Quiz 10/16

Question 1

Glucagon dosage

Answer 1

Antihypoglycemic: 1mg IM, large doses Beta blocker, calcium channel blocker: 3mg-10mg IV

Question 1

Dextrose (D50) class

Answer 1

Carbohydrate

Question 1

Nitroglycerin: Precautions

Answer 1

Check vitals after each administraton, NTG induced hypotension responds well to supine positioning and fluids. It is preferable to establish IV access prior to adminstering NTG. Right-sided MI and use of NTG can result in sever hypotension

Question 2

Dextrose (D50) side effects

Answer 2

Nausea if given too rapidly.

Question 2

Dextrose (D50) contraindications

Answer 2

None when used in emergency situations

Question 3

aspirin

dosage

Answer 3

324 mg

(four baby chewable aspirin)

Question 4

aspirin

note

Answer 4

Aspirin given at the onset of an acute MI reduces mortality and is one of the most effective treatments medics can offer. Don’t forget to give aspirin to patients with cardiac chest pain!

Question 5

activated charcoal

class

Answer 5

adsorbent

Question 6

activated charcoal

contraindications

Answer 6

Altered mental status unless administered by NG tube and airway protected with ET tube.

Question 6

aspirin

indications

Answer 6

Acute chest pain of suspected cardiac origin.

Question 6

Dextrose (D50) interactions

Answer 6

None

Question 7

Asprin

Classes

Answer 7

platelet inhibitor EMS use,

analgesic,

antipyretic,

nonsteroidal anti-inflammatory

Question 8

Glucagon pharmacokinetics

Answer 8

onset: 5-20 min (IM)

Question 9

Atropine Sulfate: Pharmacokinetics

Answer 9

Onset: immediate

Question 10

activated charcoal

indications

Answer 10

Selected indications. because activated charcoal will not bind to all substances (for example; not to alcohol or petroleum products), treatment is best dictated by OLMC and/or poison center. Treatment is usually not indicated unless it has been less than two hours since ingestion.

Question 11

aspirin

pharmacokinetics

Answer 11

Onset: 5– 30 min.

Peak: 15 min.-2 hours

Question 11

aspirin

side effects

Answer 11

There are few significant side effects to one dose of aspirin.

Question 12

Glucagon precautions

Answer 12

Ineffective with patients who have reduced glycogen stores

Question 13

Atropine Sulfate: Precautions

Answer 13

Paradoxical bradycardia can occur after slow administration or with small doses (minimum dose 0.5mg adults. 0.1mg children). Avoid in hypothermic bradycardia.

Question 14

Atropine Sulfate: Contraindications

Answer 14

None when used in emergency situations.

Question 15

Glucagon side effects

Answer 15

Nausea/vomiting if given rapid IV

Question 17

Dextrose (D50) indications

Answer 17

Hypoglycemia, hyperkalemia, (if given concurently with insulin)

Question 17

Nitroglycerin: Side effects

Answer 17

Hypotension, headache, dizziness, dry mouth.

Question 17

Nitroglycerin: Note

Answer 17

Nitroglycerin paste is not indicated for the treatment of acute chest pain. some protocols will use paste in conjunction with sublingual doses.

Question 19

Atropine Sulfate: Mechanism of Action

Answer 19

Atropine is a competitive antagonist for acetylcholine at the muscarinic receptors on the target organs of the parasympathetic system (e.g. heart, lungs. salivary glands etc.). In this way, atropine blocks the action of the parasympathetic system.

Question 20

Glucagon Mechanism of Action

Answer 20

Causes a breakdown of glycogen stores in the liver into glucose, raising circulating blood glucose. Glucagon has positive inotronic and chronotropic effects on the heart that are independent of beta-adrenergic receptors which is why it is useful with beta blocker overdose.

Question 21

Nitroglycerin: Indications

Answer 21

Chest pain thought to be cardiac in origin, acute pulmonary edema, may be used in hypertensive crisis.

Question 23

Atropine Sulfate: Supplied

Answer 23

1mg/10ml preloaded syringe.

Question 24

aspirin precautions

Answer 24

None in prehospital setting.

