Pharmacology Final Study Guide Flashcards

Cardiac arrest
Terms Definitions
A drug that blocks the effect of another drug is referred to is?
Antagonist
An Agonist: Causes expected response.
Decreased drug responsiveness which sometimes occur with chronic administration is termed?
tolerance
Individual variations in a drug's response may be caused by differences in?
Age, state of perfusion, underlying disease, dose, distribution, weight, route of administration, other medications, condition patient, absorption rate, and elimination.
The term used to describe the combined effects of two drugs which are greater than the sum of their individual effects is termed?
Synergism: 1+1=3
The pattern of distribution of any given drug will often determine?
Onset or rate of action: depending on where you have the IV, or where you injected the patient will determine how fast the drug will take to work.
Drugs that cause and increased cardiac force are referred to as?
Inotropic: increases the contractile force. (Dopamine)
A patient with which of the following Hx would alert you to observe for prolonged action of a drug?
Liver disease, Hypothermia, Age.
IM, SC injections are generally contraindicated in patients who are?
Hypothermia, MI, or other situations that will not allow perfusion from injection site to the heart.
If a medication is order that is contraindicated for a patient, the paramedic should first?
Confirm the order and document.
Which of the following solutions is hypertonic?
Hypertonic: a solution with a greater amount of solute than another. Dextrose (D50)
Hypotonic: D5w IV Bag or ½ normal saline
When a patient has PEA, the first line drug is?
Epinephrine 1mg
Atropine, with a heart rate <60
Which of the following drugs might be effective in reducing the pulmonary edema associated with CHF?
Nitro, Lasix, Morphine: all are vasodilators.
Upon arrival at the scene you find a patient on the ground who is cool, pinpoint pupils, respertions 8 shallow, after providing an airway, breathing and starting your IV. What medication would you administer?
Narcan 0.4 – 2mg up to 10mg for any suspected narcotic, ALOC Pt.
The hospital orders 10mg of a drug. Your vial shows grains 0.25/ml How many mL’s will you give the patient?
0.66 mL
The infant does of a drug is 10mcg. The adult dose is 10mg. The infant does is what of the adult dose?
1/1000
How many kg’s does a 154 lbs patient weigh?
70kg
The most predominate side effect with the use of Nitro is?
Hypotension.
A 45 y/o Pt with a Hx of angina claims to have hand sever chest pain for 45 minutes. She was initially alert but is now drowsy, cool and perspiring and her pulse is 45 and irregular. B/P 86/60, ECG shows varying degrees of bradycardia. The first drug to a
O2, Atropine, TCP.
The side effects of atropine include?
Tachycardia, VF, VT, Ischemia due to increased workload.
Atropine is indicated in all of the following except
2nd or 3rd degree HB.
The hospital orders 1mg/kg for a patient who weighs 220lbs. how many mg’s will you administer?
1/1000
The patient is taking digitalis. The pharmacological results hoped for with digitalis therapy is?
increased myocardial contractile force and cardiac output, indicated in CHF, A-fib, A-flutter, PAT (paroxysmal atrial tachycardia)
Propranolol is used in the treatment of? (Beta-blocker)
Hypertension, angina
A 55 year old patient is taking propranolol at home. Which of the following drugs might you expect to be less effective on account of the propranolol?
Sympathomimetics, B2 specific.
A selected beta-2 sympathomimetic might be less effective if the patient is taking?
Beta-blocker
Which of the following patient conditions would likely be taking Zantac?
GI ulcer.
Adenosine may be indicated for which of the following rhythms?
SVT
Which of the following agents are known to directly inhibit the cellular uptake of Adenosine and therefore potentate its effects
Potentate: Adds to the therapeutic effects of a drug.
Dipyridamole.
Adenosine is antagonized by methylxanthines such as caffeine and theophylline. Need to give more of the drug for its therapeutic effects to work. Potentate need to give less of the drug.
The initial milligram does of Adenosine is?
6mg
The contraindications for the use of Adenosine may include?
second or third degree HB
Alupent is indicated for? Beta2 specific.
Bronchial spasm/asthma
The side effects of Alupent are?
Tachycardia, dysrythmias
The dose of Alupent by nebulizer is?
0.2 - 0.3 mL of 5% solution in 2.5 mL of N/S
Pitocin (oxytocin) is given for?
to increase uterine contractions in order to stop bleeding.
The side effect of Pitocin include?
Water retention, uterine rupture, subarachnoid rupture.
Lasix is indicated in?
