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LCEMS Protocols > 400 EMS Drug Formulary > Flashcards

400 EMS Drug Formulary Flashcards

1
Q

Indications for Acetaminophen

A
  • Pain Control

- Fever

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2
Q

How is Acetaminophen supplied

A

500 mg tablet, oral

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3
Q

Adult dosage for Acetaminophen

A

15 mg/kg PO (Max dose 1000 mg)

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4
Q

Peds dosage for Acetaminophen

A

15 mg/kg PO (Max dose 1000 mg)

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5
Q

Indications for Adenocard

A
  • PSVT

- V-tach/ Wide Complex Tach with a pulse (including WPW)

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6
Q

How is Adenocard supplied

A

6 mg/ 2 ml vial (3 mg/ml)

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7
Q

Adult dosage for Adenocard

A

6 - 12 - 12

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8
Q

Peds dosage for Adenocard

A

1st dose: 0.1 mg/kg (max 6 mg)

2nd dose: 0.2 mg/kg (max 12 mg)

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9
Q

Indications for Albuterol

A
  • Respiratory distress

- Bronchospasm in COPD/ Asthma

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10
Q

How is Albuterol supplied

A

2.5 mg/ 3 ml vial

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11
Q

Adult dosage for Albuterol

A
  • 2.5 mg nebulized
  • Additional doses as needed
  • May combine with Atrovent for 1 time dose
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12
Q

Peds dosage for Albuterol

A

< 1 year: 1.25 mg (1.5 ml) nebulized

> 1 year: 2.5 mg (3 ml) nebulized

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13
Q

Indications for Amiodarone

A
  • V-fib

- Pulseless V-tach

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14
Q

How is Amiodarone supplied

A
  • 150 mg/ 3 ml ampule

- 150 mg/ 3 ml pre-filled syringe

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15
Q

Adult dosage for Amiodarone

A

1st dose - 300 mg IV/ IO push

2nd dose - 150 mg IV/ IO push

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16
Q

Peds dosage for Amiodarone

A
  • Pulseless arrest: 5 mg/kg slow IV/ IO push

- Tachycardia (probable VT): 5 mg/kg over 20 min (MC order only)

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17
Q

Indications for ASA

A

Chest pain

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18
Q

How is ASA supplied

A

81 mg chewable tablet

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19
Q

Adult dosage for ASA

A

324 mg PO

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20
Q

Indications for Atropine

A
  • Hemodynamically significant bradycardia
  • Organophosphate poisoning
  • Nerve agent exposure
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21
Q

How is Atropine supplied

A
  • 1 mg/ 10 ml prefilled syringe

- 2.1 mg DuoDote auto-injector (mixed with 600 mg Pralidoxime Chloride)

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22
Q

Adult dosage for Atropine in bradydysrhythmias

A

0.5 mg IV bolus q 3-5 min PRN (max dose 3 mg)

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23
Q

Peds dosage for Atropine in bradydysrhythmias

A

0.02 mg/kg IV/IO (dose range of 0.1 mg - 1 mg)

[May be repeated once]

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24
Q

Adult dosage for Atropine in toxic ingestion/ organophosphate poisoning/ nerve agent exposure

A

2 mg IV/IM q 5 min (no max dose)

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25
Q

Peds dosage for Atropine in toxic ingestion/ organophosphate poisoning/ nerve agent exposure

A
  • 0.02 mg/kg IV/IO (dose range 0.1 mg - 1 mg)
  • Nerve agent:
    < 2 years - 0.5 mg IM q 5 min PRN
    > 2 years - 1.0 mg IM q 5 min PRN
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26
Q

Indications for Atrovent

A
  • Respiratory distress

- Bronchospasm associated with COPD

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27
Q

How is Atrovent supplied

A

0.5 mg/ 2.5 ml (0.02%) vial

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28
Q

Adult dosage for Atrovent

A

0.5 mg nebulized (as initial tx if pt. on Atrovent at home)

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29
Q

Peds dosage for Atrovent

A

Not recommended for peds use

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30
Q

Indications for Benadryl

A
  • Symptomatic relief of allergies
  • Allergic reactions
  • Anaphylaxis
  • Acute dystonic reactions due to phenothiazines (antipsychotics, i.e. tricyclic antidepressants)
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31
Q

How is Benadryl supplied

A

50 mg/ 1 ml vial

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32
Q

Adult dosage for Benadryl

A

25-50 mg IM/IV

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33
Q

Peds dosage for Benadryl

A

1 mg/kg IM/IV

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34
Q

Indications for Calcium

A
  • Calcium channel blocker toxicity
  • Hypocalcaemia
  • Hyperkalemia in cardiac arrest (ESRD)
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35
Q

