Cardiac- Chest Pain/ Sedatives

Question 1

Fentanyl (Sublimaze)

Answer 1

Action: Narcotic, binds to opiate receptors of CNS to alter perception of pain

Indications: Pain, MI, Pulmonary edema

Dose: .5 - 1 mcg/kg slow IVP

SFx: Possible respiratory depression, HypoT

Notes: Narcan to reverse, monitor capno and pulse ox

Question 2

Morphine

Answer 2

Action: Narcotic, CNS depression, vasodilation

Indications: Pain, MI, Pulmonary edema

Dose: 1 - 4 mg slow IVP (Chest pain)
Up to 15 mg slow IV (Severe pain)

SFx: Possible respiratory depression

Notes: Slow IVP limits side effects

Question 3

Naloxone (Narcan)

Answer 3

Action: Narcotic antagonist, overrides bond of opiate receptors

Indication: Narcotic overdose

Dose: .4 - 2 mg slow IVP, up to 10 mg

SFx: HyperT, HypoT, Vfib, VTach

Notes: Doesn’t work well against oxys

Question 4

Ketamine (Ketalar)

Answer 4

Action: Anesthetic; Analgesic (non-narcotic)

Indication: Pain or sedation

Dose: .5 - 1 mg/kg over 60 seconds IV

SFx: Possible respiratory depression

Notes:

Question 5

Midazolam (Versed)

Answer 5

Action: Benzodiazepine, sedative effects, Vasodilator, CNS depressant

Indication: Sedation, Seizures, Prior to cardioversion/pacing, RSI

Dose: 1 - 2.5 mg slow IVP

SFx: Possible respiratory depression, apnea, HypoT, amnesia

Notes: Flumazenil for OD

Question 6

Diazepam (Valium)

Answer 6

Action: Benzodiazepine, CNS depressant, Hypnotic

Indication: Seizures and sedation

Dose: 5 - 10 mg slow IVP

SFx: Possible respiratory depression, HypoT, drowsy

Notes: Closest port to IV, Flumazenil for OD

Question 7

Lorazepam (Ativan)

Answer 7

Action: Benzodiazepine

Indication: Sedation or seizures

Dose: 1 - 4 mg IV

SFx: Possible respiratory depression

Notes: