Emergency Department Medications & Clinical Concepts

Vocabulary practice flashcards covering Emergency Department medications, mechanisms of action, indications, and annotated clinical terms.

Acetylcysteine (“Mucomyst”)

Medication used for acetaminophen overdose that works by replenishing glutathione stores, acting as a glutathione substitute, and enhancing sulfate conjugation of acetaminophen.

Adenosine (“Adenocard,” “Adenoscan”)

Medication used for SVT and stable narrow complex tachycardias that acts on receptors in the AV node, causing temporary heart block.

Albuterol (“Proventil,” “ProAir,” “Ventolin”)

Selective $\beta_2$ agonist used for acute bronchospasm and hyperkalemia.

Amiodarone (“Pacerone”)

Antiarrhythmic used for pulseless Vfib or Vtach and wide complex tachydysrhythmias that works by blocking $K^+$ efflux, blocking $Na^+$ and $Ca^{2+}$ channels, and beta blocking.

Atropine (“AtroPen”)

Direct anticholinergic used for bradycardia and organophosphate or carbamate toxicity.

Azithromycin (“Zithromax”)

Macrolide antibiotic used for bronchitis, sinusitis, pneumonia, otitis, skin infections, urethritis, cervicitis, PID, and genital ulcer in men.

Calcium Gluconate / Calcium Chloride

Agents used for hyperkalemia or hypocalcemia with dysrhythmia; calcium chloride is $3\times$ more potent than calcium gluconate.

Ceftriaxone (“Rocephin”)

Cephalosporin antibiotic used for skin, bone, UTI, STI, respiratory, abdominal, sepsis, meningitis, and otitis infections, as well as perioperative prophylaxis.

Clindamycin (“Cleocin”)

Lincosamide antibiotic used for skin, respiratory, sepsis, abdominal, gynecologic, and bone infections, and endocarditis prophylaxis.

Diazepam (“Valium”)

Medication used for seizures, alcohol withdrawal, agitation, and muscle spasms that works by enhancing the inhibitory effects of GABA.

Dicyclomine (“Bentyl”)

Anticholinergic medication used for IBS and muscle spasms; can hide dangerous severe abdominal emergencies.

Diltiazem (“Cardizem”)

Calcium channel blocker used for stable Afib with RVR and stable SVT; inhibits calcium influx into myocardium and vascular smooth muscle, prolonging AV nodal conduction.

Dobutamine

Medication used for decompensated heart failure and refractory hypotension that works as a $\beta_1$ and $\beta_2$ agonist.

Dopamine

Medication used for decompensated heart failure and hypotension that works as an $\alpha_1$, $\beta_1$, and dopaminergic agonist; must be administered via a central venous line.

Droperidol (“Inapsine”)

Medication used for the prevention of emesis and migraines that works by antagonizing dopamine and alpha adrenergic receptors.

Epinephrine (“EpiPen,” “Adrenalin”)

Alpha and beta receptor agonist used for anaphylaxis, ACLS arrest, PALS/NRP arrest, and severe asthma.

Enoxaparin (“Lovenox”)

Medication used for PE, NSTEMI, and unstable angina that works by binding to antithrombin III and inactivating factor Xa.

Esmolol (“Brevibloc”)

Selective $\beta_1$ antagonist used for aortic dissection.

Esomeprazole (“Nexium”)

Proton pump inhibitor (PPI) used for non-variceal upper GI bleeds that works by inhibiting parietal cell hydrogen potassium ATPase.

Etomidate (“Amidate”)

Medication used for RSI induction that produces hypnosis through inhibitory GABA-like effects on the brain stem reticular formation.

Fentanyl (“Sublimaze”)

Opioid agonist used for pain control and adjunct sedation.

Fomepizole (“Antizol”)

Medication used for methanol or ethylene glycol toxicity that works by inhibiting alcohol dehydrogenase.

Fosphenytoin (“Cerebyx”)

Medication used for status epilepticus that works by stabilizing voltage-dependent neuronal $Na^+$ channels to stop seizure activity.

