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12 Cards in this Set
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Activated Charcoal Class Mechanism of Action Indications Contraindications Adverse Reactions Drug Interactions Dosage and Administration |
EZ-Char, Actidose, Liqui-Char Class: Adsorbent. Mechanism of Action: Adsorbs toxic substances from the GI tract Indications: Most oral poisonings and medication overdose; can be used after evacuation of poisons. Contraindications: Oral administration to comatose patients; after ingestion of corrosives, caustics, petroleum distillates; simultaneous administration with other oral drugs. Use caution in patients with unknown abdominal pain or known GI Obstruction. Adverse reactions/Side effects: If aspirated, can induce fatal form of pneumonitis;constipation, black stools, vomiting, diarrhea, bowel obstruction Drug interactions: Bonds with and generally inactivates whatever it is mixed with How Supplied: 25g (black powder)/125ml bottle; 50g / 250ml bottle (200mg/ml) Dosage and administration: Adult: 1 to 2 g/kg PO or NG tube. Pediatric: same Duration of action: Onset: immediate. Peak effect: Depends on GI function. Duration: acts until excreted. Special Considerations Pregnancy safety: category C. Often used in conjunction with magnesium citrate. Store in closed container. shake well before use. Does not absorb cyanide, lithium, iron, lead, arsenic. |
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Adenosine Class Mechanism of Action Indications Contraindications Adverse Reactions Drug Interactions Dosage and Administration |
Adenocard Class Antidysrythmic Mechanism ofAction Slows conduction through the AV node; can interrupt re-entrant pathways; slows heart rate by acting directly on the sinus pacemaker cells by slowing impulse formation. Drug of choice for re-entry SVT. Can be used diagnostically for stable, wide-complex tachycardia of unknown origin after two doses of lidocaine. Indications Conversion of PSVT to sinus rythm. May convert re-entry SVT due to Wolff-Parkinson-White syndrome. Not effective in converting atrial fibrillation/flutter or V-tach. Most forms of stable-complex SVT. Contraindications Second- or third-degree AV block (with no pacemaker), sick sinus syndrome (with no pacemaker), bronchoconstrictive or bronchospastic lung disease (asthma, COPD) drug-induced tachycardia Adversereactions/Side effects Generally short duration and mild; headache, dizziness, dyspnea, bronchospasm, dysrythmias, palpitations, hypotension, chest pain, facial flushing, cardiac arrest, nausea, metallic taste, pain in head or neck, parasthesia, diaphoresis. Druginteractions Methylxanthines (Theophylline-like drugs) antagonize the effects of adensosine. Dipyridamole (Persantine) potentiates the effect of adenosine. Carbamazepine (Tegretol) may potentiate the AV node blocking effect How supplied 3 mg/ml in 2ml and 5ml flip-top vials Dosage andadministration Adult: 6-mg rapid IV bolus over 1-3 seconds, followed by a 20-mL saline flush and elevate extremity. If no response after 1-2 minutes, administer second dose of 12-mg rapid IV bolus over 1-3 seconds. Pedriatic: Initial dose 0.1 mg/kg rapid IV/IO push (maximum first dose, 6 mg) followed by a 5-10mL saline flush. Second dose 0.2 mg/kg rapid IV/IO push (maximum second dose, 12 mg) followed by a 5-10mL saline flush. Duration ofaction Onset: seconds. Peak effect: Seconds. Duration: 12 Seconds Specialconsiderations Pregnancy safety: Category C. May cause bronnchonstriction in asthma patients. Evaluate elderly for signs of dehydration requiring fluid replacement prior to administering adenosine. Short half-life limits side effects in most patients. |
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Albuterol Class Mechanism of Action Indications Contraindications Adverse Reactions Drug Interactions Dosage and Administration |
Proventil, Ventolin Class Sympathomimetic, bronchodilator Mechanism ofAction Selective beta-2 agonist that stimulates adrenergic receptors of the sympathomimetic nervous system. results in smooth-muscle relaxation in the bronchial tree and peripheral vasculature. Indications Treatment of bronchospasm in patients with reversible obstructive airway disease (COPD/asthma). Prevention of exercise-induced bronchospasm. ContraindicationsKnown prior hypersensitivity reactions to albuterol. Tachycardia, dysrythmias, especially those caused by digitalis. Synergistic with other sympathomimetics. Adversereactions/Side effects Often dose-related and include headache, fatigue, lightheadedness, irritability, restlessness, aggressive