Pharmaceuticals

Front 1

Acetylsalicylic Acid: Trade name?

Back 1

Aspirin

Front 2

Aspirin: Generic name?

Back 2

Acetylsalicylic Acid

Front 3

Acetylsalicylic acid / Aspirin - Class?

Back 3

Platelet aggregation inhibitor

Front 4

Acetylsalicylic acid / Aspirin - Mechanism of Action?

Back 4

Impedes clotting action and platelet aggregation by inhibiting platelet activation to slow or prevent further growth of clots. Locks the formation of thromboxane A2 that is responsible for platelet aggregation and artery constriction. Asa's effect on platelets is irreversible and lasts a life of each platelet (5-7 days)

Front 5

Acetylsalicylic acid / Aspirin - Indications?

Back 5

Recent onset of ischemic chest pain suggestive of acute myocardial infarction

Front 6

Acetylsalicylic acid / Aspirin - Contraindications?

Back 6

1: Hypersensitivity: severe allergy (known)

2: Bleeding disorders: (hemophilia, Von Willebrand disease)

3: Unconsciousness

4: Active GI bleed

5: Children under the age of 14 increases risk of Reye's Syndrome

6: Asthmatic with previous sensitivity to ASAP or NSAIDS

Front 7

Acetylsalicylic acid / Aspirin - Precautions / Interactions?

Back 7

1: Impaired renal and hepatic function

2: May produce bronchoconstriction in asthmatics

3: Pregnancy

4: Children and adolescents with influenza or chickenpox infections (may increase the risk of Reye's syndrome)

5: Symptoms are encephalopathy and fatty liver degeneration

May interact with Warfarin (Coumadin) and other anti-coagulants and cause bleeding

Front 8

Acetylsalicylic acid / Aspirin - Adverse effects?

Back 8

Nausea & vomiting, heartburn, bronchospasm, bleeding, Urticaria

Front 9

Acetylsalicylic acid / Aspirin - Dosage?

Back 9

160-325 mg (millagrams) po (orally); chew tablets before swallowing. Note: given even if patient has taken their own ASA

Front 10

Acetylsalicylic acid / Aspirin - Supplied?

Back 10

80 mg and 325 mg tablets are common

Front 11

Epinephrine: Trade name?

Back 11

Adrenaline

Front 12

Adrenaline: Generic name?

Back 12

Epinephrine

Front 13

Epinephrine / Adrenaline - Class?

Back 13

Sympathomimetic, Adrenergic

Front 14

Epinephrine / Adrenaline - Mechanism of Action?

Back 14

1: Directly stimulates the alpha and beta adrenergic receptors in the sympathetic nervous system

2: bronchodilation: relaxes bronchial smooth muscle (beta2 receptors) and inhibits histamine release

3: CV and vasopressor: produces positive chronotropic and Inotropic effects (beta1 receptors); increasing cardiac output, myocardial oxygen consumption and force of contraction.

4: vasodilation (beta2 receptors) and vasoconstriction (Alpha receptors) in anaphylaxis it restabilizes the mast cells.

Front 15

Epinephrine / Adrenaline - Indications?

Back 15

Anaphylaxis

Front 16

Epinephrine / Adrenaline - Contraindications?

Back 16

None in anaphylactic shock

Front 17

Epinephrine / Adrenaline - Precautions and Interactions?

Back 17

Use with caution with pre-existing cardiac problems. patient must be monitored.

Front 18

Epinephrine / Adrenaline - Adverse Effects?

Back 18

Palpations, angina, dysrhythmias, N&V, headache, nervousness

Front 19

Epinephrine / Adrenaline - Dosage?

Back 19

Adult: 0.3 mg (1:1000) IM(intramuscular) Q(Every) 5-10 minutes prn(as needed)

Pediatric: 0.01 mg/kg IM/SQ(subcutaneous) [do not exceed 0.3 mg)

Epinephrine dose is based on body weight

Front 20

Epinephrine / Adrenaline - Supplied?

Back 20

1:1000 multi-dose vial 30 mg / 30 ml

1:1000 ampoule 1 mg / ml,

EpiPen = 0.3mg

EpiPen jr = 0.15mg

Front 21

Salbutamol: Trade name?

Back 21

Ventolin

Front 22

Ventolin: Generic name?

Back 22

Salbutamol

Front 23

Salbutamol / Ventolin - Class?

Back 23

Bronchodilator

Front 24

Salbutamol / Ventolin - Mechanism of Action?

Back 24

1: Selectively stimulate beta-adrenergic receptors of the lungs, uterus, and Vascular smooth muscle

2: bronchodilation results from relaxation of the vascular smooth muscles, which relieves bronchospasm and reduces Airway resistance

3: higher doses will drive serum potassium (K+) into the cells

Front 25

Salbutamol / Ventolin - Indications?

Back 25

1: Bronchospasm due to bronchial asthma, chronic bronchitis and other chronic bronchopulmonary disorders

2: respiratory distress with bronchospasm

Front 26

Salbutamol / Ventolin - Contraindications?

