Master so far Flashcards
(156 cards)
1
Q
Narcan contrindications
A
None
2
Q
Calcium chloride side effect
A
Hypotension
Bradycardia
Cardiac dysrhythmias
Cardiac arrest
3
Q
Sodium bicarb side effect
A
Extracellular alkalosis
Cardiac arrhythmias
Decreased cerebral and cardiac functioning
4
Q
Activated charcoal action
A
Activated charcoal is a specially prepared charcoal that when given soon after ingestion of a toxin will adsorb and bind organic toxins from the GI tract
5
Q
Nitroglycerine actions
A
Reduce preload and afterload
Vasodilation of cerebral and coronary arteries
Generalized smooth muscle relaxation
Onset of action 1-2min
6
Q
Magnesium sulfate dose
A
Adult
- Torsades de pointes: 1 – 2g IVP over 1 – 2 minutes
- Eclamptic seizure: 4 – 5g IVP concurrently with up to 5g IM in each buttock then 4 – 5 g every 4 hours
- Bronchodilation: 2g IVP
Pediatrics
- Torsades de pointes: 25 – 50mg/kg/dose max dose of 2g
- Bronchodilation: 25mg/kg/dose max 2g
7
Q
Activated charcoal side effect
A
Vomiting
Abdominal cramping
Abdominal bloating
Constipation
8
Q
Diazepam dose
A
Seizures 5 – 10 mg IV/IO/IM Anxiety 2 – 5 mg IV/IM Premedication 5 – 15 mg IV/IO
Pediatric Dosage Seizures and anxiety 0.5 – 2 mg IV/IO/IM Premedication 0.2 – 0.5 mg/kg
9
Q
Glucagon class
A
Hormone, anti-hypoglycemic
10
Q
Activated charcoal class
A
Adsorbents
11
Q
Atrovent side effect
A
Dry Mouth GI distress N/V Nervousness Dizziness Headache Palpitations Blurred vision
12
Q
Thiamine contraindication
A
Hypersensitivity
13
Q
Aspirin action
A
Aspirin produces analgesia and reduces inflammation and fever by inhibiting the production of prostaglandins. It decreases platelet aggregation.
14
Q
Dextrose dose
A
Adult
25g D50 IV/IO/PO
28 Days to 8 years old
0.5g/kg D25 IV/IO/PO
Neonate
0.2g/kg D10 IV/IO/PO
15
Q
Thiamine class
A
Vitamin
16
Q
Aspirin class
A
Analgesic, antipyretic, platelet inhibitor, anti-inflammatory
17
Q
Thiamine side effect
A
Weakness
Pulmonary edema
Sweating
Nausea/vomiting
18
Q
Amiodarone dose
A
Adult
-VF/Pulseless V tach: 300mg IV/IO repeat at 150mg after 3 – 5 minutes
-Wide complex tachycardia: 150mg IV/IO over 10 minutes
-Post resuscitation maintenance: 1mg/min over 6 hours
Max dose: 2.2g IV/IO over 24 hours
Pediatrics
-VF/Pulseless V tach: 5mg/kg IV/IO
-Wide complex tachycardia: 5mg/kg IV/IO over 20 – 60 minutes
Max dose: 15mg/kg
19
Q
Dextrose action
A
Principal form of glucose used by the body to create energy
20
Q
Midazolam dose
A
Adult
1 – 2.5mg slow IV/IO
0.07 – 0.08mg/kg IM (typical max of 5mg)
Pediatrics
- 05 – 0.20mg/kg slow IV/IO
- 10 – 0.15mg/kg IM
21
Q
Activated charcoal contraindication
A
Uncontrolled airway
Ingestion of cyanide, mineral acids, caustic alkalis, organic solvents, iron, ethanol
or methanol
22
Q
Adenosine side effect
A
Palpitations Hypotension Chest discomfort Headache/dizziness Respiratory distress
23
Q
Atrovent contraindication
A
Hypersensitivity to atrovent, atropine or atropine derivatives
Not to be used as the primary treatment for bronchospasm
24
Q
Atropine contraindications
A
None
25
Albuterol dose
```
Adult
2.5 – 5.0mg via nebulizer (repeat PRN)
Pediatrics
<20kg: 1.25mg in 3ml NS via nebulizer
>20kg: 2.5mg in 3ml NS via nebulizer
```
26
Albuterol indication
Bronchospasm
Hyperkalemia
Crush syndrome
27
Lidocaine class
Antiarrhythmic, Sodium Channel Blocker
28
Ondasetron dose
Adult
4mg IVP/PO. Max dose of 8mg.
