Medications Flashcards
1
Q
Naloxone: Class
A
Naloxone: Class
Narcotic Antagonist
2
Q
Naloxone: Indication
A
Naloxone: Indication
Narcotic overdose
3
Q
Naloxone: Contraindications
A
Naloxone: Contraindications
Hypersensitivity
4
Q
Naloxone: Precautions
A
Naloxone: Precautions
- May cause withdrawal symptoms
- Many EMS systems titrate to minimum needed for respiratory sufficiency.
5
Q
Naloxone: Adult Dose
A
Naloxone: Adult Dose
> 20 kg OR > 5 years old:
1 - 2 mg q 5 mins Titrate to effect
6
Q
Naloxone: Pediatric Dose
A
Naloxone: Pediatric Dose
< 20 kg:
0.1 mg / kg
Max: 2 mg
7
Q
Naloxone: MOA
A
Naloxone: MOA
- Narcotic antagonist
- Prevents CNS depression
8
Q
Naloxone: Interactions
A
Naloxone: Interactions
NONE (Just withdrawal)
9
Q
Naloxone: Side Effects
A
Naloxone: Side Effects
(WIthdrawal symptoms:)
- chest pain
- SOB
- N/V
- arrhythmias
- seizure
- anxiety
(rare: hypo/hypertension)
10
Q
Naloxone: Form & Route
A
Naloxone: Form & Route
Form: Liquid
Route: IV, IM, SC, IN
11
Q
Oral Glucose: Class
A
Carbohydrate
12
Q
Oral Glucose: Indications
A
Hypoglycemia
13
Q
Oral Glucose: Contraindications
A
- Hypersensitivity - Unconscious - Unable to swallow
14
Q
Oral Glucose: Precautions
A
Monitor for aspiration
15
Q
Oral Glucose: Adult Dose
A
15 - 30 g
16
Q
Oral Glucose: Pediatric Dose
A
15 g WI: 15 - 30 g
17
Q
Oral Glucose: MOA
A
Increases blood glucose
18
Q
Oral Glucose: Interactions
A
NONE
19
Q
Oral Glucose: Side Effects
A
N/V
20
Q
Oral Glucose: Form & Route
A
Form: Gel Route: Buccal
21
Q
Glucagon: Class
A
Hormone with antihypoglycemic action
22
Q
Glucagon: Indication
A
Hypoglycemia (esp. inability to establish IV access)
23
Q
Glucagon: Contraindications
A
Hypersensitivity
24
Q
Glucagon: Precautions
A
Use with caution in pt with:
- CVD
- adrenal tumor
- renal disease
Not effective if glycogen depleted.
25
Glucagon: Adult Dose
\> 20 kg 1 mg
26
Glucagon: Pediatric Dose
\< 20 kg 0.5 mg OR 0.1 mg / kg MAX: 1.0 mg
27
Glucagon: MOA
Raises BG by causing liver to convert glycogen to GLU and release it.
28
Glucagon: Interactions
Few in emergency at therapeutic doses.
29
Glucagon: Side Effects
Glucagon: Side Effects: Rare: - N/V - Tachycardia - Hypotension - Dizziness - Headache
30
Glucagon: Form & Route
Form: Liquid (Reconstituted) Route: IM
31
D50: Class
- Carbohydrate - Hypertonic crystalloid solution
32
D50: Indications
Hypoglycemia
33
D50: Contraindications
- hypersensitivity - brain injury - intracranial hemorrhage - stroke
34
D50: Precautions
- Check BG before using - D50 is hypertonic: will cause necrosis if IV is infiltrated.