CHF, pulmonary edema
The standard dose of Lasix is?
40-120mg
Morphine produces all of the following effects?
CNS, respiratory depression, vasodilation, decreases preload.
A patient with severe abdominal pain of unknown etiology, which of the following medications would be contraindicated?
MS
Upon arrival you find a 47 year old patient complaining of lightheadedness and severe dyspnea. The physical exam shows JVD, left ventricular failure, pitting edema, rales, B/P 150/80 Resp.28 labored. The patients ECG shows accelerated atrial tachycardia.
O2, Nitro, Lasix, MS
Morphine is indicated in?
Moderate to severe pain, AMI, pulmonary edema.
Glucagon is a?
Hormone
The standard dose range of Naloxone is?
0.4 – 2 up to 10mg every 2-3 min.
Narcan is used to reverse the respiratory depression caused by?
Opiates/narcotics.
Which of the following statements about Calcium Chloride is not true?
Decreases myocardial contraction. “Calcium Chloride increases myocardial contractility”.
Calcium Chloride is indicated in?
Hyperkalemia, Hypocalcemia, Hypermagnesemia, calcium channel blocker toxicity.
Calcium Chloride is given?
IV push 2 – 4 mg/kg of a 10% solution every 10 minutes or as needed
(8 – 16 mg/kg) for Calcium Chloride blocker OD
All of the following are true about Sodium Biacarbonate except?
“true statements” it is a buffer, it raises the pH, it is an electrolyte, alkalizing agent, is indicated for tricyclic antidepressant and barbiturate OD, Hyperkalemia (documented), may cause severe tissue necrosis if extravasated. (NaHCO3)
The dose of Sodium Bicarbonate is?
1 mEq / kg IV push followed by 0.5 mEq / kg 10min
Bretylium is indicated in?
V-tach, V-fib refractory to lidocaine.
Which of the following is the correct initial dose for administering Bretylium in ventricular fibrillation refractory to countershock?
5 mg/kg IV, then 10 mg/kg 15 – 30 min, to a max 30 mg/kg. Following conversion administer IV infusion at 1 – 2 mg/min.
When administering 50% Dextrose by direct IV push you should watch closely for?
extravasation
Dextrose 50% is indicated for?
Hypoglycemia, altered mental status of unknown origin
The neurotransmitter releases at the preganglia on both sides of the autonomic nerves system is?
ACH
Postganglian adrenergic (Sympathetic) nerves release?
“Cholinergic: Parasympathetic”
- Nor epinephrine
When treated with Epinephrine, the patient over forty with pre-existing heart disease my experience?
Myocardial ischemia, ventricular dysrythmias.
Present evidence indicates that the dose of Epinephrine injected into the tracheobronchial tree should be?
double the dose. 2 – 2.5 mg ET every 3-5 min.
Epinephrine produces its beneficial effects during cardiac arrest through an increased myocardial and cerebral blood flow due to its?
Alpha agonist properties.
Toxic reactions from Lidocaine are manifested by?
CNS depression
Lidocaine works by?
Decreases ventricular irritability
Elevates fibrillation threshold
Lidocaine used in the V-Fib, V-Tach setting is given?
rapid IV push 1 – 1.5 mg/kg
In the presence of decreased cardiac output (CHF or patients over 70) the initial dose of Lidocaine should be?
Initial dose 1 – 1.5 mg/kg then Half dose 0.5 – 0.75 mg/kg
Lidocaine is contraindicated in which of the following patients?
second or third degree heart locks, escape rhythms.
The recommended drug for a patient experiencing extrapyramidal reactions from phenothiazine is? “Dystonic reaction”
Diphenhydramine
The generic name for Benadryl is?
Diphenhydramine
Benadryl is useful in the management of acute allergic reactions because it acts by?
Histamine blocker
he standard initial dose of Benadryl is?
25mg IV / 50mg IM (DOUBLE)
For status epileptics, the initial dose of Valium should be?
adult dose 5 – 10 mg IV/IM peds does 0.5 – 2 mg IV/IM
A common side effect of Valium is?
Coma, hypotension, respiratory depression
A common complication that can be caused by IV administration of Valium is?
extravasation at IV site
Valium possesses the following activities? Diazepam
Anticonvulsant, sedative
Valium should not be given to patients?
hypotension, coma, ALOC, +ETOH
Activated Charcoal is contraindicated in poisonings of?
Metals, corrosive solutions, solvent, ethanol, methanol.
The normal dose of Activated Charcoal is?
1 gm/kg 25gm – 50gm
Activated Charcoal works by?
