Master so far Flashcards Preview

Pharm final > Master so far > Flashcards

Flashcards in Master so far Deck (156):
1

Narcan contrindications

None

2

Calcium chloride side effect

Hypotension
Bradycardia
Cardiac dysrhythmias
Cardiac arrest

3

Sodium bicarb side effect

Extracellular alkalosis
Cardiac arrhythmias
Decreased cerebral and cardiac functioning

4

Activated charcoal action

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

Nitroglycerine actions

Reduce preload and afterload
Vasodilation of cerebral and coronary arteries
Generalized smooth muscle relaxation
Onset of action 1-2min

6

Magnesium sulfate dose

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

Activated charcoal side effect

Vomiting
Abdominal cramping
Abdominal bloating
Constipation

8

Diazepam dose

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

Glucagon class

Hormone, anti-hypoglycemic

10

Activated charcoal class

Adsorbents

11

Atrovent side effect

Dry Mouth
GI distress
N/V
Nervousness
Dizziness
Headache
Palpitations
Blurred vision

12

Thiamine contraindication

Hypersensitivity

13

Aspirin action

Aspirin produces analgesia and reduces inflammation and fever by inhibiting the production of prostaglandins. It decreases platelet aggregation.

14

Dextrose dose

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

Thiamine class

Vitamin

16

Aspirin class

Analgesic, antipyretic, platelet inhibitor, anti-inflammatory

17

Thiamine side effect

Weakness
Pulmonary edema
Sweating
Nausea/vomiting

18

Amiodarone dose

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

Dextrose action

Principal form of glucose used by the body to create energy

20

Midazolam dose

Adult
1 – 2.5mg slow IV/IO
0.07 – 0.08mg/kg IM (typical max of 5mg)

Pediatrics
0.05 – 0.20mg/kg slow IV/IO
0.10 – 0.15mg/kg IM

21

Activated charcoal contraindication

Uncontrolled airway
Ingestion of cyanide, mineral acids, caustic alkalis, organic solvents, iron, ethanol
or methanol

22

Adenosine side effect

Palpitations
Hypotension
Chest discomfort
Headache/dizziness
Respiratory distress

23

Atrovent contraindication

Hypersensitivity to atrovent, atropine or atropine derivatives

Not to be used as the primary treatment for bronchospasm

24

Atropine contraindications

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