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Paramedic > AMR South County Meds > Flashcards

AMR South County Meds Flashcards

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1
Q

Fentanyl Dose

A

Adult: IV/IO/IM 1mcg/kg over 1min max 100
Max total 200 mcg may repeat after 5min
Ped: <14 yo
1mcg/kg over 1min
Max total: 4 dose or 200 mcg repeat after 5 min

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2
Q

Fentanyl Indications

A

PAIN
SBP > 100
Unimpaired respirations
GCS normal for baseline

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3
Q

Fentanyl Contraindications

A

Hypersensitivity
Hypotension shock
Respiratory depression or hypoxia
Pathology or injury impairing respiration
Base contact for: serious head chest or ABD trauma

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4
Q

Fentanyl Mechanism

A

Opioid analgesic
Binds to opiate receptor sites producing analgesia and euphoria

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5
Q

Ketamine Dose

A

Adult: IV/IO 0.3 mg/kg in 100 ml over 5 min
Max dose 30 mg. May repeat in 10 minutes
Pediatric: IV/IO 0.3 mg/kg in 100ml over 5 min
Max dose: 10 mg. May repeat in 10 min

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6
Q

Ketamine Indications

A

PAIN
Refractory to fentanyl or when fentanyl is contraindication

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7
Q

Ketamine Contraindication

A

GCS< 14
Suspected or confirmed pregnancy
Suspected ACS
Known allergy or anaphylaxis

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8
Q

Ketamine Mechanism

A

Blocks pain receptors and minimizes spinal cord activity, affects the association pathways of the brain between the thalamus and limbic system

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9
Q

Epinephrine Dose (Anaphalaxis)

A

Adult: IM 0.5 mg every 5 min x2
Pediatric: IM 0.01 mg/kg every 5min x2

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10
Q

Epinephrine Dose (Severe Upper or Lower Obstruction)

A

Adult: IM 0.3 mg
Pediatric: IM 0.01 mg/kg Max 0.3 mg

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11
Q

Epinephrine Dose (Cardiac Arrest)

A

Adult: IV/IO 1mg (10 mL) every 3-5min
Pediatric: IV/IO 0.01mg/kg every 3-5min

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12
Q

Epinephrine (Bradycardic Pediatric)

A

IV/IO 0.01 mg/kg (1:10,000) every 3-5min

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13
Q

Epinephrine Indications

A

Anaphylaxis
Cardiac Arrest
Bradycardia
Severe upper or lower airway obstruction

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14
Q

Epinephrine Contraindications

A

None in Cardiac Arrest or Anaphylaxis

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15
Q

Epinephrine Mechanism

A

Alpha and beta agonist
Beta 1 inotrope, dromotrope, chronotrope
Beta 2 bronchial smooth muscle relaxation

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16
Q

Push Dose Epinephrine Dose

A

Adult: IV/IO 10 mcg (1mL) every 3 min-titrate to SBP >90
Pediatric: IV/IO 1 mcg/kg max 10 mcg every 3 min- titrate to appropriate pressure

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17
Q

Push Dose Epinephrine Indications

A

Unstable Anaphylaxis
Severe hypotension with signs of shock
Septic shock
Unstable bradycardia

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18
Q

Push Dose Epinephrine Contraindications

A

Sodium Bicarbonate in same access

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19
Q

Albuterol Dose

A

Adult: 5mg via nebulizer repeat as needed
Pediatric (under 3) : 2.5 mg via nebulizer repeat as needed

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20
Q

Albuterol Indications

A

Anaphylaxis with wheezing
Shortness of breath
Lower airway obstruction
Upper airway obstruction

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21
Q

Albuterol Contraindication

A

Known hypersensitivity
Tachydisrhythmias

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22
Q

Albuterol Mechanism

A

Beta 2 agonist that stimulates the sympathetic nervous system, smooth muscle relaxation in the bronchial tree and peripheral vasculature

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23
Q

Benadryl Dose

A

Adult: IM 50 mg
Pediatric: IM 1mg/kg (max 50 mg)

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24
Q

Benadryl Indications

A

Allergic Reaction (less severe)