behavior, pulmonary edema, hoarseness, nasal congestion, increased sputum, hypertension, tachycardia, dysrythmias, chest pain, palpitations, nausea/vomiting, dry mouth,epigastric pain, and tremors. Druginteractions Tricyclic antidepressants may potentiate vasculature effects. Beta blockers are antagonistic and may block pulmonary effects. May potentiate hypokalemia caused by diuretics. How supplied Metered-dose inhaler: 90 ug/metered spray. Solution for aerosolization: 0.5% (5 mg/mL), 0.083% (2.5 mg) in 3-mL unit dose nebulizer. Dosage andadministration Adult: Administer 2.5 mg. Dilute in 0.5 mL of 0.5% solution for inhalation with 2.5 mL normal saline in nebulizer and administer over 10-15 minutes. Metered-dose inhaler: 1-2 inhalations (90-180 ug); wait 5 minutes between inhalations. Pediatric: <20 kg: 1.25 mg/dose via hand-held nebulizer or mask over 20 minutes. >20 kg: 2.5 mg/dose via hand-held nebulizer or mask over 20 minutes.Repeat once in 20 minutes. Duration ofaction Onset: 5-15 minutes. Peak-effect: 30-minutes to 2 hours. Duration: 3-4 hours. Specialconsideration Pregnancy safety: Category C. May precipitate angina pectoris and dysrythmias. In prehospital emergency care, albuterol should be administered only via inhalation. |
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Alteplase, Recombinant Class Mechanism of Action Indications Contraindications Adverse Reactions Drug Interactions Dosage and Administration |
rTPA, tissue plasminogen activator, Activase Class Fibrinolytic Mechanism of Action The enzyme binds to the fibrin-bound plasminogen at the clot site, converting plasminogen to plasmin. Plasmin digests the fibrin strands of the clot, restoring perfusion. Indications Acute myocardial infarction, STEMI, massive pulmonary emboli, acute ischemic cerebrovascular accident Contraindications Active internal bleeding, recent surgery (within 2-3 weeks), previous cerebral vascular accident or seizure at onset, prolonged cardiopulmonary resuscitation, intracranial or intraspinal surgery (within 3 months); intracranial neoplasm, arteriovenous malformation, or aneurysm; recent significant trauma, especially head trauma. Uncontrolled hypertension (systolic greater than 185, diastolic greater than 110). Adversereactions/Side effects Intracranial bleeding, headache, reperfusion dysrythmias, chest pain,hypotension, GI bleeding, nausea, vomiting, abdominal pain. Drug interactions Acetylsalicylic acid may increase risk of bleeding hemorrhage. Heparin and other anti-coagulants may increase risk of hemorrhage. How supplied 50- and 100-mg powders (requires reconstituion with sterile water to a concentration of 1 mg/ml) Dosage andadministration Adult: 15-mg IV bolus over 2 minutes; then 0.75 mg/kg over 30 minutes (not to exceed 50 mg); then 0.50 mg/kg over 60 minutes; maximum total dose of 100 mg. For acute ischemic stroke, 0.9 mg/kg infused over 60 minutes, with 10% of the total dose administered in the first minute. Pediatric: Safety not established Duration of action Onset: Clot lysis most often within 60-90 minutes. Peak effect: Variable. Duration: 30 minutes with 80% cleared within 10 minutes. Special considerations Pregnancy safety: Category C. Closely monitor vital signs. Observe for bleeding. Do not administer IM injections to patients receiving tissue plasminogen activator. Only administer with an infusion pump. Due to sever spontaneous bleeding risk, invasive procedures (IV starts, injections, NG tube..) should be avoided |
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Amiodarone Class Mechanism of Action Indications Contraindications Adverse Reactions Drug Interactions Dosage and Administration |
Cordarone, Pacerone Class Antidysrythmic Mechanism of Action Blocks sodium channels and myocardial potassium channels, delaying repolarization and increasing the duration of action potential Indications Ventrical fibrillation, pulseless ventricular tachycardia, unstable vantricular tachycardia in patients refractory to other therapy. Contraindications Known hypersensitivity to amiodarone or iodine, cardiogenic shock, sinus bradycardia, socond- or third-degree AV block (without pacemaker), sever sinus node dysfunction. Adverse reactions/Side effects Dizziness, fatigue, malaise, tremor, ataxia, lack of coordination, adult respiratory distress syndrome, pulmonary edema, cough progressive dyspnea, congestive heart failure, bradycardia, hypotension, worsening of dysrythmias, prolonged QT interval, nausea, vomiting, burning at IV site, Stevens-Johnson syndrome. Drug interactions Use with digoxin may cause digitalis toxicity. Antidysrythmics may cause