Adult Doses Flashcards
Adrenal Insufficiency/Adrenal Crisis - Adult Doses
Hydrocortisone (Solu-cortef) -100 mgs IV/IO/IM
Methylprednisolone (Solu-Medrol) - 125 mgs IV/IO/IM
When should a stress dose of steroids be given?
A stress dose should be given to patients with known chronic adrenal insufficiency who have the following injuries AND known chronic adrenal insufficiency:
-shock
-fever > 100.4 f and ill-appearing
-multi-system trauma
-drownling
-environmental hyperthermia or hypothermia
-multiple long-bone fratures
-vomiting/diarrhea accompanied by dehydration
-respiratory distress
2nd of 3rd degree burns >5% BSA
-Hypoglycemia
Allergic Reaction/Anaphylaxis - Adult Doses
Diphenhydramine: 25-50 mgs IV/IO/IM
Epinephrine: 0.3 mgs 1:1,000 IM ONLY. Second dose after 5 minutes
Albuterol: 2.5 mgs via nebulizer. Repeat every 5 minutes up to 4 doses.
Hydrocortisone (Solu-cortef): 100 mgs IV/IO/IM
- OR -
Methylprednisolone (Solu-medrol) 125 mgs IV/IO/IM
Altered Mental Status/Neurological Status/Diabetic Emergency/Coma - Adult Doses
Glucagon - 1mg IV/IO/IM/IN
-Check glucose after 15 minutes and may repeat 1mg IV/IO/IM if blood glucose is still <70 mg/dl
Oral glucose - 1 tube
Dextrose 12.5g IV/IO
-May repeat after 5 minutes up to 25g IV/IO if glucose is <70mg/dl with continued altered mental status
Hydrocortisone (Solu-cortef) dose - Adult
100 mgs IV/IO/IM
Methylprednisolone (Solu-Medrol) - adult
125 mgs IV/IO/IM
Diphenhydramine dose - adult
125 mgs IV/IO/IM
Glucagon - adult
1mg IV/IO/IM
Dextrose - Adult
12.5 mgs IV/IO
Repeat dose after 5 minutes up to a max of 25 mgs.
What is hypoglycemia defined as in adults?
Glucose <70 mg/dl with associated altered mental status
Causes of hypoglycemia
Medication misuse, missed meals, infection, cardiovascular insults (myocardial infarction, arrhythmia), changes in activity such as exercise
What is hyperglycemia defined as in adults
Glucose >300 mg/dl with associated altered mental status
Behavioral Emergencies - Adult
Haloperidol: 5mg IM ONLY
-preferable for psychotic patients
-do not administer to patients with a history of seizures or prolonged QTI
Midazolam: 2-6 mg IV/IO/IM/IN
Ketamine 4mg/kg IM ONLY
-max dose of 400mg IM ONLY as a single dose
What is a normal QTI in male and female adults?
Men 350-450 ms
Women 360 - 460 ms
Haloperidol - Adult
5 mgs IM ONLY
Preferable for psychotic patients
Do not administer with a history of seizures or prolonged QT intervals
IM ONLY
*If >70 years old, half of the dose
Midazolam - Behavioral - Adult
2-6 mgs IV/IO/IM/IN
*If >70 years old, half of the dose
Ketamine - Behavioral - Adult
4mgs/kg IM ONLY
Max dose of 400mg IM ONLY as a single dose
*If >70 years old, half of the dose
Bronchospasm - Adult Doses
Albuterol: 2.5-3 mgs via nebulizer
Ipratropium Bromide 0.5 mgs may be combined with albuterol
Epinephrine: 0.3 mgs IM ONLY as a one time dose
Hydrocortisone (Solu-cortef): 100 mgs IV/IO/IM
-OR-
Methylprednisolone (Solu-medrol): 125 mgs IV/IO/IM
Magnesium sulfate: 2-4 grams IV/IO over 20 minutes
-For asthma only
Albuterol dose - Adult
2.5-3 mgs via nebulizer
Bronchosasms
Epinephrine for bronchospasm - Adult
0.3 mgs IM ONLY one dose
Ipratropium Bromide - adult
0.5 mgs to be mixed with albuterol
Bronchospams
Magnesium sulfate dose - adult
2-4 mgs IV over 20 minutes
Only if they have s history of asthma
Organophosphate Poisoning - Adult and Pedi
Administer duodote kit if available
Atropine 2mg IV/IO every 5 minutes until secretions clear
Exlamptic Seizure
Magnesium Sulfate 2-4 grams IV/IO over 5 minutes
