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33 Cards in this Set

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Dextrose 50% (D50W)
Class:

Therapeutic Effects
Class: Hyperglycemic agent: Carbohydrate

Effect: Increases blood sugar
Glucagon
Class?
Therapeutic effects?
Class: Hormone; hyperglycemic agent

Stimulates breakdown of glycogen from stories in the liver to increase blood sugar by gluconeogenesis (creation of new sugar)
Epinepherine (Adrenalin)
Class?
Therapeutic effects?
Class: Adrenergic sympathomimetic, catecholamine

Effects: (+)cardiac output due to beta 1 effects, (+) BP due to alpha effects, relaxes smooth muscle of respiratory tract due to Beta 2 effects.
(+) coronary & cerebral profusion during CPR by (+)aortic diastolic pressure. (+)electrical activity in myocardium
Diphenhydramine (Benadryl)
Class?
Therapeutic effects?
class: Antihistamine

Effects: Competes w/ H1&H2 receptor sites; Reverses histamine induced bronchospasm,broncho-secretion, vasodilation and (+)capillary permeability; Relaxes smooth muscles
Dextrose 50% (D50W)
Indications?
Contraindications?
Ind:Known hypoglycemia,based on bG test, bG <60 mg/dl, when oral glucose cannot be given. Suspected hypoglycemia w/o bG test ie. Coma, seizures, AMS, acute or chronic ETOH w/ AMS

Contra: Nonw w/ known hypoglycemia
Suspected HG: IC hemmorage w/?? bG; New onset CVA s&s w/o bG test in a non diabetic pt.
Glucagon
Indications?
Contraindications?
Ind: Known or suspected hypoglycemia wgen unable to administer dextrose throuhj a patent IV site.

Contra: Hypersensitivity to the drug
Epinepherine (Adrenalin)
Indications?
Contrindications?
Ind:Cardiac arrest including PEA,Asystole, v-fib, v-tach w/o pulse, Asthma, Allergic reaction, Ananphylaxis, ped. symptomatic brady.

Contra: Not significant in the above indications
Diphenhydramine (Benadryl)
Indications?
Contrindications?
Ind: Anaphlaxis;allergic reation, dystonic reactions due to phenothiazine or similar type drugs.

Contra: Hypersensitivity to drug or acute asthma attack.
Relative Contra: Pregnant or nursung women and narrow angle glaucoma
Dextrose 50% (D50W)
Dose / route
12-25 gm , slow IV push, continuous reassessment of IV site for extravasation, ulcers and necrosis.
Glucagon
Dose / route
1 mg IM, 21-23 ga. needle 3/8-1" in length. May repeat in 10 min. if needed
Epinepherine (Adrenalin)Dose / route
Cardiac Arrest:1 mg every 3-5 minutes IVP/IO,2.-2.5 mg. diluted w/NSS to a min. of 10cc for ET route
IVPB: 1mg in 500 cc of NSS or D5W, start at 1ug/min ( 30 uggts/min. Titrate as needed
Asthma/allergic reaction: 0.3.0.5 SQ or IM (1:1000) may repeat twice every 20 min.
Anaphylaxis: .1-.5 mg (1:10,000)SIVP 1.5-5 min. ET .3-.5 mg diluted w/ NSS to 10 cc min. May repeat in 5 min.
IVPB-1-2mg in 500cc of NSS/D5W. start 60 uggts/min titrate to effect
Diphenhydramine (Benadryl)
Dose/Route?
25-50 mg. SIVP at 25 mg./min or IM
MAY be increased to 50-100mg
Diphenhydramine (Benadryl)
Side effects?
Notes & Precautions?
SE:Hypotension;palpations; tachycardia; drowsiness;confusion; blurred vision;decreased coordination;thick dry mucus plugs;dry mouth;urinary retention.
Notes: For anaphylaxis,use in conjuction with EPI; Has a "Atropine like" effect, dries out mucus Not for acute asthma. asthma attacks already have component of dry mucus plugs. May potentiate the effects of other antihistamines,ETOH,narcs.& sedatives
Epinephrine (Adrenalin)
Side effects?
Notes & Precautions?
SE: palpations;tachycardia;chest pain;(+)myocardial O2 demand;hypotension;ectopy;V-fib;Anxiety;restlessness;headache;dizziness;tremors;seizures;N&V
Notes:Use caution in pts. w/ hypertension,pregnant women;cardio disease and pts. over 40. Must be circulated (w/ CPR)for 1 min before next dose. May be used in symptomatic brady. refractory yo other drugs and when pacing is not available. May be nebulized for allergic reation or anaphylaxis with swollen airway.
Epinephrine (Adrenalin)
Concentrations?
1:?????
1:1000- 1mg/cc used for Sub Q inj.
1:10,000- 1 mg in 10 cc -same as above but diluted and less irritating for IV & ET. Too large for Sub Q
1:100,00- 1 mg in 100cc Not a prehospital concentration. Used by doctors/dentists for antesthetize tissue and also minimizes bleeding via local vasoconstriction
Glucagon
Side effects?
Notes & Precautions?
SE:Hypertension,tachycardia;nausea and vommiting
Notes: Comes in powder form and must be dissolved in a dilutent and must be used soon after mixing. May be ineffective if glycogen stores are low in non diabetic hypoglycemia. May be indicated for beta blocker or calcium channel blocker OD. May be indicated for partial airway obstruction because its effects on smooth muscle relaxation,
Dextrose 50%(D50W)
Side effects?
Notes & Precautions?
SE: Subjective warmth; phlebitis;pain or burning at site and tissue necrosis.

