Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DENT 319 - Pharmacology > Drugs used in the Management of Medical Emergencies > Flashcards

Drugs used in the Management of Medical Emergencies Flashcards

1
Q

Time of occurence of complcations starting from most to least common

A
  1. During or after local anesthetic (54.9%)
  2. During treatment (22.9%)
  3. After treatment (15.2%)
  4. Immediately before treatment (1.5%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

4 basics of CPR

A
  • Airway
  • Breathing
  • Circulation
  • Drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

7 medications in the basical dental office emergency kit

A
  • Oxygen (400 L minimum)
  • Epinephrine
  • Diphenhydramine (syrup for children and tabs or IM)
  • Nitroglycerine (spray or tabs)
  • Salbutamol (inhalation bronchodilator)
  • Source of oral glucose
  • Aspirin (uncoated) - 80 or 160 mg tabs (avoid enteric form)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

3 apparatuses in basic emergency kit for dental office

A
  • Stethoscope w/ sphygmomanometer or tensiometer
  • 2 oxygen masks (adult and child)
  • For IM:
    • Alcohol sponges
    • 1 mL syringes with needles for 20 - 25 G (to be used with ampoules)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Rate of verification of emergency kit drugs

A

Annually (also check oxygen tanks and delivery systems regularly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Contraindication for oxygen administration

A

Hyperventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Use for oxygen

A

Any emergency situation in which respiratory distress is evident, be it conscious or unconscious and if spontaneously breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Flow rates of oxygen delivery

A
  • Mask = 6-10 L/min
  • Ambu Bag = 10-15 L/min (hose attaches to Ambu bag)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Function of epinephrine

A

Endogenous catecholamine –> agonist to all adrenal receptors

NOTE: Pts cannot be allergic to epinephrine, no contraindications in life-threatening situation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

2 uses of epinephrine in emergency situation

A
  • Acute allergic reactions/anaphylaxis
  • Second line for asthma which does not respond to salbutamol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

2 available doses of EpiPen

A
  • EpiPen (YELLOW) 0.3 mL
    • Remember yellow caution –> larger dose
    • Syringe, 1:1000
    • Unidose 0.3 mg epinephrine auto-injector
    • SINGLE DOSE ONLY
  • EpiPen Jr (GREEN) 0.3 mL
    • Syringe 1:2000
    • Unidose 0.15 mg epinephrine auto-injector
    • SINGLE DOSE ONLY
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Administration instructions for EpiPen

A
  1. Remove from clear plastic container
  2. Remove blue cap
  3. Place orange end on thigh and apply pressure (blue to the sky, orange to the thigh) –> auto-inject
    1. IM injection into anterolateral aspect of thight
    2. DO NOT inject into buttock!
    3. Designed to penetrate clothing –> do not remove pts pants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the use of solution in an EpiPen upon administration

A

2 mL solution contained but only deliver single dose of 0.3 mL –> 1.7 mL remain in unit after use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Explain management of patient for whom you’ve administered EpiPen

A
  • Most patients are fine after 1 injections, but symptoms may recur and further injections may be required to control reaction
  • Epinephrine can be re-injected every 5-15 min until there is resolution of anaphylaxis or signs of adrenaline excess
  • All individuals must be immediately transported to hospital (ideally by ambulance) for eval and observation due to possible repeated attacks hours after exposure to allergen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

4 signs of adrenaline excess

A
  • Palpitations
  • Tremor
  • Uncomfortable apprehension
  • Anxiety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Cost of EpiPen

A

$100 each

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Shelf life of epipen

A

~1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Available concentrations of epinephrine vials

A
  • 1:1000 for SC/IM
  • 1:10000 for IV

NOTE: not stocked in emergency kits at McGill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

2 uses of diphenhydramine (BENADRYL)

A
  • Management of mild allergic reactions (i.e. urticaria)
  • After epinephrine may be used in acute allergic reactions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

2 forms of benadryl in our emergency kit

A
  • 25 mg tabs (pink caplets)
  • Elixir concentration = 12.5 mg/5mL in 120 mL bottle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

