BLOCK 5: PHARM DRUGS Flashcards
lidocaine drip
-how to mix
-concentration
-run
1gram of lido into 250mL bag
concentration: 4mg/mL
ran: 1-4mg/min (dependent on what was given during resuscitation)
dopamine drip
-how to mix
-concentration
-run
200mg of dope in 250mL bag (conc: 800mcg/mL)
400mg of dope in 250mL bag (conc: 1600mcg/mL)
ran: 1-20mcg/kg/min
1-5mcg/kg/min: renal dose
5-10mcg/kg/min: cardiac dose
11-20mcg/kg/min: alpha dose
epinephrine drip
-how to mix
-concentration
-run
1mg of 1:1000 epi in 250mL bag
concentration: 4mcg/mL
ran: 2mcg/min (may increase by 2mcg up to 10mcg/min maximum)
norepinephrine
-how to mix
-concentration
-run
4mg of levophed in 250mL of D5W
concentration: 16mcg/mL
ran: 1-30mcg/min titrated to BP of >80 systolic
Acetaminophen
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: analgesic, antipyretic
actions: inhibits prostaglandins
indications: mild/moderate pain and fever
contraindications: liver disease
side effects: liver injury in high dose/OD esp. in malnourished
routes of admin and dose:
Adult - PO 500-1000mg every 6hrs (max 4000mg)
Peds - PO 10-15mg/kg every 6hrs (max 50mg/kg in 24hrs)
specific interactions: transport time should be greater than 30 mins
Adenosine
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
class: antidysrhythmic
actions: slow conduction through AV node
indications: symptomatic stable supraventricular tachycardia
contraindications: (absolute) 2nd or 3rd degree blocks, wide complex tachycardia (relative) heart transplant, asthma
side effects: flushing dyspnea, chest pressure, sense of impending doom, bradycardia, complete heart block
routes of admin administration:
Adult: 6mg rapid IV/IO followed by 10-20cc flush, second dose 12mg rapid IV/IO followed by 10-20cc flush
Peds - 0.1mg/kg (max of 6mg) rapid IV/IO - second dose 0.2mg/kg (max of 12mg) rapid IV/IO
Albuterol
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: beta agonist, bronchodilator
actions: smooth muscle relaxation, shifts potassium from blood into cells
indications: bronchospasm (wheezing) and hyperkalemia
contraindications: preexisting or suspected cardiac disease (CHF), tachycardia, hypokalemia
side effects: angina, chest discomfort, hypertension, tachycardia, palpitations, anxiety, tremor, hypokalemia, hyperglycemia
routes of admin and dose:
Adult - 2.5-5mg nebulized every 15-20mins
Peds - 0.15mg/kg nebulized every 15-20mins
specific interactions: often combined with ipratropium, levalbuterol has less side effects
Amiodarone
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: antidysrhythmic
actions: beta-blocker and calcium channel block like effects on SA and AV nodes, increases refractory period, slows cardiac conduction
indications: pulseless VF/VT refractory to defibrillation, sustained unstable VT with pulseless refractory to cardioversion, stable symptomatic VT, Afib with RVR
contraindications: CHF
side effects: hypotension, bradycardia, CHF, cardiac arrest
routes of admin and dose:
Adult -
(pulseless VF/VT) initial 300mg IV/IO, second 150mg
(dysrhythmias w/ pulse) 150mg over 10mins, followed by 1mg/min
Peds -
(pulseless VF/VT) 5mg/kg (up to 300mg) IV/IO, repeat once
(dysrhythmias w/ pulse) 5mg/kg over 20-60mins
specific interactions: any drug that lengthens QT including antidysrhythmics and TCAs, any drugs that affect SA and AV nodes like beta-blockers, digoxin, calcium channel blockers
Aspirin (ASA)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: analgesic, anti-pyretic, anti-platelet anti-coagulant, NSAID
actions: inhibits prostaglandin synthesis for anti-inflammatory and anti-pyretic effect, inhibits platelet aggregation via thromboxane for anti-coagulation effect
indications: known or suspected acute coronary syndrome, TIA/CVA post negative CT of head, prevention of clots in Afib, prolonged immobilization, Kawasaki’s disease
contraindications: (absolute) active bleed (relative) pediatric viral syndrome and chicken pox due to Reye’s syndrome
side effects: gastric irritation/bleeding, increased bleeding, tinnitus in OD situations, Reye’s syndrome (liver failure and brain damage following infection where aspirin was used to treat symptoms)
routes of admin and dose:
Adult - 160-325mg PO
