meds.txt

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Anonymous
ID:
94739
Filename:
meds.txt
Updated:
2011-07-21 00:15:29
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EMR meds
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EMR meds
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  1. ASA - everything?
    • (Acetylsalicylic Acid)
    • PROTOCOLS:
    • Offline
    • DOSE:
    • 160-325mg (generally start with the lowest dose)
    • INDICATIONS:
    • Ischemic Chest Pain (angina or MI)
    • CONTRAINDICATIONS:
    • Allergy to ASA
    • Bleeding disorders (eg: hemophilia)
    • Unconscious
    • SIDE EFFECTS:
    • GI upset
    • N/V
    • Heart Burn
    • PRECAUTIONS:
    • Asthma - May produce bronchoconstriction in asthmatics
    • Active ulcer disease
    • Impaired renal or hepatic function
    • Children and adolescents with influenza or chickenpox infections (May increase the risk of Reye's syndrome - a rare but serious illness in childhood that has a modality rate 20-30%, Symptoms are encephalopathy and fatty liver degeneration)
    • PHARMACODYNAMICS:
    • At low doses, appears to impede clotting by blocking prostaglandin synthesis, which prevents formation of platelet-aggregating substance (this is irreversible) called thromboxane A2
    • ADMINISTRATION:
    • ASA must be chewed & swallowed for proper absorption rate
  2. ASA DOSE?
    160-325mg (generally start with the lowest dose)
  3. ASA INDICATIONS?
    Ischemic Chest Pain (angina or MI)
  4. ASA CONTRAINDICATIONS:
    • Allergy to ASA
    • Bleeding disorders (eg: hemophilia)
    • Unconscious
  5. ASA SIDE EFFECTS?
    • GI upset
    • N/V
    • Heart Burn
  6. ASA PRECAUTIONS?
    • Asthma - May produce bronchoconstriction in asthmatics
    • Active ulcer disease
    • Impaired renal or hepatic function
    • Children and adolescents with influenza or chickenpox infections (May increase the risk of Reye's syndrome - a rare but serious illness in childhood that has a modality rate 20-30%, Symptoms are encephalopathy and fatty liver degeneration)
  7. ASA PHARMACODYNAMICS?
    At low doses, appears to impede clotting by blocking prostaglandin synthesis, which prevents formation of platelet-aggregating substance (this is irreversible) called thromboxane A2
  8. ASA ADMINISTRATION?
    ASA must be chewed & swallowed for proper absorption rate
  9. ORAL GLUCOSE - everything?
    • PROTOCOLS:
    • Offline
    • INDICATIONS:
    • S/S of hypoglycemia with BGL <3.8mmol/L:
    • hunger
    • shakiness
    • nervousness
    • sweating
    • dizziness or light-headedness
    • sleepiness
    • confusion
    • difficulty speaking
    • anxiety
    • weakness
    • CONTRAINDICATIONS:
    • Unconscious
    • Pt unable to follow commands
    • Hyperglycemia: (Blurred vision, Fatigue, Dry mouth, Dry or itchy skin)
    • SIDE EFFECTS:
    • N/V
    • PRECAUTIONS:
    • May cause N/V or Pt may gag when administered
    • PHARMACODYNAMICS:
    • Monosaccharide given orally & readily absorbed
    • ADMINISTRATION:
    • Swallowed for proper absorption rate
    • Tongue depressor, or simply squeezed into mouth by Pt
  10. ORAL GLUCOSE PROTOCOLS?
    Offline
  11. ORAL GLUCOSE INDICATIONS?
    • S/S of hypoglycemia with BGL <3.8mmol/L:
    • hunger
    • shakiness
    • nervousness
    • sweating
    • dizziness or light-headedness
    • sleepiness
    • confusion
    • difficulty speaking
    • anxiety
    • weakness
  12. ORAL GLUCOSE CONTRAINDICATIONS?
    • Unconscious
    • Pt unable to follow commands
    • Hyperglycemia: (Blurred vision, Fatigue, Dry mouth, Dry or itchy skin)
  13. ORAL GLUCOSE SIDE EFFECTS?
    N/V
  14. ORAL GLUCOSE PRECAUTIONS?
    May cause N/V or Pt may gag when administered
  15. ORAL GLUCOSE PHARMACODYNAMICS?
    Monosaccharide given orally & readily absorbed
  16. ORAL GLUCOSE ADMINISTRATION?
    • Swallowed for proper absorption rate
    • Tongue depressor, or simply squeezed into mouth by Pt
  17. SALBUTAMOL - everything?
    • aka (Ventolin)
    • PROTOCOLS:
    • ONLINE! Must be Pt’s & have a Px
    • DOSE:
    • 6 to 20 puffs of MCI. Each MCI = 100mcg/spray.
