Medical Drugs Flashcards
(147 cards)
1
Q
D10 Class
A
Hypertonic Dextrose containing solution
2
Q
D10 Mechanism of Action
A
10% dextrose in water provies nutrients in the form of dextrose as well as free water
3
Q
D10 Indications
A
Neonatal resuscitation, hypoglycemia
4
Q
D10 Contraindications
A
D10W should not be used as a hypovolemic volume replacement
5
Q
D10 Adverse reactions and side effects
A
Rare in the therapeutic dosages
6
Q
D10 Drug Interactions
A
Should not be used with phenytoin(Dilantin) or amiodarone(Inocor)
7
Q
D10 Dosage and Administration for Neonates
A
a 10% dextrose solution may be given as an IV boilus(2mL/kg) if the newborns blood glucose level is less than 40 mg/dL and the infant is symptomatic, with a recheck of the blood glucose in about 30 minutes. IV administration of dextrose often needs to be followed by a 10% dextrose infusion run at 60 to 100 mL/kg/d. Infusion of dextrose is based on the newborns gestational age (60 mL/kg per day for a full term newborn; adjusted upward based on the recommendations of the referring hospital for premature newborns)
8
Q
D10 Duration of action
A
Short term therapy
9
Q
D10 Special considerations
A
None
10
Q
D50 Class
A
Carbohydrate, antihypoglycemic
11
Q
D50 Mechanism of action
A
Rapidly increases serum glucose levels. short term osmotic diuresis
12
Q
D50 Indications
A
Hypoglycemia, altered level of consciousness, coma of unknown origin, seizure of unknown origin, status epilepticus
13
Q
D50 Contraindications
A
Intracranial hemorrhage
14
Q
D50 Adverse reactions and side effects
A
Extravasation leads to tissue necrosis. Cerebral hemorrhage; cerebral ischemia; pulmonary edema; warmth, pain, burning from IV infusion; hyperglycemia
15
Q
D50 Drug Interactions
A
Sodium Bicarbonate, warfarin(Coumadin)
16
Q
D50 Dosage and administration adult
A
25g slow IV push.
17
Q
D50 Duration of action
A
onset: Less than 1 minute
peak: variable
duration: variable
18
Q
Diphenhydramine (Benadryl) Class
A
Antihistamine (H1 blocker)
19
Q
Diphenhydramine (Benadryl) Mechanism of action
A
Blocks H1 histamine receptors in the respiratory tract, blood vessels, and GI smooth muscle; decreases motion sickness. Reverse extrapyramidal reactions.
20
Q
Diphenhydramine (Benadryl) Indications
A
Symptomatic relief of allergies, allergic reactions, and anaphylaxis. Blood administration reactions; used for motion sickness and relief of acute dystonic reactions caused by phenothiazines; may be useful in phenothiazine overdoses.
21
Q
Diphenhydramine (Benadryl) Contraindications
A
Hypersensitivity to antihistamines, newborns or premature infants, breastfeeding. Use with caution in infants, children, and older adults and in patients with asthma, narrow angle glaucoma, or patients taking MAOIs
22
Q
Diphenhydramine (Benadryl) Adverse Reactions and Side Effects
A
Drowsiness, sedation, seizures, dizziness, headache, blurred vision, wheezing, thickening of bronchial secretions, palpitations, hypotension, dysrhythmias, dry mouth, diarhea, nausea, vomiting. Hallucinations, confusion, and paradoxical CNS excitation can occur in children.
23
Q
Diphenhydramine (Benadryl) Drug Interactions
A
Potentiates effects of alcohol and other CNS depressants. MAOI’s prolong and intensify the anticholinergic(drying) effects of diphenhydramine.
24
Q
Diphenhydramine (Benadryl) Adult Dosage and Administration
A
25 to 50 mg IM, IV, PO.
25
Diphenhydramine (Benadryl) Pediatric Dosage and Administration
1 to 2 mg/kg IV, IO slowly, or IM. If PO 5 mg/kg per 24 hours.
26
Diphenhydramine (Benadryl) Duration of action
onset: 15 to 30 minutes
peak: 1 hour
duration: 3 to 12 hours
27
Diphenhydramine (Benadryl) Pregnancy safety Category
B
28
Diphenhydramine (Benadryl) Special considerations
Diphenhydramine (Benadryl) increases the effectiveness of epinephrine and is often used in conjunction with it, as in anaphylaxis.
29
Flumazenil (Romazicon) Class
Benzodiazepine antagonist, antidote
30
Flumazenil (Romazicon) Mechanism of action
antagonizes the action of benzodiazepines on the CNS, reversing the sedative effects
31
Flumazenil (Romazicon) Indications
Reversal of respiratory depression and sedative effects from pure benzodiazepine overdose.
32
Flumazenil (Romazicon) Contraindications
Hypersensitivity, tricyclic antidepressant overdose, seizure prone patients, coma of unknown etiology
33
Flumazenil (Romazicon) Adverse reactions and side effects
Seizures, dizziness, agitation, confusion, headache, visual disturbances, dysrhythmias, chest pain, hypertension, nausea, vomiting, vomiting, hiccups, rigors, shivering, pain at the injection site.
34
Flumazenil (Romazicon) Drug Interactions
Toxic effects of mixed drug overdose (especially tricyclics)
35
Flumazenil (Romazicon) Adult Dosage and Administration
First dose: 0.2 mg IV/IO over 15 seconds
Second dose: 0.3 mg may be given over 30 seconds;if no response give third dose.
Third dose: 0.5 mg IV/IO over 30 seconds; if no response repeat dose until adequate response or 3mg has been given.
36
Flumazenil (Romazicon) Pediatric Dosage and Administration
Not recommended
37
Flumazenil (Romazicon) Duration of action
onset: 1 to 2 minutes
peak: related to plasma concentration on benzodiazepines
duration: related to plasma concentration of benzodiazepines
38
Flumazenil (Romazicon) Pregnancy Safety category
C
39
Flumazenil (Romazicon) Special Considerations
Be prepared to manage seizures in patients who are physically dependent on benzodiazapines or who have ingested larger doses of other drugs. Flumazenil may precipitate withdrawal syndromes in patients dependent on benzodiazepines. Monitor patients for resedation and respiratory depression; be prepared to assist ventilations. Not recommended in combined drug overdoses, especially with TCAs; may result in death. Controversial use in unknown overdose or polysubstance overdose.
40
Glucagon (GlucaGen) Class
Hyperglycemic agent, pancreatic hormone, insulin antagonist
41
Glucagon (GlucaGen) Mechanism of Action
Increases blood glucose level by stimulating glycogenolysis. Unknown mechanism of stabilizing cardiac rhythm in beta blocker overdose. Minimal Positive inotropic and chronotropic response. Decreases GI motility and secretions
42
Glucagon (GlucaGen) Indications
Altered level of conciousness when hypoglycemia is suspected. May be used as a reversal agent in beta blocker and calcium channel blocker overdoses.
43
Glucagon (GlucaGen) Contraindications
Hyperglycemia, hypersensitivity
44
Glucagon (GlucaGen) Adverse Reactions and Side Effects
Dizziness, headache, hypertension, tachycardia, nausea, vomiting, rebound hypoglycemia
45
Glucagon (GlucaGen) Drug Interactions
Incompatible in solution with most other substances. No significant drug interactions with other emergency medications.
46
Glucagon (GlucaGen) Adult Dosage and Administration
Hypoglycemia: 1mg IM/IN, may repeat in 7 to 10 minutes.
Calcium channel blocker or beta blocker overdose: 3 to 10 mg IV slowly over 3 to 5 minutes initially, followed by a 3 to 5 mg/h infusion as necessary.
47
Glucagon (GlucaGen) Pediatric Dosage and Administration
Hypoglycemia: 1 mg IM/IN if 20 kg or greater (or 5 years or more); 0.5 mg IM/IN if less than 20 kg or younger than 5 years.
Calcium Channel or beta blocker toxicity: 0.05 to 0.15 mg/kg IV/IO over 3 to 5 minutes initially, followed by a 0.05 to 0.10 mg/kg per hour infusion as necessary.
48
Glucagon (GlucaGen) Duration of Action
onset: 1 minute
peak: 5 to 20 minutes
duration: 60 to 90 minutes
49
Glucagon (GlucaGen) Pregancy safety category
B
50
Glucagon (GlucaGen) Special Considerations
Ineffective if glycogen stores depleted. Should always be used in conjunction with D50 whenever possible. If patient does not respond to second dose of glucagon, D50 must be administered. Requres reconstitution with the supplied solution.
51
Haloperidol Lactate (Haldol) Class
Tranquilizer, antipsychotic
52
Haloperidol Lactate (Haldol) Mechanism of Action
Inhibits CNS catecholamine receptors: strong antidopaminergic and weak anticholinergic. Acts on CNS to depress subcortical areas, midbrain, and ascending reticular activating system in the brain.
53
Haloperidol Lactate (Haldol) Indications
Acute psychotic episodes
54
Haloperidol Lactate (Haldol) Contraindications
Parkinson disease, depressed mental status, agitation secondary to shock and hypoxia, hypersensitivity
55
Haloperidol Lactate (Haldol) Adverse Reactions and Side Effects
Seizures, sedation, confusion, restlessness, extrapyramidal reactions, dystonia, respiratory depression, hypotension, QT prolongation, sudden cardiac death, constipation, dry mouth, nausea, vomiting, drooling, blurred vision.
56
Haloperidol Lactate (Haldol) Drug Interactions
Enhanced CNS depression and hypotension in combination with alcohol. Antagonized amphetamines and epinephrine. Other CNS depressants may potentiate effects
57
Haloperidol Lactate (Haldol) Adult dosage and administrations
2 to 5 mg IM only ever 30 to 60 minutes until sedation is achieved
58
Haloperidol Lactate (Haldol) Pediatric Dosage and Administration
Not recommended
59
Haloperidol Lactate (Haldol) Duration of Action
onset: 10 minutes
peak: 30 to 45 minutes
duration: variable
60
Haloperidol Lactate (Haldol) Pregnancy Safety Category
C
61
Haloperidol Lactate (Haldol) Special Considerations
Treat hypotension secondary to haloperidol with fluids and norepinephrine, not epinephrine. Patient may also be taking benztropine mesylate if on long term therapy with haloperidol
62
Hydroxocobalamin(Cyanokit) Class
Antidote, Cyanide poisoning adjunct
63
Hydroxocobalamin(Cyanokit) Mechanism of Action
Binds with cyanide to form nontoxic cyanocobalamin, preventing its toxic effects; excreted renally
64
Hydroxocobalamin(Cyanokit) Indications
Treatment of known or suspected cyanide poisoning
65
Hydroxocobalamin(Cyanokit) Contraindications
None in the emergency setting
66
Hydroxocobalamin(Cyanokit) Adverse Reactions and Side Effects
Hypertension, allergic reactions, GI bleeding, nausea, vomiting, dyspepsia, dyspnea, dizziness, headache, injection site reactions.
67
Hydroxocobalamin(Cyanokit) Drug Interactions
Do not administer in the same IV line with Diazepam, dobutamine, dopamine, fentanyl, NTG, propofol, sodium nitrate, and sodium thiosulfate
68
Hydroxocobalamin(Cyanokit) Adult Dosage and Administration
5g IV infusion over 15 minutes at a rate of 15 mL/min, one time, may be repeated one time at the same dose.
69
Hydroxocobalamin(Cyanokit) Pediatric Dosage and Administration
70 mg/kg IV one time, may be repeated one time at same dose.
70
Hydroxocobalamin(Cyanokit) Duration of action
onset: Rapid
peak: 8 to 10 minutes
duration: varies
71
Hydroxocobalamin(Cyanokit) Pregancy safety category
c
72
Hydroxocobalamin(Cyanokit) Special Considerations
Make sure to reassess the patients airway, oxygenation, and hydration during administration. The patient may become hypertensive during treatment and will return to baseline within 4 hours.
73
Magnesium Sulfate Class
Electrolyte, anti-inflammatory
74
Magnesium Sulfate Mechanism of Action
Reduces striated muscle contractions and blocks peripheral meuromuscular transmission by reducing acetylcholine release at the myoneural junction. Manages seizures in toxemia of pregnancy. Induces uterine relaxation. Can cause bronchodilation after beta-agonists and anticholinergics have been administered
75
Magnesium Sulfate Indications
Seizures of eclampsia (toxemia of pregnancy), torsades de pointed, hypomagnesemia, VF/pulseless VT that is refractory to amiodarone, life threatening dysrhythmias due to digitalis toxicity, severe status asthmaticus, and severe bronchoconstriction with impending respiratory failure.
