Week 7 Flashcards
Dexamethasone (Decadron)
CLASS:
-Corticosteroid, adrenal glucocorticoid, anti-inflammatory
MOA:
-suppresses acute & chronic inflammation
-immunosuppressive effects
INDICATIONS:
-anaphylaxis
-acute asthma exacerbation
-AMS
-adjunct in shock treatment
-croup
-COVID 19
-elevated ICP
-HACE
-spinal cord injury
CONTRAINDICATIONS:
Etomidate (Amidate)
CLASS:
-nonbarbiturate hypnotic, anesthetic?
MOA:
-Hypnotic that causes rapid sedation w/ minimal cardiovascular or respiratory depression
INDICATIONS:
-Premedication for medication-facilitated intubation or sedation
CONTRAINDICATIONS:
-Labor/delivery
-Septic shock
DOSAGE:
Adult/ pediatric
Procedural sedation=0.2-0.4mg/kg IV
Fentanyl (Sublimaze)
CLASS: opiod analgesic, synthetic opioid, schedule 2 drug
MOA: - binds to opiod receptors
INDICATIONS:
-pain management
-anesthesia adjunct
-severe respiratory distress (palliative care)
CONTRAINDICATIONS:
-pt taken MAOI in last 14 days
-be cautious w/ GCS less then 15
-hypotension
-hypoxia/ hypoventilation
DOSAGE:
Adult/ Pediatric
-severe resp. distress=25mcg mixed in 2mL saline nebulizad
-moderate-severe discomfort
=1mcg/kg IM/IN
-Max 1st dose=100mcg
-Mad total dose=200mcg
Ketamine (Ketalar)
CLASS:
-analgesic, dissociative anesthetic, schedule 3 drug
MOA:
-blocks pain receptors & minimizes spinal cord activity
INDICATIONS:
-procedural sedation
-management of violent behavior
-pain control
CONTRAINDICATIONS:
-pregnancy
-infants >3 months
-ICP
-severe hypertension
-hyperthyroidism
-angina
-heart failure
-schizophrenia
DOSAGE:
Adult:
Procedural sedation:
-1-2mg/kg IV push over 1-2min
Mild pain control: 0.5mg/kg IN
-max 1st dose 55mg, total 100mg
Severe pain: 0.25mg/kg IM/IV/IO
-max 1st dose: 25mg, total: 100mg
Chemical restraint:
-2mg/kg IV or 4mg/kg IM
PEDIATRIC chemical restraint:
-1mg/kg IV or 3mg/kg IM
Rocuronium
Succinylcholine (Anectine)
CLASS:
-depolarizing neuromuscular blocker, skeletal muscle relaxant
MOA:
-skeletal muscle relaxant that mimics acetylcholine
INDICATIONS:
-provides skeletal muscle relaxation for intubation & ventilation
CONTRAINDICATIONS:
-stroke w/ motor dysfunction
-history of malignant hyperthermia
-ability to control airway
-acute Hyperkalemia
-renal failure
-penetrating eye injuries
-paraplegia / quadriplegia
-prolonged immobilization
-use w/ caution for difficult airways
-muscular dystrophy/neurological disease
DOSAGE:
Adult/ Pediatric:
-1-1.5mg/kg rapid IV
Infants:
-2mg/kg
Vecuronium (Norcuron)
CLASS:
-nondepolarizing neuromuscular blocking agent, cholinergic receptor antagonist
MOA:
-competes w/ acetylcholine for receptors at the motor endplate, resulting in neuromuscular blockade
INDICATIONS:
-skeletal muscle relaxation for intubation & ventilation
CONTRAINDICATIONS:
-hypersensitivity to vec. or bromide
-neuromuscular disease
-newborns
-acute narrow angle glaucoma
-penetrating eye injuries
-hepatic or renal failure
-ability to control airway
DOSAGE:
Adult:
0.08-0.1mg/kg IV push over 1min
-maintenance dose after 20-45min
0.01-0.015mg/kg IV push every 12min
Pediatric:
0.1-0.3mg/kg IV/IO
Morphine (Roxanol, MS Contin)
CLASS:
-opioid analgesic, schedule 2 drug
MOA:
-suppresses fear & anxiety in brain
-alleviates pain through CNS action
-increases peripheral venous capacitance & decreases venous return
-depresses respiratory centers
-decreases preload & afterload, which decreases myocardial oxygen demand
INDICATIONS: pain management
CONTRAINDICATIONS:
-MAOI in last 14 days
-seizure disorders
-delirium tremens
-brain tumors
-head injuries
-heart failure due to COPD
-acute or severe asthma
-upper airway obstruction
DOSAGE:
Adult:
Mild pain:
0.1mg/kg IM (max dose 15mg)
Severe pain:
0.1mg/kg slow IV/IO, max dose 10mg
STEMI:
1st dose: 2-4mg slow IV over 5min
Repeat dose: 2-8mg at 5 min intervals
NSTEMI/unstable angina:
1-5mg slow IV push
Pediatric:
0.1-0.2mg/kg per dose IV/IO
-Max dose 5mg
