Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
20 Cards in this Set
- Front
- Back
|
Bumetanide
|
Trade Name: Bumex
Class: loop diuretic; anti hypertensive Rx: Pulmonary Edema Contra: non when clinically indicated Adverse Reactions: Hypotension and hypokalemia Dose: 0.5-2.0mg IV push given over 2 min. q. 2-3 hrs Note: 1mg Bumex = 40mg Lasix Action Mechanism: Primarily inhibts sodium reabsorbtion in the proximal tubule Interactions: Bumetanide administered with other antihypertensives or diuretics may cause additive hypotension and fluid depletion Note: No Pediatric Dose |
|
|
Diazepam
|
Trade Name: Valium
Class: Benzodiazepine; Anticonvulsant; tranquilizer Rx: Seizures; Cocaine OD Contra: CNS depression and respiratory depression. Use caution in elderly pt's Adverse Reactions: Cardiovascular collapse, respiratory depression, withdrawal syndrome Dose: Adult Seizures-2-5mg IV Push SLOWLY Cocaine OD-5-15mg IV Push SLOWLY Sedation post RSI-0.1mg/kg IV Push SLOWLY Pediatric Seizures 0.1mg/kg IV Push 0.5 mg/kg PR Action Mechanism: 1/2 life is 10-15 min. Interactions: Flumazenil can reverse Valium in 1-2 minutes Will precipitate in NS or D5W |
|
|
Albuterol
|
Trade Name: Proventil
Class: B2 selective sympathomimetic; Beta Agonist Rx: Any disorder with associated bronch-constriction/wheezing; Hyperkalemia Contra:None when clinically indicated Adverse Reactions: Tachyarrhythmias, palpitations, restlessness Dose: Adult Broncho-constriction/wheezing/hyperkalemia -2.5 mg in 3cc's NSS -Administered nebulized with 5-8LPM of O2 Pediatric Broncho-constriction/wheezing/hyperkalemia -2.5 mg in 3cc's NSS -Administered nebulized with 5-8LPM of O2 Action Mechanism: Acts primarily on bronchial smooth musculature by stimulating beta 2 receptors Interactions: Efficacy may be severely reduced if taking beta blockers. Efficacy may increased if combined with other beta agonists |
|
|
Atropine
|
Trade Name: Atropine
Class: Anticholinergic; Parasympatholytic Rx: Hemodynamically compromised symptomatic bradycardia (non-AMI); Symptomatic Sinus Arrest or block; AV block at the Junctional level; Slow PEA; Asystole; Organophosphate poisoning, cholinesterase inhibiting pesticides, sarin, parathion and gas poisons Contra: Heart transplant as there are no parasympathetic connection to the heart due to the vagus nerve being severed Adverese Reactions: Serious-if given too slowly will cause rebound bradycardia Common-Mydriasis, Arrhythmia, Xerostoma, Ileus, Malignant HTN, Urine reduction output, Malignant hyperthermia (MAXIMUM) Dose:Adult:All cardiac indications -0.5-1.0mg IVP q 3-5 min up to max 3mg or (0.04mg/kg), Rapidly -Alternatively can be given ETT at 2.0-2.5X IV dose Organophosphate Poisoning -1mg q 2 min Pediatric:All Cardiac indications - max 0.04mg/kg min dose=0.1mg -0.02mg/kg IV to max of 0.5mg for child and 1mg for adolescents -Repeat 0.5mg-1mg for child and 1mg-2mg for adolescents -Alternatively can be given ETT at 2.0-2.5X IV dose Organophosphate Poisoning -0.05mg/kg IV q 10-20min Action Mechanism: -antagonizes acetylcholine receptors - blocks effect of acetylcholione -Increases myocardial O2 demand -Increases rate of discharge at SA and AV nodes -Relaxes smooth muscle in GI tract - inhibits secretions of the duct glands(sweat/saliva) -Causes relaxation of smooth muscle in bronchial tree Hot as a Hare-Dry as a Bone-Mad as a Hatter-Red as a Beet-Blind as a Bat Interactions:None |
|
|
Furosemide
|
Trade Name: Lasix