76
Magnesium Sulfate Contraindications
Heart block, myocardial damage
77
Magnesium Sulfate Adverse reactions and side effects
Drowsiness, CNS depression, respiratory depression, respiratory tract paralysis, abnormal ECG, AV block, hypotension, vasodilation, hyporeflexia
78
Magnesium Sulfate Drug Interactions
May enhance effects of other CNS depressants. Serious changes in overall cardiac function may occur with cardiac glycosides.
79
Magnesium Sulfate Adult Dosage and Administration
Seizure activity associated with pregnancy: 1 to 4 g of 10% solution IV/IO over 3 minutes.
Max: 30 to 40g/day
Cardiac arrest due to hypomagnesemia or torsades do pointes: 1 to 2 g of 10% solution IV/IO over 5 to 20 minutes.
Torsades de pointes with pulse: Loading dose of 1 to 2 g in 50 to 100 mL of D5W over 5 to 60 minutes IV. follow with 0.5 to 1 g/h IV(titrate to control torsades)
Status Asthmaticus: 1 to 2 g IV over 15 to 30 minutes
Severe bronchoconstriction or impending respiratory failure: 40 mg/kg IV max of 2g
80
Magnesium Sulfate Pediatric Dosage and Administration
Pulseless VT with torsades de pointes: 25 to 50mg /kg IV/IO of a 10% solution over 10 to 20 min Max: 2 g
Torsades de Pointes with pulses or hypomagnesemia: 25 to 50 mg/kg IV/IO of 10% solution over 10 to 20 minutes. max 2g
Status Asthmaticus: 30 to 60 mg/kg IV/IO of a 10% solution over 15 to 30 min max 2g
81
Magnesium Sulfate Duration of Action
onset IV/IO: immediate
peak: variable
duration IV/IO 30 min
82
Magnesium Sulfate Pregnancy Safety Category
D
83
Magnesium Sulfate Special Considerations
Due to confirmed evidence of human fetal risk must be used cautiously although administration may be justified.
IV calcium gluconate or calcium chloride should be available as an antagonist to magnesium if needed. Use with caution in patients with renal failure.
84
Naloxone Hydrochloride (Narcan) Class
Opiod antagonist, antidote
85
Naloxone Hydrochloride (Narcan) Mechanism of action
Competitive inhibition at narcotic receptor sites. Reverses respiratory depression secondary to opiate drugs. Completely inhibits the effect of morphine.
86
Naloxone Hydrochloride (Narcan) Indications
Opiate overdose, complete or partial reversal of CNS and respiratory depression induced by opiods, decreased level of consciousness, coma of unknown origin. Narcotic agonist for the following: morphine, heroin, hydromorphone(Dilaudid), methadone, meperidine(Demerol), paregoric, fentanyl(Sublimaze), oxycodone(Percodan), codeine, propoxyphene(Darvon). Narcotic agonist and antagonist for the following: butorphanol(Stadol), pentazocine(Talwin), nalbuphine(Nubain)
87
Naloxone Hydrochloride (Narcan) Contraindications
Use with caution in narcotic dependent patients. Use with caution in neonates of narcotic addicted mothers
88
Naloxone Hydrochloride (Narcan) Adverse Reactions and Side Effects
Restlessness, seizures, dyspnea, pulmonary edema, tachycardia, hypertension, dysrhythmias, cardiac arrest, nausea, vomiting, withdrawal symptoms in opiod addicted patients, diaphoresis.
89
Naloxone Hydrochloride (Narcan) Drug interactions
Incompatible with bisulfate and alkaline solutions
90
Naloxone Hydrochloride (Narcan) Adult dosage and administration
0.4 to 2 mg IV/IO/IM/subq/ET/IN(diluted); minimum single dose:2mg.
Repeat at 5 min intervals to a maximum total dose of 10mg
For IN route, administer half the dose in each nostril; maximum dose is 1 mL per nostril.
