On board drugs

Question 1

Precautions for Fentanyl:

Answer 1

Pregnancy, used with caution in elderly, severe respiratory/cardiac disorders

Question 2

Drug action for Fentanyl:

Answer 2

Binds with receptor sites in the brain to produce analgesic affects

Question 3

Indications for Fentanyl:

Answer 3

Pain control, sedation for invasive airway procedures (RSI and PAI)

Question 4

Route Fentanyl is given:

Answer 4

IV, IO and IN

Question 5

Class of Fentanyl:

Answer 5

Opioid analgesic, synthetic narcotic

Question 6

Side effects for Fentanyl:

Answer 6

Respiratory depression, bradycardia, hypo/hypertension, nausea/vomiting

Question 7

Contraindications for Fentanyl:

Answer 7

Respiratory depression, hypotension, head injury, cardiac dysrhythmias, hypersensitivity to opioids

Question 8

Dose for Fentanyl:

Answer 8

Adult: 1-2 mcg/kg (200 mcg max)

Pediatric: 1-2 mcg/kg

Question 9

Antidote for Fentanyl:

Answer 9

Narcan 0.4 mg IN, IVP, or IO, titrated to effect up to 2 mg

Question 10

Class of Morphine Sulfate:

Answer 10

Narcotic- narcotic analgesic or opioid analgesic

Question 11

Route Morphine is given:

Answer 11

IVP (IV push)

Question 12

Dose for Morphine:

Answer 12

Adult: 2-4 mg slow IV push up to a max of 20 mg

Pediatric: 0.1 mg/kg

Question 13

Drug action for Morphine:

Answer 13

Alleviates pain, vasodilator, decrease cardiac workload and oxygen demand, decreases anxiety, CNS depressent

Question 14

Indications for Morphine:

Answer 14

Pain and anixety secondary to AMI, chest pain unrelieved by nitro, pain control, pulmonary edema

Question 15

Precautions to Morphine:

Answer 15

Monitor respiratory and B/P status. Have narcan available

Question 16

Side effects to Morphine:

Answer 16

Respiratory depression, dizziness, hypotension, bradycardia, nausea/vomiting, itching and constipation

Question 17

Contraindicatoins for Morphine:

Answer 17

Systolic B/P <90 mmHg, traumatic brian injury, severe respiratory depression

Question 18

Antidote for Morhpine:

Answer 18

Narcan 0.4 mg IN, IVP, or IO, titrated to affect up to 2 mg

Question 19

Class of Albuterol:

Answer 19

Sympathomimetic

Question 20

Route Albuterol is given:

Answer 20

Inhaled (can be given via the ET tube)

Question 21

Dose of Albuterol:

Answer 21

Adult: Nebulized inhaler 2.5 mg over 5-15 mins

Pediatric: Same as adult

Question 22

Drug action of Albuterol:

Answer 22

Causes bronchodilation via Beta 2

Question 23

Indications for Albuterol:

Answer 23

Bronchospasm from asthma or COPD, allergic reactions, unresponsive to Epi or Benadryl

Question 24

Precautions for Albuterol:

Answer 24

Known heart disease

Question 25

Side effects for albuterol:

Answer 25

Restlessness, hypertension, tachycardia

Question 26

Contraindications for Albuterol:

Answer 26

Pregnancy (except in life-threatening situations), can increase the heart rate and blood sugar levels in the fetus

Question 27

Class of Aspirin:

Answer 27

NSAID, anti-platelet aggregator, analgesic, anti-inflammatory, antipyretic

Question 28

Route Aspirin is given:

Answer 28

Oral

Question 29

Dose for Aspirin:

Answer 29

One (325 mg) adult aspirin or four (81 mg) baby aspirin, standing order regardless of whether the patient has taken any aspirin within the previous 24 hours Pediatric: Not given; call medical control

Question 30

Drug action for Aspirin:

Answer 30

Reduces platelet stickiness, blocks pain impulses in the CNS, dilates peripheral vessels, reduces coronary artery vasoconstriction

Question 31

Indications for Aspirin:

Answer 31

Chest pain believed to be of cardiac origin, aspirin prevents blood from clotting by blocking the production of thromboxane, A-2 by platelets

Question 32

Precautions for Aspirin:

Answer 32

Any significant bleeding and chronic use can casue GI bleeding

Question 33

Side effects of Aspirin:

Answer 33

None for pre-hospital

Question 34

Contraindications for Aspirin:

Answer 34

Aspirin allergy, aspirin-induced asthma and hemorrhagic stroke

Question 35

Class of Epi 1:1:

Answer 35

Sympathomimetic

Question 36

Route Epi 1:1 is given:

Answer 36

Subcutaneous (SQ) or IVPB drip (rarely)

Question 37

Dose of Epi 1:1:

Answer 37

Adult: Asthmatic bronchonconstriction and allergic reaction/anaphylaxis- .3 mg- .05 mg SQ Proufound Bradycardia- 2-10 mcg/min IVPB continuous infusion, titrated to effect, mix 1 mg in 500 mL of NS or D5W Pediatric: Asthmatic bronchoconstriction and allergic reaction/anaphylactic- 0.01 mg/kg SQ (max 0.3 mg per dose) Profound bradycardia- 0.1-1 mcg/kg/min IVPB continuous infusion, titrated to effect, mix 1 mb in 250 mL

Question 38

Drug action of Epi 1:1:

Answer 38

Alpha: peripheral vasoconstriction- increases blood pressure in anaphylaxis, decreases vessel permeability, increases coronary cereral perfusion Beta 1: Increases heart rate and increases contractoin strength Beta 2: Bronchodilation