Peds - 3-5mg/kg per day to 5-10mg/kg per day as a single dose
specific interactions: contact MCEP before administering to patients with history of bleeding disorder or on anticoagulants
Atropine Sulfate
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: anti-cholinergic/ anti-muscarinic
actions: blocks parasympathetic receptors resulting in increased heart rate, decreased smooth muscle activity reducing effects of SLUDGE
indications: symptomatic bradycardia (HR<50 and SBP <90), organophosphate toxicity
contraindications: high degree AV blocks, GI obstruction
side effects: tachycardia, palpitations, hypertension, increased thirst, nervousness, weakness
routes of admin and dose:
Adult -
(symptomatic bradycardia) 1mg IV/IO every 5mins up to 3mg
(organophosphate toxicity) 2mg IV/IO every 3-5mins or 2mg IM every 5-10 mins until symptoms stop
Peds -
(symptomatic bradycardia) 0.02mg/kg IV/IO every 5mins to total dose of 1mg
(organophosphate toxicity) 0.04mg IV/IO (max dose of 2mg) every 3-5 mins or 0.04mg/kg IM (max dose of 2mg) every 5-10 mins
specific interactions: can potentiate anti-cholinergic effects
Calcium Chloride and Calcium Gluconate
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: electrolyte
actions: counters hyperkalemia toxicity by stabilizing cell membrane of cardiac cells, replaces calcium in hypocalcemia, competes with calcium channel blockers
indications: calcium channel blocker OD, magnesium sulfate OD, hypocalcemia, hyperkalemia, hydrofluoric acid exposure
contraindications: hypercalcemia, digitalis toxicity
side effects: tissue necrosis, bradycardia/hypotension with rapid administration
routes of admin and dose:
Adult - 500-1,000mg slow IV/IO 1-1.5mL/min (max dose of 3g)
Peds - 50-100mg/kg slow IV/IO over 5-10mins (max dose of 3g)
specific interactions: may increase digitalis toxicity, gluconate has 1/3 as much calcium per volume as chloride
Dexamethasone (Decadron)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
class: corticosteroid
actions: anti-inflammatory
indications: allergic creation, croup, asthma, suspected steroid responsive COPD
contraindications: hyperglycemia, hypothyroidism, thromboembolic disorders, active infection
side effects: headache, hallucinations, nervousness, seizures, fluid retention
routes of admin and dose:
Adult - 4-10mg IV/IO/IM/oral
Peds - 0.15-1mg/kg IV/IO/Oral (0.6mg/kg most common dose)
Dextrose (D5, D10, D24, D50)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: concentrated sugar
actions: raises available blood glucose levels
indications: hypoglycemia, hyperkalemia
contraindications: (relative) CVA, acute head trauma
side effects: tissue necrosis if extravasation occurs, hyperglycemia, hypokalemia
routes of admin and dose:
Adult - 25g (D25 or D10) PO, IV
Peds - 0.5g/kg (D25 or D10) PO, IV
Neonates - 0.5 (D25 or D10) g/kg IV
specific interactions: consider dilution if given in small vein
Diazepam (valium)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: benzodiazepine, sedative, anti-convulsant, anxiolytic
actions: stimulation of GABA which inhibits CNS
indications: anxiety, procedural sedation, seizures, alcohol withdrawal, chemical restraint, muscle spasms
contraindications: hypotension, sedation/intoxication, acute glaucoma
side effects: respiratory depression, hypotension, sedation, amnesia
routes of admin and dose:
Adult - 2-10mg IV/deep IM (only IM injectable version)
Peds - 0.2-0.5mg/kg given slow over 3-5mins IV/deep IM
specific interactions: potentiation of other CNS depressants
Diltiazam (Cardizem)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: calcium channel blocker
actions: slows conduction through AV node
indications: Afib with RVR
contraindications: AV blocks, hypotension, wide complex tachycardia, WPW, heart failure
side effects: flushing, headache, bradycardia, hypotension
routes of admin and dose:
Adult - 0.25mg/kg IV/IO slow over 2mins (20mg common dose), second dose 0.35mg/kg slow push over 2mins (25mg common second dose) 5-15mg/hr infusion
Peds - not recommended
specific interactions: used to target HR 80-100bpm, additive response with beta blockers
Diphenhydramine (Benedryl)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: anti-histamine, anti-cholinergic
