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64 Cards in this Set
- Front
- Back
BRAND NAME
charcoal, activated (without sorbitol) |
Charcola, Actidose-aqua
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CLASS
charcoal, activated (without sorbitol) |
adsorbent
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MECHANISM OF ACTION
charcoal, activated (without sorbitol) |
PHARMACOLOGICAL: Physical binding (adsorption) of toxins from GI tract.
CLINICAL EFFECTS: Prevents/reduces systemic absorption of toxins. |
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INDICATIONS
charcoal, activated (without sorbitol) |
Sole prehospital therapy of oral ingestion of toxic substances.
Pre-lavage of oral ingestions of toxic substances. |
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CONTRAINDICATIONS
charcoal, activated (without sorbitol) |
Ingestion of caustics
Ingestion of hydrocarbons (relative) Oral administration to comatose patient Simultaneous administration of other oral drugs |
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ADVERSE REACTIONS
charcoal, activated (without sorbitol) |
May provoke vomiting
May worsen overdosed induced Ileus |
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INCOMPATIBILITES/DRUG INTERACTIONS (you have to add this one)
charcoal, activated (without sorbitol) |
Ineffective for iron, lithium, heavy metals, and other ions.
May reduce the effectiveness of other treatments (Mucomyst) in pure acetaminophen OD's. Since charcoal bonds with whatever it is mixed with, flavoring with drinks reduces effectiveness. |
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ADULT DOSAGE
charcoal, activated (without sorbitol) |
30 - 60 gm (1-2 gm/kg) PO or OG/NG tube; if not in pre-mixed slurry, mix one part charcoal with four parts water.
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PEDIATRIC DOSAGE
charcoal, activated (without sorbitol) |
0.5-1.0 gm/kg PO or OG/NG tube; if not in pre-mixed slurry, mix one part charcoal with four parts water.
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BONUS
charcoal, activated (without sorbitol) |
Give it!
Charcoal mixture SHOULD NOT contain sorbitol; CAREFULLY read label of exchange supply. |
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BRAND NAME
dextrose 50% |
Dextrose 50%, D50
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CLASS
dextrose 50% |
carbohydrate, hyperglycemic
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MECHANISM OF ACTION
dextrose 50% |
PHARMACOLOGICAL: Aerobic metabolic substrate (ATP production).
CLINICAL EFFECTS: Reverses CNS effects of hypoglycemia by rapidly increasing serum glucose levels. Provides short-term osmotic diuresis. |
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INDICATIONS
dextrose 50% |
Known hypoglycemia
ALOC of unknown etiology Seizures of unknown etiology Hyperkalemia |
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CONTRAINDICATIONS
dextrose 50% |
Known thiamine deficiency (relative, if suspected give thiamine close to the same time).
Delirium tremens; use with caution in patients with acute alcoholism, may be ineffective without thiamine. Head injury (unless documented hypoglycemia). Intracranial hemorrhage (relative). Severe pain (paradoxical excitement may occur). |
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ADVERSE REACTIONS
dextrose 50% |
Cerebral edema in children when given IV undiluted.
Worsening elevated ICP or cerebral edema from trauma or cerebral vascular accident. Extravasation leads to severe tissue necrosis. Slerosing effect on peripheral veins. |
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ADULT DOSAGE
dextrose 50% |
HYPOGLYCEMIA, ALOC OR SEIZURES OF UNKNOWN ETIOLOGY: 25-100 mL of D50 (12.5-50 gm, 1 to 2 amps) IV/IO.
HYPERKALEMIA: 50 gm of Dextrose 50% IV total may be given over 1 hour. This is part of a comination drug therapy. See: CaCl and NaHCO3 |
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PEDIATRIC DOSAGE
dextrose 50% |
(14 years and below includes infant)
Administer 05.-1 gm/kg of a dextrose 10% solution; recommended to give slowly over a 20 minute period. Dilute D50 (dextrose 50% containing 25 gm of dextrose) to a 1:4 solution. To prepare, take 50 mL out of a 250 mL NS IV bag, then add 50 mL (1 amp) of dextrose 50% into the IV bag. The resultion solution is 10% in NS or 10 gm/100 mL. |
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BONUS
dextrose 50% |
Determine a blood glucose level before initiating administration of dextrose.