Back 26

Hypersensitivity

Front 27

Salbutamol / Ventolin - Precautions / Interactions?

Back 27

1: Use with caution and tachycardia

2: should not be used for patients presenting with acute heart failure

3: cardiovascular disease - cardiac dysrhythmias, hypertension

4: diabetes mellitus - risk of drug-induced hyperglycemia

5: hypokalemia - risk further reducing serum potassium levels and possible adverse cardiovascular events

Front 28

Salbutamol / Ventolin - Adverse Effects?

Back 28

Tachycardia, palpitations, dizziness, headache, angina, anxiety

Front 29

Salbutamol / Ventolin - Dosage?

Back 29

Adult: MDI minimum 6 puffs max 20

(NEB: 2.5 - 5.0 mg nebula - repeat q(every) 10 minutes prn(as needed)

Pediatric: MDI Pediatrics minimum 2 Puff Max 10

(NEB: 0.15mg/kg diluted to 2.5 ml saline via nebulizer or

[<10kg give 1.25mg with NS to 2.5 ml] [10-20kg give 2.5mg]

[> 20kg give 2.5 - 5.0mg])

Front 30

Salbutamol / Ventolin - Supplied

Back 30

2.5 mg in 2.5 ml plastic ampules

/ Puff

MDI - 100 ug / Puff

Combivent (Ventolin 2.5 mg / Atrovent 500 MCG)

Front 31

Ipratropium bromide: Trade name?

Back 31

Atrovent

Front 32

Atrovent: Generic name?

Back 32

Ipratropium bromide

Front 33

Ipratropium bromide / Atrovent - Class?

Back 33

Anticholinergic bronchodilator

Front 34

Ipratropium bromide / Atrovent - Mechanism of Action?

Back 34

1: Inhibits cholinergic receptors in the bronchial smooth muscle, resulting in decreased concentrations of cyclic guanosine monophosphate (cyclic GMP)

2: decrease levels of cyclic GMP produce local, not systemic, bronchodilation

Front 35

Ipratropium bromide / Atrovent - Indications?

Back 35

Bronchospasm from asthma, chronic bronchitis, emphysema

Front 36

Ipratropium bromide / Atrovent - Contraindications?

Back 36

Atrophy, aerosol propellant, patients with soy or peanut allergies

Front 37

Ipratropium bromide / Atrovent - Precautions / Interactions?

Back 37

1: Use with caution with patients with narrow angle glaucoma, prostatic hypertrophy, urinary retention

2: hypersensitivity to soy lecithin or related food products (soybeans, peanuts)

3: be careful to avoid accidental release into the eyes (use mouthpiece nebulizer if possible)

Front 38

Ipratropium bromide / Atrovent - Adverse Effects?

Back 38

Dry mouth, vomiting, palpitations, headache, Tremor, cough, flushing, dizziness

Front 39

Ipratropium bromide / Atrovent - Dosage?

Back 39

Adult: MDI; Minimum 1-4 puffs prn(as needed); max 10 (20mcg/spray)

Pediatric (ages 5-11)

MDI: minimum 2 Puffs prn(as needed); Max 4 (give after salbutamol; ipratropium has a much slower onset of action)

Nebulized doses:

250 - 500 MCG via Nebulizer with salbutamol (mixed) repeat up to two times as necessary

Front 40

Ipratropium bromide / Atrovent - Supplied

Back 40

Unit dose vials are available in the following doses: 125 MCG/ml, 250 MCG/ml, 500 MCG/ml

Front 41

Medical Oxygen - Class?

Back 41

Compressed Gas

Front 42

Medical Oxygen - Actions (Pharmacodynamics)?

Back 42

1: Colorless odorless and tasteless gas essential to respiration

2: at sea level, oxygen makes up approximately 10% to 16% of venous blood and 17% to 21% of arterial blood

3: transported from the lungs to the body's tissues attached to hemoglobin in the red blood cells

4: inhalation / Administration will increase arterial oxygen tension (pao 2) and hemoglobin saturation

Front 43

Medical Oxygen - Indications?

Back 43

1: Hypoxia from any cause

2: Chest pain due to cardiac ischemia to spO2 saturation of < 94%

3: Altered level of consciousness

Front 44

Medical Oxygen - Contraindications?

Back 44

None

Front 45

Medical Oxygen - Precautions / Interactions?

Back 45

Respiratory: in some cases of COPD, oxygen Administration May reduce the patient's respiratory drive. In the past this effect was vastly overstated and is generally not a concern to EMRs

Front 46

Medical Oxygen - Adverse Effects?

Back 46

Oxygen that is not humidified may dry out or irritate mucous membranes

Front 47

Medical Oxygen - Dosage?