5 forms of diphenhydramine NOT in our emergency kit

A
  • 25 mg gel capsules
  • 50 mg extra-strength gel capsules
  • Children’s liquid: each 5 mL of colorless, bubble-gum flavored liquid contains diphenhydramine hydrochloride 6.25 mg
  • PMS-DIPHENHYDRAMINE ELIXIR 2.5ML/ML
  • PMS-DIPHENHYDRAMINE INJECTION 50MG/ML IV or IM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Dosage of diphenhydraminefrom our kit for adults and children older than 12 years

A
  • 50 mg = 2 tabs
  • 50 mg = 20 mL = 4 tsp elixir 12.5 mg/mL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Dosage of diphenhydramine from out kit for children 6 to under 12 years

A

5 to 10 mL every 4 to 6 hours. 12.5 mg/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

IV or IM dosage of diphenhydramine

A

50 mg = 1 mL IV or IM 50mg/mL injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Dosage of liquid gel capsules or caplets of diphenhydramine for adults and children 12 years and over

A

25 to 50 mg every 4-6 hours. Max 200 mg/day. Not recommended for children under 12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Dosage of diphenhydramine elixir

A
  • Adults and children 12 years and over = 10 - 20 mL every 4-6 hours. Max 80 mL/day
  • Children 6 to under 12 years = 5 - 10 mL every 4-6 hours. Max 50 mL/day
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Dosage of children’s diphenhydramine liquid

A
  • Children under 2 years = 2.5 mL every 4-6 hours. Max 10 mL/day
  • Children 2 to 5 years = 5 mL every 4-6 hours. Max 20 mL/day
  • Children 6 to under 12 years = 10 - 20 mL every 4-6 hours. Max 80 mL/day
28
Q

2 available doses in kit of Nitroglycerine (MYLAN-ITRO, NITROSTAT)

A
  • 0.4 mg spray
  • 0.3 mg tabs
29
Q

Use of nitroglycerine

A

Chest pain, management of angina and early management of acute MI

30
Q

Administration instructions for nitroglycerine

A
  1. Give one spray or tablet –> START CELL PHONE TIMER
  2. Second dose 5 min if chest pain continues
  3. Third dose at 10 min mark if pain continues
  4. Max 3 doses total

NOTE: DO NOT administer 2nd or 3rd dose if hypotensive

31
Q

Describe effects of nitroglycerine post-administration

A
  • Onset of vasodilatory effect occurs approx 1-3 min after sublingual nitroglycerine admin and reaches max by 5 min postdose
  • Effects persist for at least 25 min following admin
32
Q

Contraindication for use of nitroglycerine

A

Concomitant use regularly and/or intermittently with phosphodiesterase type 5 (PDE5) such as VIAGRA (sildenafil), CIALIS (tadalafil) and LEVITRA (vardenafil) due to PDE5 amplifying vasodilatory effects of nitroglycerine –> severe hypotension

33
Q

Use of salbutamol

A
  • Bronchidilator to treat bronchospasm
  • Acute asthmatic episodes
  • Allergic reactions with bronchospasm

NOTE: Asthma may be fatal

34
Q

Available dose of salbutamol in kit

A

Metered dose inhaler 100 mcg/puff (recmmended dose 200 mcg)

35
Q

Peak effect time of salbutamol

A

30 - 60 min

36
Q

Administration instructions for oral glucose

A

Only use if patient is conscious since aspiration pneumonia can occur if placed in mouth of unconscious patient

37
Q

Use for ASA in our kit

A

Treatment of patients with chest pain (suspected MI)

38
Q

Administration instructions for ASA

A
  • Administer 2-4 tabs of 8 mg chewable (Baby Aspirin) to any pt with pain suggesting acute MI
  • Do not give to pts allergic to ASA
  • Give to pts who are taking daily dose of ASA (may not be taking meds regularly)
  • DO NOT have enteric coated tabs in kit
39
Q

Dosage of ASA

A
  • Adult dose recommended = 160-325 mg
  • 160mg minimum
40
Q

8 supplementary drugs that one can include in their emergency kit

A
  • Glucagon
  • Drugs to reverse effects of other drugs:
    • Naloxone (NARCAN)
    • Flumazenil
  • Hydrocortisone (Solu-Cortef)
  • Benzodiazepine (diazepam, midazolam, lorazepam)
  • Atropine
  • Ephedrine
  • Morphine
41
Q

