Medications

Question 1

Epinephrine (CODE)

Answer 1

1mg IV/IO of 1:10,000

Question 2

Vasopressin (CODE)

Answer 2

40 units

Question 3

Amiodarone (CODE)

Answer 3

300 mg IV/IO; additional dose is 150mg once

Question 4

Lidocaine (CODE)

Answer 4

1 to 1.5 mg/kg; can repeat up to 3 doses (total of 3mg/kg)

Question 5

Atropine (for bradycardia)

Answer 5

0.5mg IV (can repeat up to total of 3mg);

techincally max of 0.04mg / kg

Question 6

Epinephrine for Bradycardia

Answer 6

Epinephrine gtt (2-10mcg/min)

Question 7

Dopamine for Bradycardia

Answer 7

Dopamine gtt (2-10mcg/kg/min)

Question 8

Adenosine

Answer 8

6mg IVP; repeat 12mg IVP x 2

Question 9

Magnesium for Polymorphic VT / Torsades de Points

Answer 9

1-2 gm over 5-6 minutes then infusion

Question 10

Amiodarone for VT with PUlses

Answer 10

150 mg IV over 10 minutes, repeat if ineffective; then if for maintenance 1mg/min infusion x6 hours followed by 0.5mg/min over 18 hours

Question 11

Diltiazem (control of SVT or AFib with RVR)

Answer 11

0.25mg/kg followed by 0.35mg/kg if no response after 10 minutes
maintenance rate is 5 - 15 mg/hr

Question 12

Atenolol (for SVT or AFib)

Answer 12

5mg slow IV over 5 minutes; if tolerated can do second dose 5mg slow IV over 5 minutes

Question 13

Metaprolol (for SVT or AFib)

Answer 13

5mg solw IV over 5 minutes; repeat up to 15mg total as tolerated

Question 14

Propranolol (for SVT or AFib)

Answer 14

0.1 mg/kg slow IV push divided into 3 doses at 2-3 minute intervals

Question 15

Atropine (for asystole and slow PEA)

Answer 15

1mg IV push for asystolic and slow PEA; can repeat in 3-5 minutes if persistent;

Question 16

Epinephrine Infusion (anaphylaxis)

Answer 16

2-10 mcg/min infusion

Question 17

Norepinephrine (hypotension)

Answer 17

alpha and betareceptor stimulating actions; vasoconstrictor and inotropic agent
severe hypotension
initial dose 0.5 - 1 mcg/min; start at 5mcg/min most often
max at 30 mcg/min

Question 18

Vasopressin (hypotension)

Answer 18

0.03 units/min; max 0.1 units/min

Question 19

Dobutamine

Answer 19

catecholamine and inotropic agent; increases myocardial contractility and decrease left ventricular filling pressure
used in severe systolic heart failure
2 - 20 mcg/kg/min infusions

Question 20

Nitroglycerin sublingual

Answer 20

one tablet is 0.4mg; can repeat at 3-5 minute intervals for angina

Question 21

Nitroglycerin IV for CHF

Answer 21

loading 50-100 mcg/min for 1-5 minutes
infusion 50-200mcg/min titrated by 40mcg.min
max 200mcg/min

Question 22

Esmolol for Aortic Dissection

Answer 22

negative inotropie/chronotrope (beta blocker)
used for HR control
loading: 500mcg/kg IV over 1 minute
infusion 50 mcg/kg/mmin; max 300 mcg/kg/min

Question 23

Labetalol for Aortic Dissection

Answer 23

negative inotrope and arterial vasodilator
loading dose: 20mg IV over 2 minutes
infusion 2-8mg/min titrate by 0.5mg/min

Question 24

CHF Exacerbation with signs of shock and MAP > 65 or SBP > 90

Answer 24

use dobutamine infusion
2.5 mcg/kg/min IV
max 20 mcg/kg/min

Question 25

CHF Exacerbation with signs of shock and MAP < 65mmHg

Answer 25

start vasopressor therapy Norepi: 0.05mcg/kg/min IV start Epi: 1-2 mcg/kg/min start Dobutamein: 5 mcg/kg/min IV start;

