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ACCS Drugs from Study Exam Questions and
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Fentanyl, Morphine, and Hydromorphone (Dilaudid) are all Narcotics, what drug reverses the adverse affects of decreased Respiratory Rate and Heart Rate? ✔✔Narcan A drug that blocks pain is considered what class? ✔✔An Opiod Ketorolac (Toradol) and Ibuprofen are Nsaids. Which drug out of these two have an adverse affect of renal failure? ✔✔Toradol (Ketorolac) Why are Nsaids used in combination with opiods? ✔✔To reduce the amount of opiods used since Nsaids combat pain as well. Diazepam (Valium), Lorazepam ( Ativan), Midazolam (Versed) are all anti anxiety medications. These drugs can also suppress respiratory drive, what drug reverses this adverse affect? ✔✔Flumazenil PHenobarbital and pentobarbital are barbiturates (usually now replaced by benzos) for treatment of ICU sedation and seizures. Adverse effect is a decrease is HR, RR, and BP. What drug reduces this, PH is a clue. Also, what differentiates these two drugs for a specific treatment? ✔✔Physostigmine, Phenobarbital is used for sedation and alcohol withdrawal issues What type of agent is physostigmine? ✔✔An arousal agent, so this does NOT REVERSE. Mostly used on barbiturates. Used with adverse affect of a decrease in HR, RR, and BP.
Dexmedetomidine (Precedex) is used alternatively to Propofol and is a good choice for patients struggling to wean off of Propofol and other drugs, especially from vent. Why? ✔✔This drug does not result in respiratory depression Propofol (Diprivan) is a medication used for pain and sedation. This drug wears off quickly (NO REVERSAL NEEDED). If there is a hemo compromise shortly after started or increasing (Decrease in BP), what is your action? ✔✔Discontinue! Very common on exam Etomidate (Amidate) is a very common medication used in Rapid Sequence Intubation. What is the adverse affect? ✔✔May increase ICP, so do NOT use with TBI or Seizures Ketamine (Ketalar) is another common RSI medication, what are the pros and cons of this drug? ✔✔Does not suppress respiratory drive, so it is a good medication for an awake intubation. DO NOT use if patient is severely hypertensive. Haloperidol (Haldol) is used for what type of delirium, and what agent is used for reversal, only if patient developed anaphylaxis? What drug is also used for the same issue, but less common? ✔✔ICU delirium, epinephrine. Risperidone (Risperdal) What Neuromuscular blocking agent is non reversible and cannot be used with hyperkalemia? ✔✔Succinylcholine (NEED to sedate!) Nimbex (cisatracurium) is a paralytic used for mechanical ventilation when needed. When is this considered to be used and what is its adverse affect, what meds will reverse? (Rocuronium also is a paralytic with adverse affect of bradycardia, same reversal agents) ✔✔When patient is difficult to ventilate with high plateau pressures with ventilatory dyssynchrony consider this drug. (Asthma!) Reversal agents are edrophonium, pyridostigmine, and neostigmine.
Propranolol and Verapamil (Calan, Veralan) both decrease HR, Which one is a beta blocker and which one is used for supraventricular tachycardia? Labetalol (Normodyne and Metaprolol (Lopressor) are also beta blockers, decreases BP) ✔✔Propranolol beta block decreases HR and BP. Verapamil is used to SVT second line. Atropine and Dopamine are both used to increase heart rate from bradycardia, but when is Dopamine used? ✔✔After atropine has been tried What drug corrects an abnormal rhythm (AFIB) ✔✔Amiodarone Diltiazem is used for what three conditions? ✔✔Angina, Hypertension, and Arrhythmias HYdrazaline is used for what two conditions. HY is a clue. ✔✔HYpertension, adverse affect is hypotension and CNS depression What drug directly vasodilates, and has an adverse affect of thrombocytopenia? ✔✔Primacor (Milrinone) What is a calcium channel blocker that decreases blood pressure? ✔✔Nicardipine (Cardene) Nitroprusside (Nipride) affects blood pressure how? ✔✔DECREASES BP Dobutamine, Levophed, and phenylephrine are all used to treat low blood pressure. Which one is the first line in septic shock and which one is only used when other options have failed? ✔✔Levophed for septic shock
Phenylephrine when other options have failed Which drug is often used to treat CHF? ✔✔Digoxin What drug is used foat r people at risk for heparin induced thrombocytopenia? It prevents fibrin formation. Use for patients undergoing coronary procedures ✔✔Acova Plavix (clopidogrel) prevents clotting. What are the two indications for this medication? (Diminishes platelet cascades) ✔✔Unstable angina or CVA (Stroke) Heparin drugs (Lovenox) and Warfarin are used for DVT prevention and treatment of PE. Which is more preferred, low molecular weight or unfractionated? What type of PE should these drugs be used for? ✔✔Uncomplicated PE, no hemodynamic compromise instead of tPA Ateplase What drug is a clot buster and should ONLY be used when their is hemodynamic compromise in a pulmonary embolism? DO NOT use with active bleeding or recent surgery ✔✔tPA Ateplase Reteplase Bumex (bumetanide) and Lasiks are diuretics, but when should you be cautious using this? Diamox is also a diuretic, but what is it also used for? ✔✔Kidney function is very poor BUN will determine this, use dialysis instead. Diamox is a respiratory stimulant What diuretic CANNOT be used with blood product, but is used to reduced cerebral edema and ICP? ✔✔Mannitol
Bactrim is used for what type of exerbation? ✔✔COPD What is a broad type of antibiotics used for infection from line placements and MRSA? ✔✔Vancomycin Synthoid (levothyroxine) is used to treat what type of thyroidism, hypo or hyper? ✔✔HYPO, if thyroid function is high stop treatment (.4-4) Dilantin (phenytoin) treats seizures in critical care, this is not the first choice, what is? ✔✔Lorazepam What is a common steroid given for all inflammatory processes including asthma and mild stridor. What is the adverse effect? ✔✔Solumedrol. Aggravates gastritis, do not give if this is present
