Meds O-R

Home > Preview

The flashcards below were created by user cgazzard on FreezingBlue Flashcards.


  1. Ondansetron Classification
    Antiemetic
  2. Ondansetron Indications
    N/V with chemotherapy, gastroenteritis, head injury or refractory to other Tx.
  3. Ondansetron Mechanisms of Action
    Blocks serotonin (5-HT3) receptors in CTZ, GI tract and VC (vomiting centre = medulla)
  4. Ondansetron Adverse Effects
    QT prolongation
  5. Ondansetron Contraindications
    Hypersensitivity
  6. Ondansetron Dosage

    Adult:
    Peds:
    8mg IM or in 50ml over 15min

    • Peds: <4y/o 2mg PO
    •          >y/o 4mg PO

    or 0.1mg/kg IV max 4mg in 50ml over 15min
  7. Ondansetron Onset/Peak/Duration
    • Onset: 15-30min
    • Peak: 1-1.5hr
    • Duration: 6-12hrs
  8. Oxytocin Classification
    Hormone
  9. Oxytocin Indications
    • 1. Delivery
    • 2. Post partum hemorrhage
  10. Oxytocin Mechanisms of Action
    • 1. Stimulates contraction of uterine smooth muscle.
    • 2. Has vasopressor/antiduiretic effects
  11. Oxytocin Side Effects
    • 1. Fluid retension ↠ hyponatremia and hypochloremia
    • 2. Hypotension
    • 3. Uterine rupture
  12. Oxytocin Contraindications
    • 1. Hypersensitivity
    • 2. Uterine inversion
    • 3. Placenta previa
    • 4. Placenta abruptio
    • 5. If subsequent fetus not yet delivered
  13. Oxytocin Dosing
    • Delivery: 10u IM
    • Hemorrhage: 6u/hr = 40u in 1000ml = 150ml/hr
  14. Pancuronium (Pavulon) Classification
    Long acting nondeplolarizing neuromuscular blocking agent.
  15. Pancuronium (Pavulon) Indications
    • RSI
    • Surgery
  16. Pancuronium (Pavulon) Mechanisms of Action
    • 1. Blocks ACh from binding to postsynaptic receptors by competitively binding to without stimulating depolarization.
    • 2. Selectively blocks Vagus nerve resulting in tachycardia, arrhythmias and HTN
  17. Pancuronium (Pavulon) Side Effects
    • 1. Bronchospasm
    • 2. Tachycardia
    • 3. HTN
    • (4. ↑ ICP - preferable to use vecuronium in theres pts.)
  18. Pancuronium (Pavulon) Contraindications
    Hypersensitivity to bomides
  19. Pancuronium (Pavulon) Onset/Peak/Duration
    • Onset: 30-45sec
    • Peak: 3-5min
    • Duration: 30-60min
  20. Pancuronium (Pavulon) Dosing
    • 0.04-0.1mg/kg
    • infusion of 0.1mg/kg/hr

    Peds is the same
  21. Pentastarch (Pentaspan) Classification
    Plasma Volume Expander
  22. Pentastarch (Pentaspan) Indication
    Shock, volume depletion. Situations where volume expansion is needed.
  23. Pentastarch (Pentaspan) Mechanisms of Action
    Hypertonic solution that increases osmotic force and pulls fluid into vascular space from interstital space for 18-24hrs.
  24. Pentastarch (Pentaspan) Side Effects
    • 1. Coagulation disorders
    • 2. H/A
    • 3. Edema
    • 4. CP
    • 5. Fever
  25. Pentastarch (Pentaspan) Contraindications
    • 1. Hypersensitivity to hydroxyethyl
    • 2. Bleeding disorders
    • 3. CHF
    • 4. Renal failure with anuria/oliguria
  26. Pentastarch (Pentaspan) Dosage
    500-2000ml bolus