35
D50: Adult Dose
25 g (in 50 ml) 0.5 g / kg
36
D50: Pediatric Dose
D25: Mix D50 1:1 with NS 0.5 g / kg Consider D12.5 or D10 for neonates
37
D50: MOA
Increases blood glucose
38
D50: Interactions
None significant in emergency
39
D50: Side Effects
- N/V - Tissue necrosis if administered in non-patent IV - localized irritation of vein
40
D50: Form & Route
Form: Liquid Route: IV SLOW PUSH
41
Normal Saline (0.9%): Class
Isotonic crystalloid
42
Normal Saline (0.9%): Indications
- hypovolemia (dehydration, fluid loss) - heat stroke, heat exhaustion - DKA
43
Normal Saline (0.9%): Contraindications
None Book: CHF and/or fluid overload (PE)
44
Normal Saline (0.9%): Precautions
- CHF, cardiac overload - Monitor for overload (rales) - Consider Ringer's or electrolyte solution for significant electrolyte loss
45
Normal Saline (0.9%): Adult Dose
20 ml / kg Reassess every 500 ml bolus
46
Normal Saline (0.9%): Pediatric Dose
20 ml / kg Reassess every 250 ml
47
Normal Saline (0.9%): MOA
Adds fluid volume
48
Normal Saline (0.9%): Interactions
NONE
49
Normal Saline (0.9%): Side Effects
If overadministered: - Dyspnea - Edema - Hemodilution - Electrolyte imbalance
50
Normal Saline (0.9%): Form
Form: Liquid Route: IV
51
O2: Class
Gas
52
O2: Indications
Hypoxia (SpO2 \< 95%)
53
O2: Contraindications
NONE
54
O2: Precautions
- COPD patients are dependent on hypoxic drive, hence may get respiratory depression w/high dose. - Vasoactive: causes vasoconstriction. - Not for routine use in ACS (titrate to 95%)
55
O2: Adult & Ped. Dose
Titrate to 95%
56
O2: Actions
Increases SpO2
57
O2: Side Effects
Rare: - oxtox - atelectasis - apnea Dry mucous membranes w/o humidifier
58
O2: Form & Route
F: Gas R: Inhalation
59
NO2: Class
- analgesic - anesthetic
60
NO2: Indications
- isolated musculoskeletal trauma If protocol: - chest pain assoc. with ACS, and not relieved by NTG
61
NO2: Contraindications
NO2: Contraindications - CNS depression - Head injury - COPD - Suspected pneumothorax - ABD pain - Bowel obstruction
62
NO2: Dose
- Self-administered w/ 50% O2 - Peds: Contact medical control
63
NO2: Action
CNS depressant
64
NO2: Interactions
NO2: Interactions: Don't use with sedatives or hypnotics, narcotics, or EtOH.
65
NO2: Precautions
- Well-ventilated area - Teratogenic: don't use by or around pregnant patients or providers.
66
NO2: Side Effects
NO2: Side Effects: - Respiratory depression - N/V - AMS (dizziness, hallucinations)
67
NO2: Form & Route
Form: Gas Route: Inhalation
68
Nerve Agent: Class
- anticholinergic (atropine) - acetylcholinesterase regenerator (Pralidoxime Cl)
69
Nerve Agent: Indications
Suspected organophosphate nerve agent exposure. Example: sarin, tabun, VX
70
Nerve Agent: Contraindications
NONE
71
Nerve Agent: Dose
2 mg Atropine 600 mg Pralidoxamine
72
Nerve Agent: MOA
- reduced parasympathetic NS stimulation - via acetylcholine antagonism and maintaining function of acetylcholinesterase
73
Nerve Agent: Side Effects
- dizziness - tachycardia - HTN - HA - N/V - drowsiness - pain at site
74
Nerve Agent: Form & Route
Form: Liquid Route: IM (autoinjector)
75
Albuterol: Class
- beta2-selective sympathomimetic - bronchodilator
76
Albuterol: Indications
dyspnea assoc. with bronchoconstriction (sign of bronchocontriction = wheezing) (Pt. may have Hx of asthma, COPD)
77
Albuterol: Contraindications
- hypersensitivity - dysrrhythmias - symptomatic tachycardia
78
Albuterol: Precautions
- heart disease - HTN - seizure - diabetes - pregnancy - hyperthyroidism
79
Albuterol: Adult Dose
2.5 mg
80
Albuterol: Ped. Dose
0.15 mg / kg (WI: 2.5 mg)
81
Albuterol: Actions
Bronchodilation via Beta2 agonism, in bronchiolar smooth muscle. Duration ~ 4-6 hrs
82
Albuterol: Side Effects
- anxiety - tremors - HA - dizziness - bronchospasms - chest pain/discomfort - tachycardia - HTN - arrythmias - N/V - perspiration
83
Albuterol: Interactions
Do not administer other Beta agonists concurrently. (But low Beta-1 activity).