Use of glucagon

A

Treatment of hypoglycemia in an unconscious patient (opposes insulin action to raise blood glucose)

NOTE: for very severe hypoglycemia, 50% dextrose IV ideal

42
Q

Time of action of glucagon

A

15 min

43
Q

Dose of glucgon

A
  • 1 mg (supplied as 1mg vial of powder)
  • Children weighing less than 20 mg = 0.5 mg or a dose equvalent to 20-30 microgram/kg
44
Q

Administration instructions for glucagon

A
  1. Inject all fluid into vial containing white powder
  2. Shake well
  3. Use same syringe to administer either 0.5 mg or 1.0 mg
  4. Pt should awake within 15 min
    1. IV glucose MUST be given if patient fails to respond to glucagon
  5. When pt responds, give supplemental carbohydrate to restore liver glycogen and prevent secondary hypoglycemia
45
Q

Function of Naloxone

A

Opioid antagonist at all opioid receptors (should be included in kit if Morphine included)

46
Q

Onset of action of IV Naloxone

A

1-2 min with peak effect at 5-15 min

47
Q

Significant adverse effects of naloxone

A

May worsen cardiac irritability –> changes in BP, V. tach or V. fib

48
Q

3 available formulations of naloxone

A

0.02, 0.4, 1.0 mg/mL solution

49
Q

Use of naloxone

A

Postoperative Opioid-induced CNS/Respiratory Depression

50
Q

Administration directions of naloxone

A
  • Admin 0.1-0.2 mg IV (IM, SC may be used if IV route unavailable)
  • Repeat dose every 1-3 min as needed
  • May need to repeat doses every 1-2 hours
  • Supplemental IM dose provides longer duration of effect
51
Q

Function of flumazenil

A
  • Benzodiazepine receptor antagonist
  • Should be part of kit when oral or parenteral benzodiazepines are used for sedation
  • Reverses unconsciousness, sedation and amnesia
52
Q

Dose of flumazenil

A

0.1 - 0.2 mg IV incrementally without exceeding 1.0 mg

53
Q

Indication of hydrocortisone

A
  • Adrenal glucocorticosteroid for the prevention of recurrent anaphylaxis
  • May play role in management of adrenal crisis
54
Q

Function of hydrocortisone

A

Membrane-stabilizing effects –> reduction of leukotriene formation –> reduction of histamine release from mast cells

55
Q

Onset of action of hydrocortisone

A

Slow (approx. 1 hour even when admin IV)

56
Q

Supplied doses of hydrocortisone

A

200 mg vial (Act-O-Vial), 100 mg/mL –> dose is 100 mg IV or IM

57
Q

Uses of benzodiazepines

A
  • Anticonvulsants for assisting in management of seizures which may be prolonged or recurrent (diazepam is drug of choice for status epilepticus)
  • Anxiolysis, sedation, muscle relaxation
58
Q

Dose for midazolam

A

5 mg IM

59
Q

Dose for lorazepam

A

4 mg IM

60
Q

Dose for diazepam

A

5 mg IM

61
Q

Indication for atropine

A
  • Antimuscarinic
  • Anticholinergic (may be prob for pt with narrow angle glaucoma and urinary retention)
  • For management of hypotension accompanied by bradycardia –> increase HR to resolve hypotension
62
Q

Concern about atropine

A

Too great an increase in HR in pt. wth IHD

63
Q

Dose of atropine

A

0.5 mg IM initially followed by increments up to a max of 3 mg

64
Q

Indication for ephedrine

A

Vasopressor that may be used to manage significant hypotension (sympathomimetic –> stimulation of all adrenoreceptors)

NOTE: similar to epinephrine but less potent and longer duration of action

65
Q

Dose of ephedrine

A

5 mg in increments IV or 10-25 mg dose IM

Supplied as 25 or 50 mg/mL solution

66
Q

Indication for morphine

A

Narcotic analgesic for management of severe pain occuring with MI is systolic BP over 90 mm Hg and patient is not hypovolemic

67
Q

Dose of morphine

A
  • 1-3 mg titration IV until pain relieved
  • If no IV may consider 5 mg IM

DENT 319 - Pharmacology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions