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Drug Profiles (Mesa Drug Box) Flashcards

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1
Q

Fentanyl
-indications

A
  • severe pain of any etiology
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2
Q

Fentanyl - pharmacology & actions

A
  • opioid agonist-analgesic
  • increases pain threshold
  • produces analgesia and sedation
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3
Q

Fentanyl- absolute contraindications

A
  • O2 sat < 90%
  • significant respiratory depression
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4
Q

Fentanyl- precautions and side effects

A
  • causes neurologic and respiratory depression; respiratory support must be available
  • can be reversed with Narcan
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5
Q

Fentanyl- dosage

A

IV / IO / IN

STEMI: 0.5 mcg/kg; max 200 mcg
PAIN: 1 mcg/kg; max initial dose 100 mcg; max total dose 200 mcg
Consider 1/2 dose if age > 60 years

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6
Q

Fentanyl - how is it carried?

A

100 mcg / 2 mL
2 vials

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7
Q

EPINEPHRINE
“Push-dose”
1:100,000
- concentration? And how do we make it?

A

10 mcg/mL
We make a concentration of 10 mcg/mL by adding 1 mL “Code Epi” (0.1 mg/mL) to 9 mL saline flush)

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8
Q

EPINEPHRINE
1:100,000
“Push-dose”
- Guidelines containing indications

A
  • Bradycardia
  • Shock
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9
Q

EPINEPHRINE
1:100,000
“Push-dose”
- dosages

A

10-20 mcg (1-2 mL) every 2 minutes

Peds: 0.01 mcg/kg = (0.1mL) every 2 minutes

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10
Q

EPINEPHRINE
- pharmacology & actions

A
  • catecholamine with alpha and beta effects which increase heart rate and blood pressure
  • potent bronchodilator
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11
Q

EPINEPHRINE
- indications (all of them)

A
  • cardiac arrest (1:10,000 “cardiac”)
  • bradycardia (1:100,000 “Push dose”
  • shock (hypotension) (1:100,000 “push dose”)
  • anaphylaxis (1:1,000)
  • severe wheezing (IM) (1:1,000)
  • croup and bronchiolitis (nebulized) (1:1,000)
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12
Q

EPINEPHRINE
- absolute contraindications

A
  • allergy
  • uncontrolled hypertension (relative contraindication)
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13
Q

EPINEPHRINE
- precautions and side effects

A
  • increases cardiac work and can precipitate angina, MI, or major dysrhythmias in patients with ischemic heart disease
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14
Q

EPINEPHRINE
1:10,000
“Code Epi”
- how do we carry it

A

1 mg/10 mL
6 boxes

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15
Q

EPINEPHRINE
1:10,000
“Code Epi”
- dosages

A

1 mg every 3-5 minutes; max 3 doses

Peds: 0.01 mg/kg (max 1 mg); max 3 doses

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16
Q

EPINEPHRINE
1:1,000
- How do we carry it?

A

1 mg/ mL
5 vials

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17
Q

EPINEPHRINE
1:1,000
- what guidelines contain indications

A

Anaphylaxis (IM)
Wheezing (IM)
Croup, bronchiolitis (nebulized)

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18
Q

EPINEPHRINE
1:1,000
- dosages

A

IM: 0.01 mg/kg; max 0.3 mg

Nebulized: 5 mg

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19
Q

SUCCINYLCHOLINE
- how do we carry it?

A

200 mg/ 10 mL
2 vials

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20
Q

SUCCINYLCHOLINE
- pharmacology and actions

A
  • depolarizing neuromuscular blocker
  • acts on the motor end plate receptors, inhibits neuromuscular transmission
  • muscles are unable to be stimulated by Ach
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21
Q

SUCCINYLCHOLINE
- indications

A

Induction of paralysis to facilitate endotracheal intubation

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22
Q

SUCCINYLCHOLINE
- absolute contraindications

A
  • malignant hyperthermia
  • hyperkalemia
  • penetrating eye injury
  • paraplegia/quadraplegia
  • prolonged immobilization
  • allergy
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23
Q

SUCCINYLCHOLINE
- precautions and side effects

A
  • use with caution in patients with anticipated difficult airway
  • has no effect on consciousness - use with sedatives
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24
Q

SUCCINYLCHOLINE
- dosage

A

1.5 mg/kg IV/IO
One time dose only

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25
AMIODARONE - how do we carry it?
150 mg/ 3 mL 3 vials
26
AMIODARONE - pharmacology and actions
- blocks potassium-, sodium-, calcium-channels - decreases AV node conduction - prolongs cardiac action potential and repolarization - has some alpha- and beta-adrenergic blocking properties
27
AMIODARONE - indications
V-fib Pulseless v-tach Regular/irregular wide complex tachycardia with a pulse
28
AMIODARONE - absolute contraindications
-allergy -second or third degree AV blocks
29
AMIODARONE - precautions and side effects
May cause hypotension and bradycardia
30
AMIODARONE - dosages
CODE: 5 mg/kg (max 300 mg); repeat at 1/2 dose TACHYCARDIA: 150 mg over 10 min PEDS: 5 mg/kg
31
ETOMIDATE - how do we carry it?
40 mg/ 20 mL 2 vials
32
ETOMIDATE - pharmacology and actions
- sedative and hypnotic - depresses activity of the reticular activating system
33
ETOMIDATE - contraindications
Allergy
34
ETOMIDATE - dosage
IV/IO 0.3 mg/kg MAX 20 mg one time dose only
35
DILTIAZEM (CARDIZEM) - how do we carry it
25 mg/ 5 ml 2 vials
36
DILTIAZEM (CARDIZEM) - pharmacology and actions
- calcium channel blocker - inhibitory effects at AV node: slows ventricular rate associated with Afib and Aflutter - decreases cardiac contraction; thereby dilating main coronary and systemic arteries
37
DILTIAZEM (CARDIZEM) - indications
- Atrial fibrillation/atrial flutter (irregular narrow complex tachycardia) - SVT not responding to adenosine
38
DILTIAZEM (CARDIZEM) - absolute contraindications
- heart block /bradycardia - systolic BP < 90mmHg - sick sinus syndrome - V tach - allergy
39
DILTIAZEM (CARDIZEM) - precautions and side effects
- prolongation of AV node conduction may result in second or third degree AV block - should not be administered to compromised myocardium (severe CHF, AMI …) - use caution when giving to hypotensive patients
40
DILTIAZEM (CARDIZEM) - dosages
1st dose: 0.125 mg/kg; max 12.5 mg over 2 minutes; patients >65 years old, max 10 mg 2nd dose: AFTER 10 MINUTES: SAME DOSE
41
ATROPINE - pharmacology and actions
-blocks action of ACH at muscarinic receptor sites -blocks parasympathetic response, allowing sympathetic response to take over -positive chronotropic effects: increases heart rate; increases conduction through AV node -reverses muscarinic effects of cholinergic poisoning
42
ATROPINE - indications
- symptomatic bradycardia - organophosphate poisoning
43
ATROPINE -absolute contraindications
- bradycardia without evidence of cardiopulmonary compromise - atropine allergy
44
ATROPINE - dosage
1 mg IV/IO every 3-5 minutes Max total dose 3 mg
45
ADENOSINE - pharmacology and actions
- slows conduction through the AV node - interrupts AV nodal circuit, stopping tachycardia, restoring normal sinus rhythm
46
ADENOSINE - indications
- to convert hemodynamically stable narrow complex regular tachycardia with a pulse (SVT)
47
ADENOSINE - dosage
- 6 mg IV/IO; follow with 10 mL bolus - 12 mg IV/IO; follow with 10 mL bolus PEDS: - 0.1 mg/kg IV/IO; max 6 mg - repeat at 0.2 mg/kg IV/IO max 12 mg
48
ADENOSINE - how do we carry it
6 mg/2 mL 3 vials
49
GLUCAGON - pharmacology & actions
- increases serum glucose by releasing glycogen stores from the liver
50
GLUCAGON - indications
- hypoglycemia (less than 60 mg/dL)
51
GLUCAGON - absolute contraindications
- not the first line treatment for hypoglycemia and should only be used in symptomatic patients when unable to obtain IV/IO access
52
GLUCAGON - precautions & side effects
- may cause nausea and vomiting - slower onset than IV/IO dextrose
53
ALBUTEROL - pharmacology and actions
- beta2-adrenergic bronchodilator - relaxes bronchial smooth muscle - also lowers serum potassium (shifts potassium intracellular)
54
ALBUTEROL - indications
- treatment of bronchospasm - treatment of hyperkalemia
55
ALBUTEROL - absolute contraindications
- none other than ALBUTEROL allergy
56
ALBUTEROL - our guidelines containing ALBUTEROL
- bronchospasm - anaphylaxis & allergic reaction - hyperglycemia (hyperkalemia) - extremity trauma (hyperkalemia) - dermal chemical burns (hyperkalemia)
57
ALBUTEROL - dosage
5 mg nebulized Repeat as neede
58
ALBUTEROL - how do we carry it
- 2.5 mg / 0.5 mL
59
ASPIRIN - how do we carry it
81 mg tablets
60
ASPIRIN - pharmacology and actions
- disrupts platelet function and inhibits prostaglandin
61
ASPIRIN - contraindications
CONTRA: - active GI bleed - if patient has taken 324 mg in last 24 hours - allergy
62
ASPIRIN - which guidelines
Chest Pain/ACS/STEMI
63
ATROPINE - how do we carry it
1 mg / 10 mL 3 boxes
64
DIPHENHYDRAMINE (BENADRYL) - how do we carry it
50 mg/ 1mL 2 vials
65
DIPHENHYDRAMINE (BENADRYL) - pharmacology and actions
- blocks histamine receptors in respiratory tract and blood vessels - also has anticholinergic actions (can treat acute dystonic reactions to antipsychotic drugs)
66
DIPHENHYDRAMINE (BENADRYL) - indications
- treatment of allergic reactions: urticaria, rash, itching - treatment or prevention of acute dystonic reactions to antipsychotic drugs
67
DIPHENHYDRAMINE (BENADRYL) - contraindications
CONTRA: - allergy - newborns
68
DIPHENHYDRAMINE (BENADRYL) - which guidelines
- Anaphylaxis and Allergic Reaction - Poisoning / Overdose
69
DIPHENHYDRAMINE (BENADRYL) - dosage
1 mg/kg IV/IO/IM/PO Max dose 50 mg
70
IPRATROPIUM BROMIDE (ATROVENT) - how is it carried
0.5 mg/2.5 mL (3 packets)
71
IPRATROPIUM BROMIDE (ATROVENT) - pharmacology and actions
- anticholinergic: Antagonizes action of acetylcholine on the bronchial smooth muscle in the lungs - causes bronchodilation
72
IPRATROPIUM BROMIDE (ATROVENT) - indications
- bronchoconstriction (asthma and COPD) - may be given in combination with albuterol
73
IPRATROPIUM BROMIDE (ATROVENT) - contraindications
CONTRA - none other than allergy
74
IPRATROPIUM BROMIDE (ATROVENT) - dosage
0.5 mg nebulized with albuterol Max 3 doses
75
Drugs indicated for Bronchospasm due to Asthma and COPD
- albuterol / atrovent (5 mg / 0.5 mg) - epinephrine (for severe respiratory distress) 0.3 mg IM of 1:1000 - Solu-Medrol 2 mg/kg IV IO IM; max 125 mg - magnesium sulfate 50 mg/kg max dose 2 g - (NIPPV)
76
KETAMINE - how do we carry it?
500 mg / 5 mL
77
KETAMINE - pharmacology and actions
- functions as a dissociative, amnestic, analgesic, and anesthetic agent - non-competitive NMDA receptor antagonist
78
KETAMINE - indications
- delirium with agitated behavior - induction agent for intubation - pain control
79
KETAMINE - absolute contraindications
- angina - CHF - pregnancy - allergy - not indicated for postictal patients - not indicated in pediatric patients
80
KETAMINE - precautions and side effects
- must be administered slowly - transient periods of apnea (1-2 minutes) have occurred with rapid infusion of ketamine - may cause laryngospasm - may cause increased airway secretions - may cause nystagmus - use with caution in patients with schizophrenia
81
KETAMINE - which guidelines
- Agitated or Violent Patients - Acute Pain - RSI
82
KETAMINE - dosage
PAIN - 0.25 mg/kg IV/IO -Max per dose 25 mg/ Max total dose 100 mg - Should be administered slow IV push or may be diluted in 50 mL NS and administered over 3-5 minutes AGITATION - 4 mg/kg IM/IN max 250 mg - may repeat once after 5 minutes
83
LIDOCAINE - how do we carry it
100 mg / 5 mL One box
84
LIDOCAINE - pharmacology and actions
- antiarrhythmic drug that decreases automaticity by slowing depolarization - local anesthesia for IO
85
LIDOCAINE - indications
- cardiac arrest due to Vfib or Vtach - wide complex tachycardia with a pulse - pain management after IO insertion in conscious patients
86
LIDOCAINE - absolute contraindications
CONTRA: - bradycardia - allergy
87
LIDOCAINE - dosages
IO PAIN MANAGEMENT: - Adults 40 mg IO (2mL) - Peds 0.5 mg/kg MAX 40 mg CARDIAC: - 1-1.5 mg/kg every 5 minutes - MAX 3 mg/kg - may repeat at 1/2 original dose
88
METHYLPREDNISOLONE (SOLU-MEDROL) - pharmacology and actions
- anti-inflammatory corticosteroid - reduces cell permeability
89
METHYLPREDNISOLONE (SOLU-MEDROL) - how do we carry it
125 mg /2 mL 2 vials
90
METHYLPREDNISOLONE (SOLU-MEDROL) - indications
- Acute bronchospastic disease: asthma/COPD
91
METHYLPREDNISOLONE (SOLU-MEDROL) - contraindications
Traumatic brain injury Allergy
92
METHYLPREDNISOLONE (SOLU-MEDROL) - which guidelines
Bronchospasm Shock
93
METHYLPREDNISOLONE (SOLU-MEDROL) - dosages
2 mg/kg IV IO IM Max dose 125 mg ** onset 1-6 hours / peak effect 8 hours
94
ONDANSETRON (ZOFRAN) - pharmacology and actions
- selectively blocks serotonin 5-HT3 receptors - primary effect is in GI tract
95
ONDANSETRON (ZOFRAN) - indications
Nausea or vomiting
96
ONDANSETRON (ZOFRAN) - contraindications
CONTRA - patients with prolonged QT - patients <1 month old - allergy
97
ONDANSETRON (ZOFRAN) - dosages
4 mg IV / IO / oral Pediatrics: 0.15 mg/kg max 4 mg
98
ONDANSETRON (ZOFRAN) - how do we carry it
4 mg / 2 mL 2 vials
99
MORPHINE - how do we carry it
10 mg / 1 mL 2 vials
100
MORPHINE - pharmacology and actions
- narcotic analgesic
101
MORPHINE - indications
Analgesia (pain management)
102
MORPHINE - absolute contraindications
- respiratory or CNS depression - hypotension - allergy
103
MORPHINE - precautions and side effects
- causes neurological and respiratory depression - can be reversed with halo one - check and document vital signs and patient response after each dose - goal is reduction of pain, not total elimination
104
MORPHINE - guidelines
Management of Acute Pain Chest Pain/ACS/STEMI
105
MORPHINE - dosages
PAIN MANAGEMENT 0.1 mg/kg IV/IO Max 2-5 mg increments Max total dose 15 mg STEMI, unresponsive to nitrates 0.05 mg/kg IV/IO Max single dose 3 mg May repeat in 10 minutes to total max of 10 mg **use with caution in unstable angina/non-STEMI due to increased mortality
106
NITROGLYCERIN - how do we carry it
0.4 mg tablets
107
NITROGLYCERIN - pharmacology and actions
- potent smooth muscle relaxant - systemic venodilation: decreases preload - arterial vasodilation: decreases after load - coronary artery vasodilation - increases blood flow to myocardium - decreases myocardial oxygen demand
108
NITROGLYCERIN - indications
- chest pain, esp when ACS is suspected - CHF with pulmonary edema
109
NITROGLYCERIN - absolute contraindications
- hypotension (SBP below 90 mmHg) - use of erectile dysfunction meds within last 48 hours - not for use in pediatrics - allergy
110
NITROGLYCERIN - precautions and side effects
- may cause profound hypotension and reflex tachycardia - common side effects include HA, flushing, dizziness, burning under the tongue
111
NITROGLYCERIN - which guidelines
Chest Pain / ACS / STEMI Pulmonary Edema
112
NITROGLYCERIN - dosages
- 0.4 mg tablets sublingual - May repeat every 3-5 minutes, until pain resolves, as BP allows - location of infarct does not preclude use, however continuously monitor hemodynamic status
113
What drugs are indicated in our Chest Pain / ACS / STEMI protocol?
- aspirin 324 mg - nitroglycerin 0.4 mg - fentanyl 0.5 mcg/kg (50 mcg / 50 mcg) max 200 mcg - morphine 0.05 mg/kg; max single dose 3 mg; total max 10 mg
114
What drugs are indicated in Bradycardia protocol?
- (pace if unstable!) - push dose Epi 10-20 mcg (1-2 mL) every 2 minutes - atropine 1 mg every 3-5 min
115
What drugs are used in RSI
SEDATE: Etomidate 0.3 mg/kg max 20 mg Ketamine 1.5 mg/kg max 150 mg PARALYZE: Succinylcholine 1.5 mg/kg POST-INTUBATION: Fentanyl 1 mcg/kg max 50 mcg Morphine 0.1 mg/kg max 5 mg Midazolam (versed) 0.1 mg/kg max 5 mg Lorazepam (Ativan) 0.1 mg/kg max 2 mg Ketamine 1 mg/kg max 150 mg
116
What drugs are used in SVT
- (vagal maneuvers if stable) - (sync cardiovert if unstable) - Adenosine 6 mg / 10 ml rapid NS bolus - Adenosine 12 mg / 10 ml rapid NS bolus - Diltiazem/Cardizem 0.125 mg/kg max 12.5 mg (max 10 mg if over 65) - Diltiazem/Cardizem repeat same dosage Pediatrics: Adenosine 0.1 mg/kg
117
What drug is indicated for stable A-Fib A-flutter with RVR
- Diltiazem/cardizem 0.125 mg/kg max 12.5 mg (max 10 mg if over 65) - may repeat after 10 minutes
118
What drugs are indicated for stable wide complex tachycardias (Vtach)?
- Amiodarone 150 mg over 10 minutes - repeat Amio once as needed OR - Lidocaine 1-1.5 mg/kg repeat at 1/2 original dose every 5 minutes; max total dose 3mg/kg
119
What drug is indicated for stable Torsades de pointes?
Magnesium sulfate 2 g over 5-10 minutes
120
What joule settings do we use on Zoll monitor for sync cardioversion? (And what indications do we sync cardiovert?)
SVT A flutter/Afib V tach with a pulse 70 / 120 / 150 / 200 Pediatric tachycardia: 1 J/kg; 2 J/kg; 2 J/kg
121
What joule settings do we defibrillate on Zoll monitor? And for what indications?
V fib V tach without a pulse Torsades with or without a pulse 120 / 150 / 200 / 200 Pediatrics: 2 J/kg; 4 J/kg; 6 J/kg … up to 10 J/kg
122
ADENOSINE -absolute contraindications
- second or third degree heart block - poison or drug-induced tachycardia - known allergy
123
ADENOSINE - precautions and side effects
-may cause brief asystole, dizziness, facial flushing, HA, nausea -may cause bronchospasm in asthmatic patients -if patient becomes hemodynamically unstable, cardioversion should occur
124
ADENOSINE - guidelines
Tachycardia with a pulse
125
ALBUTEROL -precautions and side effects
-may cause dizziness, anxiety, palpitations, headache, sweating -relative contraindications include symptomatic tachycardia, tachyarrhythmias, or angina chest pain
126
AMIODARONE -guidelines containing it
-Cardiac Arrest (VF/VT/Asystole/PEA) -Tachycardia with a pulse
127
ASPIRIN -indications
Adult patients with suspected acute coronary syndrome
128
ASPIRIN -precautions and side effects
-may cause GI discomfort and nausea -may cause wheezing
129
ASPIRIN -dosage
324 mg chewed
130
ATROPINE - precautions and side effects
- avoid in hypothermic bradycardia - paradoxical bradycardia may result from doses less than 0.5 mg, use with caution in pediatric patients
131
ATROPINE -which guidelines contain it
-Bradycardia -Organophosphate poisoning
132
DEXTROSE - pharmacology and actions
Rapidly increase blood glucose
133
DEXTROSE -indications
Hypoglycemia
134
DEXTROSE -contraindications
None in prehospital setting
135
DEXTROSE -precautions and side effects
-extravasation of dextrose may cause tissue necrosis -use caution during administration -if extravasation does occur, immediately stop administration of drug
136
DEXTROSE -which guidelines contain it
Hypoglycemia
137
DEXTROSE -dosage
D10 IV/IO: 1 ml/kg; max dose 250 mL Max single dose 25 g Repeat as needed: titrate to effect (Same for peds)
138
DEXTROSE -how do we carry it
D10 25gm/250mL 2 bags
139
DIAZEPAM (Valium) -pharmacology and actions
-benzodiazepine -decreases seizures by increasing the seizure threshold -sedative -amnestic effect
140
DILTIAZEM (CARDIZEM) -what guidelines contain it
-tachycardia with a pulse
