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Arizona Drug Profile (revised 3/27/2015) > Dosage > Flashcards

Dosage Flashcards

1
Q

ABIXIMAB

dosage

A

Adult Dosage: Based on the EPILOG (NEJM. 1997; 336: 1689) and CAPTURE (Lancet. 1997; 349: 1429) studies:

Loading Dose: 0.25mg/kg IV over 5 minutes slow IV push

Infusion: 0.125mcg/kg/min (0.09mg/kg) if patient less than 80kg
10mcg/min (7.2mg) if patient equal to or greater than 80kg
in 250ml D5W or NS at 21ml/hr for 12 hours

Pediatric Dosage: Safety and efficacy in children have not been established.

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2
Q

ACETYLSALICYLIC ACID, ASPIRIN, ASA

dosage

A

Adult Dosage:
- Cardiac: 160- 325 mg (2-4 pediatric chewable tabs), chew or swallow
- Pain/discomfort/fever: 325 mg po (4 pediatric chewable tablets), chew or swallow

Pediatric Dosage:
Not recommended for prehospital use in children

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3
Q

ACETYLSALICYLIC ACID, ASPIRIN, ASA (EMT Administration)

dosage

A

Adult Dosage:
Cardiac: 160-325 mg (2-4 81 mg tabs), chew or swallow

Pediatric Dosage:
Not recommended for prehospital use in children

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4
Q

ADENOSINE

dosage

A

Adult Dosage:
- Initial: 6 mg rapid IV bolus over 1-3 seconds
- Special administration procedure: Follow immediately with 20 ml normal saline flush.
IV site recommended is antecubital fossa (close to central circulation); use injection port
nearest hub of IV catheter; arm elevated during procedure; constant ECG monitoring.
- Repeat: If no response in 1-2 minutes (of each dose, respectively) may repeat 12 mg
utilizing the same procedure for the repeat dose.

Pediatric Dosage: (Drug of choice for treating SVT in symptomatic infants and children)
- Initial: 0.1 mg/kg as a rapid IV bolus.
- Special administration procedure: Follow immediately with 2-3 ml normal saline flush.
Use injection port nearest the hub of IV catheter for procedure; constant ECG monitoring.
- Repeat: If no response, dose may be doubled 1 time (0.2 mg/kg) using same
administration procedure.
- Maximum single dose: Should not exceed 12 mg.
- Infants with SVT associated with shock: Adenosine may precede cardioversion if vascular access is available, but cardioversion should not be delayed while IV access is achieved.

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5
Q

ALBUMIN, normal serum 5% / 25%

dosage

A

Dosage:
Adult: IV 500 ml of 5% sol Q30 min, as needed
Child: 1⁄4 - 1⁄2 adult dose in non-emergencies

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6
Q

ALUTEROL SULFATE

dosage

A

Adult Dosage:
Give 2.5 mg of premixed solution for inhalation (0.083%) via SVN with a mouth piece, or in-line with a ventilatory device. Repeated according to medical control preference.

Pediatric Dosage: (children <40 lbs)
Give 2.5 mg of premixed solution for inhalation (0.083%) via SVN with a mouth piece, mask, or in-line with a ventilatory device. Repeated according to medical control preference.
May administer up to 5mg per dose according to medical control preference.

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7
Q

AMIODARONE

dosage

A

Adult Dosage:

VF/Pulseless VT:
300 mg IV push over 30 – 60 seconds, may repeat in 3-5 minutes with 150 mg IV push

Wide-Complex Tachycardias, Atrial Flutter, Atrial Fibrillation, SVT with cardioversion:
150 mg IV over 10 minutes (mix in 50 mL bag of D5W) may repeat every 10 minutes

Maintenance Infusion Post Resuscitation/Conversion:
After successful defibrillation, follow with up to 1mg/min IV infusion for 6 hours, then up to 0.5 mg/min IV infusion for up to 18 hours, maximum daily dose is 2.2 grams
Mix 450 mg in 250 mL of D5W (special polyolefin bag), concentration 1.8 mg/mL, and run at 33.3 mL/hr for 1 mg/min or 16.7 mL/hr for 0.5 mg/min

For Other Maintenance infusion:
Rates range from 0.5 mg/min to 1mg/min. Maximum daily dose is 2.2 grams