Notes: Ver irritating,use larger vein, confirm IV patency every 5-25cc by obtainig a free flowing aspiration of blood. If cannot confirm, stop admin. immediatly.Hypoglycemia S&S may imitate CVA. Can be diluted to D25% for peds.
Naloxone (Narcan)
Class?
Therapeutic Effects?
Class: Narcotic antagonist(blocker)
>Effects: Displaces narcotics from opiate receptor sites in CNS;
>Reverses respiratory depression,sedation,&pupillary effects of narcotics and synthetic narcotic analgesics.
Furosemide (Lasix)
Class?
Therapeutic effects?
Class: Loop diuretic
Effects: Increases urinary output
>Decreases preload by vasodilation and venous pooling
Nitroglycerin(Nitro-stat,nitro-bid)
Class?
Therapeutic effects?
Class: Vasodilator
Effects:Dilates coronary arteries;Relaxes smooth muscles resulting in peripheral arteriole and venous dilation;Reduces preload and afterload,thereby(-)myocardial workload and O2 demand
Morphine Sulfate
Class?
Therapeutic effects?
Class: Narcotic analgesis
Effects: Acts directly on CNS at opiate receptor sites to releive pain;Decreases myocardial O2 demand,causes venous pooling due to peripheral vasodilation,reduces preload and afterload by (-)venous return and PVR;Alleviates anxiety
Naloxone (Narcan)
Indications?
Contra?
Indications: Respiratory depression associated with suspected narcotic overdose
Contra: Not significant in above indications
Furosemide (Lasix)
Indications?
Contra?
Indications:Pulmonary edema, CHF
Contra: Hypersensitivity to drug;hypovolemia;dehydration
Nitroglycerin(Nitro-stat,nitro-bid)
Indications?
Contra?
Indications:Chest pain of suspected myocardial origin;ACS;Acute pulmonary edema
Contra:Head trauma,cerebral hemmorrage;hypotension;hypovolemia;Erectile dysfunction med. within last 24-48 hours
Morphine Sulfate
Indications?
Contra?
Indications:Chest pain associated w/ suspected MI,ACS
CHF,pulmonary edema,moderate to severe pain
Contra: Hypovolemia, sever hypotension,head injury,abdominal injury,severe respiratory depression, pain of unknown etiology
Morphine Sulfate
Dose?
Route?
Dose:
>SIVP 2-5 mg. every 5 mins as needed for effect, reasses vitals every 2-5 mg.
>IM,SQ 5-20 mg
Nitroglycerin(Nitro-stat,nitro-bid)
Dose?/Route?
0.4 mg SL every 5 minutes, 3 times
Furosemide (Lasix)
Dose?/Route?
40-100 mg SIVP at 20 mg/min
Naloxone (Narcan)
Dose?/Route?
>Respiratory depression; 0.4mg IV, titrate to adequate ventilation max 2 mg. or 2mg IM or IntraNasal
>Cardiac / respiratory arrest
2 mg IV/IO may repeat every 2-3 min. as needed or 2-4 mg. ET,diluted with NSS to a volume of 10 ml
Naloxone(Narcan)
Side Effects?
Notes?
SE:Tachycardia;hypotension;hypertension,Nausea & Vomiting
Notes: If no response within 10 mins. of administration,etiology of the ALOC should be questioned,With severe respiratory depression,when narcotic induced coma is suspected....Admin Narcan before intubating..In an effort to minimize SE of narcotic withdrawl and violent behavior....some push 1-2 mg. SIVP (in .04 mg increments) titrated to respiratory effects
Furosemide(Lasix)
Side Effects?
Notes?
Side effects:Postural hypotension,hypotension,syncope,dehydration,dysrhythmia,confusion,headache,blurred vision,tinnitus,hearing loss,N/V,diarrhea,Loss of electrolytes(depletion of sodium,chloride,potassium,calcium,metabolic alkalosis.
Notes: AHA recommends .5-1.0 mg/kg initial dose,repeated to max dose of 2mg/kg...(-)in preload via vasodilationmay begin within 5 min and Diuresis begins within 15-20 minutes..Use caution in pts. with CHF and COPD.. Lasix may worsen dyspnea associated with COPD. Use caution with pregnant pt....Only use in life threating situations...Lasix may be ordered in doses as high as 100 mg or more. Some systems may be indicated for ICP associated with head injury or cerebral edema
Nitroglycerin(Nitro-stat; Nitro-bid)
Side effects?
Notes?
Side effects:orthostaic hyportension;tachycardia;palpations;throbbing headache;dizziness;syncope;(+)ICP;flushed skin;sublingual burning;N&V
Notes: .4 mg is also described as 1/150 gr. another common dose is .3mg (1/200 gr.). Discontinue use is if SBP <100 or if SBP drops more than 30%;remove prescribed patches fro hypotensive pts. and those requiring defib or pacing;fatal hypotension may be caused if given to pts. who have taken drugs for ED within 24-48 hrs; Use with other vasodilators may have additive effects;DO NOT shake Nitrospray prior to admin....It will effect the metered dose;Spray may be absorbed better in dehydrated pts, and may be used when pt. is unable to elevate tongue. In most pts. adverse effects are transient and self limited.
Morphine Sulfate
Side effects?
Notes?
Side effects: Hypotension;tachycardia;bradycardia;ALOC;headache;dizziness;confusion;hypoventilation,respiratory arrest,N&V
Notes: ACLS cardiac doses may be as little as 2-4 mg. repeated 2-8 mg. every 5-15 min....
>Burns and other mechanisms causing severe pain may require larger doses
>In some systems..morphine 10mg/cc is diluted to a total of 10cc making titration easier in the field setting....