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Flashcards in Medications Deck (258):
0

What is the indication for Benadryl (diphenhydramine)?

Allergic reaction
Pediatric allergic Rxn

1

What is the dose of Benadryl that you would give to a patient having a mild allergic reaction (diphenhydramine)?

25-50 mg IV/IO/IM/PO

2

What is a contraindication for Benadryl (diphenhydramine)?

Asthma
Infants less than 3 months
Narrow angle glaucoma
Prostatic Hypertrophy

3

What dose of diphenhydramine (Benadryl) would you give to a pediatric patient experiencing a mild allergic rxn?

1mg/kg IV/IO/IM

4

What is the generic name for Zofran?

Ondansetron

5

What is the trade name for ondansatron?

Zofran

6

What is the action of Zofran (ondansetron)?

Zofran (ondansetron) antagonizes serotonin receptors.

7

What are the indications for the use of Zofran (ondansetron)?

Abdominal pain
Vomiting & diarrhea
Pediatric vomiting & diarrhea

8

What are the contraindications for the use of Zofran (ondansetron)?

Hypersensitivity
Concomitant use of apomorphine

9

What are the side effects of Zofran (ondansetron)?

Headache
Drowsiness

10

What is the adult dose/route of Zofran (ondansetron)?

ABDOMINAL PAIN — 4mg IV/IM/IO/ODT may repeat in 15 minutes
VOMITING/DIARRHEA — 4mg IV/IO/ODT may repeat in 15

11

What is the pediatric dose/route of Zofran (ondansetron)?

Serious S/S — no: 0.2mg/kg PO/ODT (max. 4mg)
Yes: 0.2mg/kg ODT -or-
0.15mg/kg IV/IO

12

What are any special considerations for the use of Zofran (ondansetron)?z

It prolongs the QT interval

13

What pregnancy category is Zofran (ondansetron)?

Pregnancy category B

14

What is the trade name for promethazine?

Phenergan

15

What is the generic name for Phenergan?

promethazine

16

What class of medication is Zofran (ondansetron)?

Antiemetic

17

What is an antiemetic?

a drug that prevents vomiting

18

What is the class of Phenergan (promethazine)?

It is an antihistamine and a antiemetic drug

19

What is the action of Phenergan (promethazine)?

It blocks H1 receptors
Possesses anticholinergic properties

20

What are the indications for Phenergan (promethazine)?

Abdominal pain
Vomiting & diarrhea

21

What are the contraindications of Phenergan (promethazine)?

Children < 2
Lactating women

22

What are the side effects of Phenergan (promethazine)?

Sedation
Respiratory depression
Induced asthma

23

What is the adult dose/route for Phenergan (promethazine)?

12.5mg IV/IO/IM repeat x 1 (as needed)

24

What is the pediatric dose/route for Phenergan (promethazine)?

None

25

What are any special considerations for the use of Phenergan (promethazine)?

Choose lower dose if reaction is suspected (ie. Age > 60)
When giving IV dilute with 10mL of NaCl & PUSH SLOWLY

26

What pregnancy category is Phenergan (promethazine)?

Pregnancy category C

27

What is the trade name for albuterol?

Proventil
Ventolin

28

What is the generic name for Ventolin and Proventil?

albuterol

29

What class of medication is albuterol?

Sympathomimetic

30

What is the action of albuterol (ALS)?

Bronchodilation

31

What are the indications for albuterol?

Allergic Rxn/anaphylaxis
Adult COPD/Asthma
Ped. Allergic Reaction
Ped. Respiratory Distress

32

What is the contraindication for albuterol?

Hypersensitivity

33

What are the side effects of albuterol?

Tremors
Paradoxical bronchospasm
Dizziness
Nausea
Angioedema

34

What is the adult dose of abuterol?

2.5-5.0mg NEB +/- 0.5mg ipratropium repeat x 3 as needed

35

What's is the pediatric dose of albuterol?

Allergic Rxn (mod/severe) 2.5-5.0mg NEB +/- 0.5mg ipratropium repeat x 3 as needed

Stridor 1.25-5.0mg NEB

Wheezing
(greater than or equal to 12 mo.) 1.25-5.0mg NEB repeat x 3 as needed
(less than 12 mo.) 1.25-2.5mg NEB repeat x 3 as needed

MAY BE USED IN CONJUNCTION WITH ATROVENT

36

What are the special considerations for albuterol?

