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185 Cards in this Set
- Front
- Back
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A drug that blocks the effect of another drug is referred to as?
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Antagonist
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Decreased drug responsiveness which sometimes occurs with chronic administration is termed.
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Tolerance
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Individual variations in a drug's response may be caused by differences in?
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Age, state of perfusion, underlying disease, dose, distribution, weight, route of administration, other meds, pt cond., absorption rate, & elimination.
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The term used to describe the combined effects of 2 drugs which are greater than the sum of their individual effects are termed?
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Synergism 1+1=3
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The pattern of distribution of any given drug will often determine?
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Onset rate of action: depending on where you have the IV, or where you injected the pt will determine how fast the drug will work.
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Drugs that cause increased cardiac force are referred to as?
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Inotropic
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A pt with what history would alert you to observe for prolonged action of a drug?
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Liver disease, Hypothermia, and Age.
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IM, SC injections are generally contraindicated in pt's who are?
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Hypothermic in cardiac arrest or any other situation which will not allow perfusion from the injection site.
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If a med is ordered that is contraindicated for a pt, the paramedic should first?
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Confirm the order and document
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Which of the following solutions is hypertonic? 1. 50% Dextrose 2. D5w IV bag 3. 1/2 Bag NS
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50% Dextrose
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When a patient has PEA, the first line drug is?
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Epi 1mg, unless a PED in Bradycardia PEA then it is Atropine .02mg/kg.
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Which of the following drugs might be effective in reducing the pulmonary edema associated with CHF? 1. Nitro 2. Lasix 3. Morphine 4. or all of the above?
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All of the above, Lasix provides the release through urine and the others help with vasodilation.
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Upon arrival at the scene you find a pt on the ground who is cool, pinpoint pupils, respirations 8 & shallow, after providing an airway, breathing and starting your IV, what med would you admin.?
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Narcan .4-2mg up to 10mg for any suspected Narcotic,with an ALOC.
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The infant dose of a drug is 10mcg. The adult dose is 10mg. The infant dose is what of the adult dose?
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1/1000
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The hospital orders 1mg/kg for a pt who weighs 220 pounds. How many mg's will you administer?
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100mg
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How many kg's does a 154lb pt weigh? What about 176lb?
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70kg
80kg |
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The most predominate side effect with the use of Nitro is?
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Hypotension (Headache is the most common)
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A 45yo pt w/a Hx of Angina c/o chest pain for 45 min. She was initially alert but in now drowsy, cool & perspiring & her pulse is 45 & regular. B/P 86/60, ECG shows varying degrees of Bradycardia. What drug should you admin. first?
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02, TCP, If TCP needs to be set up and the pt is not in a 2nd degree type II or CHB Atropine .5mg while it is being set up.
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The side effects of Atropine include?
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Tachycardia, VF, VT, Ischemia due to increased workload, convulsions, hallucinations, and palpitations.
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What are the complications for Atropine?
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Glaucoma, 2nd degree Type II Heart blocks and 3rd degree HB's may become complete blocks.
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The patient is taking Digitalis. The pharmacological results hoped for with dig therapy are? What does it treat?
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Increased myocardial contractile force and cardiac output with a decrease in heart rate, its use is indicated in CHF, A-Fib, A-Flutter, and PAT (paroxysmal a-tach).
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Propranolol is used in the tx of?
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Hypertension and Angina (it's a Beta Blocker)
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A 55yo pt is taking Propanolol at home. What drug might you expect to be less effective on this pt?
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A Sympathomimetic, B2 specific.
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A selected beta-2 Sympathomimetic might be less effective if the pt is taking?
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A Beta-Blocker
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Why would a patient be taking Zantac?
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GI ulcer
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Adenosine is indicated for what heart rhythms?
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SVT (Narrow Complex), PSVT, and Wolff Parkinsons White.
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What agent is known directly to inhibit the cellular uptake of Adenosine & therefore potentiate it's effects?
