Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
91 Cards in this Set
- Front
- Back
NS is also ___% of....
|
0.9% of Sodium Chloride
|
|
NS Class
|
Isotonic Crystalloid Solution
|
|
NS Mechanism of Action
|
To replace water and electrolytes.
|
|
NS Indications
|
Heat related problems, freshwater drowning, hypovolemia, diabetic ketoacidosis, Keep IV open.
|
|
NS contraindications and Precautions
|
Contraindicated when CHF is possible due to circulatory overload.
Use caution since it only contains sodium and chloride, when large amounts are administered, it is possible for other important physiologoical electrolytes to become depleted. |
|
Oxygen Class and Description
|
Class: Gas
Description: Odorless, tasteless, colorless gas necessary for life. |
|
Oxygen Mechanism of Action
|
Increases the oxygen concentration in the alveoli, which increases the oxygen saturation of avaible hemoglobin. Oxygen is required for efficient breakdown of glucose.
|
|
Oxygen Indications
|
Possible hypoxia
|
|
Oxygen Contraindications and Precautions
|
No contraidications.
Use caution with longterm use in COPD pts due to their respiratory drive being controlled by oxygen, NOT a reason to with hold oxygen. Not good for neonates eyes. Flow rates above 6 lpm should be humidified for longterm use to prevent drying out of mucus membrane and upper airway. |
|
EPI class
|
sympathetic agonist
|
|
EPI description
|
Naturally occurring catecholamine. It is a potent alpha and beta adrenergic stimulant, however betal stimulation is more profound.
|
|
EP Mechanism of Action
|
Stimulates alpha and beta, more profound beta effects causing: increased heart rate, cardiac contractile force, cardiac electrical activity, systemic vascular resistance, BP, and cardiac automaticity.
|
|
EPI Indications
|
Cardiac arrest, severe anaphylaxis, and severe reactive airway disease.
|
|
EPI contraidications
|
Tachydysrhythmias, coronary artery disease (patients over the age of 65 etc)
|
|
EPI Precautions
|
Like all catecholamines protect from light. It can be deactivated by alkaline solutions such as sodium bicarbonate.
|
|
EPI side effects
|
Palpitations, anxiety, tremors, H/A, dizziness, N/V. Due to strong inotropic and chronotropic properties it increases myocardial oxygen. Tachydysrhythmias, VT, VF, angina, and HTN.
|
|
EPI Dose
*(Ped dose depends a lot protocol and may need to be edited) |
1:10,000 can be administer IV, IO, or endotracheal.
-Cardiac arrest for adults via IV/IO is 1mg every 3 to 5 minutes. Via endotracheal is 2-2.5 mg every 3 to 5 mins *-Cardiac arrest for peds is initialdose of 0.01mg/kg of 1:10,000, subsequent 0.1mg/kg of 1:1,000 -Severe anaphylaxis or asthma for adults is 0.3-0.5mg of 1:1000 via SQ repeat in 5 to 15 mins PRN -In peds administer 0.01mg/kg IVP of 1:10,000 every 5 to 15 mins |
|
Dopamine Class
|
Sympathetic agonist or Adrenergic Agonist
|
|
Dopamine Description
|
Naturally occurring catecholamines, and a chemical precursor of norepinephrine. It acts on the alpha, beta 1, and dopaminergic receptors. Alpha effects are at high doses.
|
|
Dopamine Mechanism of Action
|
Dose dependant, low doses primarily effecting dopaminergic receptors causing renal and mesenteric vasodilation. High doses effect borth dopaminergic and beta 1 receptors causing cardiac stimulation and renal vasodilation. Higher doses include alpha receptors causing peripheral vasoconstriction.
|
|
Dopamine Indications
|
Adjunct tx in significant and symptomatic hypotention not resulting from hypovolemia or cardiogenic shock.
|
|
Dopamine Contraindications
|
Hypovolemia, known pheachromocytoma (adrenal gland tumor), tachycardia, HTN
|
|
Dopamine Precautions
|
Can induce or worsen SVT and ventricular dysrhythmias. Can cause localize tissue necrosis.
|
|
Dopamine Side Effects
|
tachydysrhthmias, HTN, N/V, HA, ischemia, AMI, dyspnea, chest pain, anxiety, and palpitations.
|
|
Dopamine Interactions
|
Deactivated by alkaline solution such as Sodium BiCarb. Dose must be reduced with pts on Monoamine oxidase inhibitors (MAOIs) are a class of antidepressant drugs prescribed for the treatment of depression. May cause hypotension with pheytoin(Dilantin).
|
|
Dopamine Dose and Route
|
Route is IV/IO
Renal dose is 2 to 5 mcg/kg/min. Inotopic dose is 5 to 10 mcg/kg/mine. Pressor dose is > 10 mcg/kg/min. |
|
ASA Class
|
Platelet aggregator, Anti-inflammatory agent, Salicylate
|
|
ASA Description
|
Anti-inflammatory agent which inhibits platelet functions.