Question 26

Nicardipine (hypertensive emergency)

Answer 26

goal decrease 20-25% | 5mg/hr; titrate by 2.5mg/hr

Question 27

Labetalol (hypertensive emergency)

Answer 27

loading dose 20mg IV double dose at 10 minute intervals infusion 2-8 mg;/hr

Question 28

tPA for Stroke

Answer 28

0.9mg/kg IV max 90mg | bolus 10% of tPA over 1 minute; remaining over 60 minutes

Question 29

Mannitol (for ICP / herniation signs)

Answer 29

1g/kg IV bolus Mannitol 20%

Question 30

Hypertonic Saline (IC / herniation)

Answer 30

250 cc over 20-30 min | or 3ml/kg

Question 31

Levetiracetam

Answer 31

loading dose 20mg/kg | repeat dose 500-1000mg every 12 hours

Question 32

Phenytoin / Fosphenytoin

Answer 32

20 mg/kg for both max rate 50 mg/min in phenytoin for fosphenytoin its over 60 minues

Question 33

Status Epilepticus Plan

Answer 33

Simultaneous Benzo and Anticonvulsant lorazepam 4mg / diazepam 5-10mg / midazolam 10mg Fosphenytoin 20mg/kg or phenytoin 20mg/kg or valproic acid 20-30 mg/kg if after 20 minutes no response must intubate; tx for EEG monitoring; propofol or phenobarbital

Question 34

Pantoprazole

Answer 34

UGIB: 80 mg bolus | if infusion 8mg/hr

Question 35

Octreotide (UGIB with varices)

Answer 35

50mcg IV bolus

Question 36

Somatostatin (UGIB varices)

Answer 36

loading 250 mcg IV bolus

Question 37

Enoxaparin

Answer 37

1mg/kg SQ

Question 38

Rivaroxaban

Answer 38

loading 15mg PO bid 3 weeks then 20mg PO daily

Question 39

Hemophilia A Bleeding

Answer 39

Factor VIII Deficient IU = kg x desired % increased x 0.5 severe bleeding always 100%

Question 40

Hemophilia B Bleeding

Answer 40

Factor IX Deficient | IU = 100 IU x kg

Question 41

Calcium Gluconate

Answer 41

for hyperkalemia 10% calcium give 3 amps (30ml) IV at 1.5 mL/minute

Question 42

Epinephrine Anaphylaxis

Answer 42

``` 0.01mg/kg IM of 1:1000 epinephrine typical dose is 0.3mg IM; can be repeated at q5-10 epipen is 0.3mg fluids 1-2 liter epi infusion 1-2 mcg/min ```

Question 43

Eclampsia Treatment

Answer 43

magnesium 4-6 mg IV bolus over 15-20 minutes for seizures | hydralazine for BP: give 5-10 mg IV

Question 44

tPA massive PE

Answer 44

definition SBP < 90 for 15 in | alteplase 10mg IV bolus then infusion of 90 mg over 2 hours

Question 45

albuterol for asthma

Answer 45

nebulized solution continuous 20-25 mg/hr | intermittent is 2.5-5mg q20 minutes x 3 doses

Question 46

propofol

Answer 46

procedural sedation: 1mg/kg; repeat 0.5mg/kg q5 min | continuous sedation: 5-80 mcg/kg/min

Question 47

etomidate

Answer 47

``` RSI: 0.3mg/kg (often 20mg used) procedural sedation (cardioversion): 0.1mg/kg ```

Question 48

ketamine

Answer 48

RSI: 1-2 mg/kg IV or 4-10 mg/kg IM procedural sedation 1mg/kg

Question 49

Naloxone

Answer 49

0.4mg IV up to 2mg total

Question 50

Succinylcholine

Answer 50

depolarizing agent | 1-1.5 mg/kg

Question 51

Rocuronium

Answer 51

non depolarizing | 0.6-1.2 mg/kg (often use 70mg)

Question 52

Fentanyl for Sedation

Answer 52

25-250mcg/hr