Dosages Flashcards
1
Q
Warfarin
in DVT/PE
A
0.5-6 mg PO daily
INR has to be 2-3
2
Q
Heparin (UFH) IV
in ACS
A
IV Bolus: 60-70 IU/Kg (Max 5,000 IU)
Then 12-15 IU/Kg/h Infusion,
aPTT Q6H (x1.5-2.5)
3
Q
Heparin (UFH) IV
in DVT/PE (Tx)
A
IV Bolus: 80 IU/Kg
Then 18 IU/Kg/h Infusion,
aPTT Q6H, x (1.5-2.5)
4
Q
Heparin (UFH)
in DVT/PE (Prophylaxis)
A
SC 5,000 IU Q12H or Q8H
5
Q
Enoxaparin
in ACS
A
SC 1 mg/kg BID (Max 100 mg BID)
If age>75y then 0.75 mg/kg BID
6
Q
Enoxaparin
in DVT/PE (Tx)
A
SC 1 mg/kg BID
Or 1.5 mg/kg Q24H
7
Q
Enoxaparin
in DVT/PE (Prophylaxis)
A
SC 30-40 mg Q24H
8
Q
Clopidogrel (Plavix)
in ACS
A
Loading dose 300-600 mg
Maintenance 75-150 mg/day
9
Q
ASA
in ACS vs Stroke
A
ACS: 160-325 mg
Stroke: 160 mg
10
Q
Prasugrel
in ACS
A
Loading dose 60 mg
Then 10 mg/day
11
Q
Metoprolol IV
in ACS
A
IV 5 mg over 1-2 min Repeat Q5min,
PO can be started 15 min after IV
12
Q
Metoprolol PO
in ACS
A
PO Initial 25-50 mg QID
Target 100 mg BID
13
Q
Carvedilol
in CHF
A
Initial 3.125 mg BID
Target 25 mg BID
14
Q
Labetalol in HTN
A
Initial 50 mg BID
Usual 200 mg BID
(Alpha1+Beta1 blocker)
15
Q
Atenolol
A
Initial 25-50 mg/day
Target 100 mg/day
Do not use in Pregnancy
16
Q
Nitroglycerin SL
in ACS
A
SL 0.3-0.6 mg PRN Q5min
17
Q
Nitroglycerin Spray
in ACS
A
SL 0.4 mg PRN Q5min
18
Q
Verapamil
in ACS
A
Initial 80 mg
Max 160 mg TID
(If IR form: TID, If SR form: BID)
19
Q
Amlodipine
A
Initial 2.5 mg/day
Max 10 mg/day Once daily
20
Q
Nifedipine XL
in HTN or Raynaud’s
A
Initial 30 mg/day
Usual 60 mg/day
Raynaud’s 30 mg/day
21
Q
Enalapril
in ACS, CHF, HTN
A
Initial 2.5 mg BID
Target 10-20 mg BID
22
Q
Losartan
A
Initial 50 mg/day
Target 100-150 mg/day
23
Q
Furosemide PO and IV
A
PO: Initial 20-80 mg SD If needed: increase by 20-40 mg Q6-8H
IV: 20-40 mg Single injection If needed: may repeat Q2H
24
Q
Hydrochlorothiazide
A
Initial 12.5-25 mg/day
Usual 25-100 mg/day
25
Spironolactone
in CHF
Initial 12.5 mg/day
Target 25-50 mg/day
26
Atorvastatin
10-80 mg/day At any time of the day
27
Gemfibrozil
300-1200 mg/day Divided BID 30 min prior to meals
28
Glyburide
PO 2.5-20 mg/day
If \>10 mg, then divide in 2 doses
29
Metformin (Glucophage)
500-1500 or 2500 mg/day Divided BID or TID
30
Calcium Gluconate
in Hyperkalemia (ER)
IV 10 ml of a 10% Solution Over 2-5 min
31
Ferrous Sulfate
in IDA
120 mg/day (105-200 mg/day) elemental iron In 3 divided doses 60 mg elemental iron/ 300 mg Ferrous Sulfate
32
Asthma Acute Exacerbation
Salbutamol + Ipratropium bromide dosage
pMDI 4-8 puffs Q15-20 min x3 (Both)
33
Asthma Acute Exacerbation
Oral Prednisone dosage
40-60 mg PO
34
Asthma Acute Exacerbation
IV Corticosteroids dosage
Methylprednisolone 60-80 mg IV
Or Hydrocortisone 200 mg IV
35
Asthma Acute Exacerbation in Children
Prednisone Oral dosage
1-2 mg/kg PO
36
Asthma Acute Exacerbation in Children
IV Corticosteroid dosage
Methylprednisolone 2 mg/kg IV Or Hydrocortisone 5-8 mg/kg
37
ACLS
Defibrillation in VF or Pulseless VT
360 J Monophasic Or 200 J Biphasic
38
ACLS
Epinephrine in VF or Pulseless VT
1 mg IV Q3-5 Minutes
39
ACLS
Amiodarone in VF or Pulseless VT
First dose: 300 mg IV (slowly: within 10 minutes)
Then: 150 mg IV (slowly: within 10 minutes)
40
ACLS
Vasopressin in VF or Pulseless VT
40 units IV
Can replace 1st or 2nd dose of Epinephrine
41
ACLS
Mg in Torsades
2-5 gr IV,
(slowly: within 3-5 minutes)
42
ACLS
VT with Pulse (If Persistent)
