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257 Cards in this Set
- Front
- Back
Amiodarone-Trade name
|
Codarone
|
|
Amiodarone-Class
|
Class III antiarrhymic
|
|
Amiodarone-Mechanism of action
|
Acts directly on the myocardium to delay repolarization and increase the duration of the action potential
|
|
Amiodarone-Indications
|
Ventricular arrhythmias; second line drug for atrial arrhythmias
|
|
Amiodarone-Contraindications
|
SA node dysfunction, 2nd and 3rd degree AV blocks, cardiogenic shock, syncope caused by bradycardia.
|
|
Amiodarone-Routes of administration
|
IV/IO
|
|
Amiodarone-Adult dosage
|
300mg, 150mg in 3-5 min
|
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Amiodarone-Peds dosage
|
5mg/kg to a max of 300mg
|
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Amiodarone-Adverse affects
|
Hypotension, HA, dizziness, bradycardia
|
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Amiodarone-Special considerations
|
Pregnancy Class D,
|
|
Pregnancy class A
|
No evidence of risk exists.
|
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Pregnancy class B
|
The risk of human fetal harm is possible but remote.
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Pregnancy class C
|
Human fetal risk cannot be ruled out. Drugs should only be given in the potential benefit justifies the potential risk to the fetus.
|
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Pregnancy class D
|
Positive evidence of human fetal risk. May be beneficial in life-threatening situations where no other drug can be used
|
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Pregnancy class X
|
Contraindicated during pregnancy. The use outweights any potential benefit.
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Asprin-AKA
|
ASA, acetylsalicylic acid
|
|
Asprin-Mechanism of action
|
Prevents platelet aggregation by preventing the formation of thromboxane A in the blood.
|
|
Asprin-Class
|
Antiplatelet agent, non narcotic analgesic, antipyretic
|
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Asprin-Indications
|
Pain, discomforts, CP, Fever
|
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Asprin-Contraindications
|
Known hypersensitivity, bleeding ulcer, bleeding disorder, hemorrhagic stroke, children, GI bleed.
|
|
Asprin-Dosage
|
Adult: 160mg-325mg (81 mg tablets)
|
|
Asprin-Route of administration
|
PO
|
|
Asprin-Adverse affects
|
GI bleeding, anaphylaxis, angioedema, bleeding, stomach upset, N&V
|
|
Asprin-Special considerations
|
Large doses of salicylates have a hypoglycemic affect, Pregnancy class C, last trimester is class D.
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Atropine-AKA
|
Atropine sulfate
|
|
Atropine-Class
|
Anticholinergic, parasympathetic blocker, parasympatholytic, antimuscarinic
|
|
Atropine-Mechanism of action
|
Competes reversibly with acetylcholine at the site of muscarinic receptors
|
|
Atropine-Indications
|
Symptomatic bradycardia, asytole, PEA, bronchospasm, nerve agent exposure, organophosphate poisoning
|
|
Atropine-Contraindications
|
Tachycardia, acute MI, myasthenia gravis, GI obstruction, glaucoma, 3rd degree heart block
|
|
Atropine-Route of administration
|
IV,IO, IM, Tracheal
|
|
Atropine-Adult dosage for symptomatic bradycardia
|
0.5mg IV/IO every 3-5 minutes to a max dose of 3mg
|
|
Atropine-Adolescent doseage for symptomatic bradycardia
|
0.02 mg/kg (min dose of .10mg, max dose of .5mg/dose) IV/IO up to a max of 2mg
|
|
Atropine-Pediatric-dosage for symptomatic bradycardia
|
0.02 mg/kg (min dose of .10mg, max dose of .5mg/dose) IV/IO up to a max of 1mg
|
|
Atropine-Asystole/PEA
|
1mg IV/IO every 3-5 minutes to a max dose of 3mg *may be give via ET tube a 2-2.5 mg diluted in 5-10ml of H20 or NS
|
|
Atropine-Adult dosage for nerve agent/organophosphate poisoning
|
2-4mg IV/IM every 20-30 minutes till symptoms dissipate *In severe cases, the initial dose can be as large as 2 to 6 mg IV. Repeat doses of 2 to 6 mg can be administered IV, IM every 5 to 60 minutes
