MEDIC SCHOOL MEDS! SLAY!

What is the effect of Alpha-2 receptor stimulation?

Reduces CNS stimulation, used as an antihypertensive or sedative.

What is an example of a Beta-1 receptor agonist medication?

Dobutamine

What are the effects of Beta-1 receptor stimulation?

Increases heart rate, contractility, and renin release.

What are the side effects of Beta-2 receptor agonists?

Tachycardia and hyperglycemia.

What are contraindications for Epinephrine 1:10,000?

Patients who do not require CPR efforts.

What interactions should be noted with Epinephrine?

It can be deactivated by alkaline solutions like sodium bicarbonate.

What is the effect of Alpha-1 stimulation on mucus membranes?

Decreases swelling and secretions.

What is the role of clonidine?

It is an Alpha-2 agonist used to treat hypertension and ADHD.

What are the effects of Beta-2 receptor stimulation in the lungs?

Relaxation of smooth muscle, leading to bronchodilation.

What are the indications for norepinephrine?

Hemodynamically significant hypotension not caused by hypovolemia.

What are the contraindications for norepinephrine?

Should not be given to patients hypotensive due to hypovolemic shock.

What are the potential consequences of norepinephrine overdose?

Cerebrovascular hemorrhage, aortic aneurysm, and myocardial infarction.

What is the recommended dosage of norepinephrine according to national guidelines?

0.1-0.5 mcg/kg/min (maximum 30 mcg/min) titrated to MAP >65 mmHg.

What class of drug is Phenylephrine (Neo-Synephrine)?

Sympathetic Nervous System Agonist.

What is a major indication for Phenylephrine?

Hemodynamically significant hypotension not caused by hypovolemia.

What class of drug is Dopamine (Intropin)?

Sympathetic Nervous System Agonist (Sympathomimetic).

What class of drug is Albuterol (Ventolin, Proventil)?

Sympathetic Nervous System Agonist (Sympathomimetic).

What effect do beta-blockers have on blood glucose levels in diabetics?

They can prolong, enhance, or alter symptoms of hypoglycemia and may increase blood glucose concentrations.

What are the indications for alpha-1 selective blockers?

Control blood pressure and treat benign prostatic hyperplasia.

List one indication for administering Metoprolol.

Hypertension during and following myocardial infarction.

What are the contraindications for Metoprolol?

Heart rate less than 45 beats per minute, heart blocks, systolic less than 100 mmHg, congestive heart failure, asthma or bronchospastic airway disease.

What are some common side effects of Metoprolol?

Bradycardia, hypotension, lethargy, weakness, congestive heart failure, dyspnea, wheezing.

What is the dosage for Metoprolol in an emergency setting?

5 mg, slow IV injection over 2-5 minutes, repeated every 2 minutes to a maximum dose of 20 mg.

What is the mnemonic for PNS overstimulation?

SLUDGE M BBB: Salivation, Lacrimation, Urination, Defecation, Gastrointestinal upset, Emesis, Miosis, Bronchorrhea, Bronchospasm, Bradycardia.

What class of medication is Atropine?

Anticholinergic agent.

What is the dosage for Atropine in symptomatic bradycardia?

1 mg rapid IV push, repeat every 3-5 minutes, maximum total dose 3 mg.

What are the contraindications for Ipratropium Bromide?

Glaucoma, prostatic hypertrophy, bladder neck obstruction.

What is a mnemonic to remember anticholinergic side effects?

Hot as Hell (Fever), Blind as a Bat (Mydriasis), Mad as a Hatter (Delirium), Dry as a Bone (dry mouth), Full as a Flask (urinary retention).

What is the resting membrane potential of a cardiac myocyte?

Negative 80 to negative 90 mV at baseline.

What occurs during Phase 0 of the cardiac action potential?

Depolarization phase where voltage-gated Na+ channels open, causing a rapid influx of Na+ ions.

What is the main event in Phase 3 of the cardiac action potential?

Repolarization phase primarily caused by the efflux of K+ ions, restoring the negative potential.

What is the mechanism of action of Amiodarone?

Prolongs the refractory period, slows sinus rate, increases PR and QT intervals, and decreases peripheral vascular resistance.

What are common side effects of Amiodarone?

Bradycardia, AV node blocks, hypotension, dizziness, weakness, blurred vision, nausea, and vomiting.

What are the indications for Lidocaine?

Ventricular fibrillation and ventricular tachycardia if Amiodarone is unavailable.

What class of antidysrhythmic is Adenosine?

Vaughan-Williams Class V Antidysrhythmic.

What class of antidysrhythmic is Diltiazem?

Vaughan-Williams Class IV Calcium Channel Block.

What is the mechanism of action of Diltiazem?

Slows conduction through the AV node, decreases rate of ventricular response, causes vasodilation.

What is the adult dosage for Diltiazem?

0.25 mg/kg IV infusion over 2 minutes; may be repeated in 15 minutes at 0.35 mg/kg.

What is the mechanism of action of Nitroglycerin?

Smooth muscle relaxant that reduces preload and afterload, dilates coronary arteries.

What are the indications for Nitroglycerin?

Angina pectoris.

What are the contraindications for nitroglycerin?

Hypotension, children younger than 12 years, head trauma with increased intracranial pressure, and patients taking erectile dysfunction medications.

What precautions should be taken with nitroglycerin?

Right-sided myocardial infarction is susceptible to hypotension due to dependence on preload to the left ventricle.

What are the side effects of nitroglycerin?

Hypotension, dizziness, reflex tachycardia, headache, and methemoglobinemia.

What are the contraindications for Magnesium Sulfate?

Shock and heart block.

