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Term 1 > Pharm > Flashcards

Pharm Flashcards

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1
Q

Class of Adenosine

A

Antiarrhythmic and endogenous nucleoside

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2
Q

Adenosine Dosage

A

Adult:
Initial - 6mg rapid IV push
Follow up - 12mg rapid push

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3
Q

Amiodarone Class

A

Class III Antiarrythmic - Lengthens cardiac action potential and slows conduction prolonging refractoriness by blocking K+ channels

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4
Q

Amiodarone Dosage

A

Adult: VF or PVT - 300mg IV push repeat of 150mg after 10 min.
Unstable VT - 150mg over 10 min
Stable Monomorph WCT - 150mg over 10 min.

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5
Q

Atropine Class

A

Anticholinergic and Antimuscarinic

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6
Q

Atropine Indications

A 
Restore rhythm in bradydysrythmia
Sinus brady with hemo compromise
Brady second to AV block
Organophosphate poisoning
Palliative control of secretions
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7
Q

Atropine Dosage

A

Bradycardia - 0.6mg IV (max dose 0.04mg/kg)
Organophosphate poisoning - 1-2mg repeat q 30s- 5min.
Secretion - 0.6mg IM

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8
Q

Atropine Contraindications

A 
Hypersensitivity
Tachycardia
Narrow-angle glaucoma
Thyrotoxicosis
Prostatic hypertropy
Myasthena Gravis
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9
Q

Atropine MOA

A

Antagonizes ACh at muscarinic M2 receptors producing parasympatholytic effects

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10
Q

Amiodarone MOA

A

Class III antiarrhythmic, poses characteristics of all classes. Blocks Na channels, antagonizes beta receptors, produces negative chronotropic effects in nodal tissue, lengthens action potential, and slows conduction and prolongs refractoriness by blocking K channels

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11
Q

Calcium Chloride Classification

A

Electrolyte

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12
Q

CaCl Indications

A
  • Cardiac arrest due to hyperkalemia
  • Hyperkalemia with cardiotoxicity
  • Ca channel OD with symptomatic bradycardia and hemodynamic instability
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13
Q

Calcium Chloride Dose

A

Adult dose: - 1g over 3 min. can repeat once after 10 minutes
Peds dose:
CA - 20mg/kg over 3 minutes
other causes 10mg/kg over 15 minutes

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14
Q

CaCl Contraindications

A

Hypersensitivity
Primary or secondary hypercalcemia
Tissue irritation may occur
Extravasation causes necrosis

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15
Q

Epinephrine Indications

A 
Anaphylaxis
Severe Bronchospasm
Severe croup
Cardiac Arrest
Peri Arrest Hypotension
Significant bradycardia
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16
Q

Epinephrine dosage in Arrest

A

Adult: 1mg IV/IO q 3-5 min max- 3-4 doses
Peds: 0.01mg/kg IV/IO q 3-5 min. max. 3-4 doses

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17
Q

Epinephrine - Peri Arrest Hypotension Dosage

A

Adult - 10mcg IV/IO slow push q2-3

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18
Q

Epi Dosage Adult Bradycardia

A

2-10 mcg/minute IV/IO infusion

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19
Q

Epinephrine MOA

A

Acts on alpha and beta receptors. Alpha effects - vasoconstriction, reduces vascular permeability
Beta effects - bronchial smooth muscle relaxation, increased HR, increased cardiac contractility

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20
Q

Epinephrine Pre-arrest anaphylaxis

A

Adult: 50-100mcg IV/IO
Peds: 5mcg/kg IV/IO

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21
Q

Fentanyl Dose Adult

A

Initial loading dose 0.5-1.0 mcg/kg max. 100mcg q5minutes up to 300mcg
Maintenance - 50mcg/kg q 10min max. 250mcg/hr

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22
Q

Fentanyl Onset

A

IV- Immediate

IM - 7-15 minutes

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23
Q

Ipatropium class

A

anticholinergic bronchodilator

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24
Q

Ipratropium Dose

A

160mcg (8x20mcg)

