RSI/DSI Meds, ALPHA/BETA AGONIST MEDS Flashcards
(22 cards)
Rocuronium Bromide (Zemuron)
Class: Nondepolarizing neuromuscular blocking agent, cholonergic receptor antagonist
MOA: Antagonizes acetylcholine at the motor end plate producing skeletal muscle paralysis
INDICATIONS: provide skeletal muscle relaxation and facilitate tracheal intubation and ventilation
CONTRAINDICATIONS:
*hypersensitivity to rocuronium or a bromide hypersensitivity
*inability to control the airway or support ventilation with oxygen and positive pressure
* neuromuscular disease
* caution with patients with liver and heart disease
DOSE:
Adult- 0.6-1.2 mg/kg IV/IO
Pediatric- ^
Succinylcholine Chloride
(Anectine)
Class: Depolarizing Neuromuscular blockers; Skeletal Muscle relaxtant.
MOA: super short acting depolarizing skeletal muscle relaxtant (mimics acetylcholine. Binds with cholonergic receptors on the motor endplate producing a phase 1 block manifested by muscle fasciculations
INDICATIONS: Provide skeletal muscle relaxation to facilitate tracheal intubation and ventilation
CONTRAINDICATIONS:
*renal failure
* muscular dystrophy and other NM diseases
*paraplegia/ quadriplegia
*penetrating eye injuries
*Prolonged immobilization
*Stroke
*History of malignant hyperthermia
*Acute injury after multisystem trauma
*Burns
DOSE
Adult and children: 1-1.5 mg/kg rapid IV
Pediatric: 2mg/kg
Vecuronium Bromide (Norcuron)
Class: Nondepolarizing neuromuscular blocker, Cholonergic receptor antagonist
MOA: neuromuscular agent with an intermediate duration of action that competes with acetylcholine for receptors at the motor endplate, resulting in neuromuscular blockade.
INDICATIONS: skeletal muscle relaxation and facilitate tracheal intubation and ventilation
CONTRAINDICATIONS:
*neuromuscular disease
*acute narrow angle
*glaucoma
*penetrating eye injuries
*newborns
*hepatic
*renal failure
DOSE:
Adult: 0.08 to 0.1 mg/kg IV push over 1 minute.
Maintenance dose: within 20-45 minutes 0.01 to 0.015 mg/kg IV push every 12-15 minutes
Pediatric: 0.1-0.3 mg/kg IV/IO
Bumetanide (Bumex)
Class: Loop Diuretic
MOA: a potent loop diuretic wrap it onset, short, duration, inhibits, the reabsorption of sodium and chloride in the ascending limb of the loop of henle
INDICATIONS: Pulmonary edema, Heart failure.
CONTRAINDICATIONS:
*hypovolemia
*anuria
*acid based imbalance
*electrolyte imbalance
*hepatic coma
DOSE:
Adult: 0.5 to 1mg IV slowly over 1-2 minutes or IM
Not recommended for children younger than 12
Consult MD
Ipratropium Bromide (Atrovent)
Class: Anticholinergic, Bronchodilator, short acting antimuscarinic agent
MOA: antagonizes the action of acetylcholine and bronchial smooth muscle, resulting in bronchodilation.
INDICATIONS: Persistent bronchospasm, COPD exacerbation, toxic inhalation (in conjunction with albuterol).
CONTRAINDICATIONS: use with caution in patients with
*urinary retention
*narrow angle glaucoma
*cardiovascular disease
* hypertension.