increased serum levels. Beta blocker and calcium channel blockers may potentiate bradycardia, sinus arrest, and AV heart blocks. How supplied 50 mg/mL vials and prefilled syringes. For rapid infusion, add 150 mg/3 mL to a 10-mL D5W (1.5 mg/mL) run at 600 mL/h on infusion pump Dosage and administration Adult: Ventricular fibrillation/ pulselessventricular tachycardia unresponsive to CPR, defibrilation, and vasopressors: [300 mg IV/IO push. Initial dose can be followed one time in 3-5 minutes at 150 mg IV/IO push]. Recurrent life-threatening ventricular dysrythmias: [Maximum cumulative dose 2.2 g IV in 24 h, administered as follows: Rapid infusion: 150 mg IV/IO over 10 minutes (15 mg/minute) May repeat rapid infusion (150 mg IV/IO) every 10 minutes as needed] Pedriatic: Refractory ventricular fibrillation/ pulseless ventricular tachycardia: [ 5 mg/kg IV/IO bolus up to a total dose of 15 mg/kg in 24h. Maximum single dose: 300 mg.] Perfusing supraventricular and ventrical tachycardias: [Loading dose 5 mg/kg IV/IO over 20-60 minutes (maximum single dose of 300 mg). Repeat to maximum dose of 15 mg/kg/day (2.2 g in adolescents). Maximum single dose: 300 mg] Duration of action Onset: Immediate. Peak effect: 10-15 minutes. Duration: 30-45 minutes. Special considerations Pregnancy safety: Category D. Monitor patient for hypotension. May worsen or precipitate new dysrythmias. |
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Amyl Nitrate Class Mechanism of Action Indications Contraindications Adverse Reactions Drug Interactions Dosage and Administration |
Amyl Nitrate Class Antidote, cyanide poisoning adjunct Mechanism of Action Converts hemoglobin to methemoglobin, which reacts with cyanide and chemically binds with it, preventing any toxic effects Indications Cyanide poisoning. Contraindications None in the emergency setting Adversereactions/Side effectsHeadache, dizziness, weakness, increased ICP, shortness of breath, orthostatic hypotension, tachycardia, syncope, cyanosis of the lips, fingernails, or palms (signs of methemoglobinemia). Drug interactions Increased save effects with antihypertensive, alcohol, phenothiazines, or beta blockers. How supplied 0.3-mL amulets for inhalation Dosage and administration Adult: [1-2 ampules crushed and inhaled for 30 seconds of each minute until sodium nitrite is prepared or administer for 30-60 seconds every 5 minutes until patient is conscious.] Pediatric: 1 ample crushed and inhaled for 30 seconds of each minute untilemsodium nitrite is prepared or administer for 30-60 seconds every 5 minutes until patient is conscious. Duration of action Onset: 30 seconds to 5 minutes. Peak effect: Varies. Duration: 3 to 5 minutes. Special considerations Pregnancy safety: Category X. Highly flammable: Avoid exposure to heat and flame. Patient should remain seated or supine during and after administration due to hypotensive effects of the medication. Use caution in administering to patients with cerebral hemorrhage, increased ICP, or hypotension. This is the first step in a three step treatment for cyanide poisoning, followed by sodium nitrite, then sodium thiosulfate. |
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Aspirin
Class Mechanism of Action Indications Contraindications Adverse Reactions Drug Interactions Dosage and Administration |
ASA, Bayer, Ecotrin, St. Joseph Class Platelet inhibitor, anti-inflammatory agent. Mechanism of action Prevents platelets from clumping together, or aggregating, and forming emboli. Indications New onset chest pain suggestive of acute myocardial Contraindications Hypersensitivity. Relatively contraindicated in patients with active ulcer disease or asthma Adverse reactions/side effects Bronchspsm, anaphylaxis, wheezing in allergic patients, prolonged bleeding, GI bleeding, epigastric distress, nausea, vomiting, heartburn, Reye syndrome. Drug interactions Use with caution in patients allergic to NSAIDs How supplied 81-mg, 160-mg, and 325-mg tablets. Chewable and standard. Dosage and administration Adult: 160 to 325 mg PO. Chewing is preferable to swallowing. Pediatric: Not recommended. Duration of action Onset: 30-45 minutes. Peak effect: Variable. Duration: Variable. Special considerations Pregnancy safety: Category D. Not recommended in pediatric population. |
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Dextrose Class Mechanism of Action Indications Contraindications Adverse Reactions Drug Interactions Dosage and Administration |
D50, D25, D10