Pediatric Dosage:

VF/Pulseless VT:
5 mg/kg IV push (max 300 mg single dose), may repeat every 5 minutes two times to a total maximum of 15 mg/kg/day

Probable VT with pulse:
5 mg/kg IV administered over 20 minutes may repeat two more times to a total of 15 mg/kg/day

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8
Q

ATROPINE SULFATE

dosage

A

Adult Dosage:
Special instructions

  • IV/IO – administer undiluted by rapid IV injection; slow injection may result in paradoxical bradycardia. Doses < 0.5 mg may increase vagal tone resulting in paradoxical bradycardia.
  • IM – AtroPen should be administered to outer thigh. May be given through clothing as long as pockets at injection site are clear. Hold autoinjector in place for 10 seconds following injection; massage injection site.

Symptomatic Bradycardia:
- IV/IO – 0.5 mg every 5 minutes. Do NOT exceed a total dose of 3 mg or 0.04mg/kg if symptoms profound.
- Consider atropine before pacing in mildly symptomatic patients, but do not delay
pacing in unstable patients, particularly those with high-degree AV block
- Do not rely on atropine in Mobitz type II second or third-degree AV block or in
patients with third-degree AV block with a new wide QRS complex. Hemodynamically unstable and clinically deteriorating patients require immediate pacing.

Organophosphate or carbamate poisoning:
- IV/IO – Initially: 1-5 mg. Doses should be doubled every 5 minutes until signs of
muscarinic excess abate (clearing of bronchial secretions, bronchospasm, and adequate
oxygenation)
- IV infusion – 0.5-1 mg/hour or 10-20% of loading dose/hour
- IM – (AtroPen) mild symptoms: Administer 2 mg as soon as exposure is known or
suspected. If severe symptoms develop after first dose, 2 additional doses should be repeated in 10 minutes, not to exceed more than 3 doses. Severe symptoms: Immediately administer three 2 mg doses.

Pediatric Dosage:

Symptomatic Bradycardia:
- IV/IO – 0.02 mg/kg (minimum of 0.1 mg), may repeat at 5 minute intervals to a
maximum total dose of 1 mg in children and 2 mg in adolescents
- Maximum single doses: Child 0.5 mg; Adolescent 1 mg.
For bradycardia in neonates, reserve use for those unresponsive to improved oxygenation and epinephrine.

Organophosphate or carbamate cholinergic poisoning:
- IV/IO – 0.03-0.05 mg/kg every 10 to 20 minutes until cholinergic symptoms minimize,
then every 1 to 4 hours for at least 24 hours
- IM – Administer dose as listed below as soon as exposure is known or suspected. If
sever symptoms develop after first dose, 2 additional doses should be repeated in 10 minutes.

Do not administer more than 3 doses. For severe symptoms, immediately administer 3 doses as follows:
- < 6.8 kg (15 lbs): not recommended, administer atropine 0.05 mg/kg o 6.8-18 kg (15-40 lbs): 0.5 mg/dose
- 18-41 kg (40-90 lbs): 1mg/dose
- 41 kg (> 90 lbs): 2mg/dose

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9
Q

BUMETANIDE

dosage

A

Adult Dosage:
0.5 to 1.0 mg IV slowly over 1 to 2 minutes, or IM

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10
Q

CALCIUM CHLORIDE

dosage

A

Adult Dosage:
Hypocalcemia, calcium channel blocker OD, hyperkalemia and hypermagnesemia:
5-10 ml (0.5-1 Gm) of 10% calcium chloride. May repeat in 10 minutes.
Pre-treatment for IV calcium channel blocker administration: 3 ml of 10% calcium chloride. May be repeated once.

Pediatric Dosage:
Hypocalcemia, calcium channel blocker OD hyperkalemia and hypermagnesemia:
0.2 - 0.25 ml/kg of a 10% solution infused slowly. Should not be repeated without documented calcium deficiency.

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11
Q

CALCIUM GLUCONATE GEL, 2.5%

dosage

A

Dosage: Adult and Pediatric
If hydrofluoric acid contacts the body, it is highly recommended to wash/flush the area with tepid water for at least 3 minutes to remove HF surface residue.
Apply calcium gluconate gel freely to the affected areas and continuously massage into the skin. May reapply gel every 15 minutes until arrival at hospital.

