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Clinical Basic Information > Essential Pharmacology > Flashcards

Essential Pharmacology Flashcards

1
Q

Albuterol

A

Drug Class: Sympathomimetic
Effect: Bronchial Relaxation
Mechanism: Selective beta2 adrenergic agonist
Peak Effect: 30-60 minutes
Duration of Action: 4 hours
Concentration: 90mcg/puff
Dose: 2 puffs during deep inhalation every 4-6 hours.
Method of Administration: Metered Dose Inhaler, Oral
Indications: Wheezing, bronchospasm
Contraindications: Tachydysrhythmias

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2
Q

Amiodarone

A

Drug Class: Antidysrhythmic Class 3
Effect: Block potassium ion channels resulting in prolonged depolarization, action potential duration, and the effective refractory period.
Mechanism: Sodium channel blockade (class 1), Beta-blockade (class 2), and calcium channel blockade (class 4)
Duration of Action: 4 hours
Dose: Can give 5mg/kg over 2-5 min
Dose (common): 150 mg IV loading dose over 10 minutes, followed by 1mg/min IV for 6 hours, and 0.5mg/min IV for 18 hours after.
Indications: Ventricular Tachycardia, Ventricular Fibrillation.

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3
Q

Atropine

A

Drug Class: Anticholinergic Drug
Mechanism: Muscarinic receptor antagonists. Antagonistically inhibits parasympathetic nerve conduction.
Onset: 1 minute
Duration of action: 30-60 minutes
Dose: For bradycardia 0.4-0.6 mg (up to 3mg)

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4
Q

Calcium Chloride

A

Drug Class: Electrolyte Replacement
Mechanism of action:Increase the force of cardiac contractility, by initiating myofibril shortening.
Effect: In normally functioning hearts calcium will produce positive inotropic and vasoconstrictive effects and increase systemic arterial blood
pressure. In abnormally functioning hearts calcium will produce positive inotropic effects may increase or decrease systemic vascular resistance. It also appears to increase ventricular automaticity.
Duration of Action: 10-20 minutes
Dose: 5-10 mg/kg IV
Indications: Hyperkalemia, hypermagnesemia, hypocalcemia.
Contraindications: Hypercalcemia, digitalis toxicity.

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5
Q

Cefazolin

A 
Drug Class: First Generation Cephalosporin
Effect: Prevent infection
Duration of Action: Redosed 2-6 hours
Dose: 1-2g IV (>50kg is 2g)
Contraindication: Penicillin allergy
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6
Q

Cefoxitin

A

Drug Class: Second Generation Cephalosporin
Effect: Prevent Infection
Duration of Action: Redosed 2-6 hours
Dose: 2g IV
Contraindication: Penicillin Allergy
Mechanism: Extended activity against gram-negative bacteria. Resistant to produced cephalosporinases

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7
Q

Cleocin Phosphate (converts to clindamycin)

A 
Drug Class: Macrolide Antimicrobial
Effect: Prevent and treat infection, particularly effective in GI tract and female genital tract
Duration of Action: Redose every 6 hours
Dose: 600 or 900mg IV infusion
Indication: Penicillin Allergy
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8
Q

Dexamethasone (decadron)

A

Drug Class: Corticosteroid
Effect: Reduce swelling, prevent PONV
Duration of Action: Half-life 3 hours, effects last as long as 24 hours.
Dose: 4-8mg PONV
Don’t give pre-op if possible, causes peri-anal itching.
Contraindications: Systemic Fungal Infection

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9
Q

Diphenhydramine (benadryl)

A

Drug Class: Antihistamine
Effect: Prevent histamine release
Mechanism of Action: Histamine receptor antagonist.
Duration of action: 3-6 hours
Dose: 25-50mg IV
Indications: Anaphylaxis, allergic reaction, PONV, histamine release, redman syndrome.
Contraindications: Acute asthma attack, lower respiratory tract disease. Nursing mothers

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10
Q

Ephedrine

A

Drug Class: Synthetic non-catecholamine
Effect: Increase blood pressure and heart rate
Mechanism of Action: Mostly indirect stimulation of the release of norepinephrine, stimulating alpha receptors. Some direct stimulation of beta receptors as well.
Dose: 5-20 mg
Caution: Tachyphylaxis (you will see diminishing affects with each subsequent dose as norepinephrine is depleted)

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11
Q

Epinephrine

A 
Drug Class: Catecholamine
Use: Increase Heart rate and Blood pressure, Anaphylaxis, bronchospasm
Supplied: 16mcg/mL and 4mcg/mL
Dose: 8-16mcg
Infusion: 1-2mcg/min - Beta 2 receptors
4mcg/min - Beta 1
10-20mcg/min alpha and beta
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12
Q

Employ??

