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44 Cards in this Set
- Front
- Back
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Generic name vs Trade Name |
Generic is the abbreviated drug name, usually lowercase. Trade is the name created by drug companies.
Examples: albuterol is generic, while Ventolin is the trade name. |
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Pharmacokinetics |
How a medication acts, is absorbed into the blood stream, how it is distributed, and how the body metabolizes and eliminates the drug. |
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Pharmacodynamics |
Explains how a drug works, interacts with different receptors, other drugs, and enzymes. |
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Dose vs. Dosage |
Dose: amount to be given Dosage: the size, frequency, and number of doses to be given. |
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Dose-Response Relationship/ Dose Response Curve |
As the amount of a drug increases, so does the physiologic response. This is true up to a point, at which increasing the drug no longer causes an increased physiologic response. |
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Define Enteral Medicines |
Drugs absorbed through the GI tract- Must pass through the liver!
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Advantages and Disadvantages of Enteral Medicines |
Advantages: The safest route, slow onset which prevents high blood levels, convenient.
Disadvantages- metabolized by the liver= first pass metabolism, variable rate of absorption,patient non-compliance, and interaction with the GI tract. |
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What is First Pass Metabolism and why do we care about it? |
The liver metabolizes any enteral medication, which decreases the amount that the body can use. We care because the amount we give orally will not be the amount taking effect, and we have to be cautious in patients with liver failure. |
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Bioavailability |
% of drug administered that is available in the blood stream to act on tissues. |
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Biotransformation |
Transformation of an active drug to an inactive drug through chemical reactions |
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What factors can alter drug metabolism? |
Patient's age, route of drug, dosage, genetic predisposition of the patient, diet/starvation, and preexisting disease. |
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What order of kinetics do enteral meds fall under? |
First order kinetics, which follow the exponential kinetics of absorption. |
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What is a saturable process? |
A process in which the external concentrations of the drug can reach a point at which increasing the concentration does not increase the rate of transport into the cell.
These include: carrier mediated facilitated diffusion and active transport. |
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Are half life and duration of action the same thing? |
No. Half life is the period required to eliminated half the dose from the body, whereas duration of action is the period from which the drug begins to take effect to when that effect ends. |
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What is ED50 and LD50? |
ED50- the dose that produces therapeutic effects in 1/2 the animals tested. LD50- the dose that proves to be lethal in 1/2 the animals tested. |
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A drug has a Therapeutic Index of .99. What does this mean? |
The closer a number is to 1, the more dangerous the drug is. The closer the number is to 1, the closer in value of the LD50 and the ED50. |
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Summation |
When two meds are given together, they produce the same effect as if they had been given separate of each other. (1+1=2) |
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Synergism |
Synergism- when two meds are given together, the sum of their effect is greater than the two individual effects added together (1+1>2) |
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Potentiation |
When a drug that doesn't have an effect on it's own increases the effect of another drug. (0+1=2) |
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Stimulation of the Alpha 1 receptors causes: |
Vasoconstriction of the peripheral blood vessels.
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What receptors does Dopamine stimulate and what are the effects? |
Primarily stimulated the B1 receptors of the heart, causing a release of norepi. As we increase the Dopamine dose, it stimulates alpha 1 receptors and causes vasoconstriction-> increased BP. |
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Describe how Dobutamine works and why we would use it. |
Works by stimulating the B1 receptors. It is used in CHF patients, to increase CO without increasing the heart's 02 consumption, HR or BP. |
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Phenylephrine binds to... |
Only Alpha 1 receptors. |
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When would we want to use Dopamine? |
Indicated: Hypotention and decreased CO associated with cardiogenic shock and septic shock, hypotension after ROSC, symptomatic bradycardia not responsive to atropine.
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Your patient is bradycardic and hypotensive. You optimize fluids and want to give dopamine.... What contraindications should you be aware of? |
Pheochromocytoma, VT, VF, and other ventricular arrhythmias, known hypersensitivity. |
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Your patient just had a ROSC and is hypotensive. After optimizing fluids, you want to give Dopamine. What is your dose? |
2-20 mcg/kg/min by IV or IO but usually start at 5mcg/kg/min for cardiac patients. |
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What effects does norepi have? What conditions would you give norepi for? |
Causes an increase in BP and coronary blood flow, and increased HR.
Indicated for Cardiogenic shock, septic shock, and severe HTN. |
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You want to give Norepinephrine, but your patient is taking this kind of drug! What is it? |
MAOIs |
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You tell your paramedic partner to give Norepinephrine to your patient, but he forgot how to give it! Explain to him how. |
Add 4mg to 250 mL of D5W or D5NS but not NS alone. Give as a drip of 0.5-1 mcg/minute via IV or IO. |
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Who would you NOT give Dobutamine to? |
Patients with poisonings or drug-induced shock, a systolic BP<100 mmHg, patients with IHSS, and patients with a known hypersensitivity.
Also caution in hypertensive patients, recent MI patients, arrhythmias, and hypovolemic patients. |
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What is the dose of dobutamine? |
2-20mcg/kg/min IV, IO (the same as dopamine! how nice) |
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Your partner thought Neo-Synephrine could only be used as a nose spray! You tell him all the other indications, which are...? |
Neurogenic shock, spinal shock, shock in which the patient's HR doesn't need to be increased, and drug induced hypotension |
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When would you NOT want to give Phenylephrine? |
Acute MIs, Angina, Cardiac Dysrhythmias, severe HTN, CAD, Pheochromocytoma, Narrow-angle glaucoma, cardiomyopathy, patients on MAOIs, and hypersensitivity. |
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Dose of Phenylephrine |
100-180mcg/min by IV or IO |
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When would you give a patient Propranolol? |
Angina, Narrow SVT that occurs from a reentry loop, ectopic, multifocal or junctional tachycardias that aren't controlled by vagal maneuvers or Adenosine, AF, A-flutter with preserved ventricular function, HTN, Migraines |
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You want to give your patient Propranolol, but you auscultate rales in the lungs. Can you still give it? |
No- this is a contraindication. |
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You instruct your partner to get Propranolol out of the bag. What dose do you tell her to give?
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1-3 mg Iv, IO at a rate of 1mg/ minute |
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List Labetolol Contraindications |
Hypotension, Cardiogenic shock, acute pulmonary edema, heart failure, severe bradycardia, sick-sinus syndrome, 2nd or 3rd degree heart block, asthma, cocaine-induced ACS, and hypersensitivity. |
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You have a two patients: One has ACS and one has severe HTN. What doses of Labetolol do you give each patient? |
ACS- give 10 mg IV/IO over 1-2 minutes. Max dose 150mg.
HTN- Give 20 mg IV/IO over 2 minutes. Each dose doubles and the max total is 300 mg. |
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Metropolol's dose is...? |
5mg slow IV over 5 minutes, up to 15 mg. Via IV or IO. |
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We all know Atropine is used for symptomatic Bradycardia, but what are it's other uses? |
Organophosphate poisonings and Nerve Agent Exposure |
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What are the different doses for Atropine? |
Brady- 0.5mg up to 3 mg total every 3-5 minutes.
Nerve Agent/ Organophosphate poisoning- 2-4 mg IV or IM, repeat every 20 minutes until symptoms go away. |
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What is the effect of giving too small of a dose of Atropine? |
It actually slows down the heart at very low doses. |
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What kind of receptors does Atropine bind to? |
Atropine competes with ACH to bind to Muscarinic receptors. |