84
Albuterol: Form & Route
Form: Liquid Route: Inhalation via Small-Volume Nebulizer at 6-8 LPM or Metered-Dose Inhaler, 1-2 sprays x 90 mcg, with spacer preferred.
85
Atrovent (Ipratropium Bromide): Class
parasympatholytic
86
Atrovent (Ipratropium Bromide): Indications
dyspnea associated with bronchoconstriction May have Hx of asthma, COPD
87
Atrovent (Ipratropium Bromide): Contraindications
- hypersensitivity
88
Atrovent (Ipratropium Bromide): Precautions
Should not be used as the primary agent for treatment. Allergy to atropine.
89
Atrovent (Ipratropium Bromide): Adult Dose
500 mcg (0.5 mg)
90
Atrovent (Ipratropium Bromide): Peds. Dose
250 - 500 mcg (0.25 - 0.5 mg) 0-500 mcg per protocol. Some docs don't give it to kids.
91
Atrovent (Ipratropium Bromide): MOA
Bronchodilation via parasympathetic antagonism. Duration: 4-5 hrs.
92
Atrovent (Ipratropium Bromide): Side Effects
- blurred vision - eye pain - dry mount ^ All common with anticholinergics - tachycardia - palpitations - HA - aggravated COPD
93
Atrovent (Ipratropium Bromide): Form & Route
Form: Liquid Route: Nebulizer at 6-8 LPM
94
Epinephrine: Class
sympathomimetic (endogenous hormone)
95
Epinephrine: Indications
- anaphylaxis - severe dyspnea from bronchoconstriction (based on protocol)
96
Epinephrine: Contraindications
None in life-threatening situation
97
Epinephrine: Precautions
Use with caution in pt with: - tachycardia - COPD - pregnancy - HTN - CHF Inactivated by alkaline solutions & sunlight.
98
Epinephrine: Adult Dose
\> 30 kg: 0.3 - 0.5 mg 1:1000 OR 0.3 mg EPI Pen 1:1000
99
Epinephrine: Peds. Dose
\< 30 kg: 0.01 mg/kg 1:1000 MAX: 0.5 mg OR Epi-Pen Jr. 0.15 mg 1:2000
100
Epinephrine: Actions
- bronchodilation - vasoconstriction via sympathetic agonism
101
Epinephrine: Interactions
May be intensified in pts. taking certain antidepressants.
102
Epinephrine: Side effects
Increased HR, RR chest pain pallor HA burning at site dizziness N/V anxiety (In CVD Hx: palpitations, angina, AMI)
103
Epinephrine: Form & Route
Form: Liquid Route: IM (or SC)
104
Aspirin (ASA): Class
- NSAID - analgesic - platelet aggregation inhibitor
105
Aspirin (ASA): Indications
- angina - chest pain of suspected cardiac origin - MI
106
Aspirin (ASA): Contra
- hypersensitivity - can't swallow - unconscious - GI bleed - stomach ulcer - current use of blood thinners - children or adolescents w/suspected viral illness
107
Aspirin (ASA): Precautions
Use with caution in pt with: - asthma - seasonal allergies - stomach ulcers - liver disease - alcohol abuse - kidney disease - coagulopathy
108
Aspirin (ASA): Adult Dose
160 - 325 mg (2-4 x 81 mg) MAX: 325 mg
109
Aspirin (ASA): Peds. Dose
Contact Med Ctrl
110
Aspirin (ASA): MOA
Inhibits clotting by inhibiting platelet aggregation.