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25
Benadryl Contraindications
Hypersensitivity Acute asthma attack Lower respiratory tract disease Newborns and nursing mothers
26
Benadryl Mechanism
Blocks H1 histamine receptors in the respiratory tract, blood vessels, and GI smooth muscle
27
Midazolam Dose
Adult: IM-10 mg IV- 2 mg repeat every 1 min to max of 10 Pediatric: IM- 0.1 mg/kg max of 5mg IV-0.1 mg/kg max single dose of 2 mg max total dose of 5 mg
28
Midazolam Indications
Seizures > 5 min Repeated seizures w/o regaining consciousness Excited Delirium
29
Midazolam Contraindications
Hypersensitivity Shock Coma Closed angle glaucoma
30
Midazolam Mechanism
Reversible interacts with GABA receptors in the CNS, causing sedative, amnesic, and hypnotic effects
31
Glucagon Dose
Adult: IM 1 mg Pediatric: IM 0.1 mg/kg
32
Glucagon Indications
No IV Access Blood glucose less than 60 Calcium channel blocker and beta blocker OD
33
Glucagon Contraindications
Ineffective w/o glycogen stores
34
Glucagon Mechanism
Increases blood glucose by stimulating glycogenolysis, stabilizes cardiac rhythm with beta blocker overdoses
35
D10 Dose
Adult: IV/IO 25G (250 ml) Pediatric: IV/IO 0.5g/kg (5ml/kg)
36
D10 Indications
BG less than 60 and unable to swallow safely
37
D10 Contraindications
Intracranial hemorrhage, closed head injuries
38
D10 Mechanism
Rapidly increases serum glucose levels
39
Amiodarone Dose (Cardiac Arrest)
Adult: IV/IO 300mg first dose, 150 mg second dose Pediatric: IV/IO 5 mg/kg first dose, 2.5 mg/kg second dose
40
Amiodarone Dose (Wide Complex Tachycardia)
Adult: IV/IO 150 mg in 100ml over 10 minutes Pediatrics: IV/IO 2.5 mg/kg in 100ml over 10 minutes
41
Amiodarone Indications
Persistent VF or VT in cardiac arrest Stable VT with pulses
42
Amiodarone Contraindications
Pulmonary congestion, cardiogenic shock, hypersensitivity, bradycardia, long QT, TCS overdose
43
Amiodarone Mechanism
Blocks sodium and potassium channels prolonging action potential and repolarization. Decreases AV conduction and SA node function
44
Calcium Chloride Dose
Adult: IV/IO 1 gm over 1 min repeat x1 in 10 minutes Pediatric: IV/IO 20mg/kg over 1 min
45
Calcium Chloride Indications
Suspected Renal Failure Crush Syndrome Calcium Channel Blocker OD
46
Calcium Chloride Contraindications
Hypercalcemia Vfib Digitalis Toxicity
47
Calcium Chloride Mechanism
Increases cardiac contractile state. Positive inotropic enhances ventricular automaticity
48
Sodium Bicarbonate Dose
Adult and Pediatric: IV/IO 1mEq/kg repeat 0.5mEq/kg every 5 min
49
SodiumBicarbonate Indications
TCA overdose CA w/ suspected renal failure Bradycardia w/ suspected renal failure Crush injury
50
Sodium Bicarbonate Contraindications
None when indicated
51
Sodium Bicarbonate Mechanism
In the presence of hydrogen ions, sodium bicarbonate dissociates to sodium and carbonic acid, the carbonic acid picks up a hydrogen ion changing to bicarbonate and then dissociates into water and CO2, functioning as an effective buffer and alkalinizing the blood. In summary, increases plasma bicarbonate, which can buffer metabolic acids and move TCAs and phenobarbital off receptor sites and back into circulation
52
Magnesium Sulfate Dose
Adult: IV/IO 2 g in 100mL over 5 minutes
53
Magnesium Sulfate Indications
3rd Trimester Pregnancy & No Known Seizure History with either signs and symptoms of eclampsia or active seizures Torsades de Pointes with pulse
54
Magnesium Sulfate Contraindications
Hypermagnesemia, Heart block, MI
55
Magnesium Sulfate Mechanism
reduces striated muscle contractions and blocks peripheral neuromuscular transmission by reducing Ach release at the myoneural junction.