Class: Loop Diuretic Rx: Pulmonary Edema (acute); Hypertension Contra: Allergy to sulfa drugs, hypotension with pulmonary edema and dehydration Caution with sever renal disease, acute MI, and pancreatitis Adverse Reactions: Severe-Hypotension Common-Frequent Urniation, dizziness, N/V, muscle cramps, hypokalemia, hypomagnesemia, hypotension, abdominal cramps, hyperglycemia, hypocalcemia, tinnitus, photosensitivity Dose: Adult Acute Pulmonary Edema (BP > 120 Systolic) 1.0mg/kg IV Push SLOWLY Pediatric 1mg/kg IV Push q. 6-12 hr Action Mechanism: Blocks sodium at the proximal loop of Henle; Onset of action in 5 min with max effect in 30 min; Direct vasodialating effect in pulmonary edema Interactions: None |
|
|
Ipratropium Bromide
|
Trade Name: Atrovent
Class: Anti-Cholinergic/Bronchodilator Rx: Adult Reasons 1-9 COPD Reason 10 Asthma Pediatrics Asthma Contra: none if clincally indicated Adverse Reactions: Almost none - Dry mouth Dose: 0.5mg in 2.5cc NSS = 0.02% solution Action Mechanism: Bronchiole smooth muscle relaxer Inhibits vagal mediated antagonists by blocking Acetylchonline Interactions: None Notes: Onset of action - 2 hrs. Studies have shown decrease hospital admission secondary to increase lung function. If severe respiratory distress - use albuterol as primary bronchodilator Use first in Mild - Moderate distress Some physicians mix Albuterol and Atrovent together in nebulizer Some physicians will alternate Atrovent 1st and 3rd nebulizer with Albuterol between until relief of SOB |
|
|
Diphenhydramine
|
Trade Name: Benadryl
Class: Antihistamine Rx: Relief of symptoms from allergic reactions;Anticholinergic-used to treat acute dystonic response (Stiff gait, cog wheel rigidity) extrapyramidal reactions to antipsychotic drugs (Haldol, Thorazine, Compazine) Contra: None when clincally indicated Adverse Reactions: Rare-Convulsions and death may result from OD, wheezing, and hypotension Common-Drowsiness and confusion, blurred vision, diplopia, Diffculty urinating in males, dry mouth Dose: Adult Allergic Reaction/Dystonic response-50-100mg IV Push or Deep IM Pediatric All Indication-1mg/kg IV Push or IM Action Mechanism: Blocks histamine effects in allergic reactions by preventing histamines from reaching H1 receptor sites;Sedative effects due to CNS depression;Antiemetic-inhibits motion sickness;Onset 1-3hrs; Duration 6-12hrs Interactions:combined with benzodiazepines, other sedatives, ethanol, and opiates may exacerbate CNS depression resulting in respiratory depression Note: Not recommended for newborn or premature infants |
|
|
Levalbuterol
|
Trade Name: Xopenex
Class: B2 selective sympathomimtic; Beta Antagonist Rx: Any disorder with associated broncho-constriction/wheezing<p>Bronchiolitis in infants Contra: None when clinically indicated Adverse Reactions: Tachyarrhythmias, palpitations, restlessness Dose: Adult Broncho-constriction/wheezing/hyperkalemia 1.25mg in 3CC NSS for more sever wheezing (acute setting Administered nebulized with 5 - 8LPM of O2 Other Doses 0.63mg in 3cc Nss for moderate wheezing (home therapy) Peditrics 1.25 mg in 3cc NSS for more severe wheezing (acute setting) 0.31mg in 3cc NSS for pediatric patients (home therapy) Action Mechanism: Acts primarily on bronchial smooth musculature by antagonizing beta 2 receptors Interactions: Efficacy may be severely reduced if taking beta blockers Efficacy may increase if combined with other beta agonists |
|
|
Dexamethasone Sodium Phosphate
|
Trade Name: Decadron
