Quiz 5 Flashcards
Epi 1:1 (Epi 1:1000)
Class: Sympathomimetic
Action: Endogenous catecholamine that directly stimulates both alpha and beta 1 and 2 adrenergic receptors. The effects this will have on the heart include increased contractile force, increased rate, and increased cardiac output. Epinephrine is also a potent vasoconstrictor as well as a bronchodilator. Other effects include slowing of gastric motility, miosis, and pale skin.
Indications: Anaphylaxis, cardiac arrest, asthma, bradycardia (first line in peds, not adults), shock not caused by hypovolemia, severe hypotension accompanied w/ bradycardia when pacing and atropine fails.
Contraindications: Hypovolemic shock. Caution should be used in pt’s w/ known cardiovascular disease or pt’s under 45 y/o
Onset/Duration: Onset–> 1-2 mins IV and 5-10 mins SQ, Duration–> 5-10 mins
Dose/Route:
Adult–> Anaphylaxis/Asthma- 0.3-0.5mg SQ/IM
Pedi–> Anaphylaxis/Asthma- 0.01mg/kg SQ/IM w/ single max dose of 0.3mg
Side Effects: Tachycardia, hypertension, anxiety, cardiac dysrhythmias, tremors, dyspnea
Epi 1:10 (Epi 1:10,000)
Class: Sympathomimetic
Action: Endogenous catecholamine that directly stimulates both alpha and beta 1 and 2 adrenergic receptors. The effects this will have on the heart include increased contractile force, increased rate, and increased cardiac output. Epinephrine is also a potent vasoconstrictor as well as a bronchodilator. Other effects include slowing of gastric motility, miosis, and pale skin.
Indications: Anaphylaxis, cardiac arrest, asthma, bradycardia (first line in peds, not adults), shock not caused by hypovolemia, severe hypotension accompanied w/ bradycardia when pacing and atropine fails.
Contraindications: Hypovolemic shock. Caution should be used in pt’s w/ known cardiovascular disease or pt’s under 45 y/o
Onset/Duration: Onset–> 1-2 mins IV and 5-10 mins SQ, Duration–> 5-10 mins
Dose/Route:
Adult–> Cardiac Arrest- 1mg IV/IO every 3-5 mins (NO MAX)
Pedi–> Cardiac Arrest- 0.01mg/kg IV/IO max of 1mg every 3-5 mins
Side Effects: Tachycardia, hypertension, anxiety, cardiac dysrhythmias, tremors, dyspnea
Etomidate (Amidate)
Class: Anesthetic, hypnotic
Action: Very potent drug that acts on CNS to produce short lasting anesthesia w/ amnesic properties. Has very little effect on respiratory drive which makes it ideal for certain procedures.
Indications: Premedication prior to procedures (i.e. ET intubation, synchronized cardio version, conscious sedation for bone dislocation/relocation
Contraindications: Hypersensitivity, labor/delivery
Onset/Duration: Onset–>Under 1 min; Duration–>5-10 mins
Dose/Route:
Adult–> 0.3mg/kg IV over 30-60 seconds, limited to 1 dose
Pedi–> 0.3mg/kg IV over 30-60 seconds w/ a max dose of 20mg
Side Effects: Hypotension, hypertension, dysrhythmias, hypoventilation, nausea/vomiting, cortisol suppression
Fentanyl (Sublimaze)
Class: Synthetic Opiod Analgesic
Action: Combines w/ the receptor sites in the brain to produce potent analgesic effects
Indications: Pain and sedation
Contraindications: Hypersensitivity to opiates, hypotension, head injury, respiratory depression, cardiac dysrhythmias, myasthenia gravis
Onset/Duration: Onset–> 1-2 mins; Duration–> 30-60 mins
Dose/Route:
Adult–> 0.5-2mcg/kg IV/IN over 2 mins w/ a max typically of 100mcg per dose; typically total dose= 300mcg
Peds–> 0.5-1mcg/kg IV/IN over 2 mins w/ a max typically of 100mcg per dose; max total dose of 3mcg/kg
Side Effects: Respiratory depression, hypotension or hypertension, bradycardia, nausea/vomiting, and rigidity of chest wall muscles
Furosemide (Lasix)
Class: Loop diuretic (works in Loop of Henle)
Action: Potent diuretic that inhibits the reabsorption of sodium and chloride in the proximal tubule and loop of Henle. IV doses can also reduce cardiac preload by increasing venous capacitance.
Indications: Pulmonary edema (CHF) w/ Systolic BP>90, hypertensive emergencies, hyperkalemia
Contraindications: Anuria, hypersensitivity, hypovolemia, hypokalemia
Onset/Duration: Onset–> 15-20 mins IV; Duration–> 2 hrs
Dose/Route:
Adult–> 0.5-1mg/kg IV over 1-2 min. If no response double dose to 2mg/kg over 1-2 mins; most services allow up to a max of 40-80 mg IV
Peds–> 1mg/kg/dose IV over 1-2 mins w/ a total max of 6mg/kg
Side Effects: Tinitus (if given too quickly), hypotension, hypokalemia, hyponatremia, hypocalcemia, hyperglycemia
MUST BE GIVEN SLOWLY OR MAY CAUSE PERMANENT HEARING PROBLEMS
What are the pregnancy classes on drugs?
Category A, B, C, D, or X
