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pharmpharm(from shared med emerg doc) Flashcards

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1
Q

What is the class of Oxygen?

A

Medical Gas

Oxygen is used in various medical scenarios to increase oxygen saturation in the blood.

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2
Q

What is the dose of Oxygen for non-rebreather masks?

A

10-15 lpm NRB (60%-90%)

Non-rebreather masks are used for patients requiring high concentrations of oxygen.

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3
Q

What is the primary mechanism of action (MOA) of Oxygen?

A

Increases the amount of oxygen available to the body’s tissues and saturation in the blood.

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4
Q

List the indications for administering Oxygen.

A
  • Hypoxia
  • Cardiac Arrest
  • Angina
  • Stroke
  • Respiratory distress
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5
Q

What is a contraindication for Oxygen therapy?

A

Severe COPD (hypoxic drive vs hypercarbia drive)

In patients with severe COPD, the drive to breathe may depend on low oxygen levels.

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6
Q

What is the class of Normal Saline?

A

Isotonic Solution

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7
Q

What is the dose range for Normal Saline?

A

250cc, 500cc, 1000cc IV, IO

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8
Q

What is the primary MOA of Normal Saline?

A

Provides fluid resuscitation and restores blood volume.

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9
Q

What is the indication for using Normal Saline?

A

Fluid Resuscitation & Therapy

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10
Q

What is a contraindication for Normal Saline?

A

Heart and kidney failure

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11
Q

What class of medication is Aspirin?

A

NSAID (Non-steroidal anti-inflammatory drugs)

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12
Q

What is the usual dose of Aspirin?

A

81mg x 4 = 324mg chew

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13
Q

What is the MOA of Aspirin?

A

Prevents platelets from clumping together (blood = slippery)

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14
Q

List the indications for Aspirin.

A
  • Angina
  • Suspected MI
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15
Q

What is a contraindication for Aspirin?

A

Ulcer and Asthma

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16
Q

What class of medication is Nitroglycerin?

A

Vasodilator

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17
Q

What is the dose of Nitroglycerin?

A

0.4mg SL q 3-5min

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18
Q

What is the primary MOA of Nitroglycerin?

A

Vasodilation (coronary arteries), relaxation and dilation of coronary arteries, reducing myocardial oxygen demand and improving blood flow to the heart muscle.

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19
Q

List the indications for Nitroglycerin.

A
  • Angina
  • ACS
  • Heart failure with pulmonary edema
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20
Q

What is a contraindication for Nitroglycerin?

A

ED drugs

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21
Q

What class of medication is Atropine?

A

Parasympatholytic, anticholinergic

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22
Q

What is the dose of Atropine?

A

1mg IVP (max 3 doses)

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23
Q

What is the MOA of Atropine?

A

Competes with acetylcholine at receptors on the AV and SA node, enhances SA node automaticity, and AV conduction, increases HR, CO.

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24
Q

What is the primary indication for Atropine?