1. Cardioversion.......?
2. Adenosine......?
1. 100 J Synchronized
2. 1st dose: 6 mg IV 2nd dose: 12 mg IV (Must be regular and monomorphic)
43
ACLS
VT with Pulse (If Not Persistent) With Narrow QRS
Vagal Maneuver Or Adenosine 6 mg then 12 mg Or Beta blocker Or CCB
44
ACLS
VT with Pulse (If Not Persistent) With Wide QRS
(No Adenosine) Procainamide 20-50 mg IV slow Or Amiodarone 150 mg IV slow And Consult
45
ACLS
Asystole or PEA
(Not shockable)
Epinephrine 1 mg + CPR 2 min/5 cycles And repeat Manage 5 Hs and 5 Ts
46
ACLS
Bradicardia\<50 If 2nd or 3rd degree Heart Block
Atropine 0.5 mg Q3-5 Minutes Max 6 doses Or Transcutaneous Pacing Rate 80, Amplitude: Capture+10
47
ACLS
Bradicardia\<50 If 2nd or 3rd degree Heart Block Alternative treatments
Dopamine Infusion 2-10 mcg/kg/min
Or Epinephrine 1 mg Q4-6 Minutes
48
Status Epilepticus 6-10 minutes
2 large bore IV Saline
Dextrose 50% 50 ml IV
Thiamine 100 mg IM or IV
Lorazepam 2 mg IV, Repeat once
49
Status Epilepticus 6-10 min (If no IV access)
Midazolam 5 mg IM, repeat once
Or Diazepam pr 20 mg (Either rectal gel or IV Solution)
50
Status Epilepticus In 11-30 minutes
(Two traditional choices)
First: Phenytoin 20 mg/kg IV
Then: Phenobarbital 20 mg/kg IV
51
Status Epilepticus In 11-30 minutes
(Two new alternatives)
Midazolam 10 mg IV bolus
Or Propofol 2-5 mg/kg IV bolus
52
Respiratory Suppression in Opioids overdose:
Naloxone dosage
Adults and Children \>5y:
0.4-2 mg Q2-3 Minutes IV
In Children \<5y:
0.01 mg/kg Q2-3 Minutes IV
53
Equivalent Doses of Opioids:
10 mg Morphine IV = ..... mg Morphine PO
60 mg PO
54
Equivalent Doses of Opioids
10 mg Morphine IV (=60 mg Morphine PO)
Convert to Fentanyl
0.1 mg Fentanyl IV
(Fentanyl has no Oral form)
55
Equivalent Doses of Opioids
10 mg Morphine IV (=60 mg Morphine PO)
Convert to Hydromorphone
2 mg IV
Or 5 mg PO
56
Equivalent Doses of Opioids
10 mg Morphine IV (=60 mg Morphine PO)
Convert to Meperidine (Pethidine)
75 mg IV
Or 300 mg PO
57
Equivalent Doses of Opioids
10 mg Morphine IV (=60 mg Morphine PO)
Convert to Codein
120 mg IV
Or 200 mg PO
58
Equivalent Doses of Opioids
10 mg Morphine IV (=60 mg Morphine PO)
Convert to Oxycodone
10 mg PO
(Oxycodone is only oral)
59
Gout
Colchicine in Acute Attack
First: 1.2 mg
Then: 0.6 mg 1 h later
60
Gout
Prednisone in Acute Attack
0.5 mg/kg PO daily For 5 days
61
