intermediate EMT drugs WY Flashcards
(205 cards)
1
Q
atropine sulfate brand name
A
Atro-Pen
2
Q
atropine sulfate class
A
antiarrythmic, anticholinergic
3
Q
atropine sulfate MOA
A
blocks action of acetylcholine in peripheral nervous system (PNS)
4
Q
atropine sulfate indications
A
sinus bradycardia, heart block, reverse exercise-induced bronchospasms, organophosphate poisoning
5
Q
atropine sulfate contraindications
A
known hypersensitivity, narrow-angle glaucoma, tachycardia secondary to cardiac insufficiency. Use with caution in patients with chronic renal, liver, pulmonary, or cardiac disease, intra-abdominal infection, or prostatic hyperplasia
6
Q
atropine sulfate side effects
A
tachypnea, tachycardia, drowsiness, dry mouth
7
Q
atropine sulfate dose
A
Cardiac: 0.5 to 1 mg every 3-5 mins, max dose 3 mg.
Respiratory: 0.25 to 0.5 mg/kg q.4-6h. nebulized, max dose 2.5 mg
Toxicology: 2 mg IV initial, then 1-2 mg every 10-20 mins until effects observed
8
Q
amiodarone brand name
A
Cordarone
9
Q
amiodarone class
A
Class III antiarrhythmic
10
Q
amiodarone MOA
A
prolongs action potential and refractory period, slows sinus rate, prolonging PR interval; decreases PVR
11
Q
amiodarone indications
A
VF/VT; life-threatening arrythmias
12
Q
amiodarone contraindications
A
Known hypersensitivity, 2nd and 3rd degree AV blocks. Use caution with history of CHF or thyroid disorder, severe pulmonary or liver disease. NOTE: enters breast milk and can harm neonate
13
Q
amiodarone side effects
A
ARDS; CHF; bradycardia; hypotension
14
Q
amiodarone dose
A
Pulseless VF/VT: 300 mg IVSP, may repeat 150 mg in 3-5 mins.
Ventricular arrhythmias with pulse: 150 mg IVSP over 10 mins.
15
Q
lorazepam brand name
A
Ativan
16
Q
lorazepam class
A
benzodiazepine; anticonvulsant; antianxiety
17
Q
lorazepam MOA
A
depresses CNS by potentiating GABA (inhibitory neurotransmitter)
18
Q
lorazepam indications
A
decrease anxiety, seizure activity
19
Q
lorazepam contraindications
A
Known hypersensitivity, pre-existing CNS depression, uncontrolled severe pain, narrow-angle glaucoma, severe hypotension. Use with caution in patients with severe liver, renal, or pulmonary impairment, COPD patients, history of suicide attempts or drug abuse.
20
Q
lorazepam side effects
A
apnea, lethargy, drowsiness, slurred speech
21
Q
lorazepam dose
A
50 mcg/kg, up to 4 mg
22
Q
diazepam brand name
A
Valium
23
Q
diazepam class
A
anti-anxiety, sedative/hypnotic
24
Q
diazepam MOA
A
depresses the CNS
25
diazepam indications
sedation, treating seizure activity (uncontrolled seizures and status epilepticus), skeletal muscle relaxant
26
diazepam contraindications
Known hypersensitivity, severe liver dysfunction, severe pulmonary impairment. Use with caution in patients with severe renal impairment and in patients with history of drug dependence.
27
diazepam side effects
Respiratory depression, hypotension, dizziness, drowsiness, slurred speech, blurry vision. May cause respiratory arrest.
28
diazepam dose
5-10 mg IVP, may repeat every 10-15 mins, max dose 30 mg
29
diphenhydramine brand name
Benadryl, Allerdryl
30
diphenhydramine class
antihistamine
31
diphenhydramine MOA
antagonizes effects of histamine at the H1 receptor sites, CNS depressant, anticholinergic
32
diphenhydramine indications
relief of allergic symptoms caused by histamine release
33
diphenhydramine contraindications
Known hypersensitivity, asthma. Use with caution in patients with severe liver disease, narrow-angle glaucoma, seizure disorders, prostatic hyperplasia, and peptic ulcers. Geriatric patients more susceptible to adverse drug reactions and anticholinergic effects.