Class: Synthetic Steroid; Corticosteroid Rx: Asthma/Croup;Near drowning in fresh water;Anaphylaxis or allergic state;Brain tumor with edema;Alternative to Solu-medrol Contra: Systemic fungal infection Adverse Reactions: Serious - steroid psychosis Common - None in the pre-hospital setting Dose: Adult All Indications-10mg IV Push Pediatric Croup-0.6mg/kg IM or IV Inflammation-0.08-0.3mg/kg IM or IV Action Mechanism: A potent rapid acting, short duration, anti-inflammatory steroid(stabilizes the cell wall of MAST cells, thus preventing release of histamine, etc.);Onset of action is 4-8hrs Interactions: None |
|
|
Epinephrine
|
Trade Name: Adrenalin
Class: Vasopressor, Catecholamine Rx: Bradycardia;Cardiac Arrest;Anaphylaxis;Asthma Contra:If pt is awake, administer cautiously in presence of old age, debilitation, hyperthyroidism, hypertension, and diabetes;Use caution in patients with angina, hypertension, CAD;May cause severe hypertension and reflex Bradycardia in those taking beta blockers Adverse Reactions: Serious-V-fib, V-tach, cerebral hemorrhage Common-Tachycardia, palpitations, hypertension, tremors, nervousness Dose: Adult Anaphylaxis-0.3-0.5mg SC (1:1000 Concentration) Asthma-0.3-0.5mg SC (1:1000 Concentration) Cardiac Arrest-1mg IV Push(1:10,000 Concentration) 1. 3-5min 2.0X-2.5X IV dose for ETT Administration (mix 2.0-2.5mg of 1:1000 in 10cc's of NSS) Bradycardia-1-10mcg/min IV Drip;1mg to 500cc Pediatric Cardiac Arrest-0.01mg/kg IV Push(1:10,000 Concentration) q. 3-5min Anaphylaxis-0.01mg/kg IV Push(1:10,000 Concentration);0.01mg/kg SC (1:1000 Concentration) Bradycardia-0.01mg/kg IV Push x1 dose only(1:10,000 Concentration);Max dose of 1mg Action Mechanism:Stimulates alpha and beta-adrenergic receptors;Alpha-constrics peripheral blood vessels raise systolic blood pressure; dilate pupils, makes V-fib more susceptible to DC shock. Lowers threshold for defib;Beta-positive inotropic and chronotropic effects;Dilates bronchial smooth muscle, inhibits bronchial secretions, increases myocardial O2 demand Interactions:None |
|
|
Lorazepam
|
Trade Name: Ativan
Class: Benzodiazepine;anti-convulsants;sedative CNS depressant Rx: Control seisure disorders emergent and non-emergent (not listed in PDR) Relieve anxiety Contra: Known Hypersensitivity to benodiazepines Caution in eldery patients, very ill patients or patients with reduced pulmonary reserve as hypoventilation, hypoxia Adverse Reactions: Serious-respiratory depression, withdrawl syndrome, abude/dependency Common-Amnesia, sedation, dissiness Dose: Adult Seizure/sedation/relieve anxiety IV injection-1.0 to 2.0 mg IM injection (If no Versed Available)-2.0mg up to 4.0mg injected Pediatrics Seizures 0.05-0.1mg.kg IV Push Action Mechanism:binds to benzodiazepine receptors Interactions: Additive effect with other narcotics, barbiturates, analgesics, antidepressants, and MAO inhibitors |
|
|
Magnesium Sulfate
|
Trade Name: Magnesium Sulfate
Class: Antiarrhythmic;Smooth muscle relaxant Rx: Torsades de Pointes; Pulseless VT/VF (refractory)(after Lidocaine);Seizures due to toxemia of pregnancy(eclampsia);Asthma Contra: None when clinically indicated Adverse Reactions: Serious-loss of Deep Tendon Reflexes, respiratory depression, bradycardia Common-depressed relfexes, hypotension, reduced cardiac output Dose: V-Tach w/ Pulse/Ventricular Ectopy -1-2 grams in 50-100cc's -IV Drip over 15 min Recurrent or refractory v-fib/pulseless v-tach/Torsades -1-2 grams IV in 2-4cc's -given over 1-2 min Asthma -2 grams IV Drip in 100cc's -given over 20 min Eclampsia -2-4 grams IV -given over 3 min Action Mechanism: Effects energy transfer & electric stability in the myocardium; Stabilizes cardiac cells;Regulates potassium(K);Blocks Calcium Channels;Depletion of Mg -Cardiac cells unable to maintain intracellular K(Na pump fails) -loss of K as Mg and K required for action of Na pump Interactions:None Note: Pediatric dosages are currently not available |