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Dipyridamole
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What is the initial dose of Adenosine? The next dose?
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6mg followed by 12mg and 12mg.
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The contraindications for the use of Adenosine may include?
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2nd or 3rd degree HB, Sinus node disease, and Wide V-Fib.
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Alupent is indicated for?
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It is a Beta 2 specific indicated for Bronchial Spasm/asthma, chronic bronchitis, or emphysema.
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The side effects of Alupent are?
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(Beta 2 drug)Tachycardia, dysrhythmias, cardiac arrest, palpitations, n/v, and increased sympathomimetic effects.
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What is the dose of Alupent by nebulizer?
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.2 to .3mL of 5% solution in 2.5mL of N/S
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Pitocin is given for?
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(Oxytosin) To increase uterine contractions, to stop bleeding, and to induce labor in selected cases.
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The side effects of Pitocin are?
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Water retention, uterine rupture, subarachnoid rupture, hemorrhage, and cardiac dysrhythmias.
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Glucagon is a?
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Hormone
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Lasix is indicated in?
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CHF and Pulmonary Edema
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The standard dose of Lasix is?
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Adults 40-120mg slow IV push
Peds 1mg/kg slow IV push |
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Morphine produces what effects?
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CNS, Respiratory depression, vasodilation, decreases preload, analgesic, vasopressor.
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A patient with severe abd pain of unknown etiology , which meds are contraindicated?
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ASA, and possibly Morphine.
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You find a 47yo pt c/o lightheadedness & severe dyspnea. The physical exam shows JVD, lft ventricular failure, pitting edema, rales B/P 150/80 Resp.28 labored & A-Tach on the monitor. What are the med's of choice?
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O2, Nitro, ASA, Lasix, Morphine.
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Morphine is indicated in?
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AMI, Pulmonary Edema, and Trauma with Moderate/Severe Pain.
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What are Morphines side effects?
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Allergic reactions, respiratory depression or arrest, hallucinations, convulsions, syncope, Cardiac arrest, pulmonary edema, dysphoria, restlessness, tremors, or delerium.
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The standard dose range of Naloxone is?
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(Narcan) .4-2mg titrated until ventilations are adequate up to 10mg in 10 min. IM/SQ .4-.8mg
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Narcan is used to reverse the respiratory depression caused by?
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Opiates/ Narcotics
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Which of the following statements about Calcium Chloride is not true: 1. It decreases myocardial contraction 2. It's needed by the body for blood clotting 3. It helps the body, skeleton, and teeth
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1. It decreases myocardial contraction. Calcium Chloride increases myocardial contractility.
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Calcium Chloride is indicated in?
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Hyperkalemia, Hypermagnesmia, Hypocalcemia, and calcium channel blocker toxicity.
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Calcium Chloride is given?
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Adult 500-1000mg (5 to 10mL of a 10% solution) IV slow, may be repeated as necessary.
Peds: 20mg/kg (10% solution) IV slow, repeated if necessary. |
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What does Sodium Bicarbonate do?
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Its a buffer, it raises pH, it is an electrolyte, alkalizing agent, is indicated for tryciclic antidepressant and barbiturate OD's, Hyperkalemia (documented), and may cause severe tissue necrosis if extravasated. (NaHC03)
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The dose of Sodium Bicarb is?
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1mEq/kg IV push followed by .5mEq/kg over 10min.
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Bretylium is indicated in?
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V-Tach, V-Fib refractory to Lidocaine.
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What is the correct initial dose for administering Bretylium?
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5mg/kg, then 10mg/kg 15-30min. to a max of 30mg/kg. Following conversion admin. IV infusion at 1-2mg/min.
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When administering 50% Dextrose by direct IV push you should watch closely for?
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extravasation
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50% Dextrose is indicated for?
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Hypoglycemia
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The neurotransmitter released at the preganglia on both sides of the ANS?
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ACH - Acetycholine
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The postganglian adrenergic (Sympathetic) nerves release?