Absorbent and binds to toxins
Mixing 1 gram of a drug in 250ml’s will yield a concentration of?
4 / 1 solution the
1.5 liters of fluid is to be given @ 100ml’s per hour. The administration set delivers 15 gtts./ml. How many gtts./min should the patient receive?
25 gtts/min
Give 200ml’s/hour to a 70kg patient. Using a 15gtts./ml set, how many gtts/min will the patient receive?
50gtts/min
One gram is equal to how many milligrams?
1000mg = 1gm
60mg is equal to how many grains?
1 grain
Express the strength of the following ratio in mg’s per 1ml. 0.5 liters of solution containing 60 grams of a drug?
120 mg/mL (60,000mg divided by 500mL = 120mg/mL )
You have premixed 250mg’s of a drug in 100ml’s. If you infuse the drug @ 10mg/min, how many gtts./min will you give the patient?
4 gtts/min
Identify the metric unit of measurement for volume?
Liter
Infuse a premixed drug (400mg’s / 250 ml’s) @ 10mcg/kg/min. The patient weighs 176 lb. Using a 60 gtts./ml set, how many gtts/min will you give?
30 gtts gtts/min
The hospital order 0.125mg’s. Your ampule reads 0.5mg’s/2ml’s. How many ml’s will you give?
0.5mL
Give 30mg’s. Your have 150 mg’s/5ml’s. How many ml’s will you give?
1mL
Give 2mcg/min. You have premixed 1mg/250ml’s. Using a 60 gtts./mi set. How many gtts./min will you give the patient?
30 gtts
Give 250 mg’s of a drug over 8 minutes. You have 500 mg’s/10ml’s. The drug is to be added to 50 ml’s and given with 10 gtts./mi set. How many gtts./min will you give the patient?
68.75 gtts/min
A patient who weighs 176 lb is receiving 30 gtts./min of a solution of 400mg/250ml’s through a 60 gtts./mi set. How many micrograms per minute is the patient receiving?
800mcg
A patient presents with severe anaphylactic shock, B/P 60/p capillary refill 4 seconds, and severe bronchospasms. In this patient Epinephrine is useful due to its?
Smooth muscle constriction, bronchial dilation
Vistaril is given? Hydroxyzine
to manage and acute anxiety attack, to control N/V
The standard dose of Ipecac is?
30 ml PO
The mechanism of action of Verapamil?
Verapamil is a calcium channel blocker that slows AV conduction, suppresses re-entry dysrhythmias such as PSVT, and slows ventricular response to atrial tachydysrhythmias. Isoptin also dilates coronary arteries and reduces myocardial oxygen demand.
Verapamil may have which of the following side effects?
Vertigo, sleepiness, Hypotension, CHF, Bradycardia, Severe tachycardia, Edema, and AV blocks.
The usual initial dose of Verapamil is?
2.5 – 5.0mg slow IV push, every 15 to 30 min at 5 – 10mg slow IV push. Not exceeding 30mg in 30 min
Verapamil would generally be contraindicated in?
Hypotension, 2 – 3 degree HB, WPW, CHF, Beta-blockers.
The generic name for Isoptin/Calan is?
Verapamil
The mechanism of action of Magnesium Sulfate include all of the following?
Mag puts every thing to sleep
The dose of Magnesium Sulfate is?
V-Fib, V-Tach, 1 – 2gm slow IV push over 2 min
AMI 1 – 2 gm over 5 – 30 min
Torsades 1 – 2 gm followed by a drip @ 0.5 – 1 gm/hr.
Eclampsia 2 – 4 gm
If a patient were to receive an agent that dissolves thrombi you should inform the base station of the following assessment?
time of C/C onset 1 s/s and TX. For suspected MI 6 hr. for suspected CVA 3 hr.
The side effects of Isuprel include?
“Sympathomimetic”
Decadron may be given to?
anti-inflammatory (Steroid)
A 5 mcg/kg/min dose of Intropin would have wich of the following effects?
Beta 1
During a 5mcg/kg/min dose of Intropin you would anticipate?
Beta 1
In contrast to other catecholamines, Intropin @ 0.5 – 2 mcg/kg/min is likely to cause?
dilation
A Dopamine drip @ 20mcg/kg/min will likely result in?
Pure alpha
A 45 year old patient has called you for severe precordial pain approximately 1 hour. Your initial exam reveals a cold, pale and diaphoretic patient with a B/P 60p. Resp 26 shallow. The initial pharmacological intervention is?
