Pick 6 Review Flashcards
1
Q
ativan drug class
A
anticonvulsant/sedative/hypnotic/benzodiazepine
2
Q
ativan indications
A
major motor seizures, premed for cardioversion, acute anxiety
3
Q
ativan contraindications
A
hypersensitivity
4
Q
ativan SE
A
hypotension, drowsiness, HA, amnesia, respiratory depression, blurred vision, N+V
5
Q
ativan pedi dose
A
0.05 mg/kg
6
Q
ativan precautions
A
have benzo antagonist available
7
Q
ativan interactions
A
additive effects with other CNS depressants and alcohol
8
Q
versed drug class
A
benzodiazepine/anticonvulsant/sedative/hypnotic
9
Q
versed moa
A
positive allosteric modulator for GABA receptors, hyperpolarizes cells by increasing Cl- concentration
10
Q
versed indications
A
pre med for cardioversion, post-intubation sedation, seizure
11
Q
versed contraindications
A
narrow-angle glaucoma, shock, depressed vitals, alcoholic coma
12
Q
versed side effects
A
laryngospasm, bronchospasm, dyspnea, respiratory depression and arrest, drowsiness, amnesia, AMS, tachycardia, bradycardia, PVC’s, retching
13
Q
versed pedi dose
A
0.2mg/kg max of 10mg
14
Q
versed precautions
A
have resuscitative equipment available, more potent than other benzos, have benzo antagonist available
15
Q
versed interactions
A
additive effects with other CNS depressants and alcohol
16
Q
albuterol moa
A
b2 agonist causes bronchodilation
17
Q
albuterol contraindications
A
hypersensitivity, symptomatic tachycardia
18
Q
albuterol SE
A
anxiety, HA, palpitations, sweating, dizziness, nervousness, tremor, HTN, arrhythmias, chest pain, N+V
19
Q
albuterol precautions
A
monitor vitals and EKG; caution with heart disease or HTN, check lungs before and after
20
Q
albuterol interactions
A
SE increased with other sympathetic agonists, beta blockers blunt effects, MAOI’s and TCA’s may potentiate cardiovascular effects
21
Q
solu-medrol MOA
A
upregulates genes that produce inhibit inflammatory response - is an immunosuppressant
22
Q
solu-medrol onset
A
2-6 hrs
23
Q
solu-medrol peak
A
4-8 days
24
Q
solu-medrol duration
A
1-5 weeks
25
solu-medrol indicaitons
anaphylaxis,hives; asthma, copd; spinal cord injury
26
solu-medrol contraindications
none
27
solu-medrol SE
fluid retention, CHF, HTN, abd. distention, vertigo, HA, nausea, malaise, hiccups
28
solu-medrol spinal cord injury
30mg/kg iv over 15 min, maintenance 5.4 mg/kg/hr for 24-48 hrs
29
solu-medrol precautions
one dose prehospitally, can prolong wound healing, suppression of adrenocortical steroids
30
solu-medrol interactions
lasix and thiazide diuretics increase K+ loss; decreased effect with phenytoin, phenobarbital, rifampin
31
mag sulfate drug class
electrolyte/antidysrhythmic/mineral
32
mag sulfate moa
physiological Ca2+ channel blocker causes CNS depression and smooth muscle relaxation
33
mag indications
asthma/bronchospasm; severe refractory VF or pulseless VT, torsades; post MI prophylaxis of dysrhythmias; eclampsia, pre-term labor
34
mag contraindications
3rd degree heart block, shock, severe hypertension, impaired renal function, hypocalcemia
35
mag SE
flushing, sweating, bradycardia, decreased deep tendon reflexes, drowsiness, respiratory depression, dysrhythmias, hypotension, hypothermia, itching, rash
36
mag adult asthma dose
2g in 100cc infused over 10 min
37
mag vt, vf, torsades no pulse adult dose
2g over 1-2 min
38
mag vt/torsades with pulse adult dose
1-2g in 50-100cc over 5-60 min
39
mag eclampsia dose
2-4g over 25 min
40
mag pedi asthma dose
25-50mg/kg infused over 15-30 min
41
mag pedi vt no pulse dose
25-50mg/kg
