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95 Cards in this Set

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Activated Charcoal - Names
(4)
Aqua
Acti-dose
Liqui-char
AC
Activated Charcoal - Class
(2)
adsorbent
antidote
Activated Charcoal - Action
binds and adsorbs toxins, then excretes it in the feces
Activated Charcoal - Onset
immediate
Activated Charcoal - Duration
continual in the GI tract, reaches equilibrium once saturated
Activated Charcoal - Indications
many oral poisons and medication overdoses
Activated Charcoal - Contraindications
(3)
corrosives
caustics
petroleum distillates (relatively ineffective and may induce vomiting)
Activated Charcoal - Side Effects
(2)
may indirectly induce n/v
may cause constipation or mild, transient diarrhea
Activated Charcoal - Drug Interactions
Syrup of Ipecac (adsorbs by the charcoal and results in vomiting of the charcoal)
Activated Charcoal - How Supplied
25 g/125 mL bottle (200 mg/mL)
50 g/250 mL bottle (200 mg/mL)

Most products come premixed with water or sorbital.
Activated Charcoal - Adult Dose
30 - 100 g, PO or slow NG or OG tube
Activated Charcoal - Peds Dose
15 - 30 g, PO or slow NG or OG tube
Activated Charcoal - Infant Dose
1 g/kg, PO or slow NG or OG tube
Activated Charcoal - Pregnancy Category
Category C
Activated Charcoal - Other Notes
(5)
Frequently given to pregnant women because benefit vs risk is very high. Charcoal remains in GI tract and presents virtually no risk to the fetus.

relatively insoluble in water

may blacken feces

must be stored in closed container

different preparations have varying adsorptive capacity
Activated Charcoal - Does Not Adsorb What?
(7)
phenobarbital
aspirin
cyanide
lithium
iron
lead
arsenic
Aspirin - Action
(4)
decrease inflammation
blocks pain impulses in the CNS
dilates peripheral vessels
decreases platelet aggragation
Aspirin - Onset
15 - 30 minutes
Aspirin - Duration
4 - 6 hours
Aspirin - Indications
(3)
mild to moderate pain or fever
chest pain
MI
Aspirin - Class
(4)
analgesic
antiinflammatory
antipyretic
antiplatelet
Aspirin - Contraindications
(5)
GI bleeding
active ulcers
hemmorhagic stroke
bleeding disorders
children w/flu-like symptoms
Aspirin - Side Effects
(4)
stomach irritation
heartburn/indigestion
N/V
allergic reactions
Aspirin - Drug Interactions
decreased effects w/antacids & steroids

increased effects w/anticoagulants, insulin, oral hypoglycemics, fibrinolytic agents
Aspirin - Adult Dose
pain/fever: 325 - 650 mg PO q 4 hr

MI: 160 - 325 mg PO
Aspirin - Peds Dose
> 12 yo only
40 - 100 mg/kg/day in divided doses
Aspirin - Pregnancy Class
Class D
Aspirin - Other Notes
should be given to AMI patient ASAP
Oxygen - Class
natural gas
Oxygen - Action
(3)
reverses hypoxemia
helps oxidize glucose to produce ATP
helps reduce size of infarcted tissue during MI
Oxygen - Onset
Immediate
Oxygen - Duration
< 2 minutes
Oxygen - Indications
(4)
hypoxia
ischemic chest pain
respiratory insufficiency
any cause of decreased tissue oxygenation
Oxygen - Contraindications
None
Oxygen - Side Effects
may cause respiratory depression and depressed LOC in patients with chronic CO2 retention
Oxygen - Dose
10 - 15 L/min via non-rebreather mask

1 - 4 L/min via NC
Oxygen - Other Notes
no pregnancy class

vigorously supports combustions
Glucose - Names
Glutose
Insta-Glucose
Glucose - Actions
Increases blood glucose level
Glucose - Indications
altered mental status from suspected low blood glucose level
Glucose - Contraindications
unresponsive
unable to swallow
no gag reflex
Glucose - Side Effects
none when given properly
may be aspirated if given to patients without a gag reflex
Glucose - Adult Dose
Full tube given in small doses (25-50 gm) - standing order
Glucose - Class
carbohydrate
antihypoglycemic agent
Glucose - Peds Dose
0.5 gm/kg in small doses - standing order
Glucose - Onset
1 minute
Glucose - Duration
Depends on the degree of hypoglycemia
Ipecac - Class
(2)
emetic
antidote
Ipecac - Action
acts as a local irritant on the gastric mucose and on emetic centers of the brain

vomiting induced by ipecac occurs in 80-90% of patients
Ipecac - Onset
generally 15 - 20 minutes
Ipecac - Duration
up to 1 - 2 hours
Ipecac - Indications
acute oral drug or toxin overdose in alert patients
Ipecac - Contraindications
(7)
Same as charcoal + these -