|
|
Atropine-Pediatric dosage for nerve agent/organophosphate poisoning
|
0.05 mg/kg IV, IM every 10 to 30 minutes as needed until symptoms dissipate
|
|
Atropine-Infant <15 lbs. dosage for nerve agent/organophosphate poisoning
|
0.05 mg/kg IV, IM every 5 to 20 minutes as needed until symptoms dissipate
|
|
Atropine-Adverse effects
|
Anxiety, dizziness, HA, confusion, delirium, hallucinations, decreased oral secretions , hot skin temp, facial flushing, bradycardia if given in too low a dose or too slowly
|
|
Atropine-Special considerations
|
Pregnancy class C, possibly unsafe for lactating mothers, 2.5 hour half-life
|
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Morphine-AKA
|
MS Contin, Duramorph
|
|
Morphine-Class
|
Opiate agonist, Class II controlled substance
|
|
Morphine-Mechanism of action
|
Binds with opioid receptors, reduces the stimulation of sympathetic nervous system thereby reducing pain, anxiety, HR, cardiac work, and myocardial oxygen consumption
|
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Morphine-Indications
|
Analgesia, cardiac CP, cardiac pulmonary edema
|
|
Morphine-Contraindications
|
Hypotension, head trauma, pregnancy, liver, kidney, or endocrine disease, acute asthma
|
|
Morphine-Routes of administration
|
IV/IM/IO/SubQ
|
|
Morphine-Dosages for adult pain control
|
2.5-15mg IV/IM/IO/SubQ given slowly over a period of a few minutes
|
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Morphine-Dosages for pedatric pain control (6 months to 12 years)
|
.05 - .20 mg/kg IV/IM/IO/SubQ
|
|
Morphine-Dosages for pedatric pain control (Newborn to 6 months)
|
.03 - .05 mg/kg IV/IM/IO/SubQ
|
|
Morphine-Dosages for adult cardiac CP, CHF, pulmonary edema
|
2 to 4 mg slow IV/IO over a 1- to 5-minute period with increments of 2 to 8 mg repeated every 5 to 15 minutes until patient relieved of chest pain
|
|
Morphine-Dosages for pediatric cardiac CP, CHF, pulmonary edema
|
0.1 to 0.2 mg/kg IV/ IO
|
|
Morphine-Adverse effects
|
Hypotension, syncope, tachycardia, bradycardia, euphoria, dry mouth, anaphylaxis, N&V, respiratory depression, seizures
|
|
Morphine-Special considerations
|
Patients who are allergic should receive a opioid agonist from a different subclass like dilaudid, or fentanyl. Monitor vital signs and pulse oximetry closely. Be ready to support respirations. OD should be treated with Narcan. Pregnancy class C
|
|
Nitro-AKA
|
Nitrostat, Nitrobid, Tridil
|
|
Nitro-Class
|
Vasodialator, organic nitrate, antianginal
|
|
Nitro-Mechanism of action
|
Smooth muscle relaxant dilating peripheral arteries and veins decreasing preload and afterload.
|
|
Nitro-Indications
|
CP due to angina or myocardial ischemia, pulmonary edema, hypertensive emergency
|
|
Nitro-Contraindications
|
Viagra or similar in last 48 hours, suspected inferior wall MI, Hypotension, extreme brady, tachycardia, increased ICP, uncorrected hypovolemia, pericarditis, pericardial tamponade, glaucoma
|
|
Nitro-Dosage, SL
|
0.3-0.4mg (translingual 0.4mg) at 5 minute intervals with a max dose of 3 sprays
|
|
Nitro-Dosage, ointment
|
1-2 inches covered by a transparent bandage
|
|
Nitro-Dosage, IV Bolus
|
12.5-25mcg
|
|
Nitro-Dosage, infusion
|
5mcg/min, may increase by 5-10mcg/min every 5-10 minutes till relief of pain, SBP drops 10%, or ST segment returns to baseline
|
|
Nitro-Dosage, pediatric infusion
|
0.25-0.50mcg/kg/min titrated by .25-.50mcg/kg/min to a usual dose of 1-3 mcg/min up to a max dose of 5mcg/kg/min
|
|
Nitro-Adverse effects
|
Hypotension, tachycardia, bradycardia, HA, palpitations, syncope, lightheadedness, methamoglobinemia
|
|
Nitro-Special considerations:
|
R ventricular MI Pt may have significant hypotension after administration of NTG. Hypotention may worsen myocardial ischemia. Hypotension usually responds well to IV fluids. Pregnancy class C.
