N271 Exam 1 Meds & treatment

Which bronchodilator is used to improve ventilation in respiratory acidosis from hypoventilation?

Albuterol (Proventil)

Which mucolytic is used for respiratory acidosis to help clear airway secretions?

Acetylcysteine (Mucomyst)

Which drug class is used for hyperventilation due to anxiety causing respiratory alkalosis?

Benzodiazepines (drugs ending in -am)

What medication is given first to push potassium back into cells in diabetic ketoacidosis (DKA)?

Regular insulin (rapid IV therapy)

When is sodium bicarbonate given for metabolic acidosis?

When pH < 7.1 (IV push)

Which potassium-sparing diuretic is given for metabolic alkalosis caused by loop/thiazide diuretics?

Spironolactone (Aldactone)

What medication may be given for metabolic alkalosis from persistent vomiting?

Antiemetics to stop vomiting

Which medication treats hyponatremia by blocking ADH and promoting water excretion while retaining sodium?

Tolvaptan (Samsca)

What IV solution is used for severe symptomatic hyponatremia (Na ≤120)?

3% Hypertonic Saline

Which loop diuretics are used for hypernatremia caused by poor renal excretion?

Furosemide (Lasix) or Bumetanide (Bumex)

Which corticosteroid can contribute to hypernatremia?

Prednisone

What is the priority medication for hypokalemia caused by potassium loss?

Potassium replacement (PO preferred)

How should IV potassium be administered?

Never IV push, never IM or SQ, slow IV piggyback or central line, if it burns, stop the infusion

Which potassium-sparing diuretic helps prevent further potassium loss?

Spironolactone (Aldactone)

Which medication removes potassium through the GI tract in hyperkalemia?

Kayexalate

Which medications temporarily shift potassium into cells during hyperkalemia?

Regular insulin + 50% dextrose (D50)

Which medication stabilizes the heart during severe hyperkalemia?

Calcium gluconate

Which medication should be stopped in hyperkalemia?

Potassium supplements and potassium-sparing diuretics

Which IV medications treat hypocalcemia?

Calcium gluconate and Calcium chloride

Which medications improve calcium absorption?

Vitamin D and Aluminum hydroxide

Which loop diuretic helps lower calcium in hypercalcemia?

Furosemide (Lasix)

Which medications reduce pain by blocking prostaglandins after burns?

Ibuprofen and Aspirin (NSAIDs)

Which IV fluids are used during the emergent burn phase?

Lactated Ringer's (preferred) and 0.9% Normal Saline

What is the preferred pain medication during the emergent burn phase?

Morphine

Which topical antibiotic is used for minor burns (<25% TBSA)?

Bacitracin

Which topical antibiotic is used for 2nd and 3rd degree burns >25% TBSA?

Silver sulfadiazine (Silvadene)

Which topical antimicrobial is used for patients with sulfa allergies?

Silver nitrate

Which topical antimicrobial is mainly used for electrical burns?

Mafenide acetate (Sulfamylon)

Which medications prevent Curling ulcers in severe burns?

Famotidine (Pepcid) and Cimetidine (Tagamet)

What IV fluid is started first in diabetic ketoacidosis (DKA)?

0.9% Normal Saline

Which IV fluid is started once blood glucose falls to about 300 mg/dL during DKA treatment?

D5 ½ NS

Which insulin is used IV during DKA?

Regular insulin

When may sodium bicarbonate be added during DKA?

Severe metabolic acidosis depending on blood pH

What comes first when treating DKA?

Replace fluids before electrolytes

Which insulin is rapid-acting?

Lispro and Aspart

Which insulin is short-acting and used IV in DKA?

Regular insulin

Which insulin is intermediate-acting?

NPH

Which insulin is long-acting with no peak?

Glargine (Lantus)

When mixing insulin, which is drawn up first?

Regular before NPH (Clear before cloudy)

Which insulin helps treat the Dawn phenomenon when given around 10 PM?

NPH insulin

Which oral medication decreases liver glucose production and improves insulin sensitivity?

Metformin (Glucophage)

Which sulfonylurea stimulates remaining beta cells to release insulin over several hours?

Chlorpropamide (Diabinese)

Which meglitinide causes a short burst of insulin release and is best around meals?

Repaglinide (Prandin)

Which medication slows carbohydrate digestion and must be taken with the first bite of food?

Acarbose (Precose)

Which thiazolidinedione improves insulin sensitivity but should NOT be used in heart failure?

Rosiglitazone (Avandia)

Which IV fluid is started first in HHS?

0.9% Normal Saline

Which insulin is used for HHS?

Regular insulin

If conscious, what should a diabetic patient with hypoglycemia be given first?

Orange juice or apple juice (rapid carbohydrates)

Which medication is given IV for severe hypoglycemia in an unconscious patient?

50% Dextrose (D50)

Which medication is given for severe hypoglycemia without IV access?

Glucagon IM