ALS Drugs Flashcards by David Blackthorne

Why do people take sodium channel blockers?

Ventricular and atrial arrythmias

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Which sodium channel blocker does pinellas use

Lidocaine for IO’s

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What type of drug is a tricyclic antidepressant or phenytoin?

Sodium channel blocker

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How do sodium channel blockers affect your ECG?

It widens everything, especially your QRS complex

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Lidocaine route and dose and use. OLMC?

Caridac arrest w/ OLMC

1-1.5mg/kg IV bolus

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What type of co-morbidities should you consider in a pt before giving them lidocaine?

Liver disfunction

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When are betablockers generally used?

Slows AV node conduction. For rate control & cardiovascular disease (ex. Hx stents)

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What do K channel blockers do to the body? Why do people take them?

Slows repolarization for atrial/ventricular arrhythmias

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What class is amiodarone

K, NA, CA, Alpha, and beta blocker

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Why should you draw up amio slowly and without injecting air into the vial

Avoids foam

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Short term side affects of amio

Brady or hypotension

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How does amio affect the body?

Decrease AV conduction, SA node function by inhibiting adrenergic stimulation (blocks a and b)

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What pinellas drug is a calcium channel blocker

Diltiazem

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What do calcium channel blockers do to the body?

Affects AV node and brings down BP

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When to use diltiazem?

Stable, narrow tachycardia (regular w/ hi afib or irregular)

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Diltiazem administration speed? Contraindications?

SIV over 2 min

Contra: SBP < 90, or DBP < 60, WPW, acute MI, bleeding aneurysm

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Diltiazem dose for afib

0.25mg.kg, max 20mg dose

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Mag dose for torsades

2g in 10ml NS over 10 min

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Mag dose for eclampsia

4g IVP over 10min

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Mag dose for asthma/copd

2g over 10min

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Mag dose for vfib, pvtach, induced hypothermia

2g mixed in 10ml over 10min

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Atropine dose, frequency, max dose?

0.5mg every 3-5min, max 3mg

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When can atropine be used in kids? Why?

During drug assisted intubation to combat vagal effects

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Pinellas narcan dose

2mg IV/IO repeat 3-5min

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Calcium chloride and Sodium bicarb dose? OLMC? When do you give it and which do you give first?

Both in cardiac arrest w/ hyperkalemia Calcium 1g IV/IO Sodium bicarb - 50-100 mEQ (1-2mEq / kg) Yes OLMC

Can you give calcium chloride and sodium bicarb in the same line? How well should you flush?

No, because they will crystalize. Flush well to prevent the crystalization

Other uses for bicarb besides acidosis or hyper K

Rhabdo, salicylate OD, widening QRS from TCA overdose

Glucagon uses other than hypoglycemia (and their doses)

Foreign body obstruction (1mg) - relaxes esophagus Beta blocker OD (3+ mg)

Side effects of glucagon? What should you give to prevent?

Vomiting and hyperglycemia. Consider zofran before

What are the ED meds to contraindicate Nitro and their time frames

Stendra w/in 12 hrs Levitra, staxyn, viagra w/ in 24 hrs Cialis w/in 48 hrs

What are the different Nitro doses for different BP’s in CHF?

>90 = 0.4mg >120 = 0.8mg >160 = 1.2mg spray

Benedryl use besides itching

Good for tardive diskenia and phenthiazine/haloperidol OD

Solu-medrol dose for asthma/COPD and anaphylaxis

125 mg (slow for asthma, fast for anaphylaxis)

Albuterol dose and use

2.5mg for asthma/copd. Repeat as needed

Ipratropium use and dose

For asthma/COPD 0.5mg mixed w/ albuterol for 2 max doses

Epi for adult anaphylaxis dose/ asthma/COPD

0.3mg IM, 1:1000 (1mg/ml concentration)

Opiate vs Opioids. Why the difference?