91
Naloxone Hydrochloride (Narcan) Pediatric Dosage and Administration
0.1 mg/kg per dose IV/IO/IM/ET every 2 minutes as needed. Maximum total dose of 2 mg. If no response in 10 min, administer an additional 0.1 mg/kg per dose
92
Naloxone Hydrochloride (Narcan) Duration of Action
onset: Less than 2 min
peak: Variable
duration 30 to 60 min
93
Naloxone Hydrochloride (Narcan) Pregnancy Safety category
C
94
Naloxone Hydrochloride (Narcan) Special Considerations
Assist ventilations prior to administration to avoid sympathetic stimulation. Seizures without causal relationship have been reported. May not reverse hypotension. Use with caution when administering to narcotic addicts(potential violent behavior) Half life of naloxone is often shorter than the halflife narcotics; repeat dosing may be required. In cardiac arrest, naloxone is generally not beneficial.
95
Ondansetron Hydrochloride(Zofran) Class
Serotonin receptor antagonist, antiemetic
96
Ondansetron Hydrochloride(Zofran) Mechanism of Action
Blocks action of serotonin, a natural substance that causes nausea and vomiting
97
Ondansetron Hydrochloride(Zofran) Indications
Prevention and control of nausea or vomiting. Used in hospitals for patients undergoing chemotherapy or surgical procedures.
98
Ondansetron Hydrochloride(Zofran) Contraindications
Known hypersensitivity to ondansetron or other 5-HT3 receptor antagonists
99
Ondansetron Hydrochloride(Zofran) Adverse Reactions and Side Effects
Headache, malaise, wheezing, bronchospasm, AF abnormal ECG, prolonged QT interval, ST segment depression, second degree AV block, constipation, diarrhea, hives, skin rash
100
Ondansetron Hydrochloride(Zofran) Drug interactions
Not recommended if the patient is taking apomorphine, mesoridazine, pimozide, or thioridazine.
101
Ondansetron Hydrochloride(Zofran) Adult Dosage and Administration.
4 mg IV/IM/PO/SL, may repeat once in 10 minutes
| Acute mountain sickness: 4 mg IV/PO/SL every 6 hours
102
Ondansetron Hydrochloride(Zofran) Pediatric Dosage and Administration
between age 6 months and 14 years: 0.15 mg/kg IV/PO; max 4mg
103
Ondansetron Hydrochloride(Zofran) duration of action
onset: 30 min
peak: 2 hours
duration: 3 to 6 hr
104
Ondansetron Hydrochloride(Zofran) Pregnancy Sagety Category
B
105
Ondansetron Hydrochloride(Zofran) Special Considerations
Use with caution during pregnancy and while breastfeeding.
106
Oxytocin (Pitocin) Class
Pituitary Hormone
107
Oxytocin (Pitocin) Mechanism of action
Increases uterine contractions
108
Oxytocin (Pitocin) Indications
Postpartum hemorrhage after infant or placental delivery
109
Oxytocin (Pitocin) Contraindications
Presence of second fetus, unfavorable fetal position
110
Oxytocin (Pitocin) Adverse reactions and Side Effects.
Coma, seizures, anxiety, subarachnoid hemorrhage, hypotension, tachycardia, dysrhythmias, chest pain, nausea, vomiting, painful uterine contractions, uterine rupture
111
Oxytocin (Pitocin) Drug Interactions
Other vasopressors may potentiate hypotension
112
Oxytocin (Pitocin) Adult Dosage and Administration
IM: 10 units IM following delivery of placenta.
IV: Mix 10 to 40 units in 1000 mL of nonhydrating diluent, infused at 20 to 40 milliunits/min. Titrated to severity of bleeding and uterine response.
113
Oxytocin (Pitocin) Pediatric Dosage and Administration
Not applicable
114
Oxytocin (Pitocin) Duration of Action
onset: IM: 3 to 5 min ; IV: immediate
peak: variable
duration: IM: 30 to 60 min ; IV: 20 minutes after infusion is stopped.
115
Oxytocin (Pitocin) Pregnancy Safety Category
C
116
Oxytocin (Pitocin) Special Considerations
Monitor Vital signs including fetal heart rate and uterine tone closely
117
Prochlorperazine (Compazine) Class
Antiemetic, typical antipsychotic
118
Prochlorperazine (Compazine) Mechanism of Action
By depressing the chemoreceptor trigger zone, severe nausea and vomiting is reduced
119
Prochlorperazine (Compazine) Indications
Nausea and vomiting
120
Prochlorperazine (Compazine) Contraindications
Hypersensitivity, altered level of consciousness, children under 20 pounds (9 kg) or age 2 years.