Gout
NSAID in Acute Attack
Naproxen 750 mg stat
Then 500 mg BID
62
Situational Aggression
Haloperidol 5 mg PO or IM + Lorazepam 2 mg PO or IM
63
Olanzapine IM (Immediate Acting)
2.5-10 mg IM
(Should not be used simultaneously with parenteral BZPs like Lorazepam)
64
BZPs Dosage Equivalents:
5 mg of Diazepam=
...... Clonazepam
Or ...... Chlordiazepoxide
0.25 mg Clonazepam
25 mg Chlordiazepoxide
65
BZPs Dosage Equivalents:
5 mg of Diazepam=
...... mg Alprazolam
Or .... mg Temazepam
0.5 mg Alprazolam
10 mg Temazepam
66
BZPs Dosage Equivalents:
5 mg of Diazepam=
..... mg Oxazepam
and .....mg Lorazepam
15 mg Oxazepam
1 mg Lorazepam
67
Universal Antidotes:
Thiamine dosage
100 mg IV or IM
to all patients Or At least: If hx of EtOH or patient looks malnourished
68
Universal Antidotes:
Dextrose (Glucose)
One Ampoule D50W IV
If low blood sugar on finger-prick
69
Universal Antidotes:
Naloxone
0.4-2 mg IV or 0.01 mg/kg IV
If opiate overdose suspected
70
Severe Migraine (ER):
1 L bolus of NS +
................... Or .....................
Prochlorperazine 10 mg IV
Or Ketorolac 30 mg IV
71
Moderate Allergic Reaction (Like generalized urticaria)
Treatments (ER)
1. ............
2. ...........
3. ...........
Epinephrine (1:1,000) 0.3-0.5 mg IM (not IV)
+/- IM Diphenhydramine 25-50 mg
+/- Salbutamol 1 cc via MDI
72
Severe Allergic Reaction
(Anaphylactic shock)
1. ABCs +|- Crystlloids
2. Epinephrine..............
3. ............
4. .............
Epinephrine (1:1,000) 0.1-0.3 mg IV (or via ETT)
+ Diphenhydramine 50 mg IV (~1 mg/kg)
+ Hydrocortisone 100 mg IV
(Or Methylprednisolone 1 mg/kg IV)
73
Acute Heart Failure
1. Furosemide .......
2. If BP \>100 then .......
3. If BP \< 90 then .......
1. F: 40-80 mg IV
2. Nitroglycerin: SL or IV Infusion
3. Dobutamine IV Infusion (if no shock)
or Dopamine IV Infusion (if shock)
74
Diabetes:
Hyperosmolar Hyperglycemic State
(Total Water deficit ?)
Rehydration with IV NS (Total Water deficit is 100 ml/kg)
+ O2 + monitoring
(but Insulin is controversial)
75
Hyponatremia
If Mild to Moderate: Water restriction / NPO
If Seizure or Coma............
100 cc NaCl 3%
76
Hypokalemia
K+ diuretics
+/- IV solutions with 20-40 mEq/L KCl (over 3-4h)
77
Hypocalcemia Tx
Calcium Gluconate 1-2 g IV in 10-20 minutes
78
Hypertensive Crisis
1...........
or 2...............
or 3...............
