Pharm: Emergency Drugs

Front 1

What are the steps you take if there is a medical emergency?

Back 1

Recognize it: then diagnose, Call 911, note the time, position patient properly, maintain airway, administer oxygen, monitor vitals, provide symptomatic treatment, CPR (if no breathing or pulse)

Front 2

Lost or altered consciousness emergencies?

Back 2

Syncope, hyper/hypoglycemia, seizures

Front 3

Respiratory emergencies?

Back 3

hyperventilation, asthma, anaphylaxis, acute airway obstruction

Front 4

Cardiovascular emergencies?

Back 4

Angina, MI, Cardia Arrest, CVA (stroke)

Front 5

Drug-related emergencies?

Back 5

Opioid overdose, reaction to local anesthetics, epinephrine

Front 6

What is Syncope?
Symptoms
Cause
Treatment

Back 6

-Most common emergency. Fainting
-Sweating, pale color, drop in BP
-Anxiety, fear or apprehension
-Trendelenburg (head lower than feet) Ammonia spirits may be inhaled

Front 7

Hypoglycemia?
Symptoms
Cause
Treatment

Back 7

-Insulin shock
-Hunger,dizzy,weak,sweating
Rapid pulse,decreased respiration,mental confusion
-Increase insulin, decrease blood sugar
-Conscious pt. give sugar, unconscious: IV dextrose

Front 8

Hyperglycemia?
Symptoms
Cause
Treatment

Back 8

-Diabetic coma
-Loss of appetite, N&V, urination, acetone breath, warm dry skin, rapid pulse
-Increase Blood sugar, decrease insulin
-Hospital setting- give insulin. When in doubt giving glucose is okay

Front 9

Convulsions/Seizures?
Symptoms
Cause
Treatment

Back 9

-Abnormal movements of tonic/clonic contractions.
-Epilepsy, usually grand mal. possible reaction to local
-Convulsions usually self-limiting, protect patient from self-harm, ensure open airway

Front 10

Hyperventilation?
Symptoms
Cause
Treatment

Back 10

-Tingling of finger, shortness of breath, N&V, faintedness, lightheadedness
-Usually due to anxiety
-Reassure patient, have them hold their breath or "rebreathe" into cupped hands over face, to increase CO2 concentration and warm the fingers

Front 11

Asthma?
symptoms
cause
treatment

Back 11

-Wheezing with prolonged expiration
-due to anxiety, drugs, allergens, exercise
-Acute attack-use inhaler
Administer oxygen, aminophylline, parenteral corticosteroids and epinephrine if adequate results not achieved

Front 12

Anaphylaxis?
symptoms
cause

Back 12

-weak, rapid pulse, profound drop in bp, bronchial constriction
-allergic reactions

Front 13

What is/are the most common allergic reaction?

Back 13

Most common is penicillin injection, certain foods, latex

Front 14

DOC for anaphylaxis?

Back 14

Parenteral epinephrine deltoid muscle or under tongue.

Front 15

Angina Pectoris?
symptoms
cause
treatment

Back 15

-Rapid pulse, shortness of breath, chest pain
-stress from pain, trauma or fear
-sublingual nitroglycerin tablets or spray

Front 16

Acute Myocardial Infarction?
symptoms
cause

Back 16

Sweating, irregular rapid pulse, N&V, indigestion, shortness of breath, pain not relieved by nitroglycerin tablets
-Insufficient O2 to heart muscle, trauma, atherosclerosis, congenital defects

Front 17

What type of treatment do you give a patient with Acute Myocardial Infarction?

