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EMS Medications Flashcards

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1
Q

Epinephrine

A

Class: Adrenergic Agonist (Alpha-1,2;Beta-1,2); Inotropic Agent
MOA: Produces effects by activating adrenergic receptors with direct receptor binding
Effects: Pupil constriction, vasoconstriction, bronchodilation, urinary retention, and an increase in blood pressure
Purpose: Used during cardiac arrest, bradycardia, asthma/copd, anaphylaxis, croup, and epiglottis

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2
Q

Dopamine

A

Class: Adrenergic Agonist; Inotropic Agent
MOA: Produces effects by activating adrenergic receptors with direct receptor binding. Stimulates alpha-1, beta-1.
Purpose: Used for shock (except in cases of hypovolemia)

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3
Q

Phenylephrine

A

Class: Adrenergic Agonist
MOA: Produces effects by activating adrenergic receptors with direct receptor binding
Purpose: Used during nasal intubation to minimize bleeding from the nasal cavity.

*This drug only activates alpha-1

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4
Q

Albuterol

A

Class: Adrenergic Agonist
MOA: Produces its effect by activating adrenergic receptors with direct receptor binding
Purpose: Given for bronchoconstriction and hyperkalemia.

*Albuterol is a non-selective beta agonist (beta-1 and 2)

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5
Q

Terbutaline

A

Class: Adrenergic Agonist
MOA: Produces effects by activating adrenergic receptors with direct receptor binding. Beta-2 agonist.
Purpose: Given for bronchoconstriction

*This drug is a beta-2 agonist and NOT on the Denver Health Ambulance

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6
Q

Esmolol

A

Class: Adrenergic Antagonist; Beta Blocker
Vaughn William Class: 2
MOA: Produces a direct blockade of specific adrenergic receptor
(Beta Blockers). Also effects phase two and four (slow acting cells) of the cardiac potential sequence
Purpose: Helps to control heart rate and for arrhythmias

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7
Q

Atropine

A

Class: Muscarinic Antagonist (anti-cholinergic)
MOA: Produce a blockade at muscarinic receptor sites
Purpose: Given for bradycardia, dry secretions, and organophosphate poisoning

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8
Q

Atrovent

A

Class: Muscarinic Antagonist
MOA: Provides a blockade at muscarinic receptors
Purpose: Given for bronchoconstriction, and dry respiratory secretions

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9
Q

Pralidoxime (2PAM)

A

Class: Irreversible Cholinesterase Inhibitors
MOA: Causes a disassociation of organophosphates from the active center of acytelcholinesterase
Purpose: Given for organophosphate poisioning

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10
Q

Mivacurium; Pancuronium; Vecuronium; Rocuronium

A

Class: Neuromuscular Blocking Agents (Non-Depolarizing Agent)
MOA: Prevents acetylcholine from activating nicotinic (m) receptors on skeletal muscle thereby causing paralysis
Purpose: Causes paralysis

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11
Q

Succinylcholine

A

Class: Neuromuscular Blocking Agent (Polarizing Agent)
MOA: Produces a depolarizing neuromuscular state which holds the muscle in constant depolarization
Purpose: Causes paralysis in the muscle

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12
Q

Procainamide, Lidocaine, Dilantin

A

Class: Sodium Channel Blocker
Vaughn Williams Class: 1
MOA: Blocks some not all Na channels. Effects phase 0 of the cardiac potential sequence
Purpose: Used for arrhythmias

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13
Q

Amiodarone

A

Class: Potassium Channel Blockers
Vaughn Williams Class: 3
MOA: Blocks potassium channels, has effects on phase 1,2,3 when potassium is entering the cell. This will lengthen the overall time it takes to repolarize, which will lengthen the amount of time it takes for the heart to go below threshold.
Purpose: Given for V-fib and V-tach

Bonus points: It has a long half-life, about 45 days

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14
Q

Diltiazem, Verapamil

A

Class: Calcium Channel Blocker
Vaughn Williams Class: 4
MOA: Has effects on phase four (slow acting cells) and phase two of the cardiac action potential sequence
Purpose: Rate control, arrythmias

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15
Q

Nifedipine

A

Class: Calcium Channel Blocker
MOA: Blocks calcium channels, not allowing calcium to flow from the extracellular space into the intracellular space.
Use: Helps to maintain blood pressure

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16
Q

Vasopressin

A

Class: Vasopressor; Anti-diuretic
MOA: Causes potent vasoconstriction, but mostly promotes fluid retention. Synthetic version of ADH and much more potent. Holds onto Na which also holds H2O.
Note: This doesn’t directly effect the heart, but it indirectly effects it through pre-load and after-load.

