Medication Knowledge Review

Flashcards to review key concepts related to medications, their classifications, effects, pharmacokinetics, and usage in emergency scenarios.

Duodote

A medication that acts as a Cholinergic & Muscarinic Antagonist and Cholinesterase Reactivator.

Cholinergic

Relating to the neurotransmitter acetylcholine, or the receptors that respond to it.

Muscarinic Antagonist

A substance that competitively blocks the effects of acetylcholine at muscarinic receptors.

Cholinesterase Reactivator

An agent that reactivates cholinesterase to allow breakdown of acetylcholine.

Atropine

A medication that reactivates cholinesterase and has anti-muscarinic effects.

Pralidoxime

A drug that reactivates cholinesterase and detoxifies organophosphates.

Organophosphate toxicity

Toxicity caused by exposure to organophosphates, often seen in insecticides.

SLUDGEM

A mnemonic for symptoms of organophosphate toxicity: Salivation, Lacrimation, Urination, Defecation, GI upset, Emesis, Miosis.

Dosage for Duodote

Atropine 2.1mg and Pralidoxime 600mg in autoinjector form.

Administration routes for Duodote

Administered intramuscularly (IM) in pre-hospital settings.

Indication for Duodote administration

Possible or known exposure to organophosphate insecticides or nerve agents.

Maximum dosage for severe symptoms of Duodote

3 auto-injectors for Agitation + Severe Respiratory Distress + SLUDGEM.

Glucagon

A hyperglycemic agent and pancreatic hormone that raises blood glucose levels.

Glycogen

A stored form of glucose found in the liver.

Hypoglycemia

A condition of abnormally low blood glucose levels.

Dosage form of Glucagon

1mg of dry medication mixed with 1mL of diluent.

Onset of Glucagon

5-20 minutes.

Effect of Hydroxocobalamin

Uses cobalt ion to bind to cyanide ions and convert them to cyanocobalamin.

Cyanide toxicity

A life-threatening condition caused by exposure to cyanide, affecting oxygen utilization.

Hydroxocobalamin dosage

5g in 200mL, administered intravenously (IV).

IV administration

Intravenous route for medication delivery directly into the bloodstream.

Naloxone (Narcan)

An opioid antagonist used to reverse respiratory depression from narcotic overdose.

Mechanism of Naloxone

Competes for opioid receptor sites in the central nervous system.

Duration of Naloxone

30-60 minutes IV, more than 60 minutes IM.

Onset of Naloxone

1-2 minutes for IV/IN, 2-5 minutes for IM administration.

Opioid Overdose

A condition resulting from excessive intake of opioid medications, leading to respiratory distress.

Vial of Naloxone

Available in various forms including 2mg/2mL and 0.4mg/1mL.

Common side effect of Naloxone

Acute withdrawal syndrome, which can occur after administration.

Cyanocobalamin

The form of vitamin B12 produced from the metabolism of cyanide.

Half-life of Hydroxocobalamin

Unknown, with duration effects lasting 24-36 hours.

Administration considerations for Glucagon

Use the diluent supplied, ensure complete dissolution before administering.

Symptoms of cyanide poisoning

Headache, confusion, dyspnea, chest tightness, nausea.

Contraindications of Hydroxocobalamin

Known allergy to hydroxocobalamin.

Patient management for cyanide toxicity

Provide airway support, high-flow O2, and ensure IV access.

Signs of organophosphate toxicity

Symptoms include salivation, lacrimation, urination, defecation, GI upset, miosis.

Dosing considerations for pediatric patients with Glucagon

0.5mg IM if unable to establish IV access.

Reddish tissue coloration

Possible effect of Hydroxocobalamin administration.

Adrenaline and overdoses

Naloxone is also effective for treating non-opiate narcotic analgesic overdoses.

Routine monitoring after Naloxone administration

Watch for recurrent respiratory depression and coma.

Contraindications for Duodote

Patients over 65 years must weigh ≥ 80kg to receive 1 auto-injector.

Cautions with Hydroxocobalamin

Requires its own IV line, do not mix with other medications.

Neurotransmitter affected by Cholinergic agents

Acetylcholine.

Common sources of muscarinic poisoning

Certain species of wild mushrooms.

Effects of Tachycardia

A possible side effect from atropine and other cholinergic agents.

Purpose of administering Glucagon

To rapidly increase blood glucose levels in hypoglycemic patients.

Up to how many auto-injectors can patients receive

Typically 1-3 auto-injectors based on severity of symptoms.

Importance of patient assessment in cyanide exposure

Do not wait for severe symptoms to develop before administering Hydroxocobalamin.

Potential allergic reaction from Hydroxocobalamin

Can cause skin and mucous membrane discoloration.

Characteristics leading to hypertension post-Hydroxocobalamin

Increases in blood pressure may occur after infusion.

Peak effect time of Hydroxocobalamin

8-12 hours after administration.

Dosage based on symptoms for Naloxone

0.4-1 mg IV every 3 mins as needed.

Parameter to monitor after administering Naloxone

Maintain respiratory rate at greater than 12/min.

Reassessing hypoglycemia

Consider oral glucose if the patient is conscious & alert.

IM administration

Intramuscular route of medication delivery.

Importance of 0.9% NS in Hydroxocobalamin preparation

Diluent used to prepare the medication for infusion.

Contrast between Opioid and Non-Opioid overdoses

Naloxone is effective for both types of narcotic overdoses.

Goal of Cholinesterase Reactivators like Pralidoxime

To restore normal neuromuscular transmission.

Initial symptoms of overdose treatment

Handle Agitation + Severe Respiratory Distress with 3 auto-injectors.

Central Nervous System (CNS) role

Site where opioid receptors are located for naloxone action.

Management of airway support in toxic situations

Administer high-flow O2 and monitor respiratory status.

Recognition of symptoms for organophosphate toxicity

Use the SLUDGEM mnemonic to identify symptoms.

Reversible effects of Naloxone on opioids

It reverses respiratory depression caused by opioid overdose.

Contrasting durations of effects

Opioid effects may outlast naloxone's duration of action.