|
|
Nalmefene
|
Trade Name: Revex
Class: Opioid Antagonist Rx: Complete or partial reversal of CNS and respiratory depression induced by opioids including propoxyphene, nalbuphine, pentazocine, and butorphanol Contra: Caution with CAD disease, opiate aadiction as it may precipitate withdrawl Adverse Reactions: Serious-arrythmias Common-N/V, tachycardis, hypertension, diaphoresis, bradycardia, headache, chills, dizziness Dose: Opioid OD 0.5-1.0mg.70kg IV Push May be repeated once q. 2-5 min Action Mechanism: Antagonizes various opiod receptors Interactions: None Note: No Pediatric Dose |
|
|
Methylprednisolone
|
Trade Name: Solu-Medrol
Class: Glucocoticoid Steroid Rx: Asthma;Neurogenic shock(controversial);Acute spine core injury Contra: Caution with GI bleeding, diabetes mellitus Adverse Reactions: Serious-Steroid psychosis, CHF, peptic ulcer, anaphylaxis, osteoporosis Dose: Adult Anaphylaxis, Asthma-125mg IV Push Spinal Cord Injury-30mg/kg IV Push;Followed by infusion of 5.4mg/kg/hr Pediatric Anaphylaxis, Asthma-2mg/kg/dose IV Push Action Mechanism: Methylprednisolone is a synthetic steroid that supresses acute and chronic inflammation. In addition, it potentiates vascular smooth muscle relaxation by beta adrengic agonists, and may alter airway hyperactivity. A newer usage is for the reduction of post-traumatic spinal edema;Onset 2-4hrs Interactions:None |
|
|
Naloxone
|
Trade Name: Narcan
Class: Opiod Antagonist Rx: Reverse pre-operative opiate induced sedation Odioid/Opiate OD Contra: Use caution when given to an OD patient who may be intubated, be cautious of destructive self extubation Use caution when administering to patients. Too much Narcan can induce withdrawl, only administer enough to maintain respiratory drive a good cardiac output Adverse Reactions: Tachycardia, hypertension, N/V, tremors,minor withdrawl symptoms, diaphoresis Dose: Adult Opiate OD 0.4-2.0mg IM/IV/SC/Inter-nasal Post-op opioid reversal 0.1-0.2mg q. 2-3 min PRN Pediatrics Opiate reversal (0-5 years old or < 20kg) 0.1mg/kg IV/SC/ETT q. 3 min until response Action Mechanism: Antagonizes various opiate receptors Half life is 30-100 min Interactions: None |
|
|
Midazolame Hydrochloride
|
Trade Name: Versed
Class: Benzodiazepine Rx: Pre-medication before cardioversion;Sedation;Seizures Contra: Use caution with decreased respiratory drive;Liver disease/cirrhosis Adverse Reactions: Serious-hypoventilation Common-N/V, sedation, hypotension, euphoria, hallucinations, confusion, dizziness Dose: Adult Pre-intubation/Sedation-0.1mg/kg IV Push;typical dose 5mg IV Push Seizures (When no IV access is avail)-2-5mg IM Induction agent-0.2mg/kg IV Push~7-10mg avg. adult Pediatric Seizures w/o IV access-0.1mg/kg IM Action Mechanism:Binds to benzodiazepine receptors enhancing GABA effects;Conscious sedation or to relieve apprehension or impair memory before intubationor endoscopy, etc;Antegrade amnesia/retrograde;Onset 1-5min;Peaks 5-7min;Duration 2 hours;Half life of 2-4hrs Interactions: Reversed with Romazicon Note: 2mg versed = 5mg valium |
|
|
Terbutaline
|
Trade Name: Brethine