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Norepinephrine (adrenergic= Sympathetic, Cholinergic= Parasympathetic)
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When treated with Epi, the pt over 40 with pre-existing heart disease may experience?
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MI, Myocardial Ischemia Ventricular dysrhythmias, HTN, Tachycardic Arrhythmias.
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Present evidence indicates that the dose of Epi injected into the tracheobronchial tree should be?
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Double the dose 2.0 to 2.5mg ETT every 3-5 min followed with a 10cc NS bolus.
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Epi produces its beneficial effects during Cardiac arrest through an increased myocardial and cerebral blood flow due to its?
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Alpha agonistic properties
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Toxic reactions from Lidocaine are manifested by?
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CNS depression
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Lidocaine works by?
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Decreasing the SA and AV automaticity. It suppresses automaticity in the BOH/ Purkinje system, elevating stimulation threshold of the ventricles during diastole.
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Lidocaine used in the VF, VT setting is given?
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1.0 to 1.5mg/kg (no pulses) fast push (w/pulses over 1-2 min) Half dose every 3-5min. Max of 3mg/kg.
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What is the Lidocaine first dose in a patient over 70 with CHF?
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Same as always 1.0 to 1.5mg/kg.
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Lidocaine is contraindicated in what?
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2nd or 3rd degree HB, SVT, Stokes Adam Syndrome, Bradycardia, and escape rhythms.
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The recommended drug for a pt experiencing extrapyramidal reactions from phenothiazines is?
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(Dystonic Reaction) Diphenhydramine (Benadryl),Extrapyramidal symptoms(EPS): common side effects of antiphsychotic meds, incl. muscle tremors & Parkinsonism- like effects.
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The generic name for Benadryl is?
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Diphenhydramine
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Benadryl is useful in acute allergic reactions because it acts by?
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Blocking histamines. Its an Anti-Histamine.
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The standard Adult dose for Benadryl is?
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Adult 25-50mg IV/IM
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For status epilepticus, the initial dose of valium should be?
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Adults 5-10mg IV/IM
Peds .5-2mg IV/IM (Diazepam) |
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A common side effect of Valium is?
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(Diazepam) Coma, Hypotension, Respiratory depression.
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A common complication that can be caused by IV admin. of Valium is?
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Extravasation at the site.
(Diazepam) |
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Valium possesses the following activities?
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(Diazepam) Anticonvulsant, Sedative
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Valium should not be given to pt's with?
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Hypotension, coma, ALOC, +ETOH, OB, Shock, Myasthenia Gravis, or infants under 30 days old.
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Activated Charcoal is contraindicated in poisonings of?
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Metals, Corrosive solutions, solvents, ethanol, methanol, Cyanide, and Acids.
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The normal dose of Activated Charcoal is?
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1g/kg mixed with 6-8 ounces of water.
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Activated charcoal works by?
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Absorbant that binds to toxins, acts like a magnet not a sponge. It is excreted with the chemicals or drugs in the feces but sometimes (often) causes emesis.
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Mixing 1 gram of a drug in 250 mLs will yield a concentration of?
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4/1 solution
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1 gram is equal to how many mg's?
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1000mg
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60mg is equal to how many grains?
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1 grain
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Identify the metric unit of measurement for volume?
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Liter
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A patient presents with severe anaphylactic shock, B/P 60/p cap refill 4 sec., and severe bronchospasms. What is Epi used for in this pt?
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Bronchial Dilation, and vasoconstriction
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The beta effects of Epi are?
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Beta 1: Receptors for heart which increase Dromotropic, Chromotropic and Inotropic responses. Beta 2: Receptors for lungs which cause bronchial dilation and smooth muscle dilation.
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Vistaril is given?
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(Hydroxyzine) This ia an antihistamine with anticholinergic (drying) and sedative properties that is used to treat allergic reactions. Also someitmes cold or viral infections.
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The standard dose of Ipecac?
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15-30mL PO followed by 1 cup of water. This is used to induce vomiting in accidental OD.
