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EMT-P (PAR 212-PHARMACOLOGY) > MEDICATION CARDS > Flashcards

Flashcards in MEDICATION CARDS Deck (126):
1

Brand name for Lactated Ringers?

Hartman's solution

2

Lactated Ringers class?

Isotonic crystalloid solution

3

Lactated Ringer's MOA?

Lactated Ringer’s replaces water and
electrolytes

4

Lactated Ringer's indications?

Hypovolemic shock; keep open IV

5

Lactated Ringer's contraindications?

Lactated Ringer’s should not be used in patients with congestive heart failure or renal failure

6

Lactated Ringer's onset/duration?

Short-term therapy

7

Lactated Ringer's side effects and adverse reactions?

Rare in therapeutic dosages

8

Lactated Ringer's precautions/considerations?

None

9

Lactated Ringer's route-does for adults and pets?

Hypovolemic shock; titrate according to patient’s physiologic response;
Lactated Ringer’s is supplied in 250-, 500-, and 1,000-mL bags, IV infusion

10

0.9% Sodium Chloride brand name?

normal saline flush

11

0.9% Sodium Chloride class?

Isotonic crystalloid solution

12

0.9% Sodium Chloride MOA?

Normal saline replaces water and electrolytes

13

0.9% Sodium Chloride indications?

Heat-related problems (heat exhaustion, heat stroke), freshwater drowning, hypovolemia, diabetic ketoacidosis, keep open IV

14

0.9% Sodium Chloride contraindications?

The use of 0.9% sodium chloride should not be considered in patients with congestive heart failure because circulatory overload can be easily induced

15

0.9% Sodium Chloride onset/duration?

Short-term therapy

16

0.9% Sodium Chloride side effects and adverse reactions?

Rare in therapeutic dosages

17

0.9% Sodium Chloride precautions/considerations?

None

18

0.9% Sodium Chloride route/dose for adult and peds?

The specific situation being treated will dictate the rate in which normal saline will be administered. In severe heatstroke, diabetic ketoacidosis, and freshwater drowning, it is likely that you will be called on to administer the fluid quite rapidly. In other cases, it is advis- able to administer the fluid at a moderate rate (for example, 100 mL/h).

Normal saline is supplied in 250-, 500-, and 1,000-mL bags. Sterile normal saline for irrigation should not be confused with that designed for intravenous administration

19

Brand name for 5% dextrose in water?

D5W

20

5% dextrose in water class?

Hypotonic dextrose-containing solution

21

5% dextrose in water MOA?

D5W provides nutrients in the form of dextrose as well as free water

22

5% dextrose in water indications?

IV access for emergency drugs; for dilution of concentrated drugs for intravenous infusion

23

5% dextrose in water contraindications?

D5W should not be used as a fluid replacement for hypovolemic states

24

5% dextrose in water onset/duration?

Short-term therapy

25

5% dextrose in water side effects and adverse reactions?

Rare in therapeutic dosages

26

5% dextrose in water precaution considerations?

D5W should not be used with phenytoin (Dilantin) or amrinone (Inocor)

27

5% dextrose in water route-dose in adults and peds?

D5W is usually administered through a minidrip (60 drops/mL) set at a rate of “to keep open” (TKO)

D5W is supplied in bags of 50, 100, 150, 250, 500, and 1,000 mL

28

Brand name for water is?

sterile water

29

Water pregnancy class?

Pregnancy Category C

30

Water MOA?

Water is hypotonic and will cause hemolysis; readily absorbed by the tissues

31

Water indications?

Sterile Water for Irrigation USP is indicated for use as an irrigating fluid or pharmaceutic aid. Sterile Water may also be used as an adjunct in the preparation of non-intravenously administered nutrient mixtures

32

Water contraindications?

Not for injection by usual parenteral routes

33

Water onset/duration?

immediate

34

Water side effects and adverse reactions?

Possible adverse effects arising from the irrigation of body cavities, tissues, or indwelling catheters and tubes are completely avoidable when proper procedures are followed. Displaced catheters or drainage tubes can lead to irrigation or infiltration of unintended structures or cavities. Excessive volume or pressure during irrigation of closed cavities may cause undue distention or disruption of tissues. Accidental contamination from careless technique may transmit infection.