42
mag pedi vt with pulse dose
25-50 mg/kg over 10-20 min
43
mag precautions
watch for respiratory depression, have cacl2 available if OD
44
mag interactions
cardiac conduction abnormalities with digitalis
45
epi moa
a1 agonist causes peripheral vasoconstriction (increases SVT and BP); b2 agonist causes positive inotropy, chronotropy, dromotropy; b2 agonist causes bronchodilation; blocks destruction of MAST cells in anaphylaxis
46
epi indications
cardiac arrest; anaphylaxis/severe asthma; symptomatic bradycardia/hypotension
47
epi contraindications
HTN and tachydysrhythmias, caution with pregnancy and CAD
48
epi SE
anxiety, dysrhythmias, tremulousness, dizziness, N+V, increased myocardial oxygen demand
49
epi adult cardiac arrest dose
.5-1mg 1:10,000 q3-5 min
50
epi pedi cardiac arrest dose
.01mg/kg 1:10,000 q 3-5 min
51
epi bradycardia/hypotension adult dose
2-10 mcg/min
52
epi adult anaphylaxis dose
.3-.5mg IM 1:1000, then .1mg 1:10,000 over 3 min
53
epi pedi anaphylaxis dose
.01mg/kg 1:1000 then .01mg/kg 1:10,000 max dose .3mg
54
epi precautions
protect from light
55
epi interactions
inactivated by alkaline solutions, effect intensified by antidepressants, reacts with cacl2 and nahco3 to form ppt in tubing
56
nitroglycerin trade
nitrostat
57
nitrostat generic
nitroglycerin
58
nitro drug class
nitrate/vasodilator
59
nitro moa
converted to NO, activates GTP to cGMP +2pi activates cascade that reduces intracellular Ca2+ causing VSMC relaxation, decreasing cardiac preload and afterload
60
nitro indications
angina, CHF/pulmonary edema
61
nitro contraindications
shock, ICP, children under 12, ED drugs w/in last 48 hrs
62
nitro SE
HA, dizziness, weakness, tachycardia, mg SL hypotension, rash, dry mouth, N+V
63
nitro adult dose
0.4mg SL q3-5min until BP drops or pain relief (max 3x25min)
64
nitro precautions
monitor vitals, expect HA, do 12 lead prior, don't use w/ R sided MI
65
nitro drug interactions
orthostatic hypotension with b-blockers, severe hypotension with alcohol
66
zofran drug class
antiemetic
67
zofran moa
serotonin R antagonist, especially at the vagal nerve
68
zofran indications
nausea/vomiting
69
zofran contraindications
hypersensitivity
70
zofran SE
HA, dizziness, tachycardia, chest pain, constipation, diarrhea, dry mouth, prolonged QT
71
zofran adult dose
4mg iv
72
zofran pedi dose
0.1mg/kg iv
73
zofran precaution
lower risk of sedation and dystonia than other antiemetics
74
zofran interactions
affects clearance and half-life with inducers and inhibitors of cytochrome p-450 enzymes
75
benadryl drug class
antihistamine
76
benadryl moa
competitive h1/h2 antagonist, blocks histamine release, inhibits reuptake and storage of dopamine leading to reduction of bronchoconstriction, vasodilation, increased vascular permeability
77
benadryl indications
allergic rx; anaphylaxis; dystonia
78
benadryl contraindications
hypersensitivity; asthma; nursing mothers
79
benadryl SE
sedation, dries bronchial secretions, blurred vision, HA, palpitations, dizziness, drowsiness, fatigue, euphoria
80
benadryl precautions
caution with severe liver disease, asthma, narrow angle glaucoma, BPH; may cause hypotension
81
benadryl interactions
potentiates sedative effects of alcohol, benzos, narcotics, other anti-HTN's
82
benadryl contraindications
hypersensitivity; asthma; nursing mothers
83
benadryl SE
sedation, dries bronchial secretions, blurred vision, HA, palpitations, dizziness, drowsiness, fatigue, euphoria
84
adenosine drug class
class v antidysrhythmic/ nucleoside
85
adeonise moa