Back 17

O2
325 mg aspirin tablet, opioid analgesic, transport to hospital

Front 18

Cardiac Arrest?
symptoms
cause
treatment

Back 18

-No pulse, pupils fixed and dilated
-Sudden circulator and respiratory collapse
-911, CPR, AED, transport to hospital

Front 19

Cerebrovascular Accident?
symptoms
cause
treatment

Back 19

Stroke
-sudden confusion, weakness on one side of body, slurred speech
-destruction of brain tissue due to intracerebral hemorrhage, thrombosis,embolism,or vascular insuficiency
-O2 and transport to hospital

Front 20

Are allergies dose related?
T/F

Back 20

False

Front 21

Where do most drug allergies arise from?

Back 21

Parenterally administered agents

Front 22

What 2 drugs do you use in a minor allergic reaction?

Back 22

Administer a histamine blocker
IM Diphenhydramine (Benadryl 50mg)
IM Chlorpheniramine (ChlorTrimeton 10mg)

Front 23

How do you treat a local anesthetic reaction?

Back 23

Convulsions-diazepam (Valium)
Hypotension- pressor agent to increase BP (epinephrine)
Slow HR- atropine

Front 24

Epinephrine Sensitivity, Toxicity
symptoms
cause
treatment

Back 24

-Nervousness to shaking to tachycardia
-injecting epinephrine into bloodstream, or use of impregnated cord in sulcus for impressions
-Stop treatment, remove retraction cord, reassure patient, epinephrine is quickly metabolized

Front 25

What are the symptoms of epinephrine toxicity?

Back 25

increased BP and Hr
anxiety, headache, tremor, dizzy, perspiration, weakness

Front 26

Treatment of epinephrine toxicity?

Back 26

Upright chair position, BLS, reassurance, monitor vital signs every 5 minutes, supplemental oxygen, summon medical assistance if BP and heart rate increase dramatically and if patient has headache, recovery period

Front 27

How long does it take to develop sedative-hypnotic toxicity?

Back 27

Signs develop 45 min to 1 hr following oral administration

Front 28

What do you do in a Benzodiazepine overdose?

Back 28

Trendelenburg position, BLS, oxygen administration.

Front 29

What is the DOC for opioid overdose?

Back 29

Naloxone (Narcan)

Front 30

What types of drugs need to be in an emergency kit in the dental office?

Back 30

Epinephrine, dephenhydramine, oxygen, nitroglycerine, glucose, albuterol

Front 31

Epinephrine used for?

Back 31

Cardiac arrest
Anaphylaxis
Acute Asthmatic Attack

Front 32

Diphenhydramine used for

Back 32

Allergic reactions
used with epi for severe reactions

Front 33

Oxygen

Back 33

indicated in most emergencies for support

Front 34

Nitroglycerine?

Back 34

Acute anginal attack

Front 35

Glucose?

Back 35

Hypoglycemia

Front 36

Albuterol?

Back 36

Asthma Attack

Front 37

Level 2 drugs used?

Back 37

Benzodiazepines, aromatic ammonia spirits, morphine, hydrocortisone, dextrose, glucagon, atropine, beta blockers

Front 38

Benzodiazepines?

Back 38

local anesthetic reaction

Front 39

Aromatic Ammonia Spirits?

Back 39

syncope

Front 40

Morphine?

Back 40

moderate to severe pain

Front 41

Hydrocortisone?

Back 41

Adrenal insufficiency, allergic reactions, anaphylaxis (has very slow onset)

Front 42

Dextrose?

Back 42

hypoglycemia, unconscious, IV

Front 43

Glucagon?

Back 43

severe hypoglycemia

Front 44

Atropine?

Back 44

used to increase cardiac rate

Front 45

Beta Blockers?

Back 45

used to decrease blood pressure and heart rate

Front 46

Other drugs?

Back 46

Antiarrhythmics, Naloxene, Flumazenil

Front 47

Antiarrhythmics

Back 47

Lidocaine, verapamil, procainamide

Front 48

Naloxone?

Back 48

opioid OD

Front 49

Flumazenil?

Back 49

Benzodiazepine OD

Front 50

What % of medical emergencies are related to stress and anxiety?

Back 50

75.6%