35

Water precaution considerations?

Use only if solution is clear and container and seal are intact; After opening container, its contents should be used promptly to minimize the possibility of bacterial growth or pyrogen formation; Discard unused portion of irrigating solution since it contains no preservative

36

Water route-dose for adults and peds?

The dose is dependent upon the capacity or surface area of the structure to be irrigated and the nature of the procedure. When used as a diluent or vehicle for drugs, the manufacturer’s recommendations should be followed.

Sterile Water for Irrigation, USP is supplied in single-dose 1000, 2000 and 3000 mL flexible irrigation container, single-dose 250 and 500 mL semi-rigid irrigation container, and single-dose 1000 and 1500 mL semi-rigid irrigation container

37

Etomidate Brand Name?

Amidate

38

Etomidate class?

Nonbarbiturate hypnotic, anesthesia induction agent

39

Etomidate pregnancy class?

Pregnancy safety: Category C

40

Etomidate MOA?

Short-acting hypnotic that acts at the level of the reticular activating system

41

Etomidate indications?

Premedication for tracheal intubation or cardioversion

42

Etomidate contraindications?

Hypersensitivity, labor/delivery

43

Etomidate onset/duration?

Onset: <1 minute. Peak effect: 1 minute. Duration: 5–10 minutes

44

Etomidate side effects and adverse reactions?

Apnea of short duration, respiratory depression, hypoventilation, hyperventilation, dys- rhythmias, hypotension, hypertension, nausea, vomiting, involuntary muscle movement, pain at injection site

45

Etomidate precaution considerations?

Carefully monitor vital signs. Etomidate can suppress adrenal gland production of steroid hormones, which can temporarily cause gland failure. Consider decreasing dose in elderly and patients with cardiac conditions

46

Etomidate route-dose: adults and peds

supplied via 2 mg/ml vials

Adult: 0.2–0.6 mg/kg IV over 30–60 seconds (typical adult dose is 20 mg). Pediatric: 0.2–0.4 mg/kg IV/IO over 30–60 seconds for rapid sequence intubation (older than 10 years), 1 time only. Maximum dose: 20 mg

47

Aspirin brand name?

ASA, Bayer, Ecotrin, St. Joseph

48

Aspirin class?

Platelet inhibitor, anti-inflammatory agent

49

Aspirin pregnancy class?

Pregnancy safety: Category D

50

Aspirin MOA?

Prevents platelets from clumping together, or aggregating, and forming emboli

51

Aspirin indications?

New onset chest pain suggestive of acute myocardial infarction

52

Aspirin contraindications?

Hypersensitivity. Relatively contraindicated in patients with active ulcer disease or asthma

53

Aspirin onset/duration?

Onset: 30–45 minutes. Peak effect: Variable. Duration: Variable

54

Aspirin side effects and adverse reactions?

Bronchospasm, anaphylaxis, wheezing in allergic patients, prolonged bleeding, GI bleeding, epigastric distress, nausea, vomiting, heartburn, Reye syndrome

55

Aspirin precaution considerations?

Not recommended in pediatric population

56

Aspirin route-dose: Adult and Peds?

supplied via 81-mg, 160-mg, and 325-mg tablets. Chewable and standard

Adult: 160 mg to 325 mg PO. Chewing is preferable to swallowing. Pediatric: Not recommended

57

succinylcholine chloride brand name?

Anectine

58

succinylcholine chloride class?

Neuromuscular blocker, depolarizing; skeletal muscle relaxant

59

succinylcholine chloride schedule pregnancy?

Pregnancy safety: Category C

60

succinylcholine chloride MOA?

Ultra-short-acting depolarizing skeletal muscle relaxant that mimics acetylcholine as it binds with the cholinergic receptors on the motor end plate, producing a phase 1 block as manifested by fasciculations

61

succinylcholine chloride indications?

Rapid-sequence intubation

62

succinylcholine chloride contraindications?

Acute narrow-angle glaucoma, penetrating eye injuries, malignant hyperthermia. Acute injury after multi- system trauma, major burns, or extensive muscle injury. Inability to control airway or support ventilations with oxygen and positive pressure

63

succinylcholine chloride onset/duration?