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12
Q

CHARCOAL, ACTIVATED (without sorbitol)

dosage

A

Adult Dosage:
30-60 Gm (1-2 Gm/kg); if not in pre-mixed slurry, mix one part charcoal with four parts water.

Pediatric Dosage:
0.5 -1.0 Gm/kg; if not in pre-mixed slurry, mix one part charcoal with four parts water.

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13
Q

CIMETIDINE

dosage

A

Adult Dosage:
- Pathologic hypersecretory conditions: 300mg in 50 mL normal saline infuse over 30 minutes
- Prevention of upper GI bleeding: 50 mg/hour continuous infusion

Pediatric Dosage:
Can be utilized in children 16 years or older

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14
Q

DEXAMETHASONE SODIUM PHOSPHATE

dosage

A

Adult Dosage:
Reactive Airway Disease, Anaphylaxis: 8-24 mg
Cerebral Edema: 1-5 mg/kg

Pediatric Dosage:
Reactive Airway Disease, Anaphylaxis: 0.25-0.5 mg/kg
Cerebral Edema: 0.5-1.5 mg/kg

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15
Q

DEXTROSE 50%

dosage

A

Adult Dosage:
Hypoglycemia, altered level of consciousness or seizures of unknown etiology: 25- 100 ml of D50 (12.5-50 Gm, 1/2 to 2 amps) IV.

Hyperkalemia: 50 Gm of Dextrose IV administered in conjunction with calcium chloride and sodium bicarbonate. Insulin may be given upon arrival to ED.

Pediatric Dosage: (14 yrs and below includes infant)
- Administer 0.5 - 1 Gm/kg of a dextrose 10% solution; recommended to give slowly over a 20 minute period.
- Dilute D50 (dextrose 50% containing 25 Gm of dextrose) to a 1:4 solution. To prepare, obtain a 250 ml container of normal saline for IV use; waste 50 ml and add 50 ml of dextrose 50%. The resulting solution is dextrose 10% in normal saline or 10 grams/100ml.

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16
Q

DIAZEPAM

dosage

A

Adult Dosage:
2 mg increments slow IV push. Administer no faster than 2 mg/minute.

Pediatric Dosage:
IV Dose: 0.2-0.3 mg/kg every 15-30 minutes (max. of 1.0 mg/kg); administer IV over at least 3 minutes or until seizure activity subsides.

IV Dose after rectal dose: 0.1 mg/kg with same administration instructions.
Rectal dose (less than or equal to 6 years): 0.3-0.5 mg/kg rectally at IV push rate; may repeat in 15-30 min at 0.25 mg/kg.

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17
Q

DILTIAZEM

dosage

A

Adult Dosage:
Initial: 0.25 mg/kg IVP (usually 20 mg) administered over 2 minutes
If response is inadequate, repeat in 15 minutes: 0.35 mg/kg IVP administered over 2 mins Maintenance infusion:5.0 to 15 mg/hr

Pediatric Dosage:
The safety and efficacy of this drug for use in children has not been established.

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18
Q

DIPHENHYDRAMINE HCL

dosage

A

Adult Dosage:
Anaphylaxis: 25-50 mg slow IV push or deep IM.
Extrapyramidal symptoms and antiemetic: 10-50 mg IV or deep IM, dose should be individualized according to the needs and patient response.

Pediatric Dosage:
1.0 -1.25 mg/kg slow IV push May also be given deep IM

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19
Q

DOPAMINE

dosage

A

Adult Dosage: (dosage range 2-20 mcg/kg/min)
Preparation: (If premixed not carried) Add 400 mg/ 250 ml NS or Dextrose = 1600 mcg/ml.
Bradycardia: Start at 5 mcg/kg/min
Shock: cardiogenic or septic (non-hypovolemic)
BP < 70 systolic: Start drip at 5 mcg/kg/min
BP > 70 systolic: Start drip at 2.5 mcg/kg/min

Pediatric Dosage:
2-20 mcg/kg/min for circulatory shock or shock unresponsive to fluid administration. To prepare infusion for small children: 6 x body wt. in kg = mg added to NS to make 100 ml. With this mixture 1 ml/hr delivers 1 mc/kg/min; titrate to effect.