Pediatric
4mg IVP/PO
29
Aspirin indications
Inhibit platelet aggregation in the presence of chest pain suggestive of an acute myocardial infarction.
30
Morphine action
Morphine is a natural opium alkaloid that acts on the opiate receptors in the brain. Provides both analgesic and sedative effects. Vasodilatation, reduction of venous return and decrease of myocardial oxygen demand
31
Narcan indication
Narcotic overdose
| Coma of unknown origin
32
Dextrose class
Carbohydrate
33
Midazolam class
Sedative/hypnotic
34
Succinylcholine dose
Adult
-1.0 – 1.5mg/kg IV/IM
Pediatrics
-1 – 2mg/kg IV/IM
35
Aspirin dose
160-325mg PO, not for pedi
36
Furosemide side effect
Postural hypotension
Dizziness
Hypovolemia
Circulatory collapse
37
Amiodarone contraindication
```
Hypersensitivity
Cardiogenic shock
Bradycardia
AV blocks
Liver disease
```
38
Thiamine action
Thiamine is vitamin B1. It is required for the metabolism of glucose and the production
of ATP. It is not manufactured by the body and must be constantly provided from
ingested foods.
39
Dopamine contraindication
Hemodynamically significant hypotension secondary to
Hypovolemia from blood loss or dehydration
Hemodynamically significant hypotension secondary to
third spacing fluids prior to sufficient fluid replacement
40
Midazolam indication
Sedation prior to cardioversion/Pacing/RSI
| Seizure control
41
Aspirin side effects
```
Nausea/Vomiting
Stomach pain
GI bleeding
Dizziness
Confusion
Tinnitis
```
42
Nitroglycerine indications
Angina
Chest pain
Pulmonary edema
43
Albuterol side effect
```
Tremors/anxiety/dizziness
Headache/diaphoresis
Angina/palpitations
Tachycardia
CNS stimulation
Hypertension
```
44
Calcium chloride contraindication
Ventricular fibrillation
Hypercalcemia
Digitalis toxicity
45
Adenosine action
Slows conduction time through the AV node and interrupts the reentry pathways of the AV node and SA node. Half life of <10 seconds and does not cause a decrease in blood pressure.
46
Atrovent class
Parasympatholytic (anticholinergic) bronchodilator
47
Fentanyl contraindication
Myasthenia gravis
| MAO inhibitors within 14 days
48
Sodium bicarb contraindication
None
49
Narcan side effects
```
Increase BP
Increase respirations
Tachycardia
N/V
Tremors
Withdrawal symptoms
```
50
Epinephrine dose
```
Adult
-Cardiac arrest
1mg IV 1:10,000
2-2.5mg ETT 1:1000
-Anaphylaxis
0.3-0.5mg 1:1000 IM/SC
0.5-1mg 1:10,000 IV/IO
-Brady
2-10mcg/min
Pediatric
-Cardiac arrest
0.01mg/kg IV/IO
0.1mg/kg ETT
-Anaphylaxis
0.01mg/kg 1:1000 SC/IM
0.01mg/kg 1:10,000 IV/IO
```
51
Calcium chloride indication
Hyperkalemia
Hypocalcemia
Hypermagnesemia
Calcium channel blocker OD
52
Diphenhydramine indication
Anaphylaxis, allergic reactions, and dystonic reactions
53
Epinephrine indication
To restore cardiac rhythms in a cardiac arrest event
Allergic reaction/Anaphylaxis
Bradycardia refractory to dopamine
54
Epinephrine action
Natural catecholamine, increases HRm cardiac contractile force, myocardial electrical activity, systemic vascular resistance and systolic BP. Decreases overall airway resistance and automaticity. Thru bronchial artery constriction may reduce pulmonary congestion and increase tidal volume