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The mechanism of action of Verapamil?
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(Isoptin) A Calcium Channel Blocker which slows the AV conduction, supresses reentry dysrhythmias such as PSVT, and slows ventricular response to atrial tachydysrhythmias. It also dilates coronary arteries & reduces myocardial 02 demand.
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Verapamil may have what side effects?
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Vertigo, slepiness, hypotension, CHF, Bradycardia, Severe tachycardia, edema, heart blocks, headaches, n/v, and asystole.
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The usual initial dose of Verapamil is?
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(Isoptin)
Adult 2.5-5mg slow IV push, over 2-3 min. May repeat in double dose in 15-30min. as needed not to exceed 30mg in 30min. |
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Verapamil would generally be contraindicated in?
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Left Sided Heart Failure, Hypotension, 2 type2 and 3rd HB, Wolff Parkinsons White, CHF, and Beta-Blockers.
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The generic name for Isoptin/Calan is?
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Verapamil
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The mechanism of action of Mag Sulfate is?
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Mag Sulfate puts everything it touches to sleep.
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The dose of Magnesium Sulfate is?
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V-Fib, V-Tach: 1-2g slow IV push over 2 min.
Torsades: 1-2g IV (diluted in D50) Eclampsia: 2-4g IV IV/IM |
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The side effects of Terbutaline include?
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This is a Beta 2 adrenergic drug, so it has side effects such as tremors, tachycardia, dry mouth, dizziness, weakness, upset stomach, flushing, nervousness, tachycardia, irregular heart beat, and throat irritation.
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The dose of Terbutaline is?
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.25mg SC or .2mg by Inhaler
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If a patient were to recieve an agent that dissolves thrombi you should inform the base station of what?
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Time of onset C/C, 1 sign and symptom and tx, Also any hx of internal bleeding which would contraindicate the administration.
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The side effects of Isuprel include?
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Sympathomimetic, increased hr, bp, ect..
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Decadron may be given to?
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It can be used as an Anti-Inflammatory agent.
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At 5mcg/kg/min the dose of Intropin will have what effects?
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Beta 1
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During a 5mcg/kg/min dose of Intropin you would anticipate?
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Increased contractile force, Chronotropic, Inotropic, and Dromotropic effects.
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In contrast to other catecholamines, Intropin @.5-2mcg/kg/min is likely to cause?
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Dilation (of smooth muscle)
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A Dopamine drip @ 20mcg/kg/min will likely result in?
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Alpha properties, Vasoconstriction and increased B/P and most likely Increased HR. Also at that high of a dose there will be increased Cardiac Irritability & most likely Renal Failure will occur.
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Nitro may?(With Vitals watch for what?)
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Lower B/P, increase HR
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The therapeutic action of the nitrates involves?
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Vasodilation prescribed for angina and CHF
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Postganglian cholinergic nerves release?
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ACH - Acetycholine
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Beta 1 receptors are mainly located?
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In the heart
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The major use of selective Beta 2 agonists is to?
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Bronchial dilate
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You arrive onscene to a patient who has ingested a drug that is a mild reversible acetycholineesterase inhibitor What would you give this pt?
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Atropine .5mg
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The Dose of Benadryl is?
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(Diphenhydramine) Adult 25-50mg IV/IM
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The pediatric cardiac arrest dose of Epi IV/IO is?
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.01mg/kg of 1:10,000
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The pediatric dose of atropine in cardiac arrhythmia management is?
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.02mg/kg IV/IM minimum dose is .1 mg may repeat in 5min Max dose 1mg.
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The child dose of valium is?
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.5-2mg/kg IV/IM
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The peds dose for Benadryl is?
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2-5mg/kg slow IVP
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The adult dose for Procainamide is?
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20-50mg/min up to 17mg/kg
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A drug that regulates blood clotting?
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Calcium (some say also potassium)
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Examples of Natural occuring neurotransmitters?
