Midterm Drugs Flashcards
(170 cards)
1
Q
Adenosine
Class
A
Antiarrhythmic, endogenous nucleotide
2
Q
Adenosine
Mechanism of Action
A
Slows conduction time through the AV node; can interrupt re-entrant pathways; slows heart rate; acts directly on sinus pacemaker cells. The drug of choice for re-entry SVT. Can be used diagnostically for stable, wide-complex tachycardias (suspected SVT with aberrancy).
3
Q
Adenosine
Indications
A
Regular tachycardias (narrow and wide). Conversion of PSVT to sinus rhythm. May convert re-entry SVT due to Wolff-Parkinson-White syndrome. Not effective in converting atrial fibrillation/flutter, or V-tach.
4
Q
Adenosine
Adverse Reactions
A
Facial flushing, shortness of breath, chest pain, headache, paresthesia, diaphoresis, palpitations, hypotension, nausea
5
Q
Adenosine
Adult Dosing
A
6 mg over 1 – 3 seconds, followed by a 20 mL saline flush and elevate the patients extremity.
If no response after 1 – 2 minutes, administer 12 mg over 1 – 3 seconds; maximum total dose 30 mg.
6
Q
Adenosine
Pediatric Dose
A
0.1 – 0.2 mg/kg rapid IV; maximum single dose of 12 mg.
7
Q
Adenosine
Duration:
A
12 seconds
8
Q
Albuterol
Class
A
Sympathomimetic, bronchodilator
9
Q
Albuterol
Mechanism of Action
A
Selective beta-2 agonist that stimulates adrenergic receptors of the sympathetic nervous system resulting in smooth muscle relaxation in the bronchial tree and peripheral vasculature.
10
Q
Albuterol
Indication
A
Treatment of bronchospasm in patients with reversible obstructive airway disease (COPD/Asthma). Prevention of exercise-induced asthma.
11
Q
Albuterol
Adverse Reactions
A
Often dose-related and include restlessness, tremors, dizziness, palpitations, tachycardia, nervousness, peripheral vasodilation, nausea, vomiting, hyperglycemia, increased blood pressure, and paradoxical bronchospasm
12
Q
Albuterol
Adult Dosing
A
Administer 2.5 mg. Dilute 0.5 mL of 0.5% solution for inhalation with 2.5 mL normal saline in nebulizer and administer over 10 – 15 minutes. MDI – 1 – 2 inhalations with 5 minutes between inhalations.
13
Q
Albuterol
Pediatric Dose
A
Administer a solution of 0.01 – 0.03 mL diluted in 2 mL of 0.9% NS. May be repeated every 20 minutes three times.
14
Q
Albuterol
Duration
A
Duration: 3 – 4 hours
15
Q
Amiodarone
Class
A
Antiarrhythmic
16
Q
Amiodarone
Mechanism of Action
A
Blocks sodium channels and myocardial potassium channels.
17
Q
Amiodarone
Indications
A
V-fib/pulseless and unstable V-tach
18
Q
Amiodarone
Adverse Reactions
A
Hypotension, bradycardia, prolongation of the P-R, QRS, and Q-T intervals.
19
Q
Amiodarone
Adult Dose: V-fib/ pulseless V-tach unresponsive to CPR, defibrillation, and
vasopressors:
A
300 mg IV/IO push. Initial dose may be followed one time with in 3 – 5 minutes at 150 mg IV/IO push.
20
Q
Amiodarone
Adult Dose: Recurrent life-threatening ventricular arrhythmias:
A
Maximum cumulative dose is 2.2 g/24 hours administered as: 150 mg IV/IO over 10 minutes (15 mg/min). May repeat rapid infusion (150 mg IV/IO) every 10 minutes as needed.
21
Q
Amiodarone
Adult Dose: Maintenance infusion:
A
540 mg IV/IO over 18 hours (0.5 mg/min).
22
Q
Amiodarone
Pediatric Dose:
Perfusing supraventricular and ventricular tachycardias:
A
Loading dose of 5 mg/kg IV/IO over 20 – 60 minutes with a maximum single dose of 300 mg. Can be repeated to a maximum of 15 mg/kg/day.
23
Q
Amiodarone
Duration
A
Duration: 30 – 45 minutes
24
Q
Amiodarone
Pediatric Dose:
Refractory V-fib/pulseless V-tach:
A
5 mg/kg IV/IO bolus, which may be repeated up to a total dose of 15 mg.kg per 24 hours. Maximum single dose is 300 mg.
