Pharm Class Reunion
This medication class includes morphine and fentanyl
What are opioids
A reason to avoid giving a medication because it may cause harm in this specific situation
What is a contraindication
In cardiogenic shock, this physiologic variable is typically elevated as the failing ventricle backs pressure into the pulmonary circuit
What is pulmonary capillary wedge pressure; or left sided filling pressure
The primary muscle of ventilation
What is the diaphragm
A heart sound best described as an early diastolic, low frequency gallop from rapid passive ventricular filling
What is an S3
For a wide complex tachycardia with a pulse and stable blood pressure; this antiarrhythmic is commonly used and works primarily by blocking potassium channels
What is amiodarone
This common medication for chest pain should be avoided in suspected right ventricular infarct with hypotension
What is nitroglycerin
In distributive shock from sepsis, hypotension is primarily driven by loss of this vascular property
What is systemic vascular resistance; SVR
The heart chamber that pumps blood to the lungs
What is the right ventricle
A wheeze heard primarily on expiration due to intrathoracic airway obstruction; classically associated with lower airway disease
What is an expiratory wheeze
This pressor is preferred when septic shock remains hypotensive after adequate fluid resuscitation; primarily alpha 1 with some beta 1 effects
What is norepinephrine
This antiplatelet is generally avoided when the patient has a true allergy or active significant bleeding
What is aspirin
In acute asthma, worsening hypercapnia is a late ominous sign because it suggests this underlying change in mechanics A sudden blockage of a coronary artery by a clot leading to myocardial ischemia and cell death
What is impending respiratory failure from decreased minute ventilation due to fatigue and severe air trapping
This valve prevents backflow from the left ventricle into the left atrium
What is the mitral valve
The term for persistent end expiratory crackles due to sudden opening of collapsed alveoli; often seen in pulmonary edema or fibrosis
What are fine inspiratory crackles; also called rales
This medication can terminate SVT by transiently blocking AV nodal conduction; it may cause brief flushing, chest tightness, and a sense of impending doom
What is adenosine
This drug for bronchospasm can worsen tachycardia and is used cautiously in patients already severely tachycardic
What is albuterol
STEMI versus NSTEMI is fundamentally distinguished by whether ischemia causes this event across the myocardial wall
What is transmural myocardial injury with complete coronary occlusion
This artery supplies the heart muscle itself
What are the coronary arteries
A Kussmaul pattern indicates deep, rapid respirations due to compensation for this acid base state
What is metabolic acidosis
This sedative is often chosen for RSI in hypotensive patients because it supports sympathetic tone; but can cause emergence reactions and hypersalivation
What is ketamine
This sedative class can worsen hypotension and respiratory depression; especially risky when combined with alcohol or opioids
What are benzodiazepines
A patient develops severe dyspnea and hypoxia shortly after long bone fracture; they become confused and have a petechial rash; the pathophysiology is most consistent with this syndrome involving embolized fat and inflammatory response
What is fat embolism syndrome
The brain region responsible for basic life functions like respiratory drive and heart rate
What is the brainstem; specifically the medulla oblongata
The finding of a paradoxical rise in systolic blood pressure drop of at least 10 mmHg during inspiration is called this; associated with tamponade, severe asthma, and COPD exacerbation
What is pulsus paradoxus