Use with caution in patients with cardiovascular disease

37

What pregnancy category is albuterol?

C

38

What is the generic name of Xopenex?

Levalbuterol HCL

39

What is the trade name of levalbuterol HCL?

Xopenex

40

What class of medication is Xopenex?

Beta 2 agonist

41

What is the action of levalbuterol (Xopenex)?

Activates beta 2 adrenergic receptors on bronchial smooth muscles (bronchodilator)

42

What are the indications for levalbuterol (Xopenex)?

Allergic Rxn/Anaphylaxis
Adult COPD/Asthma
Ped. Allergic Rxn
Ped Respiratory distress

43

What are the contraindications of levalbuterol (Xopenex)?

Hypersensitivity

44

What are the side effects of levalbuterol (Xopenex)?

Nervousness
Tremors
Tachycardia

45

What is the adult dosage of levalbuterol (Xopenex)?

Adults & adolescents 12 years or > 0.63mg/3mL NEB

46

What is the Ped dosage of levalbuterol (Xopenex)?

(6-11 years) 0.31mg/3mL

47

What is the pregnancy category for levalbuterol (Xopenex)?

C

48

How long does levalbuterol (Xopenex) last in the system?

8 hrs

49

What is the generic name for Atrovent?

Ipratropium

50

What is the trade name for ipratropium?

Atrovent

51

What class of medication is Atrovent (ipratropium)?

Anticholinergic (parasympathetic)

52

What is the action of Atrovent (ipratropium)?

Bronchodilation (antagonizes action of acetylcholine)

53

What are the indications for Atrovent (ipratropium)?

Adult COPD/Asthma
Allergic Reaction/Anaphylaxis
Pediatric Allergic Reaction
Pediatric Respiratory Distress

54

What are the contraindications of Atrovent (ipratropium)?

Hypersensitivity to: Atrovent, atropine, soy, peanuts

55

What are the side effects of Atrovent (ipratropium)?

Dizziness/palpitation
Bronchitis
Angioedema
Paradoxical bronchospasms

56

What are the adult dosages of Atrovent (ipratropium)?

Allergic Reaction/Anaphylaxis – 0.5mg (500mcg) repeat x 3 as needed

Adult COPD/Asthma - 0.5mg repeat x 3 as needed (may be used in conjunction with Albuterol)

57

What is the pediatric dosage of Arrovent (ipratropium)?

Allergic Rxn — 0.5mg repeat x 3 as needed

Respiratory Distress — 0.5mg repeat x 3 as needed

58

What pregnancy category is Atrovent (ipratropium)?

B

59

What is the generic name for Solu-Medrol?

Methylprednisolone

60

What is the trade name for methylprednisolone?

Soul-Medrol

61

What class of medication is Solu-Medrol (methylprednisolone)?

Corticosteroid

62

What is the action of Solu-Medrol (methylprednisolone)?

Reduces pulmonary inflammation & mucous production

Reverses capillary permeability

63

What are the indications for Solu-Medrol (methylprednisolone)?

Adult COPD/Asthma
Allergic Rxn/Anaphylaxis
Ped Allergic Rxn
Ped respiratory distress

64

What are the contraindications for Solu-Medrol (methylprednisolone)?

Hypersensitivity

65

What are the side effects for Solu-Medrol (methylprednisolone)?

Rare prehospital

66

What is the adult dose of Solu-Medrol?

Mod/severe allergic Rxn - 125mg IV/IO
COPD/Asthma - 125mg IV/IO

67

What is the ped dosage of Solu-Medrol (methylprednisolone)?

Allergic Rxn (mod/severe) - 2mg/kg IV/IO max. 125mg

Respiratory Distress - stridor - 2mg/kg IV/IO max. 125mg
Wheezing - 12 mo. or greater? Yes - 2mg/kg IV/IO (max 125mg)
No - 1st episode? None
2nd or more? 2mg/kg IV/IO max. 125mg

68

What are the special considerations for Solu-Medrol (methylprednisolone)?

IM dosing only if indicated by local protocol

69

What pregnancy category is Solu-Medrol (methylprednisolone)?

C

70

What is the pregnancy category for nalaxone?

C

71

What are any special consideration for nalaxone?

