12 Questions
Which medication is recommended as the drug of choice for PRES due to its alpha- and betablocking effects?
Labetalol
In the absence of labetalol, what alternative medication can be used as a substitute for lowering blood pressure?
Nitroglycerin
What is the infusion rate of labetalol when administered intravenously to lower blood pressure?
2 mg/min
What can be a potential consequence of giving NTG sublingually in hypertensive emergencies?
Excessive hypotension
In the context of managing a patient in decompensated shock, why is hypovolemic shock considered incorrect?
There are multiple reasons for the vital signs without hypovolemia
What treatment approach is recommended for a patient in compensated shock before considering pressor options like dopamine?
Fluid expansion
Which medication is preferred for managing cardiogenic shock due to its positive inotropic effects and minimal effects on peripheral circulation?
Dopamine
What is a common mistake when considering the management of aortic aneurysm?
Using labetalol without considering its vasodilation effects
Which legislation in the United States led to the scheduling system classifying medications with potential for abuse?
Comprehensive Drug Abuse Prevention and Control Act of 1970
How did Nitroglycerine impact blood pressure?
It lowered blood pressure
Which major U.S. law gave authority to oversee the safety of food, drugs, and cosmetics?
Food, Drug, and Cosmetic Act
What did the Comprehensive Drug Abuse Prevention and Control Act classify potentially abused medications into?
5 schedules based on abuse potential
Study Notes
Medication Management
- Labetalol is the drug of choice for Posterior Reversible Encephalopathy Syndrome (PRES) due to its alpha- and beta-blocking effects.
- In the absence of labetalol, nicardipine can be used as a substitute to lower blood pressure.
Hypertensive Emergencies
- The infusion rate of labetalol when administered intravenously to lower blood pressure is 2-8 mg/min.
- Sublingual nitroglycerine (NTG) can cause a potential rebound effect, leading to increased blood pressure in hypertensive emergencies.
Shock Management
- Hypovolemic shock is considered incorrect in decompensated shock because it does not consider other types of shock (e.g., cardiogenic, obstructive, and distributive).
- The recommended treatment approach for a patient in compensated shock is to optimize volume status and vasopressor support before considering pressor options like dopamine.
- Dopamine is preferred for managing cardiogenic shock due to its positive inotropic effects and minimal effects on peripheral circulation.
Aortic Aneurysm
- A common mistake when considering the management of aortic aneurysm is failure to consider other diagnoses that may mimic its symptoms.
Legislation and Regulations
- The Comprehensive Drug Abuse Prevention and Control Act classified potentially abused medications into five schedules.
- The Federal Food, Drug, and Cosmetic Act (FD&C Act) gave authority to oversee the safety of food, drugs, and cosmetics in the United States.
- Nitroglycerine reduces blood pressure due to its vasodilatory effects.
Learn about the use of Labetalol as the drug of choice for treating elevated blood pressure in paramedic interventions. Understand its mechanism of action and implications for patient care.
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