25
Atropine
| Class
Parasympatholytic-Parasympathetic blocker (Anticholinergic)
26
Atropine
| Mechanism of Action
Potent parasympathetic blocker used to increase the heart rate in hemodynamically significant bradycardia (accompanied by hypotension, shortness of breath, chest pain, AMS, and/or shock). It blocks acetylcholine receptors, inhibiting parasympathetic stimulation. The effects are primarily chronotropic, and atropine has almost no inotropic effect. It acts as an antidote for organophosphate poisoning.
27
Atropine
| Indications
Hemodynamically significant bradycardia with a pulse; organophosphate poisoning
28
Atropine
| Adverse Reaction
Blurred vision, dilated pupils, dry mouth, tachycardia,
| drowsiness, urinary retention, and confusion
29
Atropine
| Adult Dose
0.5 mg IV repeated every 3-5 minutes until a maximum of 3 mg is reached.
30
Atropine
| Pediatric Dose
0.02 mg/kg minimum dose of 0.1 mg, max single dose of 0.5 mg.
31
Atropine
| Duration
4 hours
32
Calcium Chloride
| Class
Electrolyte
33
Calcium Chloride
| Mechanism of Action
Increases cardiac contractility (positive chronotropic effect) and may enhance ventricular automaticity.
34
Calcium Chloride
| Indications
Hypocalcemia, hyperkalemia, magnesium sulfate overdose, calcium channel-blocker overdose, adjunctive therapy in treatment of insect bites and stings.
35
Calcium Chloride
| Adverse Reactions
Bradycardia, Asystole, hypotension, peripheral vasodilation,
| local necrosis, coronary and cerebral artery spasm, nausea and vomiting.
36
Calcium Chloride
| Adult Dose
500 – 1,000 mg (5 – 10 mL of a 10% solution) IV/IO push for hyperkalemia and calcium channel-blocker overdose (repeated as needed).
37
Calcium Chloride
| Pediatric Dose
20 mg/kg (0.2 mL/kg) slow IV/IO push. Maximum 1 g dose; may repeat in 10 minutes.
38
Calcium Chloride
| Duration
15 – 30 minutes, but may persist up to 4 hours depending on
| the dose administered.
39
Dexamethasone (Decadron, Hexadrol)
| Class
Corticosteroid
40
Dexamethasone (Decadron, Hexadrol)
| Mechanism of Action
Mechanism of action: Suppress both acute and chronic inflammation; immunosuppressive effects (especially in anaphylaxis). Possibly decreases cerebral edema.
41
Dexamethasone (Decadron, Hexadrol)
| Indications
Anaphylaxis (after epinephrine and Benadryl), asthma, COPD, croup, spinal cord injury, elevated intracranial pressure (prevention and treatment).
42
Dexamethasone (Decadron, Hexadrol)
| Adverse Reactions
GI bleeding, prolonged wound healing, TB. None from a
| single dose.
43
Dexamethasone (Decadron, Hexadrol)
| Adult Dose
10-100 mg IV (1mg/kg slow IV bolus)
44
Dexamethasone (Decadron, Hexadrol)
| Pediatric Dose
0.25 – 1.0 mg/kg/dose IV, IO, and IM.
45
Dexamethasone (Decadron, Hexadrol)
| Duration
24 – 72 hours
46
Dextrose 50%
| Class
Carbohydrate, hypertonic solution
47
Dextrose 50%
| Mechanism of Action
Rapidly increase serum glucose levels. Short-term osmotic diuresis
48
Dextrose 50%
| Indications
Hypoglycemia, altered level of consciousness.
49
Dextrose 50%
| Adult Dose
12.5-25g slow IV; may be repeated as necessary
50
Dextrose 50%
| Pediatric Dose
0.5 g/kg/dose slow IV; may be repeated as necessary
51
Diazepam (Valium)
| Class
Benzodiazepine, anxiolytic, sedative-hypnotic, and anticonvulsant
52
Diazepam (Valium)
| Mechanism of Action
Potentiates the effects of inhibitory neurotransmitters. Raises the seizure threshold. Includes amnesia and sedation.
53
Diazepam (Valium)
| Indications
Acute anxiety states, acute alcohol withdrawal (delirium tremens), muscle relaxant, seizure activity, agitation. Analgesia for medical procedures (fracture reduction, cardioversion, pacing).