A

Look for this drug in the cart

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13
Q

Etomidate (amidate)

A 
Drug Class: Imidazole Induction Agent
Use: Induction/Hypnosis
Supplied: 2mg/mL (35% propylene glycol)
Dose: 0.2-0.3mg/kg
Indication: Unstable/weak cardiovascular system
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14
Q

Fentanyl

A 
Drug Class: Synthetic Opioid
Use: Analgesia
Supplied: 50mcg/mL
Peak Effect: 3-5 minutes
Duration: 30-60 minutes
Dose: 1-2mcg/kg
Infusion: 1-2mcg/kg/hr
Caution: Synergism with Midazolam
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15
Q

Furosemide

A

Drug Class: Diuretic
Use: Severe essential hypertension, edema due to congestive heart failure, renal failure, and hepatic failure
Mechanism of Action: Inhibit reabsorption of sodium and chloride in the medullary portions of the ascending limbs of the loops of Henle.
Dose: 0.1-1mg/kg IV for edema 0.5-1.0 mg/kg IV for increased ICP

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16
Q

Glycopyrrolate

A 
Drug Class: Anticholinergic
Use: Antisialigogue, NMB reversal
Supplied: 0.2mg/mL
Dose: Pre-med antisialigogue - 0.2mg
Reversal: 0.2mg/1mg Neostigmine
Onset: 2-3minutes
Duration: 30-60 minutes
17
Q

Heparin

A 
Drug Class: Anticoagulant
Use: Anticoagulation
Supplied: 1000units/mL
Dose: Surgeon dependent. 2000-5000 units IV
Half-Life: 60-90 minutes
18
Q

Hydralazine

A 
Drug Class: Hypotensive Agent
Use: Hypertension
Supplied: 20mg/1mL
Dose: 5-20mg
Onset: 20 minutes!!
Duration: 6-8 hours!!!
Principal Arterial Dilator
Reflexive Tachycardia
19
Q

Hydrocortisone (cortisol)

A

Drug Class: Glucocorticoid
Use: Immunosupression, Antiinflammatory
Dose: 100mg/day per 70kg
Duration: 6 hours

20
Q

Hydromorphone (Dilaudid)

A 
Drug Class: Semi-Synthetic Opioid
Use: Analgesia
Supplied: 2mg/1mL
Dose: 0.5-2mg
Onset: 5 minutes
Duration: 3-6 hours
Most people dilute to 1mg/mL or even 0.2mg/mL
21
Q

Ipratropium

A 
Drug Class: Anticholinergic
Use: Bronchodilation
Supplied: 20mcg/puff
Dose: 40-80mcg
Onset: 30-90 minutes
Duration: 4-6 hours
Typically not first choice treatment of acute bronchoconstriction
22
Q

Ketorolac (Toradol)

A

Drug Class: Nonsteroidal Antiinflammatory Drug (NSAID)
Use: Analgesia (typically post-operative)
Dose: 30mg IV
Duration: 6 hours
Side Effects: Renal toxicity, hepatocellular injury, asthma exacerpation, inhibition of platelet aggregation.

23
Q

Labetalol

A

Drug Class: Non-Selective Beta Blocker
Use: Control Heart Rate and Blood Pressure
Supplied: 5mg/mL (20mL vial)
Dose: 0.1-0.25 mg/kg (5mg initial dose)
Effect: decreases blood pressure through beta effects on the heart and vasodilation through alpha receptors.
Side Effect: Can cause bronchoconstriction in patient’s with reactive airways

24
Q

Metoprolol (Lopressor)

A 
Drug Class: Beta Blocker (Beta 1)
Use: Decrease Heart Rate
Supplied: 5mg (1mg/mL)
Dose: 1-2mg
Duration: Multiple Hours
25
Q

Midazolam (Versed)

A 
Drug Class: Benzodiazepine
Uses: Anxiolysis, Sedation, Amnesia
Supplied: 1mg/mL
Dose: 1-2.5mg IV or 0.5mg/kg PO
Onset: 30-60 seconds
Duration: 15-80 minutes
Caution: Hepatic Disease, Elderly
Mechanism: attenuates GABA receptor to hyperpolarize the brain cells.
26
Q

Neostigmine

A 
Drug Class: Anticholinesterase
Use: NMB Reversal
Supplied: 1mg/mL (0.5mg/mL)
Dose: 0.04 - 0.07 mg/kg
Caution: BLUDS
Administered with glycopyrrolate
27
Q

Nitroglycerin

A 
Class: Hypotensive Agent
Use: Angina, Hypertension
Supplied: 100mcg/mL
Dose Bolus: 50-100mcg
Dose Infusion: 0.5-10mcg/kg/min
Duration: 2 minutes
Onset: 30 seconds
Caution: Principally venous dilator (reduces venous return), decrease ventricular wall tension
28
Q

