Week 2 Flashcards
Activated charcoal
Class: absorbent, antidote
MOA: Absorbs ingested toxins
Indications: Oral poisoning & med OD
Contraindications:
-Unprotected airway
-ALOC
-GI obstruction
-Be cautious w/ pt unknown ab. pain
Dosage:
Adult= 25-100g orally
Pediatric>1= 1g/kg orally
Atropine
CLASS: Anticholinergic agent
MOA:
-Reverses muscarinic effects of cholinergic poisoning
-Inhibits acetylcholine at post ganglionic parasympathetic neuroeffector sites
-Increases HR in symptomatic bradydysrhythmias
INDICATIONS:
-Acetylcholinesterase inhibitor poisoning
-Beta blocker or calcium channel blocker overdose
-Hemodynamically unstable bradycardia
-RSI in pediatrics
CONTRAINDICATIONS:
-GI obstruction
-Toxic megacolon
-Thyrotoxicosis
-Severe ulcerative colitis
-Hemorrhage/ cardiovascular unstable
-Myasthenia gravis
-Narrow-angel glaucoma
DOSAGE:
Adult:
-Symptomatic bradycardia=0.5-1mg IV/IO every 5min (max of 3mg)
-Acetylcholinesterase poisoning=ALOT
Pediatric:
Symptomatic bradycardia =0.02mg/kg
Max single dose=0.5mg
Max total dose =1mg
-Acetylcholinesterase inhibitor poisoning younger then 12=0.05mg/kg first then repeat & double @5min
-Acetylcholinesterase inhibitor poisoning older then 12 = 1mg IV/IO first then double every 5min
Glucagon
Class:
-hyperglycemic, pancreatic hormone & insulin antagonist
MOA:
-Decreases GI motility & secretions
-Unknown MOA of Stabilizing cardiac rhythm in beta blocker overdose
-Minimal positive inotropic & chronotropic responses
-Increases BG level
Indications:
-ALOC w/ suspected hypoglycemia
-Antidote for symptomatic bradycardia caused by beta blocker or calcium channel blocker overdoses
Contraindications:
-Pheochromocytoma
-Insulinoma
-Hyperglycemia
Dosage:
Adult:
Hypoglycemia = 1mg IM/IN repeat
Calcium channel blocker or beta blocker overdose=
5mg slow IV repeat @5-10min
Pediatric:
Hypoglycemia=
1mg IM/IN if >20kg otherwise 0.5mg
Calcium channel blocker or beta blocker overdose=
1mg(25-40kg) otherwise 0.5mg slow IV
Lidocaine
Class: Antidysrhythmic (Class 1b) / anesthetic
MOA:
-Inhibits recovery after depolarization
-Decreases myocardial excitability & conduction velocity
-May decrease ICP response during laryngoscopy
-Local anesthetic
Indications:
-Alternative to amiodarone in pt. w/ cardiac arrest from:
VT/VF, stable monomorphic VT, stable polymorphic VT w/ normal baseline QT interval when ischemia is treated
-Stable polymorphic VT w/ baseline QT interval prolongation if TdP is suspected
-Local anesthetic for various procedures
CONTRAINDICATIONS:
-Prophylactic use in AMI
-2nd or 3rd degree AV block
-Hypersensitivity to lidocaine or amide-type local anesthetics
DOSAGE:
Adult
Cardiac arrest / Stable regular wide-complex tachycardia=
-1st dose 1-1.5mg/kg IV
-repeat dose= 0.5-0.75mg/kg after 5min.
-Max dose= 3mg/kg
-Maintenance infusion= 1-4mg/min
Local anesthetic = varies
PEDIATRIC:
IV/IO dose= 1mg/kg push
Maintenance IV/IO infusion= 20-50mcg/kg/min, repeat after 15min
-ET dose= 2-3mg/kg
-RSI= 1-2mg/kg IV/IO
-Local anesthetic= varies by procedure