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ACH, Norepinephrine
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Antagonizes the acts of benzodiazepine?
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Flumazenil
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Center element of biological and chemical process?
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O2
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Opium alkaloid?
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Morphine
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Digitalis pharmalogical actions?
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Increases cardiac output and contractility, lowers heart rate.
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The four ending points of administration of Procainamide?
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1. Dysrhythmia is interrupted (arrhythmia suppression), 2. toxic effects are present (max dose of 17mg/kg) 3. QRS widens by 50% (p-R prolonged) 4. Hypotension.
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Charcoal is classified as?
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An absorbant
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Steroids are used to treat patients with?
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Spinal cord injury or chronic asthma
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Nitro Action?
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Vasodilates
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Pharmacology means?
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The study of drugs and their interactions with the body.
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Pharmacodynamics means?
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How a drug interacts with the body to cause its effects. Absorption, Distribution, Biotransformation, and Elimination.
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Pharmacokinetics means?
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How a drug is absorbed, distributed, metabolized and eliminated
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What are the 4 type of drug names?
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1. Chemical name (what it contains such as H20) 2. Generic name (Manufacturer name) 3. Official name has usp/NF after it 4. The brand/Trade name (this is the street name/names)
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What is Diffusion?
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the process in which there is movement of a substance from an area of high concentration of that substance to an area of lower concentration and the 2 substances will mix.
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What is osmosis?
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Movement of a solute from a high concentration to a low concentration.
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Metabolism is?
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The breaking down of chemicals into different chemicals.
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Biotransformation is?
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Special name given to the metabolism of drugs.
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Affinity is?
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The force of attraction between a drug and a receptor.
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Efficacy is?
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A drugs ability to cause the expected response.
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Autonomic Nervous System is?
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The system which controls involuntary functions/actions.
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Synapses are?
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Spaces between nerves
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"mimetic" means?
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mimic the effect
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"Lytic" means?
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Opposite effect
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Antiplatelet means?
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Drug that decreases the formation of platelets.
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Cholinesterase inhibitor does what?
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Prolongs the effects of acetycholine.
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MAO inhibitor drugs do what?
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Inhibit the breakdown of monamine oxidase. Does not allow the breakdown of norepi. Prescribed for Depression.
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SSRI drugs are?
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Selective Serotonin reuptake inhibitors, Prescribed for Depression and Antipsychotic.
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TCA drugs are?
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Tricyclic Anti-Depressants, these block the reuptake of norepinephrine and serotonin. Prescribed for Depression.
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ACE Inhibitors do what?
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Prevents the conversion of angiotensin I into angiotensin II. Prescribed for hypertension and CHF.
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Analgesics do what?
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Relieve pain.
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Anticholinergic Drugs do what?
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Block ACH at the neuro-receptor site.
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Barbiturates do what?
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Causes sedative-hypnotic effects. Used for Seizures, anziety meds.
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Benzodiazepines do what?
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Causes sedative-hypnotic effects. Used for Seizures, anxiety, and muscle relaxant.
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Cardiac Glycosides do what?
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Lower the heart rate while increasing contractile force. "Digoxin"
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Diuretics do what?
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Stimulates the kidneys to produce urine. Prescribed for HTN, and CHF.
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Cardizem is?
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a Calcium Channel blockers and is also called Diltiazam.
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Propanolol and Corgard are?
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Beta Blockers
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Beta Blockers do what?
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Block the effect of Epi at Beta receptor sites. Prescribed for Angina, HTN, and Tachydysrhythmias.
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Peds dose for Naloxone?
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.01mg/kg IV/IM up to 2mg until respirirations are restored. (Narcan)
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Idiosyncrasy is?
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An unusual reaction of a drug on an individual.
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The Cation of extracellular fluid is?
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Sodium
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The salt concentration of the body is?
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The fluid that surrounds the bodies cells is isotonic.
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What is a condition resistant to normal treatment?
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Refractory
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Steroids will benefit?