    No ped dose
  27. Phenobarbital (Luminal) Classification
    • Long acting Barbiturate
    • Anticonvulsant
    • Hypnotic
    • Sedative
  28. Phenobarbital (Luminal) Indications
    • 1. Tx of status epilepticus refractory to standard Tx - 2nd line agent.
    • 2. Febrile seizure
  29. Phenobarbital (Luminal) Mechanisms of Action
    • 1. Prosuces all levels of CNS depression - sensory cortex, motor activity and alters cerebellar function.
    • 2. Increases seizure threshold by mimicking GABA effects.
    • 3. Speeds up liver enzymes that metabolize drugs and bilirubin.
  30. Phenobarbital (Luminal) Side Effects
    • 1. Sedation
    • 2. Resp Depression
    • 3. Hypotension
    • 4. Bronchospasm
    • 5. N/V
    • (6. Neuralgia, myalgia)
  31. Phenobarbital (Luminal) Contraindications
    • 1. Hypersensitivity
    • 2. COPD/Asthma/resp difficulties
    • 3. Uncontrolled severe pain
    • 4. Severe liver disease
  32. Phenobarbital (Luminal) Dosage
    • Adult: 20mg/kg SIVP
    • Maintenance 1-3mg/kg/day

    • Peds: 20mg/kg SIVP
    • Maintenance of 6mg/kg/day
  33. Phentolamine (Rogitine) Classification
    Alpha adrenergic blocker
  34. Phentolamine (Rogitine) Indications
    • 1. HTN Crisis due to primarily pheochromocytoma
    • 2. Prevention of dermal necrosis/sloughing following extravasation of catecholamine administration (epi/norepi/dope/dobut)
  35. Phentolamine (Rogitine) Side Effects
    • 1. Cerebrovascular spasm
    • 2. Hypotension
    • 3. Tachycardia
    • 4. Angina/MI
    • 5. Arrhythmias
    • 6. N/V/D
    • 7. Abd pain
  36. Phentolamine (Rogitine) Contraindications
    • 1. Hypersensitivity
    • 2. PVD
    • 3. CAD
    • 4. cerebral atherosclerosis
  37. Phentolamine (Rogitine) dosing
    5-10mg IV
  38. Phentolamine (Rogitine) Onset/Peak/Duration
    • Onset: immediate
    • Peak: 2min
    • Duration: 15-30min
  39. Phenylephrine (Neo-Synephrine) Classification
    Sympathetic agonist
  40. Phenylephrine (Neo-Synephrine) Indications
    BP <70mmHg due to decreased peripheral vascular resistance (distributive shock), not a first line agent
  41. Phenylephrine (Neo-Synephrine) Mechanisms of action
    Acts almost exclusively of alpha receptors increasing vascular resistance and BP
  42. Phenylephrine (Neo-Synephrine) Onset/Peak/Duration
    • Onset: immediate
    • Peak: <1min
    • Duartion: 15-20min
  43. Phenylephrine (Neo-Synephrine) Contraindications
    1. Cardiogenic shock
  44. Phenylephrine (Neo-Synephrine) Side Effects
    • 1. Angina
    • 2. HTN
    • 3. Nervousness/H/A
    • 4. blurred vision
    • 5. lacrimation
    • 6. urinary retention
    • 7. arrhythmias
    • 8. N/V
  45. Phenylephrine (Neo-Synephrine) Dosage
    • 100-180mcg/min
    • Maintenance of 46-60mcg/min
  46. Phenytoin Classifications
    • 1. Anticonvulsant
    • 2. Class 1B Antiarrythmic
  47. Phenytoin Indications
    • 1. Status epilepticus refractory of other Tx (benzos etc)
    • 2. Neuropathic pain
    • 3. Ventricular arrhythmias due to digitalis toxicity
  48. Phenytoin Mechanisms of Action
    • 1. Blocks Na and Ca channels in neurons, stabilizing cell membranes. This increases threshold activity in brain, prevents spread of seizure activity and decreases speed of conduction through a neuron.
    • 2. Highly bound to plasma protein so a low serum concentration of albumin (malnourishment or chronic renal failure) there is an increased in free, unbound active phenytoin in blood.
    • 3. Antiarrhythmic: normalizes Na and Ca influx in Purkinje fibers and accelerates repolarization period.
  49. Phenytoin Side Effects
    • 1. Hypotension
    • 2. Arrhythmias
    • 3. Ataxia
    • 4. Nystagmus
    • 5. Slurred speech
    • 6. Encephalophathy

    Green = OD (narrow therapeutic index)
  50. Phenytoin Contraindication
    • 1. Hypersensitivity to hydrantoins, propylene glycol, and ethanol
    • 2. Bradycardia/Severe Heart blocks
    • 3. TCA ingestion - promotes further seizures.
    • 4. Chronic admin
  51. Phenytoin Dosing

    Adult:
    Peds
    Adult: 15-20mg/kg IV no faster than 50mg/min

    Peds: 15-20mg/kg no faster than 1mg/kg/min or 50mg/min.
  52. Phenytoin Onset/Duration/ Half Life
    • Onset 5-30min
    • Duration: 12-24hrs
    • Half Life: 10-60hrs
  53. Potassium Chloride (Slow-K, K-Dur) Classification
    Electroly
  54. Potassium Chloride Indication
    Hypokalemia
  55. Potassium Chloride Mechanisms of Action
    • Potassium is needed for:
    • - Metabolic enzymatic reactions
    • - conduction of nerve impulses
    • - renal function
    • - acid-base balance
    • - tissue synthesis
    • - carbohydrate metabolism
  56. Potassium Chloride Side Effects
    • 1. Arrhythmias/cardiac arrest
    • 2. Confusion
    • 3. Restlessness
    • 4. N/V/D
    • 5. Abd pain
  57. Potassium Chloride Contraindications
    • 1. Severe renal impairment
    • 2. Hyperkalemia
  58. Potassium Chloride Dosage

    Adult:

    Peds:
    Adult: 20-40mEq/day depending on severity, not to exceed 10-20mEq/hr.

    Peds: 0.5-1mEq/kg, max 30mEq
  59. Prednisone Classification
    corticosteriod
  60. Prednisone Indications
    • 1. Bronchospasm
    • 2. Immunosuppressant purposes
  61. Prednisone Mechanisms of action
    • 1. Prevents accumulation of inflammatory cells, including macrophages and leukocytes.
    • 2. Inhibits lysosomal enzyme release and synthesis of chemical mediators of inflammation.
  62. Prednisone Side Effects
    • 1. Increased intraocular pressure
    • 2. HF, cardiac edema
    • 3. HF
    • 4. HTN
    • 5. tooo many to list
  63. Prednisone Contraindications
    • 1. Pts already taking prednisone
    • 2. Hypersensitivity
    • 3. Systemic infections
  64. Prednisone Dosage
    50mg PO
  65. Procainamide (Procan) Classification
    Class 1A antiarrhythmic
  66. Procainamide (Procan) Indications
    • 1. VT
    • 2. WPW
    • 3. SVTs/A-fib
    • 4. Suppression of PVCs
  67. Procainamide (Procan) Mechanisms of Action
    • 1. Stabilizes cell membranes by blocking Na channels depressing myocardial excitability
    • 2. Increases action potential duration
    • 3. Prolongs effective refractory period time by decreasing repolarization
    • 4. Decreases or eliminates ectopic foci stimulation
    • 5. Anticholinergic activity
    • 6. Negative inotropic effect
  68. Procainamide (Procan) Side effects
    • 1. ++ CNS effects including seizures, confusion
    • 2. ++ Arrhythmias - ventricular, QT prolongation
    • 3. Blood disorders
    • 4. N/V/D
    • 5. Fever
    • 6.... Lots more
  69. Procainamide (Procan) Contraindications
    • 1. Hypersensitivity
    • 2. 2nd and 3rd degree blocks
    • 3. Torsades
  70. Procainamide (Procan) Dosing
    • 20-50mg/min until :
    • 1. Arrhythmia suppressed
    • 2. Hypotension
    • 3. QRS widens by 50%
    • 4. Max of 17mg/kg