adenosine R agonist, slows AV conduction
86
adenosine indications
SVT; wide complex tachycardia
87
adenosine contraindications
2/3rd degree blocks; chemical induced SVT's; caution with asthma, bronchospasm, unstable angine; torsades
88
adenosine SE
facial flushing, HA, chest pain, dizziness
89
adenosine pedi dose
1st dose 0.1mg/kg (max 6); 2nd dose 0.2 mg/kg (max 12) all followed by flush
90
adenosine precautions
print a strip as you're pushing it; give in AC or higher
91
adenosine interactions
double the dose with methylxanthines; halve the dose with carbamazepines
92
amiodarone drug class
antidysrhythmic
93
amiodarone moa
class III antidysrhythmic/ K+ channel blocker prolongs cardiac AP and refractory period; has properties of Na+/Ca2+ channel blocker
94
amiodarone indications
VF and VT; wide complex tachycardia
95
amiodarone contraindications
cardiogenic shock, sinus node dysfunction, symptomatic bradycardia, 2nd/3rd degree blocks
96
amiodarone SE
hypotension, bradycardia, dyspnea, cough, dizziness, prolonged PR, QRS, QT intervals, increased ventricular beats
97
amiodarone VF/pulseless VT dose
300mg, repeat 150mg q3-5
98
amiodarone VF/ VT with a pulse dose
150mg over 10 min
99
amiodarone maintenance dose
1mg/min first 6 hrs, then 0.5mg/min
100
amiodarone VF/pulselss VT pedi dose
5mg/kg, max 300mg, max total dose 15 mg/kg
101
amiodarone VT with pulse pedi dose
5mg/kg over 20-60 min; max 300mg
102
amiodarone precautions
caution in Pt's with heart failure
103
amiodarone interactions
warfarin, digoxin, procainamide, quinidine, phenytoin
104
atropine drug class
anticholinergic
105
atropine MOA
Ach R antagonist, positive chronotropy, no inotropic effect
106
atropine indications
symptomatic bradycardia; premed for RSI hr<50 bpm; OP poisoning
107
atropine contraindications
no longer recommended for PEA and asystole
108
atropine SE
blurred vision, dilated pupils, dry mouth, tachycardia, drowsiness, confusion
109
atropine adult bradycardia dose
0.5mg q3-5min max 3mg
110
atropine RSI adult dose
.5-1mg
111
atropine adult OP dose
2-5mg
112
atropine pedi bradycardia dose
0.02mg/kg; min .1mg max .5mg in single dose
113
atropine RSI pedi dose
0.02mg/kg
114
atropine pedi OP dose
0.02-0.05mg/kg q 20-30min
115
atropine precautions
don't give less than .5 adult or .1 pedi; may cause paradoxical effect; may be ineffective in 2nd degree type II/3rd degree blocks; increases myocardial o2 demand
116
atropine interactions
few ems
117
cardizem drug class
Ca2+ channel blocker
118
cardizem MOA
Ca2+ channel blocker, peripheral and coronary vasodilation, slowed conduction through AV node, negative inotropy, decreased myocardial O2 demand
119
cardizem indications
rapid a-fib/a-flutter; SVT refractory to adenosine
120
cadizem contraindications
severe hypotension, cardiogenic shock, CHF; wide complex tachycardia; WPW
121
cardizem SE
N+V, dizziness, HA, bradycardia, heart block, hypotension, asystole
122
cardizem adult dose
1st) 0.25mg/kg over 2 min (usually 15-20 mg; 2nd) 0.35mg/kg; maintenance dose 5-15 mg/hr
123
cardizem pedi dose
not for pedi's
124
cardizem precautions
may cause hypotension, monitor BP, have CaCl2 available; lasts for 1 month out of refrigeration
125
cardizem interactions
do not give to Pt's receiving IV B-blockers, increases risk of CHF, bradycardia
126
fentanyl moa
opiate receptor agonist causes analgesia
127
fentanyl indications
pain/adjunct for RSI
128
fentanyl contraindications
hemmorhage/shock, hypersensitivity
129
fentanyl SE
bradycardia, respiratory depression, apnea, chest wall rigidity