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20
Q

EPINEPHRINE AUTO-INJECTOR

dosage

A

Adult Dosage:
Intramuscular: 0.3 mg (one adult auto-injector)

Pediatric Dosage:
Intramuscular: 0.15 mg (one pediatric auto-injector), for patients less than or equal to 30 kg (66 lbs) body weight
Intramuscular: 0.3 mg (one adult auto-injector) for patients >30 kg (66 lbs) body weight

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21
Q

EPINEPHRINE HCL

dosage

A

Adult Dosage:
Pulseless Arrest –
IV/IO: 1 mg of 1:10,000 solution repeat every 3 - 5 minutes or,
ET: Give 2 - 2.5 mg via the ET tube.
May use 1:10,000 or dilute 1:1000 to equal 10 mL via ET tube for adult. (i.e., 2 mg of 1:1,000 epinephrine diluted with 8 mL NS in a 10 mL syringe)
Continuous Infusion for Hypotension or Symptomatic Bradycardia: 1 mg added to 500 mL of NS administered at 1 mcg/min titrated to desired hemodynamic response (range 2-10 mcg/min); not first-line therapy.
Anaphylaxis and asthma: Give 0.3 - 0.5 mg of 1:1,000 solution IM (preferred), SC, or inject SL, may repeat every 15 to 20 minutes; or in extreme cases only, may be asked to use 1:10,000 solution and give 0.1 mg every 5 minutes IV/IO or continuous IV/IO infusion of 1 - 4 mcg/min to prevent need for multiple injections.

Pediatric Dosage:
Pulseless Arrest or Refractory Bradycardia:
IV/IO: 0.01 mg/kg of 1:10,000 repeat every 3 - 5 minutes, maximum single dose 1 mg.
ET: 0.1 mg/kg of 1:1,000; diluted with NS to a volume of 3 - 5 mL prior to instillation or followed with flush of 3 - 5 mL of NS after instillation repeat every 3 - 5 minutes, maximum single dose 10 mg.
Asthma/anaphylaxis: Use 1:1,000 solution; give 0.01 mg/kg IM (preferred), SC (maximum single dose of 0.5 mg/dose).
IV Infusion: 0.1 – 1 mcg/kg/min; to prepare for small children 0. 6 x body wt. in kg = mg added to NS to make 100 mL. With this mixture, 1 mL/hr delivers 0.1 mcg/kg/min.
Croup: 3 mg 1:1,000 mixed in 3 mL NS via SVN.

Neonatal Dose for First 12 hours of life:
IV/IO Initial and Repeat Dose for Cardiac Arrest or Refractory Bradycardia: 0.01- 0.03 mg/kg of 1:10,000 every 3-5 minutes
ET: 0.1 mg/kg of 1:10,000 every 3 – 5 minutes if neonate has no vascular access, fails to respond to positive pressure ventilation with 100% O2.

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22
Q

EPTIFIBATIDE

dosage

A

Adult Dosage:
Acute Coronary Syndrome: Standard Orders based on the PURSUIT trial: (N Engl J Med. May 21, 1998; 339: 436-43.)
Loading Dose: 180mcg/kg
Infusion: 2.0mcg/kg/minute for 72 hours, until discharge or if angioplasty or CABG
procedure then 20 to 24 hours post procedure (total 96 hours).
Percutaneous Coronary Intervention in patients not presenting with an acute coronary syndrome: Standard Orders based on the IMPACT-II trial: (Lancet. 1997; 349-28)
Loading Dose:135mcg/kg immediately prior to PTCA
Infusion: 0.5mcg/kg/minute, following loading dose and continued for 20-24 hours.

Pediatric Dosage:
Safety and efficacy in children have not been established.

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23
Q

ETOMIDATE

dosage

A

Adult Dosage:
0.3 mg/kg IV over 30-60 seconds

24
Q

FAMOTIDINE

dosage

A

Adult Dosage:
20mg in 50 mL normal saline IV every 12 hours infuse over 15-30 minutes

Pediatric Dosage:
Safety and efficacy of IV infusion of drug have not been established.