How is Calcium supplied

A

1 Gm/ 10 ml prefilled syringe

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36
Q

Adult dosage for Calcium

A
  • Arrest: 1 Gm slow IO/IV push
  • Cardizem reaction: 1 Gm over 5 min (1 Gm in 50 ml D5W; 10 gtt; 100 gtts/min)
  • Overdose/ Toxic Ingestion: 20 mg/kg slow IO/IV
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37
Q

Peds dosage for Calcium

A

Overdose/ Toxic ingestion: 20 mg/kg slow IO/IV

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38
Q

Indications for Captopril

A
  • Hypertension

- Hypertension associated with acute pulmonary edema

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39
Q

How is Captopril supplied

A

25 mg tablet

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40
Q

Adult dosage for Captopril

A

25 mg SL

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41
Q

Peds dosage for Captopril

A

Not recommended for peds

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42
Q

Indications for Cardizem

A
  • Narrow complex PSVT refractory to Adenocard

- Symptomatic A-fib/flutter

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43
Q

How is Cardizem supplied

A

25 mg/ 5 ml vial (5mg/ml)

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44
Q

Adult dosage for Cardizem

A
  • 0.25 mg/kg IV over 2 min (max dose 20 mg)

- May repeat in 15 min at 0.35 mg/kg IV over 2 min (max dose 25 mg).

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45
Q

Peds dosage for Cardizem

A

Not recommended for peds

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46
Q

Indications for Cipro

A

Inhalation Anthrax

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47
Q

How is Cipro supplied

A

500 mg tablet

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48
Q

Adult dosage for Cipro

A

500 mg tablet PO q 12 hrs (per CDC)

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49
Q

Peds dosage for Cipro

A

< 31 kg: Weight-based dosing of oral suspension.

> 31 kg: 500 mg tablet PO q 12 hrs (per CDC)

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50
Q

Indications for Cyanokit

A

Known or suspected cyanide poisoning

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51
Q

How is Cyanokit supplied

A

5 Gm kit when reconstituted with 200 ml saline

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52
Q

Adult dosage for Cyanokit

A

5 Gm IV over 15 min (entire kit)

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53
Q

Peds dosage for Cyanokit

A

75 mg/kg IV over 15 min (using Burette)

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54
Q

Indications for D50

A

Hypoglycemia

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55
Q

How is D50 supplied

A

25 Gm/ 50 ml prefilled syringe

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56
Q

Adult dosage for D50

A

25 Gm IV (repeat dosing PRN)

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57
Q

Peds dosage for D50

A
  • 0-30 days: 0.2 Gm/kg D10W [(D50 - 40 ml) + 40 ml NS]
  • 31 days-24mths: 0.5 Gm/kg D25W [(D50 - 25 ml) + 25 ml NS]
  • > 2 yrs: 0.5 Gm/kg D50W
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58
Q

Indications for Dilaudid

A

Moderate to severe pain

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59
Q

How is Dilaudid supplied

A

1 mg/ 1 ml Carpuject

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60
Q

Adult dosage for Dilaudid

A

1-2 mg IM/IV/IO over 2-5 min (max 4 mg total dose)

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61
Q

Peds dosage for Dilaudid

A
  • *MUST BE 5 YRS OLD OR 20 KG**

0. 015 mg/kg IM/IV/IO over 2-5 min (max 2 mg total dose)

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62
Q

Indications for Dopamine

A
  • Acute heart failure
  • Hypotension
  • Bradycardia with low cardiac output
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63
Q

How is Dopamine supplied

A

400 mg/ 10 ml vial

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64
Q

How is Dopamine mixed

A

400 mg added to 250 ml of D5W (1600 mcg/ml)

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65
Q

Adult dosage for Dopamine

A

5-20 mcg/kg/min

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66
Q

Peds dosage for Dopamine

A

5-20 mcg/kg/min

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67
Q

Indications for Doxycycline

A
  • Brucellosis
  • Fever (of suspected biological agent)
  • Pneumonic plague
  • Typhoidal Tularemia
  • Anthrax exposure
68
Q

How is Doxycycline supplied

A

100 mg tablet

69
Q

Adult dosage for Doxycycline

A

100 mg PO q 12 hrs (per CDC)

70
Q

Peds dosage for Doxycycline

A

< 35 kg: 2.2 mg/kg q 12 hrs (per CDC)