Onset: 1 minute. Peak effect: 1–3 minutes. Duration: 5–10 minutes

64

succinylcholine chloride side effects and adverse reactions?

Apnea, respiratory depression, bradydysrhythmia, tachydysrhythmia, dysrhythmia, cardiac arrest, salivation, prolonged muscle rigidity, rhabdomyolysis, malignant hyperthermia, increased intraocular pressure, hyperkalemia (trauma patients)

65

succinylcholine chloride precaution considerations?

If the patient is conscious, explain the effects of the drug before administration. Consider premedication with atropine, particularly in pediatric age group. Premedication with lidocaine may blunt any increase in intracranial pressure during intubation. Etomidate, diazepam, or midazolam should be used in any conscious patient before undergoing neuromuscular blockade

66

succinylcholine chloride route-dose: Adult/Peds?

supplied via 20 mg/mL vials

Adult: 1–1.5 mg/kg rapid IV. Repeat once if needed. Pediatric: 1–1.5 mg/kg rapid IV/IO. Repeat once if needed. 2 mg/kg in infants

67

Vecuronium Bromide brand name?

Norcuron

68

Vecuronium Bromide class?

Neuromuscular blocker, nondepolarizing

69

Vecuronium Bromide schedule pregnancy?

Pregnancy safety: Category C

70

Vecuronium Bromide MOA?

Neuromuscular agent with intermediate duration of action that competes with acetylcholine for receptors at the motor end plate, resulting in neuromuscular
blockade

71

Vecuronium Bromide indications?

Rapid-sequence intubation

72

Vecuronium Bromide contraindications?

Acute narrow-angle glaucoma, penetrating eye injuries, inability to control airway or support ventilations with oxygen and positive pressure, newborns, myasthenia gravis, hepatic or renal failure

73

Vecuronium Bromide onset/duration?

Onset: 1–3 minutes. Peak effect: Varies. Duration: 45–90 minutes

74

Vecuronium Bromide side effects and adverse reactions?

Weakness, prolonged neuro- muscular block, bronchospasm, apnea, dysrhythmias, brady- cardia, tachycardia, PVCs, transient hypotension, cardiac arrest, excessive salivation

75

Vecuronium Bromide precaution considerations?

If patient is conscious, explain the effect of the medication before administration and always sedate the patient before using vecuronium. Intubation and ventilatory support must be readily available. Monitor the patient carefully. Vecuronium has no effect on consciousness or pain. Will not stop neuronal seizure activity. Pulse rate and cardiac output are increased. Decrease doses for patients with renal disease

76

Vecuronium Bromide route-dose: Adult/peds?

supplied via 10- and 20-mg powder (requires reconstitution before administration)

Adult: 0.1–0.2 mg/kg IV push. Maintenance dose within 45–60 minutes: 0.8–1.2 mg/kg IV push. Pediatric: 0.1–0.3 mg/kg IV/IO. Maintenance dose within 20–35 minutes: 0.01–0.05 mg/kg IV/IO push

77

Ketamine brand name?

Ketalar

78

ketamine class?

anesthetic

79

ketamine pregnancy class?

pregnancy class B

80

Ketamine MOA?

acts on cortex and limbic receptors, producing dissociative analgesia and sedation

81

Ketamine indications?

sole anesthetic agent for diagnostic and surgical procedures not requiring skeletal relaxation; induction prior to other general anesthesia; supplment to low potency agents

82

Ketamine contraindications?

Hypersensitivity; Conditions in which an increase in blood pressure would be hazardous; stroke

83

Ketamine onset/duration?

varied depending on dose, route, age. Rapid induction if administered intravenously

84

Ketamine side effects and adverse reactions?

emergency reactions, HTN, increased cardiac output, increased ICP, tachycardia, tonic clonic movements, visual hallucinations, vivid dreams
1-10% - bradycardia, diplopia, hypotension, increased IOP, injection site pain, nystagmus
<1% - anaphylaxis, cardiac arrhythmia, depressed cough reflex, fasciculations, hypersalivation, increased IOP, increased metabolic rate, hypertonia,, laryngospasm, respiratory depression

85

Ketamine precaution consideration?

administered under supervision of medical professionals with resuscitative equipment available for ready use. Overdosage may lead to respiratory depression; be cautious for use on patients with glaucoma, seizures, mental illness, hypertension, respiratory infections