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17
Q

Captopril (Capoten), Enalapril (Vasotec)

A

Class: Ace Inhibitors
MOA: Blocks ACE, inhibiting conversion of angiotensin-1 to angiotensin-2
Use: BP Control

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18
Q

Nitroglycerin

Trade name: NitroBid, Nitro-Quick, Nitrostat

A

Class: Vasodilator
MOA: Converts into Nitric oxide in the presence of sylphydryl group, which causes MOSTLY venus vasodilation through multiple biochemical reactions.
Use: Chest pain, CHF, and Hypertension

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19
Q

Epinephrine, Dopamine, and Norepinephrine

A

Class: Inotropic agents; Adrenergic Agonist
MOA: Improves contraction of heart cells by manipulating the cells to increase their intracellular Ca++
Uses: Shock, Cardiogenic shock

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20
Q

Digoxin

Trade name: Lanoxin

A

Class: Cardiac Glycside/Inotropic Agent
MOA: Slows down the Na/K pump, slows down its effectiveness. Increases the amount of Calcium in the cardiac cell.
Use: Slows heart rate and increases contraction

*Never give Calcium Gluconate to someone on Digoxin and this patient is at high risk of hyperkalemia

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21
Q

Adenosine

Trade name: Adenocard

A

Class: Cardiac Nucleotide/Anti-dysrhythmic
MOA: Binds to adenosine receptor on the membrane, inhibits beta-1 action through G-Protein. Opens potassium channels, blocks calcium channels. Slows AV conduction time.
Use: Used to prevent, treat, or suppress irregular heart rhythms

Use: The main target is the AV node, with slight effect on the SA node

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22
Q

Name the Vaughn Williams Class 1 drug group?

A

Sodium Channel Blockers

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23
Q

Name three Sodium channel blockers?

A

Procainamide
Lidocaine
Dilantin

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24
Q

Name the Vaughn Williams Class 2 drug group?