    • INDICATIONS:
    • Severe bronchospasm due to COPD, or dyspnea from Asthma
    • CONTRAINDICATIONS:
    • Allergic to Salbutamol
    • SIDE EFFECTS:
    • Nervousness
    • Headache
    • Tachycardia
    • Palpitations
    • N/V
    • Transient muscle cramps
    • Muscle tremors
    • weakness
    • PRECAUTIONS:
    • NOT to be used on Pt. presenting with acute heart failure, or CVD
    • Risk of hyperglycemia in diabetics
    • Hypokalemia - a lower-than-normal amount of potassium in the blood, which can be further lowered by this med.
    • PHARMACODYNAMICS:
    • Binds to Beta-2 receptor sites promoting bronchodilation. Also activates cardiac receptors (B1) explaining increased Heart Rate and BP
    • ADMINISTRATION:
    • Shake for 30-60 seconds
    • Breath in and hold as per obvious
  18. SALBUTAMOL PROTOCOLS?
    ONLINE! Must be Pt’s & have a Px
  19. SALBUTAMOL DOSE?
    6 to 20 puffs of MCI. Each MCI = 100mcg/spray.
  20. SALBUTAMOL INDICATIONS?
    Severe bronchospasm due to COPD, or dyspnea from Asthma
  21. SALBUTAMOL CONTRAINDICATIONS?
    Allergic to Salbutamol
  22. SALBUTAMOL SIDE EFFECTS?
    • Nervousness
    • Headache
    • Tachycardia
    • Palpitations
    • N/V
    • Transient muscle cramps
    • Muscle tremors
    • weakness
  23. SALBUTAMOL PRECAUTIONS?
    • NOT to be used on Pt. presenting with acute heart failure, or CVD
    • Risk of hyperglycemia in diabetics
    • Hypokalemia - a lower-than-normal amount of potassium in the blood, which can be further lowered by this med.
  24. SALBUTAMOL PHARMACODYNAMICS?
    Binds to Beta-2 receptor sites promoting bronchodilation. Also activates cardiac receptors (B1) explaining increased Heart Rate and BP
  25. SALBUTAMOL ADMINISTRATION?
    • Shake for 30-60 seconds
    • Breath in and hold as per obvious
  26. IPRATROPIUM BROMIDE - everything?
    • aka (Atrovent)
    • PROTOCOLS:
    • ONLINE! Must be Pt’s & have a Px
    • DOSE:
    • 4 to 10 puffs of MCI. Each MCI = 20mcg/spray.
    • INDICATIONS:
    • Severe bronchospasm due to COPD, or dyspnea from Asthma
    • CONTRAINDICATIONS:
    • Allergic to Ipratropium or atropine
    • Allergic to soy lethicin or sooy, peanuts (it’s the propellant)
    • Children under 5
    • SIDE EFFECTS:
    • Nervousness
    • Headache
    • Tachycardia
    • Palpitations
    • N/V
    • Transient muscle cramps
    • Muscle tremors
    • Weakness
    • PRECAUTIONS:
    • Pt’s with narrow angle glaucoma
    • Don’t spray in any Pt’s eyes!
    • PHARMACODYNAMICS:
    • Inhibits Parasympathetic bronchoconstriction, resulting in open lower airway and bronchodilation.
    • ADMINISTRATION:
    • Shake for 30-60 seconds
    • Breath in and hold as per obvious
  27. IPRATROPIUM BROMIDE PROTOCOLS?
    ONLINE! Must be Pt’s & have a Px
  28. IPRATROPIUM BROMIDE DOSE?
    4 to 10 puffs of MCI. Each MCI = 20mcg/spray.
  29. IPRATROPIUM BROMIDE INDICATIONS?
    Severe bronchospasm due to COPD, or dyspnea from Asthma
  30. IPRATROPIUM BROMIDE CONTRAINDICATIONS?
    • Allergic to Ipratropium or atropine
    • Allergic to soy lethicin or sooy, peanuts (it’s the propellant)
    • Children under 5
  31. IPRATROPIUM BROMIDE SIDE EFFECTS?
    • Nervousness
    • Headache
    • Tachycardia
    • Palpitations
    • N/V
    • Transient muscle cramps
    • Muscle tremors
    • Weakness
  32. IPRATROPIUM BROMIDE PRECAUTIONS?
    • Pt’s with narrow angle glaucoma
    • Don’t spray in any Pt’s eyes!
  33. IPRATROPIUM BROMIDE PHARMACODYNAMICS?
    Inhibits Parasympathetic bronchoconstriction, resulting in open lower airway and bronchodilation.