O2, fluid, Dopamine
Nitroglycerin may?
lower B/P
The therapeutic action of the nitrates involves?
Vasodilatation Prescribed for angina and CHF
Postganglian cholinergic nerves release?
ACH
Beta 1 receptors are mainly located in the?
HEART
The major use of selective beta 2 agonists is to?
Bronchial dilate
You have responded to the chemistry department of a high school on a 17 year old patient showing bizarre behavior. Upon examination you find a vial labeled aminophylline is the ethylenediamine salt of theophylline. You know this drug to be a beta-adrenerg
rapid, tachycardia
You have arrived on scene of a patient who has ingested something labeled carbarynl. You know this product to be a mild reversible acatacholines inhibitor. The medication of choice in this setting is?
Atropine
The pediatric cardiac arrest dose of Epinephrine is?
0.01 mg/kg
The child dose of atropine in cardiac arrhythmia management is?
0.02 mg/kg
The child dose of Valium is?
0.5 – 2mg
The adult dose of Procainamide is?
20 – 30 mg/min up to 17 mg/kg
A drug that regulates blood clotting?
calcium or potassium (?)
Natural occurring neurotransmitter?
ACH, norepinephrine
Antagonizes the acts of benzodiazepine?
flumazinil
Center element of biological and chemical process?
oxygen
Opium alkaloid?
Morphine
Digitalis pharmalogical actions?
Increases cardiac output and contractablility.
our ending points of procainamide?
1. dysrhythmia is interrupted
2. toxic effects are present
3. QRS is widen greater that 50%
4. P-R is prolonged
Charcoal is classified as an?
absorbant
Steroids are used to treat patients with?
Spinal cord injury or chronic asthma.
Nitro action?
Vasodilates
define: Pharmacology
the study of drugs and their interactions with the body.
Pharmacodynamics
How a drug interacts with the body to cause its effects. Absorption, Distribution, Biotransformation, Elimination.
Pharmacokinetics
How a drug is absorbed , distributed, metabolized.
Drug names
Chemical name: Chemical composition
Generic name: Suggested by manufacture and confirmed by US adopted name council.
Official name: Listed by the US Pharmacopeia
Brand / Trade name: First letter only capitalized
Diffusion > to <
Movement of a solute from a high concentration to an area of low concentration.
Osmosis < to >
Movement of a solute from a low concentration to an area of high concentration.
Metabolism
The body breaking down chemicals in to different chemicals.
Biotransformation
Special name given to the metabolism of drugs.
Affinity
Force of attraction between a drug and a receptor.
Autonomic nervous system
The part of the nervous system that controls involuntary action.
Synapse
space between nerves
Mimetic
Mimics the effect
lytic
opposite effects
anti-platelet
Drug that decrease the formation of platelets.
Cholinesterase inhibitor
nhibits the break down of monamine oxidase. Dose not allow the break down of norepi. Prescribed for depression.
SSRI drugs
Selective serotonin reuptake inhibitors. Prescribed for depression and antipsychotic.
TCA drugs
Tricyclic antidepressant blocks the reuptake of norepinephrine and serotonin. Prescribed for depression.
ACE Inhibitor
Prevents the conversion of angiotensin I into angiotensin II. Prescribed for hypertension and CHF.
Analgesic
Drugs that relieve pain.
nticholinergic
Blocks ACH at the neuro-receptor site.
Barbiturate
Causes sedative-hypnotic effects. Seizures, anxiety meds
Benzodiazepine
Causes sedative-hypnotic effects. Seizures, anxiety, muscle relaxant.
Cardiac glycoside
Lowers heart rate while increasing contractile force. “Digoxin”
Diuretic
Stimulates the kidneys to produce urine. Prescribed for HTN and CHF.
Cardizem
Calcium Channel Blockers also called diltiazam
Propranolol and Corgard are?
Beta blockers
Beta Blockers
Blocks the effect of epinephrine at beta receptor sites. Prescribed for angina, HTN, Tachydysrhythmias.
Peds dose for Naloxone
0.01 mg/kg IV/IM
Idiosyncrasy
An unusual reaction of a drug on an individual.
Cation of extracellular fluid
sodium
0.25 or ¼ grains = how many mg
15mg
The salt concentrations of the body is?
Isotonic
Vagolytic
Increases heart rate
Cation of extracellular fluid
sodium
0.25 or ¼ grains = how many mg
15mg
The salt concentrations of the body is?
Isotonic
Vagolytic
Increases heart rate
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Term:
Definition:
Definition:

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