Drugs Flashcards
(32 cards)
Epi 1:10,000
- Arrest:
- Peds Arrest and Brady
- 1 mg IV/IO every 3-5 min
* Peds- Arrest and Brady= 0.01 mg/k every 3-5 min
Amiodarone:
- Arrest
- Post-Resus/Tachy
- Peds
- Arrest= 300mg IV/IO repeat once 150mg
- Post-Resus/Tachy= 150mg/100ml NS over 10min
- Peds-Pulseless VF/VT 5mg/k may repeat
Sodium Bicarbonate
- Arrest:
- Tricyclic Anti-depressant overdose:
- Crush Injury:
- Peds Arrest/ TCA overdose:
- Peds Crush Injury:
- Arrest/TCA= 1mEq/kg IV/IO
- Crush= 50mEq w/ initial NS liter prior to removal
- Peds Arrest/TCA= 1mEq/kg (max 50mEq)
- Peds Crush= 1mEq/kg (max 50mEq) with initial NS liter prior to removalNote: only different is adult crush and ped crush when it comes to administration
Adenosine:
- Stable SVT
- Peds
- SVT= 6mg rapid IV push; repeat once at 12mg
* Peds= 0.1mg/kg (max 6) may repeat once 0.2mg/kg (max 12)
Epi 1:1000
- Asthma & Allergic/ sever distress
- Brady/Hypotension
- Peds Asthma & Allergic/ sever distress
- Peds Croup
•Severe Distress= 0.3-0.5mg IM
(0.3mg =>50)
•Brady/Hypotension= 2-10mcg/min 1mg mixed in 100cc NS refractory to everything
•Peds Asthma & Allergic= 0.01mg/kg
IM (max 0.3mg) may repeat 15 min for allergic
•Peds Croup= 0.5mg in 5ml NS/ nebulizer
Note: Peds Asthma/ sever epi is first; Peds allergic reaction/ severe albuterol and atrovent is first then epi
Adult= epi is first on both sever distress
Atropine:
- Unstable Brady
- Post-Resus Brady w/ hypotension
- Organo
- Peds Organo
•Unstable Brady= 1mg IV IO may repeat once in 3 to 5 min
•Post-Resus Brady w/ Hypotension=
0.5mg IV IO repeat every 5 min to max 3mg
- Organo= 2-4 mg every 3-5 min until dry
- Organo Peds= 0.05mg/kg max single 2mg
•precautions: ~acute myocardial infarction MI
~wide complex atria-ventricular blocks
~slow administration
~doses less than 0.5mg
Magnesium Sulfate (Mag):
- Arrest/ Torsade de pointes, Polymorphic V-Tach, Refactory V-fib/V-tach
- Asthma/COPD
- Eclampsia (seizure)
- Peds Arrest
- Peds Asthma
- Arrest= 2g IV/IO
- Asthma/COPD= 2g in 100ml NS over 5 min
- Eclampsia= 4g IV/IO
- Peds Arrest= 50mg/kg IV/IO max single 2g
- Peds Asthma= 50mg/kg 100ml NS o/ 10min
Solu-Medrol:
- COPD
- Asthma
- Allergic Reaction
- Peds
- Adult= 125mg IV/IO/IM
* Peds= 2mg/kg IV/IO/IM max 125mg
Albuterol
- COPD
- Asthma
- Respiratory Distress
- Allergic Reaction/ Anaphylaxis
- Peds
- Adult= 5mg repeat once
- Peds= 5mg repeat once
- Peds under 10Kg= 2.5mg
:Note- in Respiratory Distress it say known or suspected pneumonia(fever, decreased long sounds, and/or cough) Albuterol and Atrovent
Atrovent:
- COPD
- Asthma
- Respiratory Distress
- Allergic Reaction
- Peds
•0.5 mg w/ albuterol one dose
~ same on all!!!!!
Benadryl:
•Allergic Reaction/Anaphylaxis:
~mild
~moderate
~moderate w/ respiratory compromise
~severe/ Anaphylaxis
•OD/poisoning:
~ acute Dystonic Reaction to Anti-
psychotics
•Peds
- Adult= 25mg IV/IM
* Peds= 1mg/kg IV/IO/IM single max 25mg
Thiamine:
•Alcohol Related Illness:
~alcohol syndrome and
~malnourished
•100mg IV/IM
Nitroglycerin (NTG):
- Chest Pain
- Acute Heart Failure Pulmonary EdemaNote: consider withholding if PT is 30y or younger without Acute Coronary Syndrome symptoms
•Chest Pain= 0.4 mg SL every 5min until pain is resolved or systolic B/P drops below 110
•Acute Heart Failure Pulmonary Edema=
~normotensive(SBP=>110)or hyper
~ 0.4mg SL every 5 min until....
~ if CPAP in place apply 1inch Nitropaste
to PT left anterior chest
•Note: contraindications:
~ systolic B/P <110
~ hypovolemia
•Precautions:
~ drop in Sys B/P of 20 or more
~ erectile within 24 to 72 hours
~ inferior MI hypotension may result
~ hypotension wipe off paste
Normal Saline:
- Arrest
- Hypotension/ Tachy
- Diabetic BGL>300
- Chest Pain/ inferior MI prior to NTG
- Chest Pain/ if prior to Dopamine
- Peds Arrest
- Peds Croup
- Peds Diabetic BGL>300
•Arrest= 20ml/kg max 2L •Hypotension/Tachy= 20ml/kg SBP of 90 •Diabetic= 20ml/kg max2L •CP/Inferior MI= 20ml/kg max2L •CP/prior to dop= NS bolus of 250ML repeat up to 1L to maintain SBP of 90, if PT develops pulmonary edema stop and administer Dopamine •Peds= 20ml/kg max2L •Peds Croup= 5ml nebulized •Peds Diabetic= 2ml/kg
Dextrose:
- D50
- D25
- D10
•D50W 25 grams BGL below 60 after 5min below 50 repeat D50W 12.5g
~stroke BGL below 50 12.5g
Repeat after 5min if below 60
~Adolescent(13-18) D50W 1ml/kg <60
•D25W 2ml/kg= infant/child(1month-12y)
~BGL <60
•D10W 5ml/kg= neonate (0-1month)
~BGL <45
Note: no improvement <50 repeat appropriate dextrose for Pediatric PT
Narcan:
- Arrest
- OD/Poisoning w/ respiratory depression
- Peds Arrest
- Peds OD/ w/ respiratory depression
- Arrest= 1-2mg IV/IO/IM max 2mg
- OD w/ resp. dep.= 0.4mg repeat in 2min max total 1mg
- Peds Arrest= 0.1mg/kg max 2mg
- Peds OD/ w/ resp. dep.= 0.1mg/k (max single dose 1mg)
Dopamine: first line medication for Cardiogenic Shock (pulmonary edema w/ hypotension
- Acute Heart Failure Pulmonary Edema/ hypotension SBP<90
- Bradycardia/ if atropine or pacing does not improve BP (SBP <90) & Post-Resuscitation
- Spinal Trauma/ after 1L NS hypotension persist and neurogenic shock is suspected
- Chest Pain/ if PT develops pulmonary edema
- Beta blocker overdose
- contraindications:
- Acute HFPE= hypo may indicate cardiogenic shock 5-10mcg/kg/min IV titrate to effect
- Brady= 5-10mcg/kg/min IV/IO titrate to effect
- Spinal Trauma= 5-10mcg/kg/min IV/IO
- Chest Pain= 5-10mcg/kg/min IV titrate to effect
•contra. Hypovolemic shock,
Tachydysrythmias
- Beta blocker OD= if hypotension after 500 ML fluid administration 5-10mcg/kg/min titrate to SBP of 90
- Calcium Channel Blocker toxicity: use dopamine after Calcium Chloride if hypotensive after 500 ML of fluid
- precautions: PT’s receiving monoamine oxidase inhibitors
Calcium Chloride:
•Arrest H’s and T’s
~ hyperkalemia in dialysis PT’s
~ Calcium channel blocker OD
- Overdose/ calcium channel blocker
- Crush injury/ peaked T waves or wide QRS
•on all cases 5mg/kg (max dose 500mg)
Glucagon:
- Hypoglycemia
- Peds Hypo
No IV access BGL<50
- adult 1mg IM
- Peds 20kg or greater 1mg IM
- Peds <20kg 0.5mg IM
- considerations: onset 1min; peak onset 30; most PT’s awake at 15min; repeat BGL after 15min
Glucose paste:
•Conscious and Alert PT w/ BGL less than 60
•glucose paste 15 grams(1tube)
may repeat once in 20 min if BGL is still below 60
•contra: altered level of consciousness
Difficulty swallowing
Aspirin:
- Chest Pain
- contraindications
•Chest Pain 324mg PO
•Chest Pain w/ history of GI bleed
~ consider half 162mg
•contra: Active GI bleed; allergies to salicylates
•precautions: use of anticoagulant;
~pregnancy: w/ ST elevation give ASA, withhold if no ST elevation
Neo-Synephrine:
- Nose Bleed
- Contraindications
•2 gtts in affected nostril
•contra: nose bleed secondary to hypertension (BP=>160/110)
Nose bleed secondary to head injury and CSF drainage and hypersensitivity
Tetracaine:
•contraindications
•Chemical/Irritant Exposure(i.e.pepper spray, tear gas)
~ 2 drops to each eye before and after irrigation, may repeat every 10 minutes
•contra: known hypersensitivity or other ophthalmic anesthetic and open ocular Trauma
Phenergan:
•Contraindications
•Nausea/ Vomiting
~gastrointestinal related
•12.5mg IV diluted 100ml of NS
infused over several min 60gtt/set
•>64 years old 6.25mg
• may repeat once after 15min if vomiting
Persist
Contra: Pediatric patients