34
diphenhydramine side effects
chest tightness, hypotension, drowsiness, dizziness, headaches, tinnitus, blurred vision, anorexia, constipation, dry mouth
35
diphenhydramine dose
IM, IV 25-50 mg q.4h.
36
sodium bicarbonate class
alkalinizing agent
37
sodium bicarbonate MOA
Buffers excess acid to return blood to physiological pH. Causes increased urinary elimination of some drugs such as barbiturates and aspirin.
38
sodium bicarbonate indications
metabolic acidosis; in certain poisoning or overdoses of ethylene glycol, aspirin, and methanol
39
sodium bicarbonate contraindications
Known hypersensitivity. Don't give to patients with metabolic or respiratory alkalosis, hypocalcemia, or excessive chloride loss. Use with caution in patients with CHF and kidney insufficiency and in those using corticosteroid therapy.
40
sodium bicarbonate side effects
edema, irritation at IV site
41
sodium bicarbonate dose
1 mEq/kg
42
levalbuterol brand name
Xopenex
43
levalbuterol class
adrenergic, bronchodilator
44
levalbuterol MOA
binds to beta2 adrenergic receptors in airway smooth muscle, causing bronchodilation
45
levalbuterol indications
short-term use for bronchodilation due to reversible airway disease
46
levalbuterol contraindications
Hypersensitivity to albuterol. Use with caution in patients with hypertension, coronary insufficiency, arrhythmias, history of seizures, hypokalemia, or diabetes.
47
levalbuterol side effects
paradoxical bronchospasm, tachycardia, anxiety, dizziness, headache, hyperglycemia
48
levalbuterol dose
0.63 mg via nebulization 3 times daily. Get baseline vitals prior to administering and watch for wheezing.
49
fentanyl brand name
Sublimaze
50
fentanyl class
opioid analgesic
51
fentanyl MOA
binds to opiate receptors in CNS, altering response to and perception of pain
52
fentanyl indications
severe pain, analgesia maintenance in the intubated patient
53
fentanyl contraindications
Known hypersensitivity. Use with caution in patients with diabetes; severe renal, pulmonary, liver, or cardiac disease; increased ICP, undiagnosed abdominal pain. Avoid in patients who have received MAOIs in the past 14 days, may cause potentially fatal reaction. Do not use with other CNS depressants.
54
fentanyl side effects
apnea, respiratory depression, bronchospasm, laryngospasm, arrhythmias, hypotension, confusion, nausea and vomiting
55
fentanyl dose
0.5 to 1 mcg/kg *Be prepared to manage airway and/or provide reversal agent. Use continuous monitoring.
56
morphine sulfate brand name
Astramorph, Duramorph
57
morphine sulfate class
opioid analgesic
58
morphine sulfate MOA
binds to opiate receptors in CNS, altering perception of and response to pain
59
morphine sulfate indications
severe pain, pulmonary edema, pain with AMI
60
morphine sulfate contraindications
Known hypersensitivity. Avoid in patients hypersensitive to tartrazine, bisulfates, ETOH. Use with caution in patients with head trauma, increased ICP, abdominal pain, renal/liver dysfunction, pulmonary disease, history of substance abuse. Use with caution in patients using MAOIs within last 14 days.
61
morphine sulfate side effects
respiratory depression, hypotension, confusion , constipation, physical/psychological dependence
62
morphine sulfate dose
4-10 mg IV/IM/SQ
63
furosemide brand name
Lasix
64
furosemide class
loop diuretic
65
furosemide MOA
inhibits reabsorption of sodium and chloride in the distal renal tubule and the loop of Henle; increases excretion of H2O, sodium, chloride, magnesium, and calcium, and potassium
66
furosemide indications
Edema due to heart failure, liver impairment, or renal disease. Can be used to treat hypertension.