Class: Synthetic sympathomimetic amine Beta-adrenergic Bronchodilator;smooth muscle relexant Rx: Asthma and bronchospasms Premature labor Contra: Caution with hypertension and ventricular arrhythmias Adverse Reactions: Rare-arrythmia, hypotension, angina Common- nervousness, headache, tachycardia, palpitations, N/V, sweating, muscle cramps Dose: Adult:Asthma/Bronchospasms/premature labor - 0.25mg SC to start, wait 15 min, repeat if necessary Pediatrics:Not recommended for pediatrics in the pre-hospital setting Action Mechanism:Stimulates beta-2 adrenergic receptors Interactions: None |
|
|
Morphine Sulfate
|
Trade Name: Morphine
Class: Narcotic;Named after Morphous, Greek god for dreams Rx: Pain (burns, MI, and others);Cardiac chest pain Contra: Existing respiratory depression;Allergy to sulfate drugs Adverse Reactions: Serious-respiratory, apnea, severe hypotension Common-decreased LOC, N/V, dizziness, hypotension, euphoria, diaphoresis, miosis, constipation, dry mouth Dose: Adult Pain(MI, sickle cenn, and other)-2-5mg IV Push q. 5min until desired effects Pain(burns)-5-10mg IV Push q. 5 min until desired effect;Often high dose morphine is required for pain relief Pediatric Pain(all indications)-0.1mg/kg IV Push Action Mechanism: binds to various receptors producing analgesia and sedation;Dilates venous system therefore reducing preload and afterload and intern decreasing myocardial O2 demand;Vagotonic effect on heart Interactions: None Note: Have respiratory equipment readily available;Narcan reverses effects of morphine;may be ordered in pulmonary edema |
|
|
Nitroglycerin
|
Trade Name: Nitrostat, Nitrospan, Nitrodisc, Nitrodur, Tridil
Class: Nitrate, Vasodilator Rx: MI(not right ventricular);Angina Pain;Pulmonary Edema from CHF Contra: None when clinically indicated Adverse Reactions: Serious-hypotension, bradycardia, developed tolerance Common-headache, lightheadedness, dizziness, flushing, reflex tachycardia, burning or tingling during SL administration Dose: All Indications -0.4mg(2% solution) SL spray;administeron mucus membranes of mouth (under tounge) -0.4mg(1/150grains) SL tablet q. 3-5min;store in brown glass or opaque container as sunlight will inactivate -1-2 inches as on ointment;Apply to skin w/o hair;Avoid self exposure during administration -10-20mcg/min IV Drip -Increased by 5-10mcg/min q 5-10min until desired response -Mixed 50-100mg in 250cc's Action Mechanism: Stimulates cGMP production resulting in vascular smooth muscle relaxation;Decreases preload(venous dilation) therefore reducing myocardial O2 demand;Dilate coronary arteries(effect may be limited by atherosclerosis);Increases subendocardial blood flow;Onset 1-2min Interactions:None Note:No prehospital administration suggested in pediatrics. DO NOT attempt to defibrillate a pt through a nitroglycerin patch. |
|
|
Oxygen
|
Trade Name: Oxygen
Class: Naturally occuring gas Rx: Confirmed or suspected hypoxia;Ischemic chest pain;Respiratory insufficiency;Confirmed or suspected carbon monoxide poisoning and other causes of decreased issue oxygenation(cardiac arrest) Contra: None Adverse Reactions: Serious-respiratory depression within hours with patients who have hypoxic drive after long periods of exposure to high concentration oxygen Dose: All indications-High concentration 10-15 lpm via NRB;Low concentration 1-4 lpm via nasal cannula Action Mechanism: Oxygen is an odorless, tasteless, colorless gas that is present in room air at a concentration of approximately 21%. It is an important emergency drug that is used to reverse hypoxemia; in doing so, it helps oxidize glucose to produce ATP(aerobic metabolism) Interactions: None |
