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PAAM Week 13
4/20 Raspatory & Endocrine Medications
| Question | Answer |
|---|---|
| Epi 1:1,000 should always be given via what rout? | IM never ever ever give epi 1:1 IV |
| What is the equation for Cardiac output? | CO=(Stroke volume [SV] X Heart rate [HR]) |
| What is the equation for Blood pressure? | BP=(SV x HR) x SVR |
| What is the Resting potential and action potential for the Cardiac autorhythmic cell? | -60mV to -40mV 25 or 6 to 4 |
| What is the resting potential and action potential of a cardiac contractile cell? | -90 to -85 |
| What is the action potential and resting potential of a Neuron? | -70 to -55 cant drive 55 |
| What is a Class I Antiarrhythmics | Sodium Channel Blocker |
| What is a Class II Antiarrhythmics | Beta Blocker |
| What is a Class III Antiarrhythmics | Potassium Channel Blockers |
| What are Class IV Antiarrhythmics | Calcium Channel Blockers |
| What are Miscellaneous | antiarrhythmic agents that do not fit into the traditional Class Adenosine, Digoxin, Mag-Sulfate, Atropine |
| Atrovent is what type of medication? | Parasympatholytic medication, it blocks muscarinic receptors and allows the sympathetic system to help Can be used in conjunction with a beta 2 agonist to open up the bronchioles and alveoli |
| What would occur if you introduce Atrovent (ipotropium) into the lungs | Block Ach from binding to muscarinic receptors (Parasympatholytic ) causing indirect bronchodilation and dries up condensation. *never give Atrovent alone always conjoin with albuterol (duo neb)* *Dont use with CHF Hypertensive Pt Tacky cardia* |
| Mag-Sulfate is used for what? | Can be used as a bronchodilator, if pt has good bp NEVER EVER GIVE TO HYPOTENSIVE PT Can be used for seizures, Can be used for eclampsia. Can be used for antiarrhythmic Can be used for torsabs de points |
| Mag- sulfate is what kind of channel blocker? | very powerful non-adrenergic bronchodilating physiological Calcium channel blocker muscle is all about calcium |
| What is myosin and tropomyosin | tropomyosin is a protective coating over the myosin cells when calcium binds to myosin its going to make the muscles contract mag-sulfate is going to block calcium from binding. Non-adrenergic |
| what medication would you give to a women whom is having secures and is also pregnant | Mag-Sulfate is going to be the first line medication. |
| Eclampsia is going to have what kind of effect of your neurons? | They are going to have a super influx of calcium. Calcium is all about your neurons releasing neuro transmitters |
| What are contraindications for the use of meg-sulfate? | High degree heart blocks, Bradycardia you don't want to kill their heart rate. Shock they'll already be hypotensive you don't want to assist with that. Dialysis Hypocalcemia |
| What are two types of dialysis. | Hemipenile dialysis connected to a machine based off of osmosis and diffusion. Peritoneal dialysis they have a catheter in their abdomen. |
| signs and symptoms of hypocalcemia | Bradycardia, hypotension, blood work, ECG |
| What are the adverse effects of Mag-sulfate | Flushing of the skin sweating Bradycardia stopping sodium from getting into phase 0 Raspatory depression because of how the neurotransmitters get inside your brain. Hypothermia Hypotension |
| What is the Dose for mag-sulfate | 1-2 Grams over 10-20 min 2g over 20 is the same as 1g over 10 min so put 2g in 100mL for 20 min because = 1g over 10 minuets |
| What is the pediatric dose with mag sulfate? | 25-50 mg/kg IV/IO over 15-30 min **Max dose of 2 Grams** do not supersede the adult dose. because you are giving IV/IO its going to have a greater effect over the heart a veins so drip over more time 15-30 minutes. works great for asthma, and anaphylaxis. |
| pulmonary steroids | Glucocorticoid medications |
| How long does it take for steroids to kick in | hours and hours 4-20hrs |
| when are you not going to give a steroid medication | When they have an active infection in their because you would hinder their immune system. |
| What is a corticosteroid? | Glucocorticoid medications help by suppressing cells like mast cells, eosinophils, and lymphocytes. They also enhance the effects of β2 medications. |
| What are your corticosteroid medications? | Dexamethasone Solu-Medrol |
| What is more powerful Dexamethasone or Solu-Medrol? | Dexamethasone is 10x more powerful then Solu-Medrol |
| What are the pharmacodynamics of Dexamethasone? | Anti-inflammatory; suppresses immune response |
| What are the indications for Dexamethasone? | Bronchial Asthma COPD Anaphylaxis this is not yout go2 medication you should use your rep medications first. |
| What are the contraindications of Dexamethasone? | Know hypersensitivity Fungal infections Any infections Sepsis |
| What are the adverse effects of Dexamethasone? | Fluid retentions makes capillaries for permeable more leakage of stuff. Think hydrostatic pressure holes are bigger going to push more fluid out. Hinders wound healing because it shuts down the immune system Raised blood sugar. |
| What Effects will corticosteroids have on your blood glucose? | Spikes BGLs |
| What is the adult and pediatric dose for Dexamethasone? | Adult dose 10mg IV/IO/PO Pediatric dose 0.5 mg/kg IV/IO/PO **MAX DOSE 10mg** Do not exceed adult dose. |