55
Ondasetron contraindication
Hypersensitivity
| Prolonged QT syndrome
56
Lidocaine contraindication
Not used for supraventricular rhythms or bradycardias
Hypersensitivity to any of the “caines”
57
Amiodarone class
Antiarrhythmic
58
Albuterol action
Selective beta-2 adrenergic bronchodilator causing bronchial smooth muscle relaxation with minimal beta-1 or alpha stimulation. Inhibits histamine release reducing mucus secretion and mucosal edema
59
Diphenhydramine dose
Adult
25 – 50mg IV/IM/PO
Pedi (6 – 12 years old)
12.5 – 25mg IV/IM/PO
Pedi (under 6 years old)
2 – 5 mg/kg IV/IM not to exceed 25mg
60
Narcan action
Competes and displaces narcotic molecules from opiate receptors in the brain. Blocks the effects of both natural and synthetic narcotics and may reverse respiratory depression
61
Dopamine dose
Cardiogenic shock and bradycardia
5 – 10mcg/kg/min
Anaphylaxis
20mcg/kg/min
Crush syndrome
2mcg/kg/min
Pediatric dosing is the same as adult dosing
62
Diphenhydramine side effect
Drowsiness
Tachycardia
Dizziness
Hypertension/Hypotension
63
Furosemide indication
Congestive heart failure
| Pulmonary edema
64
Magnesium sulfate action
Magnesium sulfate acts as a physiological calcium channel blocker, CNS depressant and
anti-convulsant. It depresses the function of smooth, skeletal and cardiac muscles
65
Diazepam side effect
Hypotension
Tachycardia
Edema
Cardiovascular collapse
66
Diphenhydramine contraindication
Asthma and other lower respiratory diseases
67
Midazolam action
Short acting parenteral benzodiazepine with CNS depressant, muscle relaxant,
anticonvulsant and anterograde amnestic effects
68
Fentanyl class
Narcotic analgesic
69
Sodium bicarb indication
Prolonged cardiac arrest
Known hyperkalemia
Tricyclic antidepressants/barbiturates OD
Refractory metabolic acidosis
70
Succinylcholine indication
Facilitated endotracheal intubation
71
Glucagon contrindication
Hypersensitivity to glucagon or protein compounds
| Glucagon is only effective if there are glycogen stores in the liver
72
Ondasetron side effect
Dizziness
| Constipation
73
Amiodarone side effect
```
Hypotension
Bradycardia
Cardiogenic shock
Headache/dizziness
AV block
```
74
Furosemide contraindication
Hypersensitivity to sulfonamides
Hepatic coma
Pregnancy (except in life threatening emergencies)
75
Albuterol class
Sympathomimetic Bronchodilator
76
Morphine contraindication
Undiagnosed head and abdominal injuries
Hypotension/Hypovolemia
Respiratory depression
Acute bronchial asthma
77
Sodium bicarb class
Alkalinizing agent
78
Activated charcoal indication
Acute ingested poisoning
79
Dextrose indication
To increase the blood sugar in documented hypoglycemia
80
Furosemide class
Non-potassium sparing loop diuretic
81
Succinylcholine class
Depolarizing neuromuscular blocker
82
Atrovent action
Atrovent causes bronchodialtion and decreases respiratory secretions through competitive inhibition of cholinergic receptors on bronchial smooth muscles. Atrovent also abolishes vagally mediated reflex bronchospasm.
