortex.
29
FENTANYL CITRATE Pharmacokinetics
OoA: immediate PE: 3-5min IV DoE: 30-60min HL: 6-8 hrs
30
FENTANYL CITRATE indications/field use
Pain management Chest Pain (suspected ACS) Premedication for RSI Post-intubation SEDATION
31
FENTANYL CITRATE contraindications
Respiratory DEPRESSION or INSUFFICIENCY UNCORRECTED HYPOTENSION w/BP <100 Systolic
32
FENTANYL CITRATE side effects/adverse reactions
Bradycardia Chest Wall Rigidity
33
FENTANYL CITRATE Dose Pain Mngt/Premedication/Sedation
ADULT: 1ug/kg IV IO IM IN slow q 5min MD 100ug; MTD 300ug If > 65y/o 0.5ug/kg IV IO IM IN slow q 5min MD 50ug; up to 3 doses PEDI: 1ug/kg IV IO IM IN slow MD 100ug
34
FENTANYL CITRATE precautions
Caution in pt’s w/KIDNEY and LIVER Failure Fentanyl causes REDUCED CHEMORECEPTOR responsiveness to INCREASES in CO2–> May lead to respiratory depression
35
FENTANYL CITRATE drug-drug interactions
ADDITIVE effects w/CNS depressants May cause SEROTONIN SYNDROME if pt’s used MAOI in last 14 days.
36
MORPHINE SULFATE drug class
Opioid Analgesic
37
MORPHINE SULFATE MOA
Opiate R-AGONIST—> HYPERPOLARIZATION of InterNEURONS + DECREASED release of NEUROTRANSMITTERS responsible for the transmission of PAIN IMPULSES to the THALAMUS and CEREBRAL Cortex.
38
MORPHINE SULFATE Pharmacokinetics IV
OoA: Immediate PE: 20 min DoE: 2-7hrs HL: 1-7hrs
39
MORPHINE SULFATE Pharmacokinetics IM
OoA: 15-30 min PE: 30-60 min DoE: 2-7 hrs HL: 1-7 hrs
40
MORPHINE SULFATE Indications/field use
Pain management Chest pain/ suspected ACS
41
MORPHINE SULFATE Contraindications
Respiratory depression or insufficiency UNCORRECTED Hypotension <100 Syst
42
MORPHINE SULFATE Side effects/adverse reactions.
``` AMS Abdominal cramping Blurred vision Constricted pupils Headache Nausea Vomiting ```
43
MORPHINE SULFATE Dose
ADULT: 0.1 mg/kg IV IO IM q 10 min MD 10mg (2mg/min) TMDx3 >65 0.05mg/kg IV IO IM q 10 min PEDI: 0.1 mg/kg IV IO IM (give all doses slowly)
44
MORPHINE SULFATE Precautions
Morphine causes REDUCED CHEMORECEPTOR responsiveness to INCREASES in CO2–> May lead to respiratory depression CAUTION with patients with HYPERSENSITIVITY to analogs of MORPHINE
45
MORPHINE SULFATE drug-drug interactions
Additive effects (CNS depression) when given with ``` Alcohol Antiemetics Antihistamines Barbiturates Hypnotics Sedatives ```
46
NITROGLYCERIN (nitrostat) Drug Class
Vasodilator/Nitrate
47
NITROGLYCERIN Pharmacokinetics
``` IV. SL. Topical OoA: 1-2 min 1-3min 30 min PE: 5-10min Varies DoE: 20-30min 3-6hrs HL:1-4 minutes ```
48
NITROGLYCERIN Indications/field use
Chest Pain associated w/ angina or MI Acute Pulmonary Edema
49
NITROGLYCERIN contraindications
``` Increased ICP Shock Hypotension ED drugs (last 48 hrs) Children under 12 ```
50
NITROGLYCERIN side effects/ adverse reactions
``` Dizziness Dry mouth Hypotension Headache Nausea Vomiting Tachycardia Rash Weakness ```
51
NITROGLYCERIN doses
ADULT: 0.4mg SL q3-5 min 1-2 inches topical paste MD x 3 in 25 min. PEDI: n/a
52
NITROGLYCERIN Precautions
Expect headache from cerebral vasodilation Routine use may cause tolerance 12 lead ECG prior to administration Doesn’t improve morbidity or mortality, pain use only Use extreme CAUTION in pt’s w/ inferior wall MI
53
NITROGLYCERIN drug drug interaction
Orthostatic HYPOTENSION with B-blockers | Severe HYPOTENSION with Alcohol
54
ONDANESTRON (Zofran) Drug class
Antiemetic
55
ONDANESTRON MOA
5HT3 (Serotonin) R-Antagonist—> Blocks serotonin binding to RECEPTORS at VAGAL NERVE terminals—> Inhibits vomiting reflex
56
ONDANESTRON Pharmacokinetics
OoA: Rapid PE: 15-30 min DoE: 4-8 hrs HL: 4hrs
57
ONDANESTRON Indications/ field use
Nausea and vomiting
58
ONDANESTRON contraindications
None
59
ONDANESTRON side effects/ adverse reactions
Dizziness Headache Prolonged QT interval Tachycardia
60
ONDANESTRON Dose
ADULT: 4mg IV IO IM PO ``` PEDI: 0.1mg/kg IV IO IM 4mg PO (if pt 5+) ```
61
ONDANESTRON Precautions
HYPERSENSITIVITY to other 5HT3 selective antagonists
62
ONDANESTRON drug-drug interactions
QT interval prolongation if used with similar drugs

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