G - M Flashcards
Oral Glucose
INDICATION
- Altered LOC caused by hypoglycemia.
CONTRA
-No gag reflex
-Unable to protect airway
DOSE - 25-50g (full tube)
SIDE EFFECT
-Aspiration
Glucagon
INDICATION
-Hypoglycemia (IN or IM)
-Beta-blocker OD
-Calcium Channel Blocker Toxicity
CONTRA
- Hypersensitivity to Proteins
DOSE
-Low sugar: 1mg IM or IN
CCB or Beta Blocker OD:
1mg IV/IO up to 3mg
SIDE EFFECT
-N&V
-Tachycardia
Haldol
(Haloperidol)
INDICATION
- Patients who require sedation for comfort or safety during transport
CONTRA
- Preexisting coma
* Intoxication
* Known cardiovascular disease
DOSE
- Adult: 18 y.o.+ 5-10 mg IM Not to exceed 100 mg in 24 hours
SIDE EFFECTS
- dystonic reaction
- Antidote: Diphenhydramine Benadryl 25-50 mg IVP
* Tardive dyskinesia
* Potentially fatal Neuroleptic Malignant Syndrome (NMS) – symptom: fever
Heparin
INDICATION
- Prevention of thrombus formation in acute MI
CONTRA
- Active bleeding or bleeding tendencies
* Recent major surgery or trauma
DOSE
IV/ IV Infusion
* Adult: 5,000 units IV
Follow with 20,000-40,000 units IV over 24 hrs
- Follow with 28 units/kg/hour IV Infusion
SIDE EFFECTS
- Potentially life-threatening bleeding
* May cause hematologic disorder
Hydroxocobalamin (Cyanokit®)
INDICATION
- Cyanide toxicity
CONTRA
- Absolute: None
Relative: History of anaphylactic reaction to hydroxocobalamin or cyanocobalamin
DOSE
- 5 grams (2 vials) over 15 minutes
SIDE EFFECTS
- Flushing, urticaria, itching or rash
- Chest tightness and dyspnea Transient blood pressure elevation Anaphylaxis Red skin, tears, sweat and urine
Ketamine (ketalar)
INDICATION
-Anesthesia prior to RSI
-Chemical sedation for Psychiatric/Behavioral issues
CONTRA
-Hypersensitivity
DOSE
- RSI: 1mg/kg IV may repeat every 5-10
- Sedation: 1mg/kg IV or 4mg/kg IM
SIDE EFFECTS
-Hypertension
-Tachycardia
-Sedation
-Vomiting
-Involuntary muscle movement
Labetolol
(Trandate or Normodyne)
INDICATION
- Acute hypertensive crisis with End-Organ Dysfunction
- Unstable angina
- Non Q-wave MI
- Abdominal Aortic Aneurysm (AAA)
- Supraventricular tachycardia (SVT) with Rapid Ventricular Response (RVR)
- Ventricular Tachycardia refractory to Lidocaine
CONTRA
- Cocaine or amphetamine overdose
- Congestive Heart Failure (CHF)
Hypertension
DOSE
- Adult: Hypertensive Crisis: 5-10 mg IV May repeat to total of 20 mg IVP
Add 4 mL Labetalol to 6 mL NS
Administer 2.5-5 mL of mix, may repeat
* Goal: Diastolic BP: 115-130 mmHg
Resolve of End-Organ Dysfunction S/S
SIDE EFFECTS
* Bronchospasm -
* Hypotension (AVOID!) –
- Hallucinations -
- Hyponatremia
- Hyperkalemia -
Lasix (Furosmede)
INDICATION
- Acute Pulmonary Edema
CONTRA
-Hypersensitivity
-Hypovolemia/
- Dehydration
DOSE
1mg/kg over 2 min
If Already on Lasix: give twice their daily dose
SIDE EFFECTS
-Hypotension
-Dry mouth
-Electrolyte imbalance
-if given too fast, can cause hearing loss
Levophed
(Norepinephrine bitartrate)
INDICATION
- Neurogenic & Cardiogenic Shock & Septic Shock
- BP<70
CONTRA
- Hypovolemia
DOSE
- 8-12 mcg/min
SIDE EFFECTS
-HTN
-Dysrhythmias
-Angina
-Reflex Brady
-Tissue Necrosis
Lidocaine
INDICATION
- Cardiac Arrest from VTach / VFib
- Maintenance Infusion @ ROSC assoc. w/ VT/VF
CONTRA
- 2nd/3rd heart block
- Strokes-Adams syndrome
- Prophylactic use in AMI
DOSE
CA- 1-1.5mg/kg
every 5-10min to MAX 3mg/kg
- ROSC- 1-4mg/min
SIDE EFFECT
-Light-headed
-Confusion
-Blurred Vission
-Hypotension
-Bradycardia
-Altered LOC
-Seizures
Magnesium Sulfate
INDICAITON
-Eclamptic Seizure
-Ventricular Dysrhythmias
-Torsades
-Digitoxin Toxicity
-Asthma
CONTRA
-Heart Block
-Myocardial Damage
DOSE
Eclampsia, Torsades, Asthma: 1-2 g over 10mins
Cardiac Arrest 1-2g IV push
SIDE EFFECTS
-Diaphoresis
-Hypothermia
-Respiratory Depression
-Facial Flush
-Bradycardia
-Hypotension
-N/V
Methylprednisolone (Solu-medrol®)
INDICATION
- Wheezing refractory to inhaled bronchodilators
- Status asthmaticus
- Severe anaphylaxis, in conjunction with epinephrine and diphenhydramine
CONTRA
Known hypersensitivity to the product and its constituents
DOSE
- 60 – 125 mg IV/IO, if there are no contraindications
- IM in Asthma
- Anaphylaxis bp is to low for IM
SIDE EFFECTS
- May produce hypertension
- Rare instances of:
- Anaphylactic reactions
- Exacerbation of congestive heart failure
- Seizure
Midazolam
(Versed)
INDICATION
-Active Seizure
-Status Epilepticus
-Sedation prior to Cardioversion/Pacing
CONTRA
-Hypersensitivity
-Acute Narrow Angle Glaucoma
DOSE
2.5-5mg may repeat once (IV or IN)
SIDE EFFECTS
-Respiratory Depression
-Confusion
-Hypotension
-Nausea
Morphine
INDICATION
-Pain & Anxiety
-Chest Pain unrelieved by NITRO
CONTRA
-BP <90
-Traumatic Brain Inj.
-Respiratory Depression
DOSE
2-4 mg q 3-5 mins to hypotension or respiratory depression
SIDE EFFECTS
-Respiratory depression
-Dizziness
-N/V
-Hypotension
-Bradycardia