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25
Ketamine Indications
Analgesia, Induction, Sedation, Procedural Sedation, Severe agitation
26
Ketamine Analgesia Dose
``` IV Analgesia - 0.3mg/kg slow push repeat @ 5min. 0.15mg/kg Max. 0.6 mg/kg in 45 minutes IM 0.5mg/kg ```
27
Ketamine Procedural Sedation Dose
0.1-0.5mg/kg slow IV Push q 60 seconds to effect
28
Ketamine MOA
Ketamine is a non-competitive NMDA receptor antagonist that blocks glutamate. Low doses produce analgesia and modulate central sensitization, hyperalgesia, and opioid tolerance. Reduces polysynaptic spinal reflexes.
29
Lidocaine MOA
As a sodium channel blocker, lidocaine decreases the duration of the action potential by shortening the period of repolarization.
30
Magnesium Sulfate MOA
The precise mechanism of action of magnesium sulfate is not entirely clear. It appears to alter membrane potential, slowing conduction and relaxing smooth muscle.
31
Midazolam MOA
Like other benzodiazepines, MIDAZOLam intensifies the activity of gamma aminobutyric acid, the major inhibitory neurotransmitter in the central nervous system. This action is believed to result in hyperpolarization of neuronal cells, which then take longer to reach threshold and depolarize.
32
Phenylephrine MOA
Agonizes alpha-adrenergic receptors producing arterial vasoconstriction.
33
Amiodarone Indications
VF. pVT, unstable VT, Recurrent VT following cardioversion
34
Amiodarone Contraindications
Hypersensitivity Cardiogenic Shock Marked Sinus Bradycardia Second and Third degree block
35
Adenosine contraindications
Hypersensitivity | 2nd and 3rd degree AV block or sick sinus without a pacemaker
36
Adenosine Pharmacokinetics
Onset - immediate Peak - immediate Duration <10s
37
Adenosine Indications
Conversion and termination of SVT
38
Amiodarone Phamacokinetics
2-2-2 Onset - 2 minutes Peak - 20 minutes Duration 2 hours
39
Atropine Pharmacokinetics
Onset - <2 minutes Peak - 2-4 min IV Duration 2-6 hours
40
Calcium Chloride Pharmacokinetics
Onset 5-15 minutes | Duration - Dose-dependent may persist up to 4 hrs
41
Calcium Chloride MOA
Essential for nerve conductions, muscle contraction and coagulation. Administered to improve myocardial contractility and ventricular automaticity In hyperkalemia causes an increase in threshold potential and restoration of gradient between resting potential and threshold potential
42
Epinephrine Pharmacokinetics
Onset - 30s IV; 30-90s IM Peak - 3-5min IV; 4-10min IM Duration - 5-10 min
43
Fentanyl Contraindications
``` Hypersensitivity Myasthenia gravis Pre-existing resp depression Acute Asthma Upper airway obstruction ```
44
Fentanyl Pharmacokinetics
Onset - Immediate (IV); 7-15 min(IM) Peak - <5min(IV); 2min (IN); 1-2 hrs (IM) Duration 30-60 min(IV); 1-2 hrs(IM)
45
Fentanyl Indications
Moderate or severe pain | Adjunct to awake intubation
46
Fentanyl MOA
Inhibits ascending pain pathways in CNS, alters pain perception by binding to operate receptors producing analgesia and euphoria
47
Ipatropium Contraindications
Hypersensitivity
48
Ipatropium Indications
Severe bronchospasm
49
Ipatropium Pharmacokinetics
Onset 3-5 minutes Peak - 1.5 -2 hrs Duration - 6 hrs
50
Ketamine Contraindications
Hypersensitivity Unable to manage adverse effects Conditions where elevated BP may be harmful Age <6 months
51
Ketamine Pharmacokinetics
Onset - 30s | Duration - 5-10 minutes with recovery 1-2 hrs
52
Ketamine Induction dose
Shock index >1 1mg/kg | Shock index <1 2mg/kg
53
Lidocaine contraindications
Hypersensitivity Third degree AV block Vent escape rhythm WPW
54
Lidocaine Pharmacokinetics
Onset - 45-90 s Peak - 5-10 min Duration - 10 - 20 min (IV)
55
Lidocaine Indications
Control of ventricular arrhythmias | Local anesthesia during IO or awake intubation
56
Magnesium Sulfate Contraindications
Hypersensitivity | Second or third degree AV block
57
Magnesium Sulfate Pharmacokinetics
Onset 1-2 minutes Peak <5 min Duration- 30 min as anticonvulsant
58
Magnesium Sulfate Indications
VF or VT refractory to first line treatment Recurrent intermittent episodes of WCT Torsades Bronchospasm in acute asthma refractory to bronchodilators Seizures in pregnancy with associate HTN
59
Midazolam Contraindications
``` DLOC Hypotension Shock Hypersensitivity Acute narrow angle glaucoma ```
60
Midazolam indications
Sedation of agitated pt Control of seizures Anesthesia maintenance
61
Nitro contraindications
``` Hypersensitivity Use of sildenafil or vardenafil within 24 hours Use of tadalafil within 48 hours Severe anemia Tamponade or restrictive pericarditis Right sided MI Hypotension ```
62
Nitro Pharmacokinetics
Onset - 30s-2 min (SL) Peak - 5-10 min (SL) Duration 15-30 min
63
Phenylephrine Contraindications
Hypersensitivity Hypersensitivity to sulfites Severe HTN or VTach Pheochromocytoma
64
Sodium Bicarbonate Contraindications
Suspected metabolic alkalosis | Hx of excessive vomiting (excessive Cl- loss)
65
Sodium Bicarb dosage
1mEq/kg repeat half dose q 10-15min
66
Sodium Bicarb MOA
Buffers or neutralizes excess acid raising pH
67
Sodium Bicarb Pharmacokinetics
Onset 1-2 minutes Peak 30 min Duration 1-2 hrs
68
Sodium Bicarb Indications
Known or suspected hyperkalemia TCA or Salicylate OD Suspected or confirmed metabolic acidosis Pretreatment prior to weight release in crush injury

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