ED Medications

Question 1

What is Levophed (norepinephrine) used for?

Answer 1

Treats hypotension by increasing MAP/SBP; first-line vasopressor.

Question 2

What is the route and constitution of Levophed?

Answer 2

Infusion; 8 mg or 16 mg in 250 mL D5W.

Question 3

What is the initial dose and titration for Levophed?

Answer 3

Initial: 2 mcg/min; Titrate 1–2 mcg/min every 2 min.

Question 4

What are key considerations for Levophed?

Answer 4

May cause tachycardia, increased O2 demand, peripheral hypoperfusion.

Question 5

What is Vasopressin used for?

Answer 5

2nd-line pressor for septic shock.

Question 6

What is the dose and titration for Vasopressin?

Answer 6

0.01–0.04 units/min; Do not titrate.

Question 7

What is a major safety concern with Vasopressin?

Answer 7

Constricts coronary arteries at doses >0.04 units/min.

Question 8

What is Epinephrine used for?

Answer 8

Treats hypotension and bradycardia; used in slow rhythms.

Question 9

What is the route and dose for Epinephrine?

Answer 9

Infusion; 1–40 mcg/min.

Question 10

What are key safety concerns for Epinephrine?

Answer 10

Causes severe tachycardia; a1, b1, b2 agonist.

Question 11

What is Neosynephrine used for?

Answer 11

Alternative pressor that causes less tachycardia.

Question 12

What is its dose and titration for neosynephrin?

Answer 12

40–200 mcg/min; titrate 10–20 mcg/min every 2 min.

Question 13

What receptor does Neosynephrine work on?

Answer 13

Alpha-1 only (vasoconstriction).

Question 14

What is Dopamine used for?

Answer 14

Dose-dependent effects: renal (low), heart (mid), vasoconstriction (high).

Question 15

What is its route and dose range for dopamine?

Answer 15

Infusion; 1–20 mcg/kg/min.

Question 16

What are key considerations with Dopamine?

Answer 16

May cause tachycardia and increased O2 demand at high doses.

Question 17

What is Labetalol used for?

Answer 17

BP and HR control; beta-blocker.

Question 18

When should you hold Labetalol?

Answer 18

Hold if HR <60 bpm or SBP <90 mmHg.

Question 19

What is its route and dose for labetalol?

Answer 19

IVP or infusion; 1–4 mg/min infusion; 10–40 mg IVP.

Question 20

What is Esmolol used for?

Answer 20

Rapid HR control; short-acting beta-blocker.

Question 21

What is the loading dose for Esmolol?

Answer 21

500 mcg/kg, then start 50 mcg/kg/min.

Question 22

What are contraindications for Esmolol?

Answer 22

Bradycardia, 2nd/3rd-degree heart block, LV failure, asthma/COPD.

Question 23

What is Metoprolol used for?

Answer 23

HR and BP control; beta-1 selective blocker.

Question 24

What is its dose and route for metoprolol?

Answer 24

IVP; 2.5–10 mg.

Question 25

When should you hold Metoprolol?

Answer 25

Hold if HR <60 bpm or SBP <90 mmHg.

Question 26

What is Cardizem (Diltiazem) used for?

Answer 26

Rate and rhythm control in atrial arrhythmias.

Question 27

What is its route and loading dose Cardizem?

Answer 27

Infusion or IVP; 0.25–0.35 mg/kg over 2 min.

Question 28

What is a key effect of Cardizem?

Answer 28

Slows AV conduction, reduces HR.

Question 29

What is Verapamil used for?

Answer 29

Rate/rhythm control.

Question 30

What is its route and dose for Verapamil?

Answer 30

IVP; 5 mg.

Question 31

What is a key concern with Verapamil?

Answer 31

May cause significant hypotension.

Question 32

What is Versed (Midazolam) used for?

Answer 32

Sedation; benzodiazepine.

Question 33

What is the dose and titration for Versed?

Answer 33

1–20 mg/hr; titrate 0.5–1 mg/hr every hour.

Question 34

What are key considerations Versed?

Answer 34

Respiratory depression, hypotension.

Question 35

What is Propofol (Diprivan) used for?

Answer 35

Sedation; short-term anesthetic.

Question 36

What is the dose and titration for propofol?

Answer 36

5–50 mcg/kg/min; titrate every 5 min.

Question 37

Key concern with Propofol?

Answer 37

Hypotension; short-term use preferred.

Question 38

What is Precedex (Dexmedetomidine) used for?

Answer 38

Sedation without respiratory depression.

Question 39

What is the dose and titration for Precedex?

Answer 39

0.2–1.5 mcg/kg/hr; titrate 0.1–0.2 mcg/kg/hr q30min.

Question 40

Key consideration with Precedex?

Answer 40

May cause bradycardia and hypotension.

Question 41

What is Nimbex (Cisatracurium) used for?

Answer 41

Paralytic agent for ventilated patients.

Question 42

What is its dose and titration?

Answer 42

0.5–10 mcg/kg/min; titrate 0.5–2 mcg/kg/min q1hr.

Question 43

What must be monitored with Nimbex?

Answer 43

TOF monitoring; ensure BIS and sedation before use.

Question 44

What is Amiodarone used for?

Answer 44

Treats ventricular arrhythmias, A-fib, SVT.

Question 45

What is the IV bolus and infusion rate?

Answer 45

Bolus: 150 mg over 10 min; Infusion: 1 mg/min x6 hr, then 0.5 mg/min x18 hr.

Question 46

What are safety concerns with Amiodarone?

Answer 46

QT prolongation, bradycardia, Torsades; use filter tubing.

Question 47

What is Lidocaine used for?

Answer 47

Treats ventricular rhythms.

Question 48

What is the bolus and infusion dose?

Answer 48

IVP: 1–1.5 mg/kg; Infusion: 1–4 mg/min.

Question 49

Key concern with Lidocaine?

Answer 49

CNS toxicity; alternate to Amiodarone in arrest.

Question 50

What is Adenosine used for?

Answer 50

Treats SVT (not VT); antiarrhythmic/vasodilator.

Question 51

How is Adenosine given?

Answer 51

IVP: 6 mg, then 12 mg rapid push with 20 mL flush.

Question 52

What happens after Adenosine is given?

Answer 52

Short asystole, chest discomfort; short half-life <10 sec.

Question 53

What is Dobutamine used for?

Answer 53

Inotrope to increase cardiac output.

Question 54

What is the dose and titration?

Answer 54

0.5–20 mcg/kg/min; titrate 2.5–5 mcg/kg/min q10min.

Question 55

What are concerns with Dobutamine?

Answer 55

Tachycardia, hypotension at high doses.

Question 56

What is Milrinone used for?

Answer 56

Inotrope/vasodilator for heart failure.

Question 57

What is the dose and titration?

Answer 57

0.125–0.75 mcg/kg/min; titrate hourly.

Question 58

Key risk with Milrinone?

Answer 58

Hypotension due to vasodilation; onset 20–25 min.

Question 59

What is Morphine used for in critical care?

Answer 59

Pain relief; reduces preload/afterload and O2 demand.

Question 60

What is the infusion dose and titration?

Answer 60

1–40 mg/hr; titrate 1 mg every 30 min.

Question 61

Key side effect of Morphine?

Answer 61

Hypotension, respiratory depression.

Question 62

What is Fentanyl used for?

Answer 62

Opioid pain control; rapid onset.

Question 63

What is the dose and titration?

Answer 63

50–400 mcg/hr; titrate 25 mcg/hr q30min.

Question 64

Why choose Fentanyl over Morphine?

Answer 64

Less hypotension; more hemodynamically stable.