Question 24

Dextrose (D50) pharmacokinetics

Answer 24

Onset: immediate if given IV

Question 26

Nitroglycerin: Dosage

Answer 26

1 tablet (0.4 mg) given sublingually q 5 minutes. 1 metered dose spray (0.4mg) sublingually q 5 minutes. 1-2" of paste. 5mcg/min IV (titrate to 5mcg/min q 5 minutes untill desired effect is achieved.)

Question 27

aspirin contraindications

Answer 27

confirmed allergy, active G.I. bleeding, suspected aortic dissection (Local protocols may permit administration of ASA to patients on anticoagulants, although it is not an actual contraindication since warfarin does not inhibit platelet aggregation). Children or adolescents with viral infection should not take aspirin (Reye's syndrome).

Question 29

Atropine Sulfate: Class

Answer 29

Parasympathetic, anticholinergic, antimuscarinic, vagolytic

Question 31

Glucagon Indications

Answer 31

Hypoglycemia when IV is unobtainable, beta blocker overdose, calcium channel blocker overdose.

Question 33

Atropine Sulfate: Interactions

Answer 33

Additive anticholinergic effects with other anticholinergic compounds, including antihistamines,TCA's.

Question 34

Dextrose (D50) dosage

Answer 34

Adult: initial dose 25g, slow bolus. Second dose of 25g may be given if needed. Pediatric: 0.5 g/kg given as D50 to children older than infancy, as D25 to infants and as D10 to neonates

Question 36

Nitroglycerine: Class

Answer 36

Nitrate

Question 37

Nitroglycerne: Mechanism of action

Answer 37

Causes vasodialation that reduces preload, reducing cardiac workload and myocardial oxygen demand. Dialates coronary arteries, resulting in improved perfusion to ischemic myocardium. Relief of ischemia alleviates chest pain.

Question 38

activated charcoal dosage

Answer 38

1 g per kilogram Activated charcoal comes in bottles of 25 – 50 g in slurry with water or sorbitol.

Question 39

Glucagon supplied

Answer 39

Powder form, must be reconstituted

Question 39

Glucagon Class

Answer 39

Hormone, antihypoglycemic

Question 40

activated charcoal side effects

Answer 40

abdominal cramping, constipation

Question 41

Glucagon contraindications

Answer 41

None in prehospital setting

Question 43

activated charcoal mechanism of action

Answer 43

Adsorbs toxin molecules to the outside surface of charcoal. The combined complex is then excreted from the body.

Question 44

Atropine Sulfate: Side effects

Answer 44

Acute psychosis, vasodialation, dehydration, elevated temperature, and mydriasis (pupil dialation). Hint: Mad as a hatter, hot as a hare, red as a beet, dry as a bone, and blind as a bat.

Question 45

Atropine Sulfate: Dosage

Answer 45

Bradycardia: 0.5-1mg every 3-5 minutes (max dose is 0.04mg/kg). Poisoning: 1-2mg initially, can be repeated every 5-60 minutes as needed.

Question 46

Dextrose (D50) mechanism of action

Answer 46

Increases blood glucose

Question 47

Dextrose (D50) precautions

Answer 47

Infiltration causes tissue necrousis Use large bore IV if available. Give thiamine before D50 if patient is suspected to be malnourished e.g. alcoholic, homeless, elderly (protocol dependent)

Question 49

Nitroglycerin: Contraindications

Answer 49

Hypotension (generally systolic

Question 50

Atropine Sulfate: Indications

Answer 50

Symptomatic bradycardia, organophosphate poisoning, nerve agent poisoning. Atropine is considered ineffective for bradycardia associated with high-level AV blocks (2^nd degree type II and 3^rd degree). In these cases , consider pacing or dopamine first.

Question 51

aspirin mechanism of action

Answer 51

Inhibits the production of certain prostaglandins, which accounts for it's antiplatelet, anti-inflammatory, antipyretic, and analgesic actions. Aspirin inhibits platelet aggregation for the life of the platelet (7 to 10 days).

Question 52

Nitroglycerin: phamacokineics

Answer 52

Onset:1-2 minutes