Norepinephrine (Levophed)

A 
Drug Class: Sympathomimetic
Use: Increase Heart Rate and Blood Pressure
Mechanism: Alpha and Beta 1 Agonist
Supplied: 4mg/4mL ampule
Dose Bolus: 0.1mcg/kg
Dose Infusion: 2-20mcg/min
Duration: 1-2 minutes
29
Q

Odansetron (Zofran)

A 
Drug Class: 5-HT3 Receptor Antagonist
Use: PONV
Mechanism: Selectively blocks serotonin 5-HT3 receptors which would otherwise initiate the vomiting reflex.
Onset: 30 minutes
Supplied: 4mg/2mL
Dose: 4mg IV
Duration: 4 hours
30
Q

Phenylephrine

A 
Drug Class: Sympathomimetic
Use: Increase Blood Pressure
Mechanism: Alpha adreneric agonist which causes systemic arterial vasoconstriction.
Onset: Near Immediate
Duration of Action: 15-20 minutes
Dose: 50-100 mcg boluses
Supplied: 10mg/mL
31
Q

Propofol (Diprivan)

A 
Drug Class: Diisopropylphenol
Use: Induction, Sedation, MAC
Supplied: 10mg/mL (1%)
Dose Induction: 1.0-2.5mg/kg
Dose Infusion: 25-200mcg/kg/min
Caution: Bacterial Growth after 6 hours
Mechanism: attenuates GABA receptor to hyperpolarize the brain cells.
32
Q

Rocuronium

A 
Drug Class: Non-depolarizing Neuromuscular Blocker
Use: Intubation, paralysis
Supplied: 10mg/mL
Onset: 1-2 minutes
Duration: 20-35 minutes
Dose Intubation: 0.6-1.2 mg/kg
Dose Maintenance: 0.1mg/kg
Dose Infusion: 5-12 mcg/kg/min
33
Q

Scopolamine

A

Drug Class: Anticholinergic
Use: Antisialigogue, Increase Cardiac Output
Mechanism: Blocks acetylcholine receptors on the parasympathetic nervous system.
Supplied: 0.3, 0.4, and 1mg/mL
Dose: 0.3-0.65 mg IV, IM, or SubQ
Duration: 4 hours
Onset: 10 minutes IV

34
Q

Succinylcholine (Anectine)

A 
Drug Class: Depolarizing Neuromuscular Blocker
Use: Intubation, Paralysis, Laryngospasm
Supplied: 20mg/mL
Onset: 30 seconds
Dose Intubation: 1-2 mg/kg
Dose Laryngospasm: 0.1 mg/kg
Duration of Action: 3-5 minutes
Caution: Malignant Hyperthermia
35
Q

Vancomycin

A 
Drug Class: Antibiotic
Use: Prevent Infection
Dose: 90kg 1.5g IV over 1 hour
Redose: 8-12 hours
Indication: Penicillin Allergy
Caution: Redman syndrom where there is hypotension and flushing of the torso due to large histamine release. Must be started within 2 hours of incision so it's all in within 1 hour.
36
Q

Vasopressin

A

Potent vasoconstrictor.
Functions similar to epinephrine without the cardiac stimulation.
Can be used in code situations or anaphylaxis depending on symptoms.
More effective than epinephrine in asystolic cardiac arrest
Code Dose: 40 units
Therapeutic Dose: ~2 units at a time

37
Q

Vecuronium

A 
Drug Class: Aminosteroid, Non-depolarizing
Use: Paralysis
Supplied: 10mg powder reconstituted to 1mg/mL
Onset: 3-5 minutes
Duration: 20-35 minutes
Metabolism: Liver and Kidneys
Dose Intubation: 0.08-.012 mg/kg
Dose Infusion: 1-2 mcg/kg/min
Maintenance: 0.01 mg/kg
38
Q

Cisatracurium (Nimbex)

A 
Class: Benzyl isoquinolinium, Non-depolarizing
Use: Paralysis
Supplied: 20 mg vial (2mg/mL)
Onset: 3-5 minutes
Duration: 20-35 minutes
Dose Intubation: 0.1-0.15 mg/kg
Dose Infusion: 1-2 mcg/kg/min
Good for renal/hepatic dysfunction.
39
Q

Naloxone (Narcan)

A

Class: Opioid Antagonist
Use: Overdose, respiratory depression
Supplied: 0.4 mg vial
Dose: 1-4 mcg/kg
Caution: Nausea and Vomiting, Pain, Tachycardia, increased sympathetic nervous system.
Dilute 0.4 mg vial in 10mL and give 1-2mL over 2-3 minutes

Clinical Basic Information (4 decks)

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