SAEMS drugs

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jjansen
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160599
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SAEMS drugs
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2012-07-01 04:16:37
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SAEMS drugs
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SAEMS drugs
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  1. Epinephrine
    • Adrenalin
    • Sympathomimetic
    • Direct act on A & B
    • Positive inotropic and chronotropic
    • Blocks Histamine
    • Give for
    • -Cardiac Arrest
    • -astha
    • -anaphylaxis
    • -Bradicardia
    • -hypotension
    • 1:10,000 pre filled 6_8
    • 1:1000 ampule 1-2
    • 1:1000 multi dose vial

  2. Vasopressin
    • ADH
    • Causes vasoconstriction
    • Give for
    • -cardiac arrest
    • (Substitute first or second epi dose)
    • Not carried in AZ drug box
    • 20 U/ml

  3. Atropine
    • Parasympatholytic- parasympathetic blocker
    • Anticholinergic
    • Blocks acetylcholine and allows sympathetic to take over
    • Positive chronotropic, dromo and ino(slight)
    • Causes mydration- pupil dialation
    • Use for-
    • Symptamatic Brady
    • Organophosphate poisoning
    • Bronchial spasm
    • 1mg/10ml pre filled syringe x 3
    • 8mg/20ml multi dose vial (0.4 mg/ml)

  4. Adenosine
    • Adenocard
    • Slows conduction time through AV
    • Slows sinus rate- stops and resets the heart
    • Used to-
    • Convert SVT
    • Or wide complex tachy
    • 6mg/2ml vials, syringe
    • (3mg/1ml) concentrated doses

  5. Sodium Bicarbonate
    • Buffers H+ and increases pH
    • Given as antidote for TCA (like amytriptaline/ Elivil)
    • Or given for overdose in ASA
    • Used for-
    • Cardiac arrest - after interventions and ventilation are complete
    • 50 mEq/50ml prefilled x 3

  6. Albuterol
    • Proventil, Ventolin
    • Sympathomimetic, bronchodilator
    • B agonist (B2)
    • Decrease airway resistance
    • Bronchodilation
    • 2.5mg in 3ml x 6

  7. Atrovent
    • Ipratropium Bromide
    • Parasympatholytic, anticholinergic, parasympathetic blocker
    • Dilation of larger central airways where beta agonists affect peripheral
    • Out of light, avoid humidity
    • Used to treat-
    • Bronchspasm, COPD,
    • 500 mcg/2.5ml (0.02%) X 2-4

  8. Solu-medtrol
    • Methylprednisolone Sodium Succinate
    • Corticosteroid, glucocordicoid, anti-inflamitory
    • Has immunosuppresive effects
    • Use for-
    • Acute asthma, COPD
    • Anaphylaxis
    • Burns involving airway
    • Acute spinal cord trauma
    • 125mg/2ml mix-a-vial x 1-2

  9. Midazolam
    • RSI drug
    • Versed
    • CNS depressant mediated through gaba
    • Benzodiazepine {not the same but similar to Diazepam/Valium} (schedule IV)
    • Acts @ limbic, thalamic, hypothalamic
    • Used for- anxiolytic, sedative, hypnotic, anticonvulsant
    • 1mg/1ml in a 5ml vial 5 mg total x 4 vials

  10. Succinylcholine
    • RSI drug
    • Ultra short acting depolarizing- skeletal muscle relaxant
    • Combines to cholinergic receptors of motor end plate to produce depolarization
    • Used for endo tracheal intubation causes complete muscle paralysis
    • 200mg/10ml vials- recommended 400 milligrams

  11. Etomidate
    • RSI drug
    • Sedative/ hypnotic agent
    • CNS Depression and anesthesia
    • No analgesic ( pain relieving)
    • 40mg/20ml pre filled or vial- recommended 80 milligrams

  12. Diphenhydramine
    • Benadryl
    • Blocks H1 H2 histamine receptors, not the histamine release
    • Antihistamine, anticholinergic
    • Used for-
    • -anaphylaxis (2nd line)
    • (Phenothiazine) so it is an antidote for psychotic pts on Haldol
    • 50mg/1ml syringes and vials x 1-2

  13. Aspirin
    • ASA, Bufferin, Anacin
    • Analgesic, antipyretic, anti-inflamatory
    • Blocks thromboxane A2
    • Platelet aggregant, vasoconstrictor ( decreases platelet aggregation)
    • Use for- MI
    • Chest pains
    • Unstable angina
    • 81-325 mg tablet 50-100 tablets

  14. Nitroglycerin
    • Nitrostat, Tridil
    • Vasodialator, smooth muscle relaxant,
    • Decrease pre load by dialating veins
    • Arteriolar vasodilation- so it decreases the afterload
    • Decreases heart O2 demand by opening coronary vessels and increasing blood flow
    • Use for- angina, and MI, and CHF
    • Beware other nitrates -viagra, livetra, cialis
    • 1/150 grain tablets x 25 in a bottle (0.4 mg)
    • IV infusion pump used on inter facility transfers

  15. Morphine Sulfate
    • Schedule II opiod drug
    • Narcotic agonist
    • Elevates pain threshold, binds to pain receptors
    • Depresses CNS respiratory centers
    • Artery and vein dilator- so reduces preload and afterload
    • Causes histamine release
    • Used for -
    • Pain relief especially for burns
    • treat MI
    • Treat pulmonary edema
    • 10mg/ml ampules or syringe only x2 or 20mg total

  16. Activated Charcoal
    • Charcola, Actidose-aqua
    • adsorbent,
    • Physical binding of toxins of GI tract
    • prevents adsorption
    • sole prehospital therapy for toxic ingestion
    • may lessen effect of Mucomyst for acetylmetaphine ODs
    • 25 gm premixed tubes x 2-4

  17. Magnesium Sulfate
    • Electrolyte, anti-contraction medication(tocolytic)
    • 2nd most plentiful intracellular cation (1st is Potassium, K+)
    • essential to cause intracellular K+ replenishment
    • decreases myocardial, neuromuscular irritability(by decreasing acetylcholine released by nerve inpulse)
    • use for- Pre-term Labor
    • hypomagnesemia
    • severe asthma
    • Pregnancy induced hypertension
    • pre-eclampsia/eclampsia (convultions in pregnancy)
    • torsade de pointes
    • 1gm/2ml vials x 4-10

  18. Oxytocin
    • Pitocin, Syntocin
    • Pituitary Hormone, polypetide, uterine stimulant
    • increases force and frequency of uterine contractions by binding to uterine smooth muscles
    • use for-
    • postpartum hemorrage=excess of 500ml @ delivery
    • fundal massage also indicated along with giving med
    • is optional drug
    • 10 USP units/1ml ampule x 1-2

  19. Amiodarone
    • Cordarone
    • antiarrhythmic- used after epi
    • effects- sodium, potassium, and calcium channels
    • sodium- slows conduction
    • potassium-prolongs action potential
    • Calcium- negg chronotropic effects, because blocks calcium and B receptors
    • dilates coronary arteries because blocks B receptors
    • use for-
    • VF,VT
    • control stable VT when cardioversion not successful
    • -only for interfacility transport
    • -prefered AHA Ventric antiarrhythmic

  20. Lidocaine
    • Xylocaine
    • antiarrhythmic, local anesthetic
    • decreases automaticity by slowing depolorization
    • stops re-entry by decreasing conduction, it equalizes the speed
    • increases VFib threshold
    • use for-
    • suppress VFib and VTach
    • as a drip to prevent going back to VFIB/Tach after conversion
    • preintubation for head trauma or intracrainial pressure(hypertension)
    • 100mg/5ml prefilled syringe x 3-4
    • 1g/25ml vial x 1
    • 2g premixed bag in 500 ml D5W x 1

  21. Phenylephrine Nasal Spray 0.5%
    • Neo-synephrine Nasal Spray 0.5%
    • topical vasoconstrictor
    • stimulates receptors in blood vessels to consrict
    • decreases nasal bleeding
    • 15ml bottle 0.5% solution x1

  22. Naloxone
    • Narcan
    • ET diliverable drug
    • Direct but slow IV push
    • Narcotic (opioid) antagonist
    • competes for narcotic receptors
    • reverses/antidote for respiratory depression caused by narcotics
    • antidote for opioid overdoses
    • 1mg/ml
    • 1ml, 2ml ampules
    • 1,5,or 10ml vials
    • 10mg total

  23. Nalmefene
    • Revex
    • -back up for Narcan/Naloxone
    • replaces narcan if unavailable
    • narcotic (opioid) antagonist
    • competes for narcotic recoptor sites
    • reverses respiratory depression caused by narcotics
    • antidote for Opioid overdoses
    • 1mg/ml
    • 1,2 ml vials

  24. Diazepam
    • Valium
    • Benzodiazepine {not the same as but similar to midazolam/Versed} (Schedule IV)
    • acts on limbic system, thalamus, and hypothalamus- to produce calming effects
    • DECREASES SEIZURES-by increasing seizure threshold
    • sedative
    • use for-
    • Grand Mal Seizures-especially in status elipticus
    • analgesic, amnesic {used for fraction reducing, and cardioversion/pacing}
    • Delirium Tremens DT (withdraw shakes from alcoholism)
    • TREAT THE CAUSE FIRST
    • 10mg/2ml prefilled syringe, ampule, vial x2

  25. Calcium Chloride
    • Electrolyte
    • increases intra/extracellular calcium levels
    • stimulates catacholmine release (epi, noreoi, & dopamine)
    • calcium channel blockers decrease concraction, but clacium put back in will increase contraction/AUTOMATICITY
    • inhibits adenosine on mast cells
    • use for-
    • OVERDOSE of Calccium channel blockers (verapamil/diltiazem)
    • OVERDOSE OF Magnesium (hypermagnesemia)
    • Acute hypoCalcemia (low calcium levels)
    • Acute hypoKalemia (low potassium levels)
    • pre-treat for verapamil admin
    • 1gm/10ml prefilled syringe x 1-2