> 35 kg: 100 mg PO q 12 hrs (per CDC)

71
Q

Class of Epinephrine (Adrenaline)

A

Sympathomimetic

72
Q

Indications for Epi

A
  • Cardiac arrest
  • Anaphylaxis
  • Asthma
  • Unstable bradycardia
73
Q

How is Epi supplied

A
  • 1 mg/ 10 ml prefilled syringe (0.1 mg/ml)

- 30 mg/ 30 ml multi-dose vial (1 mg/ml)

74
Q

Adult dosage for Epi in arrest

A

1 mg (0.1 mg/ml) IV/IO q 5 min PRN

75
Q

Adult dosage for Epi in Allergy/ Anaphylaxis

A
  • Allergy: 0.5 mg (1 mg/ml) IM

- Anaphylaxis: 0.3 mg (0.1 mg/ml) IV

76
Q

Adult dosage for Epi in Respiratory Distress

A
  • Wheezes: 0.5 mg (1 mg/ml) IM
  • Stridor: 0.5 mg (1 mg/ml) nebulized or IM
  • Hemodynamically unstable: 0.3 mg (0.1 mg/ml) IV
77
Q

Adult dosage for Epi in Bradycardia

A

2-10 mcg/min

78
Q

How is an Epi drip mixed

A

2mg (1 mg/ml) Epi in 250 ml D5W (8 mcg/ml)

2 mcg/min = 15 gtts
4 mcg/min = 30 gtts
6 mcg/min = 45 gtts
8 mcg/min = 60 gtts

79
Q

Peds dosage for Epi in arrest

A

0.01 mg/kg IV/IO q 5 min PRN

80
Q

Peds dosage for Epi in Allergy/ Anaphylaxis

A
  • Allergy: 0.01 mg/kg (1 mg/ml) IM [max 0.5 mg]

- Anaphylaxis: 0.01 mg/kg (0.1 mg/ml) IV [max 0.5 mg]

81
Q

Peds dosage for Epi in Respiratory Distress

A
  • Wheezes (<18 mths): 1 mg (1 mg/ml) nebulized with 2ml NS
  • Wheezes (>18 mths): 0.01 mg/kg (1 mg/ml) IM [max 0.5 mg]
  • Stridor/ Croup: 1 mg (1 mg/ml) nebulized with 2 ml NS
82
Q

Peds dosage for Epi in Bradycardia

A

0.01 mg/kg (0.1 mg/ml) IV/IO

83
Q

Indications for Etomidate

A

Sedation for ICE

84
Q

How is Etomidate supplied

A
  • 40 mg/ 20 ml vial (2 mg/ml)

- 20 mg/ 10 ml vial (2 mg/ml)

85
Q

Adult dosage for Etomidate

A

20 mg slow IV/IO push

86
Q

Indications for Fentanyl

A
  • Pain management

- Sedative for ICE

87
Q

How is Fentanyl supplied

A
  • 100 mcg/ 2 ml Carpuject (50 mcg/ml)

- 100 mcg/ 2 ml ampule (50 mcg/ml)

88
Q

Adult dosage for Fentanyl

A

1 mcg/kg IV/IO/IM/IN

  • max 50 mcg per dose
  • max 200 mcg total dose
89
Q

Peds dosage for Fentanyl

A

1 mcg/kg IV/IO/IM/IN

- max 50 mcg dose

90
Q

Indications for Glucagon

A
  • Hypoglycemia
  • Beta blocker OD
  • Calcium channel blocker OD
91
Q

How is Glucagon supplied

A

1 mg vial (when reconstituted)

92
Q

Adult dosage for Glucagon

A

1 mg IN/IM

- For beta blocker OD give IV

93
Q

Peds dosage for Glucagon

A
  1. 1 mg/kg IN/IM

- For beta blocker OD give IV

94
Q

Indications for Glucose

A

Hypoglycemia in conscious pt.

