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Flashcards in Pick 6 Review Deck (251):
1

ativan drug class

anticonvulsant/sedative/hypnotic/benzodiazepine

2

ativan indications

major motor seizures, premed for cardioversion, acute anxiety

3

ativan contraindications

hypersensitivity

4

ativan SE

hypotension, drowsiness, HA, amnesia, respiratory depression, blurred vision, N+V

5

ativan pedi dose

0.05 mg/kg

6

ativan precautions

have benzo antagonist available

7

ativan interactions

additive effects with other CNS depressants and alcohol

8

versed drug class

benzodiazepine/anticonvulsant/sedative/hypnotic

9

versed moa

positive allosteric modulator for GABA receptors, hyperpolarizes cells by increasing Cl- concentration

10

versed indications

pre med for cardioversion, post-intubation sedation, seizure

11

versed contraindications

narrow-angle glaucoma, shock, depressed vitals, alcoholic coma

12

versed side effects

laryngospasm, bronchospasm, dyspnea, respiratory depression and arrest, drowsiness, amnesia, AMS, tachycardia, bradycardia, PVC's, retching

13

versed pedi dose

0.2mg/kg max of 10mg

14

versed precautions

have resuscitative equipment available, more potent than other benzos, have benzo antagonist available

15

versed interactions

additive effects with other CNS depressants and alcohol

16

albuterol moa

b2 agonist causes bronchodilation

17

albuterol contraindications

hypersensitivity, symptomatic tachycardia

18

albuterol SE

anxiety, HA, palpitations, sweating, dizziness, nervousness, tremor, HTN, arrhythmias, chest pain, N+V

19

albuterol precautions

monitor vitals and EKG; caution with heart disease or HTN, check lungs before and after

20

albuterol interactions

SE increased with other sympathetic agonists, beta blockers blunt effects, MAOI's and TCA's may potentiate cardiovascular effects

21

solu-medrol MOA

upregulates genes that produce inhibit inflammatory response - is an immunosuppressant

22

solu-medrol onset

2-6 hrs

23

solu-medrol peak

4-8 days

24

solu-medrol duration

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