|
|
ASA Mechanism of Action
|
Blocks the formation of the substance thromboxane A2, which causes platelets to aggregate and arteries to contrict.
|
|
ASA Indications
|
New onset chest pain suggest of acute coronary syndrome.
|
|
ASA Contraindications
|
Active ulcers or asthma.
|
|
ASA Precautions
|
Pt allergic to NSAIDs, pts with asthma, ulcers, GI bleeds and other bleeding disorders.
|
|
ASA Side Effects
|
Heartburn, GI bleeding, N/V, wheezing, and prolonged bleeding.
|
|
ASA interactions
|
Together with other anti-inflammatory and may increase side effect and increase blood levels of other drugs. Decrease absorption rate when mixed with antacids.
|
|
ASA Dose and Route
|
160 to 325mg
4 baby ASA is 324mg Route is PO |
|
Furosemide Brand Name
|
Lasix
|
|
Furosemide Class
|
Loop Diurectic
|
|
Furosemide Description
|
Inhibits reabsorption of sodum and chloridein the ascending loop of Henle and distal renal tubule, interfering with the chloride binding cotransport system, thus causing increase excretion of water, sodium, chloride, magnesium, and calcium. Increase venous dilation causing a decrease in cardiac work.
|
|
Furosemide Indications
|
CHF and pulmonary edema. Sometimes used for tx of HTN.
|
|
Furosemide Contraindications
|
Pregnancy except when life-threat. Hypersensitivity to sulfa class. Dehydration, hypokalemia, and hepatic coma.
|
|
Furosemide Precautions
|
Monitor BP for hypotension. Protect from light.
|
|
Furosemide Side Effects
|
HA, dizziness, hypotension, volume depletion, potassium depletion, dysrhythmias, and N/V/D.
|
|
Furosemide Interations
|
Do not administer in same IV line as amrinone(Inocor) as it forms precipitate.
With other diurectics it increases volume depletion and electrolyte imbalance. |
|
Furosemide Dose and Route
|
Pts already on lasix usually receive 40mg slow IVP. Pts not on Lasix receive 20 mg slow IVP.
Doses may as high as 80 to 120mg in severe cases. |
|
Lidocaine Brand Name
|
Xylocaine
|
|
Lidocaine Class
|
Antidysrhthmic
|
|
Lidocaine Desciption
|
Amide-type localanesthetic, also frequently used to tx life threatening ventricular dysrhythmias.
|
|
Lidocaine Mechanism of Actions
|
Depresses depolarization and automaticity in the ventricles with little effects on atrial tissues. Therapeutic dose do not show AV conduction and does not depress myocardial contractility. Suppresses ventricular ectopy in the setting of myocardial infartion and increase the ventricular fibrillation theshold. Prevents PVCs from inducing ventricular fibrillation. Because electrical defibrillation tends to cause ventricular irritability, pts who have been successfully defibrillated should be tx with lidocaine.
|
|
Lidocaine Indications
|
Ventricular Tachycardia, Vitricular Fibrilation, and malignant premature ventricular contractions.
|
|
Lidocaine Contraindcations
|
Second-degree type 1 and third degree blocks.
|
|
Lidocaine Precautions
|
Dose over 300mg/hr cause CNS depression. Excessively high doses can result in coma and death.
|
|
Lidocaine Side Effects
|
Drowsiness, seizures, confusion, HTN, bradycardia, heart blocks, N/V, and respiratory and cardiac arrest. Slurred speech.
|
|
Lidocaine Interactions
|
Caution when given with procainamide, hyenytoin, quindine, beta blockers due to toxicity.
|
|
Lidocaine Dose and Route
|
-Cardiac arrest is 1 to 1.5 mg/kg IV/IO
Repeat every 5 to 10 mins at 0.5 to 0.75 mg/kg IV/IO Max dose is 3mg/kg ET dose 2 to 4 mg/kg V-Tach with pulse is 1-1.5 mg/kg IVP than repeat in 5 to 1o mins at 0.5 to 0.75 mg/kg up to 3 mg/kg. PVCs: 0.5 to 1.5 mg/kg than half the original dose up to 3 mg/kg Once loading dose works start maintance drip |
|
Adenosine Brand name
|
Adenocard, Adenoscan
|
|
Adenosine Description
|
A naturally occurring nucleoside that slows AV conduction through the AV node. Has a short half-life and a good safety profile.
|
|
Adenosine Mechanism of Action
|
Slows conduction time through the AV node, interrupting the re-entry pathways through the AV node, [hopefully] restoring NSR.
|
|
Adenosine Indications
|
Tx of PSVT refactory to common vagal maneuvers.
|
|
Adenosine Contraindications
|
Pt's with 2nd and 3rd degree heart blocks, sick sinus syndrome.
