Meds

Question 1

what are the 5 indications for use of antibiotics?

Answer 1

• Open wounds with obvious surface contamination and delayed transit times
• Penetrating eye injury
• Abdominal injury with suspected/known bowel injury
• Serious orofacial infections
• Burn injuries if visible infection develops (PCC)

Question 2

contraindications to use of antibiotics?

Answer 2

Known hypersensitivity

Question 3

Moxifloxacin dosage

Answer 3

400mg po q24h

Question 4

Contraindications of nitroglycerin
1.1 suspected cardiac chest pain

Answer 4

• hypersensitivity and severe hypotension
• Cannot give if HR < 60
• Cannot give without a manual blood pressure reading. need bp >90
• No ED medications within 24 hrs

Question 5

Nitroglycerin dosage and max dosage

Answer 5

0.4mg SL spray q5min (max 3 doses every 30min)

Question 6

ASA dosage and max

Answer 6

chewable asa 160mg po (single dose only)

If no chewable ASA give 325mg preferably non enteric coated to chew

Question 7

ASA contraindications

Answer 7

hypersensitivity; bleeding disorder; active GI bleeding

Question 8

Normal saline:
Indications and contraindications
Regular maintenance rate

Answer 8

Indication: protocols requiring IV access

Contraindication: pulmonary edema

Maintenance rate in adults 100ml/hr

Question 9

Oxygen flow rates (dosage) for NRB, simple face mask, nasal prongs

Answer 9

NRB with reservoir bag 10-15L/min “100% 02”
simple face mask 6-10L/min high flow
Nasal prongs 2-4L/min low flow

Question 10

Salbutamol contraindications

Answer 10

hypersensitivity to salbutamol

Question 11

Salbutamol dosage for mild/moderate asthma attack. And max dosage.

Answer 11

4-8 puffs MDI q20min prn x3 doses or 5mg via nebulizer q20min prn x3 doses.

Can repeat another 3 doses if improvement noted, for a max 6.

Question 12

salbutamol dosage for a severe asthma attack

Answer 12

2 puffs MDI q1min or continuous via nebulizer

Question 13

Salbutamol dosage for anaphylaxis (adults and child)

Answer 13

> 30kg 4-8 puffs MDI q20min prn or 5mg via nebulizer q20min prn

<30kg 2 puffs MDI q20min prn or 2.5mg via nebulizer q20min prn

Question 14

Contraindications of acetaminophen

Answer 14

hypersensitivity; known G6PD deficiency; liver failure

Question 15

acetaminophen adult dosage and max

Answer 15

1g PO q6h prn
max 4000mg/24hr

Question 16

Contraindications of Ibuprofen

Answer 16

Bleeding; hypersensitivity to ASA, ibuprofen and other NSAIDS; GI ulcer; active inflammatory bowel disease; severe liver and or kidney impairment; hyperkalemia; systemic lupus erythematous; pregnancy.

Question 17

Ibuprofen adult dosage and max

Answer 17

800 mg PO q8h (max 2400mg/day)

Question 18

Contraindications of meloxicam

Answer 18

known hypersensitivity; history of asthma; urticaria or other allergic rxns after taking aspirin or NSAIDS; post coronary bypass graft

Question 19

Meloxicam dosage and max

Answer 19

15mg PO once daily

Question 20

contraindications of moxifloxacin

Answer 20

hypersensitivity to quinolone antibacterial agents

Question 21

indications and contraindications for epinephrine

Answer 21

anaphylaxis protocol
shortness of breath suggestive of asthma protocol (QL5)

no contraindications to giving Epi for a life threatening allergic response such as anaphylaxis

Question 22

Epinephrine dosage for SOB suggestive of asthma (QL5 only)

Answer 22

0.3mg IM (one dose)

Question 23

Epinephrine dosage for anaphylaxis in adults and max dose

Answer 23

Epipen 0.3mg or IM 1:1000 0.3mg q5min prn x 3 Doses

Question 24

considerations when giving epinephrine

Answer 24

assess for airway obstruction and hypotension after each dose

keep epipen needle in muscle for 5 seconds

one ampoule of epi contains more than one dose

Question 25

Diphenhydramine contraindications

Answer 25

hypersensitivity to diphenhydramine; acute asthma; don't use on neonates

Question 26

diphenhydramine adult dosage for anaphylaxis (and max dose) what do you do for the elderly?

Answer 26

50mg IM/PO (IV Cpl) q2-4h prn (max dose 400mg/day) greater than 60 years old half the dose

Question 27

what are the four meds you can give in the anaphylaxis protocol

Answer 27

oxygen salbutamol diphenhydramine epinephrine

Question 28

Indications for naloxone

Answer 28

Suspected narcotic overdose 4.1 unconscious NYD 4.6

Question 29

contraindications of naloxone

Answer 29

hypersensitivity to naloxone

Question 30

Naloxone (Narcan) dosage (and max dose)

Answer 30

0.4mg IV/IO over 1 min q3min prn (max 5mg) 0.8mg IM/SC q3min prn (max 5mg) 4mg IN q3min prn (max 5 doses) alternate nostrils

Question 31

indications for moxifloxacin

Answer 31

Antibiotic protocol 4.3 Eye injury protocol 3.8

Question 32

Glucose Gel indications and contraindications

Answer 32

Hypoglycemic emergency 4.5 blood glucose less than 4 mmol/L no contraindications

Question 33

Glucose gel precaution

Answer 33

do not administer to unconscious patient

Question 34

Glucose gel dosage

Answer 34

1 tube inside lip and cheeks

Question 35

Indications and contraindications of dextrose (D10W)

Answer 35

hypoglycemic emergency 4.5 contraindication: hyperglycemia

Question 36

dextrose dosage

Answer 36

100ml IV/IO bolus x2 prn if blood glucose <4 if blood glucose still < 4 reduce flow rate to 100ml/hr

Question 37

Indications for use of glucagon (baqsimi)

Answer 37

hypoglycaemic emergency 4.5 If unable to gain IV access for dextrose, use glucagon

Question 38

contraindications of glucagon

Answer 38

known allergy to glucagon; pheochromocytoma

Question 39

glucagon dosage and what do you have to do after

Answer 39

3mg IN; can repeat after 5min if no response after they respond give oral carbohydrate (glucose gel) to restore liver glycogen

Question 40

Dimenhydrinate dosage

Answer 40

25-50mg IV/PO/IM q4h prn Max 400mg/24hrs

Question 41

Fentanyl dosage

Answer 41

Lozenge buccal 800 micro grams q15min max 2