May impair renal function, may prolong labor in pregnancy with increased bleeding
What are Aspirin's Precautions
1.Medical Hx of pre-existing ulcers, liver diseas, or bleeding disorders 2. Due to the possible association with reye's syndrome, do not give drug to children or teenagers with signs and symptoms of chickenpox withour physician consultation
What are Aspirin's interactions
1. Aspirin inhibits anti-hypertensive effects of ACE inhibitors 2. Ammoniun chloride and other urin acidifying drugs will increase effects of aspirin- watch for toxicity
Aspirin's Onset and durration of Action
Onset is 5-30 min and may last 1-4 hr, peak in 15 min
What is the Classification of Morphine Sulfate
Opioid Narcotic, CNS Depressant
What is the First Mechanism of Action for Morphine Sulfate
Alters pain perception and produces euphoria
What is the Second Mechanism of Action for Morphine Sulfate
Decreases myocardial oxygen demand by decreasing preload and decreasing afterload
What is the Third Mechanism of Action for Morphine Sulfate
Decreases the CNS by interacting with opiate receptors in the brain
What are the indications for Morphine Sulfate
1. Moderate to severe pain 2. Chest pain of suspected myocardial orgin 3. Pulmonary Edema from CHF with or without chest pain 4. Burns
What are the Contraindications for Morphine Sulfate
1. Altered level of consciousness 2. Adbominal pain of unknown etiology 3. Patients at risk of respiratory depression 4. Head injury 5. Hypovolemia
What are the Cardiovascular side effects for Morphine sulfate
What are the Respiratory side effects for Morphine Sulfate
respiratory depression and respiratory arrest
What are the Gastrointesinal side effects for Morphine Sulfate
Nausea/ Vomiting
What are the precautions for Morphine Sulfate
Morphine sulfate is an opiate derivative- Naloxone should be available to reverse any severe respiratory side effects
What are the interactions for Morphine Sulfate
Use with caution with patients taking other analgesics, depressants or narcotics
What are the Routes of Administration for Morphine Sulfate
IV, IO, IM
What is the Onset and Duration of Action for Morphine Sulfate
IV/IO will have an onset of 2-5 min and IM will have an onset of 5-10 min. Each will last approximately 3-5 hr
What are the Dosages for Morphine Sulfate
Adult: Pain Relief 1.0 - 10.0 mg IV titrated to pain relief or 5.0 - 10.0 mg IM as a single dose only Pulmonary Edema: 5.0 -10.0 mg slow IV push (2.0 mg/min)Pediatric: 0.1 -0.2 mg/kg slow IV push (1.0mg/min) titrated to pain relief or 0.1 mg/kg IM
Morphine Sulfate Notes
May Draw 10 mg (1ml) into a syringe and mix with 9ml of normal saline. This creates a 1mg/1ml concentration for better control when administering the medication
What is the Classification for Activated Charcoal
Adsorbent
What is the Mechanism of Action for Activated Charcoal
Binds (adsorbs) toxic substances inhibiting gastrointestinal absorption, leaving less toxic substance in body circulation; increasing fecal elimination of drug/charcoal complex
What is the indication for Activated Charcoal
Suspected ingestion of drugs or chemicals
What are the contraindications for Activated Charcoal
1. Patients with a compromised airway – need to minimize chance for aspiration or obstruction 2. Ingestion of Iron or multi-vitamins
What are the side effects for Activated Charcoal
Respiratory: choking Gastrointestinal: vomiting, black stools, abdominal cramping/bloating
What are the percautions for Activated Charcoal
1. Should not be administered immediately after Syrup of Ipecac 2. Must shake vigorously prior to administration 3. Do not use charcoal with sorbitol (an added sweetener) in children < 1 yr
What are the interactions for Activated Charcoal
Will not bind with alcohol
What are the routs of administration for Activated Charcoal
voluntarily by patient or PO via nasogastric/orogastric tube
What is the onset and duration of action for Activated Charcoal
Onset is immediate, peak effect and duration are unknown
What is the dosage for Activated Charcoal
Adult: Initially 1g/kg PO Pediatric: Initially 1g/kg PO
Notes for Activated Charcoal
1. Does not absorb cyanide, ethanol, methanol, ferrous sulfate, caustic alkali or mineral acids 2. Most effective if administered within 30 minutes of ingestion 3. Use very cautiously in patients who cannot protect their own airway
What are some of the trade names for Activated Charcoal
1. Relaxes smooth muscles causing venous dilation 2. Reduces preload and afterload to the heart 3. Dilates the coronary arteries resulting in increased perfusion of the myocardium
What are the indications for Nitroglycerin
1. Chest pain of cardiac origin 2. Acute pulmonary edema
What are the contraindications for Nirtoglycerin
1. Blood pressure less than 100 mmHg systolic2. Patients who have taken Erectile Dysfunction medications in the last 24-48 hours3. Signs and symptoms of head trauma (increased intracranial pressure) or cerebral hemorrhage4. Poor systemic perfusion
What are the Cardiovascular side effects of Nitroglycerin
What are the Neurological side effects of Nirtoglycerin
headache
What are the Other side effects of Nitroglycerin
flushed skin, sublingual burning
What are the precautions for Nitroglycerin
Monitor blood pressure closely for signs of hypotension (before and after administration)
What are the interactions for Nitroglycerin
Use with caution with patients who already use vasodilators, alcohol, calcium channel blockers, beta blockers and phenothiazides
What are the routes of administration for Nitroglycerin
SL, TM (transmucosal), transdermal (nitropaste)
What is the onset and duration of action for Nitroglycerin
Onset in 1-3 minutes and may last 30-60 minutes
What is the dosage for Nitroglycerin
Adult: 0.4 mg as a single spray or single tablet. May repeat every 3-5 minutesPediatric: not recommended
Notes for Nitroglycerin
1. Do not shake canister if administered as a spray as it will altered the metered dose in a single spray 2. Do not have patient inhale drug on administration as it will alter absorption rate
Notes 2 for Nitroglycerin
3. Establish IV prior to or immediately following administration to combat hypotension if necessary
What is the classificationof Oxygen
Gas
What is the Mechanism of Action for Oxygen
Increases percentage of oxygen in inspired air (FiO2)
What is FiO2
Fractional Inhaled O2
What are the indications of Oxygen
1. Increase oxygen demand2. Hypoxemia or hypoxia3. Chest pain of myocardial origin, cardiovascular compromise or emergencies4. Respiratory insufficiency5. Neurological diseases or disorders6. Hypoperfusion state or trauma
What are the Routes of Administration for Oxygen
Inhaled
What is the Onset and Duration of Action for Oxygen
Cardio Block2anatomy