111
Aspirin (ASA): Side effects
N/V GI Irritation & bleeding (with overuse)
112
Aspirin (ASA): Interactions
Few in prehospital setting
113
Aspirin (ASA): Form & Route
Form: Tablet Route: PO
114
Nitroglycerin (NTG): Class
- nitrate - vasodilator
115
Nitroglycerin (NTG): Indications
- angina, of suspected cardiac origin - AMI (-CHF, -HTN)
116
Nitroglycerin (NTG): Contra
- hypersensitivity - SBP \< 90 - Head injury - Sexual enhancement drugs or herbs within 48 hrs
117
Nitroglycerin (NTG): Precautions
- monitor BP closely - deteriorates in light & air
118
Nitroglycerin (NTG): Adult Dose
0.4 mg every 5 mins MAX: 3 doses
119
Nitroglycerin (NTG): Peds. Dose
Contact Med Ctrl
120
Nitroglycerin (NTG): MOA
- vasodilation via conversion to nitric oxide (NO) - dilating coronary arteries
121
Nitroglycerin (NTG): Interactions
Accentuated by: - alcohol use - ED/Sexual enhancement drugs - Beta blockers
122
Nitroglycerin (NTG): Side Effects
- HA (immediate HA is common) - hypotension - N/V - palpitations - dizziness - flushing - burning under tongue
123
Nitroglycerin (NTG): Form & Route
Form: Tablet or liquid Route: Sublingual
124
Activated Charcoal: Class
Adsorbent
125
Activated Charcoal: Indications
Ingested poisons (best w/in 1-1.5 hrs)
126
Activated Charcoal: Contra
- hypersensitivity - can't swallow - ALOC / Unconscious Ingestion of: - strong acid or alkali - corrosive - petroleum distillates
127
Activated Charcoal: Precautions
Inactivates other oral meds.
128
Activated Charcoal: Adult Dose
25 - 50 g (GRAMS) 1 g/kg
129
Activated Charcoal: Peds. Dose
12.5 - 25 g 1 g/kg
130
Activated Charcoal: MOA
Adsorption (binds to poison)
131
Activated Charcoal: Interactions
None
132
Activated Charcoal: Side Effects
- N/V - Black and/or tarry stool - Diarrhea
133
Activated Charcoal: Form & Route
F: Suspension R: Oral
134
Acetaminophen (APAP): Class
- analgesic - antipyretic (APAP = N-acetyl-para-aminophenol)
135
Acetaminophen (APAP): Indications
- pain - fever
136
Acetaminophen (APAP): Contra
- hypersensitivity
137
Acetaminophen (APAP): Precautions
- hepatotoxic - with w/caution in patients with liver disease
138
Acetaminophen (APAP): Adult Dose
650 - 1000 mg q 4-6 hr MAX: 4g in 24 hr (FDA recommends \< 3g)
139
APAP: Peds. Dose
10 - 15 mg/kg q 4-6 hr MAX: 40 mg/kg/24 hr
140
APAP: MOA
-increases pain threshold by blocking prostoglandin synthesis -inhibits pyrogens in CNS
141
APAP: Interactions
EtOH leads to toxicity
142
APAP: Side Effects
hepatotoxicity in high doses
143
APAP: Form / Route
F: tablet or liquid R: PO or PR (per rectal)
144
Ibuprofen (IBU): Class
- NSAID - analgesic & antipyretic
145
Ibuprofen (IBU): Indications
- pain - fever
146
Ibuprofen (IBU): Contraindications
- hypersensitivity
147
Ibuprofen (IBU): Precautions
- GI irritation at high doses - Increased risk of GI bleed
148
Ibuprofen (IBU): Adult Dose
200 - 400 mg q 6-8 hr MAX: 3200 mg / 24 hr
149
Ibuprofen (IBU): Peds. Dose
5 - 10 mg/kg q 6-8 hr
150
Ibuprofen (IBU): MOA
- inhibits inflammatory response (COX-2 inhibitor) (COX-2 being a mediator of inflammatory prostaglandins)
151
Ibuprofen (IBU): Interactions
Do not give with Aspirin or other NSAIDS
152
Ibuprofen (IBU): Side Effects
GI irritation
153
Ibuprofen (IBU): Form / Route
- tablet or liquid - PO or PR