A

Beta Blocker

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25
Name four Beta Blockers?
Esmolol Labetalol Propanaolol Metoprolol (Not a Vaughn Williams Class)
26
Name the Vaughn Williams Class 3 drug group?
Potassium Channel Blocker
27
What is the main potassium channel blocker we use?
Amiodarone
28
Name the Vaughn Williams Class 4 drug group?
Calcium Channel Blocker
29
Name three Calcium channel blockers?
Diltiazem Verapamil Nifedipine (not a Vaughn William Class)
30
Labetalol | Trade name: Normodyne and Trandate
Class: Adrenergic Antagonist/Beta-blocker Vaughn William Class: 2 MOA: Selectively antagonizes alpha-1, beta-1, and beta-2 receptors. Also effects phase two and four (slow acting cells) of the cardiac potential sequence Purpose: Helps to control heart rate and for arrhythmias
31
Metoprolol | Trade name: Lopressor and Toprol XL
Class: Adrenergic Antagonist/Beta-blocker MOA: Selectively blocks (antagonizes) beta-1. Also effects phase two and four (slow acting cells) of the cardiac potential sequence Purpose: Helps to control heart rate and arrhythmias
32
Propranolol | Trade name: Inderal
Class: Adrenergic Antagonist/Beta-blocker Vaughn William Class: 2 MOA: Non-selectively antagonizes (blocks) beta-1 and beta-2. Also effects phase two and four (slow acting cells) of the cardiac potential sequence Purpose: Helps to control heart rate and for arrhythmias
33
Norepinephrine | Levophed
Class: Adrenergic Agonist/Vasopressor MOA: Stimulates alpha- and beta-adrenergic receptors Use: Hypotension, improve cardiac function during decompensation associated with CHF
34
Magnesium
Class: Mineral/Electrolyte; Anti-epileptic Use: Blocks the NMDA receptor thus blocking the normal ion diffusion and blocking the propagation of the action potentials Purpose: Given to pregnant women seizing before having the baby (pre-eclampsia)
35
Inapsine | Droperidol
Class: Anti-psychotic/Anti-emetic MOA: Dopamine Antagonist (primary), also inhibits histamine (secondary), acetylcholine, adrenergic receptors. It blocks alpha-1, watch for hypotension Use: Psychosis, or nausea
36
Haldol
Class: Anti-psychotic MOA: Dopamine Antagonist Use: Psychosis
37
Benadryl
Class: Acetylcholine and Histamine Antagonist; Muscarinic Antagonist Use: Allergies, or sedation Benadryl blocks acetylcholine but is not typically thought of as a muscarinic antagonist Proper doses make you sleepy High doses make you hyper, irritable, and agitated
38
Clonodine
MOA: Used to treat hypertension by blocking calcium influx on the presynaptic neuron this prevents some NE from being released from the vesicles Use: Hypertension
39
Zofran
Class: Serotonin Antagonist/Anti-emetic MOA: Used to treat vomiting by blocking the serotonin receptor in the VTZ (Vomiting trigger zone, Area postrimia) Use: Decrease nausea and vomiting
40
Phenergan | Hydroxyzine
Class: Histamine Antagonist, Muscarinic Antagonist Decrease nausea and vomiting associated with movement or balance and fix dystonic reactions through its antagonist actions of muscarinic sites. Can also have sedative effects.
41
Name three benzodiazapines
Versed (Midazalam) Valium (Diazepam) Ativan
42
Name three barbituates
Phenobarbital Methoexital Thiopental
43
Etomidate
Type: Anti-epileptic; Induction Agent; Sedative MOA: Enhances GABA Use: Reduce anxiety, promote sleep (hypnotic,sedative), RAS, muscle relaxation, amnesia, depresses vasomotor and respiratory centers in the medulla
44
How does versed,valium, ativan, phenbarbital, methoexital, and thiopental work? What do they do?
Type: Anti-epileptic MOA: Enhances GABA, when Gaba is released it decreases activity in the brain Use: Reduce anxiety, promote sleep (hypnotic,sedative), RAS, muscle relaxation, amnesia, depresses vasomotor and respiratory centers in the medulla
45
Lisinopril
Class: Ace Inhibitor MOA: Blocks ACE which in turn allows the blood vessels to dilate. This med also decreases afterload on the heart. Use: Treats high blood pressure, CHF
46
Fentanyl
Class: Narcotic Analgesic; Opioid Agonist MOA: Strong agonist at both Mu and Kappa opioid receptors. 100 times for potent than morphine, blocks glutamate from being released. Effects: Causes analgesia, respiratory depression, sedation, euphoria, and decreased GI motility Use: Pain relief, sedation
47
Nubain; Stadol
Class: Opioid Agonist/Antagonist MOA: Antagonist to Mu receptors and agonist to Kappa receptors. Blocks glutamate from being released. Effects: Increases analgesia, sedation, and decreases GI motility. Use: Moderate pain relief
48
Morphine Sulfate