actions: binds to and blocks H1 receptors, binds to and blocks muscarinic acetylcholine receptors
indications: symptomatic allergic reactions, extrapyramidal reactions (acute or prophylaxis), motion sickness
contraindications: (relative) asthma, prostate hypertrophy, narrow-angle glaucoma, less than 3months old, elderly
side effects: sedation, dry mouth, blurred vision, paradoxical CNS excitement (kids), thickening of bronchial secretions, tachycardia, dysrhythmias, urinary retention
routes of admin and dose:
Adult - 25-50mg PO, IM, IV/IO slow push
Peds - 1mg/kg IM, IV/IO slow push (max 25mg)
specific interactions: no immediate benefit in severe allergic reactions, may potentiate other sedating medications
Dopamine (Intropin)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: adrenergic agonist, Vasopressor, inotropic
actions: stimulates alpha and beta receptor sites depending on dose (beta for 2-10mcg/kg/min and alpha for 10-20mcg/kg/min)
indications: cardiogenic shock, septic shock, refractory bradycardia
contraindications: (relative) ventricular rhythms, tachycardia, hypovolemia, ACS
side effects: tachycardia, tachydysrhythmias, hypertension, cardiac ischemia, vomiting, skin necrosis
routes of admin and dose:
Adult - 2-20mcg/kg/min IV/IO
Peds - same as adult dose
specific interactions: half life is 2mins
Epinephrine (1:1000 and 1:10,000)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: adrenergic agent, inotropic
actions: potent alpha and beta agonist
indications: asthma, allergic reaction, hypotension, cardiac arrest, pediatric bradycardia, croup (inhaled), upper airway swelling (inhaled)
contraindications: (relative) hypertension, HX of coronary artery disease or stroke, over 65y/o, chest pain, glaucoma, pregnancy, hypersensitivity to sulfites
side effects: hypertension, angina/MI, stroke, tachycardia/palpitations, anxiety/restlessness
routes of admin and dose:
Adult -
anaphylaxis/severe asthma/hypotension: push dose: 0.3-0.5mg 1:1000 SC/IM every 5-10mins drip: 5-20mcg/min
cardiac arrest: 1mg 1:10,000 IV/IO every 3-5mins
inhaled: 0.05mg/kg of 1:1000 in 3mL up to 3mg
Peds -
anaphylaxis/severe asthma/hypotension: 0.01mg/kg 1:1000 SC/IM every 5-10mins
cardiac arrest: 0.01mg/kg 1:10,000 every 3-5mins
specific interactions: may potentiate other alpha and beta agonist meds
Fentanyl Citrate (Sublimaze)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: synthetic opioid analgesic
actions: binds to opioid receptor sites producing analgesia and euphoria
indications: pain
contraindications: TBI, respiratory depression
side effects: respiratory depression, apnea, dizziness, euphoria, nausea, vomiting, hypotension
routes of admin and dose:
Adult - 25-100mcg IV/IO, IM, SQ, IN slow push (1-2mins) max dose 200mcg
Peds - 1-2mcg/kg IV/IO, IM, SQ slow push (1-2mins)
specific interactions: may potentiate other CNS depressants and narcotics, lasts 15-20mins
Glucagon
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
class: endogenous hormone
actions: stimulates liver to release glycogen stores and helps convert glycogen to glucose
indications: hypoglycemia when IV cannot be obtained, beta blocker OD, anaphylaxis in patients on beta blockers
contraindications: pheochromocytoma, insulinoma, (relative) hyperglycemia, altered mental status
side effects: hyperglycemia, nausea, vomiting, hypertension, sinus tachycardia
routes of admin and dose:
Adult -
hypoglycemia: 1mg IV/IO, IM, SQ
beta blocker OD and anaphylaxis on beta blockers: 2-10mg IV/IO slow push (1minute) second dose 10mg IV/IO slow push or IV infusion of 2-5mg/hr if bradycardic or hypotensive
Peds -
hypoglycemia: <44lbs (20kgs) 0.5mg IM, SQ, IV/IO
beta blocker OD and anaphylaxis: <44lbs (20kgs) 0.5mg IV/IO
Hydroxocobalamin (Cyanokit)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: cyanide antidote
actions: binds to cyanide ion to be excreted in urine
indications: suspected cyanide poisoning
contraindications: (relative) hypertension
side effects: hypertension, nausea, red skin
routes of admin and dose:
Adult - 5g IV/IO over 15-30mins
Peds - 70mg/kg up to 5g IV/IO over 15-30mins
specific interactions: needs to be temperature controlled
Ibuprofen (Motrin, Advil)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: NSAID
