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ALS Protocols > ALS Drugs > Flashcards

ALS Drugs Flashcards

1
Q

Why do people take sodium channel blockers?

A

Ventricular and atrial arrythmias

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2
Q

Which sodium channel blocker does pinellas use

A

Lidocaine for IO’s

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3
Q

What type of drug is a tricyclic antidepressant or phenytoin?

A

Sodium channel blocker

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4
Q

How do sodium channel blockers affect your ECG?

A

It widens everything, especially your QRS complex

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5
Q

Lidocaine route and dose and use. OLMC?

A

Caridac arrest w/ OLMC

1-1.5mg/kg IV bolus

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6
Q

What type of co-morbidities should you consider in a pt before giving them lidocaine?

A

Liver disfunction

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7
Q

When are betablockers generally used?

A

Slows AV node conduction. For rate control & cardiovascular disease (ex. Hx stents)

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8
Q

What do K channel blockers do to the body? Why do people take them?

A

Slows repolarization for atrial/ventricular arrhythmias

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9
Q

What class is amiodarone

A

K, NA, CA, Alpha, and beta blocker

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10
Q

Why should you draw up amio slowly and without injecting air into the vial

A

Avoids foam

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11
Q

Short term side affects of amio

A

Brady or hypotension

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12
Q

How does amio affect the body?

A

Decrease AV conduction, SA node function by inhibiting adrenergic stimulation (blocks a and b)

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13
Q

What pinellas drug is a calcium channel blocker

A

Diltiazem

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14
Q

What do calcium channel blockers do to the body?

A

Affects AV node and brings down BP

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15
Q

When to use diltiazem?

A

Stable, narrow tachycardia (regular w/ hi afib or irregular)

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16
Q

Diltiazem administration speed? Contraindications?

A

SIV over 2 min

Contra: SBP < 90, or DBP < 60, WPW, acute MI, bleeding aneurysm

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17
Q

Diltiazem dose for afib

A

0.25mg.kg, max 20mg dose

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18
Q

Mag dose for torsades

A

2g in 10ml NS over 10 min

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19
Q

Mag dose for eclampsia

A

4g IVP over 10min

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20
Q

Mag dose for asthma/copd

A

2g over 10min

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21
Q

Mag dose for vfib, pvtach, induced hypothermia

A

2g mixed in 10ml over 10min

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22
Q

Atropine dose, frequency, max dose?

A

0.5mg every 3-5min, max 3mg

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23
Q

When can atropine be used in kids? Why?

A

During drug assisted intubation to combat vagal effects

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24
Q

Pinellas narcan dose

A

2mg IV/IO repeat 3-5min

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25
Q

Calcium chloride and Sodium bicarb dose? OLMC? When do you give it and which do you give first?

A

Both in cardiac arrest w/ hyperkalemia
Calcium 1g IV/IO

Sodium bicarb - 50-100 mEQ (1-2mEq / kg)

Yes OLMC

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26
Q

Can you give calcium chloride and sodium bicarb in the same line? How well should you flush?

A

No, because they will crystalize. Flush well to prevent the crystalization

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27
Q

Other uses for bicarb besides acidosis or hyper K

A

Rhabdo, salicylate OD, widening QRS from TCA overdose

28
Q

Glucagon uses other than hypoglycemia (and their doses)

A

Foreign body obstruction (1mg) - relaxes esophagus

Beta blocker OD (3+ mg)

29
Q

Side effects of glucagon? What should you give to prevent?

A

Vomiting and hyperglycemia. Consider zofran before

30
Q

What are the ED meds to contraindicate Nitro and their time frames

A

Stendra w/in 12 hrs

Levitra, staxyn, viagra w/ in 24 hrs

Cialis w/in 48 hrs

31
Q

What are the different Nitro doses for different BP’s in CHF?

A

> 90 = 0.4mg

> 120 = 0.8mg

> 160 = 1.2mg spray

32
Q

Benedryl use besides itching

A

Good for tardive diskenia and phenthiazine/haloperidol OD

33
Q

Solu-medrol dose for asthma/COPD and anaphylaxis

A

125 mg (slow for asthma, fast for anaphylaxis)

34
Q

Albuterol dose and use

A

2.5mg for asthma/copd. Repeat as needed

35
Q

Ipratropium use and dose

A

For asthma/COPD

0.5mg mixed w/ albuterol for 2 max doses

36
Q

Epi for adult anaphylaxis dose/ asthma/COPD

A

0.3mg IM, 1:1000 (1mg/ml concentration)

37
Q

Opiate vs Opioids. Why the difference?