Nitroprusside IV
Fenoldopam IV
Enalapril IV
79
Prednisone dosage
in GCA
40-60 mg daily PO x 4 weeks Then taper
80
Ranitidine dosage
in Dyspepsia
150 mg BID
81
Omeprazole dosage
in GERD
20-40 mg Once daily 30 minutes before food
82
End of Life Care: Morphine
PO: 5-10 mg Q4-6H + PRN
IV/SC: 2.5-5 mg Q4-6H + PRN
83
Risperidone dosage
In Delirium vs Dementia
Delirium: 0.5-2 mg/day PO
Dementia: 0.25-2 mg/day PO
84
Risperidone dosage
In Psychosis vs Mania
Psychosis: 2-8 mg/day PO
Mania: 2-3 mg/day PO
85
Lithium dosage
In Bipolar disorder (Maintenance)
900-2100 mg/day PO Single daily dose preferred,
Guided by serum concentration (Target: 1-1.2 mmol/L)
86
Temazepam dosage
in Insomnia
15 mg QHS PRN PO
87
Insomnia Best BZP Agonist + dosage
Zopiclone 3.75 mg QHS PRN PO
88
Bupropion dosage
in Smoking Cessation
150 mg PO for 3 days Then 150 mg BID PO
89
Acetaminophen dosage
in Acute Headache (ER)
650-1300 mg Q4H Only 1 or 2 doses
90
Dihydroergotamine dosage
in Acute Migraine (ER)
1 Spray (0.5 mg) In each nostril
May repeat in 15 minutes
Max 2 gr (4 sprays) per day
91
Headache in Children:
Acetaminophen dosage
10-15 mg/kg/dose Q4H PO PRN
92
Headache in Children:
Ibuprofen dosage
5-10 mg/kg/dose Up to 4 times daily
93
Post Coital Contraception Oral Method
Levonorgestrel (Plan B) 1.5 mg Single dose within 24h
94
OCPs Yaz
EE 20 ug + Drospirenone 3 mg
95
Menopause Estrogen (Vaginal)
Premarin Vaginal Cream 0.625 mg
96
Acetaminophen in Fever (Children)
PO 10-15 mg/kg/dose Q6H or Q8H
Max daily 75mg/kg or 4 gr
97
Ibuprofen in Fever (Children)
PO 5-10 mg/kg/dose Q6H or Q8H
Max daily 40 mg/kg or 2.4 gr
98
Cephalexin Adults & Children
PO
A 250-500 mg Q6H
C 6-12 mg/kg/dose Q6H
99
Ciprofloxacin Adults only
500-750 mg BID
100
Clindamycin Adults PO & IV
PO 150-300 mg Q6H
IV 450-600 mg QH8
101
Amoxicillin/ Clavulanate (Clavulin) Adults & Children
A 250-500 mg Q8H
C 40 mg/kg/day, divided Q8H
102
Vancomycin IV Adults & Children
IV
A 1 gr Q12H
C 10 mg/kg/dose Q6H
103
Cefazolin IV Adults and Children
IV
A 1 gr Q8H
C 50-100 mg/kg/day, divided Q8H
104
Amoxicillin in Strep Sore Throat
Adults & Children
50 mg/kg Once daily
or divided BID x10 days
Max 1 g/day
105
Azithromycin in Strep Sore Throat
Adults
500 mg x1 day Then 250 mg x4 days Once daily
Children
12 mg/kg x1 day Max 500mg/day Then 6 mg/kg x4 days
Max 250mg/day
106
SMX/TMP in Cystitis
800/160 mg BID PO (2 Regular Strength tablets Or 1 DS tablet BID)
107
Nitrofurantoin in Cystitis (Sulfa Allergic)
100 mg BID PO
108
Ciprofloxacin in Mild to Moderate Pyelonephritis
250-500 mg BID
109
Gentamicin +|- Ampicillin in Severe Pyelonephritis
G: 3-5 mg/kg/day IV
A: 1 g Q6H IV
110
Pyelonephritis in Pregnancy
Ceftriaxone 1 g Q24H IM or IV
111
Acute Sinusitis First Line Tx in Children & Adults
Amoxicillin
Children: 40 mg/kg/day x 10 days Divided TID PO
Adults 500 mg - 1 g TID x 5-7 days
112
Acute Sinusitis If Amoxicillin fails (Children)
Amoxicillin/Clavulanate x 10 days (7:1)
Children: 45 mg/kg/day (Amoxi Component) Divided BId-TID
113
Acute Sinusitis If Penicillin Allergic (Adults)
Adults
Doxycycline x 5-7 days 200 mg PO once Then 100 mg BID
114
