Med Pharm 2 Flashcards by Jason Herrera

CIDC D50

Intracranial hemorrhage
ICP
Stroke w/o hypoglycemia

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D50 dose

12.5-25 g IV

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D25 ped dose

0.5-1 g/kg betweeon 2 months - 8 years

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D50 can cause what in alcoholics

May cause wernicke’s encephalopathy in thiamine deficient pt

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How to use D50 in alcoholics

Give 100 mg of thiamine prior

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What is glucagon

A prancreatic hormone

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CIDC Glucagon

Hypersensitivity

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Glucagon adult and ped dose

Adult: 0.5-1mg, can go again in 10 min
Ped: >20kg, same

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Onset of glucagon

10-20 min IM, 1 min IV

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Glucagon duration

60-90 min

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Side effects of glucagon

Tachycardia, hypotension, N/V, urticaria

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Oral Glucose Dose adult and ped

Adult: 25 g
Ped: 0.5-1g

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Oral glucose onset

10 min

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CIDCs Insulin

Hypoglycemia, hypokalemia

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MOA Insulin

Transport glucose into cells of all tissues, converts glycogen into fat

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What does insulin do with electrolytes

Produces intracellular shift of potassium and magnesium to reduce elevated serum levels of these electrolytes

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Short acting insulin

6-8 hrs

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Intermediate acting insulin

24 hrs

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Long acting insulin

36 hrs

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Absorption of insulin depending on location(fast to slow)

Abd wall, arm, thigh

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Insulin Glargine

Lantus
Long acting insulin

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Biguanides

Metformin

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Sodium-glucose transporter inhibutors (SGLT)

Empagliflozin (Jardiance)

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Sulfonylureas

Glyburide

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What is Hydrocortisone?

Solu-cortef is an adrenal glucocorticoid

MOA Solu-cortef

Anti-inflammatory; Immunosuppressive with salt-retaining properties

IDC Hydrocortisone

Shock due to acute adrenocortical insufficiency

CIDC Solu-cortef

Fungal infections, known hypersensitivity

Adult/Ped dose Hydrocortisone

Adult 4mg/kg slow IV bolus Ped 2 mg/kg slow IV bolus Max 100 mg

Solu-cortef onset

1 hr

duration of hydrocortisone

8-12hr

SE Solu-cortef

HA, vertigo, pulmonary TB, HF, HTN, fluid retention, nausea

How do benzos work

Binds to benzo receptors on postsynaptic GABA neuron with CNS, including in limbic system. Neurons become more permeable to Cl- which leads to hyperpolarization

IDCS Diazepam

Valium should be used for seizures, anxiety, alcohol withdrawl

CIDCs Valium

Hypersensitivity, resp depress, OPEN-ANGLE GLAUCOMA

Diazepam Adult/Ped dose

Adult: 5-10 mg/2 min every 10-15 min, max 30 mg Ped: 30d- 5yr 0.2-0.5-2mg slow/2 min, 2-5 min, max 5 mg 5+ 1mg/2min, every 2-5min, max 10mg

Valium Onset

1-5 min IV 15-30 min IM

Diazepam Duration

15-60 min

Order of benzos

Midazolam Lorazepam Diazepam

Lorazepam CIDC

Ativan Hypersensitivity, resp depress, NARROW-ANGLE GLAUCOMA

Ativan Adult/ped dose

Adult: 4 mg at 2mg/min, every 5-10 min Ped: 0.1 mg/kg, max 4 mg

Lorazepam Onset

<10 min

Ativan duration

6-8hrs

Be prepared to do what with 2 rounds of lorazepam

Intubate

Lipid solubility of benzos most to least

Dizepam(valium) Lorazepam(ativan) Midazolam(Versed)

Which benzo is water soluble

Versed(midazolam)

Midazolam Adult dose

10 mg IM once 5-10 mf IV .1mg/kg 5-10 mg IN, max 15 mg 10 mg buccal, max 30 mg

Versed ped dose

0.1 mg/kg IV, max 5 mg 0.2 mg/kg IM/IN, max 10 mg

Midazolam Onset

1-3 min IV

Duration Versed

2-6 hrs IV

Don't give midazolam to who?

Alcoholics

MOA Mag sulfate

Reduces striated muscle contraction and block peripheral NM transmission by reducing ACH release at myoneural junction

CIDCs Mag sulfate

Heart block or myocardial damage, hypotension

Dose for mag sulfate

Eclampsia 1-4 g of a 10% solution IV/IO over 3 min Max dose 30-40 g/day

SE mag sulfate

Hypotension, facial flushing, hyporeflexia, bradycardia, resp depress, diaphoresis

How to reverse Mag sulafate

CaCl, Calcium glucanate

IDCs of Decadron

CNS infection

Dexamethasone Dose

10 mg IV once

Decadron SE

>3wk infection susceptibility Adrenal suppression & cushing syndrome

Thiamine

Vitamin B1

MOA Thiamine

Combines with ATP to form thiamine pyrophosphate, a coenzyme for carb metabolism

IDCs of Thiamine

Hypoglycemia with malnourishment Suspected alcoholism Wernicke's encephalopathy

CIDC thiamine

None in prehospital

Thiamine dose adult/ped

Adult 100mg slow IV Ped Nope

Onset Thiamine

IV: Rapid IM: 5-15 min

Mannitol

Osmitrol

Mannitol Class

Osmotic Diuretic

MOA Osmitrol

Promoted movement of fluid from intracellular space to extracellular space. -decreases cerebral edema and ICP -promoted urinary excretion of toxins

IDCs Mannitol

Cerebral edema, ICP, IOP

Osmitrol Adult/ped dose

Adult: 0.5-1g/kg over 30 min, followed by 0.25-2g/kg every 4-6 min Ped: 0.5-1 g/kg IV,IO over 30-60 min

Mannitol Onset

15 min for ICP

Duration of osmitrol

3-8 hrs

SE Mannitol

HA, vomiting, wheezing, sore throat

CIDCs Osmitrol

Hypotension, PE, severe dehydration, Intracranial bleeding, HF

Always use what with mannitol

In-line filter and have vent ready cause it's a bronchocontrictor

Oxymetazoline MOA

Stimulates alpha-adrenergic receptors in the arterioles of the nasal mucosa to promote vasoconstriction

IDC Afrin

Nasal congestion, epistaxis

CIDCs oxymetazoline

Heart disease, HTN, CAD

Afrin Dose

2 puffs per nostril/12 hrs

Onset of afrin

<10 min

SE Oxymetazoline

Rebound nasal congestion Nasal mucosa irritation

Med Pharm 2 Flashcards

(81 cards)