54
Diazepam (Valium)
| Adult Dose IV
Seizure activity 5 – 10 mg IV q 10 – 15 minutes prn (5 mg over 5 minutes)(maximum single dose, 30 mg).
55
Diazepam (Valium)
| Pediatric Dose IV
0.2 – 0.5 mg slow IV q 2 – 5 minutes up to 5 mg (maximum dose 10 mg/kg).
56
Diazepam (Valium)
| Sedation for cardioversion:
5 – 15 mg IV over 5 – 10 minutes prior to cardioversion.
57
```
Diltiazem Hydrochloride (Cardizem, Lyo-Ject)
Class
```
Calcium channel blocker
58
```
Diltiazem Hydrochloride (Cardizem, Lyo-Ject)
Indications:
```
Control of rapid ventricular rates due to atrial flutter, atrial fibrillation, and re-entry SVT; angina pectoris.
59
```
Diltiazem Hydrochloride (Cardizem, Lyo-Ject)
Adult Dose
```
Initial bolus: 0.25 mg/kg (average does of 15 – 20 mg) IV over 2 minutes. If inadequate response, may repeat bolus in 15 minutes: 0.35 mg/kg (average dose 20 – 25 mg) IV over 2 minutes. Maintenance infusion of 5 – 15 mg/hr
60
```
Diltiazem Hydrochloride (Cardizem, Lyo-Ject)
Pediatric Dose
```
Not recommended
61
Dopamine
| Class
Sympathomimetic, inotropic agent
62
Dopamine
| Indications:
Cardiogenic, septic or spinal shock, hypotension with low cardiac output states, and distributive shock.
63
Dopamine
| Adult Dose
IV infusion at 2 – 20 mcg/kg/min titrated to effect 400 mg in 250 ml ( or 800mg/500ml or 1600mg/1000mL)
64
Dopamine
| Pediatric Dose
2 – 20 mcg/kg/min titrated to effect
65
Dopamine
| dilates vessels in kidneys; increased urine output.
2 – 5 mcg/kg/min:
66
```
Dopamine
primarily vasoconstriction (alpha effects)
```
o 10 – 20 mcg/kg/min:
67
Dopamine
| increased heart rate (beta effects)
o 5 – 10 mcg/kg/min:
68
Enoxaparin (Lovenox)
| Class
Anticoagulant-low molecular weight heparin/ heparin derivative.
69
Enoxaparin (Lovenox)
| Mechanism of Action
Deactivates thrombin. Also prevents the conversion of fibrinogen to fibrin.
70
Enoxaparin (Lovenox)
| Indications
Used to inhibit clot formation in ACS including STEMI, NSTEMI, and unstable angina. It is also used to prevent pulmonary embolism and DVT in patients predisposed to such problems.
71
Enoxaparin (Lovenox)
| Adult: STEMI:
Single IV bolus of 30 mg plus 1 mg/kg SQ dose followed by 1 mg/kg SQ every 12 hours (maximum 100 mg)
72
Enoxaparin (Lovenox)
| Pediatric Dose
1 mg/kg SQ
73
Epinephrine 1:10,000 (Adrenalin)
| Class
Sympathomimetic
74
Epinephrine 1:10,000 (Adrenalin)
| Mechanism of Action
Direct-acting alpha- and beta-agonist. Alpha: vasoconstriction. Beta-1: positive inotropic, chronotropic, and dromotropic effects. Beta-2: bronchial smooth muscle relaxation and dilation of skeletal vasculature.
75
Epinephrine 1:10,000 (Adrenalin)
| Indications
Cardiac arrest (V-fib/pulseless V-tach, Asystole, PEA), anaphylaxis. Should not be used for patients who do not require extensive resuscitative efforts.
76
Epinephrine 1:10,000 (Adrenalin)
| Pediatric Cardiac arrest:
IV/IO dose: 0.01 mg/kg (0.01 mL/kg) of 1:10,000 solution every 3 – 5 minutes during arrest.
77
Epinephrine 1:10,000 (Adrenalin)
| Adult Cardiac arrest:
```
IV/IO dose: 1 mg (10 mL of 1:10,000 solution) every 3 – 5 minutes during resuscitation. Follow each dose with 20 mL flush and evaluate arm for 10 – 20 seconds after dose.
Higher doses (up to 0.2 mg/kg) may be administered for specific conditions (beta-blocker and calcium channel- blocker overdose).
