Which drug (other than Valium) may be used to terminate status epilepticus?

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Presentation transcript:

Which drug (other than Valium) may be used to terminate status epilepticus?

50% Dextrose Also Ativan (lorazepam)

You carry only one injectable drug which may normally be a color other than clear. 1) What drug is it? 2) What color?

1) Valium 2) pale yellow

What is the first drug of choice in Pulseless Electrical Activitiy (PEA)?

Epinephrine

What is the generic name for: 1) Narcan 2) Isuprel 3) Lasix 4) Valium

1) Naloxone 2) Isoproterenol 3) Furosemide 4) Diazepam

You have been ordered to give 8 mg. of drug Alpha 1. It is supplied in 2 mg/ml. How many ml should you give?

4 ml. 2 mg. = 8 mg. 1 ml. X 2X = 8; X = 4 ml.

Why should the total number of nitroglycerine tablets taken per angina attack be limited?

to minimize hypotension

Name two drugs carried on the ambulance which may cause CNS depression

1) Benadryl 2) morphine 3) Valium

Name two contraindications for the administration of Syrup of Ipecac

1) coma (decreased LOC) 2) convulsions 3) caustic/corrosive ingestion 4) <1mL/Kg hydrocarbons 5) cyclic OD Use with caution: 1) cardiac disease 2) last 1/2 of pregnancy

What volume of Epinephrine 1:1000 will contain 0.4 mg?

0.4 mL

What does atropine do to pupils?

dilates

What is the ANS action of glucagon?

sympathomimetic

Name all the drugs carried in the ambulance which can safely be given down the ET tube

1) Lidocaine 2) Atropine 3) Naloxone 4) Epinephrine 5) Vasopressin

Name all the drugs carried in the ambulance which should be given down the ET tube

None. AHA recommends using IO if IV access is not easily obtained. All drugs may be given via IO.

What is the formula for calculating the dose for a bolus of Lidocaine?

1 to 1.5 mg per Kg

Why is it undesirable to give medications IM to a chest pain patient?

Later diagnosis will be more difficult since IM injections will elevate the same serum enzymes as a MI

What is the name of the narcotic which may be used to treat diarrhea?

Lomotil

What may happen if sodium bicarbonate is mixed with: 1) Calcium 2) Epinephrine

1) it precipitates 2) the epinephrine is inactivated

You have just placed 200 mg of drug Beta 2 into a 250 cc bag. Your orders are to infuse 40 mcg/min. How many gtts/min will you give? No peeking!

200 mg into 250 cc bag 200 mg. = 200,000 mcg = 80 mcg 250 cc 250 cc 1 cc (60 gtts) 80 mcg. = 40 mcg. 60 gtts X 80 X = 2400 X=30 gtts/min.

Name the two primary problems that are treated with epinephrine 1:1000

1) allergic reaction 2) asthma

What is the duration of action of Lidocaine?

10-20 minutes

Name a side effect of Lidocaine which indicates that too large a dose has been given, and that the infusion of Lidocaine should be stopped.

1) convulsions 2) hypotension 3) bradycardia 4) heart block

If you want to give a patient 60 mL of D5W in one hour, how many drops per minute should you give: 1) using mini-drip 2) using regular drip

1) 60 gtts/min. 2) 10 gtts/min.

Name two effects that Isuprel has on the heart.

Increased conduction Increased Rate Increased Strength of contraction so: Increased cardiac output Increased myocardial O2 demand Increased ventricular irritability

How long should a patient be allowed to continue in seizure activity before Valium is given?

5 minutes

What is the first drug of choice to treat sinus bradycardia with PVC’s?

atropine

If you give a patient 50 mL of 50% dextrose, how many grams did you give?

25 grams of dextrose

List the four end-points for giving Procainamide

17 mg/kg rhythm converts QRS widens hypotension

What is the standard dosing of Adenosine 1) initial 2) repeat

1) 6 mg 2) 12 mg

What type of drug is Compazine?

Phenothiazine

Name two more phenothiazines

thorazine, haldol, prolixin, mellaril, stelazine

What is the other name for Diltiazem

Cardizem

What kind of drug is Elavil?

Cyclic antidepressant

What is the standard concentration of solution for an infusion of Lidocaine

1 gram in 250 cc

What is the standard concentration of solution for an infusion of Dopamine?

400 mg in 250 cc

You have been ordered to infuse Dopamine at 20 mcg/kg/min to a patient who weighs 132 lbs. At what drip rate will you flow the medication?

132 lbs. / 2.2 = 60 kg. 20 mcg/kg x 60 kg = 1200 mcg total dose 400 mg Dopamine = 400,000 mcg 250 cc 250 cc But wait…..there’s more!

400,000 mcg = 1600 mcg 250 cc 1 cc (60 gtts) 1600 mcg = 1200 mcg (total dose) 60 gtts X gtts 1600 X = X= 45 gtts/min (whew!) and it’s easier still…..

Remember this one? Dose x weight x So… 20 mcg x 60 kg x = 720 = 90 = 45 gtts/min (it works!) 1600 = 16 = 2

Give one trade name for Albuterol

Proventil, Ventolin

Which is more likely to cause respiratory depression: IV Valium or Rectal Valium

IV Valium