| Solu-Medrol Comes non constituted what does non-constituted mean? | Its not mixed it comes in powder form. |
| What is the pharmacodynamics of Solu-Medrol? | Same as Dexamethasone Little bit weaker shorter duration of action. |
| What is the dose for Solu-Medrol for adults and pediatrics? | Adult dose: 125-250 mg IV/IO Pediatric dose: 2mg/kg IV/IO MAX DOSE OF 60MG |
| What are your Antihistamine medications? | Diphenhydramine (Benadryl) |
| What cells release histamine and what does it do to the body. | Granulocytes: Basophils and Mastcells. through a presses called degranulation. Heparin/Histamine Causes bronchoconstriction and vasodilation seen in anaphylaxis all about histamine. |
| What receptors does histamine bind to? | H1 H2 Histamine receptors |
| Where else in the body does histamine effect? | Blocks histamine in your brain and makes you drowsy. GI histamine blocks acid production in your stomach (perlosec) Asthma the body produces histamine with an asthma response you dont want to give someone Diphenhydramine sedation sleep aid |
| What are the indications for Diphenhydramine? | Allergic reactions Anaphylaxis Extrapyramidal Sedation |
| What are the contraindication of Diphenhydramine? | Known hypersensitivity |
| What are the adverse effects of Diphenhydramine? | Drowsiness Ø Dizziness Ø Loss of coordination Ø Blurred vision Ø Hypotension you have to use this with anaphylaxis you should have used epi before this Ø Tachycardia |
| What is the dose for adults with Diphenhydramine? | 25 - 50 mg slow IV/IO or IM 25 for moderate 50 for sevier reactions |
| What is the Pediatric Dose for pediatrics? | 1-2 mg/kg slow IV/IO/IM **MAX DOSE 50MG** |
| What are your endocrine medications? | Glucagon Insulin Dextrose |
| The endocrine system controls your body via what? | Hormones |
| What are the different endocrine glands in the body? | Pituitary gland the master pineal gland releases melatonin regulate sleep thalamus adrenal glands thyroid parathyroid Pancreas but we mess with diabetes |
| What does the pancreas do for the body? | Controls your blood glucose level Secretes insulin 2% Releases pancreatic juice an accessory digestive organ 98% Exocrine is digestive functions endocrine is blood glucose regulation systemic |
| Where is the endocrine tissue located inside the pancreas | The Islets of Langerhans. |
| Inside the Islets of Langerhans are different types of cells what are they? | Alpha cells Beta cells Delta cells |
| What do Delta Cells in the pancreas release | Somatostatin |
| What do Beta Cells in the pancreas release | Releases isoline when the pancreases detects a rise in sugar levels causing a decrease in sugar levels. |
| What do Alpha Cells in the pancreas do? | Releases glucagon which goes to your liver looking for glycogen |
| How does glucagon help with your blood glucose levels? | It doesn't it needs to go to your liver to break down glycogen into glucose |
| What is found in the liver that helps with BGL | Glycogen a big storage of glucose |
| What is the preces that is responsible for releasing glucose into the bloodstream? | Glycogenolysis (lysis means to cut down) |
| What is does somatostatin do in the body? | Inhibit or stop the release of other hormones and bodily secretions. |
| What do Delta cells do in the body? | Regulate the Alpha and Beta Cells by releasing somatostatin which inhibits the production sequences of those cells |
| Aggies are Great=A G/ Alpha cells, Glucagon | Bull Shit= B S /Beta cell, iSoline Negative feedback loop |
| What is a normal BGL range? | 120/80 |
| Who don't have storages of glycogen? | babies alcoholic the starved and so administering glucagon doesn't really work for them |
| What dose IDDM stand for? | Insulin dependent diabetes mellitus |
| What is type 1 diabetes? | An autoimmune disease destroyed the beta cells . Non-reversible. |
| What is NIDDM? | Non insulin dependent diabetes mellitus |
| What is type 2 diabetes? | Insulin resistance. Insulin receptors have changed morphology. acn become insulin dependent. being overweight |
| What medication would you give to an unconscious pt | Dextrose |
| What is Dextrose | A medication is a monosaccharide its sugar. |
| What are the indications for Dextrose? | Correction of hyperglycemia. |
| What are the contraindications of Dextrose? | Hyperglycemia. |
| What are some adverse effects of Dextrose? | May worsen pre-existing hyperglycemia Tissue necrosis if extravasation occurs you have to make sure that you IV line a patent throughout administration |
| What is the dose for Dextrose? | 25 G IV or IO (D50) 25 G IV or IO (D10) |
| What is the pediatric dose for Dextrose? | 5-10 mL/kg (D10) |
| What is Glucagon? | Classification: Synthetic Hormone Made by the alpha cells. |
| What is the action of Glucagon? | Ø Elevates blood glucose levels through conversion of glycogen to glucose (IM route) Binds to Glucagon receptors and stimulates adenyl clyclase, which increases cAMP (IV route) Increase in cAMP causes an up- regulation of calcium channels in SA and AV n |
| The release of histamine in the body causes what two bad things to occur? | Vasodilation, Bronchoconstriction |
Created by:
ejarami4