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185 Cards in this Set

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