ALS drugs

Question 1

diphenhydromine (ALS)

Answer 1

Class: antihistamine

Adult Dosage: 25-50mg IV/IO/IM/PO
Peds Dosage: 1mg/kg IV/IO/IM/PO max 50mg

MOA: H1 histamine antagonist; acetylcholine antagonist.

Indication: mild-severe allergic reactions; acute extrapyramidal reactions.

Contraindication: newborns/preme infants; hypersensitivity

Pharmacokinetic: onset- rapid. Duration 4-6hrs

Question 2

acetominaphen (ALS)

Answer 2

Class: analgesic, antipyretic

Adult Dosage: 325-1000mg PO/IV q4-6hrs
Peds Dosage: 15mg/kg PO/PR q4-6hrs

MOA: COX pathway inhibitor; decreasing prostaglandin synthesis

Indication: mild-moderate pain

Contraindication: severe hepatic impairment (liver); hypersensitivity; cold/flu meds

Pharmacokinetic: onset- 15min IV; 60min PO. Duration 4-6hrs

Question 3

albuterol (ALS)

Answer 3

Class: sympathomimetic, bronchodilator

Adult Dosage: 2.5-5mg neb q5minPRN
Peds Dosage: 1.25-2.5mg neb q5minPRN

MOA: β2 agonist. Relaxes bronchial smooth muscle. Mild chronotropic effect.

Indication: Bronchospasm, COPD, Hyperkalemia

Contraindication: newborns/preme infants; hypersensitivity

Pharmacokinetic: onset- rapid. Duration 4-6hrs

Question 4

naloxone (ALS)

Answer 4

Class: Antidote, opiate reversal agent
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Adult Dosage: 0.4-2mg IV/IO/IM/IN q3-5minPRN
Peds Dosage: 0.1mg IV/IO/IM/IN/ETT q3-5minPRN
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MOA: opiate antagonist
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Indication: suspected opiate overdose w/ respiratory depression
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Contraindication: known hypersensitivity (relative)
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Pharmacokinetic: onset- 2-5min (<2 IV). Duration- 30-120min

Question 5

epinephrine 1:10,000

Code Epi

Answer 5

Class: sympathomimetic

Adult Dosage:
CA- 1mg IV/IO q3-5min
Gtt- 2-10mcg/min IV/IO titrate to effect
Peds Dosage:
CA- 0.01mg/kg IV/IO q3-5min max 1mg
Gtt- 0.1-1mcg/kg/min IV/IO max 10mcg/min titrate to effect

MOA: catacholamine; α-, β1,β2 agonist. Positive ino-,domo-, and chronotropic effects. Vasopressor. Broncho dilator.

Indication: cardiac arrest; symptomatic bradycardia, hypotension

Contraindication: None

Pharmacokinetic: onset- IV immediatevariable; IM variable. Duration IV short; IV 1-4 hrs.

Question 6

ibuprofen

Answer 6

Class: analgesic, NSAID

Adult Dosage: 400-800mg PO q6-8hrs
Peds Dosage: 10mg/kg PO q6-8hrs

MOA: COX pathway inhibitor; decreasing prostaglandin synthesis. Anti-inflammatory

Indication: mild-moderate pain

Contraindication: renal disease/dialysis; GI bleeds; hypersensitivity

Pharmacokinetic: onset- 30-60min PO. Duration 4-6hrs

Question 7

activated charcoal

Answer 7

Class: antidote

Adult Dosage: 1g/kg max50g
Peds Dosage: 1g/kg max50g

MOA: Absorbes ingested toxins/chemicals. Reduces bioavailability.

Indication: Toxic ingestion <1hr.

Contraindication: cyanide, mineral scid, caustic alkalis, organic solvents, iron. Airway compromise and/or AMS.

Pharmacokinetic: onset- immediate. Duration none

Question 8

epinephrine 1:1,000 (ALS)

Answer 8

Class: sympathomimetic

Adult Dosage: 0.3-0.5mg IM q5min x3.
Peds Dosage: <30kg = .15mg IM q5min x3. (Asthma 0.01mg/kg IM max 0.3mg)

MOA: catacholamine; α-, β1,β2 agonist. Positive ino-,domo-, and chronotropic effects. Vasopressor. Broncho dilator.

Indication: anaphylaxis; severe asthma

Contraindication: None

Pharmacokinetic: onset- variable. Duration 1-4 hrs.

Question 9

push-dose epinephrine

Answer 9

Class: sympathomimetic

Adult Dosage: 0.3-0.5mg IM q5min x3.
Peds Dosage: <30kg = .15mg IM q5min x3.

MOA: catacholamine; α-, β1,β2 agonist. Positive ino-,domo-, and chronotropic effects. Vasopressor. Broncho dilator.

Indication: anaphylaxis

Contraindication: None

Pharmacokinetic: onset- variable. Duration 1-4 hrs.