A

Opiate = natural/ plant-based.

Opioid = synthetic

Opiate = more allergy risk

38
Q

Fentanyl dose for pain vs facilitated intubation

How to convert to mL

A

Pain = 1mcg/kg - 100mcg max

Intubated = 2mcg/kg

Ex. 100kg pt = 100mcg or 2.0 ml

39
Q

Etomidate dose for facilitated intubation. How to convert to mL

A

0.3mg/kg SIVP (>20s)

EX. 100kg pt = 30mg = 15mL

40
Q

Narcan dose for OD vs Cardiac arrest

A

OD = 0.4mg IV or 2mg IN, repeat up to 4mg

Cardiac arrest = 2mg IV/IO repeat x 1 per 3-5min

41
Q

How long does narcan actually last?

A

Only 20-30 min

42
Q

What to give for post-intubation sedation? What dose?

A

Versed 2.5mg IVP, repeat x1

Duration <2hr IV/IO/IN

43
Q

How long does etomidate last? What is the onset time?

A

Duration <5min

Onset = <30-60s

44
Q

Earliest way to notice if a sedated pt needs more versed?

A

Biting on tube or breathing against ventilation

45
Q

Cyanokit dose, mixture, and administration time frame.

A

5g vial w/ 200 ml NS infused over 15min

46
Q

Can you give other meds in your line w/ your cyanokit?

A

No, because of Crystalization risk.

47
Q

Versed dose for psychs

A

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)

48
Q

How to set up an epi drip for bradycardia

A

1mg 1:10,000 in a 1000L bag w/ 60 gtt set at 2-5mcg/min (1mcg = 60 drop increments)

49
Q

When to give Diltiazem to adults? What dose? Max dose?

A

Stable, irregular afib or regular but has hx afib

0.25mg/kg slow IV. Max single dose 20mg

50
Q

Dose of amiodarone for stable arrythmias

A

150mg infusion over 10min

51
Q

How do you convert a fentanyl dose from mcg into ml? Example 80kg pt

A

Move the decimal left one and multiply by 2 (pn mgmt) or 4 (facilitated)= 8 x 4 = 3.2ml

52
Q

How do you dose for etomidate from mg to ml? Example 80kg pt

A

Drop the last number, multiply by 3. Then divide by 2

80kg = 8 x3 = 24mg / 2 = 12ml

53
Q

Dose of midazolam for seizures adults

A

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)

54
Q

Whats the general MAX fluid dose for adults? What about peds?

A

Adults = 2000mL. Re-assess every 500cc

Peds or <100kg = 20ml/kg

55
Q

How to setup an Epi drip. Dose? Drip rate?

A

1mg of 1:10,000 in 1000cc bag w/ a 60gtt set

1-5mcg/min = 60-120-180 (go up in 60 increments)

56
Q

How to set up a nor epi drip? Dose? Rate?

A

4mg norepi in 1000cc bag @ 1-10mcg/min

Set a 60gtt set dial start at 15 (1mcg) and increase by 15 increments

57
Q

What Rx dose for a hypoglycemic

A

D10 250ml (25mg) OR 15g oral glucose OR 1mg glucagon

58
Q

Dose of zofran for nausea/vomiting

A

4mg SIVP or 4mg tab. Repeat x1 after 15min PRN

59
Q

Dose of fluids for abdominal pn pt that has nausea and vomiting

A

Adult = 500ml

60
Q

How much fluids for a burn pt

A

Bolus 20ml/kg

61
Q

When would you give fentanyl to pts

A

When their pain > or = 7

62
Q

When does a burn go to a burn center?

A

2nd or 3rd > 15% BSA w/ no multisystem trauma. Or 2nd 3rd in critical places

63
Q

How much fluids for a burn pt?

A

Same as trauma arrest

64
Q

Diving/barotrauma injury Rx

A

ABCs and fluids (same as trauma arrest dose)

65
Q

How much fluids for a trauma arrest adult? Age 14-15? Ped?

A

Adult = 2000mL

14-15 = 1500

Ped = hand tevy

66
Q

How much Benadryl for anaphylaxis

A

50mg iv Io IM

ALS Protocols (4 decks)

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