Question 39

Indications for Epi1:1:

Answer 39

Asthmatic bronchospasm refractory (doesn't respond) to Albuterol and Atrovent. Allergic reaction/anaphylaxis. Profound, symptomatic bradycardia refractory to other treatments

Question 40

Precautions for Epi1:1:

Answer 40

Monitor ECG closely, massage the site vigorously after SQ injections, patients on beta blockers may need higher doses of ipinephrine and/or Glucagon

Question 41

Side effects of Epi 1:1:

Answer 41

Headache, flushing. Nausea, vominting. Restlessness, tremors, trachycardia, HTN, myocradial ischemia/infarction, chest pain and arrhythmias

Question 42

Contraindications of Epi 1:1:

Answer 42

Asthma-heart disease/history of AMI, over 45, arrhythmias, labor

Question 43

Class of Epi 1:10:

Question 44

Route Epi 1:10 is given:

Answer 44

IVP (IV push)

Question 45

Dose for Epi 1:10:

Answer 45

Adult: Cardiac arrest- 1 mg IVP Anaphylaxis- 0.1-0.2 mg slow IVP (.1 mg/min), Profound symptomatic bradycardia- 2-10 mcg/min IVPB continuous infusion, titrated to effect. Mix 1 mg in 250 mL or 500 mL of NS or D5W Pediatric: Cardiac arrest- IV 0.01 mg/kg rapid IVP Anaphylaxis- 0.01 mg/kg slow push (0.1 mg/min- max is 0.3 mg per dose) Proufound symptomatic bradycardia- 0.01 mg/kg slow IVP (0.1 mg/min- max 0.3 mg per dose)

Question 46

Drug action of Epi 1:10:

Answer 46

Alpha: Peripheral vasoconstriction Beta 1: Increases heart rate and increases contraction strength Beta 2: Bronchodilation

Question 47

Indicatoins for Epi 1:10:

Answer 47

Cardiac arrest, anaphylaxis that is refractory to epi 1:1 and fluid boluses Pediatric- profound, symptomtic bradycardia refractory to other treatments- never give Epi IVP to live adults in bradycardia

Question 48

Precautions of Epi 1:10:

Answer 48

None in CPR, anaphylaxis- use cautiously in patients with COPD, CHF, history of AMI or heart diease, age over 45, HTN, arrhythmias and labor. Monitor ECG closely. Patients on beta blockers may need higher doses of Epi and/or Glucagon. Don't mix with Sodiuym Bicarb- flush between drugs

Question 49

Side effects of Epi 1:10:

Answer 49

CPR none. Anaphylaxis- increases in myocardial oxygen deman leading to tachycardia, chest pain and arrhythmias, headache, flushing, nausea, vomiting, restlessness and tremors

Question 50

Contraindications for Epi 1:10:

Answer 50

None- if the need it, give it to them

Question 51

Class of Atrovent (ipratropium bromide):

Answer 51

Anticholinergic

Question 52

Route Atrovent is given:

Answer 52

Inhaled

Question 53

Dose of Atrovent:

Answer 53

Adult: Nebulized inhaler 0.5 in 2.5 mL NS Pediatric: \<1 year old 0.25 in 2.5 mL NS \>1 year or older- same as adult

Question 54

Drug action of Atrovent:

Answer 54

Causes bronchodilation and dries secretions, anticholinergic action

Question 55

Indications for Atrovent:

Answer 55

Bronchospasm from asthma or COPD that does not respond to 1st dose of Albuterol, also used for bronchospasm from chemical toxins

Question 56

Precautions for Atrovent:

Answer 56

Notify med control prior to administratoin if patient has a PMHX of glaucoma, prostatic hypertrophy (BPH), bladder neck obstruction

Question 57

Side effects of Atrovent:

Answer 57

Dry mouth, cough or worsening of symptoms, skin rash, nausea/vomiting, headache and blurred vision

Question 58

Contraindications of Atrovent:

Answer 58

Sensitivity to soy products (soybeans, peanuts), sensitivity to Atropine, bronchoconstriction due to allergic reaction

Question 59

Class of Nitroglycerin:

Answer 59

Vasodilator

Question 60

Route Nitro is given:

Answer 60

SL usually a spray or tablet

Question 61

Dose for Nitro:

Answer 61

Adult: 1 spray (0.4 mg) or 1 tablet (0.4) SL, may repeat twice q 5 Pediatric: Not used in the pre-hospital setting

Question 62

Drug action for Nitro:

Answer 62

Dilates coronary and systemic vessels, decreases PVR, preload and afterload, decreases cardiac workload, decreases O2 demand on heart

Question 63

Indications for Nitro:

Answer 63

Chest pain of cardiac origin, pulmonary edema associated with CHF (Bp needs to be greater than 90)

Question 64

Precautions for Nitro:

Answer 64

For acute coronary syndrome, perform 12 lead first, watch BP closely, ensure patient is sitting or lying down, may "sting" under tongue or taste bitter, if suspected inferior wall AMI, ensure IV in place prior to administration

Question 65

Side effects to Nitro:

Answer 65

Hypotension, headache, postural hypotension/syncope, reflex tachycardia, nauseas/vomiting, diaphoresis

Question 66

Contraindications for Nitro:

Answer 66

Systolic B/P \<90 mmHg, increases intracranial pressure, Viagra or Levitra within previous 24 hrs or Cialis (48 hrs), hypersensitivity, extreme bradycardia (HR \<50), extreme tachycardias ( HR \>100)