141
DIPHENHYDRAMINE (BENADRYL) -precautions/side effects
-usually causes sedation, however it may paradoxically cause excitation in children -may have additive sedation effect with alcohol or other CNS depressants -may cause hypotension when given IV/IO
142
ETOMIDATE -indications
Induction of anesthesia for RSI
143
ETOMIDATE -precautions of side effects
Not intended for prolonged infusion
144
ETOMIDATE -precautions / side effects
Not intended for prolonged infusion
145
ETOMIDATE -which guidelines contain it
RSI
146
FENTANYL -guidelines
-Management of Acute Pain -Chest Pain/ACS/STEMI -Pharmacological Management: Synch Cardioversion and NIPPV
147
GLUCAGON -Guidelines
Hypoglycemia
148
GLUCAGON -dosage
1 mg IM/IN Peds: 1 mg IM/IN (if >20 kg or >5 yo) 0.5 mg IM/IN (if <20 kg or <5 yo)
149
GLUCAGON - how do we carry it
1 mg/mL (2 vials)
150
IPRATROPIUM BROMIDE (ATROVENT) -precautions and side effects
-use with caution in patients with narrow angle glaucoma -side effects may include palpitations, dizziness, anxiety, headache
151
IPRATROPIUM BROMIDE (ATROVENT) -Guidelines
Bronchospasm
152
LIDOCAINE -precautions and side effects
-at higher doses may cause CNS stimulation, seizure, depression
153
LIDOCAINE -Guidelines
Conscious IO Tachycardia with a Pulse Cardiac Arrest (VF/VT/Asystole/PEA)
154
LORAZEPAM (ATIVAN) -pharmacology and actions
Benzodiazepine that functions as a CNS depressant, anticonvulsant, and sedative
155
LORAZEPAM (ATIVAN) -indications
-seizures -pharmacologic management of painful/anxiety producing procedures -delirium with agitated behavior -uncontrolled shivering in hyperthermia
156
LORAZEPAM (ATIVAN) -contraindications
-neurologic or respiratory depression -acute angle glaucoma -allergy
157
LORAZEPAM (ATIVAN) -precautions and side effects
-respiratory depression and/or hypotension can occur (more likely when used with other depressants, or when given rapidly)
158
LORAZEPAM (ATIVAN) -Guidelines
-Agitated or Violent Patient -Bradycardia -Seizures -Hyperthermia/Heat Exposure
159
LORAZEPAM (ATIVAN) - dosage
- 2-4 mg IM OR - 2 mg IV/IO May repeat once after 15 min Max total dose 4mg PEDS: 0.05 mg/kg IM/IV/IO MAX dose 2 mg IV/IO Max dose 4 mg IM
160
LORAZEPAM - how do we carry it
2 mg/ 1mL
161
MAGNESIUM SULFATE - pharmacology and actions
-smooth muscle relaxant -reduces arrhythmias -decreases seizure in eclampsia and preeclampsia -CNS depressant
162
MAGNESIUM SULFATE - indications
- eclampsia and preeclampsia - tornadoes de pointes - severe bronchospasm in asthma or COPD
163
MAGNESIUM SULFATE - absolute contraindications
Known allergy
164
MAGNESIUM SULFATE - precautions and side effects
-may cause hypotension and respiratory depression in large doses - caution with use in patients with renal failure
165
MAGNESIUM SULFATE - Guidelines
- Bronchospasm - OB - Childbirth - Tachycardia with a pulse - Seizures - Cardiac Arrest
166
MAGNESIUM SULFATE - dosages
BRONCHOSPASM 50 mg/kg over 5-10 minutes IV/IO MAX dose 2 g SEIZURES IN PREGNANCY Prophylaxis: 4 g over 10-15 min Management: 5 g slow push over 5-10 min TORSADES 2 g over 5-10 minutes IV/IO
167
MAGNESIUM SULFATE - how do we carry it
2 G / 50 mL (bags) May also have vial (check concentration)
168
METHYLPREDNISOLONE (SOLU-MEDROL) - precautions and side effects
None
169
MIDAZOLAM (VERSED) - pharmacology and actions
Benzodiazepine that functions as a CNS depressant, anticonvulsant, and sedative
170
MIDAZOLAM (VERSED) - indications
- seizures - pharmacologic management of painful/anxiety producing procedures - delirium with agitated behavior - uncontrolled shivering in hyperthermia
171
MIDAZOLAM (VERSED) - absolute contraindications
- respiratory and/or CNS depression - allergy
172