56
Aspirin Dose
Adult: 324 mg
57
Aspirin Indications
Chest pain suggestive of MI
58
Aspirin Contraindications
Asthma, allergy to ASA, peptic under disease, head injury/bleeding
59
Aspirin Mechanism
Prevents platelet aggregation
60
Nitro Dose
0.4 mg every 4 min for continued pain
61
Nitro indication
Chest pain/angina Acute pulmonary edema w/hypertension
62
Nitro contraindication
Inferior STEMI SBP<100 Pulmonary HT/ED drugs within last 24 hours Allergies to nitrates Hympvolemia, Head injury ICP
63
Nitro Mechanism
smooth muscle relaxant acting on vasculature, smooth muscle dilation of arterioles and veins. reduces preload and afterload decreasing workload of the heart and therefore myocardial oxygen demand.
64
Atropine Dose
Adult: Bradycardia-0.5 mg Nerve gas poisoning- 2 mg
65
Atropine Indications
Symptomatic Bradycardias, nerve agent poisoning organophosphate poison
66
Atropine Contraindications
None in emergency setting
67
Atropine Mechanism
inhibits ach at parasympathetic neuroeffector sites increases heart rate,
68
Adenosine Dose
Adult: IV/IO 6mg, 12 mg, 12 mg Pediatric: IV/IO 0.1 mg/kg, 0.2mg/kg, 0.2mg/kg
69
Adenosine Indications
SVT 160+ bpm
70
Adenosine Contraindications
23 Sick Hypersensitivity
71
Adenosine Mechanism
Acts directly on the sinus pacemaker cells and vagal nerve terminals.slows conduction through AV node. blocks reentry into AV node.
72
Zofran Dose
ADULT: PO – 4mg ODT May repeat x 1 in 10 min IV/IO/IM – 4mg May repeat x 1 in 10 min PEDIATRIC: > 4 yo PO – 4mg IV/IO/IM – 4mg
73
Zofran Indications
Moderate to severe nausea and vomiting
74
Zofran Contraindiactions
Hypersensitivity, Prolonged QT interval, Concurrent use of Apomorphine (apokyn) an anti-parkasonian drug.
75
Zofran Mechanism
blocks serotonin a natural substance that causes nausea and vomiting
76
Naloxone Dose
IV/IO – 0.4mg every 1 min Total max 8mg PRN to 12 resp/min IN/IM: 2mg Pediatric IV/IM/IO – 0.1mg/kg every 1 min Total max 8mg PRN to 12 resp/min
77
Naloxone Indications
Complete or partial reversal of depression caused by narcotics or synthetic narcotics, Coma of unknown etiology.
78
Naloxone Contraindications
Known hypersensitivity
79
Naloxone Mechanism
competitive inhibition at narcotic receptor sites. reverses respiratory depression due to opiate use.
80
Charcoal Dose
Adult/Pediatric: 1g/kg. Adult max 50 g Pediatric max 25 g
81
Charcoal Indications
Oral ingestion within 1 hour, awake and gag reflex present
82
Charcoal Contraindications
Should not be used in treatment for poisonings of cyanide, mineral acids, caustic substances, ethanol or methanol
83
Charcoal Mechanism
Absorbs and neutralizes poison at the stomach
84
TXA Dose
1 gram in 100 mL normal saline IV/IO infused over >10 min
85
TXA indications
Blunt or penetrating traumatic injury with SBP <= 90 Significant blood loss with ongoing bleeding not controlled by direct pressure, hemostatic agents, or tourniquet application
86
TXA Contraindications
Patients less than 15 years of age, 3 hours post injury, Isolated head injury, Isolated spinal shock Isolated extremity hemorrhage controlled active stroke, myocardial infarction, PE Hypersensitivity to TXA, traumatic arrest with >5 min of CPR w/o ROSC, Drowning or hanging victims
87
TXA Mechanism
reduces plasminogen activation mitigating conversion to plasmin.
88
Lidocaine Dose
0.5mg/kg (max of 40mg) slow IVP over 60 seconds
89
Lidocaine Indications
IO on a conscious patient prior to fluids
90
Lidocaine Contraindications
None
91
Lidocaine Mechanism
slows rate of depolarization. inhibits transport ions across neuron, blocking conduction of normal nerve impulses..

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