Back 47

Nasal cannula: @ 2-6 L / min (provides 24% - 40% O2 concentration)

Simple & pocket-mask: @ 6-10 L / min (provides 40% - 60% O2 concentration)

Partial / non-rebreather (NRB): @ 10-15 L / Min (provides up to 98% O2 concentration)

Bag-valve mask (BVM): @ 10-15 L / Min (provides up to 100% O2 concentration)

Route: Inhalation.

Front 48

Medical Oxygen - Supplied?

Back 48

Compressed oxygen cylinders of various sizes

Front 49

Oral Glucose: Trade name?

Back 49

Glucola, Insta-Glucose

Front 50

Glucola, Insta-Glucose: Generic name?

Back 50

Oral glucose

Front 51

Glucola, Insta-Glucose / Oral Glucose - Class?

Back 51

Hyperglycemic agent

Front 52

Glucola, Insta-Glucose / Oral Glucose - Actions (pharmacodynamics)?

Back 52

Provides a quickly absorbed form of glucose to increase blood sugar levels

Front 53

Glucola, Insta-Glucose / Oral Glucose - indications?

Back 53

Conscious patients with suspected hypoglycemia and an intact gag reflex

Front 54

Glucola, Insta-Glucose / Oral Glucose - Contraindications?

Back 54

1: Decreased level of Consciousness (no gag reflex)

2: Hyperglycemia

3: Any patient unable to follow commands

4: Any patient who likes a gag reflex

Front 55

Glucola, Insta-Glucose / Oral Glucose - Precautions / Interactions?

Back 55

Nausea, vomiting

Front 56

Glucola, Insta-Glucose / Oral Glucose - Adverse Effects?

Back 56

Nausea, vomiting

Front 57

Glucola, Insta-Glucose / Oral Glucose - Dosage?

Back 57

Adult / Pediatric: 25g administered slowly until Improvement is noted

Front 58

Glucola, Insta-Glucose / Oral Glucose - Supplied?

Back 58

25g Gel paste: Chewable tablets in various volumes (25g)

Repeat q(every)10 minutes as necessary

Front 59

Naloxone: Trade name?

Back 59

Narcan

Front 60

Narcan: Generic name?

Back 60

Naloxone

Front 61

Naloxone / Narcan - Class?

Back 61

Opioid antagonist

Front 62

Naloxone / Narcan - Actions (pharmacodynamics)?

Back 62

1: Prevents or reverses the effects of opioids by blocking the opioid receptor sites in the central nervous system

2: effects of opioids include: respiratory depression; sedation, hypotension

3: has no pharmacological effect in the absence of opioids

Front 63

Naloxone / Narcan - Indications?

Back 63

Acute opioid overdose or complete or partial reversal of opioid depression (Respiratory despression)

Front 64

Naloxone / Narcan - Contraindications?

Back 64

Hypersensitivity to naloxone or any ingredient in the formulation which includes: Naloxone, Hydrochloride, Methylparaben, Opropylparaben

Front 65

Naloxone / Narcan - Precautions / Interactions?

Back 65

Naloxone should be used with caution in clients with pre-existing cardiac disease or in clients receiving potentially cardiotoxic drugs, reports of hypotension, hypertension, ventricular fibrillation, ventricular tachycardia, and pulmonary edema have been reported

Front 66

Naloxone / Narcan - Adverse Effects?

Back 66

Produces withdrawal symptoms such as: nausea, vomiting, diarrhea, stomach pain, fever, sweating, body aches, weakness, Tremors or shivering, fast heart rate, pounding heartbeat, increased blood pressure, feeling nervous, Restless, or irritable, Goosebumps, shivering, runny nose, yawning

Front 67

Naloxone / Narcan - Dosage?

Back 67

Initial dose of 1ml of 0.4mg intramuscular (IM) followed by a repeat 0.4mg dose every two minutes prn(as needed)

Front 68

Naloxone / Narcan - Supplied?

Back 68

Each kit contains two 0.4mg / 1ml vials

Front 69

Nitrous oxide - Trade name?

Back 69

Entonox

Front 70

Entonox - Generic name?

Back 70

Nitrous oxide

Front 71

Nitrous oxide / Entonox - Class?

Back 71

Pulmonary / Other

Front 72

Nitrous oxide / Entonox - Mechanism of Action

Back 72

Nitrous oxide has analgesic actions thought to be mediated by activation of opioid receptors in the periaqueductal grey of the midbrain

Front 73

Nitrous oxide / Entonox - Indications?

Back 73

Pain managament

Front 74

Nitrous oxide / Entonox - Contraindications?

Back 74

Potential for dead air space, pneumothorax, bowel obstruction, any undiagnosed abdominal pain, intoxication, head injuries, altered mental status, unable to follow commands

Front 75

Nitrous oxide / Entonox - Adverse Effects?

Back 75

Low blood pressure, withdrawal, collapsed lung, blood in the urine, hyperglycemia, sepsis, infection, cellulitis, Stridor

Front 76

Nitrous oxide / Entonox - Dosage?

Back 76

50% oxygen, 50% nitrogen via demand valve mask until relief of pain