95
Q

How is glucose supplied

A

Oral gel 15 gm/ tube

96
Q

Adult dosage for Glucose

A

15 Gm PO

97
Q

Peds dosage for Glucose

A

< 3 yrs: Not indicated

> 3 yrs: 15 Gm PO

98
Q

Indications for Ibuprofen

A
  • Pain management

- Fever

99
Q

How is Ibuprofen supplied

A

200 mg tablet

100
Q

Adult dosage for Ibuprofen

A

10 mg/kg PO (max dose 800 mg)

101
Q

Peds dosage for Ibuprofen

A

> 6 mths: 10 mg/kg PO (max dose 800 mg)

102
Q

Indications for Ketamine

A
  • Excited Delirium

- Pain management

103
Q

How is Ketamine supplied

A

500 mg/ 5 ml (50 mg/ml)

104
Q

Adult dosage for Ketamine

A
  • Excited Delirium: 4 mg/kg IM/IN (max dose 400 mg)
  • Analgesia: 0.25 mg/kg IM/IV/IO
    • Max initial dose 25 mg
    • May repeat in 5 min PRN
    • Additional dosing by MC order
    • Max total dose per protocol 100 mg
105
Q

Peds dosage for Ketamine

A
  • Excited Delirium and Analgesia:

By MC order only

106
Q

Indications for Mag

A
  • Hypomagnesemia
  • Pre-eclampsia/ Eclampsia
  • Torsades de pointes
  • Respiratory distress
107
Q

How is Mag supplied

A

5 Gm/ 10 ml vial (0.5 Gm/ml)

108
Q

How is a Mag drip mixed

A
  • Respiratory Distress:
    2 Gm in 50 ml D5W
  • Pre/Eclampsia:
    4 Gm in 50 ml D5W
109
Q

Adult dosage of Mag in Cardiac arrest

A

2 Gm IV/IO push

110
Q

Adult dosage of Mag in Pre/Eclampsia

A

4 Gm IV drip over 10-20 min (wide open)

111
Q

Adult dosage of Mag in Respiratory distress

A

2 Gm IV drip over 10-20 min (wide open)

112
Q

Indications for Morphine

A
  • Chest pain due to Acute Coronary Syndrome

- Pain management

113
Q

How is Morphine supplied

A

10 mg/ 1 ml Carpuject

114
Q

Adult dosage for Morphine

A
  1. 1 mg/kg IV/IO/IM
    - Max initial dose 10 mg
    - Max total dose 20 mg
115
Q

Peds dosage for Morphine

A
  1. 1 mg/kg IV/IO/IM
    - Max initial dose 5 mg
    - Re-dosing by MC
116
Q

Indications for Narcan

A
  • Opioid reversal

- Coma of unknown origin

117
Q

How is Narcan supplied

A

2 mg/ 2 ml Luer-Jet prefilled syringe

118
Q

Adult dosage for Narcan

A

4 mg IV/IO/IM/IN/ET

- 2-2.5 times recommended dose for ET

119
Q

Peds dosage for Narcan

A

0.1 mg/kg IV/IO/IM/IN/ET

120
Q

Indications for NTG

A
  • Chest pain of suspected ischemic origin
  • Myocardial ischemia
  • Hypertension
  • CHF
121
Q

How is NTG supplied

A
  • 1/150 gr sublingual tablet (0.4 mg)

- 400 mcg Nitrolingual spray

122
Q

Adult dosage for NTG

A
  • Chest pain/ ACS:
    0.4 mg SL (tablet or spray) q 5 min PRN. Maintain
    SBP > 100 mmHg
  • Pulmonary Edema:
    0.4 mg SL (tablet or spray) q 3-5 min PRN. Maintain
    SBP > 110 mmHg
123
Q

Indications for Norcuron

A

Neuromuscular blockade for induction of ICE

124
Q

How is Norcuron supplied

A

10 mg vial (1 mg/ml when reconstituted with 10 ml sterile water

125
Q

Adult dosage for Norcuron

A

0.1 mg/kg slow IV/IO (max dose 10 mg)

126
Q

Indications for 2-PAM

A

Nerve agent poisoning

127
Q

How is 2-PAM supplied

A

600 mg/ 2 ml Auto-injector

128
Q

Adult dosage for 2-PAM

A
  • Dyspnea, vomiting or diarrhea: One (1) Duo-Dote kit (2-PAM/ Atropine)
  • Seizures, apnea, severe respiratory distress, unconsciousness, muscle twitching: Three (3) Duo-Dote kits (2-PAM/ Atropine)
129
Q

Peds dosage for 2-PAM

A

15 mg/kg

130
Q

Indications for Prednisone

A
  • Bronchial asthma
  • Emphysema (COPD)
  • Pulmonary fibrosis
131
Q

How is Prednisone supplied

A

20 mg tablet

132
Q

Adult dosage for Prednisone

A

40 mg PO

133
Q

Peds dosage for Prednisone

A

20 mg PO (if able to swallow and maintain own airway)