83
Epinephrine contraindication
None in the emergency setting
Hemorrhagic shock
Cardiogenic shock
Hypertension
84
Fentanyl dose
```
Adult
-25 – 100mcg slow IV/IO over 2 – 3 minutes
-1.0mcg/kg slow IV/IO over 2 – 3 minutes
Pediatrics
-1.0mcg/kg slow IV/IO over 2 – 3 minutes
```
85
Thiamine indication
Coma of unknown origin
Alcohol induced coma
Delirium tremens
86
Morphine indication
Management of moderate to severe pain
| To reduce venous return in pulmonary edema/CHF/AMI
87
Morphine dose
```
Adult
-Pain management
2.5 – 15mg IV/IO
5 – 20mg IM/SC
-Pulmonary edema/CHF/AMI
1 – 2mg IV/IO every 6 – 10 minutes
```
Pediatric
0. 05 – 0.1mg/kg IV/IO
0. 1 – 0.2mg/kg IM/SC
88
Diazepam contraindication
Shock
Coma
Depressed vital signs
Neonates
89
Atropine dose
Bradycardia
0.5mg IVP/IO (may repeat as needed every 3-5 min to a max of 3mg)
Pedi: 0.02mg/kg (minimum single dose of 0.1mg) IV/IO
Organophosphate
2-5mg IV/IO/IM (repeat as needed every 10-15min)
Pedi: 0.05mg/kg IV/IO/IM
90
Ondasetron class
Antiemetic
91
Sodium bicarb action
Raises the pH of blood plasma by buffering excess hydrogen ions. Provides vascular bicarbonate to assist the buffer system in reducing the effects of metabolic acidosis and in the treatments of some overdoses.
92
Magnesium sulfate class
Electrolyte
93
Dopamine action
Precursor to norepinephrine an endogenous catecholamine. Stimulates alpha, beta and dopaminergic receptors in a dose –dependent fashion
2 – 5 mcg/kg/min Dilates renal, mesenteric and cerebral arteries by dopaminergic receptor stimulation (has minimal effect on blood pressure and heart rate).
5 – 10mcg/kg/min Predominately beta and alpha-adrenergic receptor stimulating actions increasing cardiac output (inotropic) with minor increase in systemic vascular resistance and preload
10 – 20mcg/kg/min Increasingly alpha adrenergic receptor stimulating actions resulting in increased peripheral, renal and mesenteric arterial and venous vasoconstriction which thereby increases systemic vascular resistance and preload.
Doses higher than 20mcg/kg/min produce pure alpha receptor effects mimicking norepinephrine effects. For this reason if hypotension is refractory to dopamine either
epinephrine infusions or Dobutamine infusions are added.
Onset of action: 1 – 2 minutes
Half life: 2 minutes
94
Narcan dose
0.4-2mg IV/IO/IM (may repeat 2-3min prn)
2-2.5mg ETT
Pedi:
0.1mg/kg IV/IO/IM
95
Fentanyl action
A potent short acting narcotic agonist used for its analgesic properties. Fentanyl does not cause the vasodilation associated with morphine and so may be acceptable for use in hypovolemic patients.
96
Glucagon action
Natural polypeptide hormone secreted by the pancreas. Released to breakdown stored glycogen to glucose and inhibits the synthesis of glycogen from glucose. Acts on
receptor sites similar to those of epinephrine producing catecholamine like effects.
97
Dextrose contraindication
None in documented hypoglycemia
98
Lidocaine indication
Ventricular tachycardia or wide-complex tachycardia with pulses
Recurrent or refractory ventricular fibrillation/pulseless v-tach.
Following successful defibrillation
Pre-intubation in head injuries (may minimize the rise in ICP associated with intubation).
99
Dextrose side effect
Pain at the injection site
Necrosis
Hyperglycemia
100
Lidocaine action
- Depresses the automaticity of the Purkinje Fibers therefore raises the depolarization threshold in the ventricular fibers and decreases tendency to fibrillate.
- Little antiarrhythmic effect on atrial muscle at sub-toxic levels
-Cardiovascular effects:
o Decreased conduction rate and force of contraction, mainly at toxic levels
o Prolongs phase 4 depolarization and shortens action potential
-CNS stimulation:
o Tremors, restlessness, clonic convulsions followed by respiratory depression and
respiratory failure at higher doses.
-Onset of action: less than 3 minutes
101
Morphine side effect
```
Respiratory distress
Bradycardia
Palpitation
Hypotension
Cardiac arrest
```
102
Dopamine indication
Cardiogenic shock (pulmonary edema with NON-HYPOVOLEMIC hypotension)
Anaphylaxis refractory to epinephrine and fluid boluses
Bradycardia refractory to atropine and pacing
Shock states with Hemodynamically significant hypotension in the ABSENCE of
Hypovolemia (sepsis, neurogenic shock).