A

1st line treatment for sinus bradycardia

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25
What is a contraindication for Atropine?
Acute MI
26
What class of medication is Clopidogrel (Plavix)?
Antiplatelet
27
What is the dose of Clopidogrel?
300-600mg loading dose
28
What is the MOA of Clopidogrel?
Block ADP binding site (makes it slippery)
29
List the indications for Clopidogrel.
* Angina * Suspected STEMI
30
What is a contraindication for Clopidogrel?
Increased risk of bleeding
31
What class of medication is Epinephrine?
Catecholamine, Sympathomimetic, bronchodilator, vasopressor
32
What is the dose of Epinephrine?
2-10mcg/min (titrate to patient response)
33
What is the MOA of Epinephrine?
Alpha/Beta agonism increases inotropy, chronotropy, systemic vascular resistance.
34
List the indications for Epinephrine.
* 1st line treatment for cardiac arrest * Treatment of severe symptomatic hypotensive sinus bradycardia
35
What is a contraindication for Epinephrine?
Active arrhythmias with a pulse
36
What class of medication is Heparin?
Anticoagulant
37
What is the dose of Heparin?
60u/kg up to 4,000U
38
What is the MOA of Heparin?
Anticoagulant, prevents conversion of fibrinogen to fibrin.
39
List the indications for Heparin.
* Acute STEMI * ACS * DVT * PE * Ischemic stroke
40
What is a contraindication for Heparin?
Active bleeding
41
What class of medication is Dopamine?
Inotropic agent, vasopressor, adrenergic.
42
What is the dose range for Dopamine?
* 1-3 mcg/kg/min for Dopaminergic effect * 3-10 mcg/kg/min for Beta 1 & 2 and Dopaminergic effect * 10+ mcg/kg/min for Alpha, Beta 1, Beta 2, and Dopaminergic effect
43
What is the MOA of Dopamine?
Stimulates both alpha and beta-adrenergic receptors, increases HR, CO.
44
List the indications for Dopamine.
* 2nd line drug for symptomatic bradycardia * Use for hypertension SBP <70-100 with signs of shock
45
What is a contraindication for Dopamine?
Tachycardia
46
What class of medication is Furosemide (Lasix)?
Loop diuretic
47
What is the dosing for Furosemide in emergencies?
Begin with 40 mg IV, IO.
48
What is the MOA of Furosemide?
Inhibits the absorption of sodium and chloride ions and water in the loop of Henle, increasing urine production.
49
List the indications for Furosemide.
* Pulmonary edema * CHF * Hypertensive emergency
50
What is a contraindication for Furosemide?
Known sensitivity to sulfonamides or furosemide.
51
What class of medication is Procainamide?
Antiarrhythmic, Class IA
52
What is the dose of Procainamide?
20mg/min IV infusion (max 17mg/kg)
53
What is the MOA of Procainamide?
Blocks the influx of sodium through membrane pores, suppressing atrial and ventricular arrhythmias.
54
List the indications for Procainamide.
* A-fib with RVR in WPW syndrome * V-Tach
55
What is a contraindication for Procainamide?
AV block, QT prolongation, torsades de pointes.
56
What class of medication is Lidocaine?
Class 1b Antiarrhythmic (Sodium Channel Blocker)
57
What is the dose of Lidocaine for cardiac arrest?
1 - 1.5mg/kg IV (cardiac arrest)
58
What is the MOA of Lidocaine?
Blocks sodium channels, decreasing slope of phase 0 of depolarization.
59
List the indications for Lidocaine.
* V-Tach * V-Fib
60
What is a contraindication for Lidocaine?
Normally not given to patients who are awake.
61
What class of medication is Metoprolol?
Class II antiarrhythmic (Beta-Blocker)
62
What is the dose of Metoprolol?
5mg IV q 5min slow over 2min (max 3 doses)
63
What is the MOA of Metoprolol?
Decreased HR, cardiac contractility, BP, and myocardial O2 demand.
64
List the indications for Metoprolol.
* ACS * Hypertension * SVT * Atrial Flutter * AFib * Thyrotoxicosis
65
What is a contraindication for Metoprolol?
Pulmonary edema, cardiogenic shock, hypotension, or bradycardia.
66
What class of medication is Amiodarone?
Class III Antiarrhythmic, Potassium Channel Blocker
67
What is the dose of Amiodarone for V-Tach with pulse?
150mg over 10min
68
What is the MOA of Amiodarone?
Blocks sodium, potassium, and calcium channels, prolonging cardiac action potential and repolarization.
69
List the indications for Amiodarone.
* V-Tach with pulse * Cardiac Arrest
70
What is a contraindication for Amiodarone?
Hypersensitivity
71
What class of medication is Diltiazem?
Calcium channel blocker (Class IV antiarrhythmic)
72
What is the dose of Diltiazem?
15-20 mg (0.25 mg/kg) over 2 min SLOW IV PUSH
73
What is the MOA of Diltiazem?
Calcium channel blockade inhibits calcium transport into the cell, decreasing SA and AV node conduction.
74
List the indications for Diltiazem.
