Paramedic Drug Quiz

Competitive narcotic and opiod antagonist

Antiarrhythmic

Ca+ channel blocker

Vasopressor

5-10 mg q 15 min

0.01-0.1 mg/kg

0.4-2 mg MR q5 min

4-20 mg q 5 min

2nd Type II AV Heart Blocks

Partial/complete reversal of CNS/Respiratory depression by opiods and narcotics

Beta-blocker OD

Antidote for D50

Hypertension, tachydysrhythmias, fever, sweating

Vasocontsriction, headache, dizziness, dry mouth

None

Hypotension, tachydysrhythmias, irritability, GI upset, pulmonary edema

The max dose is appropriate as an initial dose, don't want to waste time.

Only give enough to reverse CNS/Resp depression, pts can become violent when they come out of their high.

You never want to repeat Narcan, pts need hospital intervention.

Narcans side effects are minimal, so give the pt as much as possible.

Hypoglycemia in conscious and alert pts.

Hyperglycemia in pts with a known blood glucose.

Hypoglycemia in unconscious pts.

Immediately for any unconscious pts.

No, D50 can be absorbed through the muscle surrounding the blown vein.

Yes, D50 can cause local tissure necrosis and burning at the site.

Yes, but they are minimal compared to the side effects of the hypoglycemia.

Extravasation is very unlikely and is least of your concerns in an unconsious pt.

None, in documented hypoglycemia. Use caution with a suspected intracranial bleed, D50 can increase ICP.

None, everyone can use more sugar.

Dysrhythmias

Adults and Peds: 25 mg of 50% soln

Adults: 1 mg/kg 50% soln, Peds: 0.1 mg/kg 50% soln

Adults and Peds: 1mg/kg 50% soln

Adults: 1 amp of 50% soln. Pediatrics: 2ml/kg 25% soln.

Class IV antiarrhythmic

Parasympatholytic

Sympathmimetic

Opiod

Pt with a 2nd degree Heart Block

Pt with PSVT refractory to vagal maneuvers

Pt with complete A-V dissociation

Pt with Sick Sinus Syndrome

Small peripheral IV, 6mg slow IV push, with an infusion of 12 mg in 1000mL NS over 1 hr

IV closest to heart, 6 mg rapid IV push, MR at 12mg in 1-2 min, MR 12mg dose once.

30mg slow IV in large vein over 10 min

6mg IM, MR at 12 mg IM in alternative site in 1-2 min.

Hypotension, heart attack, chest pressure, dyspnea, facial flushing

Cherry-red skin, hypertension

Pale, cool and clammy skin, hypertension and bradycardia

Wheezing, peripheral edema, hypertension

Vasopressor(low dose)2-5mcg/kg/min, Dopaminergic(medium dose)5-10mcg/kg/min, and Inotropic(high dose)>10mcg/kg/min

Inotropic(low dose)2-5mcg/kg/min, Vasopressor(medium dose)5-10mcg/kg/min, and Dopaminergic(high dose)>10mcg/kg/min

Dopaminergic(low dose)15mcg/kg/min

Dopaminergic(low dose)2-5mcg/kg/min, Inotropic(medium dose)5-10mcg/kg/min, and Vasopressor(high dose)>10mcg/kg/min

Pheochromocytoma

Ventricular fibrillation

Short-term cardiac decompensation secondary to decreased contractility when no hypovolemia is present, increase organ perfusion.

Adrenal Gland tumor

Tachydysrhythmias, hypotension, vasoconstricion, dyspnea

Hypertension, flushing, petechiae

Bradycardia, heart blocks

Since dopamines doses are so varied, there are no signifcant side effects.

A pt with and opiod overdose who is experiencing CNS/Resp depression.

A pt who has severe uncontrolled pain from a rollover car accident with many obvious fractures and massive blood loss.

A pt who is actively seizing and is reported to have been seizing for the last 3 minutes without intermittent periods of consciousness.

A pt who is severly edamatous and volume depleted.

Class IV antiarrhythmic

Skeletal muscle relaxant, anticonvulsant, sedative/hypnotic.

Isotonic electrolyte soln.

Antiarrhytmic

Adults: 5-10 mg IV/IM Peds: 0.5-2 mg IV/IM

Adults: 2-5 mg IV/IM Peds: 2-5 mg IV/IM

Adults and Peds: 0.2-5mg/kg IV/IM

Adults: 0.5-2mg IV/IM Peds: 0.2-0.5mg IV/IM

Narcan

Sodium Thiosulfate and Amyl Nitrate Inhalants

Epinephrine and Benadryl

Atropine and Glucagon

Anxiety, tachycardia, increased BP

Hypertension, bradycardia, cyanosis

Increased ICP, internal hemorrhage, hyperthermia

N/V, hypotension, dizziness, flushing, skin rash, tachycardia

1-2 mg IM, 2-4 mg ETT

12.5mg over 10-20 min MR at 0.5 original dose in 30 min

2-5 mg over 10-20 min, MR at 2x the original dose in 20min

400mg/kg over 10-20 min MR at 0.5 the original dose in 30 min

Amyl Nitrate Inhalants cause an increase in gluconeogenesis and glycogenolysis which increases blood glucose; overdose can lead to hyperglycemia

Amyl Nitrate Inhalants decrease conduction through the AV node, which caused decreased HR; overdose can lead to conduction disorders

Amyl Nitrate Inhalants relax blood vessels and increase blood and oxygen return to the heart while reducing workload; this can cause headache, dizzy, light-headedness; and overdose can lead to cyanosis, feeling of extreme pressure in head, weak and fast HR, unusual tired or weakness, SOB

0.3mL(1 ampule) MR q5 min if symptoms persist

3 mL(1 ampule) MR q5min if symptoms persist

0.3mL/kg MR q5min if symptoms persist

3mL/kg MR q5min if symptoms persist

A pt who is unconscious with an unknown etiology; admin rapid IV 1gm/kg.

A pt with a history of constipation x3days who is altered and complaining of severe abdominal pain; admin ETT 1gm/kg.

A conscious alert pt who called 9-1-1 stating they just took a handful of pills 5 minutes ago because their boyfriend broke up with them; admin PO 1gm/kg.

A pt who is obviously drunk and is vomiting uncontrollably, A&Ox2, and states they've had a fifth of vodka; admin PO 1gm/kg.