86

Ketamine route-dose:
adult/peds?

adults
IV: 1-4.5 mg/kg slow IV once
0.5-2 mg/kg slow IV if adjuvant drugs (eg, midazolam) are used
IM: 6.5-13 mg/kg IM once
Alternatively (off-label): 4-10 mg/kg IM once if adjuvant drugs (eg, midazolam) are used

Peds, 3 months or older
IV: Various recommendations, 1.5-2 mg/kg over 30-60 sec
IM: 4-5 mg/kg IM once; may give a repeat dose (range 2-5 mg/kg) if sedation inadequate after 5-10 min or if additional doses are required

16 years or older
IV: 1-4.5 mg/kg slow IV once; 0.5-2 mg/kg slow IV if adjuvant drugs (eg, midazolam) are used
IM: 6.5-13 mg/kg IM once; 4-10 mg/kg IM once if adjuvant drugs (eg, midazolam) are used

87

Lorazepam brand name?

Ativan

88

Lorazepam class?

Benzodiazepine, short/intermediate acting; sedative, anticonvulsant, schedule IV drug

89

Lorazepam pregnancy class?

Pregnancy safety: Category D

90

Lorazepam MOA?

Anxiolytic, anticonvulsant, and sedative effect; suppresses propagation of seizure activity produced by foci in cortex, thalamus, and limbic areas

91

Lorazepam indications?

Initial control of status epilepticus or severe recurrent seizures, severe anxiety, sedation

92

Lorazepam contraindications?

Acute narrow-angle glaucoma, coma, shock, suspected drug abuse

93

Lorazepam onset/duration?

Onset: 1–5 minutes. Peak effect: Variable. Duration: 6–8 hours

94

Lorazepam side effects and adverse reactions?

Dizziness, drowsiness, CNS depression, headache, sedation, respiratory depression, apnea, hypotension, bradycardia

95

Lorazepam precaution considerations?

Monitor respiratory rate and blood pressure during administration. Have advanced airway equipment readily available. Inadvertent arterial injection may result in vasospasm and gangrene. Lorazepam expires in 6 weeks when not refrigerated

96

Lorazepam route-dose: Adult/Peds?

supplied via 2 and 4 mg/mL vials and Tubex syringes

When given IV/IO, must be diluted with equal volume of sterile water or sterile saline. When given IM, lorazepam is not diluted. Adult: 2–4 mg slow IM/IV at
2 mg/min; may be repeated in 15–20 minutes. Maximum dose of 8 mg. For sedation: 0.05 mg/kg up to 4 mg IM. Pediatric: 0.05– 0.20 mg/kg slow IV/IO/IM over 2 minutes. May be repeated once in 5–20 minutes. Maximum dose of 0.2 mg/kg

97

midazolam brand name?

Versed

98

midazolam class?

Benzodiazepine, short/intermediate acting; schedule IV drug

99

midazolam pregnancy class?

Pregnancy safety: Category D

100

midazolam MOA

Reversibly interacts with gamma-amino butyric acid (GABA) receptors in the central nervous system causing sedative, anxiolytic, amnesic, and hypnotic effects

101

midazolam indications?

Sedation for medical procedures (eg, intubation, ventilated patients, cardioversion)

102

midazolam contraindications?

Acute narrow-angle glaucoma, shock, coma, alcohol intoxication, overdose, depressed vital signs. Concomitant use with barbiturates, alcohol, narcotics, or other central nervous system depressants

103

midazolam onset/duration?

Onset: 1–3 minutes, IV and dose dependent. Peak effect: Variable. Duration: 2–6 hours, dose dependent

104

midazolam side effects and adverse reactions?

Headache, somnolence, respiratory depression, respiratory arrest, apnea, hypotension, cardiac arrest, nausea, vomiting, pain at the injection site

105

midazolam precaution considerations?

Administer immediately prior to intubation procedure. Requires continuous monitoring of respiratory and cardiac function. Decrease dose by 50% in patients with hepatic and renal dysfunction

106

midazolam route-dose adult/peds?

supplied via 1 mg/mL and 5 mg/mL vials and Tubex syringes

Adult: 2–2.5 mg slow IV (over 2–3 minutes). May be repeated to total maximum: 0.1 mg/ kg. Pediatric: 0.1–0.3 mg/kg IV/IO (maximum single dose: 10 mg)

107

morphine brand name?