tricyclic antidepressant OD
camphor ingestion
unprotected airway
no gag reflex
children < 1 year old
upper GI bleed
Ipecac - Side effects
(3)
prolonged vomiting
muscle aches & weakness
drowsiness
Ipecac - Drug interactions
activated charcoal adsorbs ipecac
Ipecac - How supplied
10 mL & 15 mL vials
Ipecac - Adult dose
15 - 30 mL PO followed by 3 - 4 glasses of water, may repeat with 15 mL once in 20 min if ineffective
Ipecac - Peds dose
(1 - 12 years)
5 - 15 ml PO followed by 1.5 - 2 glasses of water, may repeat with 15 mL once in 20 min if ineffective
Ipecac - Pregnancy Class
Class C
Ipecac - Notes
(3)
90% of patients vomit within 30 minutes (avg time 20 min)

save emesis sample for evaluation

patients usually vomit 2 - 3 times per dose over 1 - 2 periods. Keep pt awake NPO for 2 hr
Albuterol - Name
Proventil
Albuterol - Class
(3)
sympathomimetic
bronchodilator
beta-2 agonist
Albuterol - Action
relaxes smooth muscles of the bronchial tree and peripheral vasculature by stimulating adrenergic receptors of the sympathetic nervous system.
Albuterol - Onset
5 - 15 minutes after inhalation
Albuterol - Duration
3 - 4 hours after inhalation
Albuterol - Indications
(2)
bronchospasms

prevents exercise induced bronchospasms
Albuterol - Contraindications
(2)
prior sensitivity to albuterol

cardiac dysrhythmias associated with tachycardia
Albuterol - Side effects
(6)
(Usually dose related)

restlessness
apprehension
dizziness
palpitations
tachycardia
dysrhythmias
Albuterol - Drug interactions
(3)
antidepressants may potentiate vasodilation

beta-blockers may antagonize albuterol

may potentiate diuretic-induced hypokalemia
Albuterol - Adult Dose
(2)
metered dose inhaler: 1 - 2 inhalations (90 - 180 mcg), repeat in 4 - 6 hours (5 minutes between inhalations); max 12 inhalations/day

solution: 2.5 mg diluted to 3 mL with 0.9% NS viz nebulizer over 5 - 15 min
Albuterol - Peds dose
(2)
Metered dose inhaler: same as adults

solution: 0.01 - 0.03 mL/kg/dose diluted in 2 mL of 0.9% NS via nebulizer (max dose 0.5 mL/dose)
Albuterol - Pregnancy class
Class C
Ipratropium - Name
Atrovent
Atrovent - Class
(2)
anticholinergic
bronchodilator
Atrovent - Action
inhibits interaction of acetylcholine on bronchial smooth muscle, resulting in decreased cyclic guanosine monophosphate and bronchodilation
Atrovent - Onset
5 - 15 minutes
Atrovent - Duration
4 - 6 hours
Atrovent - Indications
(2)
persistent bronchospasm
COPD exacerbation
Atrovent - Contraindications
(5)
hypersensitivity to:
ipratropium
atropine
alkaloid
soybean protein
peanuts
Atrovent - Side effects
(6)
N/V
coughing
headache
tachycardia
dry mouth
blurred vision
Atrovent - Drug interactions
None
Atrovent - Adult & Peds (> 12 yo) dose
1 - 2 inhalations (18 - 36 mcg)
Atrovent - Pregnancy class
Class B
Diphenhydramine - Name
Benadryl
Benadryl - Class
antihistamine
Benadryl - Action
prevents physiological actions of histamine by blocking H-1 and H-2 receptor sites
Benadryl - Onset
max effects 1 - 3 hours
Benadryl - Duration
6 - 12 hours
Benadryl - Indications
(3)
moderate to severe allergic reactions (after epi)

anaphylaxis

acute extrapyramidal reactions
Benadryl - Contraindications
(4)
MAOI's
hypersensitivity
narrow angle glaucoma (relative)
newborns/nursing mothers
Benadryl - Side effects
(9)
drowsiness
hypotension
palpitations
tachycardia
bradycardia
thickening of bronchial secretions
paradoxical excitement in children
Benadryl - Drug interactions
CNS depressants may increase depressant effects

MAOIs may prolong and intensify anticholinergic effects of antihistamines
Benadryl - Adult dose
10 - 50 mg IM/IV every 6 - 8 hours (max: 400 mg/day)
Benadryl - Peds dose
( > 10 kg only )

1.25 mg/kg/dose, repeat in 6 hours (max: 300 mg/day)
Benadryl - Pregnancy class
Category C