    Maintenance of 1-4mg/min
  71. Prochlorperazine (Stemetil) Classifications
    • 1. Antiemetic
    • 2. Antipsychotic
  72. Prochlorperazine (Stemetil) Indications
    • 1. N/V
    • 2. Psychosis
  73. Prochlorperazine (Stemetil) Mechanisms of Action
    • 1. Blocks Dopamine D2 receptors in CTZ.
    • 2. Blocks Vagus nerve in GI tract
    • 3. Alpha blocking activity
  74. Prochlorperazine (Stemetil) Side Effects
    • 1. EPS
    • 2. Anticholinergic effects
    • 3. Neuroleptic malignant syndrome
    • 4. Hypotension
  75. Prochlorperazine (Stemetil) Contraindications
    • 1. Hypersensitivity to or to bisulfites or benzyl alcohol
    • 2. Seizures
    • 3. Encephalopathy
    • 4. Parkinson's
  76. Prochlorperazine (Stemetil) Dosing
    • 2.5-10mg IV tid-qid
    • 5-10mg IM tid-qid
  77. Propranolol (Inderal) Classification
    Non-selective β blocker
  78. Propranolol (Inderal) Indications
    • 1. HTN
    • 2. MI/Angina
    • 3. Rate control with SVTs/Afib
    • 4. Tachyarrhythmias with cardiac glycoside ingestion, thyrotoxicosis (excessive thyroid hormones)
    • 5. Migraines
  79. Propranolol (Inderal) Side Effects
    • 1. Bronchospasm
    • 2. Hypotension
    • 3. Bradycardia/Heart Blocks
    • 4. CHF/pul edema
    • 5. Arrhythmias
    • 6. Fatigue/dizziness/weakness
  80. Propranolol (Inderal) Contraindications
    • 1. Hypersensitivity
    • 2. Bradycardia/Heart blocks
    • 3. Asthma/COPD
    • 4. CHF/Cardiogenic shock
  81. Propranolol (Inderal) Dosing

    Adult:

    Ped:
    Adult: 1-3mg in D5W (10-30ml) over 2min. May repeat x1 in 2min.

    Ped: 10-100mcg/kg, max 1mg over 2min q6-8hrs prn
  82. Propofol (Diprivan) Classification
    • General Anesthetic
    • Ultra short acting hypnotic
  83. Propofol (Diprivan) Indications
    • Anesthesia
    • Sedation/maintenance of
  84. Propofol (Diprivan) Mechanisms of Action
    • 1. Specific mechs are ukn, ultra short acting sedative
    • 2. Potent resp and cardiovascular depressant
    • 3. No analgesic properties
    • 4. Vasodilation
  85. Propofol (Diprivan) Side Effects
    • 1. Severe resp depression/apnea
    • 2. Bradycardia
    • 3. Hypotension
    • 4. Pain/stinging at injection site
    • 5. Twithcing extremities
  86. Propofol (Diprivan) Contraindications
    • 1. Hypersensitivity to or to soybean oil, egg lecithin, or glycerol
    • 2. Peds <3y/o
  87. Propofol (Diprivan) Dosage
    • Induction: 1-3mg/kg in D5W only
    •              or 40mg prn until sedation

    • Maintenance: 100-200mcg/kg/min for first 30min, then reduce dose by 30-50%.
    •              or: 25-50mg prn

