ALS Drugs

Question 1

Adenosine

Answer 1

 Concentration: 6 mg/2 ml
 IV
o 1st dose – draw up 6 mg (2 mls) in a 3 ml - 6 ml syringe. Have 20 ml NS for
flush, drawn up in a 20 ml syringe
o 2nd dose – draw up 12 mg (4 mls) in a 6 ml - 12 ml syringe. Have 20 ml NS for
flush, drawn up in a 20 ml syringe
 *It is recommended to use a Y-port /T-port for simultaneous infusion

Question 2

Amiodarone

Answer 2

 Concentration: 150 mg/3 ml
 IV
o 1st dose – draw up 300 mg (6 mls) in a 35 ml syringe. NS.
o 2nd dose – draw up 150 mg (3 mls) in a 35 ml syringe. NS.
Add 20 mls to 30 mls of Add 20 mls to 30 mls of
o Loading Dose Infusion – Draw 150 mg (3 mls) and add to 100 ml bag NS. Prime pump line and hook up to main line. Primary line should have the filter set added.
o Maintenance Dose Infusion – Draw 450 mg (9 mls) and add to 250 ml bag D5W. Prime pump line and hook up to main line. Primary line should have the filter set added.
Amiodarone

Question 3

Dextrose

Answer 3

Concentration: 25 G/50 ml
 D10W – 5 G/ 50 mls
o Option One - Draw out 50 mls of NS out of a 250 ml bag of NS, then add 1 ampule of D50W (blunt on the end of the syringe) or;
o Option Two – Draw out 100 mls of NS out of a 500 ml bag of NS, then add 2 ampules of D50W (blunt on the end of the syringe);
o Option Three – Discard 40 mls of the D50W ampule and add 40 mls of NS;
o Option Four – using the female to female connector, attach the D50W syringe to
a 60 ml syringe and draw out 10 mls of D50W. Add 40 mls of NS from the IV line.
 D25W
o Discard 1⁄2 the ampule of D50W and add 25 mls of NS. This will give 12.5 G in
50 mls.

Question 4

Diphenhydramine

Answer 4

 Concentration: 50 mg/1 ml
 IM - Draw up desired dose in 3 ml syringe with needle.
 IV Infusion - Draw up 50 mg (1 ml) or desired dose at 1mg/kg and add to a 50 ml bag
of NS. Prime pump line with medication and hook up to the Primary line.

Question 5

Epi 1:10000

Answer 5

IVP
 Option one – Draw up 1 mg (1 ml) in a 12 ml syringe and add 9 mls or NS or;
 Option two – Draw 10 mls of NS out of a 100 ml bag. Draw up 10 mg (10 mls of Epi 1:1000) and add it to the 100 ml bag. This will give you 10 mg in 100 mls of NS. You can now draw 10 mls off the 100 ml bag and you will have Epi 1:10000 or 1 mg in 10 mls.

Question 6

Epi 1:100000

Answer 6

o Push Dose Presser – Draw up 1 mg (1 ml) of Epi 1:1000 and add it to a 100 ml
bag. This will give you Epi 1:100000 or 10 mcg/ml. Draw up 100 mcg (10 mls)
into a syringe  Infusion - 16 mcg/ml
o Draw up 4 mg (4 mls) and add it to a 250 ml bag of NS. Prime a pump line with the infusion.
 ** All Epi MUST be labeled with a med sticker**.

Question 7

Fentanyl

Answer 7

Fentanyl
 Concentration: 250 mcg/5 mls
 IM
o Draw up desired dose in 3 ml syringe with a needle.
 IVP
o Option One: Draw up 250 mcg (5 mls) in a 6 ml or 12 ml syringe (50 mcg / ml)
or;
o Option Two: Draw up 250 mcg (5 mls) in a 12 ml syringe with 5 mls of NS (25
mcg/ml)
o It is up to the ACP which way they want the drug drawn up.