May induce withdrawals
Use cautiously in drug-dependent adults/newborns

72

What is the pediatric dose of nalaxone?

0.1mg/kg IV/IO/IM/IN/ETT max. 2mg

Titrated to effect
Adequate oxygenation/ventilation
Not to be given to restore consciousness

73

What is the adult dose of nalaxone?

0.4-2mg IV/IO/IM/IN/ETT

Titrated to effect
Adequate ventilation/oxygenation
Not to be given to restore consciousness

74

What are the side effects for nalaxone?

Nausea/vomiting
Drowsiness

75

What are the contraindications of nalaxone?

Hypersensitivity

76

What is the indications for nalaxone?

Overdose/toxic ingestion
Pediatric overdose/toxic ingestion

77

Naloxone is generic for ?

Narcan

78

What is the class for Narcan ( Naloxone)?

Narcotic antagonist

79

What action does Narcan provide (Naloxone)?

Binds opioid receptors and blocks the effects of narcotics

80

What are the indications for Narcan( Naloxone)?

#31 overdose/toxic ingestion
#60 ped overdose/toxic ingestion

81

What are the contraindications for Narcan (Naloxone)?

hypersensitivity

82

What are the side effects for Narcan ? (Naloxone)

Nausea
Drowsiness

83

What is the adult Dosage for Narcan ( Naloxone)?

0.4 -2mg IV/ IO/ IM/ IN/ ETT

84

What is the dosage for Peds for Narcan( Naloxone)?

0.1 mg/kg IV/ IO/ IM/ IN/ ETT

Max 2mg

85

What pregnancy category is Narcan (Naloxone)?

C

86

What is the trade name for glucagon?

Glucogen

87

What is the generic name for Glucogen?

glucagon

88

What is the class for Glucogen (glucagon)?

Antihypoglycemic agent
Hormone

89

What is the action of Glucogen (glucagon)?

Causes the breakdown of glycogen to glucose
Increases chronotropy
Increases inotropy

90

What are the indications for Glucogen (glucagon)?

Diabetic adult
Overdose/toxic ingestion
Ped. Diabetic
Ped. Overdose/toxic ingestion

91

What are the contraindications of Glucogen (glucagon)?

Patients with inadequate glucogen stores
Malnutrition
Alcoholic
Diabetic

92

What are the side effects of Glucogen (glucagon)?

Rare in emergency setting

93

What is the dosage for Glucogen (glucagon)?

Diabetic — Blood sugar less than or equal to 69mg/dl and symptomatic:
1-2mg IM repeat in 15 minutes if needed

OD/TI — 2mg IV/IO may repeat in 15 minutes

94

What is the pediatric dose of Glucogen (glucagon)?

Diabetic — blood sugar less than or equal to 69mg/dl & symptomatic
0.1mg/kg IM may repeat every 15 minutes as needed MAX 1mg

OD/TI — beta blocker OD
0.1mg/kg IV/IO/IM max. 2mg

95

What are the special considerations for the use of Glucogen (glucagon)?

Use with caution in patients with heart/renal diseases.

96

What pregnancy category is Glucagen (glucagon)?

B

97

What is the trade name for dextrose 50%?

D50

98

What is the trade name for d50?

Dextrose 50%

99

What class is dextrose 50% (d50)?

Carbohydrate

100

What is the action of dextrose 50% (d50)?

Increases circulating glucose
Transient osmotic diuretic

101

What are the indications for the use of dextrose 50 (d50)?

Adult diabetic
Pediatric diabetic

102

What are the contraindications for dextrose (d50)?

None in the emergency setting

103

What is the dose of dextrose (d50)?3

Awake/Alert/symptomatic BS 69mg/dl or less
12.5g IV/IO (after considering oral glucose)

ALOC BS 69mg/dl or less
12.5-25g IV/IO
Repeat every 5 minutes until BS is greater than or equal to 70mg/dl

104

What are the side effects of dextrose 50% (d50)?

Extravasation
Phlebitis
Hyperglycemia

105

What is the pediatric dose of dextrose (d50)?

Awake/alert/symptomatic
BS 69mg/dl or less
Consider oral glucose

ALOC BS 69mg/dl or less

Less than 1month —D10 6ml/kg IV/IO repeat as needed
1month— 2 years D25 4ml/kg IV/IO Repeat as needed
Older than 2 years D50 2ml/kg IV/IO max 25g per dose repeat as needed

Repeat every 5 mins until BS is higher than 70mg/dl

106

What are special considerations for the use of dextrose 50% (d50)?