```
78
Epinephrine 1:10,000 (Adrenalin)
| Continuous infusion:
Add 1 mg (1 mL of 1:1,000 solution) to 500 mL of NS or D5W. Initial infusion rate of 1 mcg/min titrated to effect (typical dose 2 – 10 mcg/min).
79
Epinephrine 1:10,000
| Profound bradycardia or hypotension:
2 – 10 mcg/min; titrate to patient response.
80
Epinephrine 1:10,000 (Adrenalin)
| Duration:
several minutes
81
Etomidate
| Class
Sedative hypnotic
82
Etomidate
| Mechanism of Action
Ultra-short-acting sedative hypnotic
83
Etomidate
| Indications
Induction agent for RSI
84
Etomidate
| Dosage
0.1 – 0.3 mg/kg IV over 15 – 30 seconds.
85
```
Fentanyl Citrate (Sublimaze)
Class
```
• Class: Narcotic Analgesic
86
```
Fentanyl Citrate (Sublimaze)
Mechanism of Action
```
Agonist actions at the body’s opioid receptor. Increases tone and decreases smooth muscle of the GI tract.
87
```
Fentanyl Citrate (Sublimaze)
Indications
```
Severe pain, adjunct to RSI, and maintenance of analgesia
88
```
Fentanyl Citrate (Sublimaze)
Adult Dose
```
25 – 100 mcg IV, IN, IM, IO
89
```
Fentanyl Citrate (Sublimaze)
Pediatric Dose
```
2 – 12 years old: 1 – 2 mcg/kg/dose
90
Glucagon
| Mechanism of Action other than hypoglycemia
Unknown mechanism of stabilizing cardiac rhythm in beta-blocker overdose
91
Glucagon
| Indications other than hypoglycemia
May be used as an inotropic agent in beta-blocker overdose.
92
Glucagon
| Adult Beta Blocker Dose or Calcium Channel Blocker overdose
3 mg
| initially, followed by the 3 mg/hr infusion as necessary.
93
Glucagon
| Pediatric Beta Blocker Dose or Calcium Channel Blocker Overdose
▪ Calcium channel blocker or beta-blocker overdose: Not
| recommended
94
Heparin
| Class
• Class: Anti-coagulant
95
Heparin
| Mechanism of Action
Direct inhibitor of thrombin
96
Heparin
| Indications:
Acute coronary syndrome (ACS), pulmonary embolism
97
Heparin
| Adult Dose
Loading: 60 units/kg (max 4,000 units IV)
Maintenance: 12 units/kg/hr (max 1,000 units/hr)
98
Heparin
| Pediatric Dose
50 units/kg followed by infusion
99
Hydromorphone (Dilaudid)
| Class
Narcotic
100
Hydromorphone (Dilaudid)
| Mechanism of Action
Central nervous system depressant, decreases sensitivity to pain
101
Hydromorphone (Dilaudid)
| Indications
Severe pain
102
Hydromorphone (Dilaudid)
| Adult Dose
1-4 mg IV, IO, IM, PO
103
Hydromorphone (Dilaudid)
| Pediatric Dose
0.015 mg/kg/dose
104
Ketamine (Ketalar)
| Class
Ultra-Short-acting nonbarbiturate hypnotic agent (dissociative anesthetic)
105
Ketamine (Ketalar)
| Mechanism of Action
It interrupts the pathways within the cortex and limbic system, prompting the release of endogenous catecholamines.
106
Ketamine (Ketalar)
| Indications
Anesthetic agent, airway maintenance, chemical restraint
107
Ketamine (Ketalar)
| Adverse Reactions
Hallucinations, HTN, increased ICP, tremors.
