ACCS Pharmacology, Exam Review Questions and answers, Full review.

ACCS Pharmacology, Exam Review Questions and answers, Full review. Fentanyl Citrate (Sublimaze) - -Pain management (Analgesia) (Opioid) Use: any indication of pain (vitals, pain scale), s/p MVA, SCI, vent asynchrony Adverse: resp depression Notes: may also come across Sufentanil and Remifentanil (both opiod based as well) Morphine - -Pain management (Analgesia) (Opioid) (Powerful narcotic)! Use: any indication of pain (vitals, pain scale), dyspnea, hospice, pallative care, end of life Adverse: resp depression, cardiac, lowers RR, BP, cardiovascular hemodynamics. Reverse: Naloxone (Narcan) Notes: nebulize for SOB, may be instilled via ETT, large doses required for continuous sedation so not optimal choice for that. Inhaled morphine has less potential side effects than the IV route Hydromorphone (Dilaudid) - -Pain management (Analgesia) (Opioid) (very powerful narcotic)! Use: any indication of pain (vitals, pain scale) Adverse: resp depression, cardiac, reduce dosage for renal failure Reverse: Naloxone (Narcan) Ketorolac (Toradol) - -Pain management (Analgesia) (NSAID) Use: for management of moderately severe pain Adverse: do not use if renal failure + hypotensive d/t volume Notes: often used in combination w/ an opioid as it decreases the required opioid dose dose to adequately manage pain Ibuprofen (Advil, Motrin) - -Pain management (Analgesia) (NSAID) Use: management of pain Notes: just like Ketorolac, Ibuprofen is often used in combo w/ an opioid as it decreases the required opioid dose dose to adequately manage pain Naloxone (Narcan) - -Opioid Reversal Agent Reverses: opioids (Fentanyl, Morphine, Hydromorphone) Opioids may cause resp depression or cardiac effects. If it is clinically significant, reverse. Quick duration, may require several doses (adverse effect will reappear) Adverse: hypertension, tachycardia Clues to use Narcan: pt on Morphina PCA, Fentanyl, any opioids, pin point pupils Lorazepam (Ativan) - -Anti-anxiety (Benzodiazepines) Use: anxiety (weaning, NPPV), drug/alcohol withdrawal Adverse: may interact w/ narcotics and suppress resp drive, play role in ICU delirium Reverse: Flumazenil Midazolam (Versed) - -Anti-anxiety (Benzodiazepines) Use: procedural sedation, anxiety (weaning, NPPV), drug/alcohol withdrawal Adverse: may interact w/ narcotics and suppress resp drive, play role in ICU delirium Reverse: Flumazenil Notes: use in either kidney or liver failure will prolong effect of the drug (takes longer to leave the system) Admin: IV push or drip Diazepam (Valium) - -Anti-anxiety (Benzodiazepines) Use: procedural sedation, anxiety (weaning, NPPV), drug/alcohol withdrawal Adverse: may interact w/ narcotics and suppress resp drive, play role in ICU delirium Reverse: Flumazenil Note: NOT OFTEN USED in critical care d/t "drug accumulation" issues