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Stuff I should know. Maybe. > Medications > Flashcards

Medications Flashcards

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1
Q

Norepinephrine dose

A

.1 mcg/kg/min IV

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2
Q

Norepinephrine therapeutic effect

A

increases BP and cardiac output

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3
Q

Norepinephrine mechanism

A

Stimulates alpha adrenergic receptors located mainly in blood vessels
Causes constriction of both capacitance and resistance of blood vessels
Minor beta adrenergic activity that includes myocardial stimulation

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4
Q

How long is norepinephrine active in the blood

A

1-2 minutes

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5
Q

Norepinephrine contraindication

A

Vascular, mesenteric or peripheral thrombosis

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6
Q

Norepinephrine side effects

A

anxiety, dizziness, h/a, dyspnea, arrhythmias, chest pain, htn, bradycardia, metabolic acidosis

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7
Q

Norepinephrine nursing instructions for frequency of monitoring

A

check bp every 2-3 minutes until stabilized and every 5 mins after. continuously check ecg

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8
Q

Norepinephrine toxicity treatment

A

discontinue norepi and administer fluid and electrolyte replacement therapy. and phentolamine (alpha adrenergic blocking agent)

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9
Q

Norepinephrine what to correct before initiation

A

volume depeletion

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10
Q

Norepinephrine continuous infusion instructions

A

dilute 4 mg in 1000 ml of d5w or d5/.9% saline. this creates 4 mcg/ml

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11
Q

Norepinephrine how to stop

A

discontinue gradually.

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12
Q

Midazolam indication

A

reduce anxiety, preop sedation, anti seizure

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13
Q

Midazolam mechanism

A

acts at different levels within the CNS to produce generalized CNS depression. Mediated by GABA, an inhibatory neurotransmitter

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14
Q

Midazolam therapeutic effect

A

induce short term sedation

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15
Q

Midazolam half lfie

A

3-7 hours in children

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16
Q

Midazolam time to start working

A

15 mins im, peaks in 30-60 mins

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17
Q

Midazolam side effects

A

agitation, drowsiness, excess sedation, headache, respiratory depression, bronchospasm, coughing, cardiac arrest, arrhythmias

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18
Q

Midazolam drug drug interaction

A

alcohol, opioid analgesics, sedatives (dec midazolam dose by 50% if given in conjunction with these drugs)

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19
Q

Midazolam metabolism

A

P450 enyzme

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20
Q

Midazolam dose PO 6months to 16 years for conscious sedation

A

.25-.5mg/kg

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21
Q

Midazolam dose IM for conscious sedation

A

.1-.15 mg/kg

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22
Q

Midazolam dose for status epilepticus kids >2mos IV

A

.15mg/kg load followed by a continuous infusion of 1 mcg/kg/min. titrate dose upward q5min until seizure controlled 1-18 mcg/kg/min

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23
Q

Midazolam nursing instructions for monitoring

A

monitor level of sedation and level of consciousness during and throughout for 2-6 hours after administration