DOSE
Adult and pediatric: give 0.5 mg nebulized up to three doses in conjunction with albuterol
Dopamine hydrochloride (intropin)
Class: endogenous catecholamine, adrenergic, vasopressor, inotropic agent
INDICATIONS: refractory cardiogenic or distributive shock hypotension with low cardiac output states, second line drug for symptomatic bradycardia
CONTRAINDICATIONS:
*hypovolemia
*pheochromocytoma
* uncorrected tachy dysrhythmias,
*VF
DOSE:
ADULT- IV/IO infusion at 5-20 mcg/kg/min slowly titrated to patients response
Dobutamine hydrochloride (dobutrex)
Class: Adrenergic, inotropic agent
MOA: synthetic catecholamine that primary stimulates beta one receptors with minor stimulation of beta 2 and alpha 1 receptors increases myocardial contractility, and stroke volume resulting increased cardiac output with modest chronotropic effects increases renal blood flow secondary to increase cardiac output
INDICATIONS: Heart failure with a SBP of 70 to 100mm Hg and no signs of shock
CONTRAINDICATIONS: suspected or known poison/ drug induced shock
DOSE:
Adult & Pediatric: IV infusion 2 -20 mcg/kg/min titrated to desired effect
Fentanyl Citrate (Sublimaze)
Class: opioid analgesic; synthetic opioid; scheduled 2
MOA: binds to opioid receptors, producing analgesia, euphoria, respiratory depression and sedation 
INDICATION: pain management, anesthesia, adjunct, severe respiratory distress 
CONTRAINDICATIONS: have taken a MOAI in past 14 days, administer with caution to patients with hypotension hypoxia after max supplemental oxygen therapy or signs of hypoventilation
DOSE:
ADULT: severe respiratory distress 25mcg mixed in 2mL saline nebulized
Moderate discomfort: 1mcg/kg IM/IN (max initial dose 100 mcg, max total 200mcg;
Severe discomfort: 1 mcG/kg ivy/Io maximum initial dose 100 MCG maximum total dose 200mcg
PEDIATRIC: moderate discomfort 1mcg/kg IM/IN
SEVERE : 1mcg/kg IV/IO
Solu medrol
Class: corticosteroid, synthetic glucocorticoid, anti-inflammatory agent
MOA:  highly potent synthetic glucocorticoid that suppresses, acute and chronic inflammation, potentates vascular muscle relaxation by beta adrenic agonist has to no mineralocoid properties
Indications : allergic reaction, anaphylaxis , acute Broncospastic disease management, shock with a history of adrenal insufficiency or long-term steroid dependence
 Contraindications; serious untreated infections, premature infants used with caution impatience with G.I. bleeding, heart failure, hypertension, recent AMI, renal disease, seizure disorder, Cushing disease
Dose:
ADULT: broncospasm- give 2mg/kg IV/IM/IO MAX DOSE 125mg
 Shock with a history of adrenal insufficiency or long-term steroid dependence- Give 2 mg/kg IV
PEDIATRIC: for status asthmaticus anaphylaxis- 2mg/kg IV/IO/IM loading dose MAX DOSE 60mg
Maintenance dose 0.5mg/kg IV up to every 6 hours or 1 mg/kg IV every 12 hours up to 120mg a day
Nitroglycerin
CLASS: vasodilator nitrate antianginal
MOA:  smooth muscle relaxant, which acts on the vasculature, bronchial, uterine and intestinal, smooth muscle dilates peripheral arterials and veins reduces, peripheral vascular resistance, preload, and afterload decrease in the heart workload of myocardial oxygen demand
INDICATIONS: ischemic type, chest pain, acute and symptomatic hypertension, heart failure, pulmonary edema
CONTRAINDICATIONS: Hypotension, hypovolemia, cranial, bleeding or head injury, pericardial, tamponade, severe bradycardia or tachycardia, RV, infarction, previous administration of NFL, Viagra levitra within 24 hours or Cialis within 48 hours
DOSE:
ADULT- SL 0.3 to 0.4mg may repeat in 3 to 5 minutes to a maximum of three doses,
NTG IV: 12.5 to 25 mcg bolus if no SL spray is given then begin 10mcg/ min every 3-5 minutes until symptoms response or desire effect
Max dose 200mcg/min
Furosemide (Lasix)
CLASS: loop diuretic
Indications; heart failure, hypertension
 Contraindications hypovolemia aniuria suspected electrolyte imbalance
Nor epinephrine
CLASS: sympathomietic, vasopressor
MOA: predominantly on alpha adrenal receptors to produce constriction of resistance and capacitance vessels, thereby increasing systemic BP and coronary artery blood flow also act on beta, one receptors in relatively lower doses the cardiac stimulate effect of norepinephrine predominance with larger doses, the vasoconstrictor effect predominance
INDICATIONS: first line vasoppressor and neurogenic shock, hypotension unresponsive to IV/IO fluid resuscitation
CONTRAINDICATIONS: hypotension caused by hypovolemia, pregnancy
DOSE
ADULT: 0.1 to 0.5 mcg/kg/min IV/IO infusion titrated to effect
Pediatric: begin at 0.05 to 0.1 mcg/kg/min IV infusion adjust rate to achieve desired change in BP AND SYSTEMIC perfusion
MAX INFUSION RATE 2mcg/kg/min
Lorazapam (Ativan)
Class: benzodiazepine sedative, hypnotic anti-convulsion schedule IV drug