67
furosemide contraindications
Known hypersensitivity, hepatic encephalopathy, anuria. Do not give to patients with severe liver disease or diabetes mellitus. Note: Geriatric patients may have increased risk of hypotension and electrolyte imbalance at normal doses.
68
furosemide side effects
dehydration, hypochloremia, hypokalemia, hypomagnesemia, hyponatremia, hypovolemia, hypocalcemia, metabolic acidosis
69
furosemide dose
20-40 mg IVSP or 2 times the amount the patient is already on
70
heparin sodium brand name
Heparin
71
heparin sodium class
anticoagulant, antithrombotic
72
heparin sodium MOA
potentiates inhibitory effect of antithrombin on factor Xa and thrombin
73
heparin sodium indications
used prophylactically for the treatment of various thrombotic disorders
74
heparin sodium contraindications
Known hypersensitivity. Should not be given to patients with uncontrolled bleeding, severe thrombocytopenia, or open wounds. Use extreme caution in patients with uncontrolled hypertension, bacterial endocarditis, bleeding disorders, hemorrhage, or stroke.
75
heparin sodium side effects
bleeding, anemia, thrombocytopenia
76
heparin sodium dose
Varies depending on protocol. Generally, 5000 IU loading dose IVSP, then 800 to 1200 IU/hr. Note: Continually monitor for evidence of bleeding.
77
vasopressin brand name
Pitressin
78
vasopressin class
antidiuretic hormone
79
vasopressin MOA
In high doses, acts as a nonadrenergic peripheral vasoconstrictor.
80
vasopressin contraindications
Known hypersensitivity. Should not be given to patients with chronic renal failure or to those who are hypersensitive to beef or pork. Use with caution in patients with history of seizures, asthma, heart failure, migraine headaches, and renal impairment.
81
vasopressin side effects
MI, angina, dizziness, abdominal cramps, diarrhea
82
vasopressin dose
40 units IV
83
thiamine brand name
Betaxin, vitamin B1, Blamine
84
thiamine class
water-soluble vitamin
85
thiamine MOA
metabolism of carbs and fats
86
thiamine indications
vitamin deficiencies, prevention of Wernicke encephalopathy
87
thiamine contraindications
Known hypersensitivity. Should not be given to patients with known alcohol intolerance. Use caution in patients with Wernicke encephalopathy.
88
thiamine side effects
pulmonary edema, vascular collapse, hypotension, angioedema, vasodilation, GI bleeding
89
thiamine dose
IM, IV 5 to 100 mg
90
ondansetron brand name
Zofran
91
ondansetron class
antiemetic
92
ondansetron MOA
blocks the effects of serotonin located in the chemoreceptor trigger zone (CTZ) in the CNS
93
ondansetron indications
prevention of nausea and vomiting
94
ondansetron contraindications
Known hypersensitivity. Use with caution in patients with liver impairment.
95
ondansetron side effects
headache, constipation, diarrhea
96
ondansetron dose
4-8 mg PO
97
Lactated Ringer's Solution class
isotonic crystalloid solution
98
Lactated Ringer's description
sterile water with electrolytes: sodium 130 mEq/L, potassium 4 mEq/L, calcium 30 mEq/L, chloride 109 mEq/L, lactate 28 mEq/L
99
Lactated Ringer's MOA
replaces fluid and electrolytes
100
Lactated Ringer's indications
significant burns and hypovolemia
101
Lactated Ringer's contraindications
Heart failure, renal failure, suspected hyperkalemia. Do not use with blood product infusion.
102
Lactated Ringer's side effects
rare in therapeutic dosages
103
Lactated Ringer's dose
depends on condition being administered for. Follow protocols. Monitor closely for signs of circulatory overload. Keep open rate 30 mL/hr. (1000 mL bags)
104
5% dextrose in water for IV infusion class
hypotonic carbohydrate-containing solution
105
5% dextrose description
sterile water containing 5% dextrose (5 g/100 mL)
106
5% dextrose MOA
combines dextrose and water in a hypotonic concentration that will not remain in the vascular space, reducing danger of overload.