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Lidocaine-AKA
|
Xylocaine
|
|
Lidocaine-Class
|
Class 1b antiarrhythmic
|
|
Lidocaine-Mechanism of action
|
Blocks sodium channels increasing the recovery period after repolarization. Suppresses the automaticity in the His-Purkinje system and depolarization in the ventricles
|
|
Lidocaine-Indications
|
VT, VF, cardiac arrest, wide complex VT when amiodarone is not available, pre-intubation for head trauma or intracranial bleeding
|
|
Lidocaine-Contraindications
|
Hypersensitivity to amide-type local anesthetics, severe SA, AV, or intraventricular block in the absence of an artificial pacemaker. WPW syndrome. Adams-Stokes syndrome.
|
|
Lidocaine-Route of administration
|
IV, IO, tracheal
|
|
Lidocaine-ADULT dose, pulseless VT/VF
|
1-1.5mg/kg IV/IO. May repeat at 0.5-0.75mg/kg every 5-10 minutes to a max dose of 3mg/kg
|
|
Lidocaine-ADULT dose, pulseless VT/VF--Tracheal
|
2-10mg/kg followed by a 10ml NS/sterile H20 flush
|
|
Lidocaine- ADULT dose, perfusing ventricular rhythms
|
0.5-0.75mg/kg Repeat every 5-10 minutes to a max dose of 3mg/kg
|
|
Lidocaine-PEDS dose, pulseless VT/VF
|
1mg/kg IV/IO to a max dose of 100mg
|
|
Lidocaine-Adverse effects
|
Bradycardia, hypotension, may cause SA node depression or conduction problems if given in large doses or given too rapidly. Toxicity with symptoms including anxiety, euphoria, blurred vision, dizziness, seizures.
|
|
Lidocaine-PEDS dose, pulseless VT/VF--Tracheal
|
2-3mg/kg ET, followed by a 5ml NS/sterile H20 flush
|
|
Lidocaine-Special considerations
|
Half-life may be prolonged in patients with liver dysfunction. MAY BE LETHAL in a bradycardia with a ventricular escape rhythm.
|
|
Epi: AKA
|
Adrenalin, EpiPen
|
|
Epi: Class
|
Adrenergic agent, Inotrope, natural catecholamine, sympathomemetic
|
|
Epi: Mechanism of action
|
Binds strongly with both alpha and beta receptors increasing BP, HR, and bronchodilation.
|
|
Epi: Indications
|
Cardiac arrest, profound bradycardia, severe bronchospasm, anaphylaxis
|
|
Epi: Contraindications
|
None in cardiac arrest, hypovolemic shock, coronary insufficiency, glaucoma, diabetes, pregnant women, arrhythmias other than VF, asystole, PEA
|
|
Epi: Route of administration
|
IV/IO/IM/SubQ/Tracheal
|
|
Epi: Dosage-ADULT Cardiac Arrest
|
1mg (1:10,000) IV/IO every 3 to 5 minutes
|
|
Epi: Dosage-ADULT Symptomatic Bradycardia
|
1mcg/min (1:10,000) as a continuous IV infusion. Usual dosage 2-10mcg/min
|
|
Epi: Dosage-PEDS Cardiac Arrest
|
0.01mg/kg (1:10,000) IV/IO every 3 to 5 minutes with a max dose of 1mg
|
|
Epi: Dosage- PEDS Symptomatic Bradycardia
|
0.01mg/kg (1:10,000) every 3-5 min to a max dose of 1mg
|
|
Epi: Dosage-ADULT Asthma
|
0.3-0.5mg (1:1000) IM or SubQ every 10 min to a max dose of 1mg
|
|
Epi: Dosage-PEDS Asthma
|
0.01mg/kg (1:1000) IM or SubQ every 10 min to a max dose of 0.5mg
|
|
Epi: Dosage-ADULT Anaphylaxis
|
0.1mg (1:10,000) IV slowly over 5 minutes OR 1-4mcg/min titrated to effect
|
|
Epi: Dosage-PEDS Anaphylaxis
|
0.1-1mcg/kg/min (1:10,000) continuous IV infusion titrated to effect
|
|
Epi: Adverse Effects
|
Palpitations, tachycardia, hypertension, dysrhythmias, angina, myocardial ischemia, tremors, anxiety, HA, dizziness, N&V
|
|
Epi: Special Considerations
|
Deteriorates rapidly on exposure to light or air. Solutions that show signs of discoloration should be replaced. Half-life is 1 minute. Pregnancy class C.
|
|
Vasopressin-AKA
|
N/A
|
|
Vasopressin-Class
|
Nonadrenergic vasoconstrictor
|
|
Vasopressin-Mechanism of Action
|
Causes vasoconstriction independent of adrenergic receptors or neural invervation.