130
fentanyl adult dose
1 mcg/kg max 100mcg, q10
131
fentanyl pedi dose
1-2mcg/kg
132
fentanyl precautions
caution with kidney and liver disfunction, halve the dose for elderly and administer q5
133
fentanyl drug interactions
additive effects with CNS depressants, not for Pt who used MAOI's w/in last 14 days
134
morphine moa
opiate r agonist causes analgesia; increases periopheral venous capacitance and decreases venous return, decreasing myocardial o2 demand
135
morphine indications
severe pain; pulmonary edema
136
morphine contraindications
hypovolemia/hypotension, head injury with AMS, hypersensitivity to morphine, codeine, percodan; copd/compromised respiratory status
137
morphine SE
N+V, abd. cramps, blurred vision, constricted pupils, AMS, HA, respiratory depression
138
morphine adult dose
2-10mg initial, then 2mg q3 until relief
139
morphine pedi dose
0.1mg/kg
140
morphine precautions
causes respiratory depression, have narcan available
141
morphine interactions
CNS depression with antihistamines, antiemetics, sedatives, hypnotics, barbituates, alcohol
142
aspirin trade
bayer
143
bayer generic
aspirin, acetylsalicylic acid, ASA
144
aspirin drug class
platelet aggregation inhibitor/NSAID
145
aspirin moa
inhibits platelet aggregation by blocking the formation of thromboxane a2; a cox inhibitor, inhibits prostaglandin synthesis and spread of inflammation
146
aspirin indications
ACS
147
aspirin contraindications
hypersensitivity, active ulcers and asthma
148
aspirin SE
GI bleeding, wheezing, N+V, heartburn, prolonged bleeding
149
aspirin adult dose
160-324mg of baby aspirin chewed
150
aspirin pedi dose
not for pedi
151
aspirin precautions
can cause GI upset
152
aspirin drug interactions
increased SE with other anti-inflammatories, decreased absorption with antacids
153
dopamine HCL trade
intropin
154
intropin generic
dopamine hcl
155
dopamine moa
a1 agonist causes peripheral vasoconstriction; b1 agonist causes positive inotropy
156
dopamine indications
hypotension not caused by hypovolemia, cardiogenic shock, symptomatic bradycardia
157
dopamine contraindications
hypovolemia where fluids have not been administered to max capacity, pheochromocytoma, tachydysrhythmias and VF
158
dopamine SE
nervousness, HA, dysrhythmias, palpitations, chest pain, dyspnea, N+V
159
dopamine dose
2-5mcg/kg/min mesentery dose; 5-10mcg/kg/min stimulates b effects; 10-20mcg/kg/min stimulates a effects
160
dopamine precautions
keep out of sunlight
161
dopamine interactions
deactivated by alkaline solutions; maoi's; hypotension with dilantin
162
succinylcholine generic
anectine
163
anectine generic
succinylcholine
164
succ drug class
depolarizing neuromuscular blocker
165
succ moa
cholinergic r-agonist; causes initial wide-spread depolarization and prevents Ach from binding and causing further stimulation
166
succ indications
to paralyze Pt before intubating
167
succ contraindications
penetrating eye injuries, narrow angle glaucoma, hyperkalemia, malignant hyperthermia
168
succ SE
wheezing, respiratory depression, apnea, aspiration, dysrhythmias, bradycardia, sinus arrest, HTN, hypotension, increased intraocular pressure, increased ICP
169
succ adult dose
1-2mg/kg
170
succ pedi dose
1mg/kg
171
succ precautions
Fx in children, may cause dysrhythmias and CA, should be used by experienced providers, have rescue airways available
172
succ interactions
potentiated by lidocaine, procainamide, B blockers, mag sulfate, other neuromuscular blockers
173
etomidate trade
amidate
174