* Ventricular rate control in rapid AFib and A-flutter * Second line after adenosine for narrow complex SVT
75
What is a contraindication for Diltiazem?
It may cause hypotension. Do not give to a hypotensive patient.
76
What class of medication is Adenosine?
Antiarrhythmic (regular)
77
What is the dose of Adenosine?
6mg Rapid IVP (IO) followed by 20cc NS flush
78
What is the MOA of Adenosine?
Slows the conduction of the electrical impulses of the AV node, causes transient asystole.
79
What is the indication for Adenosine?
SVT (AVNRT)
80
What is a contraindication for Adenosine?
Sick sinus syndrome, 2nd or 3rd-degree heart block.
81
What class of medication is Etomidate (Amidate)?
Anesthetic induction agent, Sedative, Hypnotic
82
What is the dose of Etomidate?
0.2 to 0.6 mg/kg slow IV, IO (over 30 to 60 seconds)
83
What is the MOA of Etomidate?
Enhances the activity of the GABA receptors in the central nervous system.
84
List the indications for Etomidate.
* Procedural Sedation * Induction for rapid sequence intubation * Induction of anesthesia
85
What is a contraindication for Etomidate?
Hypersensitivity
86
What class of medication is Ketamine?
Analgesic, Sedative
87
What is the dose of Ketamine for RSI?
1.5mg/kg
88
What is the MOA of Ketamine?
NMDA Receptor stimulator.
89
List the indications for Ketamine.
* Pain and anesthesia for procedures of short duration * RSI Induction agent
90
What is a contraindication for Ketamine?
Hypoglycemia or known sensitivity.
91
What class of medication is Versed (Midazolam)?
Benzodiazepine
92
What is the dose of Versed?
0.2-0.3mg/kg
93
What is the MOA of Versed?
Binds to drug-specific receptors of the GABA complex, increasing the frequency of chloride channel openings.
94
List the indications for Versed.
To promote amnesia and sedation.
95
What is a contraindication for Versed?
Use caution in volume-depleted or hemodynamically compromised PTs.
96
What class of medication is Fentanyl?
Opioid Analgesic
97
What is the dose of Fentanyl?
50-100mcg/min (max total 300mcg)
98
What is the MOA of Fentanyl?
Binds to mu-opioid receptors in the central nervous system, leading to analgesic and sedative effects.
99
List the indications for Fentanyl.
* Moderate to severe pain * Procedural sedation
100
What is a contraindication for Fentanyl?
Hypersensitivity
101
What class of medication is Propofol?
Anesthetic
102
What is the dose of Propofol?
1.5mg/kg
103
What is the MOA of Propofol?
Enhances GABA activity at the GABA receptor complex.
104
List the indications for Propofol.
Induction agent of choice for pregnant PTs.
105
What is a contraindication for Propofol?
No absolute contraindications. Use caution in PTs with egg allergy.
106
What class of medication is Morphine?
Opioid Analgesic
107
What is the dose of Morphine?
2-4mg IV
108
What is the MOA of Morphine?
Binds to mu-opioid receptors in the CNS, producing analgesic and sedative effects.
109
List the indications for Morphine.
* Moderate to severe pain * Chest pain associated with ACS * Angina * Congestive heart failure * Pulmonary edema
110
What is a contraindication for Morphine?
Hypotension
111
What class of medication is Succinylcholine?
Depolarizing neuromuscular blocker
112
What is the dose of Succinylcholine?
2mg/kg rapid onset
113
What is the MOA of Succinylcholine?
Competes with ACH receptors of the motor end plates on the muscle cells, resulting in paralysis.
114
List the indications for Succinylcholine.
To induce paralysis for the facilitation of ET intubation.
115
What is a contraindication for Succinylcholine?
Malignant hyperthermia, burns, trauma.
116
What class of medication is Rocuronium?
Non-depolarizing NM blocker
117
What is the dose of Rocuronium?
1.5mg/kg IV/IO push
118
What is the MOA of Rocuronium?
Competitive NMBA, Non-depolarizing.
119
List the indications for Rocuronium.
Provides skeletal muscle relaxation to facilitate ET intubation.
120
What is a contraindication for Rocuronium?
Known sensitivity to bromides.
121
What class of medication is Vecuronium?
Non-depolarizing NMBA
122
What is the dose of Vecuronium?
0.1mg/kg
123
What is the MOA of Vecuronium?
Antagonizes the action of acetylcholine at the neuromuscular junction.
124
What is the dose for Succinylcholine?
1.5mg/kg IV/IO push ## Footnote Onset: 40sec, Duration: 40-60min
125
What is the mechanism of action (MOA) of Succinylcholine?
Competitive NMBA, Non-depolarizing
126
What are the indications for Succinylcholine?
Provides skeletal muscle relaxation to facilitate ET intubation
127
What is a contraindication for Succinylcholine?
Known sensitivity to bromides
128