What are the side effects of Magnesium Sulfate?

Hypotension, dizziness, respiratory depression, muscle paralysis, weakness, flushing, and diaphoresis.

What is the mechanism of action of Calcium Chloride?

Replaces calcium in hypocalcemia, increases myocardial contractile force, and increases ventricular automaticity.

What are the contraindications for Calcium Chloride?

Administration to patients taking digitalis can cause digitalis toxicity.

What is the class of Sodium Bicarbonate?

Alkalinizing agent.

What are the indications for Sodium Bicarbonate?

Select poisons and overdoses, hyperkalemia, and crush injuries.

What are the contraindications for Sodium Bicarbonate?

Metabolic alkalosis and hypocalcemia.

What are the side effects of Sodium Bicarbonate?

Excessive urination, headache, nausea, vomiting, muscle pain, and twitching.

What is the mechanism of action of Dextrose?

Increases blood glucose concentrations and decreases potassium levels.

What are the indications for Dextrose?

Hypoglycemia with altered mental status and hyperkalemia.

What are the indications for Glucagon?

Hypoglycemia with inability to follow commands, beta blocker overdose, and calcium channel blocker overdose.

What is the recommended method for sewering medications?

Sewering should be a last resort, and medications should not be mixed to make a slurry.

What are contraindications for pain management?

Altered mental status, hypoventilation, hypotension (BP less than 100 mmHg systolic).

What is the historical belief regarding pain management for patients with undiagnosed abdominal pain?

It was believed that pain management should be withheld, but studies have shown this assumption is no longer valid.

What is the mechanism of action of Morphine?

Central nervous system depressant, peripheral vasodilation, decreased sensitivity to pain.

What precautions should be taken when administering Morphine?

Respiratory depression can occur; Naloxone (Narcan) should be available.

What are common side effects of Morphine?

Hypotension, bradycardia, hypoventilation, dizziness, nausea, pruritus.

What is the standard dosage for Morphine IV?

0.05 mg/kg, may be repeated after 5 minutes to a maximum of 10 mg.

What class of medication is ketamine?

Analgesic, sedative, hypnotic.

What is the mechanism of action of ketamine?

Causes dissociation between the cortical and limbic systems.

What is the maximum dose of ketamine?

Not to exceed 250 mg.

What are the contraindications for midazolam?

Shock with hypotension and narrow-angle glaucoma.

What are common side effects of midazolam?

Respiratory depression, amnesia, and altered mental status.

What is the dosage for midazolam?

5 mg IM, IV, or IN; repeat once in 5 minutes.

What class of medication is etomidate?

Anticonvulsant and sedative.

What is the mechanism of action of etomidate?

Ultra-short acting sedative by activating GABAA receptors.

What are common side effects of etomidate?

Hypotension, cardiac dysrhythmias, and myoclonic movements.

What class of medication is olanzapine?

Antipsychotic and antimanic agent.

What are the indications for olanzapine?

Agitated or violent patients experiencing a behavioral emergency.

What class of medication is ondansetron?

Antiemetic.

What are common side effects of ondansetron?

Hypertension, headache, and ECG changes.

What class of medication is diphenhydramine?

H1 receptor antihistamine.

List three indications for Diphenhydramine.

Anaphylaxis secondary to epinephrine, allergic reactions, and antiemetic for motion sickness.

What precautions should be taken with Dexamethasone?

Protect from heat; onset of action may be 2-6 hours.

What are the side effects of Dexamethasone?

Gastrointestinal bleeding and prolonged wound healing.

What class of drug is Succinylcholine?

Neuromuscular blocker, depolarizing.

What is the mechanism of action of Succinylcholine?

Competes with acetylcholine at the motor neuron end plate, resulting in muscle paralysis.

What is the dosage for Succinylcholine?

1.5 mg/kg rapid IV push to a maximum of 200 mg.

What class of drug is Oxymetazoline (Afrin)?

Direct-acting sympathomimetic.

What are the side effects of Oxymetazoline?

Burning, rebound congestion, and sneezing.

What are the side effects of Tranexamic Acid?

Seizures, headache, visual changes, and hypotension.

What class of drug is Aspirin?

Platelet inhibitor and anti-inflammatory.

What are the contraindications for Ibuprofen?

Renal failure, patients over 60 years old, and known hypersensitivity.

What class of drug is Ketorolac?

Non-steroidal anti-inflammatory agent (NSAID).

What are the side effects of Ketorolac?

Edema, rash, and heartburn.

What are sympathomimetics?

Drugs that imitate or stimulate the effects of the sympathetic nervous system.

Name a common sympathomimetic medication.

Epinephrine

What is the primary neurotransmitter of the sympathetic nervous system?

Norepinephrine

What is the nickname for the sympathetic nervous system?

The 'Fight or Flight' system

What type of receptors do adrenergic agonists stimulate?

Alpha-1, Alpha-2, Beta-1, or Beta-2 receptors

What effect does stimulation of Alpha-1 receptors have?

Causes vasoconstriction, increasing blood pressure.

What is an example of an Alpha-1 agonist medication?

Phenylephrine

What are the indications for using Epinephrine?

Cardiac arrest, severe anaphylaxis, severe bronchoconstriction.

What can result from extravasation of Epinephrine?

Tissue necrosis.

What is the significance of the sympathetic nervous system in emergency medicine?

It prepares the body for rapid response to stress or danger.

What are common side effects of epinephrine?

Tachycardia, hypertension, palpitations, anxiety, tremors, diaphoresis, headache, dizziness, nausea, and vomiting.

How often can epinephrine be repeated in cardiac arrest?

Every 3-5 minutes.