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Advanced Pharmacology for Flight Nurses Flashcards
| Front | Back |
| Calcium gluconate administration in hyperkalemia at altitude: dose and infusion rate | Give 10 mL of 10% Ca gluconate over 2 minutes, monitor ECG changes; no altitude dose adjustment but watch for IV line air expansion |
| Describe the interaction between propofol and fentanyl in air medical sedation and recommended titration | Synergistic CNS and respiratory depression; reduce each agent by ~25%, titrate to target sedation score and monitor capnography and hemodynamics |
| Dexmedetomidine infusion titration nuances in air medical sedation and altitude effects | Loading dose 0.5 mcg/kg over 10 minutes then infusion at 0.2–0.7 mcg/kg/hr; start at lower end, monitor for bradycardia and hypotension |
| Drug interaction between albuterol and nonselective beta-blockers in flight | Nonselectives blunt albuterol effect and increase bronchospasm risk; avoid nonselectives or switch to beta-1 selective blockers |
| Heparin titration for DVT prophylaxis in air transport with limited monitoring | Start 80 units/kg bolus then 18 units/kg/hr infusion; maintain PTT at 1.5–2× baseline using intermittent point-of-care labs for adjustments |
| How does altitude-induced hypoxia alter midazolam pharmacokinetics and titration strategy | Decreased hepatic clearance prolongs effect; use a lower initial dose (1 mg IV), titrate in 0.5 mg increments with extended monitoring intervals |
| Ketamine dosing adjustments for analgesia in hypobaric conditions | Use 0.2–0.5 mg/kg IV bolus; expect prolonged effect, titrate in 5 mg increments and monitor for emergence reactions |
| Magnesium sulfate infusion for eclampsia transport: dosing and altitude considerations | Administer 4 g IV over 20 minutes then 1 g/hr infusion; monitor magnesium levels and deep tendon reflexes, adjust if reflexes are absent |
| Norepinephrine infusion challenges at altitude and dosing considerations | Validate infusion pump calibration due to pressure changes; start at 0.05 mcg/kg/min and titrate by 0.01 mcg/kg/min based on MAP |
| Optimal dosing adjustment for fentanyl in flight nursing given increased CNS sensitivity at altitude | Reduce initial bolus by 25% and monitor respiratory rate and SpO2; titrate in 10–20 mcg increments waiting 2–3 minutes between doses |
| Rocuronium onset and duration changes during flight and monitoring tips | Onset may be delayed and duration prolonged; use TOF monitoring, wait 90 seconds before intubation, redose based on TOF count |
| Vancomycin infusion rate concerns at altitude and associated precaution | Faster infusion increases Red Man syndrome risk; infuse over at least 60 minutes and monitor for flushing and hypotension |
Front
How does altitude-induced hypoxia alter midazolam pharmacokinetics and titration strategy
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Back
Decreased hepatic clearance prolongs effect; use a lower initial dose (1 mg IV), titrate in 0.5 mg increments with extended monitoring intervals
Front
Optimal dosing adjustment for fentanyl in flight nursing given increased CNS sensitivity at altitude
Back
Reduce initial bolus by 25% and monitor respiratory rate and SpO2; titrate in 10–20 mcg increments waiting 2–3 minutes between doses
Front
Ketamine dosing adjustments for analgesia in hypobaric conditions
Back
Use 0.2–0.5 mg/kg IV bolus; expect prolonged effect, titrate in 5 mg increments and monitor for emergence reactions
Front
Norepinephrine infusion challenges at altitude and dosing considerations
Back
Validate infusion pump calibration due to pressure changes; start at 0.05 mcg/kg/min and titrate by 0.01 mcg/kg/min based on MAP
Front
Drug interaction between albuterol and nonselective beta-blockers in flight
Back
Nonselectives blunt albuterol effect and increase bronchospasm risk; avoid nonselectives or switch to beta-1 selective blockers
Front
Rocuronium onset and duration changes during flight and monitoring tips
Back
Onset may be delayed and duration prolonged; use TOF monitoring, wait 90 seconds before intubation, redose based on TOF count
Front
Describe the interaction between propofol and fentanyl in air medical sedation and recommended titration
Back
Synergistic CNS and respiratory depression; reduce each agent by ~25%, titrate to target sedation score and monitor capnography and hemodynamics
Front
Vancomycin infusion rate concerns at altitude and associated precaution
Back
Faster infusion increases Red Man syndrome risk; infuse over at least 60 minutes and monitor for flushing and hypotension
Front
Heparin titration for DVT prophylaxis in air transport with limited monitoring
Back
Start 80 units/kg bolus then 18 units/kg/hr infusion; maintain PTT at 1.5–2× baseline using intermittent point-of-care labs for adjustments
Front
Magnesium sulfate infusion for eclampsia transport: dosing and altitude considerations
Back
Administer 4 g IV over 20 minutes then 1 g/hr infusion; monitor magnesium levels and deep tendon reflexes, adjust if reflexes are absent
Front
Calcium gluconate administration in hyperkalemia at altitude: dose and infusion rate
Back
Give 10 mL of 10% Ca gluconate over 2 minutes, monitor ECG changes; no altitude dose adjustment but watch for IV line air expansion
Front
Dexmedetomidine infusion titration nuances in air medical sedation and altitude effects
Back
Loading dose 0.5 mcg/kg over 10 minutes then infusion at 0.2–0.7 mcg/kg/hr; start at lower end, monitor for bradycardia and hypotension
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Explores critical medications, dosing challenges at altitude, titration nuances, and drug interactions frequently encountered in air medical settings.