Crush injury
103
Adenosine indication
PSVT (Refractory to vagal maneuvers)
| Stable wide complex tachycardia thought to be reentry SVT
104
Sodium bicarb dose
Adult
1mEq/kg IV/IO, may repeat at half dose every 10 minutes
Pediatrics
Same as adult
105
Succinylcholine contraindication
```
Family history of malignant hyperthermia
Glaucoma
Penetrating eye trauma
Liver disease
Significant burns older than 24 hours
```
106
Magnesium sulfate contraindication
Hypocalcaemia
Heart block
Myocardial damage
Anuria
107
Adenosine dose
Adult
6mg rapid IVP w/ 10ml followed by 12mg
Pedi
0.1mg/kg rapid IVP w/ 10ml followed by 0.2mg/kg
108
Furosemide action
Lasix is a rapid acting potent diuretic and antihypertensive that inhibits sodium reabsorption by the kidney. Its vasodilating effects reduce venous return and cardiac workload.
109
Dopamine side effect
Tachycardia, ectopic beats, nausea, vomiting, angina, palpitations, headache and dyspnea
High doses can cause hypertension requiring reduction in infusion rate.
110
Diazepam action
Benzodiazepine sedative and skeletal muscle relaxant that reduces tremors, induces amnesia and reduces the recurrence of seizures. It relaxes muscle spasms in orthopedic injuries and produces amnesia for painful procedures.
111
Ondasetron action
Selective serotonin (5HT3) receptor antagonist. Its effects are thought to be on both peripheral and central nerves. Ondansetron reduces the activity of the vagus nerve, which deactivates the vomiting center in the medulla oblongata, and also blocks serotonin receptors in the chemoreceptor trigger zone. It has little effect on vomiting caused by motion sickness.
112
Midazolam contraindication
```
Shock
Comatose patients
Narrow angle-closure glaucoma
Hypotension
Use cautiously in CHF patients
```
113
Activated charcoal dose
Adult
1 g/kg mixed with 6 – 8 ounces water PO or NG tube
Pediatric
Same as adult dosing
114
Diphenhydramine action
Diphenhydramine blocks histamine release, thereby reducing bronchoconstriction, vasodilation and edema. It suppresses central cholinergic activity and prolongs the action of dopamine by inhibiting its reuptake and storage.
115
Diazepam class
Anti-anxiety, sedative/hypnotic, anti-convulsant
116
Nitroglycerine side effects
```
Hypotension
Use cautiously with right sided or inferior MI
Throbbing headache
Flushing
Dizzy
Tachycardia
Burning under tongue
```
117
Atropine class
Parasympatholytic/anticholinergic
118
Ondasetron indication
Prevention and treatment of nausea and vomiting
119
Adenosine contraindication
Second or third degree AV block
| Poison or drug induced tachycardia
120
Dopamine class
Sympathomimetic
121
Glucagon indication
To increase blood sugar levels in hypoglycemia without vascular access
Beta-blocker overdose
122
Nitroglycerine dose
0.4mg tablet or spray, not for pedi
123
Furosemide dose
Adult
-40-120mg slow IV
Pediatric
-1mg/kg slow IV push
124
Glucagon dose
Adult
- Hypoglycemia: 1.0 unit IM/SC (may repeat as needed 5 – 20 minutes)
- Beta-blocker OD: 2 – 3 units IV/IO over 2 – 5 minutes
Pediatric (less than 20kg)
- Hypoglycemia: 0.5 units
- Beta-blocker OD: 0.05 units/kg over 2 – 5 minutes (not to exceed adult dose)
Pediatric (greater than 20kg)
- Hypoglycemia: 1.0 units
- Beta-blocker OD: same as above
125
Diazepam indication
Seizures, status epilepticus
Premedication before cadioversion
Muscle tremors due to injury
Acute anxiety attack
126
Fentanyl indication
Pain management
127
Aspirin contraindications
Hypersensitivity
Active gastro-intestinal bleed
