- Name: LABA (Long Acting Beta Agonist) -Medications end in “ol” •Salmeterol, Vilanterol, Formoterol (S V F on sailboat with 'ol' on sail. Picture is of volcano from LAVA short movie, LAVA like LABA)MOA: Long-acting B2-agonistUse: Convenient and more effective at producing long term symptom relief than SABA. Reduce exacerbations and hospitalizations. Sustained improvement of lung function. Should not be used alone in asthma management (Talking about being better than SABA, lasting longer with better singing/lungs, sings about "everybody" in regards to used with something else in asthma)Adverse Effects• Headache, chest/skeletal pain, throat irritation (Red on his forehead, throat, chest)
- Name: Glucocorticoids: prednisone, prednisolone, dexamethasone, cortisone, hydrocortisone MOA: bind to glucocorticoid receptor to alter DNA synthesis Indications: Suppress inflammation, allergy and immune response. Treatment of adrenal insufficiency. Adverse Effects: Development of cushingoid syndrome (cushing features: buffalo hump, moon face, HTN, central obesity), weight gain, cataracts (cat eye), increased IOP (hat), fluid retention/HTN, increased risk of AFIB, dyslipidemia, adverse GI effects, osteoporosis, myopathy, mood disorders, psychosis, memory impairment, hyperglycemia, increased risk of infection Contraindications: hypersensitivity, systemic fungal infection, undiagnosed malignancy, herpetic keratitis, administration of live vaccines, use with caution in HF, HTN, diabetes, GI disease, hepatic impairment, myasthenia gravis Interactions:Notes:
- Name: 2nd generation H1 antagonists: Cetirizine (Zyrtec), fexofenadine (Allegra) (ZyrAll box name, H1 with block/antagonize)MOA: non-sedating antihistamines that antagonize H1 receptors without crossing the blood brain barrier (Stop-BBB card, Hand in face with red inhibit marks at head, Zzzz crossed out, don't sleep on this box)Clinical: Treatment of allergic rhinitis (Card with nose with rhinitis)ADME: Formulated to be charged at physiological pH, preventing entry into the CNS. Metabolized by CYPs, so cautious with drug interactions. All oral except olapatadine, which is an eye drop (Card with PH of philly, and CYP in crowd)AE: Well tolerated (New, no AE)
- Name: Oseltamivir (Tamiflu) remember Tammy Swanson from Parks and Rec? MOA: Competitive Neuramidase inhibitor (earrings). Inhibition of NA prevents release of viral progeny from infected cells. Clinical: Treat and prevent influenza A and B infections (necklaces- the green thing is to symbolize prophylaxis) AE: Nausea, abdominal discomfort, emesis (she clutches her stomach). Prevented by taking with food (cereal bowl). Headaches (red lines by head). Psychiatric syndromes (remember that Tammy was crazy), renal syndromes (kidney on her sleeve). ADME: oral administration (cereal bowl, GI side effects). Renal clearance requires dose reduction in kidney failure (kidney on the sleeve with arrow)
- NAME: Rapid-acting insulinMOA: Human insulin analogClinical: for the control of hyperglycemia in T1DM, T2DM, and GDM (off-label)ADME: Parenteral dosingAE: hypoglycemia and injection site reactionNotes: Blood glucose monitoring required
- __________ is a formal extension of the training period, with conditions established by agency policy.
- APCO standards are organized into three broad areas of concern: Operational Standards, Technical Standards, and Training Standards. For CTOs, the __________ are of a special importance.