actions: prostaglandin inhibitors
indications: mild to moderate pain, fever, inflammatory conditions (arthritis)
contraindications: hypersensitivity to salicylates (relative) asthma, hepatic/renal disease, CHF, hypertension, cardiac disease, cardiac arrythmias, coronary artery disease
side effects: anorexia, nausea, vomiting, epigastric/abdominal pain, dyspepsia, constipation, diarrhea, gastritis, melena
routes of admin and dose:
Adult - 250mL IV over 30mins as needed, 200-600mg oral every 4-6hrs
Peds - 1-2mL/kg IV over 30 mins as needed, 10mg/kg oral (not to exceed adult dose) every 4-6hrs
specific interactions: monitor serum sodium levels after 500mL
Ipratropium (Atrovent)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: bronchodilator, anti-cholinergic
actions: antagonizes acetylcholine receptors on bronchial smooth muscle producing bronchial dilation
indications: bronchospasms due to asthma or COPD
contraindications: peanut and soy sensitivity (relative) glaucoma, prostate hypertrophy, atropine or atropine derivatives
side effects: tachycardia/palpitations, paradoxical acute bronchospasm, cough, dizziness, headache
routes of admin and dose:
Adult - 0.25-0.5mg nebulized every 20mins max of 2 doses
Peds - 250-500mcg every 20 mins max of 3 doses (none under 2y/o)
specific interactions: given with albuterol
Ketamine (Ketalar)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: general anesthetic, PCP derivative, sedative, analgesic
actions: produces a state of anesthesia while maintaining airway reflexes, HR, and BP
indications: RSI induction, awake intubation, sedation and analgesia of intubated hypotensive or asthmatic patient, chemical restraint, moderate to severe pain (low dose) in opioid tolerant patients
contraindications: <3 months old (relative) < 6 months old, suspected ICP elevation, hypertension, tachycardia, coronary artery disease, pregnancy, psychosis
side effects: sedation, dysphoria/hallucinations, laryngospasm, increased oral secretions, emergence phenomenon, vomiting, hypertension, sinus tachycardia
routes of admin and dose:
Adult -
RSI induction: 1.5mg/kg IV
sedation (intubated): 0.5mg/kg every 10-20mins
chemical restraint: 2mg IV or 5mg/kg IM
pain: 0.1-0.3mg/kg IV slow push
procedural sedation: 1-1.5mg/kg IV or 4-5mg/kg IM
Peds -
0.5-2mg’kg IV/IO, 4-5 mg/kg IM
specific interactions: may potentiate other CNS meds
Acetazolamide
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: diuretic
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
Adult -
Peds -
specific interactions:
Acetic Acid
what is it and what is it used for
vinegar
pour it on non-United States jellyfish stings
Acetylcysteine
class:
actions:
indications:
contraindications:
side effects:
class: acetaminophen antidote
actions: binds with acetaminophen in liver
indications: acetaminophen OD
contraindications: renal failure/insufficiency
side effects: anaphylactic reactions (urticaria, flushing, rash, angioedema, nausea
/vomiting)
Activated Charcoal
class:
actions:
indications:
contraindications:
side effects:
dose:
class: antidote
actions: binds and inactivates toxins in GI tract for excretion
indications: oral poisonings and med OD’s in alert patient
contraindications: unprotected airway, intestinal obstruction, ingestion of heavy metals, acids, alcohols
side effects:
emesis, constipation, black stools, diarrhea
dose: 25-100grams PO
Amyl Nitrite
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
class: antidote for cyanide toxicity
actions: stimulates production of methemoglobin to bind to cyanide for removal
indications: suspected cyanide toxicity
contraindications: none (relative) can cause hypotension
side effects: hypotension
routes of admin and dose:
Adult - one ampule inhaled thru nebulizer
Peds - same as adult
Dobutamine
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
class: adrenergic agent, inotropic
actions: beta 1 agonist
indications: CHF, cardiogenic shock
contraindications: none (relative) tachycardia, hypotension, hypovolemia, ROSC patient
side effects: tachycardia, hypertension, hypotension, PVCs
routes of admin and dose:
Adult: 0.5-1mcg/kg/min IV/IO, maintenance dose: 2-20mcg/kg/min IV/IO
Peds - same as adults
Droperidol
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