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Asthma and Spinal Cord injury patients.
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Parenternal route med administration is what?
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Delivery of a med outside of the gi tract. (given through and IV/IM/or SubQ usually)
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Enternal route med administration is administered how?
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These are meds that are absorbed through the gi tract. (taken orally)
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What should Diabetics not take?
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Steroids, because it doesnt allow transfer in and out of the cell.
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What is Thiamine and what is the normal dose?
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Vitamin B12 dose is 100mg IV
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What should you give peds with Cardiogenic Shock/CHF? What does this do?
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Milrinone 50-75mcg/kg over 10-60min. Then infusion of .5 to .75mcg/kg/min. It Increases myocardial contractility and reduces preload and afterload, by relaxing vascular smooth muscle.
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How do you treat left and right sided heart failure?
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MONA= O2, Nitro, ASA, Morphine
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With a bacterial infection what kinds of things would you expect to find?
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Fever, Tachycardia, lowered pulse ox, possibly a transmissible disease such as Epiglottitis so wear PPE's.
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Amoxicillin would be taken for what kind of illness?
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A bacterial infection.
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If the Liver is affected on a patient what sign would you probably see? Can you give Lidocaine?
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They will probably be yellow, (jaundice), and do not give Lidocaine.
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A mineral is?
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Inorganic term for the source of a drug.
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What should you take for Organophosphate poisoning and at what dose?
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Adult Atropine 2-4mg
Peds .05mg/kg Give until the mouth is dry, or pt is better you cant kill them with Atropine and you need to reverse this. |
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Aminophyline is what kind of drug?
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Methylxanthine
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When do we use Sodium Bicarbonate?
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For Drug OD's, to correct know severe acidosis refractory to hyperventilation, known hyperkalemia, return of spontanseous circulation after long arrest, arrest w/CPR w/out intubation, and Crush Syndrome.
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Diazepam/Valiums dosages? Narcan/Naloxones dosages?
(Adult and Peds) |
Diazepam/Valium: Adult 2-15mg IV/IM
Ped: .5-2mg/kg IV/IM Narcan/Naloxone: Adult .4-2mg IV (titrate until ventilations are adequate) Adult IM/SQ .4-.8mg Peds: .01mg/kg IV/IM up to 2mg until respirations are restored. |
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Sodium Bicarb is indicated as an antidote for what?
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Tricyclic Antidepressants and Barbiturates, but can also be used in other OD's to alkalinize the urine to enhance secretion of the drug.
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Ace Inhibitors work in what part of the body?
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The Kidneys
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What is the name for the affects that drugs have that are 1+1+1=3??
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Accumulative
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Amoxicillin has what side effects?
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It decreases the effects of birth control, and is tough on the stomach. It kills the bad bacteria but also the good bacteria (the flora).
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What are the 3 sources of drugs?
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Plants, Minerals, and Synthetics.
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What is Active Transport?
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This requires the use of energy to move a substance. (ATP)
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What is bioequivalence?
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the relationship between two preparations of the same drug in the same dosage form that have a similar bioavailability.
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What does Amoxicillin do to birth control?
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It decreases the effects.
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What can Amoxicillin cause in DM patients glucose level checks?
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False readings
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Does Amoxicillin cause yeast infections?
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Yes it can.
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What are the units of measurement for the metric system?
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Liter: Volume, Meter: Length, and Gram: Weight.
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1000mg/250ml's will reduce to what?
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4mg/ml
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What does MAO-A breakdown? What about MAO-B?
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MAO-A breaks down Norepinephrine and Serotonin
MAO-B breaks down Dopamine. |
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T or F Patients with Diabetes should not take steroids? If so why not?
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True, it doesnt allow for transfer in and out of the cell.
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Explain the Dopamine med administration scale and its properties.
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0-2mcg/kg/min: Beta 2 properties (Dilation of smooth muscle. 2-10: Beta 1 (heart prop) 10-20: (Alpha constriction properties)
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