  34. IPRATROPIUM BROMIDE ADMINISTRATION?
    • Shake for 30-60 seconds
    • Breath in and hold as per obvious
  35. EPINEPHRINE - Everything?
    • PROTOCOLS:
    • ONLINE!
    • DOSE:
    • 0.3mg given IM at lateral aspect of thigh
    • INDICATIONS:
    • Anaphylaxis
    • CONTRAINDICATIONS:
    • None in emergent setting
    • SIDE EFFECTS:
    • Nervousness
    • Headache
    • Palpitations
    • N/V
    • Angina
    • Dyspnea
    • Pallor
    • Cardiac arrhythmias
    • Acute hypertension
    • PRECAUTIONS:
    • Use with geriatrics
    • Acute hypertention (BP over 140/90 that doesn’t respond to meds)
    • Cardiac History
    • Pulmonary Edema
    • PHARMACODYNAMICS:
    • Binds to Alpha-1, Beta-1, and Beta-2 receptors of sympathetic system, resulting in bronchodilation and drying of bronchial mucus membranes. Activation of Alpha & Beta receptors explains increased HR & BP
    • ADMINISTRATION:
    • Injected into lateral aspect of thigh at 90deg angle, held in place for 10 seconds. Place needle in sharps container after. Massage site to encourage blood flow at site.
  36. EPINEPHRINE PROTOCOLS?
    ONLINE!
  37. EPINEPHRINE DOSE?
    0.3mg given IM at lateral aspect of thigh
  38. EPINEPHRINE INDICATIONS?
    Anaphylaxis
  39. EPINEPHRINE CONTRAINDICATIONS?
    None in emergent setting
  40. EPINEPHRINE SIDE EFFECTS?
    • Nervousness
    • Headache
    • Palpitations
    • N/V
    • Angina
    • Dyspnea
    • Pallor
    • Cardiac arrhythmias
    • Acute hypertension
  41. EPINEPHRINE PRECAUTIONS?
    • Use with geriatrics
    • Acute hypertention (BP over 140/90 that doesn’t respond to meds)
    • Cardiac History
    • Pulmonary Edema
  42. EPINEPHRINE PHARMACODYNAMICS?
    Binds to Alpha-1, Beta-1, and Beta-2 receptors of sympathetic system, resulting in bronchodilation and drying of bronchial mucus membranes. Activation of Alpha & Beta receptors explains increased HR & BP
  43. EPINEPHRINE ADMINISTRATION?
    Injected into lateral aspect of thigh at 90deg angle, held in place for 10 seconds. Place needle in sharps container after. Massage site to encourage blood flow at site.
  44. NITROGLYCERIN - everything?
    • aka (Nitrostat)
    • PROTOCOLS:
    • NOT ALLOWED!
    • DOSE:
    • 0.4mg SL spray
    • INDICATIONS:
    • Suspected Angina or MI
    • CONTRAINDICATIONS:
    • Systolic BP <100
    • Viagra within last 24hrs
    • Ciallis within last 36hrs
    • Levitra within last 48hrs
    • SIDE EFFECTS:
    • Lightheadedness
    • Headache
    • Dizziness
    • N/V
    • Syncope (Loss of consciousness)
    • PHARMACODYNAMICS:
    • Antianginal: relaxes vascular smooth muscle of both arterial and venous beds, causing net decrease of Myocardial O2 consumption.
    • Dilates coronary vessels redistributing blood to ischemic tissue.
    • Vasodilating: Dilates peripheral vessels, decreasing venous return to the heart which treats pulmonary edema and heart failure. Also reduces left ventricular load aiding a failing heart.
  45. NITROGLYCERIN PROTOCOLS?
    NOT ALLOWED!
  46. NITROGLYCERIN DOSE:
    0.4mg SL spray
  47. NITROGLYCERIN INDICATIONS:
    Suspected Angina or MI
  48. NITROGLYCERIN CONTRAINDICATIONS:
    • Systolic BP <100
    • Viagra within last 24hrs
    • Ciallis within last 36hrs
    • Levitra within last 48hrs
  49. NITROGLYCERIN SIDE EFFECTS:
    • Lightheadedness
    • Headache
    • Dizziness
    • N/V
    • Syncope (Loss of consciousness)
  50. NITROGLYCERIN PHARMACODYNAMICS:
    • Antianginal: relaxes vascular smooth muscle of both arterial and venous beds, causing net decrease of Myocardial O2 consumption.
    • Dilates coronary vessels redistributing blood to ischemic tissue.
    • Vasodilating: Dilates peripheral vessels, decreasing venous return to the heart which treats pulmonary edema and heart failure. Also reduces left ventricular load aiding a failing heart.

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