25
Q

FENTANYL CITRATE

dosage

A 
Adult Dosage:
IV/IO Dose: Administer 25-50 mcg (0.5 – 1.0 mL of 50mcg/mL concentration) increments slow IV push (over 1-5 minutes) until desired effect. Consider the lower dose in the elderly, debilitated, or those with chronic lung disease. Onset of analgesic action almost immediate, duration of analgesic action 30-60 minutes.
IM Dose: Same as IV/IO dose. Onset of analgesic action seven to eight minutes, duration of analgesic action one to two hours.
IN Dose: 25-50 mcg
Total Dose: Not to exceed 200 mcg
(Note: Duration of respiratory depressant effect of fentanyl may be longer than analgesic effect.)

Pediatric Dosage (12 months ≤ 17 years):
IV/IO Dose: 1-2 mcg/kg (0.02-0.04 mL/kg of 50mcg/mL concentration) slow IV/IO push.
IM Dose: Same as IV/IO dose.
IN Dose: 1-2mcg/kg
Total Dose: Not to exceed 50 mcg, Q1hr prn
(Note: Patch for on-line medical direction if Fentanyl citrate use is considered in children <2 or if additional doses are needed.)
26
Q

FUROSEMIDE

dosage

A

Adult Dosage:
On oral furosemide therapy: Consider initial dose of 2 times daily oral dose, if no effect in 20 minutes may double initial dose.
Not on oral furosemide therapy: 0.5-1 mg/kg to a maximum of 2 mg/kg (usually 20-40 mg) IV slowly.

Pediatric Dosage:
1 mg/kg IV slowly

27
Q

GLUCAGON

dosage

A

Adult Dosage: (children and adults greater than 20 kg or 44 lbs)
Hypoglycemia: 1 mg IM, may repeat in 7-10 minutes

Pediatric Dosage: (for children under 20 kg or 44 lbs)
Hypoglycemia: 0.5 mg IM or a dose equivalent to 20-30 μg/kg, may repeat in 7-10 minutes

28
Q

HEMOSTATIC AGENTS

dosage

A

Adult/Pediatric Dosage:
Quantity necessary to fully cover bleeding area

29
Q

HYDROXOCOBALAMIN

dosage

A

Adult Dosage:
5 grams, administered as IV infusion over 15 minutes. Depending upon the severity of the poisoning, a second dose of 5 g may be administered, over 15 minutes to 2 hours, depending on clinical response.

Pediatric Dosage:
Safety and effectiveness have not been established in this population. A dose of 70 mg/kg has been used to treat pediatric patients.

30
Q

INSULIN

dosage

A

Dosage:
Adults and children: Continuous infusion of 0.1 unit/kg/hour until glucose level drops to 250 mg/dl or lower.

31
Q

IPRATROPIUM BROMIDE

dosage

A

Adult Dosage:
Give 500 mcg in 2.5 ml normal saline (1 unit dose vial) via SVN with a mouth piece or in-line with a ventilatory device. Repeat according to medical control preference. May mix one unit dose vial of ipratropium with one unit dose vial of albuterol.

Pediatric Dosage:
Give 500 mcg in 2.5 ml normal saline (1 unit dose vial) via SVN with a mouth piece or in-line with a ventilatory device. Do not repeat.

32
Q

KETAMINE HYDROCHLORIC INJECTION

dosage

A

Adult Dosage (15 years and older):
IV/IO 0.5-2 mg/kg over 1 minute. Half-life 5-10 minutes.
IM 2-4 mg/kg. Half-life 12-25 minutes.

Pediatric Dosage:
Not currently recommended for field use in patients less than 15 years old

33
Q

LIDOCAINE HCL

dosage

A

Adult Dosage:
Pulseless VF/VT: Initial bolus of 1.0-1.5 mg/kg IV PUSH every 3-5 minutes to a total of 3 mg/kg. An initial bolus of 1.5 mg/kg should be given for cardiac arrest situations. Following the return of a spontaneous rhythm, initiate a drip at 2-4 mg/min. See: Maintenance Infusion below.

Antidysrhythmic or rhythms with a pulse: Initial boluses can be given as 0.5-0.75 mg/kg, up to 1.0-1.5 mg/kg, IV PUSH and additional boluses can be given as 0.5-0.75 mg/kg every 5-10 minutes to a total dose of 3 mg/kg. Following the return of a spontaneous rhythm, initiate a drip at 2-4 mg/min; see below.