Roxanol, MS Contin

108

morphine class?

Opioid analgesic (schedule II narcotic)

109

morphine schedule pregnancy class?

Category C

110

morphine MOA?

Alleviates pain through CNS action. Suppresses fear and anxiety centers in the brain. Depresses brainstem respiratory centers. Increases peripheral venous capacitance and decreases venous return. Decreases preload and afterload, which decreases myocardial oxygen demand

111

morphine indications?

Severe CHF, acute cardiogenic pulmonary edema, chest pain associated with acute myocardial infarction, analgesia for moderate to severe acute and chronic pain

112

morphine contraindications?

Head injury, exacerbated COPD, depressed respiratory drive, hypotension, undiagnosed abdominal pain, decreased level of consciousness, suspected hypovolemia, patients who have taken MAOIs within 14 days

113

morphine onset/duration?

Onset: Immediate. Peak effect: 20 minutes. Duration: 2–7 hours

114

morphine side effects/adverse reactions?

Confusion, sedation, headache, CNS depression, respiratory depression, apnea, bronchospasm, dyspnea, hypotension, orthostatic hypotension, syncope, bra- dycardia, tachycardia, nausea, vomiting, dry mouth

115

morphine precaution considerations?

Morphine rapidly crosses the placenta. Safety in neonates has not been established. Use with caution in the elderly, those with asthma, and in those susceptible to central nervous system depression. Vagotonic effect in patients with acute inferior MI (bradycardia, heart block). Naloxone hydrochloride (Narcan) should be readily available as an antidote

116

morphine route-dose in adults and peds?

supplied via 2 mg/mL, 4 mg/mL, 8 mg/mL, 10 mg/mL ampules, vials, and Tubex syringe

Adult: STEMI: Initial dose: 2–4 mg slow IV (over 1–5 minutes). Repeat dose: 2–8 mg at 5–15 min- ute intervals. NSTEMI/Unstable angina. 1–5 mg IV push if symptoms not relieved by nitrates, use with caution. Pediatric: 0.1–0.2 mg/kg/dose IV, IO, IM, SC. Maximum dose: 5 mg

117

Diazepam brand name?

Valium

118

Diazepam class?

Benzodiazepine, long-acting; sedative-hypnotic; anticonvulsant; schedule IV drug

119

Diazepam pregnancy class?

Pregnancy safety: Category D

120

Diazepam MOA?

Potentiates effects of inhibitory neu- rotransmitters. Raises the seizure threshold. Induces amnesia and sedation

121

Diazepam indications?

Acute anxiety states and agitation, acute alcohol withdrawal, muscle relaxant, seizure activity, sedation for medical procedures (eg, intubation, ventilated patients, cardiover- sion), may be helpful in acute symptomatic cocaine overdose

122

Diazepam contraindications?

Hypersensitivity, narrow-angle glaucoma, myasthenia gravis, respiratory insufficiency, coma, head injury

123

Diazepam onset/duration?

Onset: 1–5 minutes. Peak effect: 15 minutes. Duration: 20–50 minutes

124

Diazepam side effects and adverse reactions?

Dizziness, drowsiness, con- fusion, headache, respiratory depression, hypotension, reflex tachycardia, nausea, vomiting, muscle weakness, tissue necrosis, ataxia, thrombosis, phlebitis

125

Diazepam precaution considerations?

Short duration for anticonvulsant effect. Reduce dose by 50% in elderly patients

126

Diazepam route-dose in adults and peds?

supplied via 5 mg/mL prefilled syringes, ampules, vials, and Tubex syringes

Adult: Seizure activity: 5–10 mg IV q 10–15 minutes PRN (5 mg over 5 minutes) (maximum dose: 30 mg). Premedication for cardioversion: 5–15 mg IV over 5–10 minutes prior to cardioversion. Pediatric: Seizure activity: 0.2 mg/kg to 0.5 mg/kg slow IV q 2–5 minutes up to 5 mg (maximum dose 10 mg/kg). Rectal diazepam: 0.5 mg/kg via 2" rectal catheter and flush with 2–3 mL air after administration