Inducing an unnecessary hyperosmolar state during certain illness/injury states (ie head injuries, cerebral edema, intracranial bleeds, etc) may worsen neurological outcome. Additionally dextrose is very necrosing to the vascular system, will cause necrosis if infiltrated and should not be administered through small veins. |
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BRAND NAME
glucagon |
Glucagon
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CLASS
glucagon |
pancreatic hormone, polypeptide, hyperglycemic agent
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MECHANISM OF ACTIONS
glucagon |
PHARMACOLOGIC: Acts only on liver glycogen, converting it to glucose. Counteracts the effect of insulin. Relaxes GI smooth muscle causing dilation and decreased motility. Cardiac inotrope.
CLINICAL EFFECT: May reverse hypoglycemia (if patient has glycogen stored in liver) within 4-8 minutes (could be as long as 15 or more). |
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INDICATIONS
glucagon |
Symptomatic hypoglycemia when IV access is delayed.
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CONTRAINDICATIONS
glucagon |
Known hypersensitivity
Pheochromocytoma ( a rare tumor of the adrenal gland that cause too much release of epi and norepi). Insulinoma Should not be routinely used to replace dextrose when IV access has been obtained. |
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ADVERSE REACTIONS
glucagon |
N/V
Generalized allergic reactions including urticaria, respiratory distress, and hypotension (made from beef/pork pancreas) Palpitations, HTN, tachycardia |
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ADULT DOSAGE
glucagon |
(children and adults greater than 20 kg or 44 lbs)
HYPOGLYCEMIA: 1 mg IM, may repeat in 7-10 min |
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PEDIATRIC DOSAGE
glucagon |
(for children under 20 kg or 44 lbs)
HYPOGLYCEMIA: 0.5 mg IM or a dose equivalent to 20-30 mcg/kg, may repeat in 7-10 minutes. |
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BONUS
glucagon |
Blood sugar should be measured rapidly before deciding upon the administration of D50 or glucagon, especially in the non-diabetic patient.
Documented hypoglycemia is a true medical emergency, IM glucagon, should be administered rapidly if IV access is delayed. In known alcoholics, administer thiamine in addition to glucagon to prevent inducing an encephalopathy in a thiamine-deficient patient. Patients with Type I diabetes do not have as great a response in blood glucose levels as Type II stable patients. For all patients having hypoglycemic episode, supplementary complex carbohydrates should be eaten within 2 hours, especially in a child or adolescent. |
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BRAND NAME
ondansetron |
Zofran
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CLASS
ondansetron |
antiemetic agent
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MECHANISM OF ACTION
ondansetron |
Selectively blocks serotonin 5-HT3 receptors located in the CNS at the chemoreceptor trigger zone and in the peripheral nervous system on nerve-terminals of the vagus nerve
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INDICATIONS
ondansetron |
N/V
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CONTRAINDICATIONS
ondansetron |
Hypersensitivity
Use with caution in patients with hepatic impairment |
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ADVERSE REACTIONS
ondansetron |
CNS: HA, malaise, fatigue, dizziness, fever, sedation, extrapyramidal syndrome
CV: CP, arrhythmias RESP: Hypoxia GI & HEPATIC: Diarrhea, constipation, abdominal pain, xerostomia, decreased appetite SKIN: Rash |
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ADULT DOSAGE
ondansetron |
4-8 mg IV slow push over 2-5 min
8mg PO ODT or tablet |
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PEDIATRIC DOSAGE
ondansetron |
(1 month to 12 years old)
Greater than 40 kg - 4 mg IV slow push over 2-5 min Less than 40 kg - 0.1 mg/kg IV slow push over 2-5 min 4-12 years old 4 mg PO ODT or Tablet |
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BONUS
ondansetron |
Do not attempt to push Zofran ODT tablets through the foil backing. With dry hands, PEEL BACK the foil backing of 1 blister and GENTLY remove the tablet. IMMEDIATELY place the Zofran ODT tablet on top of the tongue where it will dissolve in seconds, then swallow with saliva. Administration with liquid is not necessary.