Acute asthma attack
Bleeding disorder
128
Succinylcholine side effect
```
Bradycardia
Malignant hyperthermia
Tachycardia
Hypo/hypertension
Respiratory depression
Sinus arrest
```
129
Nitroglycerine class
Nitrate, anti-anginal
130
Thiamine dose
Adult
50 – 100mg IV/IO/IM
Pediatrics:
10 – 25mg IV/IO/IM
131
Magnesium sulfate side effect
ALOC
Hypotension
Heart block
Hypocalcemia
132
Lidocaine side effect
CNS disturbances:
o Sleepiness, dizziness, disorientation, confusion and convulsions
Cardiovascular:
o Hypotension, bradycardia, decreased myocardial contractility and increased AV blocks at toxic levels only
133
Midazolam side effect
```
Hypotension
Respiratory arrest
ALOC
N/V
Headache
```
134
Atrovent dose
Adult
500 mcg in 3 ml saline via nebulizer
Pediatric
250 mcg in 3 ml saline via nebulizer
135
Atropine indications
Hemodynamically significant bradycardia
| Organophosphate poisoning
136
Atropine action
Atropine blocks the parasympathetic nervous system, specifically the vagal effects on the heart. It does not increase contractility but may increase myocardial oxygen demand. Decreases airway secretions
137
Lidocaine dose
Adult
-1 – 1.5mg/kg IV bolus; may repeat doses every 3 – 5 minutes at 0.5 – 0.75mg/kg to a total dose of 3mg/kg. May then start continuous infusion of 1 – 4 mg/min
Use 4mg/ml concentration for infusion
-For endotracheal administration use 2 – 2.5 the loading dose followed by a 10ml NS flush.
-Pediatric:
1mg/kg IV bolus (not to exceed 100mg), may repeat at 0.5 – 1.0mg/kg every 3-5 minutes as needed to a total dose of 3mg/kg. May then start continuous administration of 20 – 50mcg/kg/min.
For ETT use, increase loading dose by 2 -3 times
138
Calcium chloride dose
Adult
2 – 4mg/kg IV/IO every 10 minutes as needed
Pediatrics
20mg/kg IV/IO every 10 minutes as needed
139
Adenosine class
Antiarrhythmic
140
Atrovent indication
Asthma (in combination with other bronchodilators)
| COPD
141
Morphine class
Narcotic Analgesic
142
Albuterol contraindication
Hypersensitivity and symptomatic tachycardias (absolute)
| Cardiac arrhythmias and hypertension (relative)
143
Fentanyl side effects
```
ALOC
Hypotension
Bradycardia
Cardiac arrest
Chest wall paralysis
```
144
Narcan class
Narcotic antagonist
145
Magnesium sulfate indication
Hypomagnesaemia
Torsades de pointes
Eclamptic seizure
Adjunctive treatment in moderate to severe acute asthma
146
Glucagon side effect
Hypotension
Hyperglycemia
Headache/dizziness
Nausea/vomiting
147
Diphenhydramine class
Antihistamine
148
Succinylcholine action
Succinylcholine as an ultra short acting neuromuscular blocker with a high affinity for Ach receptor sites
149
Calcium chloride class
Electrolyte
150
Atropine side effects
```
H/D
ALOC
Hyper/hypotension
A-fib/V-fib
Increase size of MI
```
151
Amiodarone action
Amiodarone is an Antiarrhythmic that prolongs the action potential and refractory period. It inhibits adrenergic stimulation. Slows the sinus rate, increases PR and QT intervals, and decreases peripheral vascular resistance.
152
Epinephrine class
Sympathomimetic
153
Nitroglycerine contraindications
```
Hypotension
Chest trauma
Head trauma
Brain bleed
Increased ICP
Use of ED drugs
Hypersensitivity
```
154
Epinephrine side effects
```
Weakness
Headache/dizziness
Syncope
Hypertension
MI/CVA
Tachycardia
```
155
Calcium chloride action
Increases myocardial contractility and increases ventricular automaticity
156
Amiodarone indication
VF/Pulseless V tach
| Wide complex tachycardia with a pulse