Maintenance Infusion: Started after return of spontaneous rhythm for either indication above. Add 1 gm - 2 gms to a 250 ml NS or 5 % dextrose solution or use premixed solution (2 gm in 500 ml) and initiate a drip at 2-4 mg/min according to concentration. Patients > 70 years or with hepatic, renal disease or poor perfusion state, reduce maintenance infusion by half.
IO pain management 20-40 mg, very slow IO push.

Pediatric Dosage:
Initial Bolus doses: 1 mg/kg, may repeat 1 time in 3-5 minutes for VF/Pulseless VT or in 15 minutes if used for refractory dysrhythmias with a pulse (VT with pulse, significant ventricular ectopy).
Infusion with return of spontaneous rhythm, optional: 20-50 mcg/kg/min; prepared by adding 120 mg (3mL) of 1 Gm/25 ml (40 mg/ml) solution to 97 ml of NS, yielding 1200 mcg/ml.
1 ml/kg/hr delivers 20 mcg/kg/min. 2.5 ml/kg/hr delivers 50 mcg/kg/min. Reduce to less than or greater to 20 mcg/kg/min for children with low cardiac output, severe CHF or compromised hepatic blood flow. Infusion should be avoided unless infusion pump available.

IO pain management, 0.1 mg/kg, not to exceed adult dosage.

34
Q

LORAZEPAM

dosage

A

Adult Dosage:
Status epilepticus: 2mg to 5mg IV/IO given slowly (over 2-5 minutes) May repeat dose in 10-15 minutes if needed (maximum 10mg). May give IM if no IV/IO access.

Pediatric Dosage:
Status epilepticus: 0.05-0.1 mg/kg IV/IO over 2-5 minutes (maximum 4mg). May repeat in 10-15 minutes.

35
Q

MAGNESIUM SULFATE

dosage

A

Adult Dosage:
Cardiac:
- Torsade de pointes: 1-2 Gm IV diluted in 50-100 ml NS or D5W administered over 1-2
minutes, followed by the same amount infused over 1 hour.
- Hypomagnesemia: Dilute 1-2 Gm in 50-100 ml NS or D5W administered IV push over
5-60 minutes.
- Respiratory/Severe Asthma: Initial Infusion (field) 2 Gm Magnesium Sulfate mixed in
50 ml NS or D5W to be infused IV using microdrip tubing over 5 to 10 minutes. Stop infusion if hypotension, respiratory depression or bradycardia develop.

Pregnancy:
Pre-term labor (PTL): Initial bolus (Field and Interfacility): 4-6 Gm over 15-20 minutes (Suggested method is the addition of 4 Gm to 100 ml D5W, LR or NS. Resultant concentration is 40 mg/ml.) Maintenance Infusion (Interfacility only): 1-4 Gm/hour infusion rate. (Suggested method for treatment of premature labor is to follow initial bolus with infusion of 2 Gm/hr which may be continued until uterine contractions are reduced to < 1 every 10 minutes. Then, infusion is decreased to 1 Gm/hr and continued for 24-72 hrs. One method for mixing infusion is the addition of 40 Gm to 1000 ml LR. Resultant concentration equals 40 mg/ml. If this concentration is run at 50 ml/hr, Magnesium Sulfate delivered equals 2 Gm/hr).

Pregnancy induced hypertension, pre-eclampsia/eclampsia, (PIH): Initial bolus (Field and Interfacility): 3-6 Gm over 10-15 minutes (Suggested method is the addition of 4 Gm to 100 ml D5W, LR or NS. Resultant concentration is 40 mg/ml). Maintenance Infusion (Interfacility only): Follow bolus with 1-3 Gm/hour infusion rate. (Same mixture as for PTL). Rebolus: In an eclamptic emergency may rebolus with Magnesium Sulfate, 2-4 Gm depending on patient size (mixed as an initial bolus) over 10-15 minutes if respirations >12/minute and urine output >30 ml/hr.

36
Q

METHYLPREDNISOLONE SODIUM SUCCINATE

dosage

A

Adult Dosage:
Reactive Airway Disease, Anaphylaxis, Burns Potentially Involving the Airway
Usual dose 125 mg slow IV bolus (much larger doses can be used).