MOA: anxiolytic,  anti-convulsant and sedative effect suppress propagation of seizure activity produced by foci in the cortex, thalamus and limbic areas inhibits GABA receptors in the CNS, reducing neuron excitability
Indications uncontrolled shivering associated with hyperthermia, heat, exposure, active seizures, active sedation, chemical restraint
Contraindications : documented, hypersensitivity, neurologic, or respiratory depression, acute narrow angle, glaucoma, sleep apnea, shock, suspected drug abuse
Etomidate (Amidate)
Class: Nahan, perpetuate, hypnotic, anesthesia, induction agent
MOA : short acting hypnotic that produces rapid sedation with minimal cardiovascular or respiratory depression
Indications: medication for medication, facilitated intubation, or procedural sedation
Contraindications: labor delivery, or septic shock
Propofol (Diprivan)
Class: short acting general anesthetic, sedative hypnotic
MOA: produces a rapid and brief state of general anesthesia
Indications : maintenance of sedation in mechanically ventilated patients
Contraindications : hypovolemia
Mag sulfate
Class: electrolyte class V antidysrhythmic
Indications management of TDP severe bronchoconstriction with impending respiratory failure seizure during the third trimester of pregnancy or in the postpartum patient
Contraindications heart block, myocardial damage, diabetic coma, magnesium hypercalcemia use with caution and patience with known renal insufficiencies
Albuterol
Class: sympathomimic bronchodilator short, acting beta 2 adrenergic agonist
MOA : selective beta 2 adrenergic agonist that causes bronchial, smooth muscle relaxation, and inhibits mediator release from mass cells
Indications : treatment and prevention of broncos, spasms and patients with reversible, obstructive, airway disease, treatment of inhaled airway and respiratory irate agents, and hyperkalemia, treatment, contraindications: dysrhythmias, especially those caused by digital synergistic with other sympathomimienics
Valium (diazepam)
Class: benzodiazepine anti-convulsant ANXIOLYTIC to sedative, skeletal muscle reactant schedule IV drug
Indications uncontrolled, shivering associated with hypothermia, heat, exposure, active seizures, chemical restraint, acetone, mise inhibitor poisoning
Contraindications, neurological, respiratory depression, narrow angle, glaucoma, myasthenia gravis head injury
Midazolam hydrochloride (versed)
Class: benzodiazepine anti-convulsant anti-anxiety agent sedative hypnotic schedule IV drug
MOA inhibits GABA receptors in the CNS, thereby reducing neuron, excitability and causing sedative amnesic and hypnotic effects
Indications: uncontrolled shivering associated with hypothermia heat, exposure, active seizures, chemical strain, severe respiratory distress sedation for medical procedures poisoning/overdose care
Contra indications : neurological or respiratory depression, acute angle, glaucoma, sleep apnea, shock, alcohol, intoxication, overdose, depressed, vital signs
Epi
Class sympathomimetic sympathetic alpha/beta adrenergic agonist
MOA chemical meme with strong, alpha, adrenergic, strong, beta, one and moderate beta two effects effects of alpha stimulation, result, and systematic vasoconstriction increasing peripheral vascular resistance effects of fatal stimulation result increases in heart rate, myocardial, contractility, cardiac output in myocardial oxygen demand effect abated two stimulation, result and bronchial, smooth muscle relaxation, secondary relaxation effect on the smooth muscle of the stomach, intestine uterus and urinary bladder
Indications, cardiac arrest, bradycardia shock, anaphylaxis, severe refractory croup, bronchiolitis
Contra indications, coronary insufficiency, cardiac dilation, uncontrolled hypertension, hypothermia, pulmonary edema, myocardial ischemia hypovalemic shock 
Phenylephrine (neo synephrine)
Class adrenergic Alpha agonist nasal vasal constructor
MOA stimulates, alpha electronic receptors in the arterials of the nasal mucosa to produce vasoconstruction
Indications epistaxis
Contraindications used with extreme caution in geriatric patients with pre-existing cardiovascular disease
Morphine sulphate
Class
Opioid analgesic schedule to drug
MOA alleviates pain through CNS action suppresses the fear and anxiety centers in the brain depresses. The brain stem respiratory centers increases peripheral vous capacitance. Venus decreases preloading after which decreases myocardial oxygen demand.
Indications management of acute pain
Contraindications patients who have taken during the previous 14 days paralytic eyas to mediated diarrhea heart failure due to chronic lung disease, head injuries, brain tumors, delirium tremens seizure disorders during labor, when premature death is anticipated, acute severe bronchial, asthma, upper airway obstruction