Note: Sick sinus syndrome is a relatively uncommon syndrome. It can result in many abnormal heart rhythms (arrhythmias), including sinus arrest, sinus node exit block, sinus bradycardia, and other types of bradycardia (slow heart rate). Sick sinus syndrome may also be associated with tachycardias (fast heart rate) such as paroxysmal supraventricular tachycardia (PSVT) and atrial fibrillation. Tachycardias that occur with sick sinus syndrome are characterized by a long pause after the tachycardia. |
|
Adenosine Precautions
|
May cause dysrythmias at time of cardioversion, may even cause asystole. Use caution with pts with asthma.
|
|
Adenosine Side Effects
|
Facial flushing, HA, SOA, dizziness, N/V. Note side effects are usually very limited secondary to short half-life.
|
|
Adenosine Interactions
|
Methylxanthrines may decrease effects so consider increasing dose.
Dipyridamole may increase effects of adenosine so cosider decreasing the dose. |
|
Adenosine Route and Dose
|
Rapid IVP
Initial 6mg, repeat in 2 to 3 mins with 12mg if indicated. A second 12mg may be administered if the first 2 doses donot work. |
|
Sodium Bicab Class
|
Alkalinizing agent
|
|
Sodium Bicarb Description
|
A salt that provides bicarbonate to buffer metabolic acidosis, which can accompany several disease processes.
|
|
Sodium Bicarb Mechanism of Action
|
Dissociates to provide bicarbonate ion which neutralizes hydrogen ion concentration and increase blood and urine pH.
|
|
Sodium Bicab Indications
|
Management of metabolic acidosis (ie cardiac arrest with long down time). Tx of hyperkalemia. Management of tricyclic antidepressant, ASA, and phenobarbital overdoses.
|
|
Sodium Bicarb Contraindications
|
Alkalosis, hypernatremia, severe pulmonary edema, and hypocalcemia.
|
|
Sodium Bicarb Precautions
|
Be cautions with dose as overdosing can cause alkalosis.
|
|
Sodium Bicarb Side Effects
|
Metabolic alkalosis, decrease potassium, and fluid overload.
|
|
Sodium Bicarb Interactions
|
Deactivates most catecholamines and vasopressors (ie. dopamine and epinephrine). Never administer with calcium chloride as it basically makes chalk.
|
|
Sodium Bicarb Route and Dose
|
IV
1mEq/kg follow by 0.5mEq/kg every 10 mins |
|
Atropine Brand Name
|
Atropiso, Isopto
|
|
Atropine Class
|
Anticholinergic
|
|
Atropine Description
|
A parasympatholytic that is derived from parts of the Atopa belladonna plant.
|
|
Atropine Mechanism of Action
|
Blocks the action of acetylcholine at parasympathetic sites in smooth muscle, secretory glands and the CNS; increase cardiac output, dries secretions, antagonizes histamine and serotonin.
|
|
Atropine Indications
|
Hemodynamically significant bradycardia and asystole (soon to be taken off of standard for asystole). Also used for antidote for organophosphate poisoning.
|
|
Atropine Contoraindications
|
None in an emergency situation. Glaucoma, tachycardia, and Mobitiz type II block.
|
|
Atropine Precautions
|
May actually worsen bradycardia associated with second degree Mobitz type II block.
Increases cardiac and O2 demand. |
|
Atropine Side Effects
|
Blurred vision, dilated pupils, dry mouth, tachycardia, drosiness, and confusion.
|
|
Atropine Interactions
|
Few interactions in prehospital setting.
|
|
Atropine Route and Dose
|
Max is 3mg or 0.04mg/kg
Bradycardia 0.5 IV repeat every 3 to 5 mins. Asystole is 1mg ever 3-5 mins via IV or 2 to 2.5 mg every 3 to 5 mins via endotracheal. |
|
Morphine Class
|
Narcotic analgesic
|
|
Morphone Description
|
Potent anagesic with properties additional effects.
|
|
Morphine Mechanism of Action
|
Binds to opiate receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain. Produces a generalize CNS depression. Also increases peripheral venous capacitance and dereases venous return, thus decreasing myocardial oxygen demand.
|
|
Morphine Indications
|
Severe pain especially related to active MI. Also used in severe CHF.
|
|
Morphine Contraindications
|
Volume depletion, hypotensive, undiagnose head injury.
|
|
Morphine Precautions
|
Very addictive, schedule II drug.
|
|
Morphine Side Effects
|
N/V, abdominal craping, blurred vision, constricted pupils, alter mental status, headache, and respiratory depression.
|
|
Morphine Interactions
|
Inhances antihistamines, antimetics, sedatives, hypnotics, barbiturates, and alcohol.
|
|
Morphine Dose and Route
|
Initial 2 to 10mg IV with 2mg every few mins. IM 5 to 15mg based on pt weight.
|