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A patient, 8 years old, presents with a fever. What drug will you provide?
Acetaminophen (Tylenol)
10-15 mg/kg orally
Not to exceed 50 mg/kg/24 hours
What are contraindications for Dextrose ?
Hyperglycemia, Diabetic coma, intra-cranial or intraspinal hemorrhage, anuria, dehydrated patients with delirium tremens, UNCONSCIOUS(for oral)
What is the right dose and route for activated charcoal for an adult ?
1gm/kg PO
Pharmacological action for Acetylasicylic acid (asprin)
Inhibits synthesis of prostaglandin by cyclooxygenase; inhibits platelet aggregation; has antipyretic and analgesic activity
What class of drug is Albuterol? and what is the correct dose?
Beta 2 Agonist
2.5-5.0mg in 3mL of sterile NS given as nebulized inhalation therapy over 5-15 minutes
What drug will you provide for a patient who presents with a suspected cardiac chest pain or a possible AMI patient?
Acetylsalicylic Acid (ASA, Asprin)
324mg orally
Contraindications of Oxygen
None
What is the right dose of epinephrine?
0.3 mg of 1:1000 IM using a 0.3 mL syringe or prefilled device.
What is the pharmacological action for nitroglycerin?
Organic nitrate which causes systemic venodilation, decreasing preload. Cellular mechanism: nitrate enters vascular smooth muscle and converted to nitric oxide leading to activation of cyclic guanosine monophosphate and vasodilation. Relaxes smooth muscle via dose-dependant dilation of arterial and venous beds to reduce both preload and afterload, and mycardial O2 demand. Improves coronary collateral circulation. Lower BP, increases HR, occasional paradoxical bradycardia
What is the class of drug for Ipratropium? and what is the correct dose?
Anticholinergic, respiratory
.25-.5 mg via nebulization
1-2 inhalations via metered dose inhaler
A patient, 44 years old, presents with chest pain and states "it feels like squeezing to my chest" and the following vital signs are BP 135/75 HR 105 RR 20. What medication would you provide to this patient?
Nitroglycerin
When should you not administer activated charcoal?
1. Acids or alkali ingestion unless other drugs have ingested. 2. GI obstruction 3. Unprotected airway(beware of aspiration)
The PT must be capable of protecting their airway over time.
You are about to administer dextrose to a patient, what is the right dose and route?
12-25 gm of paste, oral
Pharmacologic Action for Epinephrine
Strong alpha-adrenergic effects, which cause an increase in cardiac output and heart rate, a decrease in renal perfusion and peripheral vascular resistance, and a variable effect on BP, resulting in systemic vasoconstriction and increased vascular permeability. Strong beta-1 and moderate beta 2 adrenergic effects, resulting in bronchial smooth muscle relaxation. Secondary relaxation effect on smooth muscle of stomach, intestine, uterus, and urinary bladder
What is the class of drug for naloxone? and what is the correct dose?
Opiod reversal agent
.4 mg-2.0mg IM,SQ
When should you administer Epinephrine?
Severe bronchospasm, anaphylaxis, cardiac arrest, symptomatic bradycardia refractory to other treatments, shock,
Contraindications of nitroglycerin
Hypersensitivity, severe hypotension (SBP<90mm Hg or > or = 30 mm Hg below baseline), increased intra-cranial pressure, severe anemia, extreme bradycardia(<50 bpm), tachycardia in the absence of heart failure (> 120 bpm), confirmed right ventricular infarction
What is the right dose and right route for nitroglycerin?
0.3-0.4 mg tablet. Sublingual
Repeat 3-5 minutes as needed to a total of three tablets, or more by MCEP order.
What is the class of drug for nitroglycerin?
Nitrates, anti-anginal agent/vascular dilating agent
What is the class of drug for Epinephrene?
Sympathomimetic, alpha/beta adrenergic agonist
Oxygen flow for NC, NRB, BVM
NC 2-6 L/min, NRB 8-12 L/min , BMV 15 L/min
Contraindications for acetaminophen (tylenol)
Hypersensitivity to the drug. Hepatic failure or impairment
Special notes for naloxone
The patient may quickly become conscious and combative
Pharmacological action for acetaminophen (tylenol)
May work peripherally to block pain impulse generation; may also inhibit prostaglandin synthesis in CNS
What is the class of drug for dextrose?
Glucose-elevating agents; metabolic and endocrine, other