class: antipsychotic, antiemetic
actions: dopamine antagonist
indications: chemical restraint, psychosis, excited delirium, nausea/vomiting, migraine
contraindications: (relative) prolonged QT, AMS, hypotension, seizure disorder, Parkinson’s
side effects: sedation, hypotension, Torsades de Pointes, dystonia
routes of admin and dose:
Adult -
chemical restraint: 5-10mg IM every 15mins as needed or 2.5-5mg IV every 5 mins as needed
nausea/headache: 1.25-2.5mg IV
Peds - N/A
Famotidine
class:
actions:
indications:
contraindications:
routes of admin and dose:
class: histamine H2 antagonist
actions: blocks H2 receptors of gastric parietal cells to inhibit gastric secretions
indications: management of gastric ulcers, after anaphylaxis has been stabilized
contraindications: none
routes of admin and dose:
Adult - 5mg tablet PO
Peds -
Hydralazine
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
class: antihypertensive
actions: vasodilator
indications: hypertension (esp. during pregnancy - gestational) and pre-eclampsia
contraindications: hypotension
side effects: hypotension, palpitations
dose: adult - 5mg IV, repeat after 20 mins if needed
peds: N/A
Hydrocortisone
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: corticosteroid
actions: anti-inflammatory, immunosuppressive with salt-retaining actions
indications: shock with history of adrenal insufficiency, anaphylaxis, COPD, asthma
contraindications: fungal infection
side effects: headache, vertigo, hypertension
routes of admin and dose:
Adult - 2mg/kg IV/IM (100mg max)
Peds - N/A
specific interactions: lasts 8-12hrs, increases chance of GI bleed/ulcers in combination with other NSAIDs
Hydromorphone (Dilaudid)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: opioid agonist
actions: stimulates Mu receptors
indications: moderate-severe pain
contraindications: head/abdominal injury (relative) respiratory depression, hypotension, multi-systems trauma w/ blood loss
side effects: respiratory depression, hypotension, bradycardia, nausea/vomiting, sedation
routes of admin and dose:
Adult - 0.5-1mg IV/IO slow push
Peds -
specific interactions: 8x stronger than morphine
Isopropyl Alcohol uses
antiemetic (constant sniffing to reduce nausea)
Metoclopramide (Reglan)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
class: antiemetic
actions: blocks dopamine and serotonin receptors, increases GI motility and lower esophageal sphincter tone
indications: nausea, vomiting
contraindications: prolonged QT, GI obstruction/bleed/perforation
side effects: akathisia
routes of admin and dose:
Adult - 5-10mg IV
Peds - N/A
Metoprolol
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: beta blocker, antihypertensive, anti-dysrhythmic
actions: blocks response to beta adrenergic stimulation, cardio selective for beta-1 at low doses
indications: narrow complex tachycardias, ACS, hypertension, thyroid storm
contraindications: bradycardia, hypotension, heart blocks, asthma
side effects: bradycardia, hypotension, 1/2/3rd degree heart blocks, bronchospasm
routes of admin and dose:
Adult - 5mg slow IV push every 5 mins up to 15mg max
Peds - N/A
specific interactions: Labetalol is more common
Potassium Iodide
class:
actions:
indications:
class: antidote
actions: thyroid protective agent
indications: patients receiving radiation therapy to prevent thyroid from taking up the radioactive isotopes
Prednisolone
class:
contraindications:
dose range:
class: corticosteroid
contraindications: fungal infections
does range: wider range than Prednisone
Prednisone
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: corticosteroid
actions:
indications: COPD and asthma
contraindications: fungal infections
side effects:
routes of admin and dose:
Adult -
Peds -
specific interactions:
Prochlorperazine
class:
actions:
indications:
routes of admin and dose:
specific interactions:
class: antiemetic, antipsychotic
actions: antiemetic, antidopinergic effect, blocks vagus nerve
indications: nausea, vomiting
routes of admin and dose:
Adult - 10mg IV
Peds -
specific interactions: works similary to metoclopramide and promethazine
Sildenafil (Viagra)
class:
actions:
indications:
contraindications:
specific interactions:
class: arterial pulmonary hypertension