Consider d50 for any pt with ALOC/AMS

107

what pregnancy category is dextrose (d50)?

C

108

What is the trade name for thiamine?

Betaxin

109

What is the generic name for Betaxin?

thiamine

110

What class of medication is thiamine?

vitamin (B1)

111

What action is thiamine (Betaxin)?

assists in carbohydrate metabolism

112

What are the indications of thiamine (Betaxin)?

DTs
Malnutrition
Coma of unknown origin

113

What are contraindications for thiamine (Betaxin)?

Hypersensitivity

114

What are the side effects of thiamine (Betaxin)?

Hypotensive (from rapid push)
N/V

115

What is the dose of thiamine (Betaxin)?

100mg slow IVP

116

What is the pregnancy category for thiamine (Betaxin)?

A

117

What is the action of nalaxone?

It binds to opioid receptors and blocks the effects of narcotics

118

What class of medication is nalaxone?

Narcotic antagonist

119

What is the trade name for nalaxone?

Narcan

120

What is the generic name for Narcan?

Nalaxone

121

What is the dose of diphenhydramine (Benadryl) that you would give to an adult have a Moderate/severe allergic Rxn?

25-50mg IV/IO/IM (if not already given PO)

121

What are the side effects for the administration of diphenhydramine?

Drowsiness/sedation
Anxiety/tremors
Thickens bronchial secretions

121

What dose of Benadryl would you give to a pediatric patient experiencing a moderate/severe allergic rxn?

1mg/kg IV/IO/IM (if not given PO)

121

What are the special considerations for the administration of Benadryl?

Peds OD: hallucinations, convulsions, death

121

What class of medication is Benadryl?

Antihistamine

121

What is the action of diphenhydramine?

Blocks H1 receptors
Possesses anticholinergic and antiemetic properties

121

What pregnancy category is Benadryl?

B

121

What class of medication is epi?

Sympathomimetic

121

What is the action of epi?

Vasoconstriction/relaxes bronchiole smooth muscles

126

What are the side effects for epi?

Anxiety/palpitations
Headaches

128

What are the contraindications for the use of epinephrine?

None

130

You responded to a call for a 25y/o patient experiencing wheezing. Your protocol calls for the administration of epinephrine. What dose/route could you administer?

0.3-0.5mg IM

131

You have been dispatched to a 6 y/o allergic reaction. Your protocol suggests the administration of epinephrine. How much and by what route could you administer this medication?

0.01mg/kg IM
MAX 0.3mg
Repeat in 5 min if no improvement

132

You are responding to a 19 y/o patient with stridor. Your protocols suggests the administration of epi. What dose/route could you administer?

1mg in 2mL of NS NEB

134

What is the dosage of epi for a pediatric patient experiencing wheezing?

If they are less than 12 months and it is their first time, 1mg in 2mL of NS NEB

135

Your 45 y/o patient is experiencing wheezing as a result of his COPD. Your protocol calls for the administration of epi. What dose/route could you administer this epinephrine?

0.3-0.5mg IM

137

You respond to a 5 y/o patient experiencing stridor. Your local protocol suggests the administration of epinephrine. What dose/route could you administer?

1mg in 2mL of NS NEB
may repeat once

-or-

0.01mg/kg IM
Max 0.3mg

138

What is the action of fentanyl?

It binds to opioid receptors and produces an analgesic effect

138

Your patient is having an moderate/severe allergic reaction. What dose range of epinephrine would you consider?

0.3-0.5mg IM
Repeat in 5 minutes if no improvement

139

What pregnancy category is epinephrine?

C

140

What are special considerations for the use of epinephrine?

Any patient 50 years or older
Any patient with cardiac disease
Any patient on: digitoxin or beta blockers
If the patient has a HR of 150 or greater, administer half the dose (0.15-0.25mg)
Epi 1:1000 May be administered IV (consult med control)

141

What are contraindications for the use of fentanyl (sublimaze)?

Hypersensitivity
Known intolerance to opioids

141

What are the side effects for the use of fentanyl?

