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Pharmacology: Calcium Chloride and Dextrose Administration
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Pharmacology: Calcium Chloride and Dextrose Administration

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Questions and Answers

What is the primary action of Dextrose?

  • Rapidly increases serum glucose levels (correct)
  • Rapidly decreases serum calcium levels
  • Rapidly increases serum potassium levels
  • Rapidly decreases serum sodium levels

    • What is the maximum field adult dosing of 50% dextrose IV?

  • 250 mL of 50% dextrose
  • 25 mL of 50% dextrose
  • 50 mL of 50% dextrose (correct)
  • 100 mL of 50% dextrose

    • What is a special consideration when administering Diazepam?

  • Do not administer to patients with known allergy
  • Do not administer to patients with known kidney disease
  • Do not administer to patients with known stroke unless hypoglycemia is documented (correct)
  • Do not administer to patients with known heart failure

    • What is the pediatric dose of Diazepam for seizures?

    <p>0.1 mg/kg IV/IO</p> Signup and view all the answers

    What is a side effect of Dextrose administration?

    <p>Cerebral hemorrhage</p> Signup and view all the answers

    Why should Calcium Chloride and Sodium Bicarbonate administrations be separated?

    <p>To prevent adverse cardiac reactions</p> Signup and view all the answers

    What is the classification of Diazepam?

    <p>Benzodiazepine, anticonvulsant</p> Signup and view all the answers

    What is the trade name of Diazepam?

    <p>Valium</p> Signup and view all the answers

    What is the effect of alpha stimulation on peripheral vascular resistance?

    <p>Increase</p> Signup and view all the answers

    What is the indication for using epinephrine in anaphylaxis?

    <p>Severe refractory wheezing</p> Signup and view all the answers

    What is the contraindication for using epinephrine in a patient with coronary insufficiency?

    <p>Coronary insufficiency</p> Signup and view all the answers

    What is the dose of epinephrine for anaphylaxis in an adult?

    <p>0.3 mg IM</p> Signup and view all the answers

    What is the effect of beta 1 stimulation on heart rate?

    <p>Increase</p> Signup and view all the answers

    What is the effect of beta 2 stimulation on bronchial smooth muscle?

    <p>Relaxation</p> Signup and view all the answers

    What is the special consideration before administering epinephrine?

    <p>Correct hypokalemia</p> Signup and view all the answers

    What is the pediatric dose of epinephrine for anaphylaxis?

    <p>25 kgs 0.3 mg IM</p> Signup and view all the answers

    What is the primary reason for using the IV route for administering diphenhydramine in severe anaphylactic shock?

    <p>To achieve faster onset of action</p> Signup and view all the answers

    What is the contraindication for dopamine administration in a patient with cardiac arrhythmias?

    <p>Uncorrected tachydysrhythmias</p> Signup and view all the answers

    What is the primary action of dopamine at infusion rates of 1 to 2 mcg/kg/min?

    <p>Vasal dilation</p> Signup and view all the answers

    What is the dose of diphenhydramine for pediatric patients >2 years of age and >12 kg for antiemetic effects?

    <p>0.1 mg/kg up to 25 mg</p> Signup and view all the answers

    What is the indication for dopamine administration in a patient with bradycardia?

    <p>Second-line treatment</p> Signup and view all the answers

    What is the side effect of diphenhydramine that may cause respiratory distress?

    <p>Wheezing</p> Signup and view all the answers

    What is the contraindication for diphenhydramine administration in a patient with a history of asthma?

    <p>Use with caution</p> Signup and view all the answers

    What is the classification of dopamine?

    <p>Endogenous catecholamine, adrenergic, vasopressor, inotropic agent</p> Signup and view all the answers

    What is the effect of alpha stimulation on peripheral vascular resistance?

    <p>Increases</p> Signup and view all the answers

    What is the indication for Epinephrine 1:10,000 in adults?

    <p>Cardiac arrest</p> Signup and view all the answers

    What is the maximum single dose of Epinephrine 1:10,000 in pediatric patients?

    <p>1 ml</p> Signup and view all the answers

    What is the contraindication for Epinephrine 1:10,000 in pregnant patients?

