Pti Drug Cards 2010

Front 1

Dextrose 50% in H2O: Classification

Back 1

Carbohydrate

Front 2

Dextrose 50% in H2O: Indications

Back 2

ALOC due to hypoglycemia

Front 3

Dextrose 50% in H2O: Administration

Back 3

50ml (25g) IVP
May rep x1

Front 4

Dextrose 50% in H2O: Actions/Pharm

Back 4

Principle form of glucose (sugar) used by the body to create energy

Front 5

Dextrose 50% in H2O: Pharmacokinetics

Back 5

Immediate onset < 1min
Peak effect and duration depends upon degree of hypoglycemia

Front 6

Dextrose 50% in H2O: Contraindications

Back 6

None known

Front 7

Dextrose 50% in H2O: Adverse Effects

Back 7

- Pain or burning at injection site
- Neurological symptoms, can cause Wernicke's/Korsakoff's psychosis if pt is thyamine deficient

Front 8

Dextrose 50% in H2O: Interactions

Back 8

None

Front 9

Dextrose 50% in H2O: Considerations

Back 9

- To dilute from D50 to D25, empty 25cc of D50 and fill w/ 25cc NS
- Ensure patent IV line (severe tissue damage w/ extravasationof solution)
- Report/record BG levels before/after administration
- Ensure pts w/ ICP have low BG prior to admin. Can worsen cerebral edema

Front 10

Glucagon: Classification

Back 10

Hormone (pancreatic)

Front 11

Glucagon: Indications

Back 11

ALOC when hypoglycemia is susp & IV cannot be established

Front 12

Glucagon: Administration

Back 12

1 mg IM if known diabetic
May rep q 20 min 2x

Front 13

Glucagon: Actions/Pharm

Back 13

- Natural hormone prod by alpha cells of the islets of Langerhans in the pancreas
- When released causes breakdown of glycogen (stored in liver) to glucose & inhibits synthesis of glycogen from glucose
- Both actions increase BG levels

Front 14

Glucagon: Pharmacokinetics

Back 14

Onset 5-20 min
Duration 1-1.5 hr

Front 15

Glucagon: Contraindications

Back 15

None, if indicated

Front 16

Glucagon: Adverse Effects

Back 16

Hypotension

Front 17

Glucagon: Interactions

Back 17

None

Front 18

Glucagon: Considerations

Back 18

- After reconstitution of dry powder/solution, use mixture immediately
- PT usually awakens from hypoglycemic coma in 5-20 min after injection
- ASAP after PT regains cons, PO carbohydrate should be given
- After recovery: headache, nausea, weakness
- Effective only if glucagon stores in liver

Front 19

Calcium Chloride: Classification

Back 19

Electrolyte

Front 20

Calcium Chloride: Indications

Back 20

- Cardiac Arrest assoc w/ hyperkalemia or Ca+ channel blocker toxicity
- Crush Syndrome w/ susp hyperkalemia or crush force > 4 hrs

Front 21

Calcium Chloride: Administration
Cardiac Arrest

Back 21

1 g (1,000mg) SIVP over 60 sec
May rep every 10 min

Front 22

Calcium Chloride: Administration
Crush Syndrome

Back 22

1 g (1,000mg) SIVP over 60 sec
1x only

Front 23

Calcium Chloride: Actions/Pharm

Back 23

-Essential regulator for the excitation threshold of nerves and muscles
- Inc in myocardial contractility & ventricular automaticity
- Antidote for some electrolyte imbalances & Ca+ channel blocker toxicity

Front 24

Calcium Chloride: Pharmacokinetics

Back 24

Onset/peaks immediate
Duration unknown

Front 25

Calcium Chloride: Contraindications

Back 25

Hypercalcemia

Front 26

Calcium Chloride: Adverse Effects

Back 26

- Pain & burning at injection site
- Tingling sensation
- Hypotension
- Cardiac arrest

Front 27

Calcium Chloride: Interactions

Back 27

- Precipitates to form calcium carbonate (chalk) when used with Sodium Bicarb
- Inactivates or minimizes the effects of catecholamines if not flushed properly

Front 28

Calcium Chloride: Considerations

Back 28

- Flush IV line before/after admin
- Ensure IV is patent, necrosis & sloughing in extravasation

Front 29

Sodium Bicarbonate: Classification

Back 29

Electrolyte

Front 30

Sodium Bicarbonate: Indications

Back 30

A) Cardiopulmonary arrest
- Unsuccessful drug therapy & defib
- Susp hyperkalemia
- Susp tricyclic OD

