Week 8 Drugs

Question 0

Alteplase Recombinant, TPA

Pharmacology and Actions

Answer 0

TPA promotes fibrinolysis by forming the active proteolytic enzyme plasmin. Plasmin in turn degrades fibrin, fibrinogen and the clot.

Question 1

Alteplase Recombinant, TPA

Class

Answer 1

Fibrinolytic

Question 2

Alteplase Recombinant, TPA

Indications

Answer 2

Fibrinolysis in acute myocardial infraction
Acute ischemic shock
Pulmonary embolism

Question 3

Alteplase Recombinant, TPA

Contraindications

Answer 3

Internal bleeding 
Aortic emergencies 
Increased intracranial pressure 
Hemorrhagic shock within the past 6 months 
Uncontrolled hypertension

Question 4

Alteplase Recombinant, TPA

Precautions and Side Effects

Answer 4

Internal bleeding
Superficial bleeding
Hemorrhagic stroke

Question 5

Alteplase Recombinant, TPA

Dosage

Answer 5

Adult
MI/CVA: 15mg followed by 0.75mg/kg over 30min, max dose of 50mg, then provide 0.5mg/kg over 60min, max of 35mg.
Pulmonary embolism: 100mg infused over 2 hr
Pedi

Question 6

Decadron

Class

Answer 6

Steroid

Question 7

Decadron

Pharmacology and Actions

Answer 7

Prevents the accumulation of inflammatory cells at the sites of infection; inhibits phagocytosis, lysosomal enzyme releases, and synthesis of selected chemical mediators of inflammation.

Question 8

Decadron

Indications

Answer 8

Anaphylaxis
Asthma
COPD
Acute spinal cord edema

Question 9

Decadron

Contraindications

Answer 9

No absolute contraindications in the emergency setting

Question 10

Decadron

Precautions and Side Effects

Answer 10

Arrhythmias
Hyperglycemia
CHF
Hypertension

Question 11

Decadron

Dosage

Answer 11

Adult
4-24mg IV/IO/IM
Pedi
0.5-1.0mg/kg

Question 12

Mannitol, Cystosol, Osmitrol

Class

Answer 12

Osmotic diuretic

Question 13

Mannitol, Cystosol, Osmitrol

Pharmacology and Actions

Answer 13

Mannitol is an osmotic diuretic that draws water from the Intracellular space into the intravascular space through its hypertonic effects.

Question 14

Mannitol, Cystosol, Osmitrol

Indications

Answer 14

To reduce acute cerebral edema and increased intracranial pressure.

Question 15

Mannitol, Cystosol, Osmitrol

Contraindications

Answer 15

CHF 
Shock 
Pulmonary edema 
Active intracranial bleeding 
Use with renal failure may result in fluid overload

Question 16

Mannitol, Cystosol, Osmitrol

Precautions and Side Effects

Answer 16

CHF 
Pulmonary edema 
Hypotension 
Hypertension 
Convulsions

Question 17

Mannitol, Cystosol, Osmitrol

Dosage

Answer 17

Adult
0.5-2g/kg over 5-10min through an inline filter
Additional doses of 0.25-2g/kg can be given every 4-6hr as needed
Pedi
0.25-2g/kg over 30-60 min

Question 18

Oxytocin, Pitocin

Class

Answer 18

Hormone

Question 19

Oxytocin, Pitocin

Pharmacology and Actions

Answer 19

Oxytocin is a natural hormone that causes the uterus to contract inducing labor and encouraging delivery of the placenta. Oxytocin also helps to control post partum bleeding through uterine contractions.

Question 20

Oxytocin, Pitocin

Indications

Answer 20

To control post partum bleeding

Question 21

Oxytocin, Pitocin

Contraindications

Answer 21

Prior to delivery of the baby

Hypersensitivity

Question 22

Oxytocin, Pitocin

Precautions and Side Effects

Answer 22

Hypotension
Subarachnoid bleeding
Cardiac arrhythmias
N/V

Question 23

Oxytocin, Pitocin

Dosage

Answer 23

Adult
3-10 units IM after the delivery of the placenta
10-20 units in 1000cc D5W or NS IV infusion, titrate to the sensitivity of the bleeding
Pedi
Not indicated for pediatrics

Question 24

Propranolol Class

Answer 24

Beta blocker

Question 25

Propranolol Pharmacology and Actions

Answer 25

Propranolol is a non selective beta blocker affecting both bronchial and cardiac sites. It reduces heart rate, myocardial irritability, contractile forces, cardiac output and blood pressure.

Question 26

Propranolol Indications

Answer 26

PSVT not controlled by vagal maneuvers and adenosine

Question 27

Propranolol Contraindications

Answer 27

``` High degree AV blocks CHF Cardiogenic shock Asthma COPD ```

Question 28

Propranolol Precautions and Side Effects

Answer 28

``` Confusion Respiratory distress AV heart blocks Hypotension Profound bradycardia ```

Question 29

Propranolol Dosage

Answer 29

Adult 1-3mg slow IVP over 2-5 min, not to exceed 1mg/min (May repeat in 2 min) max dose of 0.1mg/kg Pedi 0.1mg/kg slow IVP

Question 30

Thiamine Class

Answer 30

Vitamin

Question 31

Thiamine Pharmacology and Actions

Answer 31

Thiamine is vitamin B1. It is required for the metabolism of glucose and the production of ATP. It is not manufactured by the body and must be continually provided by ingested food.

Question 32

Thiamine Indications

Answer 32

Coma of unknown origin Alcohol induced coma Delirium tremors

Question 33

Thiamine Contraindications

Answer 33

Hypersensitivity

Question 34

Thiamine Precautions and Side Effects

Answer 34

Weakness Pulmonary edema Sweating N/V

Question 35

Thiamine Dosage

Answer 35

Adult 50-100mg IV/IM/IO Pedi 10-25mg IV/IM/IO