|
|
Vasopressin-Indications
|
Adult shock refractory of VF, pulseless VT, Asystole, PEA, vasodilatory shock
|
|
Vasopressin-Contraindications
|
Responsive patients with cardiac disease
|
|
Vasopressin-Dosage, ADULT
|
40U IV/IO may replace either the 1st or 2nd dose of Epi.
|
|
Vasopressin-Adverse Effects
|
Cardiac ischemia, angina
|
|
Vasopressin-Special Considerations
|
Pregnancy class C. May be given ET but the dosage is not known.
|
|
Vasopressin-Route of administration
|
IV/IO/Tracheal
|
|
Oxygen-AKA
|
O2, O's
|
|
Oxygen-Class
|
Elemental gas
|
|
Oxygen-Mechanism of Action
|
Facilitates cellular energy metabolism
|
|
Oxygen-Indications
|
Hypoxia, CP, Shock, Respiratory distress, CO poisoning, cardiac arrest, trauma
|
|
Oxygen-Contraindications
|
Known paraquat poisoning
|
|
Oxygen-Route of administration
|
Inhalation
|
|
Oxygen-Doseage
|
High concentration=15LPM via mask. Low concentration=6LPM via nasal canula
|
|
Oxygen-Adverse Effects
|
High concentrations can cause decreased LOC in patients with increased CO2 retention and COPD.
|
|
Oxygen-Special Considerations
|
Pregnancy class A
|
|
Metoprolol-AKA:
|
AKA: Lopressor, Toprol XL
|
|
Metoprolol-Class:
|
Class: Beta Blocker, antihypertensive, antianginal
|
|
Metoprolol-Mechanism of Action:
|
Mechanism of action: Inhibits the strength of the hearts contraction as well as heart rate causing a decrease in the hearts O2 consumption.
|
|
Metoprolol-Indications:
|
Indications: ACS, SVT, A-flutter, A-fib, HTN
|
|
Metoprolol-Contraindications:
|
Contraindications: Heart failure, 2nd or 3rd degree blocks, hypotension (SBP<100), bradycardia (HR<45), cardiogenic shock.
|
|
Metoprolol-Route of Administration:
|
Route of administration: IV, IO, oral
|
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Metoprolol-Dosage
|
Dosages: 5mg IV slow IV push over 5 minutes. May be repeated at 5 minute intervals to a max dose of 15mg.
|
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Metoprolol-Special Considerations
|
Special Considerations: Pregnancy class C
|
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Metoprolol-Adverse Effects
|
Adverse effects: Bradycardia, AV blocks, hypotension, dizziness, diarrhea, N&V
|
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Sodium Bicarbonate-AKA
|
AKA: Sodium Bicarb
|
|
Sodium Bicarbonate-Class
|
Class: Electrolyte Replacement
|
|
Sodium Bicarbonate-Mechanism of Action
|
Mechanism of action: Counteracts existing acidosis, short acting strong antacid
|
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Sodium Bicarbonate-Indications
|
Indications: TCA OD, prolonged cardiac arrest, hyperkalemia, metabolic acidosis, crush syndrome
|
|
Sodium Bicarbonate-Contraindications
|
Contraindications: Alkalosis, hypocalcemia
|
|
Sodium Bicarbonate-Routes of Administration
|
Route of administration: IV/IO
|
|
Sodium Bicarbonate-Dosage
|
Dosages: 1 mEq/kg IV/IO. May repeat at .5mEq/kg if needed in 10 minutes.