B) Crush Syndrome
- Susp hyperkalemia
- Crush force > 4hrs

Front 31

Sodium Bicarbonate: Administration
Cardiac Arrest

Back 31

1 mEq/kg IVP
May rep 0.5 mEq/kg every 10-15 min

Front 32

Sodium Bicarbonate: Administration
Crush Syndrome

Back 32

Concentration of 1 mEq/kg added to 1st 1,000 ml NS run IV wide open

Front 33

Sodium Bicarbonate: Actions/Pharm

Back 33

- Short-acting, potent, systemic antacid
- Immediately raises pH of blood plasma by buffering excess hydrogen ions (acidosis)

Front 34

Sodium Bicarbonate: Pharmacokinetics

Back 34

Onset < 15 min
Duration 1-2 hrs

Front 35

Sodium Bicarbonate: Contraindications

Back 35

None, if indicated

Front 36

Sodium Bicarbonate: Adverse Effects

Back 36

- May cause extracellular alkalosis
- Severe tissue damage if IV infiltrates

Front 37

Sodium Bicarbonate: Interactions

Back 37

- Catecholamines & vasopressors can be deactivated
- When admin w/ CaCl, a precipitate may clog line

Front 38

Sodium Bicarbonate: Considerations

Back 38

- Not rec for routine use in cardiac arrest pts
- Infusion stopped immediately if extravasation occurs (severe tissue damage)
- Always flush line following admin

Front 39

Adenosine: Classification

Back 39

Antidysrhythmic

Front 40

Adenosine: Indications

Back 40

- Perfusing SVT unresponsive to valsalva
- Poorly perfusing SVT (if conscious)

Front 41

Adenosine: Administration

Back 41

6 or 12mg rapid IVP w/in 1-3 sec f/b rapid NSF 10-20ml
May rep 12mg in 1-2min 1x

Front 42

Adenosine: Actions/Pharm

Back 42

- Slows conduction through AV node
- Can interrupt reentry pathways thru AV and SA nodes

Front 43

Adenosine: Pharmacokinetics

Back 43

Onset Immediate
Duration < 10 sec

Front 44

Adenosine: Contraindications

Back 44

Hx SA node disease
Preexisting 2nd or 3rd degree HB

Front 45

Adenosine: Adverse Effects

Back 45

CP/pressure
Hypotension
Bradycardia/asystole
Palpitations
Dyspnea/SOB
Head Pressure
Lightheadedness/Dizziness
Tingling/Numbness
Blurred vision
Metallic Taste
Throat Tightness

Front 46

Adenosine: Interactions

Back 46

Potentiated by: Blockers of nucleoside transport
- Dipypridamole (Persantine) and
- Carbamazepine (Tegretol)

Antagonized by:
- Methylxanthines (caffeine)
- Theophylline

Front 47

Adenosine: Considerations

Back 47

- Large vein (18-20 guage)
- IV port closest to PT
- Immed. NSF
- 6 sec strip
- 10 sec of escape beats or asystole
- CP, hypotension, SOB for 1-2 min
- Caution w/ COPD or Persantine/Tegretol
- Could worsen bronchoconstrictive disease

Front 48

Amiodarone: Classification

Back 48

Antidysrhythmic

Front 49

Amiodarone: Indications

Back 49

V-Fib, Pulseless V-Tach

Front 50

Amiodarone: Administration

Back 50

300 mg IV/IO over 1 min f/b NSF 10-20 ml
If no conversion, may rep 150 mg IV/IO in 3-5 min 1x
Max 450 mg

Front 51

Amiodarone: Actions/Pharm

Back 51

- Acts directly on all cardiac tissue
- Relaxes smooth muscle, dec PVR, inc coronary blood flow
- Blocks effects of sympathetic stim

Front 52

Amiodarone: Pharmacokinetics

Back 52

- Rapid distribution following IV admin
- Metabolism & Elimination in liver

Front 53

Amiodarone: Contraindications

Back 53

None, if indicated

Front 54

Amiodarone: Adverse Effects

Back 54

Bradydysrhythmias
Hypotension
CHF

Front 55

Amiodarone: Interactions

Back 55

- Inc digoxin levels
- Enhances anticoagulant effects
- Potentiated by (poss): Beta blockers, Ca+ channel blockers