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32 Cards in this Set
- Front
- Back
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Glucagon
type |
• Polypeptide hormone produced by pancreatic alpha cells
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Glucagon
Mechanism of Action |
• Glycogenolysis
• Gluconeogenesis • Decreased Glyconeogenesis • Increases intracellular cAMP • Relaxes smooth muscle in the GI tract |
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Glucagon
Pharmacokinetics |
• Peak effect within approximately 15 minutes
• Onset should be seen within approximately 10 minutes • Duration of action is 60-90 minutes • Plasma, Liver, and Renal metabolism |
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Glucagon
Uses |
• Unresponsive hypoglycemic without vascular access
• BB/CCB OD |
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Glucagon
Adverse Effects |
• N/V
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Glucagon
Precautions |
• Must have sufficient glycogen stores (malnourishment)
• Cardiac Hx |
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Glucagon
Drug Interactions |
• Sympathomimetics
• Sympatholytics • Anticholinergics |
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Glucagon
Contraindications |
• Hypersensitivity
• Pheochromocytoma |
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Glucagon
Dose |
• Must reconstitute dry powder (1mg/ml)
• Hypoglycemia - 1mg IM/SubQ • BB/CCB OD (Loading) - 100mcg/kg IV over 10 minutes • BB/CCB OD (Maintenance) - 100mcg/kg/hr |
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Thiamine HCL
type |
Vitamin B1
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Thiamine HCL
Mechanism of Action |
• Important coenzyme for the metabolism of glucose.
• Cannot adequately utilize glucose during cellular respiration in deficiency states. |
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Thiamine HCL
Use |
• Deficiency is common with malnourishment and alcoholism.
• Should be used before administration of glucose when the above is suspected in a hypoglycemic patient. • May also be used when a patient is unresponsive to glucose administration (elevation in BGL, symptomatic) |
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Thiamine HCL
Adverse Effects |
• Deficiency leads to Wernicke-Korsakoff syndrome
• Deficiency may also lead to beriberi |
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Thiamine HCL
Precautions |
Anything that increases glucose metabolism will exacerbate Thiamine deficiency (i.e. Administration of D50W).
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Thiamine HCL
Dose |
100mg IV/IM
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Thiamine HCL
Wernicke’s Encephalopathy |
-is due to an acute thiamine deficiency and is reversible.
-is characterized by the clinical triad of ophthalmoplegia, confusion and ataxia. |
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Thiamine HCL
Korsakoff’s Syndrome |
- is due to a chronic thiamine deficiency and is non-reversible
-is characterized by • memory problems, • decreased cognition, • disorientation, • hallucinations, and • in some cases painful extremities. |
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Sodium Bicarbonate
trade type |
NaHCO3
Electrolyte Alkalinizing Agent |
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Sodium Bicarbonate
Mechanism of Action |
Bicarbonate is an important component of the plasma buffering system.
HCO3 + H+ = H2CO3 = H2O + CO2 A rise in pH will shift K+ intracellularly (H+/K+) |
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Sodium Bicarbonate
Pharmacokinetics |
8.4% Solution (4.2% for PED’s)
1mmol Na+ and 1mmol HCO3 per ml pH = 7.8 |
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Sodium Bicarbonate
Uses |
Prolonged Cardiac Arrest
Hyperkalemia Metabolic Acidosis Cocaine OD TCA OD ASA OD |
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Sodium Bicarbonate
Adverse Effects |
Use a dedicated line (precipitate formation)
Alkalosis Hypernatremia Extravasation causes significant tissue damage |
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Sodium Bicarbonate
Contraindications |
Cardiac arrest without intubation
Hypernatremia Alkalosis |
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Sodium Bicarbonate
Precautions |
Lab values (pH, PaCO2, HCO3, Electrolytes) should be monitored if possible.
Hypocalcemia (tetany) Excessive chloride loss (vomiting, GI suctioning) Will exacerbate hypokalemia Renal Failure or CHF |
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Sodium Bicarbonate
Dose |
Cardiac Arrest - 1mEq/kg IVP
OD - 1mEq/Kg SIVP (Repeat once q 5 minutes) Hyperkalemia - 50mEq SIVP |
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Calcium Chloride
tyoe |
Electrolyte
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Calcium Chloride
Mechanism of Action |
Contraction of muscle via association of actin and myosin.
Depolarization of slow cardiac channels via influx during stage 0. Regulation of neuronal transmission |
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Calcium Chloride
Pharmacokinetics |
Half bound to albumin
Half ionized (active) Alkalosis increases albumin binding |
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Calcium Chloride
Uses |
Hypocalcemia
Hypermagnesemia Hyperkalemia BB/CCB OD |
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Calcium Chloride
Contraindications |
Hypercalcemia
Digoxin Toxicity |
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Calcium Chloride
Precautions |
Use a dedicated line (precipitate formation)
Use only IV Extravasation can cause significant tissue damage |
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Calcium Chloride
Dose |
Cardiac Arrest - 1g SIVP (Repeat once q 10 minutes)
OD - 500mg in 50ml over 10 minutes (Repeat x1) |