|
|
Sodium Bicarbonate-Adverse Effects
|
Adverse effects: Hypernatremia, Alkalosis, peripheral and pulmonary edema, hypokalemia, intracranial bleeding
|
|
Sodium Bicarbonate-Special Considerations
|
Special Considerations: Use with caution in pt with CHF or renal disease, Do not mix with other meds in the same IV line, pregnancy class C
|
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Mag Sulfate-AKA:
|
Magnesium Sulfate
|
|
Mag Sulfate-Class:
|
Class: Electrolyte, tocolytic
|
|
Mag Sulfate-Mechanism of Action:
|
Mechanism of action: CNS depressant, smooth muscle relaxant, laxative if taken PO
|
|
Mag Sulfate-Indications:
|
Indications: Torsades de pointes, eclampsia, SZ prophylaxis in eclampsia, status asthmaticus
|
|
Mag Sulfate-Contraindications:
|
Contraindications: AV Block, GI obstruction, use with caution in renal impairment
|
|
Mag Sulfate-Route of Administration:
|
Route of administration: IV/IO
|
|
Mag Sulfate-Dosages: Adult Cardiac
|
Cardiac: 1-2g in 10ml D5W IV/IO over 5-10 minutes
|
|
Mag Sulfate-Dosages: Eclampsia
|
Eclampsia: 4-6g IV/IO over 20-30 minutes followed by 1-2g/hour
|
|
Mag Sulfate-Dosages: Status Asthmaticus
|
Status Asthmaticus: 1.2-2g SLOW IV/IO over 20 minutes
|
|
Mag Sulfate-Adverse Effects:
|
Adverse effects: Magnesium toxicity, Hypotension, depressed cardiac function
|
|
Mag Sulfate-Special Considerations
|
Special Considerations: Pregnancy Class A
|
|
Calcium Gluconate-AKA
|
AKA: Kalcinate
|
|
Calcium Gluconate-Class
|
Class: Electrolyte
|
|
Calcium Gluconate-Mechanism of Action:
|
Mechanism of action: Counteracts the toxicity of hyperkalemia by stabilizing the membranes of the cardiac cells, reducing the likelihood of fibrillation.
|
|
Calcium Gluconate-Indications:
|
Indications: Hyperkalemia, Hypocalcemia, hypermagnesmia, antidote for mag sulfate
|
|
Calcium Gluconate-Contraindications:
|
Contraindications: VF, digitalis toxicity, hypercalcemia, DO NOT mix with sodium bicarb
|
|
Calcium Gluconate-Route of Administration
|
Route of administration: IV/IO NOT IM
|
|
Calcium Gluconate-Dosage
|
Dosages: 500-1000mg IV/IO SLOW IVP (1-1.5ml/min) to a max dose of 3g
|
|
Calcium Gluconate-Adverse Effects:
|
Adverse effects: Soft tissue necrosis, hypotension, bradycardia (if administered too rapidly)
|
|
Calcium Gluconate-Special Considerations:
|
Special Considerations: NO IM, do NOT administer too rapidly, do NOT mix with sodium bicarb, Pregnancy class C
|
|
Hypertonic Saline-AKA
|
3% Saline
|
|
Hypertonic Saline-Class
|
Class: Electrolyte solution, volume expander
|
|
Hypertonic Saline-Mechanism of action:
|
Mechanism of action: Pulls extravascular fluid in to the vascular space to act as a volume expander. Also used to reduce ICP.
|
|
Hypertonic Saline-Indications
|
Indications: ICP, hypovolemic shock
|
|
Hypertonic Saline-Contraindications:
|
Pulmonary edema, NOT to be administered IO
|
|
Hypertonic Saline-Route of administration:
|
IV ONLY
|
|
Hypertonic Saline-Dosages
|
Dosages: 250ml IV over 1 hour
|
|
Hypertonic Saline-Adverse Effects:
|
Adverse effects: Increased rate of bleeding, alteration of blood clotting ability
|
|
Hypertonic Saline-Special considerations:
|
Special Considerations: NOT to be administered IO, can cause damage to vein administered in, Pregnancy class C
|
|
Lorazepam-AKA:
|
Lorazepam-AKA: Ativan
|
|
Lorazepam-Class:
|
Lorazepam-Class: Benzodiazepine, anticonvulsant, anxiolytic, schedule 4 narcotic
|
|
Lorazepam-Mechanism of action:
|
Lorazepam-Mechanism of action: Binds to the benzo receptors and enhances the GABA receptors in the brain.
|
|
Lorazepam-Indications:
|
Lorazepam-Indications: Anxiety, status epilepticus, sedation
|
|
Lorazepam-Contraindications:
|
Lorazepam-Contraindications: Known sensitivity, coma, hypotension, COPD, sleep apnea, glaucoma
|
|
Lorazepam-Routes of Administration:
|
Lorazepam-Routes of Administration: IV/IO/IN/IM/PO
|
|
Lorazepam-Dosages:
|
Lorazepam-Dosages: Analgesia/Sedation-2 mg or 0.44 mh/kg (whichever is smaller) Status Seizures: 4 mg over 2-5 minutes. May repeat in 10-15 minutes. Max dose of 8 mg in 24 hours.