Opiate = natural/ plant-based. Opioid = synthetic Opiate = more allergy risk

Fentanyl dose for pain vs facilitated intubation How to convert to mL

Pain = 1mcg/kg - 100mcg max Intubated = 2mcg/kg Ex. 100kg pt = 100mcg or 2.0 ml

Etomidate dose for facilitated intubation. How to convert to mL

0.3mg/kg SIVP (>20s) EX. 100kg pt = 30mg = 15mL

Narcan dose for OD vs Cardiac arrest

OD = 0.4mg IV or 2mg IN, repeat up to 4mg Cardiac arrest = 2mg IV/IO repeat x 1 per 3-5min

How long does narcan actually last?

Only 20-30 min

What to give for post-intubation sedation? What dose?

Versed 2.5mg IVP, repeat x1 Duration <2hr IV/IO/IN

How long does etomidate last? What is the onset time?

Duration <5min Onset = <30-60s

Earliest way to notice if a sedated pt needs more versed?

Biting on tube or breathing against ventilation

Cyanokit dose, mixture, and administration time frame.

5g vial w/ 200 ml NS infused over 15min

Can you give other meds in your line w/ your cyanokit?

No, because of Crystalization risk.

Versed dose for psychs

Potentially violent = 2.5mg IV/IM or 5mg IN (repeat x1 after 3-5min) Actively violent = 5mg IV/IM or 10mg IN (repeat at 2.5mg IV/IM or 5mg IN after 3-5min)

How to set up an epi drip for bradycardia

1mg 1:10,000 in a 1000L bag w/ 60 gtt set at 2-5mcg/min (1mcg = 60 drop increments)

When to give Diltiazem to adults? What dose? Max dose?

Stable, irregular afib or regular but has hx afib 0.25mg/kg slow IV. Max single dose 20mg

Dose of amiodarone for stable arrythmias

150mg infusion over 10min

How do you convert a fentanyl dose from mcg into ml? Example 80kg pt

Move the decimal left one and multiply by 2 (pn mgmt) or 4 (facilitated)= 8 x 4 = 3.2ml

How do you dose for etomidate from mg to ml? Example 80kg pt

Drop the last number, multiply by 3. Then divide by 2 80kg = 8 x3 = 24mg / 2 = 12ml

Dose of midazolam for seizures adults

1st dose = 2.5mg IV/IO or 5mg IN IV/IO repeat every 5min until max 10mg IN repeat x 1 after 5 min (max 10mg)

Whats the general MAX fluid dose for adults? What about peds?

Adults = 2000mL. Re-assess every 500cc Peds or <100kg = 20ml/kg

How to setup an Epi drip. Dose? Drip rate?

1mg of 1:10,000 in 1000cc bag w/ a 60gtt set 1-5mcg/min = 60-120-180 (go up in 60 increments)

How to set up a nor epi drip? Dose? Rate?

4mg norepi in 1000cc bag @ 1-10mcg/min Set a 60gtt set dial start at 15 (1mcg) and increase by 15 increments

What Rx dose for a hypoglycemic

D10 250ml (25mg) OR 15g oral glucose OR 1mg glucagon

Dose of zofran for nausea/vomiting

4mg SIVP or 4mg tab. Repeat x1 after 15min PRN

Dose of fluids for abdominal pn pt that has nausea and vomiting

Adult = 500ml

How much fluids for a burn pt

Bolus 20ml/kg

When would you give fentanyl to pts

When their pain > or = 7

When does a burn go to a burn center?

2nd or 3rd > 15% BSA w/ no multisystem trauma. Or 2nd 3rd in critical places

How much fluids for a burn pt?

Same as trauma arrest

Diving/barotrauma injury Rx

ABCs and fluids (same as trauma arrest dose)

How much fluids for a trauma arrest adult? Age 14-15? Ped?

Adult = 2000mL 14-15 = 1500 Ped = hand tevy

How much Benadryl for anaphylaxis

50mg iv Io IM

ALS Drugs Flashcards

(66 cards)