amidate generic
etomidate
175
etomidate drug class
sedative/hypnotic
176
etomidate moa
depresses reticular activating system and potentiates GABA
177
etomidate indications
induction agent for RSI
178
etomidate contraindications
hypersensitivity
179
etomidate SE
myoclonic skeletal muscle movement, apnea, hyperventilation, hypoventilation, laryngospasm, HTN, hypotension, tachycardia, bradycardia, N+V
180
etomidate adult dose
0.1-0.3mg/kg over 15-30 sec
181
etomidate pedi dose
0.1-0.3mg/kg over 15-30 sec
182
etomidate precautions
caution with hypotension, severe asthma, severe cardiovascular disease
183
etomidate interactions
prolonged respiratory depression with verapamil
184
Succ onset
30-60 sec iv; 2-3 min im
185
Succ peak
1-3 min
186
Succ duration
2-3 min iv, 10-30 min im
187
Etomidate onset
10-20 sec
188
Etomidate peak
<1 min
189
Etomidate duration
3-5 min
190
Albuterol onset
5-15 min
191
Albuterol peak
1-1.5hrs
192
Albuterol duration
3-6 hrs
193
Mag onset
Immediate iv, 1hr im
194
Mag peak
Varies
195
Mag duration
1 hr
196
Mag half life
N/a
197
epi onset
<2 min iv; 3-10 min im
198
epi peak
<20 min im, 5 min iv
199
epi duration
5-10 min iv; 20-30 min im
200
fentanyl onset
immediate
201
fentanyl peak
3-5 min
202
fentanyl duration
30-60 min
203
morphine onset
immediate iv; 15-30 min im
204
morphine peak
20 min iv; 30-60 min im
205
morphine duration
2-7 hrs
206
adenosine onset
immediate
207
adenosine peak
immediate
208
adenosine duration
30-45 seconds
209
amiodarone onset
immediate
210
amiodarone peak
30-45 min
211
amiodarone duration
varies
212
atropine onset
immediate
213
atropine peak
2-4 min
214
atropine duration
4 hrs
215
cardizem onset
3 min
216
cardizem peak
7 min
217
cardizem duration
1-3 hrs
218
vecuronium trade
norcuron
219
norcuron generic
vecuronium
220
vecuronium drug class
non-depolarizing neuromuscular blocker
221
vecuronium moa
cholinergic r-antagonist, prevents binding of Ach at neuromuscular junction
222
vecuronium onset
<1 min
223
vecuronium peak
3-5 min
224
vecuronium duration
25-40 min
225
vecuronium indications
paralytic for RSI
226
vecuronium contraindications
hypersensitivity
227
vecuronium SE
wheezing, respiratory depression, apnea, aspiration, dysrhythmias, bradycardia, sinus arrest, HTN, hypotension, increased intraocular pressure, increased ICP
228
vecuronium adult dose
0.08-0.1mg/kg
229
vecuronium pedi dose
0.1mg/kg
230
vecuronium precautions
skilled provider, have rescue airway device ready
231
vecuronium interactions
potentiated by lidocaine, procainamide, B blockers, mag sulfate, other neuromuscular blockers
232
rocuronium trade
zemuron
233
zemuron generic
rocuronium
234
rocuronium drug class
non-depolarizing neuromuscular blocker
235
rocuronium onset
30-60 sec
236
rocuronium moa
cholinergic R-antagonist, prevents Ach from binding at neuromuscular junction
237
rocuronium peak
1-3 min
238
rocuronium duration
30-60 min
239
rocuronium contraindications
hypersensitivity
240
rocuronium indications
paralytic for RSI
241
rocuronium SE
bronchospasms
242
rocuronium adult dose
0.6-1.2mg/kg
243
rocuronium pedi dose
0.6mg/kg
244
rocuronium precautions
skilled provider, have rescue airway available
245
rocuronium interactions
potentiated by procainamide, lidocaine, B blockers, mag sulfate, other neuromuscular blockers
246
nitro onset
1-3 min SL; 30 min topical
247
nitro peak
5-10 min SL; topical varies
248
nitro duration
20-30 min SL; 3-6 hrs topical
249
epi onset
<2 min iv, 3-10 min im
250
epi peak
<5 min iv, 20 min im
251
epi duration
5-10 min iv, 20-30 min im