Class: Narcotic Analgesic; Opioid Agonist MOA: Strong agonist at both Mu and Kappa opioid receptors. Blocks glutamate from being released. Effects: Causes analgesia, respiratory depression, sedation, euphoria, and decreased GI motility Use: Pain relief, sedation
49
Demerol
Class: Narcotic Analgesic; Opioid Agonist MOA: Strong agonist at both Mu and Kappa opioid receptors. Blocks glutamate from being released. Effects: Causes analgesia, respiratory depression, sedation, euphoria, and decreased GI motility Use: Pain relief, sedation
50
HcTZ (hydrochlorothiazide)
Class: Thiazide Diuretics MOA: Blocks the Na+/Cl- transporter which holds these ions in lumen and are then excreted Effects: Helps keep the body from absorbing to much salt, thereby preventing water retention Use: Congestive heart failure, high blood pressure, kidney disorders, or edema
51
Compazine
Class: Dopamine Antagonist; Anti-psychotic; Anti-emetic MOA: Blocks dopamine receptors Effects/Use: reduces nausea/vomiting, also reduces psychosis
52
Mannitol
Class: Osmotic Diuretic MOA: Prevents the reabsorption of water and sodium along the renal tubule. Circulating freely within the tubule, mannitol retains fluid, which is converted to urine and excreted from the body. Effects: Causes potent diuresis Use: Helps to reduce ICP, and edema
53
Calcium Gluconate
Class: Mineral/Electrolyte MOA: Can be used to restore the balance of the cell Effects: It increases the excitability/contractility the heart Use: Helps to restore normal heart rhythm as a result of hyperkalemia.
54
Sodium Bicarbonate
Class: Mineral/Electrolyte; Antacid (buffering compound) MOA: Changes the acid/buffer system, decreasing the acidity in the body (raising Ph). Can lower the respiratory rate in a patient hyperventilating. Use: Used in cases of respiratory acidosis, treats aspirin overdoses, tricyclic anti-depressant overdoses, as well as cases of hyperkalemia
55
Oxygen
Class: Gas MOA: Increased O2 concentration in the lungs helps to displace carbon monoxide from the heme group of hemoglobin. Increases aerobic production in the cell, increase ATP synthesis Use: Many
56
Glucose | Dextrose 50%
Class: Carbohydrate MOA: Absorbed by the cell and plays a large role in ATP production. This is a simple sugar so it acts extremely fast. Use: Used to restore blood glucose levels.
57
Glucagon
Class: Hormone MOA: Attaches to the G-protein in hepatocytes (liver cells) which ultimately causes a breakdown of glycogen into glucose. Don't forget water follows glucose. Use: Hypoglycemia, beta and calcium channel overdoses
58
What does the Muscarinic receptor do?
Increases glandular secretion Slows the heart Contraction of the sphincter of the iris (miosis, pupil constriction) Contraction of the ciliary muscle (near vision)
59
What are the four Adrenergic receptors?
Alpha-1;Alpha-2;Beta-1;Beta-2
60
Where is alpha-1 located and what does it do?
Location: Eye, blood vessels, male sex organs, neck of bladder Purpose: Dilates pupils (mydryasis), Vasoconstriction, Ejaculation, Bladder neck constriction
61
Where is alpha-2 located and what does it do?
Location: Pre-synaptic terminals on the nerves in the CNS Purpose: Assists in activation of the sympathetic nervous system, primarily effects breathing and vasomotor responses
62
Where is beta-1 located and what does it do?
Location: Heart and Kidneys Purpose: Heart: Increases HR, force of contraction and velocity of impulse through the AV node Kidney: Causes a release of renin
63
Where is beta-2 located and what does it do?
Location: Lungs, uterus, muscles, and liver Purpose: Lungs: Bronchial dilation Uterus: Relaxation of the uterus Muscles: Vasodilation Liver: Glycogenelysis (Breakdown of glycogen into glucose)
64
What does the Mu receptor do?
When activated causes analgesia, respiratory depression, sedation, euphoria, and decreased GI motility
65
What does the Kappa receptor do?
Activates analgesia, sedation, and decreased GI motility
66
What are the effects of the Dopamine receptor?
``` Cognition Vomiting Voluntary movement Punishment Reward Sleep Mood Attention Working memory Learning ```
67
What does the histamine neurotransmitter effect?
Balance, vomiting, and the RAS
68
Narcan
Opioid Antagonist against Mu and Kappa receptors Blocks Mu and Kappa receptors
69
Dobutamine
Class: Adrenergic Agonist/Inotropic Agent MOA: Stimulates beta-1, allowing Ca to come into the cell. Effects: Increased HR and force of contraction through the AV node. Also increases the release of renin in the kidneys.

Pharmacology (4 decks)

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