Bottles: Store between 2 degrees C and 30 degrees C (36F-86F). Protect from light. Dispense in tight, light-resistant container as defined in the USP. Unit dose packs: store between 2C-30C (36F-86F) Protect from light. Store blisters in cartons. |
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BRAND NAME
naloxone HCl |
Narcan
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CLASS
naloxone HCl |
narcotic (opioid) antagonist
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MECHANISM OF ACTION
naloxone HCl |
Competitive inhibition at narcotic receptor sites.
Reverses respiratory depression secondary to narcotics. |
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INDICATIONS
naloxone HCl |
ANTIDOTE FOR: Opioid overdoses.
May differentiate opioid-induced coma from other causes. |
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CONTRAINDICATIONS
naloxone HCl |
Hypersensitivity
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ADVERSE REACTIONS
naloxone HCl |
Withdrawal symptoms, especially in neonates (N/V, diaphoresis, increased HR, falling BP, tremors).
BE PREPARED FOR COMBATIVE PT AFTER ADMINISTRATION. |
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ADULT DOSAGE
naloxone HCl |
IV, IM, SC, Inject SL, ET: 2.0 mg initial bolus IV or ET, may repeat every 2 minutes as necessary; titrate to effect.
INTRA-NASAL: 1.0 mg each nostril using a Mucosal Atomizer Device for a total of 2 mg. May repeat every 2 minutes as necessary. Titrate to effect. |
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PEDIATRIC DOSAGE
naloxone HCl |
< 5 years or < 20 kg: 0.1 mg/kg IV, ET, inject SL, SC, IO (includes neonate)
> 5 years or > 20 kg: 2 mg IV, ET, inject SL, SC, or IO |
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BONUS
naloxone HCl |
Opioid drugs include heroin, Dilaudid, morphine, meperidine, codeine, methadone, Lomotil, Darvon, Darvocet, Talwin and others.
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BRAND NAME
thiamine HCl (vitamin B1) |
Betalin
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CLASS
thiamine HCl (vitamin B1) |
vitamin
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MECHANISM OF ACTION
thiamine HCl (vitamin B1) |
Required for carbohydrate metabolism.
Deficiency leads to anemia, polyneuritis, Wernicke's encephalopathy, cardiomyopathy. Administration may reverse symptoms of deficiency, but effects are dependent upon duration of illness and severity of disease. |
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INDICATIONS
thiamine HCl |
Alcoholism, delirium tremens.
Coma of unknown origin, especially if alcohol or malnourishment may be involved. Suspect Wernicke or Korsakoff Syndrome Other thiamine deficiency syndromes Severe CHF |
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CONTRAINDICATIONS
thiamine HCl |
Do not give intra-arterial
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ADVERSE REACTIONS
thiamine HCl |
Hypotension (rare)
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ADULT DOSAGE
thiamine HCl (vitamin B1) |
100 mg SIVP or Deep IM
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PEDIATRIC DOSAGE
thiamine HCl (vitamin B1) |
Rarely used.
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BONUS
thiamine HCl (vitamin B1) |
In the known alcoholic patient, dextrose should not be administered without thiamine.
Thiamine has been shown to be useful in severe CHF. |
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BRAND NAME
oxytocin |
Pitocin, Syntocin
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CLASS
oxytocin |
pituitary hormone, polypeptide, uterine stimulant
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MECHANISM OF ACTION
oxytocin |
Binds to oxytocin receptor sites on the surface of uterine smooth muscles: increases force and frequency of uterine contractions.
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INDICATIONS
oxytocin |
Postpartum hemorrhage due to uterine atony
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CONTRAINDICATIONS
oxytocin |
Hypersensitivity
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ADVERSE REACTIONS
oxytocin |
CV: Shock, tachycardia, dysrhythmias
RESP: Anaphylaxis GI: N/V GU: If used prior to deliver, can cause uterine rupture, uterine spasm, lacerations, and fetal damage. OTHER: Clotting disorders, electrolyte disturbances. |
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ADULT DOSAGE
oxytocin |
POSTPARTUM HEMORRHAGE: 10-20 USP units added to 1000 mL NS or LR and run at a rate necessary to control uterine atony or 10 USP units may be given IM after delivery of the placenta.
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PEDIATRIC DOSAGE
oxytocin |
Not applicable.
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BONUS
oxytocin |
Post partum hemorrhage is defined as blood loss in excess of 500 mL at delivery and during the first 24 hours after delivery.
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