Acute Sinusitis If Amoxicillin Fails (Adults)
Amoxicillin/Clavulanate x 5-10 days
Adults: 875 mg BID PO
115
Chronic Sinusitis in Children & Adults
Amoxicillin/Clavulanate X 3 weeks
Ch: 45 mg/kg/day divided TID
Ad: 875 mg BID
116
Chronic Sinusitis
If Betalactam Allergic Children & Adults
Clindamycin x 3 weeks
Ch: 20-30 mg/kg/day divided TID or QID
Ad: 300 mg QID PO
117
Otitis Media in Children First Line
Amoxicillin HD:
75-90 mg/kg/day Divided BID or TID
x10 days if \<2y
x5 days if \>2y
118
Otitis Media in Children Second Line
Amoxicillin/Clavulanate HD: 75-90 mg/kg/day amoxicillin Divided BID or TID
119
Otitis Media in Children If frequent bouts
Amoxicillin/Clavulanate
HD: 75-90 mg/kg/day amoxicillin Divided BID or TID
120
Otitis Media in Children If Penicillin Allergic
Azithromycin (if anaphylaxis) Or Cefuroxim (if rash)
Az: Day 1: 10 mg/kg Once daily Day 2-5: 5 mg/kg Once daily
Cef: 30 mg/kg/day divided BID
121
Azithromycin in Children 5-day treatment vs 3-day treatment
5-day: Day 1: 10 mg/kg once daily Day 2-5: 5 mg/kg once daily
3-day: 10 mg/kg Once daily for 3 days
122
Bacterial Meningitis in Adults
Vancomycin + Ceftriaxone
Vancomycin: 15-20 mg/kg Q8-12H
Ceftriaxone: 2 gr Q12-24H
123
Bacterial Meningitis Post-Exposure Prophylaxis Hemophilus vs Meningococcus
H: Rifampin 20 mg/kg once daily x4 days
M: Rifampin 5-10 mg/kg Q12H x2 days
124
Cefotaxime in CAP (adults)
1-2 g Q8H IV X 5-10 days
125
Ceftriaxone in CAP (adults)
1-2 g Q24H IV X 5-10 days
126
Levofloxacin in CAP (adults)
Oral: 500 mg Q24H x10 days Or 750 mg Q24H x5 days IV: 500 mg once daily
127
Azithromycin in CAP
Oral: 500 mg 1st day Then 250 mg x4 days
Or 500 mg daily x3 days
128
Croup First Line Treatment
Dexamethasone 0.2-0.6 mg/kg
PO/IM/IV Single dose
129
Endocarditis Oral Prophylaxis in Children and Adults
Amoxicillin PO
Children: 50 mg/kg
Adults: 2 g
130
Endocarditis
Parenteral Prophylaxis in Children and Adults
Ampicillin
Children: 50 mg/kg IV or IM
Adults: 2 g IV or IM
131
Endocarditis
Oral Prophylaxis in Children and Adults
if Penicillin Allergic
Cephalexin
Children: 50 mg/kg
Adults: 2 g
132
Endocarditis
Parenteral Prophylaxis in Children and Adults
if Penicillin Allergic
Cefazolin
Children 50 mg/kg IM or IV
Adults 1 g IM or IV
133
Metronidazole in C.Difficile
PO 500 mg TID x 10-14 days + S.Boulardii
134
Vancomycin in Severe C. Difficile
PO 125 mg QID x10-14 days
135
Ciprofloxacin in Travellers Diarrhea
PO 500 mg BID x3 days
Or 750 mg Single dose
136
H Pylori Eradication Standard triple therapy
PPI BID
Clarithromycin 500 mg BID
Amoxicillin 1 gr BID
x 10-14 days
137
Trichomoniasis Treatment
Metronidazole 2 g PO Single Dose
Or 500 mg BID PO x7 days (Safe in Pregnancy)
138
Bacterial Vaginosis Treatment
Metronidazole
Preferred dose: 500 mg BID PO x7 days
Alternative dose: 2 g PO Single Dose
139
Vulvovaginal Candidiasis Treatment (Uncomplicated)
Clotrimazole 200 mg Vaginal Tablet 1 tab daily PV x3 days
Or 500 mg Vaginal Tablet 1 tab PV Single Dose
Or Fluconazole 150 mg PO x Single Dose
140
Chlamydia Infection Treatment
Azithromycin 1 g PO Single Dose
141
Gonorrhea Infection
Ceftriaxone 250 mg IM Single Dose