What is the class of Vecuronium?
Non-depolarizing NMBA
129
What is the dose for Vecuronium?
0.1mg/kg
130
What is the onset time for Vecuronium?
1-2 minutes
131
What is the duration of action for Vecuronium?
25-30 minutes
132
What is the MOA of Vecuronium?
Antagonizes ACH receptors at the neuromuscular end plates, inducing paralysis
133
What are the indications for Vecuronium?
NMB for ET intubation
134
What is the class of Diazepam (Valium)?
Benzo
135
What is the dose range for Diazepam?
2-5 mg IV/IM
136
What is the onset time for Diazepam?
1-5 minutes
137
What is the duration of action for Diazepam?
15-60 minutes
138
What is the MOA of Diazepam?
Benzodiazepine that depresses CNS and has anticonvulsant properties
139
What are the indications for Diazepam?
Post-intubation sedation
140
What is a contraindication for Diazepam?
Inadequate pulmonary function, hypotension, and apnea
141
What is the class of Albuterol?
Adrenergic Bronchodilator
142
What is the dose for Albuterol via nebulizer?
2.5mg Nebulizer for COPD/Asthma
143
What is the duration of action for Albuterol?
3-6 hours
144
What is the MOA of Albuterol?
Relaxes airways and smooth muscles, causing Bronchodilation by binding to Beta 2 adrenergic receptors
145
What are the indications for Albuterol?
COPD, Asthma
146
What is a contraindication for Albuterol?
Known hypersensitivity
147
What is the class of Dexamethasone?
Corticosteroid
148
What is the dose for Dexamethasone?
0.6mg/kg up to 10mg IV
149
What is the MOA of Dexamethasone?
Suppresses inflammation and immune response
150
What are the indications for Dexamethasone?
Anaphylaxis, Asthma
151
What is a contraindication for Dexamethasone?
Untreated infections
152
What is the class of Diphenhydramine (Benadryl)?
Antihistamine
153
What is the dose range for Diphenhydramine?
25-50mg IV/IM
154
What is the MOA of Diphenhydramine?
Antagonizes histamine effects
155
What are the indications for Diphenhydramine?
Allergic reaction
156
What is a contraindication for Diphenhydramine?
Known hypersensitivity
157
What is the class of Epinephrine?
Bronchodilator
158
What is the dose range for Epinephrine in anaphylaxis?
0.3-0.5mg SQ/IM of epi 1:1,000
159
What is the MOA of Epinephrine?
Beta-2 adrenergic effects causing bronchodilation
160
What are the indications for Epinephrine?
Anaphylaxis, Severe Asthma
161
What is a contraindication for Epinephrine?
Known hypersensitivity
162
What is the class of Ipratropium Bromide (Atrovent)?
Anticholinergic Bronchodilator
163
What is the dose for Ipratropium Bromide?
0.5mg Nebulized
164
What is the MOA of Ipratropium Bromide?
Inhibits bronchial secretions and constriction by blocking parasympathetic response
165
What are the indications for Ipratropium Bromide?
Asthma/COPD
166
What is a contraindication for Ipratropium Bromide?
Known hypersensitivity
167
What is the class of Magnesium Sulfate?
Electrolyte
168
What is the dose range for Magnesium Sulfate?
1.2-2g over 20 mins
169
What is the MOA of Magnesium Sulfate?
Smooth muscle relaxant, bronchodilator
170
What are the indications for Magnesium Sulfate?
Asthma exacerbation
171
What is a contraindication for Magnesium Sulfate?
Known hypersensitivity
172
What is the class of Methylprednisolone (Solu-Medrol)?
Corticosteroid
173
What is the dose for Methylprednisolone?
2mg/kg IV/IM or 125mg IV/IM
174
What is the MOA of Methylprednisolone?
Suppresses inflammation and immune response
175
What are the indications for Methylprednisolone?
Severe asthma
176
What is a contraindication for Methylprednisolone?
Known hypersensitivity
177
What is the class of Epinephrine in cardiac arrest?
Catecholamine, adrenergic agent, vasopressor, bronchodilator
178
What is the dose for Epinephrine in cardiac arrest?
1mg (1:10,000) IV/IO q3-5mins
179
What is the MOA of Epinephrine in cardiac arrest?
Beta 1 & 2 agonist, Alpha 1 agonist
180
What are the indications for Epinephrine in cardiac arrest?
Cardiac arrest or symptomatic bradycardia
181
What is a contraindication for Epinephrine in cardiac arrest?
Known hypersensitivity or cardiac arrhythmias
182
What is the class of Amiodarone?
Class III antiarrhythmic
183
What is the dose for Amiodarone in V-Fib/pV-Tach?
300mg IV/IO followed by 150mg IV/IO
184
What is the MOA of Amiodarone?
Prolongs action potential and refractory period; slows sinus rate
185
What are the indications for Amiodarone?
Ventricular fibrillation/ventricular tachycardia
186
What is a contraindication for Amiodarone?
Known hypersensitivity
187
What is the class of Lidocaine?
Class IB antiarrhythmic
188
What is the dose for Lidocaine in cardiac arrest?
