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Trauma And Pain Flashcards

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1
Q

Fentanyl trade name

A

Sublimaze

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2
Q

Fentanyl generic name

A

Fentanyl

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3
Q

Fentanyl classification

A

Opioid analgesic

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4
Q

Fentanyl actions

A

Combines with receptor sites in the brain to produce potent analgesic effects

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5
Q

Fentanyl onset and duration

A

Iv-1-2 minutes, 30/60 minutes

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6
Q

Fentanyl indications

A

Pain control,sedation for invasive airway procedures, pain for right sided MI.

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7
Q

Fentanyl Contrindication

A

Respiratory depression, hypotension, head injury, cardiac dysrhythmias, myasthenia Gravis, hypersensitivity

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8
Q

Fentanyl side effects

A

Respiratory depression, Brady, hypotension or HTN, N&V, chest wall muscle rigidity

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9
Q

Fentanyl route

A

IV, IO, IM, IN

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10
Q

Fentanyl dose adult

A

50-100mcg (max 100mcg), slow over 1-2minutes every 1-2 hours for pain control

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11
Q

Fentanyl dose peds

A

1-2mcg/kg

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12
Q

Fentanyl supplied

A

100mcg/kg

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13
Q

Fentanyl special considerations

A

Preg cat C, schedule 2 drug, use in cation with elder. Do not use with amiodarone, it can cause Brady, sinus arrest, and hypotension.
Give narcan for revered effect.

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14
Q

Hydromorphine trade name

A

Dilaudid

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15
Q

Hydromorphine generic name

A

Hydromorphine

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16
Q

Hydromorphine classification

A

Opioid agonist, analgesic

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17
Q

Hydromorphine actions

A

Inhibits pain pathways altering perception and response to pain

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18
Q

Hydromorphine onset and duration

A

5 minutes/ 3-5hours in nondependent pts

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19
Q

Hydromorphine indications

A

Moderate to severe pain management, burns, analgesia

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20
Q

Hydromorphine contraindications

A

Hypersensitivity, head injury or trauma, hypotension, respiratory depression, asthma and GI obstruction

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21
Q

Hydromorphine side effects

A

Respiratory depression, altered LOC, Brady, N&V, constricted pupils, drowsiness, hypotension, seizures, hallucinations, agitation, delirium.

