ALS Drugs Flashcards
Why do people take sodium channel blockers?
Ventricular and atrial arrythmias
Which sodium channel blocker does pinellas use
Lidocaine for IO’s
What type of drug is a tricyclic antidepressant or phenytoin?
Sodium channel blocker
How do sodium channel blockers affect your ECG?
It widens everything, especially your QRS complex
Lidocaine route and dose and use. OLMC?
Caridac arrest w/ OLMC
1-1.5mg/kg IV bolus
What type of co-morbidities should you consider in a pt before giving them lidocaine?
Liver disfunction
When are betablockers generally used?
Slows AV node conduction. For rate control & cardiovascular disease (ex. Hx stents)
What do K channel blockers do to the body? Why do people take them?
Slows repolarization for atrial/ventricular arrhythmias
What class is amiodarone
K, NA, CA, Alpha, and beta blocker
Why should you draw up amio slowly and without injecting air into the vial
Avoids foam
Short term side affects of amio
Brady or hypotension
How does amio affect the body?
Decrease AV conduction, SA node function by inhibiting adrenergic stimulation (blocks a and b)
What pinellas drug is a calcium channel blocker
Diltiazem
What do calcium channel blockers do to the body?
Affects AV node and brings down BP
When to use diltiazem?
Stable, narrow tachycardia (regular w/ hi afib or irregular)
Diltiazem administration speed? Contraindications?
SIV over 2 min
Contra: SBP < 90, or DBP < 60, WPW, acute MI, bleeding aneurysm
Diltiazem dose for afib
0.25mg.kg, max 20mg dose
Mag dose for torsades
2g in 10ml NS over 10 min
Mag dose for eclampsia
4g IVP over 10min
Mag dose for asthma/copd
2g over 10min
Mag dose for vfib, pvtach, induced hypothermia
2g mixed in 10ml over 10min
Atropine dose, frequency, max dose?
0.5mg every 3-5min, max 3mg
When can atropine be used in kids? Why?
During drug assisted intubation to combat vagal effects
Pinellas narcan dose
2mg IV/IO repeat 3-5min
Calcium chloride and Sodium bicarb dose? OLMC? When do you give it and which do you give first?
Both in cardiac arrest w/ hyperkalemia
Calcium 1g IV/IO
Sodium bicarb - 50-100 mEQ (1-2mEq / kg)
Yes OLMC
Can you give calcium chloride and sodium bicarb in the same line? How well should you flush?
No, because they will crystalize. Flush well to prevent the crystalization
Other uses for bicarb besides acidosis or hyper K
Rhabdo, salicylate OD, widening QRS from TCA overdose
Glucagon uses other than hypoglycemia (and their doses)
Foreign body obstruction (1mg) - relaxes esophagus
Beta blocker OD (3+ mg)
Side effects of glucagon? What should you give to prevent?
Vomiting and hyperglycemia. Consider zofran before
What are the ED meds to contraindicate Nitro and their time frames
Stendra w/in 12 hrs
Levitra, staxyn, viagra w/ in 24 hrs
Cialis w/in 48 hrs
What are the different Nitro doses for different BP’s in CHF?
> 90 = 0.4mg
> 120 = 0.8mg
> 160 = 1.2mg spray
Benedryl use besides itching
Good for tardive diskenia and phenthiazine/haloperidol OD
Solu-medrol dose for asthma/COPD and anaphylaxis
125 mg (slow for asthma, fast for anaphylaxis)
Albuterol dose and use
2.5mg for asthma/copd. Repeat as needed
Ipratropium use and dose
For asthma/COPD
0.5mg mixed w/ albuterol for 2 max doses
Epi for adult anaphylaxis dose/ asthma/COPD
0.3mg IM, 1:1000 (1mg/ml concentration)
Opiate vs Opioids. Why the difference?
Opiate = natural/ plant-based.