MIDAZOLAM - precautions and side effects
- a high potential to cause respiratory depression and/or hypotension
173
MIDAZOLAM - Guidelines
- Seizures - pharmacologic management when pacing - Agitated or Violent Patient
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MIDAZOLAM - dosages
SEIZURES 0.2 mg/kg IM/IN MAX 5-10 mg 0.1 mg/kg IV/IO Administer slowly over 2 minutes MAX 4 mg AGITATED PATIENTS 5 mg IM/IN/IV/IO May repeat every 3 minutes MAX total 20 mg PHARMACOLOGIC MGMT FOR PACING 1 mg IV/IO slowly every 2-3 doses MAX 5 mg
175
MIDAZOLAM - how do we carry it
Multiple concentrations — always double-check! 5 mg/ 1 mL 5 mg / 5 mL 10 mg/ 2 mL
176
NALOXONE (NARCAN) - pharmacology and actions
-narcotic antagonist which competitively binds to opioid receptors in the brain -displaces opioid molecules, reversing the effect of opioids on the brain
177
NALOXONE (NARCAN) - indications
- reversal of acute opioid toxicity
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NALOXONE (NARCAN) - precautions and side effects
- may precipitate acute withdrawal symptoms: be prepared to manage - duration of some narcotics is longer than NARCAN - repeated doses may be necessary
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NALOXONE (NARCAN) - Guidelines
- Altered Mental Status - Opioid Overdose
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NALOXONE (NARCAN) - dosages
-4 mg IN -0.4 - 2 mg IV/IO/IM/IN PEDS 0.1 mg/kg IV/IO/IM/IN
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ONDANSETRON (ZOFRAN) - precautions and side effects
May cause QT prolongation
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ONDANSETRON (ZOFRAN) - Guidelines
Nausea/Vomiting
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SUCCINYLCHOLINE - Guidelines
RSI
184
CALCIUM CHLORIDE - pharmacology and actions
- increases calcium levels - stimulates release of catecholamines - increases cardiac contractility (positive inotropic effect) - stabilizes myocardial cell membranes in hyperkalemia
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CALCIUM CHLORIDE - indications
- suspected hyperkalemia - antidote for calcium channel blocker overdose
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CALCIUM CHLORIDE - contraindications
- do not use in suspected digoxin toxicity - hypercalcemia - suspected severe hypokalemia - allergy
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CALCIUM CHLORIDE - precautions and side effects
- may cause discomfort at injection site - will precipitate if mixed with sodium bicarbonate
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CALCIUM CHLORIDE - dosage
1 g IV/IO over 5 minutes Ensure IV/IO latency and do not exceed 1 mL/minute
189
CALCIUM CHLORIDE - how do we carry it
1 gm / 10 mL
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PROPARACAINE OPHTHALMIC - pharmacology and actions
- site of action is ophthalmic pain nerve cell membrane - alleviates eye pain
191
PROPARACAINE - indications
Topical anesthetic prior to irrigation of eyes with Morgan’s lens
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PROPARACAINE - contraindications
Allergy
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PROPARACAINE - precautions and side effects
- each bottle is single patient use only - may dilate pupils, cause local irritation
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PROPARACAINE - Guidelines
Dermal Chemical Burns
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PROPARACAINE - dosages
1-2 drops in affected eye Wait 30-60 seconds for anesthetic effect
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PROPARACAINE - how do we carry it
Single use bottle

My Paramedic Shit (3 decks)

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