- NAME: Long-acting insulin: Insulin glargine (Lantus), Insulin detemir (Levemir)MOA: Synthetic versions of human insulin that is long-acting and provides a basal insulin level throughout the dayClinical: Clinically indicated for the treatment of T1DM, T2DM, and GDM (insulin detemir only) to improve and maintain glycemic controlADME: Subcutaneous injectionAE: Hypoglycemia, soft tissue damageContraindications: Hypersensitivity, current hypoglycemiaInteractions: Many drug interactions. Be sure to checkNotes: Patients taking insulin must monitor blood sugar routinely
- NAME: Sulfonylureas glipizide (Glucotrol) (TROLL) and glyburide (Diabeta) (dead beta fish) MOA: enhance insulin release (the troll's chest has an arrow pointing up with an "I" to signify iodine) Clinical: combination therapy of T2DM (the eyes have a 2) ADME: oral (pink lips) AE: hypoglycemia, weight gain (note the belly), GI, derm rxns (pink rashes), dizziness (swirls), HA (red hairs), anxiety (the swirls around the head) Contraindications: sulfonamide hypersensitivity (exclamation points on yellow hairs), T1DM and DKA (earrings) Interactions: Notes:
- What is the CTO's most important document in a liability case?
- Most modern CAD systems include an __________ capability that allows linked users to send and receive instantaneous messages via CAD terminals.
- The __________ gives civil rights protections to individuals with disabilities, similar to those provided to individuals on the basis of race, color, sex, national origin, age, and religion.
- Liability exposures for public safety agencies typically revolve around issues where the service and __________ provided did not meet the expectations of the public.
- Counseling occurs any time a CTO or other authority in the program discusses trainee performance or behavior with the trainee, and is ONLY disciplinary in action.
- According to the text, while the length of training programs varies depending on the agency, programs less than __________ weeks are considered ineffective.
- Name: Inhaled corticosteroids. Fluticasone, mometasone, beclomethasone. They end in "-one" (the 1 candle on the cake) MOA: Suppresses airway inflammation Use: Primarily asthma: fewer asthma symptoms, increased lung function, improved asthma-specific QOL, fewer asthmatic exacerbation (happy birthday asthma)Adverse Effects: Sore throat (red throat), coughing on inhalation (the blue lines look like a cough), weak or hoarse voice (toy horse), candidiasis (candies AND the white mouth)
- NAME: Metformin (Glucophage)MOA: Decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilizationClinical: First-line treatment of T2DM, prevention of T2DM in individuals with pre-diabetesADME: onset is days with maximum effect in about 2 weeks, high Vd due to partitioning into liver, kidney, and GI tract, 90% excreted unchanged in urine, CONTRAINDICATED in renal failure (GFR < 70)AE: Gastrointestinal (most common, titrate to desired dose slowly, take with food, GI discomfort essens over several weeks, XR may reduce GI effects), malabsorption of vitamin B12 and folate, metallic taste, lactic acidosis with renal insufficiency (rare)Contraindications: Absolute contraindications: severe renal impairment (GFR < 30 ml/min/1.73 m2), known metformin hypersensitivity, acute or chronic metabolic acidosis, including diabetic ketoacidosis (treat DKA with insulin)Relative contraindications: 30 < GFR < 45 30 ml/min/1.73 m2, pause metformin for 48 hours following radiology with contrast, alcoholic patients, patients with severe hepatic impairmentInteractions: Alcohol, others. Check for drug interactions
- In the __________ presentation methodology, the CTO starts an activity with the trainee doing nothing except observing, with an eventual transition to the trainee doing everything, with the CTO simply observing.
- CTOs have no need to remain informed about details of any changes coming to their respective comm centers with NextGen 9-1-1.
- Drug Name/Class: Class IB Na+ blockers (Lidocaine and Mexiletine) (candy cane and Mexico flag colors on the flower + the margarita) MOA: weak Na+ blockade Clinical Use: Post-STEMI arrhythmias (STEM of a flower) Adverse Effects: Mexiletine is a CYP2D6 substrate. Lidocaine only is used to ventricular arrhythmias in hospitalized pt's (note the "V Tach" pattern on the candy cane), and both cause CNS confusion, dizziness, seizures and depression (represented by the 4 swirly things) and decreases isotropy (no symbol, remember its messing with ions).