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22
Q

Hydromorphine route

A

IV/IO, IM

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23
Q

Hydromorphine dose adult

A

.015mg/kg; Max inital dose 2mg

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24
Q

Hydromorphine dose peds

A

N/A

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25
Hydromorphine supplied
1mg/mL prefilled syringes (carpuject)
26
Hydromorphine special considerations
Preg cat C Schedule 2 med. Liver failure, renal failure, give half dose in 64yrs or older. Give narcane to reverse effect.
27
Ketorolac Tromethamine trade name
Toradol
28
Ketorolac Tromethamine generic name
Ketorolac Tromethamine
29
Ketorolac Tromethamine classification
NSAID
30
Ketorolac Tromethamine actions
Anti-inflammatroy drug that also exhibits peripherally acting nonnarcotic analgesic activity by inhibiting prostaglandin synthesis
31
Ketorolac Tromethamine onset/duration
Within 10 minutes /6-8 hrs
32
Ketorolac Tromethamine indications
Short-term management (<5 days) of moderate or severe pain
33
Ketorolac Tromethamine contraindications
Hypersensitivity, allergies to aspirin or other NSAIDS, bleeding disorder, renal failure. Active peptic ulcer disease
34
Ketorolac Tromethamine side effects
Anaphylaxis, edema, sedation, bleeding disorder, rash, nausea and headache
35
Ketorolac Tromethamine route
IV, IM
36
Ketorolac Tromethamine dose
IV: 15mg over 1 minute IM:30MG
37
Ketorolac Tromethamine supplied
15 or 30mg in 1mL or 60mg in 2mL
38
Ketorolac Tromethamine special considerations
Preg cat C | Reduce dose when administering to adults >65
39
Morphine sulfate trade name
Duramorph, astramorph
40
Morphine sulfate generic name
Morphine sulfate
41
Morphine sulfate classification
Narcotic, opioid analgesic
42
Morphine sulfate actions
Morphine is a powerful painkiller. It is also an arterial and venodilator that pools blood and decreases both preload and afterload of the heart. This decreases workload on the heart that decreases myocardial oxygen demand. It is a CNS depressant which helps to alleviate anxiety.
43
Morphine sulfate onset/duration
5-10 minutes, peaked in 20 minutes /4-5hrs
44
Morphine sulfate indications
Chest pain unrelieved by nitro, severe pain.
45
Morphine sulfate contraindications
Hypotension, head injury, abdominal injury, or pain.
46
Morphine sulfate side effect
Respiratory depression, hypotension, N&V
47
Morphine sulfate route
IV slow push, IM (do not give I'm to cardiac pain)
48
Morphine sulfate dose
STEMI: 2-4mg IV; may give additional at 2-8mg at 5-15 minutes NSTEMI: 1-5mg IV; only if pain is not reduced by nitrates. Pain: IM: 0.1mg/kg; max 15mg. IV/IO: 0.qmg/kg max dose 10mg.
49
Morphine sulfate dose peds
0.1-.2mg/kg slow IVP; max dose 15mg
50
Morphine sulfate supplied
Prefilled syringes containing 10mg/1mL
51
Morphine sulfate special considerations
Narcan should be ready to reverse effect. May worsen with Brady or heart block in inferior MI. Safety in neonates has not been established.
52
Ondansetron trade name
Zofran
53
Ondansetron generic name
Ondansetron
54
Ondansetron classification
Antiemetic
55
Ondansetron actions
Block serotonin 5-HT3 receptors found in the chemoreceptor trigger zone and peripherally at Vagal nerve terminals in the intestines
56
Ondansetron onset and duration
Within 30 minutes. 3/6 hours
57
Ondansetron indications
N&V
58
Ondansetron contraindications
Hypersensitivity, gi obstructions, liver disease, prolonged QT syndrome.
59
Ondansetronside effect
Flushing, hiccups, dizziness, constipation, headache, drowsiness, dry mouth
60
Ondansetron route
PO, IV,IM,SL
61
Ondansetron dose
IV:4mg, injected over 30 seconds. IM:4mg PO: 4mg tablet
62
Ondansetron supplied
4mg/2mL vials 2mg/mL vial 4mg tablet
63
Ondansetron special considerations
Preg cat B
64
Sodium bicarbonate trade name
None
65
Sodium bicarbonate generic name
Sodium bicarbonate
66
Sodium bicarbonate classification
Alkalinizing agent, electrolyte replacement.
67
Sodium bicarbonate actions
Neutralizes excess acid in the blood and interstitial fluid. Returns blood to a normal physiologic pH by increasing the availability of the bicarbonate ion.
68
Sodium bicarboin. Onset and duration
Rapid and 8-10 minutes
69
Sodium bicarbonate indications
Pre-existing metabolic acidosis associated with cardiac arrest, shock and DKA. Hyperkalemia. To promote excretion of some type of barbiturate and salicylate overdoses. Tricyclic anti-depressent overdoses and crush injuries.
70
Sodium bicarbonate contraindications
Hypokalemia, conditions in which h a pt cannot handle an increased salt load, such as CHF or renal failure. Metabolic alkolosis.
71
Sodium bicarbonate side effects
Increases intravascular volume. Lowers serum potassium. Raises the arterial carbon dioxide levels. Inactivates catecholamines. Metabolic alkalosis. Tissue necrosis if infiltrated at the IV site.
72
Sodium bicarbonate route
IV, IV infusion
73
Sodium bicarbonate dose
IV: 1 mEq/kg Crush: IVP: 1mEq/Kg
74
Sodium bicarbonate peds dose
IV,IO: 1mEq/kg per dose
75
Sodium bicarbonate supplied
Prefilled syringes of 59mL containing 1 mEq/mL (8.4%)
76
Sodium bicarbonate special considerations
Preg cat C. Flush the IV line well when using sodium bicarbonate before and after epinephrine or calcium chloride. During cardiac arrest, do not over use. Metabolic alkolosis is difficult to counteract in the field. IVP doses should be followed by 20ml of saline flush.
77
Tranexamic Acid trade name
Tranexamic Acid
78
Tranexamic Acid generic name
TXA
79
Tranexamic Acid classification
Antifibrinolytic
80
Tranexamic Acid actions
Synthetic amino acid that blocks plasminogen from being converted to the enzyme plasmin. Plasmin works to break down already formed blood clotd in a process known as fibrinolysis.
81
Tranexamic Acid onset and duration
Unknown. And 7-8 hrs.
82
Tranexamic Acid indications
Major trauma with severe blood loss
83
Tranexamic Acid contraindications
Hypersensitivity, thromboembic disorders.
84
Tranexamic Acid side effects
N&V, joint pain, headache, hypotension, thrombus
85
Tranexamic Acid route
IV drip
86
Tranexamic Acid dose
1g in 100mL NS over 10 minutes. 10gtts/mL drip set=2gtts/second or 100gtts/min 15gtts/mL drip set=3gtts/second or 165/gyts/min 60gtts/mL drip set=wide open.
87
Tranexamic Acid supplied
Different concentrations, refer to med control
88
Tranexamic Acid special considerations
Preg cat B. TXA checklist: Adult>16yrs old Hemorrhagic shock from recent trauma <1hr Sustained tachy (>100BPM) and or hypotension (SBP<90) Must be given within 60 minutes from time of injury.

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