LABEL SYRINGE

Question 8

Haldol

Answer 8

Concentration: 5 mg/1 ml
 IM
o Draw up desired dose in 3 ml syringe with needle. o Can only be given IM at this time.

Question 9

Ketamine

Answer 9

Concentration: 500 mg/10 mls
 IVP
o Draw up 500 mg (10 mls) in a 12 ml syringe.
 Shock dosing
o Draw up 100 mg (2 mls) into a 12 ml syringe and add 8 mls of NS (10 mg/ml).
 Ensure the syringe is marked with the concentration to avoid Med Errors.

Question 10

Magnesium Sulfate

Answer 10

 Concentration: 2 G/10 mls
 IVP – Cardiac Arrest
o Draw up desired dose (1 to 2 G) into a 12 ml syringe.
 Infusions:
o AdultAsthma
 Remove 5 (1 G) mls to 10 mls (2 G) of NS from 50 ml NS bag. Add desired dose to bag and run through pump. Flush with 19 mls of NS when infusion is done. Run over 20 (1 G) or 30 (2 G) minutes.
o PedsAsthma
 Option One: Remove 10 mls (2 G) of NS from 50 ml NS bag. Weight and
VBTI set at same number (i.e., 25 kg = 25 VTBI) and run through pump.
Flush with 19 mls of NS when infusion is done. Ran over 20 minutes.
 Option Two: Following the 10% rule, remove fluid needed and add
desired dose. Run through the pump and flush with 19 mls of NS. Run
over 20 minutes.
 It is highly recommended that ACP in charge will set this medication up and double check with partner.
o Eclampsia
 Add 2 G (10 mls) to a 100 ml bag of NS (total volume 120 mls). Each
infusion is run over 20 minutes. Flush with 19 mls of NS when infusion is
done.
o Torsade’s de pointes (with a pulse)
 Remove 5 mls (1 G) to 10 (2 G) mls of NS from 50 ml NS bag. Add desired dose to bag and run through pump. Run over 15 minutes (1 G) or 30 (2 G) minutes. Flush with 19 mls of NS when infusion is done.

Question 11

Methylprednisolone

Answer 11

Concentration: 125 mg/ml  Infusion
o Push in stopper or add 1 ml of NS to powdered drug. Roll medication to mix. Removed Solution (slowly, drug will froth easy if pushed too fast) from vial and add it to a 50 ml bag of NS. Flush with 19 mls of NS when infusion is done.

Question 12

Midaz

Answer 12

Midazolam
 Concentration: 10 mg/2 mls
 IM
o Draw up desired dose in 3 ml syringe with needle.
 IVP
o Draw up 10 mg (2 mls) into a 12 ml syringe. Add 8 mls of NS (1 mg/ml).

Question 13

Morphine

Answer 13

Concentration: 10 mg/ml
 IM
o Draw up desired dose in 3 ml syringe with needle.
 IVP
o Draw up 10 mg (1 mls) into a 12 ml syringe. Add 9 mls of NS (1 mg/ml).

Question 14

Syntocinon

Answer 14

 Concentration: 10 units/1 ml
 IM
o Draw up into 3 ml syringe with needle.
 Infusion (2nd Dose postpartum Hemorrhage):
o Draw up 5 to 10 units (0.5 ml – 1 ml) and add to a NS 50 ml mini bag.
Prime pump line and run in infusion. Flush with 19 mls of NS.

Question 15

Thiamine

Answer 15

 Concentration: 100 mg/1 ml  SIVP
o Draw up in 12 ml syringe and add 4 to 9 mls of NS to allow for SIVP.

Question 16

TXA

Answer 16

 Concentration: 1 G/10 mls  Loading Infusion
o Remove 20 mls of NS from a 100 ml bag. Draw up 2 G (20 mls) and add it to the bag. Prime pump line and flush with 19 mls of NS when infusion is complete.