108
Ketamine (Ketalar)
| Adult Dose
Optimal dose is 1.5 mg/kg IV. 4-5 mg/kg IM o
109
Ketamine (Ketalar)
| Pediatric Dose
0.5 – 3.0 mg IV/IM
110
Ketamine (Ketalar)
| Duration:
10-15minutes IV-IO, 15-20 IM
111
```
Lidocaine Hydrochloride (Xylocaine)
Class
```
Antidysrhythmic
112
```
Lidocaine Hydrochloride (Xylocaine)
Mechanism of Action
```
Decreases automaticity by slowing rate of phase 4 depolarization, suppresses ventricular ectopy, and increases the fibrillation threshold
113
```
Lidocaine Hydrochloride (Xylocaine)
Indications
```
Malignant PVCs, V-tach (w/ or w/o a pulse), v-fib, occasionally as a pre-med for RSI
114
```
Lidocaine Hydrochloride (Xylocaine)
Adult:
```
Initial:1 – 1.5 mg/kg IV, IO may repeat in 5-10 min w/ 0.5 – 0.75mg/kg; to a max dose of 3 mg/kg
115
```
Lidocaine Hydrochloride (Xylocaine)
Stable V-tach:
```
0. 5 – 0.75 mg /kg and up to 1 – 1.5 mg/kg. Repeat
| 0. 5 – 0.75 mg/kg; to a max dose of 3 mg/kg
116
```
Lidocaine Hydrochloride (Xylocaine)
Maintenance infusion:
```
1 – 4 mg/min diluted in either NS or D5W
117
```
Lidocaine Hydrochloride (Xylocaine)
Duration:
```
Variable
118
Magnesium Sulfate
| Class
Electrolyte
119
Magnesium Sulfate
| Mechanism of Action
Reduces striated muscle contractions and blocks peripheral neuromuscular transmission by reducing acetylcholine release at the myoneural junction, manages seizure in toxemia of pregnancy, induces uterine relaxation. Can cause bronchodilation after beta-agonists and anticholinergics have been used.
120
Magnesium Sulfate
| Indications
Seizures of eclampsia, torsade de points, hypomagnesaemia
121
Magnesium Sulfate
| Adult: Seizures w/ Pregnancy
Seizure activity associated with pregnancy: 1 – 4 g IV/IO over 3 minutes; maximum dose of 30 – 40 g/day
122
Magnesium Sulfate
| Torsades or Cardiac Arrest due to hypomagnesemia
▪ Torsades de pointes or cardiac arrest due to hypomagnesaemia: 1 -2 g diluted in D5W IV/IO over 5 – 20 minutes.
123
Magnesium Sulfate
| Torsades de pointes w/ a pulse or AMI w/ hypomagnesaemia:
Loading dose of 1 – 2 g mixed in 50 – 100 mL D5W over 50 – 60 minutes IV. Follow with 0.5 – 1 g/hr IV titrated to effect.
124
Magnesium Sulfate
| Asthma:
1-2 g mixed in 50-100 ml given over 10-20 mins
125
Magnesium Sulfate
| For asthma: Pediatric
25 – 50 mg/kg over 10 – 20 minutes
126
Methylprednisolone (Solumedrol)
| Class
• Class: Anti-inflammatory glucocorticoid
127
Methylprednisolone (Solumedrol)
| Mechanism of Action
Synthetic corticosteroid that suppresses acute and chronic inflammation; potentiates vascular smooth muscle relaxation by beta-adrenergic agonists.
128
Methylprednisolone (Solumedrol)
| Indications:
Acute spinal cord trauma, anaphylaxis, and bronchodilator for unresponsive asthma.
129
Methylprednisolone (Solumedrol)
Adult Dosage
Acute spinal cord injury:
30 mg/kg IV over 30 minutes followed
| by infusion 5.4 mg/kg/hr
130
Methylprednisolone (Solumedrol)
| Asthma and COPD:
1 -2 mg/kg IV generally 125-250 mg
131
Methylprednisolone (Solumedrol)
| Pediatric Acute spinal cord injury:
30 mg/kg IV over 30 minutes followed
| by infusion 5.4 mg/kg/hr
132
Methylprednisolone (Solumedrol)
| Pediatric Asthma:
1 -2 mg/kg IV
133
Metoclopramide (Reglan)
| Class
Phenothiazine antiemetic
134
Metoclopramide (Reglan)
| Mechanism of Action
Reduces gastroesophageal reflux
135
Metoclopramide (Reglan)
| Indications
Nausea and vomiting
136
Metoclopramide (Reglan)
| Adult Dose
IM 10 – 20 mg; IV 10 mg slow IVP over 1 – 2 minutes
137
Metoclopramide (Reglan)
| Pediatric Dose
Rarely used
138
```
Morphine Sulfate (Astramorph)
Class
```
Opioid analgesic
139
```
Morphine Sulfate (Astramorph)
Mechanism of Action
```
Alleviates pain through CNS action, suppresses fear and anxiety centers of the brain; depresses brain stem respiratory centers, increases peripheral venous capacitance and decreases venous return, decreases preload and afterload, which decreases myocardial oxygen demand.
140
```
Morphine Sulfate (Astramorph)
Indications
```
Severe CHF, pulmonary edema, chest pain associated with an acute MI, analgesia for moderate to severe acute and chronic pain.