121
Prochlorperazine (Compazine) Adverse Reactions and Side Effects
Aspiration, seizures, prolonged QT interval, extrapyramidal reactions.
122
Prochlorperazine (Compazine) Drug interactions
CNS depressants, antihistamines, antipsychotics.
123
Prochlorperazine (Compazine) Adult Dosage and Administration
5 to 10 mg IV/IM/PO.
124
Prochlorperazine (Compazine) Pediatric Dosage and Administration
Over age 2 or greater than 9 kg: 0.2 mg/kg slow IV or Deep IM; maximum dose is 10 mg
125
Prochlorperazine (Compazine) Duration of action
onset: rapid
peak effect: 10 to 30 minutes
duration: 3 to 4 hours
126
Prochlorperazine (Compazine) Pregnancy safety category
C
127
Prochlorperazine (Compazine) Special Considerations
Contraindicated for use in women breastfeeding women
128
Promethazine Hydrochloride (Phenergan) Class
Phenothiazine, antiemetic, antihistamine
129
Promethazine Hydrochloride (Phenergan) Mechanism of Action
H-1 receptor antagonist; blocks action of histamine; possesses sedative, anti-motion, antiemetic, and anticholinergic activity; potentiates the effects of narcotics to induce analgesia
130
Promethazine Hydrochloride (Phenergan) Indications
Nausea/vomiting, motion sickness, sedation for patients in labor, potentiates the analgesic effects of
narcotics
131
Promethazine Hydrochloride (Phenergan) Contraindications
Coma, CNS depression from alcohol, barbiturates, or narcotics, Reye syndrome, lower respiratory symptoms(asthma)
132
Promethazine Hydrochloride (Phenergan) Adverse Reactions and Side Effects
Headache, Dizziness, drowsiness, confusion, restlessness, wheezing, chest tightness, thickening of bronchial secretions, palpitations, bradycardia, reflex tachycardia, QT prolongation, postural hypotension, diarrhea, nausea, vomiting.
133
Promethazine Hydrochloride (Phenergan) Drug Interactions
Additive with other CNS depressants, increased extrapyramidal effects with MAOIs
134
Promethazine Hydrochloride (Phenergan) Adult Dosage and Administration
12.5 to 25 mg IV, deep IM, PO, PR
135
Promethazine Hydrochloride (Phenergan) Pediatric Dosage and administration
older than 2: 0.25 to 0.5 mg/kg deep IM
136
Promethazine Hydrochloride (Phenergan) Duration of action
onset: IV: immediate
peak: 30 to 60 min
duration: 4 to 6 hr
137
Promethazine Hydrochloride (Phenergan) Pregnancy Safety Category
C
138
Promethazine Hydrochloride (Phenergan) Special Considerations
Convulsions and sudden death when used with children. Use with caution in patients with asthma, peptic ulcer, and bone marrow suppression. do not use in children with vomiting of unknown etiology. Avoid intra arterial injection. Warn patients of impending burning sensation. Some systems have removed IM administration because of reported pain and potential for tissue necrosis.
139
Thiamine (B1) Class
Vitamin
140
Thiamine (B1) Mechanism of Action
Assists in converting glucose into energy
141
Thiamine (B1) Indications
```
coma of unknown origin
Chronic alcoholism with associated coma
delirium tremens
precursor of d50 to prevent wernickes encephalopathy(problem with neurotransmitters in brain which results in retained altered LOC) in alcoholics
Beriberi (thiamine deficiency)
```
142
Thiamine (B1) Contraindications
None
143
Thiamine (B1) Precautions
When giving with D50 and Narcan, must precede d50 and give in the following order: Thiamin, D50, Narcan
144
Thiamine (B1) Side Effects
Slight vasodilation and hypotension
| Overdoses may result in weakness, dyspnea and respiratory failure(rare)
145
Thiamine (B1) Adult Dosage and Administration
100 mg
146
Thiamine (B1) Route
IV or IM
147
Thiamine (B1) Pediatric Dosage
10 - 25 mg slow IV or IM