    Degrades plastic

    Vents: 5-50mcg/kg/min

    Peds = same as adult
  88. Propofol (Diprivan) Onset/Duration
    • Onset: immediate
    • Duration: 3-5min
  89. Racemic Epinephrine (Vaponefrin) Indications
    1. Laryngo/bronchospasm - croup mainly, asthma, bronchitis, bronchiolitis
  90. Racemic Epinephrine (Vaponefrin) Dosing
    0.25-5ml 2.25% solution (mixed with 3ml NS if necessary) neb q 5min prn.
  91. Ranitidine (Zantac) Classification
    Histamine H2 receptor antagonist
  92. Ranitidine (Zantac) Indications
    • 1. GERD
    • 2. Peptic ulcers
    • 3. Indigestion
    • 4. Zollinger-Ellison Syndrome (excessive HCl secreting)
  93. Ranitidine (Zantac) Side Effects
    • Rarely any
    • (confusion)
  94. Ranitidine (Zantac) Mechanisms of Action
    • 1. Copetitively blocks H2 receptors of parietal cells, decreasing responsiveness to histamine, ACh and gastrin. This reduced acid secretion by up to 90%.
    • 2. Stomach pH increases
    • 3. Increases prolactin secretion from anterior pituitary
  95. Ranitidine (Zantac) Contraindications
    Hypersensitivity
  96. Ranitidine (Zantac) Dosing
    Adult:
    Ped:
    Adult: 50mg IV/IM q4-6hrs, max 400mg/day

    Peds: 2-4mg/kg/day divided into 3-4 doses/day
  97. Reteplase (Retavase) Classification
    Fibrinolytic
  98. Reteplase (Retavase) Indication
    AMI
  99. Reteplase (Retavase) Mechanisms of action
    1. Catalyzes conversion of plasminogen into plasmin. Plasmin degrades the fibrin matrix of clots.
  100. Reteplase (Retavase) Side Effects
    • 1. Bleeding
    • 2. Reperfusion arrhythmias
    • 3. N/V
    • 4. Fever
    • 5. Anaphylaxis
  101. Reteplase (Retavase) Contraindications
    • 1. Prior intracranial hemorrhage
    • 2. CVA lesion
    • 3. Malignant intracranial neoplasm
    • 4. Ischemic stroke within 3 months except acute within 3 hrs
    • 5. Aortic dissection
    • 6. Active bleeding
    • 7. Significant closed head trauma of facial trauma within 3 months

    • Relative:
    • 1. Poorly/uncontrolled HTN
    • 2. Uncontrolled HTN sys >180 or DBP >110
    • 3. Ischemis stroke >3 months
    • 4. Traumatic or prolonged CPR or major bleed within 3 weeks
    • 5. Recent intracranial bleed (2-4wks)
    • 6. Noncompressible vascular punctures
    • 7. Strptokinase/anitrplase greater than 5 days
    • 8. Pregnancy
  102. Reteplase (Retavase) Dosing
    10u IV over 2min q30min max 20u.
  103. Rocuronium (Zemuron) Classification
    Intermediate acting Nondepolarizing neuromuscular blocking agent
  104. Rocuronium (Zemuron) Indications
    • RSI
    • Surgery
    • Maintenance of paralysis
  105. Rocuronium (Zemuron) Mechanisms of Action
    1. Blocks ACh from binding to postsynaptic receptors by competitively binding to without stimulating depolarization.
  106. Rocuronium (Zemuron) Side Effects
    1. Bronchospasm
  107. Rocuronium (Zemuron) Contraindications
    Hypersensitivity to or to bromide
  108. Rocuronium (Zemuron) Dosing
    1mg/kg repeat 0.5mg/kg q10min prn

    Peds = same
  109. Rocuronium (Zemuron) Onset/Peak/Duration
    • Onset: 1-3min
    • Duration 30-60min
  110. Ritodrine (Yutopar) Info
    Discontinued tocolytic

    β2 agonist that relaxes uterine smooth muscle and supression of preterm labour.

    50-350mcg/min IV

Card Set Information

Author:
cgazzard
ID:
319960
Filename:
Meds O-R
Updated:
2016-05-10 23:24:47
Tags:
Meds
Folders:

Description:
Paramedic Meds O-R
Show Answers:

Home > Flashcards > Print Preview