Pediatric Dosage:
Reactive Airway Disease, Anaphylaxis, Burns Potentially Involving the Airway
2-4 mg/kg slow IV bolus

37
Q

MIDAZOLAM HYDROCHLORIDE

dosage

A

Adult Dosage:
Patients 14 to 60 years of age:
- 2 to 5 mg IM
- 1 to 10 mg IV/IO, titrate to effect, administer slowly in small increments of no
more than 2.5 mg over at least 2 minutes.

Patients over 60 years of age:
- 1 to 5 mg IM
- 1 to 3.5 mg IV/IO, titrate to effect, administer slowly in small increments of no
more than 1.5 mg over at least 2 minutes.

Total dose:
Should not exceed 20 mg

For emergency intubation:
0.1 mg/kg up to 0.3 mg/kg with dosage limit of 20 mg. 0.2 mg/kg IM/0.3mg/kg IN if no IV/IO access

Pediatric Dosage:
Pediatric patients:
0.05 to 0.1 mg/kg slow IV/IO push
0.2 mg/kg IM/IN if no IV/IO access

IN dose divided equally in each nostril.

38
Q

MORPHINE SULFATE

dosage

A

Adult Dosage:
IV Dose: Administer 1-3 mg increments slow IV PUSH (over 1-5 minutes) until desired effect.

Pediatric Dosage: 0.1-0.2 mg/kg slow IV push

39
Q

NALMEFENE HCL

dosage

A

Adult Dosage:
IV, IM, and SC: 0.5 mg to a maximum of 1.5 mg (or 1.5 mg/70 kg) Initial dose 0.5 mg/70 kg; then 1 mg/70 kg 2-5 minutes later if needed

Pediatric Dosage:
Safety and effectiveness of nalmefene HCl in pediatrics and neonates have not been established.

40
Q

NALOXONE HCL

dosage

A

Adult Dosage:
IV/IO, IM, inject SL, SC, ET: 2.0 mg initial bolus IV or ET, may repeat every 2 minutes as necessary; titrate to effect.

Intra-nasal: 1.0 mg each nostril using a Mucosal Atomizer Device for a total of 2 mg. May repeat every 2 minutes as necessary. Titrate to effect.

Continuous IV Infusion: 2/3 of the initial bolus/hr (bolus that it took to reverse) administered as a continuous infusion; i.e., if 2 mg Narcan resulted in opioid reversal initially, then it can be maintained by continuous infusion of 1.4 mg/hr. Put 1.4 mg Narcan in 250 ml NS and run at 250 ml/hr. A repeat IV bolus of 2 the initial bolus administered 15 minutes after the initial bolus is recommended.

Pediatric Dosage:
Less than or equal to 5 years or < 20 kg: 0.1 mg/kg IV, ET, inject SL, SC, IO, IN (includes neonate)
Greater than or equal to 5 years or > 20 kg: 2 mg IV, ET, inject SL, SC or IO, IN

41
Q

NITROGLYCERIN

dosage

A

Adult Dosage:
SL for Chest pain: 1/150 gr (0.4 mg) tablet or one full spray, may repeat x 3
SL for Pulmonary edema: 1-2 of the 1/150 gr (0.4 mg) tablets may be given SL every 5-10 minutes as long as the systolic BP is greater 90-100 systolic
IV infusion during interfacility transport must be given via infusion pump: Start at low range of 5 μg/min and increase in increments of 5 μg, monitoring pain and blood pressure until desired hemodynamic or clinical response is achieved (fall in SVR, relief of chest pain); most patients respond to 50-200 μg/min

Pediatric
Not used

42
Q

NOREPINEPHRINE

dosage

A

Adult Dosages:
Initial dose: 2 to 4 mcg/min
Maintenance dose: Adjust the rate for a low normal blood pressure (usually 80 to 100 mm Hg systolic). The average maintenance dose ranges from 1 to12 mcg/min (maximum dose 30 mcg/min).

Pediatric Dosages:
0.1 – 2 mcg/kg/min; 2 mcg/kg/min max

43
Q

ONDANSETRON

dosage

A

Adult Dosage:
4 – 8 mg IV slow push over 2 – 5 minutes 8 mg PO ODT or tablet

Pediatric Dosage: (1 month to 12 years old)
Greater than 40 kg- 4 mg IV slow push over 2 – 5 minutes
Less than 40 kg- 0.1 mg/kg IV slow push over 2 – 5 minutes
4-12 years old 4 mg PO ODT or ODT

44
Q

OXYTOCIN

dosage

A

Adult Dosage:
Postpartum hemorrhage: 10-20 USP units added to 1000 mL NS or LR and run at a rate necessary to control uterine atony or 10 USP units may be given IM after delivery of placenta.