Respiratory depression/apnea
Muscle rigidity
Bradycardia

142

What is the generic name of fentanyl?

Sublimaze

143

Fentanyl (sublimaze) is in what class of medication?

opioid analgesic

144

What are special considerations for the use of fentanyl (sublimaze)?

Avoid use if SBP

145

You are about to perform RSI on your patient. How much fentanyl will you administer?

50-75mcg IV/IO
repeat 25mcg every 20 minutes as needed
Max 200mcg

146

What are the indications for the use of fentanyl (sublimaze)?

Airway RSI
Adult Pain Control
Pediatric Pain Control

147

What pregnancy category is fentanyl?

C

148

How much fentanyl will you administer to a pediatric patient experiencing pain?

1mcg/kg IV/IM/IN
may repeat 0.5mcg every 5 minutes as needed
Max 2mcg/kg

149

What is the generic name for atropine?

Atropen

150

What class of medication is atropine?

Anticholinergic (parasympatholytic)

151

What is the action of atropine?

Blocks acetylcholine
Increases heart rate

152

What are the indications for the use of atropine?

Bradycardia, Pulse Present
Pediatric bradycardia
WMP nerve agent

153

What are the contraindications for the use of atropine?

High degree heart block
Pts predisposed to narrow angle glaucoma

154

What are the side effects of atropine?

V-fib
SVT
Dizziness
N/V

155

Your patient is bradycardic, how much atropine will administer?

0.5-1mg IV every 3-5 minutes (max. 3mg)
(ET max. 6mg)

156

What is the organophosphate dose of atropine?

1-2mg IV/IO

157

Your pediatric patient you just intubated has become bradycardic. How much atropine will you administer?

0.02mg/kg IV/IO (max. 1mg) may repeat in 3-5 minutes

158

What is the pediatric organophosphate dose?

0.05mg/kg IV/IO

159

What are special considerations for the use of atropine?

May be given other route per med control
For ET dose, double the dose

160

What is the pregnancy category of atropine?

C

161

What is the trade name for lidocaine?

Xylocaine

162

What class of medication is lidocaine (xylocaine)?

Anesthetic
Antiarrythmic med

163

What is the action of lidocaine (xylocaine)?

Stabilizes neuronal membrane by inhibiting ionic fluxes

164

What are the indications for the use of lidocaine (xylocaine)?

Airway, RSI
VF, pulseless VT
Ped VF pulseless VT

165

What are contraindications for the use of lidocaine?

WPW syndrome
2nd or 3rd degree heart block
Hypersensitivity to corn products

166

What are the side effects of lidocaine?

Dizziness
N/V

167

You are preparing to intubate your 25 y/o trauma patient. What is the dose/route of lidocaine you could give him to prevent his ICP?

1.5mg IV/IO bolus; 3mg ETT (max. 3mg/kg)

168

You have a pulseless VT pediatric patient. What dose/route could you administer your lidocaine?

1mg/kg IV/IO (max. 100mg) may repeat 0.5mg/kg
(Max 3mg/kg)

169

What are special considerations for the use of lidocaine?

Use with caution in hypotensive pts

170

What pregnancy category is lidocaine?

B

171

What is the trade name for midazolam?

Versed

172

What class is Versed (midazolam)?

Benzodiazepine

173

What is the action of midazolam (versed)?

Sedative
Hypnotic

174

What are the indications for the use of midazolam (versed)?

Seizures
Pediatric seizures
Behavior emergencies

175

What are the contraindications for the use of versed?

Hypersensitivity
Shock
Narrow angle glaucoma
Acute alcohol intoxication

176

What are the side effects for the use of versed?

Respiratory depression
Apnea

177

What are the special considerations for the use of versed?

Do not delay IM administration for IV/IO Access
Titrate slowly
May dilute to facilitate slower administration
Schedule IV control

178

What pregnancy category is versed?

D

179

What is the adult dose of versed?

0.5-2.5mg IV/IO
5mg IM
2mg IN
May repeat every 3-5 minutes (max 5mg)

180

What is the pediatric dose of versed?

0.1-0.2mg/kg IV/IO (max 2mg)
0.2mg/kg IN (max 2mg)
0.2mg/kg IM (max 10mg)

181

What is the trade name for recuronium?

Zemuron

182

What class of medication is recuronium?