Midazolam 2-6 mgs IV/IO/IM/IN
Adult Pain Management
Ibuprofem - 600 mg by liquid or tablets
Acetaminophen - 650-1000 mgs by liquid or tablet
Ketorolac - 15 mg IV or 30 mg IM
Fentanyl: 1 mch/kg IV/IO/IM/IN up to a max dose of 150 mcgs
-if needed, you can repeat up to two additional doses 5 minutes apart not to exceed 450 mcgs
Morphine Sulfate: 0.1 mg/kg IV/IO/IM
Ketamine: 0.15 mg/kg IV/IO
-may repeat one time in 15 minutes
-OR-
Ketamine 0.3 mgs/kg IM
-may repeat one dose in 20 minutes
Ibuprofen - Adult
600 mg by liquid or tablet
-contraindicated for pregnancy
Acetaminophen - Adult
650-1000 mgs by liquid or tablet
-contraindicated in patients with liver failure
Ketorolac - adult
15mg IV
30mg IM
Contraindicated for head injury, chest pain, abd pain, or any potential for bleeding likely needing surgury
Fentanyl - adult
1mcg/kg up to 150mcgs
May repeat up to two doses 5 minutes apart
Max total dose 450mcgs
Morphine Sulfate - adult
0.1mgs/kg IV/IO/IM
Max of 10 mgs
Ketamine for pain - adult
0.15 mg/kg IV/IO
May repeat one time in 15 minutes
-OR-
0.30 mg/kg IM/IN
May repeat one time in 20 minutes
Poisoning/Substance Abuse/Overdose/Toxicology - Adult
Opioids:
Naloxone - 0.4-8mg IN or IM
ALL MEDICAL CONTROL ORDERS
Calcium blocker toxicity:
Calcium chloride - 20 mg/kg IV/IO over 5 minutes
-max dose of 1g
Organophosphate poisoning:
Atropine - 2-5 mg IV/IO
Beta-blocker or Calcium Channel blocker overdose:
Glucagon - 1-5 mgs IV/IO/IM
Calcium blocker toxicity:
Calcium chloride - 20 mg/kg IV/IO over 5 minutes
-max dose of 1g
Organophosphate poisoning:
Atropine - 2-5 mg IV/IO
Beta-blocker or Calcium Channel blocker overdose:
Glucagon - 1-5 mgs IV/IO/IM
Seizures - Adult
Midazolam 2-6 mg slow IV/IO/IM
Magnesium Sulfate 2-4 grams IV/IO over 5 minutes if suspected elampsia
Shock - Adult
Epinephrine Infusion - 2-10 mcg/min IV/IO
Dopamine - 2-20 mcg/kg/min
Sepsis Criteria - Adult
2 or more of the following:
-Temp less than 96.8 or greater than 100.4
-HR >90 bpm
-RR >22 bpm
-SBP <90 mmHg or MAP <65 mmHg
-New onest AMS or increasing mental status chance with previous AMS
-Serum Lactate level >4 mmol/l
-STCO2 less than or equal to 25 mmHg
Medical Control Can Order:
-Epinephrine infusion 2-10 mcg/min
-OR-
Dopamine 2-20 mcg/kg/min
Stroke alert if symptoms are less than __ hours old.
24 hours
Hyperkalemia - Adult
Calcium chloride: 1 gram IV over 5 minutes
-may be repeated once after 5 minutes
Nebulized Albuterol: Up to a max dose of 20 mg
ACS - Adult
Aspirin: 324mgs
Nitroglycerin - x1 0.4 mg tab or spray SL
-systolic BP must be >120mmHg
-IV must be established before administering nitro!
-Every 3-5 minutes as long as symptoms persist and SBP >120
- AVOID in all patients who have used viagra, cialis, levitra within the last 48 hours
-often used for erectile dysfunction and pulmonary hypertension
Atrial Flutter
Diltiazem:
HR >150 and the patient is stable but symptomatic
-0.25mg/kg slow IV over 2 minutes
-If no response after 15 minutes repeat at 0.35mg/kg slow IV over 2 minutes
Synchronized cardioversion dose starts at 50 jules
Atrial Fibrilation
Diltiazem:
HR >150 and the patient is stable but symptomatic
-0.25mg/kg slow IV over 2 minutes
-If no response after 15 minutes repeat at 0.35mg/kg slow IV over 2 minutes
Syncronized cardioversion starting at 120
Never give diltiazem to someone who has ______ syndrome
wolff-parkinson-white syndrome
If patient is already taking a beta blocker, you can use ____ as an alternative
Metoprolol
-2.5-5 mg slow IV/IO over 2 minutes
-Repeat dosing 5-minute intervals for a max of 15 mg