Furosemide (“Lasix”)

Loop diuretic used for pulmonary edema, CHF exacerbation, and hyperkalemia that works by inhibiting $Na^+$ and $Cl^-$ reabsorption in the distal renal tubule and ascending loop of Henle.

Glucagon (“GlucaGen”)

Medication used for beta blocker toxicity, calcium channel blocker toxicity, and hypoglycemia; works by stimulating cAMP production independent of beta receptors.

Haloperidol (“Haldol”)

Antipsychotic used for agitation or psychosis that acts as an antagonist at D1 and D1 receptors.

Heparin

Anticoagulant used for thromboembolism and ACS/Afib that works by binding to antithrombin III, potentiating inactivation of thrombin factors, and preventing fibrinogen from creating fibrin.

Hydrocortisone (“SoluCortef”)

Glucocorticoid and mineralocorticoid medication used for acute adrenal insufficiency, status asthmaticus, and vasopressor refractory septic shock.

Hydromorphone (“Dilaudid”)

Opioid agonist used for analgesia with sedative effects, where $1\,mg$ IV Dilaudid is equivalent to approximately $7\,mg$ IV morphine.

ACS

Acute coronary syndrome, encompassing unstable angina, NSTEMI, and STEMI.

Insulin Regular

Agent used for hyperkalemia, DKA or HHS, and CCB overdose; increases peripheral glucose uptake, increases inotropy, and shifts potassium intracellularly.

CCB

Calcium channel blocker; a drug class that can cause hyperglycemia.

Emergence reactions

A temporary state of confusion, agitation, or hallucinations that occurs when a person wakes up from general anesthesia.

IOP increase

Increased intraocular pressure.

Ketamine (“Ketalar”)

NMDA receptor antagonist acting on the cortex and limbic system, used for analgesia, sedation, RSI induction, and general anesthesia.

Labetalol (“Trandate”)

Antihypertensive used for hypertensive emergencies that works as an $\alpha_1$, $\beta_1$, and $\beta_2$ agonist.

Lorazepam (“Ativan”)

Benzodiazepine used for delirium tremens, status epilepticus, serotonin syndrome, and agitation; works by enhancing the inhibitory effects of GABA.

Magnesium Sulfate

Agent used for torsades, ventricular dysrhythmias, eclampsia, and status asthmaticus; works by participating in physiologic processes.

Mannitol (“Osmitrol”)

Osmotic diuretic used for elevated ICP and impending herniation.

Methohexital (“Brevital”)

Ultra short-acting barbiturate used for procedural sedation that produces cortical and cerebellar sedation and hypnosis.

Methylprednisolone (“SoluMedrol”)

Corticosteroid used for severe asthma, PCP PNA with elevated A-a gradient or $\text{PaO}_2 < 70\,mmHg$, and acute hypersensitivity reactions.

PCP PNA

Pneumocystis pneumonia, common in people with a weakened immune system.

Metoclopramide (“Reglan”)

Antiemetic used for vomiting prevention and treatment that antagonizes dopamine receptors in the chemoreceptor trigger zone.

Midazolam (“Versed”)

Benzodiazepine used for seizures, procedural sedation, ventilator sedation, and RSI; enhances the inhibitory effects of GABA.

Morphine Sulfate

Opioid agonist used for pain that causes analgesia with sedation; recommended dose is $0.1\,mg/kg$ IV.

Nimodipine (“Nimotop”)

Calcium channel blocker selective for cerebral arteries used in subarachnoid hemorrhage.

Nitroglycerin

Venodilator used for CHF and angina that works by stimulating cGMP production.

Nitroprusside (“Nipride”)

Vasodilator used for hypertensive emergencies that breaks down to release NO.

Norepinephrine (“Levophed”)

Vasopressor used for hypotension refractory to IVF that works primarily as an $\alpha_1$ agonist > $\beta_1$ agonist.