Opioid = synthetic
Opiate = more allergy risk
Fentanyl dose for pain vs facilitated intubation
How to convert to mL
Pain = 1mcg/kg - 100mcg max
Intubated = 2mcg/kg
Ex. 100kg pt = 100mcg or 2.0 ml
Etomidate dose for facilitated intubation. How to convert to mL
0.3mg/kg SIVP (>20s)
EX. 100kg pt = 30mg = 15mL
Narcan dose for OD vs Cardiac arrest
OD = 0.4mg IV or 2mg IN, repeat up to 4mg
Cardiac arrest = 2mg IV/IO repeat x 1 per 3-5min
How long does narcan actually last?
Only 20-30 min
What to give for post-intubation sedation? What dose?
Versed 2.5mg IVP, repeat x1
Duration <2hr IV/IO/IN
How long does etomidate last? What is the onset time?
Duration <5min
Onset = <30-60s
Earliest way to notice if a sedated pt needs more versed?
Biting on tube or breathing against ventilation
Cyanokit dose, mixture, and administration time frame.
5g vial w/ 200 ml NS infused over 15min
Can you give other meds in your line w/ your cyanokit?
No, because of Crystalization risk.
Versed dose for psychs
Potentially violent = 2.5mg IV/IM or 5mg IN (repeat x1 after 3-5min)
Actively violent = 5mg IV/IM or 10mg IN (repeat at 2.5mg IV/IM or 5mg IN after 3-5min)
How to set up an epi drip for bradycardia
1mg 1:10,000 in a 1000L bag w/ 60 gtt set at 2-5mcg/min (1mcg = 60 drop increments)
When to give Diltiazem to adults? What dose? Max dose?
Stable, irregular afib or regular but has hx afib
0.25mg/kg slow IV. Max single dose 20mg
Dose of amiodarone for stable arrythmias
150mg infusion over 10min
How do you convert a fentanyl dose from mcg into ml? Example 80kg pt
Move the decimal left one and multiply by 2 (pn mgmt) or 4 (facilitated)= 8 x 4 = 3.2ml
How do you dose for etomidate from mg to ml? Example 80kg pt
Drop the last number, multiply by 3. Then divide by 2
80kg = 8 x3 = 24mg / 2 = 12ml
Dose of midazolam for seizures adults
1st dose = 2.5mg IV/IO or 5mg IN
IV/IO repeat every 5min until max 10mg
IN repeat x 1 after 5 min (max 10mg)
Whats the general MAX fluid dose for adults? What about peds?
Adults = 2000mL. Re-assess every 500cc
Peds or <100kg = 20ml/kg
How to setup an Epi drip. Dose? Drip rate?
1mg of 1:10,000 in 1000cc bag w/ a 60gtt set
1-5mcg/min = 60-120-180 (go up in 60 increments)
How to set up a nor epi drip? Dose? Rate?
4mg norepi in 1000cc bag @ 1-10mcg/min
Set a 60gtt set dial start at 15 (1mcg) and increase by 15 increments
What Rx dose for a hypoglycemic
D10 250ml (25mg) OR 15g oral glucose OR 1mg glucagon
Dose of zofran for nausea/vomiting
4mg SIVP or 4mg tab. Repeat x1 after 15min PRN
Dose of fluids for abdominal pn pt that has nausea and vomiting
Adult = 500ml
How much fluids for a burn pt
Bolus 20ml/kg
When would you give fentanyl to pts
When their pain > or = 7
When does a burn go to a burn center?
2nd or 3rd > 15% BSA w/ no multisystem trauma. Or 2nd 3rd in critical places
How much fluids for a burn pt?
Same as trauma arrest
Diving/barotrauma injury Rx
ABCs and fluids (same as trauma arrest dose)
How much fluids for a trauma arrest adult? Age 14-15? Ped?
Adult = 2000mL
14-15 = 1500
Ped = hand tevy
How much Benadryl for anaphylaxis
50mg iv Io IM