Pediatric Dosage:
Not applicable

45
Q

PHENYLEPHRINE NASAL SPRAY 0.5%

dosage

A

Adult Dosage:
2-4 sprays in each nostril before attempting tube insertion

Pediatric Dosage:
None

46
Q

PROPARACAINE HYDROCHLORIDE OPTHALMIC

dosage

A

Dosage: Adult and Pediatric
Administer 1 or 2 drops 1-2 minutes before irrigation. May repeat every 5-10 minutes for 5 doses.

47
Q

PROPOFOL

dosage

A

Adult Dosages:
ICU Sedation: Initial: 5 mcg/kg/min IV for at least 5 min, then increased by increments of 5-10 mcg/kg/min IV over 5-10 min until desired clinical effect. Maint: 5-50 mcg/kg/min IV or higher may be required. Max: 4000 mcg/kg/hr.

Pediatric Dosages:
Safety and efficacy has not been well established for continuous sedation.

48
Q

RACEMIC EPINEPHRINE

dosage

A

Adult Dosage/Pediatric Dosage:
0.5 mL (2.25%) in 2.5 to 4.5 mL normal saline via nebulizer

49
Q

RANITIDINE

dosage

A

Adult Dosage:
50 mg in 50-100 mL normal saline infuse over 15-20 minutes every 6-8 hours.

Pediatric Dosage:
Safety and efficacy of IV infusion of drug have not been established.

50
Q

SODIUM BICARBONATE 8.4%

dosage

A

Adult Dosage:
Pre-existing Metabolic Acidosis or Alkalinization of Blood: 50-100 mEq IV per medical control authority.

Infusion: 50 mEq of sodium bicarbonate/250 ml of NS or as determined by medical control.

Cardiac arrest: First dose usually 1 mEq/kg (or as determined by blood gas analysis), with subsequent doses of 0.5 mEq/kg every 10 minutes in cardiac arrest after other standard treatment (defibrillation, CPR, intubation, ventilation and more than one trial of epinephrine) has been used.

Pediatric Dosage:
1 mEq/kg IV or IO slowly, if ventilation is adequate according to medical control authority. Can contribute to acidosis and cause fluid overload.

Neonatal Dosage:
1 mEq/kg IV or IO of 4.2% slowly. Waste 25 ml of 8.4% solution and add 25 ml of NS from IV bag, each ml will contain 0.5 mEq of sodium bicarbonate

51
Q

SUCCINYLCHOLINE

dosage

A

Adult Dosage:
0.6-2 mg/kg IV push, may repeat once in 2-3 minutes if inadequate response to initial dose to achieve paralysis. If additional dosing is needed, contact medical direction.

Pediatric Dosage:
1-2 mg/kg IV push, may repeat once in 2-3 minutes if inadequate response to initial dose to achieve paralysis. If additional dosing is needed, contact medical direction

52
Q 
THIAMINE HCL (VITAMIN B1)
dosage
A

Adult Dosage:
100 mg

Pediatric Dosage:
Rarely used

53
Q

TIROFIBAN

dosage

A

Adult Dosage:
Loading Dose: 0.4mcg/kg/min for 30 minutes
Infusion: 0.1mcg/kg/min, for a minimum of 48 hours and 12 to 24 hours post
angioplasty.
Standard Solution: 50mcg/ml NS or D5W 500ml

Pediatric Dosage:
Safety and efficacy in children have not been established.

54
Q

VASOPRESSIN

dosage

A

Adult Dosage:
For ventricular fibrillation/pulseless ventricular tachycardia: 40 U one time-may replace the FIRST or SECOND dose of epinephrine.

Pediatric Dosage:
The efficacy of this drug for use in children has not been established

55
Q

VERAPAMIL HCL

dosage

A

Adult Dosage:
2.5 - 5 mg slow IV push over 2-3 minutes. May rebolus in 15-30 minutes with 5-10 mg IV push until a maximum dose of 30 mg

Pediatric Dosage:
IV form not used in children in the field

Arizona Drug Profile (revised 3/27/2015) (8 decks)

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