Octreotide (“Sandostatin”)

GI-selective vasoconstrictor used for bleeding esophageal varices and sulfonylurea overdose.

Olanzapine (“Zyprexa”)

Antipsychotic used for agitation and psychosis that antagonizes dopamine, histamine, $\alpha_1$, and $5\text{HT}_2$ receptors; contraindicated for IV administration.

Ondansetron (“Zofran”)

Centrally acting antiemetic used for vomiting prevention and treatment that antagonizes $5\text{HT}_3$ receptors.

Phenobarbital

Barbiturate used for status epilepticus that produces sedation, hypnosis, and anesthesia.

Prednisone

Glucocorticoid/mineralocorticoid used for asthma exacerbation, PCP PNA with A-a gradient $> 35$ or $\text{PaO}_2 < 70\,mmHg$, and allergic reactions.

Propofol (“Diprivan”)

GABAa agonist and $Na^+$ channel blocker used for procedural sedation, RSI, and ventilator sedation.

Protamine Sulfate

Antidote for heparin-induced bleeding that works by ionically binding heparin at a dose ratio of $1\,mg$ per $100\,\text{units}$ of heparin.

Rocuronium

Non-depolarizing neuromuscular blocking agent used for RSI paralysis.

Sodium Bicarbonate

Agent used for hyperkalemia, TCA toxicity, salicylate toxicity, and metabolic acidosis that works by increasing serum bicarbonate and buffer stores.

Succinylcholine

Depolarizing neuromuscular blocking agent used for RSI paralysis.

Ziprasidone (“Geodon”)

Antipsychotic used for agitation, schizophrenia, and mania that mediates antagonism of dopamine $D_2$, $5\text{HT}_2$, and $\alpha_2$ adrenergic receptors.

Apixaban (“Eliquis”)

Factor Xa inhibitor used for thromboembolic prevention and treatment that reversibly inhibits free and bound factor Xa.

Rivaroxaban (“Xarelto”)

Factor Xa inhibitor used for thromboembolic or cardiovascular prevention and events.

Metoprolol Succinate (“Toprol XL”, “Kapspargo Sprinkle”)

Extended-release beta-blocker that selectively blocks $\beta_1$ myocardial adrenergic receptors, used for hypertension, angina, and MI prevention.

Metoprolol Tartrate (“Lopressor”)

Immediate-release, short-acting beta-blocker used for hypertension, angina, MI, and Afib.

Metronidazole (“Flagyl”)

Antibiotic and antiprotozoal that works by disrupting DNA and protein synthesis in susceptible organisms.

Piperacillin-tazobactam (“Zosyn”)

Extended-spectrum penicillin combination antibiotic used for appendicitis, peritonitis, skin and gynecological infections, and pneumonia.

Pantoprazole (“Protonix”)

Proton pump inhibitor used for GERD, erosive esophagitis, and suspected GI bleeding.

Cephalexin (“Keflex”)

Cephalosporin antibiotic used for skin, respiratory, otitis, UTI, and bone infections.

Trimethoprim / Sulfamethoxazole (“Bactrim”)

Sulfonamide antibiotic used for bronchitis, shigella, otitis, PJP, diarrhea, and bacterial infection prophylaxis.

Amoxicillin / Clavulanate (“Augmentin”)

Aminopenicillin beta-lactamase inhibitor combination used for skin, otitis, sinusitis, respiratory, and genitourinary infections.

Amoxicillin (“Amoxil,” “Trimox”)

Aminopenicillin antibiotic used for skin, otitis, sinusitis, respiratory, and genitourinary infections, endocarditis and anthrax prophylaxis, and ulcer disease.

Penicillin G (“Pfizerpen”)

Antibiotic used for pneumonia, strep, syphilis, and gonorrhea infections, and for prevention of rheumatic fever.

Doxycycline (“Vibramycin”)

Tetracycline antibiotic used for infections caused by unusual organisms, anthrax, bronchitis, and syphilis.