|
|
Lorazepam-Adverse Effects:
|
Lorazepam-Adverse Effects: Respiratory depression, hypotension, HA, drowsiness, dizziness, amnesia, euphoria, vertigo, ataxia
|
|
Lorazepam-Special Considerations:
|
Lorazepam-Special Considerations: Be prepared to support respirations
|
|
Diazepam-AKA:
|
Diazepam-AKA: Valium
|
|
Diazepam-Class:
|
Diazepam-Class: Benzodiazepine, anticonvulsant, sedative, anxiolytic, schedule 4 narcotic
|
|
Diazepam-Mechanism of Actions:
|
Diazepam-Mechanism of action: Binds to the benzodiazepine receptors and enhances the effects of the GABA receptors in the brain.
|
|
Diazepam-Indications:
|
Diazepam-Indications: Status epilepticus, analgesia/amnesia for procedures, ETOH withdrawal (DT’s), anxiety
|
|
Diazepam-Contraindications
|
Diazepam-Contraindications: Hypersensivity, children <6 months, coma, glaucoma, respiratory depression
|
|
Diazepam-Routes of Administration:
|
Diazepam-Route of administration: IV/IO/IN/IM/PO
|
|
Diazepam- Dosages:
|
Diazepam-Dosages: Adult:
Severe: 5-10 mg slow IVP (no faster than 5 mg/min) Moderate: 2-5 mg slow IVP Low: Low dosages are often required for the elderly DT’s: 10mg slow IVP (no faster than 5 mg/min) Seizure: 5-10 mg slow IV/IO/IN/IM every 10 minutes to a max dose of 30 mg |
|
Diazepam-Adverse Effects:
|
Diazepam-Adverse effects: Respiratory depression, hypotension, tachycardia, HA, drowsiness, ataxia, nausea, fatigue, oversedation.
|
|
Diazepam-Special Considerations:
|
Diazepam-Special Considerations: Use with caution with other respiratory depressants of board, ensure patent IV as tissue necrosis can occur if fluid leaks into the extravascular space.
|
|
Midazolam-AKA:
|
Midazolam-AKA: Versed
|
|
Midazolam-Class:
|
Midazolam-Class: Benzodiazepine, Schedule 4 narcotic, amnesiac
|
|
Midazolam-Mechanism of Action:
|
Midazolam-Mechanism of action: Binds to the benzodiazepine receptors and enhances the effects of the GABA receptors in the brain.
|
|
Midazolam-Indications:
|
Midazolam-Indications: Sedation, anxiety, skeletal muscle relaxation
|
|
Midazolam-Contraindications:
|
Midazolam-Contraindications: Pregnancy, glaucoma, known sensitivity
|
|
Midazolam-Route of Administration:
|
Midazolam-Route of administration: IV/IO/IM/IN
|
|
Midazolam-Dosages:
|
Midazolam-Dosages: Each dose should be individualized, some require only 1 mg. If other narcotics on board, 30% less than may be effective. Max dose of 5 mg. Use caution in elderly or chronically ill. If continuous infusion is required for intubated or critically ill, 0.02-0.10 mg/kg/hr
|
|
Midazolam-Adverse Effects:
|
Midazolam-Adverse effects: Respiratory depression, respiratory arrest, cardiac arrest, hypotension, N&V, HA
|
|
Midazolam-Special Considerations:
|
Midazolam-Special Considerations: Must monitor vitals closely, be prepared to support respirations, Pregnancy class D
|
|
Fentanyl-AKA:
|
Fentanyl-AKA Sublimaze
|
|
Fentanyl-Class:
|
Fentanyl-Class: Narcotic analgesic, general anesthetic, schedule 2 narcotic
|
|
Fentanyl-Mechanism of Action:
|
Fentanyl-Mechanism of Action: Binds to opiate receptors
|
|
Fentanyl-Indications:
|
Fentanyl-Indications: Pain, sedation for RSI or prolonged intubation
|
|
Fentanyl-Contraindications:
|
Fentanyl-Contraindications: Known sensitivity, use caution in TBI, respiratory depression
|
|
Fentanyl-Route of Administration:
|
Fentanyl: Route of Administration: IV, IM, IO
|
|
Fentanyl-Dose:
|
Fentanyl-Dose: 50-100 mcg
|
|
Fentanyl-Adverse Effects
|
Fentanyl-Adverse effects: Respiratory depression, apnea, hypotension, brady/tachy, HTN, N&V, dizziness
|
|
Fentanyl-Special Considerations
|
Fentanyl-Special Considerations: Pregnancy class B, O2 and resuscitative equipment should be nearby
|
|
Haldol-AKA:
|
Haldol-AKA: Haloperidol
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Haldol-Class:
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Haldol-Class: Antipsychotic agent
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Haldol-:Mechanism of Action:
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Haldol-Mechanism of action: Selectively blocks postsynaptic dopamine receptors
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Haldol-Indications:
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Haldol-Indications: Psychotic disorders, agitation
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Haldol-Contraindications:
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Haldol-Contraindications: Depressed mental status, Parkinson’s disease
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Haldol-Routes of Administration:
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Haldol-Route of administration: IV, IM, PO
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Haldol-Dosages:
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Haldol-Dosages:
Mild agitation: 0.5-2.0 mg Moderate agitation: 5-10 mg Severe agitation: 10 mg |
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Haldol-Adverse Effects:
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Haldol-Adverse effects: VT, Hypotension, HTN, Tachy, Torsades, extrapyramidal symptoms, drowsiness, tardive dyskinesia,
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Haldol-Special Considerations:
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Haldol-Special Considerations: Pregnancy class C
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Ketamine-AKA:
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Ketamine-AKA: Ketalar
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Ketamine-Class:
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Ketamine-Class: General anesthetic
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Ketamine-Mechanism of Action:
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Ketamine-Mechanism of action: Produces a state of anesthesia while maintaining airway reflexes, HR, BP
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Ketamine-Indications:
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Ketamine-Indications: Pain and as anesthesia for procedures of short duration
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Ketamine-Contraindications:
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Ketamine-Contraindications: HTN, CVA, ICP, head trauma, bleeding, MI, glaucoma, hypovolemia, dehydration
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Ketamine-Route of Administration:
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Ketamine-Route of administration: IV, IO, IM
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Ketamine-Dosages
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Ketamine-Dosages:
Adult: IV: 1-4.5 mg/kg IM: 6.5-13 mg/kg |
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Ketamine-Adverse Effects:
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Ketamine-Adverse effects: Emergence phenomena, HTN, Tachycardia, Hypotension, bradycardia, respiratory depression, apnea, laryngospasams, tonic/clonic movements, vomiting.
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Ketamine-Special Considerations
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Ketamine-Special Considerations: Concomitant administration of a benzodiazepine reduces the chances of an emergence reaction. Pregnancy class C
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Toradol-AKA:
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Toradol-AKA: Ketorolac
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Toradol-Class:
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Toradol-Class: NSAID
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Toradol-Mechanism of Actions:
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Toradol-Mechanism of action: Inhibits production of prostiglandins in inflamed tissue which decreases the responsiveness of pain receptors.
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Toradol-Indications:
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Toradol-Indications: Moderate pain
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Toradol-Contraindications:
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Toradol-Contraindications: Hx of ulcers, GI bleed, renal disease, hypovolemia, 3rd trimester pregnancy, nursing mothers, allergy to ASA or other NSAIDS, CVA or head trauma, need for immediate surgery
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Toradol-Route of Administration:
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Toradol-Route of administration: IV, IO, IM
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Toradol-Dosages:
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Toradol-Dosages:
Adult <65: 30mg IV or 60mg IM Adult >65: 15mg IV or 30mg IM |
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Toradol-Adverse Effects:
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Toradol-Adverse effects: HA, drowsiness, dizziness, Abd pain, N&V, diarrhea, dyspepsia
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Toradol-Special Considerations:
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Toradol-Special Considerations: Pregnancy class C, class D in 3rd trimester.
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Demerol-AKA:
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Demerol-AKA: Meperidine
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Demerol-Class:
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Demerol-Class: Analgesic, Schedule 2 narcotic
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Demerol-Mechanism of Action
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Demerol-Mechanism of action: Binds to opiate receptors producing analgesia and euphoria
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Demerol-Indications:
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Demerol-Indications: Moderate to severe pain
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Demerol-Contraindications:
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Demerol-Contraindications: Use of a MAOI in past 2 weeks, use of other CNS depressants or ETOH, Use with caution with chronic respiratory conditions, pregnant or nursing women, A-flutter.
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Demerol-Route of Administration:
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Demerol-Route of administration: IV, IO, IM
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Demerol-Doseages
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Demerol-Dosages: 50-150mg IV,IO,IM,Sub-Q
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Demerol-Adverse Effects:
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Demerol-Adverse effects: Respiratory depression, cardiac arrest, bradycardia, tachycardia, HTN, hypertension, N&V, syncope, shock
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Demerol-Special Considerations:
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Demerol-Special Considerations: Half life approx 4 hours, but may last 30 hours in the bloodstream. Pregnancy class C, class D near term.