1-1.5 mg/kg IV/IO
189
What is the MOA of Lidocaine?
Suppresses automaticity and spontaneous depolarization of ventricles
190
What are the indications for Lidocaine?
Alternative to amiodarone in VF/VT cardiac arrest
191
What is a contraindication for Lidocaine?
3rd degree AV block
192
What is the class of Magnesium?
Mineral/Electrolyte
193
What is the dose for Magnesium in TdP?
1-2g IV/IO diluted in 10mL of D5 or NS
194
What is the MOA of Magnesium?
Essential for the activity of many enzymes
195
What are the indications for Magnesium?
Polymorphic V-Tach with Torsades de Pointes
196
What is a contraindication for Magnesium?
Heart block
197
What is the class of Calcium Chloride?
Electrolyte, positive inotrope
198
What is the dose for Calcium Chloride?
500-1000mg IV/IO for hyperkalemia
199
What is the MOA of Calcium Chloride?
Returns Ca++ levels to normal for optimal nerve and muscle function
200
What are the indications for Calcium Chloride?
Hyperkalemia, Hypocalcemia, Calcium channel blocker overdose
201
What is the class of Sodium Bicarbonate?
Alkalizing agent
202
What is the dose for Sodium Bicarbonate?
1mEq/kg IV bolus
203
What is the MOA of Sodium Bicarbonate?
Acts as a buffer to hydrogen ions, reducing acidosis
204
What are the indications for Sodium Bicarbonate?
Hyperkalemia, acidosis, prolonged downtime
205
What is a contraindication for Sodium Bicarbonate?
Lack of effective ventilation
206
What is the class of Lorazepam (Ativan)?
Benzodiazepine, Schedule C-IV
207
What is the dose for Lorazepam?
1-2mg IV/IM
208
What is the MOA of Lorazepam?
Enhances effects of GABA, leading to sedation and anticonvulsant activity
209
What are the indications for Lorazepam?
Pre-procedure sedation induction, Anxiety, Status Epilepticus
210
What is a contraindication for Lorazepam?
Known sensitivity to lorazepam or benzodiazepines
211
What is the class of Midazolam (Versed)?
Benzodiazepine, Schedule C-IV
212
What is the dose for Midazolam?
5-10mg IV/IM
213
What is the MOA of Midazolam?
Enhances effects of GABA, producing CNS depression
214
What are the indications for Midazolam?
Sedation, Anxiety, Skeletal muscle relaxation
215
What is a contraindication for Midazolam?
Acute-angle glaucoma, pregnant women
216
What is the class of Meperidine hydrochloride (Demerol)?
Opioid analgesic; synthetic opioid; Schedule II drug
217
What is the dose for Meperidine?
50 to 100 mg IM or 25 to 50 mg slowly IV/IO
218
What is the MOA of Meperidine?
Synthetic opioid analgesic that acts similarly to morphine
219
What are the indications for Meperidine?
Analgesia for moderate to severe pain
220
What is a contraindication for Meperidine?
Known hypersensitivity, diarrhea caused by poisoning
221
What is the class of Morphine?
Opioid Analgesic
222
What is the dose for Morphine?
2-4mg IV
223
What is the MOA of Morphine?
Binds to mu-opioid receptors in the CNS, producing analgesic effects
224
What are the indications for Morphine?
Moderate to severe pain, including chest pain associated with ACS
225
What is the class of Ketorolac (Toradol)?
NSAID, nonopioid analgesic
226
What is the dose for Ketorolac?
30-60 mg IM or 15 mg IVP
227
What is the MOA of Ketorolac?
Inhibits prostaglandin synthesis
228
What are the indications for Ketorolac?
Acute management of moderate to severe pain
229
What is a contraindication for Ketorolac?
NSAID or ASA allergy
230
What is the class of Fentanyl?
Opioid Analgesic
231
What is the dose for Fentanyl?
50-100mcg/min (max total 300mcg)
232
What is the MOA of Fentanyl?
Binds to mu-opioid receptors, increasing potassium efflux and decreasing calcium influx
233
What are the indications for Fentanyl?
Moderate to severe pain, Procedural sedation
234
What is the class of Ondansetron (Zofran)?
Selective serotonin receptor (5-HT3) antagonist, antiemetic
235
What is the dose for Ondansetron?
4 mg IV/SL or orally
236
What is the MOA of Ondansetron?
Blocks the action of serotonin, preventing nausea and vomiting
237
What are the indications for Ondansetron?
Prevention and control of nausea or vomiting
238
What is a contraindication for Ondansetron?
Known hypersensitivity to ondansetron
239
What is the class of Promethazine (Phenergan)?
Phenothiazine, antiemetic, antihistamine
240
What is the dose for Promethazine?
12.5 to 25 mg deep IM
241
What is the MOA of Promethazine?
H1 receptor antagonist; blocks action of histamine
242
What are the indications for Promethazine?
Nausea and vomiting
243
What is a contraindication for Promethazine?
Known hypersensitivity to promethazine

TCC pm pharm (4 decks)

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