141
```
Morphine Sulfate (Astramorph)
Adult Dose
```
Initial dose: 2 – 5 mg IV (over 1 – 5 minutes). Repeat dose: 2 mg every 2 minutes titrated to effect.
5-15 mg IM based on patients weight
142
```
Morphine Sulfate (Astramorph)
Pediatric Dose
```
0.1 – 0.2 mg/kg with a maximum dose of 5 mg, IV, IM, IO, or SC.
143
Oxytocin (Pitocin)
| Class
Hormone
144
Oxytocin (Pitocin)
| Mechanism of Action
Increase uterine contractions
145
Oxytocin (Pitocin)
| Indications
Postpartum hemorrhage after infant and placental delivery.
146
Oxytocin (Pitocin)
| Adult Dose
IM administration: 3 – 10 units after deliver of the placenta. IV administration: Mix 10 – 40 units in 1,000 mL of a nonhydrating diluent: infused at 20 – 40 milliunits/min, titrated to severity of bleeding and uterine response.
147
Pancuronium (Pavulon)
| Class
Nondepolarizing neuromuscular blocker/paralytic
148
Pancuronium (Pavulon)
| Mechanism of Action
Binds to the receptor for acetylcholine at the neuromuscular junction.
149
Pancuronium (Pavulon)
| Indications
Induction or maintenance of paralysis after intubation to assist ventilations.
150
Pancuronium (Pavulon)
| Adult Dose
0.04-0.1 mg/kg slow IV; repeat every 30 – 60 minutes PRN.
151
Pancuronium (Pavulon)
| Pediatric Dose
0.1 mg/kg slow IV, IO
152
Sodium Bicarbonate
| Class
Alkalinizing agent
153
Sodium Bicarbonate
| Mechanism of Action
Combines with excessive acids to form a weak volatile acid
154
Sodium Bicarbonate
| Indications
Tricyclic antidepressant overdose, severe acidosis secondary to hyperventilation
155
Sodium Bicarbonate
| Adult Dose
1 mEq/kg initially followed by 0.5 mEq/kg every 10 minutes as indicated by blood gas studies
156
Sodium Bicarbonate
| Pediatric Dose
1 mEq/kg initially followed by 0.5 mEq/kg every 10 minutes
157
Succinylcholine
| Class
Depolarizing neuromuscular blocker, paralyzing agent
158
Succinylcholine
| Mechanism of Action
Bind to the receptors of acetylcholine.
159
Succinylcholine
| Indications
To facilitate intubation, to terminate laryngospasm, to promote muscle relaxation, and to facilitate electroconvulsive shock therapy.
160
Succinylcholine
| Adult Dose
1 -2 mg/kg rapid IV; repeat once if needed
161
Succinylcholine
| Pediatric Dose
1 – 1.5 mg/kg dose rapid IV/IO; repeat once if needed
162
Succinylcholine
| Duration:
5 minutes
163
Terbutaline (Brethine)
| Class
• Class: Sympathomimetic bronchodilator
164
Terbutaline (Brethine)
| Mechanism of Action
Selective beat-2 adrenergic receptor activity resulting in relaxation of smooth muscles of the bronchial tree and peripheral vasculature. Minimal cardiac effects.
165
Terbutaline (Brethine)
| Indications
Bronchial asthma, reversible bronchospasm associated with exercise, chronic bronchitis, and emphysema.
166
Terbutaline (Brethine)
| Adult Dose
0.25 mg SC, may repeat in 15 – 30 minutes to a maximum dose of 0.5 mg in a 4-hour period.
167
Terbutaline (Brethine)
| Pediatric Dose
Not recommended in children under 12 years of age; 0.01 mg/kg/dose SC every 15 – 20 minutes PRN to a maximum dose of 0.25 mg.
168
Diltiazem
| Mechanism of Action
Block influx of calcium ions into cardiac muscle; prevents spasm of coronary arteries. Decreases the rate of ventricular response. Arterial and venous vasodilator. Reduces preload and afterload. Reduces myocardial oxygen demand.
169
Enoxaparin (Lovenox)
| Adult: NSTEMI:
Unstable Angina: 1 mg/kg SQ every 12 hours in conjunction with oral aspirin therapy (100-325 mg daily)
170
Magnesium Sulfate
| Pediatric Dose IV/IO infusion:
25 – 50 mg/kg over 10 – 20 minutes;
| faster if treating Torsade de pointes.