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Verapamil-AKA
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Verapamil-AKA: Isoptin
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Verapamil-Mechanism of Action:
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Verapamil-Mechanism of action: Blocks calcium from moving into the heart muscle cell which prolongs the conductions of electrical impulses through the AV node.
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Verapamil-Indications:
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Verapamil-Indications: A-Fib, HTN, PSVT, PSVT prophylaxis
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Verapamil-Contraindications:
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Verapamil-Contraindications: 2nd, 3rd degree blocks (except with patients that have a pacemaker), SBP<90, WPW
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Verapamil-Route of Administration:
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Verapamil-Route of administration: IV/IO
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Verapamil-Dosages
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Verapamil-Dosages: 2.5-5.0 mg IV/IO over 2 minutes (3 min in elderly). May repeat at 5-10mg every 15-30 minutes to a max dose of 30mg.
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Verapamil-Adverse Effects:
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Verapamil-Adverse effects: Bradycardia, Hypotension, AV block (1,2,3), asystole
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Verapamil-Special Considerations:
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Verapamil-Special Considerations: Pregnancy class C
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Verapamil-Class:
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Verapamil-Class: Calcium channel blocker, Class 4 antiarrhythmic
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Dopamine-AKA:
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Dopamine-AKA: Intropin
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Dopamine-Class:
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Dopamine-Class: Inotrope vasopressor, adrenergic agonist.
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Dopamine-Mechanism of Action:
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Dopamine-Mechanism of action: Stimulates alpha and beta adrenergic receptors. At low doses (2-10mcg) dopamine stimulates beta 1 receptors resulting in increased cardiac inotropy and increased cardiac output while maintaining vasodilatory effects. At higher doses (>10mcg/kg/min), alpha agonism predominates and increased peripheral vascular resistance and vasoconstriction result
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Dopamine-Indications:
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Dopamine-Indications: Hypotension and decreased cardiac output associated with cardiogenic shock and septic shock. Hypotension after ROSC, symptomatic bradycardia unresponsive to atropine.
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Dopamine-Contraindications:
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Dopamine-Contraindications: VF/VT or other ventricular arrhythmias. Correct hypovolemia before administering dopamine. Pheochromacytoma (rare tumor of the adrenal gland causing production of too much epinephrine and norepinephrine).
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Dopamine-Route of Administration:
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Dopamine-Route of administration: IV/IO
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Dopamine-Dosages:
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Dopamine-Dosages: Starting dose is 5mg/kg/min; may gradually increase by 5-10 mcg/kg/min to desired effect. Cardiac dose is usually 5-10 mcg/kg/min; vasopressor dose is usually 10-20 mcg/kg/min. Little benefit is gained beyond 20 mcg/kg/min.
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Dopamine-Adverse Effects:
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Dopamine-Adverse effects: Tachycardia, arrhythmias, severe HTN from excessive vasoconstriction, angina, dyspnea, HA, N&V. Skin and soft tissue necrosis if IV infiltration.
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Dopamine-Special Considerations:
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Dopamine-Special Considerations: Half life= 2min. Pregnancy class C.
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Adenosine-AKA:
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Adenosine-AKA: Adenocard
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Adenosine-Class:
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Adenosine-Class: Antiarrhythmic
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Adenosine-Mechanism of Action:
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Adenosine-Mechanism of action: Slows the conduction of electrical impulses at the AV node
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Adenosine-Indications:
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Adenosine-Indications: Stable reentry SVT, does not convert AFib, Aflutter, or VT.
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Adenosine-Contraindications:
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Adenosine-Contraindications: Sick sinus syndrome, 2nd or 3rd AVB or poison/drug induced tachycardia.
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Adenosine-Route of Administration:
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Adenosine-IV/IO
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Adenosine-Dosages:
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Adenosine-Dosages: 6 mg rapid IV/IO push immediately followed by a 20 ml flush. May repeat at 6 mg and then 12 mg if rhythm does not convert after 1-2 minutes.
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Adenosine-Adverse Effects:
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Adenosine-Adverse effects: Will have a brief period of asystole after administration. Common adverse reactions are short lived: flushing of skin, throat tightness, numbness, chest pressure.
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Adenosine-Special Considerations:
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Adenosine-Special Considerations: Use caution with preexisting bronchospasm and those with a hx of AFib. Elderly with no hx of PSVT should be carefully evaluated for dehydration and rapid sinus tachycardia requiring fluid replacement rather than simply treating with adenosine. Pregnancy class C.
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