  26. Dopamine
    • Intropin
    • sympathomimetic/catacholmine
    • Effects are dose-depentent
    • 1-2 micrograms/kg/min-stimulate cerebral,renal,messenteric vasculature to dilate
    • 2-10 micrograms/kg/min-B1 (heart) stimulant, increases cardiac output and vasoconstricts
    • 10-20 micrograms/kg/min-A-adrenergic effects=peripheral artery&vein constriction and @ this high dose-it constrics the renal and messenteric vasculature
    • Used for-
    • bradycardia w/symtoms
    • significant hypotension w/out hypovolemia(hole in bloodvesels-cause it will constrict and make the bleed worse)
    • SHOCK-
    • -CARDIO/SEPTIC- after administration & ASSESMENT of LUNG SOUNDS!!!
    • 400mg/5ml vials
    • 400mg/ 250ml D5W premixed IV solution bag

  27. Dextrose 50%
    • D50
    • it's a carbohydrate
    • ATP production
    • reverse hypoglycemia
    • makes short term osmotic diuresis (increased urine production)
    • Use for-
    • known hypoglycemia
    • unknown- Altered LOC/seizures
    • hyperKlemia (increased potassium)
    • 25gms/50ml prefilled x 2-4

  28. Glucagon
    • Glucagen
    • Pancreatic hormone, polypeptide, hyperglycemic agent- Alpha cell of pancrease
    • gets more glucose from the Liver
    • converts liver glycogen-to glucose
    • counteracts insulin
    • reverse hypoglycemia- in 4-8 min up to 15 min
    • Used for-
    • low sugar when IV is delayed
    • Beta-blocker(like metaprpolol) OVERDOSE
    • Esophageal lodgement-cause relaxes GI smooth muscle
    • 1mg, 1unit kit of diluting solution

  29. Thiamine
    • Betalin
    • Vitamin required for carb metabolism
    • deficiency= anemia, inflamation of peripheral nerves, Wernicke's encephalopathy (commonly caused by excessive alcoholizm)-all the fluid get dehydrated out especially thiamine, whch inturn causes the disease, dificeincy also leads to weakened and enlarged heart muscle(cardiomyopathy)
    • Used for-
    • to reverse effects of above dieseases
    • alcoholism
    • Delirium tremens (DTs)
    • Coma/alcoholor malnurishment
    • severe congestive heart failure
    • 100mg/ml 1ml ampule or tubex x 1-2

  30. Furosemide
    • Lasix
    • Loop diuretic-inhibites electrolyte reabsorption in ascending loop of Henle
    • excrete a lot of POTASSIUM!!!!,¬†and sodium&chloride
    • VASODILATES- to decrease afterload
    • Used for-
    • Pulmonary edema
    • CHF
    • 40mg/4ml ampule, vial, syringe (20mg/2ml)

  31. Bumetanide
    • Bumex
    • -Back up for Furosemide/Lasix
    • loop diuretic=inhibits electrolyte reabsorption in loop of Henle
    • -DOES NOT HAVE VASODILATORY PROPERTIES OF FUROSEMIDE
    • -may reduce blood suply to fetus
    • -1MG Bumetanide= 40mg furosemide
    • Used for-
    • Pulmonary Edema
    • CHF
    • used if furosemide not available
    • 1mg/4ml vial x 4-8 (0.25mg/1mL)

  32. Verapamil
    • Isoptin, Calan, Verelan
    • Calcium Channel blocker
    • -blocks calcium from cardiac and smooth muscle causing depressant effect on contracttility, which=negative inotropy
    • slow conduction, & prolongs refractory period
    • slows SA node and AV conduction
    • Use for-
    • Supraventricular Tachy
    • Atrial Fib
    • -ACLS no longer recommends this drug, they say Diltiazem is safer
    • 5mg/2mL (2.5mg/1ml) prefilled, ampule, vial x2-3

  33. Diltiazem
    • Cardizem
    • Calcium channel blocker (Verapamil is also a calcium channel blocker and works similar to it)
    • decreases myocardial contract force, and slows SA and AV conduction-also dilates coronary/peripheral vessels
    • Used for-
    • Supraventricular Tachycardia after not responding to Adenosine
    • AFib and AFlutter w/rapid ventricular response
    • 100mg powered form vial, because fluid must be refrigerated

  34. Ondansetron
    • Zofran
    • Antiemetic agent (keep from vomiting)
    • selectively blocks serotonin 5-HT3 receptors in CNS @ chemoreceptor trigger zone and in Peripheral nervous of the vagus nerve
    • Use for-
    • Nausea Vomiting
    • 4mg/2ml vials x 1-2

  35. Nitrous Oxide
    • Nitronox
    • Anagesic/inhalation
    • Centrally acting agent-makes CNS depression & elevate pain threshold
    • Use for-
    • PAIN from:
    • trauma, burns, AMI (severe pain)
    • machine-delivers nitrous oxide & O2 (50:50) separate tanks and self admin mask
    • optional item, seldom carried due to size

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