Nondepolarizing neuromuscular blocking agent

183

What is the action of recuronium?

Paralytic

184

What are the indications for the use of recuronium?

Airway RSI

185

What are the contraindications for the use of recuronium?

Hypersensitivity

186

What are the side effects for the use of recuronium?

N/V
Prolonged skeletal muscle weakness/atropy

187

What is the adult dose of recuronium?

1mg/kg IV/IO may repeat x 1

188

What is the pediatric dose of recuronium?

None

189

What pregnancy category is recuronium?

C

190

What are the special considerations for the use of recuronium?

Onset is longer than succinylcholine. May take up to 3-5 minutes
Only use is succinylcholine is contraindicated

191

What is the trade name for etomidate?

Amidate

192

What class is etomidate (amidate)?

Anesthetic agent

193

What is the action for etomidate (amidate)?

Sedative :

Hypnotic

194

What are the indications for etomidate (amidate)?

Airway RSI
Induced hypothermia

195

What are the contraindications for etomidate (amidate)?

Hypersensitivity
Patients less than 10 years

196

What are the side effects for etomidate (amidate)?

Adrenal suppression
Injection site pain
Tonic skeletal muscle movements

197

What is the adult dose for etomidate (amidate)?

0.3mg/kg IV/IO
Usual does 20mg

198

What is the pediatric dose for etomidate (amidate)?

None

199

What are the special considerations for etomidate (amidate)?

Use with caution in hypotensive patients and patients where respirations are suppressed

200

What is the pregnancy category etomidate (amidate)?

C

201

What is the trade name for Succinylcholine?

Quelcin

202

What class is succinylcholine (quelicin)?

Paralytic

203

What is the action for succinylcholine (quelicin)?

Airway RSI

204

What are the contraindications for succinylcholine (quelicin)?

Burns less than 24 hours
Chronic neuromuscular disease
ESRD

205

What are the side effects for succinylcholine (quelicin)?

Apnea
Hyperkalemia
Anaphylaxis
Malignant Hypothermia

206

What is the adult dose/route of succinylcholine (quelicin)?

1.5mg/kg IV/IO may repeat x1

207

What is the pediatric dose for succinylcholine (quelicin)?

None

208

What are the special considerations for succinylcholine (quelicin)?

Consider premeditating with atropine
Premeditating with lidocaine may blunt any increase in ICP

209

What is the pregnancy category succinylcholine (quelicin)?

C

210

What is the tear name for Vecuronium bromide?

Norcuiron

211

What class is vercuronium bromide ( norcuiron)?

Paralytic

212

What is the action for vercuronium bromide ( norcuiron)?

Neuromuscular blocking agent

213

What is the indications for vercuronium bromide ( norcuiron)?

Airway RSI
Post Resuscitation
Induced hypothermia

214

What are the contraindications vercuronium bromide ( norcuiron)?

Patients with chronic neuromuscular disease

215

What are the side effects vercuronium bromide ( norcuiron)?

Apnea
Muscular skeletal weakness/prolonged atrophy
Hypotension/tachycardia
Bronchospasm

216

What is the adult dose for vercuronium bromide ( norcuiron)?

10mg (0.1mg/kg) IV/IO (If needed for patients movement)
10mg IV/IO (If needed)
10mg IV/IO (If needed x 1 dose)

217

What is the pediatric dose for vercuronium bromide ( norcuiron)?

None

218

What are the special considerations for vercuronium bromide ( norcuiron)?

Paralytic therapy should be started after sedation
Use with caution in patients with poor renal function
Ongoing sedation should be maintained and monitored periodically

219

What is the pregnancy category for vercuronium bromide ( norcuiron)?

C

220

What is the trade name for Oxymetazoline HCL?

Afrin

221

What class is Oxymetazoline ( Afrin)?

Sympathamimetic

222

What is the action for Oxymetazoline (Afrin)?

Antagonizes a1 and a2 adrenergic receptors
(Vaso Constriction)

223

What are the indications for Oxymetazoline (Afrin)?

Epistaxis
Nasotracheal intubation

224

What are the contraindications for Oxymetazoline (Afrin)?

Hypersensitivity
Significant hypertension

225

What are the side effects for Oxymetazoline (Afrin)?

Trembling
Nervousness
Headache,dizziness,drowsiness
Blurred vision

226

What is the adult dose for Oxymetazoline (Afrin)?