Class Carbohydrate, antihypoglycemic Mechanism of action Rapidly increases serum glucose levels Indications hypoglycemia Contraindications intracranial hemorrhage Adverse reactions extravasation leads to tissue necrosis, cerebral hemorrhage, cerebral ischemia, pulmonary edema, hyperglycemia Drug interactions sodium bicarbonate, warfarin Dosage and administration Adults: (12.5-25 g of 50% solution slow IV push.) Pediatric: (0.5-1 g/kg of 25% solution slow IV push.) Neonates and Infants: (200-500mg of 10% -25% Solution slow IV push) Duration Of action onset: less than a minute. Duration: variable Special considerations Pregnancy category C. Thiamin prior in known alcoholics. Do not use with CVA unless hypoglycemia Is documented |
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Glucagon Class Mechanism of Action Indications Contraindications Adverse Reactions Drug Interactions Dosage and Administration |
GlucaGen Class Hyperglycemia agent, pancreatic hormone, insulin antagonist Mechanism of Action increase blood glucose by stimulating glycogenolysis. Indications Altered LOC with hypoglycemia. Reversal agent in Beta blocker and calcium channel blocker overdoses. Contraindications Hyperglycemia, tachycardia, rebound hypoglycemia. Drug interactions Incompatible in solution with most other substances. No significant drug interactions with other emergency medications. Dosage and Administrations Adult: [Hypoglycemia 0.5-1mg IM; may repeat in 7-10min.] [Overdose 3-10mg IV slowly over 3-5 min followed by 3-5mg/hr infusion as needed] Pediatric: [Hypoglycemia 0.03-0.1mg/kg IM, IO,SQ,slow IV. May repeat in 20 min. Max dose 1 mg] [Overdose 0.05 - 0.15mg/kg IV/IO over 3-5 min followed by a 0.05-0.10mg/kg/hr infusion as needed.] Duration of Action Onset: 1 min. Peak: 5-20 min. Duration: 60-90 min. Special Considerations Pregnancy category B. Inneffective if glycogen stores depleted. If patient does not respond to second dose, 50% dextrose must be administered. |
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Furosemide Class Mechanism of Action Indications Contraindications Adverse Reactions Drug Interactions Dosage and Administration |
Lasix Class Loop Diuretic Mechanism of Action Blocks absorption of Na+ and Cl- at the distal and proximal tubules and the loop of Henle Indications CHF, pulmonary edema, hypertensive crisis Contraindications Hypovolemia, anuria, hypotension (relative contraindication), hypersensitivity, hepatic coma Adverse Reactions ECG changes, orthostatic hypotension, hypokalemia Drug Interactions Lithium toxicity may be potentiated due to sodium depletion. Digitalis toxicity may be potentiated. Dosage and Administration Adult: [0.5-1mg/kg IV over 1-2 min. If no response, 2mg/kg IV over 1-2 min.] Pediatric: [1 mg/kg IV/IO] Duration of Action Onset: 5 min. Peak: 20-60 min. Duration of action: 4-6 hours Special Considerations: Pregnancy Category C. Ototoxicity, deafness, and projectile vomiting can occur with rapid administration. |
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Diphenhydramine Class Mechanism of Action Indications Contraindications Adverse Reactions Drug Interactions Dosage and Administration |
Benadryl Class Antihistamine, anticholinergic Mechanism of action blocks histamine receptors Indications allergic reaction and anaphylaxis Contraindications Asthma, glaucoma, pregnancy, hypertension, narrow-angle glaucoma, infants, MAOIs Adverse Reactions Drowsiness, sedation, seizures, paradoxical CNS excitements in children, wheezing, thickening of bronchial secretions Drug Interactions Potentiates effects of alcohol and other anticholinergics Dosage and Administration Adult: [25-50mg IM,IV,PO.] Pediatric: [1-2mg/kg SLOOW IV,IO; or IM, PO. 5mg/kg/24hr] Duration of Action Onset: 15-30 min. Peak: 1hr. Duration: 3-12 hours. Special Considerations: Pregnancy Category B. Not used in infants. If used in anaphylaxis, must be in conjunction with epinephrine and corticosteroids. |
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Magnesium Sulfate Class Mechanism of Action Indications Contraindications Adverse Reactions Drug Interactions Dosage and Administration |
MgSO4 Class Electrolyte, anti-inflamatory Mechanism of Action reduces acetylcholine release at the monaural junction. Manages seizures in toxemia of pregnancy. Induces uterine relaxation. Indications Seizures of eclampsia, torsades de pointes, hypomagnesia Contraindications Heart blocks, myocardial damage Adverse reactions CNS Depression, Respiratory depression, respiratory tract paralysis, av block, abnormal AV block, hypotension. Drug interactions enhance effects of other CNS depressants Dosage and Administration Adult: [Seizure with pregnancy: 1-4g IV/IO over 3 min maximum dose of 30-40 g/day. ] |