107
5% dextrose indications
for prophylactic IV access or to dilute concentrated drugs for IV infusion
108
5% dextrose contraindications
patients who require IV fluid replacement or who are hyperglycemic
109
5% dextrose side effects
Rare in therapeutic doses. *Do not use for blood product infusion
110
5% dextrose dose
Usually administered at keep open rate (30 mL/hr). Monitor IV site for irritation/swelling/redness. (250 mL or 500 mL bags)
111
normal saline IV infusion (0.9% sodium chloride) class
isotonic crystalloid
112
normal saline description
clear liquid containing water, 154 mEq/L sodium and approximately 154 mEq/L chloride to match concentration in human body
113
normal saline MOA
used to expand the vascular volume temporarily by replacing water and electrolytes
114
normal saline indications
hypovolemia, heat exhaustion, heat stroke, diabetic ketoacidosis
115
normal saline contraindications
heart failure (overload may occur)
116
normal saline side effects
may result in hemodilution and electrolyte imbalance
117
normal saline dose
Depends on condition. Follow protocols. Keep open rate 30 mL/hr. Monitor carefully for fluid overload in patients receiving large volumes of NS.
118
albuterol brand name
Proventil, Ventolin
119
albuterol class
beta2 adrenergic, bronchodilator
120
albuterol MOA
binds to beta2 receptors in airway smooth muscle causing bronchodilation
121
albuterol indications
reversible airway obstruction caused by asthma or COPD
122
albuterol contraindications
Known hypersensitivity, hypersensitivity to adrenergic amines. Use with caution in patients with cardiac disease, hypertension, hyperthyroidism, diabetes, glaucoma, seizure disorder.
123
albuterol side effects
anxiety, tachycardias
124
albuterol dose
MDI: 2 puffs q.4-6h.
SVN: 2.5 to 5 mg every 20 mins x3 doses
125
lidocaine brand name
Xylocaine, Xylocard
126
lidocaine class
1B antiarrhythmic
127
lidocaine MOA
Suppresses automaticity and spontaneous depolarization of the ventricles during diastole by altering the flux of sodium ions across cell membranes with little or no effect on the heart rate.
128
lidocaine indications
Alternative to amiodarone for cardiac arrest from V-fib/pulseless VT after successful conversion of perfusing rhythm; wide complex tachycardias of uncertain origin, and ventricular ectopy in acute MI. Also used in RSI to blunt the ICP rise.
129
lidocaine contraindications
Known hypersensitivity. Should not be given to patients with 3rd degree heart block. Use with caution in patients with liver disease, CHF, shock, respiratory depression, heart blocks.
130
lidocaine side effects
bronchospasm, cardiac arrest, arrhythmias, hypotension, seizures, blurred vision, dizziness, confusion, slurred speech, anaphylaxis, nause, and vomiting
131
lidocaine dose
1 to 1.5 mg/kg bolus. May repeat dose of 0.5 to 0.75 mg/kg every 5-10 mins, up to 3 mg/kg. Continuous infusion rate 1-4 mg/min.
Pediatric dose: 1 mg/kg
*Dosing is same for RSI. Monitor vital signs and ECG.
Advanced EMT: bolus
Intermediate EMT: drip
132
epinephrine brand name
Adrenalin
133
epinephrine class
vasopressor, sympathomimetic
134
epinephrine MOA
Affects B1 and B2 adrenergic receptor sites. Also affects A1 adrenergic sites.
135
epinephrine indications
symptomatic bradycardia, cardiac arrest, severe allergic reaction, reversible airway disease due to asthma or COPD
136
epinephrine contraindications
Known hypersensitivity, hypersensitivity to adrenergic amines or bisulfates, cardiac arrhythmias. Use with caution in patients with cardiac disease, hypertension, diabetes, hyperthyroidism, cerebral arteriosclerosis.
137
epinephrine side effects
angina, arrhythmias, hypertension, tachycardia
138
epinephrine dose
Cardiac arrest: 1 mg 1:10,000 IV/IO q.3-5min.
| Allergic reaction: 0.3 mg to 0.5 mg 1:1,000 SQ/IM q.10-15min.