    <p>Active labor</p> Signup and view all the answers

    What is the primary classification of Etomidate?

    <p>Nonbarbiturate hypnotic</p> Signup and view all the answers

    What is a contraindication for the use of Etomidate?

    <p>Labor/delivery</p> Signup and view all the answers

    What is the classification of Push Dose Epinephrine (Epi 1:100,000)?

    <p>Sympathomimetic, sympathetic agonist</p> Signup and view all the answers

    What is the recommended dose of Etomidate for adults?

    <p>0.2 to 0.4 mg/kg IV/IO</p> Signup and view all the answers

    What is the effect of beta 1 stimulation on heart rate?

    <p>Increases</p> Signup and view all the answers

    What is the trade name of Fentanyl Citrate?

    <p>Sublimaze</p> Signup and view all the answers

    What is the indication for Push Dose Epinephrine (Epi 1:100,000)?

    <p>Profound bradycardia</p> Signup and view all the answers

    What is a contraindication for the use of Fentanyl Citrate?

    <p>Known hypersensitivity</p> Signup and view all the answers

    What is the adult dose of Epinephrine 1:10,000?

    <p>1 mg every 3 to 5 minutes</p> Signup and view all the answers

    What is a side effect of Etomidate administration?

    <p>Hyperventilation</p> Signup and view all the answers

    Study Notes

    Dextrose

    • Classification: Carbohydrate
    • Action: Rapidly increases serum glucose levels, produces short-term osmotic diuresis
    • Indications: Hypoglycemia
    • Contraindications: None in the emergency setting
    • Adult dose: Maximum field adult dosing is 25 g of 50% dextrose IV
    • Pediatric dose: 0.5 to 1 g/kg D10, D25 IV/IO
    • Side Effects: Cerebral hemorrhage, cerebral ischemia, warmth, pain, burning

    Diazepam

    • Classification: Benzodiazepine, anticonvulsant
    • Action: Depresses the Central Nervous System (CNS) by potentiating GABA, an inhibitory neurotransmitter
    • Produces skeletal muscle relaxation, raises the seizure threshold, induces amnesia and sedation
    • Indications: Uncontrolled shivering due to hypothermia, active seizures
    • Contraindications: Known hypersensitivity, neurologic or respiratory depression, narrow angle glaucoma, head injury
    • Adult dose: 2 mg IV/IO for shivering, 0.1 mg/kg IV/IO maximum 4mg for seizures
    • Pediatric dose: 2 mg IV/IO for shivering, 0.1 mg/kg IV/IO maximum 4mg for seizures
    • Side Effects: Sedation, respiratory depression, hypotension, and amnesia

    Dopamine

    • Classification: Endogenous catecholamine, adrenergic, vasopressor, inotropic agent
    • Action: At doses of 1 to 2 mcg/kg/min, causes vasal dilation in the renal, mesenteric, coronary, and industrial vascular beds
    • At doses 2 to 10 mcg/kg/min, dopamine stimulates beta-1 receptors, increasing myocardial contractility and enhancing cardiac impulse conduction
    • At infusion rates of 10 to 20 mcg/kg/min, dopamine stimulates alpha receptors resulting in vasoconstriction, increased systemic vascular resistance and a rise in BP
    • Indications: Refractory cardiogenic or distributive shock, hypotension with low cardiac output states, second line drug for symptomatic bradycardia
    • Contraindications: Known hypersensitivity, hypovolemia, uncorrected tachydysrhythmias, VF
    • Adult dose: IV/IO infusion at 5 to 20 mcg/kg/min, slowly titrate to patient response
    • Side effects: Headache, anxiety, dyspnea, dysrhythmias, hypertension, palpitations, chest pain, dyspnea, nausea, vomiting

    Epinephrine 1:1000

    • Classification: Sympathomimetic, sympathetic agonist
    • Action: Catecholamine with strong alpha adrenergic, strong beta 1, and moderate beta 2 effects
    • Effects of alpha stimulation result in systemic vasoconstriction, increasing peripheral vascular resistance
    • Effects of beta 1 stimulation results in increases in heart rate, myocardial contractility, cardiac output, and myocardial oxygen demand
    • Effects of beta 2 stimulation result in bronchial smooth muscle relaxation
    • Indications: Bradycardia, shock, anaphylaxis, severe refractory wheezing, (IM) croup/bronchiolitis (nebulized)
    • Contraindications: Known hypersensitivity, coronary insufficiency, uncontrolled hypertension, hypothermia, pulmonary edema, myocardial ischemia, hypovolemic shock
    • Adult dose: Anaphylaxis: 0.3 mg IM in the anterior lateral thigh; Respiratory distress: 5 ml of 1 mg/ml nebulized
    • Pediatric dose: Anaphylaxis: 0.3 mg IM in anterior lateral thigh; Respiratory distress: 5 ml of 1 mg/ml nebulized
    • Side Effects: Nervousness, restlessness, headache, tremor, dysrhythmias, chest pain, increased myocardial oxygen demand, hypertension, palpitations, nausea, vomiting

    Epinephrine 1:10,000

    • Classification: Sympathomimetic, sympathetic agonist
    • Action: Catecholamine with strong alpha adrenergic, strong beta 1, and moderate beta 2 effects
    • Effects of alpha stimulation result in systemic vasoconstriction, increasing peripheral vascular resistance
    • Effects of beta 1 stimulation results in increases in heart rate, myocardial contractility, cardiac output, and myocardial oxygen demand
    • Indications: Cardiac arrest
    • Contraindications: None in cardiac arrest
    • Adult dose: 1 mg every 3 to 5 minutes or every other 2-minute assessment
    • Pediatric dose: 0.01 mg/kg every 3 to 5 minutes or every other 2-minute assessment
    • Side Effects: Nervousness, restlessness, headache, tremor, dysrhythmias, chest pain, increased myocardial oxygen demand, hypertension, palpitations, nausea, vomiting

    Push Dose Epinephrine

    • Classification: Sympathomimetic, sympathetic agonist
    • Action: Catecholamine with strong alpha adrenergic, strong beta 1, and moderate beta 2 effects
    • Effects of alpha stimulation result in systemic vasoconstriction, increasing peripheral vascular resistance
    • Effects of beta 1 stimulation results in increases in heart rate, myocardial contractility, cardiac output, and myocardial oxygen demand
    • Indications: Profound bradycardia, shock unresponsive to IV fluids
    • Contraindications: Patients in active labor
    • Side Effects: Nervousness, restlessness, headache, tremor, dysrhythmias, chest pain, increased myocardial oxygen demand, hypertension, palpitations, nausea, vomiting

    Etomidate

    • Classification: Nonbarbiturate hypnotic, anesthesia induction agent
    • Action: Ultra short acting hypnotic that produces rapid sedation with minimal cardiovascular or respiratory depression
    • Indications: Premedication for medicated facilitated intubation or procedural sedation
    • Contraindications: Known hypersensitivity, labor/delivery, or septic shock, particularly in children
    • Adult/Pediatric dose: 0.2 to 0.4 mg/kg IV/IO over 30 to 60 seconds
    • Side Effects: Apnea of short duration, respiratory depression, hypoventilation, hyperventilation, nystagmus, dysrhythmias, hypertension, hypertension, nausea, vomiting, transient involuntary skeletal movements

    Fentanyl Citrate

    • Classification: Opioid analgesic; Synthetic opioid
    • Action: Bind to opioid receptors, producing analgesia, euphoria, respiratory depression, and sedation
    • Indications: Pain management, anesthesia adjunct, severe respiratory distress (palliative care)
    • Contraindications: Known hypersensitivity, administer with caution to patients with a Glasgow Coma Scale less than 15, hypotension, hypoxia after maximal supplemental oxygen therapy, or signs of hypoventilation
    • Side Effects: Respiratory depression, nausea, vomiting, dysrhythmias, hypertension, hypotension, hypoventilation

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    Description

    This quiz covers the administration of Calcium Chloride and Dextrose, including their actions, indications, and contraindications.

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