2 sprays in affected nostrils

227

What is the pediatric dose for Oxymetazoline (Afrin)?

1 - 2 sprays in affected nostrils

228

What are the special considerations for Oxymetazoline (Afrin)?

Use with caution in patients with narrow angle glaucoma
Use with caution in lactating women

229

What is the pregnancy category for Oxymetazoline (Afrin)?

C

230

What is the trade name for Vasopressin?

Pitressin

231

What are the protocols that warrant the use of vasopressin?

Asystole, PEA, and V-Fib

232

What class of medication is vasopressin?

Nonadrenergic vasoconstrictor
Posterior pituitary hormone (ADH)

233

What is the mechanism of action of vasopressin?

Vasoconstrictor.
Targets the V1 receptors in the smooth muscle of vessels
Targets the V2 receptors in the kidney promoting fluid absorption

234

What are the indications for the use of vasopressin?

V Fib
Pulseless V Tach
Asystole
PEA

235

What are the contraindications of the use of vasopressin?

None in cardiac arrest
Responsive patients with cardiac disease

236

What are the side effects of vasopressin?

Cardiac ischemia
Angina
Headache
Vertigo
Diaphoresis

237

What is the adult dose of vasopressin?

40 units IV/IO (may be used to replace 1st or 2nd dose of epinephrine)

238

What is the pediatric dose of vasopressin?

None

239

What pregnancy category of vasopressin?

C

240

What are any special considerations for the use of vasopressin?

EMS will only use for patients without a pulse

241

What is the trade name for dopamine?

Intropin

242

What are the protocols associated with the use of dopamine?

Bradycardia
Hypotension
Post Resuscitation
PEA
Pediatric Hypotension

243

What class of medication is dopamine?

Adrenergic agonist
Inotropic
Vasopressin
Natural catecholamine

244

At what dose does dopamine stimulate dopaminergic receptors dilating renal, mesenteric, and cerebral arteries?

1-2mcg/kg/min

245

At what dose does dopamine act on beta receptors increasing Inotropy and chronotropy?

2-10mcg/kg/min

246

At what dose does dopamine act on alpha and beta receptors beginning vasoconstriction of peripheral arteries and veins?

10-20mcg/kg/min

247

On what dose does dopamine act on alpha receptors only and mimic the effects of norepinephrine?

>20mg/kg/min

248

What receptors does dopamine act on?

Alpha, beta1, and dopaminergic receptors.

249

What are the mechanisms of action of dopamine?

Stimulates alpha, beta1, and dopaminergic receptors.

Does not increase oxygen demand as much as epinephrine.

Has greater effect on systolic pressure than diastolic pressure (widening the pulse pressure)

250

What are the indications for the use of dopamine?

Hypotension and/or bradycardia associated with:
•cardiogenic shock
•septic shock
•neurogenic shock
•anaphylaxis shock after epi 1:1000 had been given

Hypotension after return of spontaneous circulation following cardiac arrest

Symptomatic bradycardia unresponsive to atropine

For the correction of hemodynamic imbalances present during shock due to:
•MI
•Trauma
•Endotoxic septicemia
•Open Heart Surgery
•Renal failure
•Chronic cardiac decomp. (CHF)

251

What are the contraindications for the use of dopamine?

-Hypovolemia (without fluid replacement)

-Patients with known pheochromocytoma (adrenal tumor)

-V-Tach, V-Fib, or other ventricular arrhythmias

-Known hypersensitivity (including sulfites)

252

What are the side effects of dopamine?

Nervousness
Headache
Dysrrhythmias
Palpitations
Chest pain
Dyspnea
N/V
Tachycardia
Skin & soft tissue necrosis
Severe hypertension (excessive vasoconstriction)
Cardiac conduction abnormalities
Anxiety

253

What is the dose for the use of dopamine? (Adult& Ped)

2-20mcg/kg/min tot rate to systolic BP of 90mmHg

Titrate to systolic BP appropriate for age

254

What are any special considerations for the use of dopamine?

Dopamine is deactivated by alkaline solutions (do not administer in same line)

Can worsen SVT and ventricle arrhythmias

Dosage of >20mcg/kg/min cause necrosis (by squeezing down on vessles)

Onset

255

What pregnancy class is dopamine?

C