Drug Doses

Question 0

Albuterol(Proventil, Ventolin)

Answer 0

Bronchospasm: 5mg HHN over 5-15 minutes, PRN

Crush Syndrome: 5mg HHN continuous

Pediatrics less than 1yr= 2.5mg HHN over 5-15 minutes

Question 1

Adenosine (Adenocard)

Answer 1

SVT: 6mg rapid(within 1-3 seconds) IVP, followed immediately with 20ml NS rapid IVP bolus.
May repeat 12mg rapid IVP in 1-2 minutes

Poorly Perfusing SVT: 12mg rapid (within 1-3 seconds) IVP, followed by 20ml NS rapid IVP bolus.
May repeat 12mg rapid IVP in 1-2 minutes

Pediatrics: 0.1mg/kg rapid IVP, followed by 10ml NS rapid IVP bolus
May repeat 0.2mg/kg rapid IVP in 1-2 minutes

Question 2

Amiodarone (Cordarone, Pacerone)

Answer 2

300mg Rapid IVP/IO, flush with 10ml NS after 150mg.
May repeat in 3-5 minutes with 150mg IVP/IO
Max total dose is 450mg

Pediatrics: 5mg/kg Rapid IVP/IO, May repeat after 3-5 minutes x 2
Max dose is 15mg/kg. Max single dose is 300mg

Question 3

Amyl Nitrite

Answer 3

0.3mg ampule. inhalation of fumes for 30-60 seconds
Repeat PRN
replace ampule every 2-3 minutes. Avoid touching skin.

Question 4

Aspirin

Answer 4

81-324mg PO

Not recommended for pediatrics in the prehospital setting

Question 5

Atropine

Answer 5

Bradydysrhythmias: 0.5mg rapid IVP/IO. Repeat 3-5 minutes to a max of 3mg. Repeat until HR >60 or signs of adequate perfusion

Organophosphate poisoning: 2mg IVP, IM. Repeat every 5 minutes PRN

Pediatrics(> 1 month): Bradydysrhythmias= EPI/O2 initial meds

increased vagal tone: 0.02mg/kg Rapid IVP/IO Max dose is 0.1mg
organophosphates: < or equal to 12 YO, Max single dose 0.5mg total dose 1mg
> or equal to 13 YO Max single dose is 1mg, Total dose 2mg

Question 6

Calcium Chloride

Answer 6

Cardiac Arrest: 1g slowly over 1 minute IVP, Repeat PRN every 10 minutes
Crush Syndrome: 1g slowly over 1 minute IVP. One time only.

Pediatrics:
Cardiac Arrest: 20mg/kg slowly over 1 minute. Repeat in 10 minutes

Crush syndrome 20mg/kg slowly over 1 minute. One time only.

Question 7

Dextrose 50%

Answer 7

50ml(25g) IVP

Pediatrics: 0-2 Years dilute to a 25% 2ml/kg slowly (10ml/minute) IVP
over 2 Years 1ml/kg slowly (10ml/minute) IVP

Question 8

Diphenhydramine (Benadryl)

Answer 8

50mg slow IVP at 25mg/minute or deep IM
May repeat 50mg after 15 minutes. Max total 100mg

Pediatrics: 1mg/kg slow IVP over several minutes

Question 9

Dopamine

Answer 9

Add 400mg to 500ml of NS as an IVPB start at 30mcgtts/minutes
titrate to BP 90-100 systolic and adequate perfusion

Pediatrics: Add 6mg/kg to 100ml of NS. start at 10mcgtts/minute to a max of 20gtts/minute

Question 10

Epinephrine

Answer 10

Cardiac arrest: 1mg(1:10,000) IVP/IO. Repeat PRN 3-5 minutes
Asthma/Allergic Reaction: 0.3mg(1:1,000) SQ Repeat every 20 min x2
Anaphylaxis with shock: 0.1mg(1:10,000) slowly over 1 min IVP
Repeat every 3-5 min or 0.5mg(1:1,000) IM
Pediatrics:
Cardiac Arrest: 0.01mg/kg (1:10,000) IVP/IO Repeat every 3-5 min
Max single dose is 1mg
Asthma/Allergic reaction: 0.01mg/kg (1:1,000) SQ Max single dose
0.3mg. Repeat every 20 minutes x 2
Anaphylaxis with shock: 0.01mg/kg (1:10,000) slowly over 1 min IVP
Max single dose 0.1mg. Repeat 3-5 min
Bradydysrhythmias: 0.01mg/kg (1:10,000) IVP Max single dose 0.1mg
May repeat 0.02mg/kg IVP every 3-5min
Stridor with croup: 1 and over= 5mg (1:1,000) diluted with 5ml NS HHN
less than 1= 2.5mg (1:1,000) diluted w/ 5ml NS HHN

Question 11

Glucagon

Answer 11

Hypoglycemia= 1mg IM Repeat every 20 minutes x2
Overdose of CCB/BB= 3mg IVP

Pediatrics: 1mg IM if known diabetic, May repeat every 20 minutes x2

Question 12

Midazolam (Versed, Hypnovel)

Answer 12

Sedation= 1-2mg slow IVP at 1mg/min Titrate to produce sedation.
2.5mg IM/IN. Max total dose 10mg
Seizures= 2-5mg slow IVP at 1m/min Titrate to suppress seizure
May repeat IVP every 3-5 min PRN 5mg IM/IN May repeat x1 in 5 minutes. Max total dose is 10mg
Agitated Delirium= 2-5mg slow IVP at 1mg/min
5mg IM/IN may repeat 1 time. Max 10mg
Pediatrics: Not for infants less than 6 months old.
0.1mg/kg slow IVP at 1mg/min or 0.1mg/kg IM/IN
May repeat IVP/IM/IN one time PRN
Max total dose is 5mg
Sedation: Same as above except you may repeat every 3-5 minutes

Question 13

Morphine

Answer 13

Pain control: 2-10mg slow IVP at 2mg/min Titrate to relieve pain May repeat IVP dose as needed to a max of 20mg
5-10mg IM as a single dose only

Pediatrics: 0.1mg/kg slow IVP at 1mg/minute Titrate to relieve pain
0.1mg/kg IM as a single dose only

Question 14

Naloxone (Narcan)

Answer 14

0.8-2mg IVP/IM/IN repeat PRN every 5 minutes

Pediatrics: 0.1mg/kg IVP/IM/IN PRN every 5 minutes

Question 15

Nitroglycerin Spray(Nitrolingual)

Answer 15

Chest pain: 0.4mg SL with BP >100 Repeat every 3-5 minutes x 2

Pulmonary Edema: 0.4 SL with BP >100
0.8 SL with BP >150
1.2 SL with BP >200
May repeat dose x2

Question 16

Ondansetron(Zofran)

Answer 16

4mg ODT
4mg IV/IM

Max dose is 4mg all routes

Question 17

Sodium Bicarbonate

Answer 17

Cardiac Arrest: 1mEq/kg IVP May repeat 0.5mEq/kg IVP every 10-15 minutes
Crush Syndrome: 1mEq/kg IVPB, added to first 1L NS

Pediatrics: Cardiac Arrest: 1mEq/kg slow IVP at 10ml/min May repeat 0.5mEq/kg IVP every 10-15 minutes. Rarely indicated in peds
Crush syndrome: same as adult