139
adenosine brand name
Adenocard
140
adenosine class
cardiac antidysrhythmic, nucleoside (a biologic molecule that serves as a building block of RNA and DNA
141
adenosine MOA
Decreases electrical conduction through the AV node. Also acts directly on the sinus node to decrease automaticity to slow the heart rate. Adenosine has an immediate onset but a duration of less than 10 seconds.
142
adenosine indications
Used for narrow complex tachycardia. Not indicated for atrial fibrillation with rapid ventricular response, atrial flutter, or ventricular tachycardia because it is ineffective in converting those rhythms.
143
adenosine contraindications
Do not use in patients with 2nd or 3rd degree AV node block, sick sinus syndrome, or hypersensitivity to adenosine.
144
adenosine side effects
lightheadedness, headache, chest pain, flushing, hypotension, shortness of breath, nausea, metallic taste, transient rhythm disturbances (bradydysrhythmia, sinus pause, ventricular ectopy, or asystole)
145
adenosine dose
Adults: 6 mg rapid IV bolus through a proximal IV, followed by a 20 mL saline bolus to ensure that adenosine reaches the central circulation. If there is no change in rhythm after 1-2 mins, give a 12 mg rapid IV bolus. If rhythm persists 1-2 mins following 2nd dose, one additional 12 mg rapid IV bolus may be given. Do not exceed 30 mg total.
Pediatrics: 0.1 mg/kg (up to 6 mg) initial dose. May repeat in 1-2 mins at double the initial dose. Follow each dose with a 20 mL saline flush.
146
adenosine special notes
Adenosine has a short half life (less than 10 seconds), so administer adenosine through an IV that has been established as near as possible to the central circulation, such as in the antecubital fossa. Use as large a catheter is practical (minimum 18 gauge) to facilitate a rapid bolus. Place the patient supine prior to administration, and warn the patient of possible sensations such as flushing or transient chest tightness when the drug is administered. Push the medication as rapidly as possible, immediately following each bolus with a 10 mL bolus of normal saline. Activate the recorder on the cardiac monitor prior to administration to document any rhythm changes.
147
ipratropium bromide brand name
Atrovent
148
ipratropium bromide class
anticholinergic, bronchodilator
149
ipratropium bromide MOA
antagonizes acetylcholine receptors, producing bronchodilation
150
ipratropium bromide indications
maintenance for airway obstruction due to COPD, including chronic bronchitis and emphysema
151
ipratropium bromide contraindications
Hypersensitivity to atropine or bromide, acute bronchospasm. Use with caution with bladder neck obstruction, prostatic hyperplasia, glaucoma, urinary retention.
152
ipratropium bromide side effects
hypotension, cough, blurred vision, dizziness, palpitations
153
ipratropium bromide dose
Nebulizer: (acute) 500 mcg every 30 min for 3 doses, then every 2-4 hrs as needed.
154
nitroglycerin brand name
Rectiv, Nitrolingual, Nitro-Time, Nitrostat, and GoNitro
155
nitroglycerin class
antianginal, nitrate
156
nitroglycerin MOA
Dilates coronary arteries increasing blood flow, decresases left ventricular end-diastolic pressure, decreases preload, decreases myocardial O2 consumption.
157
nitroglycerin indications
acute and long-term management of angina pectoris
158
nitroglycerin contraindications
Known hypersensitivity, pericardial tamponade, pericarditis, PDE-5 use within last 24 hrs. Use with caution in patients with head trauma, cerebral hemorrhage, glaucoma, hypertrophic cardiomyopathy, severe liver impairment.
159
nitroglycerin dose
0.4 mg SL x3
5 mcg/min drip titrated to desired effect
0.4 mg (1 tablet or spray) max 3 doses
*monitor vital signs frequently. *air/light/temp extremes may cause deterioration
160
naloxone brand name
Narcan
161
naloxone class
antidote (opioids)
162
naloxone MOA
blocks effects of opioids, including CNS and respiratory depression, without producing any opioid-like effects
163
naloxone indications
suspected opioid overdose
164
naloxone contraindications
Known hypersensitivity. Use with caution in patients with CV disease and in patients physically dependent on opioids. May cause withdrawal symptoms.
165
naloxone side effects
ventricular arrhythmias, hyper- or hypotension, vomiting, nausea
166
naloxone dose
0.4 to 1 mg IM, slow IV push, subcutaneous; 2 mg intranasal
167
glucagon brand name
GlucaGen
168
glucagon class
hormone
169
glucagon MOA
increases blood sugar by releasing glycogen from the liver. Causes smooth muscle relaxation and positive inotropic and chronotropic effects of the heart.
170
glucagon indications
severe hypoglycemia and when glucose is not feasible
171
glucagon contraindications
Known hypersensitivity, pheochromocytoma. Use with caution in patients with renal or CV disease.
172
glucagon side effects
hypotension, nausea, vomiting, anaphylaxis
173
glucagon dose
1 mg IV/IM/SQ, may be repeated in 15 mins. Should only be used IM/SQ if unable to establish an IV.
174
activated charcoal class
antidote, adsorbent
175
activated charcoal MOA
adsorbs toxic substances or irritants, inhibits GI absorption. May include sorbitol, which promotes elimination of toxic substance through the GI tract.
176
activated charcoal indications
toxic ingestion within 60 minutes, following emesis or lavage
177
activated charcoal contraindications
Known hypersensitivity, inability to maintain/protect airway. Use with caution in poisonings involving petroleum distillates and caustic ingestions.
178
activated charcoal side effects
may cause vomiting, dark stool
179
activated charcoal dose
25 to 100 g PO or via NG/OG
180
nitrous oxide brand name
Nitronox
181
nitrous oxide class
medicinal gas, analgesic
182
nitrous oxide MOA
produces CNS depression and pain relief
183
nitrous oxide indications
moderate to severe pain management
184
nitrous oxide contraindications
Known hypersensitivity; decreased LOC. Patients with thoracic trauma, respiratory compromise, or abdominal distension. *Closely monitor; watch for nausea/vomiting.
185
nitrous oxide side effects
apnea, nausea/vomiting
186
nitrous oxide dose
self administered via inhalation
187
oxygen class
medicinal gas
188
oxygen MOA
enables the cells to break down glucose into usable energy
189
oxygen indications
used to treat severe chest pain, hypoxemia, and cardiac arrest
190
oxygen contraindications
None in out of hospital use. If patient has COPD, begin oxygen at lower rate.
191
oxygen side effects
none
192
oxygen dose
1-6 lpm via nasal cannula, 10-15 lpm via NRB
193
dextrose class
carbohydrate, hyperglycemic (antihypoglycemic)
194
dextrose MOA
dextrose in water increases the circulatory blood sugar level to normal
195
dextrose indications
treat patients in coma from hypoglycemia and patients in a coma of unkown cause. hypoglycemic patients.
196
dextrose contraindications
Known hypersensitivity. Do not use in patients with increased ICP or intracranial bleeding. *Use caution in patients who cannot tolerate carbohydrate agents.
197
dextrose side effects
May aggravate hypertension, may cause neurological symptoms in alcoholics, may cause skin necrosis, may cause Wernicke encephalopathy or Korsakoff syndrome in alcoholics.
198
dextrose dose
10-50 g slowly. May be repeated.
199
aspirin brand name
Bayer, Bufferin
200
aspirin class
antipyretic, nonopioid analgesic, salicylate
201
aspirin MOA
produces analgesia, reduces inflammation and fever by reducing production of prostaglandin, decreases platelet aggregation
202
aspirin indications
prophylaxis use in MI and TIA
203
aspirin contraindications
Known hypersensitivity. Do not give w/ bleeding disorders. *Use with caution in patients with history of GI bleeding, ulcer disease, chronic use of ETOH, severe renal/liver disease.
204
aspirin side effects
tinnitus, GI bleed, anaphylaxis, laryngeal edema
205
aspirin dose
162-324 mg chewed and swallowed for MI. Do not use enteric coated aspirin.