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24
Q

What to monitor specifically in midazolam administration

A

BP, pulse, respiration continuously during iv admin

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25
Midazolam rescue drug
flumazenil (romazicon)
26
How to administer midazolam IV
administer undiluted or diluted with D5W .9% NaCl. Undiluted concentration of 1 mg/ml or 5mg/ml. Diluted: .02-3mg/ml
27
Midazolam IV rate
2-5 min. titrate dose to patient response
28
Midazolam continuous IV instructions
dilute with .9% NaCl or D5W. get a concentration of .5-1mg/mL
29
Midazolam intranasal route, 6 mo and older dose
0.2 mg/kg intranasally x1; Max: 10 mg/dose; Info: may repeat dose x1 after 5-15min
30
Acetaminophen indication
mild pain, fever
31
Acetaminophen mechanism
inhibits synthesis of prostaglandins that may serve as mediators of pain and fever in the CNS. Has no significant anti inflammatory properties
32
Acetaminophen therapeutic effect
analgesia
33
Acetaminophen half life
1-3 hours
34
Acetaminophen onset for po and iv
PO onset in .5-1 hr peaks in 1-3 hours and lasts 3-8 hours | IV onset in 30 mins peaks in 30 minutes and lasts 4-6 hours`
35
Acetaminophen contraindication
alcohol. use cautiously in patients with hepatic disease
36
Acetaminophen side effects
agitation, anxiety, headache, fatigue, insomnia, atlectasis, dyspnea, htn, vomiting.
37
Acetaminophen PO dose >12 years old
325-650 mg q4-6 hours or 1g 3-4 times daily
38
Acetaminophen PO dose kids 1-12 years
10-15mg/kg/dose q4-6 hours
39
Acetaminophen IV dose >13 years
1000mg q 6hrs or 650 mg q4hr not exceed 4g/day
40
Acetaminophen IV dose 2-12 years
15mg/kg q6hr or 12.5 mg/kg q4hr not to exceed 75 mg/kg/day
41
Acetaminophen nursing, when to recheck patient
30-60 minutes after administration.
42
Acetaminophen toxicity treatment
acetylcysteine
43
Acetaminophen IV infusion rate
infuse over 15 minutes. no need to dilute
44
Morphine indication
severe pain and pulmonary edema
45
Morphine mechanism
binds to opiate receptors in the CNS to alter perception of and response to painful stimuli. it also causes CNS depression.
46
Morphine therapeutic effect
decrease severity of pain.
47
Morphine onset
PO onset=unknown IM onset=10-30 mins, peaks in 30-60 IV onset=rapid and peaks in 20 mins
48
Morphine contraindication
avoid in patients w hypersensitivity or who have had alcohol
49
Morphine: when to use cautiously
in patients with head trauma, increased ICP, renal or hepatic disease.
50
Morphine adverse effects
*confusion, sedation*, dizziness, hallucinations, headache, unusual dreams, blurry vision, *respiratory depression*, hypotension, *constipation*
51
Morphine drug drug interaction
Use cautiously in patients receiving MAO inhibitors within 14 days prior
52
Morphine dose for PO
.2-.5 mg/kg/dose q4-6 hours as needed
53
Morphine dose for IV kids <50kg
.05-.2 mg/kg/ q3-4hr. maximum 15mg/dose
54
Morphine dose IV > 50 kg
initial 4-10 mg q3-4 hr. For very severe pain additional smaller doses may be given every 3-4 hours.
55
Morphine dose for continuous administration
.01-.04 mg/kg/hr. If cancer or sickle cell pain, can give .02-2.6 mg/kg/hr
56
Morphine: what to assess for after administration
type, location, and intensity of pain prior to and 1 hr following administration.
57
Morphine: how to titrate up
increase doses 25-50% until patients pain is decreased by 50%.
58
Morphine: for pts on continuous drip, when can boluses be given?
every 15-30 min as needed for pain. The bolus amount is set to the amount of drug infused each hour by continuous infusion.
59
Morphine what to assess for
bp, respiratory rate, level of consciousness. if respiratory rate is <10/min, assess level of sedation. physical stimulation may be enough to prevent significant hypoventilation.
60
Morphine, when to give laxatives
after 2-3 days of opioid administration.
61
Morphine toxicity treatment
naloxone (narcan) dilute .4mg of naloxone in 10ml of .9% nacal and administer .5ml (.02mg) by direct iv push every 2 minutes. if less than 40Kg administer .1mg in 10ml (0.5mcg/kg)
62
Morphine direct IV administration
dilute with at least 5ml of sterile water or .9% NaCl for injection. concentration of .5-5 mg/ml. Administer 2.5-15 mg over 5 min
63
Epinephrine indications
cardiac arrest (aystole and pulseless electrical activity) and in bradycardia and hypotension.
64
Epinephrine effects
It increases heart rate, myocardial contractility, systemic vascular resistance and cardiac automaticity. SE=causes inc myocardial demand
65
Epinephrine IV dose
0.01mg/kg (0.1 mL/kg) 1:10,000 concentration every 3-5 minutes
66
Atropine effects
a parasympathetic drug that inhibits vagal activity, accelerates sinoatrial pacemakers, and enhances atrioventricular conduction.
67
Atropine indication
indicated for symptomatic bradycardia due to increased vagal tone, cholinergic drug toxicity, or AV heart block.
68
Atropine dose
0.02 mg/kg IV

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