134
Q

Indications for Procainamide

A
  • Sustained VT

- Tachyarrhythmias from WPW

135
Q

How is Procainamide supplied

A

1 Gm/ 2 ml vial (500 mg/ml)

136
Q

How is Procainamide mixed

A

Treatment drip:
- 1 Gm in 50 ml D5W (20 mg/ml)

Maintenance drip:
- 1 Gm in 250 ml D5W (4 mg/ml)
1 mg/min = 15 gtts
2 mg/min = 30 gtts
3 mg/min = 45 gtts
4 mg/min = 60 gtts
137
Q

Adult dosage for Procainamide

A

20 mg/min (60 gtts/min)

138
Q

Indications for Bicarb

A
  • Metabolic acidosis
  • Cardiac arrest
  • Acidosis associated with Tricyclic OD
139
Q

How is Bicarb supplied

A

50 mEq/ 50 ml prefilled syringe (1 mEq/ml)

140
Q

Adult dosage for Bicarb

A
  • Cardiac arrest: 50 mEq IO/IV push

- Tricyclic OD: 1 mEq/kg IO/IV

141
Q

Peds dosage for Bicarb

A
  • Cardiac arrest: 1 mEq/kg IO/IV

- Tricyclic OD: 1 mEq/kg IO/IV

142
Q

Indications for Solu-Medrol

A
  • Oral Prednisone not feasible
  • Bronchial asthma
  • Emphysema (COPD)
  • Allergic reaction/ Anaphylaxis
  • Pulmonary fibrosis
143
Q

How is Solu-Medrol supplied

A

125 mg/ 2 ml Act-O-Vial

144
Q

Adult dosage of Solu-Medrol

A

125 mg IV

145
Q

Peds dosage of Solu-Medrol

A

1 mg/kg IV

146
Q

Indications for Thiamine

A
  • Coma of unknown origin (before D50 or Narcan)
  • Delirium tremens
  • Wernicke’s encephalopathy
  • Anemia from Thiamine deficiency
147
Q

How is Thiamine supplied

A

200 mg/ 2 ml vial (100 mg/ml)

148
Q

Adult dosage for Thiamine

A

100 mg IV/IM

149
Q

Indications for Toradol

A

Pain management

150
Q

How is Toradol supplied

A

30 mg/ 1 ml vial

151
Q

Adult dosage for Toradol

A

30 mg IM or 15 mg IV

152
Q

Peds dosage for Toradol

A

MC order

153
Q

Indications for TXA

A
  • Evidence of marked blood loss
  • Sustained tachycardia > 110/min (despite 500 ml bolus)
  • Sustained hypotension < 90 SBP (despite 500 ml bolus)
  • Major trauma with suspicion of pelvic and/or abdominal injury
  • Major arterial bleeding requiring a tourniquet
154
Q

How is TXA supplied

A

1 Gm in 10 ml vial

155
Q

Adult dosage for TXA

A

1 Gm in 50 ml D5W IV ASAP given over 10 minutes

156
Q

Indications for Valium

A

Nerve agent exposure

157
Q

How is Valium supplied

A

10 mg/ 2 ml Auto-injector

158
Q

Adult dosage for Valium

A

10 mg auto-injector in conjunction with Duo-Dote auto-injector

159
Q

Peds dosage for Valium

A

0.2 mg/kg (10 mg max)

160
Q

Indications for Versed

A
  • Sedation
  • Seizures
  • Anxiety
161
Q

How is Versed supplied

A

2 mg/ 2 ml vial (1 mg/ml)

162
Q

Adult dosage for Versed

A
  • Cardioversion/ TCP/ Airway control:
    2 mg IV/IN/IM (May be repeated x1 PRN)
  • Seizures:
    2-4 mg IV/IN/IM (May be repeated x1 PRN)
163
Q

Peds dosage for Versed

A
  • Cardioversion/ TCP/ Seizures:

0. 1 mg/kg IO/IV or 0.2 mg/kg IN/IM with a max single dose of 2 mg. (May be repeated x1 PRN)

164
Q

Indications for Zofran

A

Nausea

165
Q

How is Zofran supplied

A
  • 4 mg/ 2 ml vial

- 4 mg ODT (Oral Disintegrating Tablet)

166
Q

Adult dosage for Zofran

A

4 mg SL/IV/IN/IM (May be repeated x1 in 5-10 min PRN)

167
Q

Peds dosage for Zofran

A

0.1 mg/kg for children 2-15 (Max dose 4 mg)

LCEMS Protocols (7 decks)

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