actions: relaxes blood vessels in the lungs and decreases pulmonary BP
indications: adjunct in high altitude pulmonary edema
contraindications: cardiogenic shock, unstable angina
specific interactions: given with other organic nitrates can cause sudden hypotension
Sodium Nitrite
class:
actions:
indications:
contraindications:
side effects:
specific interactions:
class: cyanide antidote
actions: detoxifies cyanide thru generation of methemoglobin
indications: cyanide toxicity
contraindications: (relative) anemia
side effects: hypotension
specific interactions: have to give sodium thiosulfate with it
Sodium Thiosulfate
class:
actions:
indications:
side effects:
class: cyanide antidote
actions: converts cyanide into less toxic thiocyanate
indications: cyanide toxicity
specific interactions: given after sodium nitrite
Sorbitol
class:
actions:
indications:
contraindications:
side effects:
class: laxative
actions: hyperosmotic effects to get GI moving
indications: toxic ingestions
contraindications: (relative) acute abdominal pain, nausea/vomiting
side effects: cramping, diarrhea
Ziprasidone
class:
actions:
indications:
contraindications:
class: second generation antipsychotic
actions: efficacy in schizophrenia through dopamine and serotonin
indications: known schizophrenia
contraindications: prolonged QT
Tadalafil (Cialis)
class:
actions:
indications:
class: arterial pulmonary hypertension
actions: relaxation of lung blood vessels and decrease in pulmonary BP
indications: high altitude pulmonary edema
Ketorolac (Toradol)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: NSAID, analgesic, anti-inflammatory, anti-pyretic
actions: prostaglandin inhibitor
indications: moderate-severe pain, fever
contraindications: history of peptic ulcers, renal failure/insufficiency, stroke, head injury, hypovolemia, active labor and 3rd trimester pregnancy
side effects: GI irritation, bleeding, kidney injury, abdominal pain, headache, nausea/vomiting
routes of admin and dose:
Adult - 10-30mg IV/IO, 30-60mg IM every 6hrs (max120ng/24hrs)
Peds - >1yr 0.5mg/kg IV/IO, IM
specific interactions: potentiates blood thinners, ASA, and other NSAIDs, best for patients with kidney stones
Labetalol (Trandate)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: beta blockers, alpha activity
actions: nonselective beta blocker with sympathomimetic activity, also alpha blocker
indications: severe hypertension with pre-eclampsia symptoms
contraindications: asthma, severe bradycardia, 2/3rd degree heart block, cardiogenic shock (relative) calcium channel blockers
side effects: dizziness, headache, general weakness
routes of admin and dose:
Adult - 20mg IV over 2mins, may repeat twice every 10mins
Peds - N/A
specific interactions: may interact with other BP meds lowering BP too much, NSAIDs may stop it from working properly
Lidocaine (Xylocaine)
class:
actions:
indications:
contraindications:
side effects:
routes of admin and dose:
specific interactions:
class: anti-arrhythmic (class 1)
actions: blocks sodium channels to increase refractory period
indications: cardiac arrest from VF and VT, stable monomorphic VT, local anesthetic for IO
contraindications: AV blocks, bleeding, thrombocytopenia (relative) bradycardia, hypovolemia, cardiogenic shock, reduce dose for liver disease and elderly
side effects: bradycardia, seizures, hypotension, toxicity, arrhythmias, cardiac arrest
routes of admin and dose:
Adult -
pulseless VF and VT: 1-1.5mg/kg IV/IO slow push over 2mins, 0.5-0.75mg/kg every 5-10 mins to max dose of 3mg/kg, 1-4mg/min IV/IO infusion post conversion
Peds -
specific interactions: potentiation with cardiac depression with phenytoin
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Adult -
Peds -
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Adult -
Peds -
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Adult -
Peds -
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Adult -
Peds -
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Adult -
Peds -
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Adult -
Peds -
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Adult -
Peds -
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Adult -
Peds -
specific interactions:
