Advanced Pharmacology for Flight Nurses Flashcards
BCEN CFRN 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 |
About the Flashcards
Flashcards for the BCEN CFRN exam help you master medication management in the challenging environment of rotor- and fixed-wing transport. Each card reviews altitude-related changes in pharmacokinetics and pharmacodynamics, emphasizing safe analgesia, sedation, neuromuscular blockade, and hemodynamic support while in flight.
Detailed dosing pearls cover fentanyl, midazolam, ketamine, propofol, norepinephrine, dexmedetomidine, vancomycin, heparin, and more, highlighting when to reduce boluses, adjust infusion rates, and extend monitoring intervals. These flashcards reinforce critical terminology such as train-of-four, Red Man syndrome, and MAP targets so you can quickly recall evidence-based titration steps during exam scenarios.
Topics covered in this flashcard deck:
- Altitude dosing adjustments
- Sedation pharmacology
- Analgesia strategies
- Vasoactive infusions
- Neuromuscular blockade
- Drug interaction risks