drug dosing Flashcards
route of radio-iodine vs pertechnetate dosing
radio-iodine is oral pertechnetate is IV
meckel scan cimetidine dosing
20 mg/kg per day x 2 days Premedication can improve the sensitivity of a Meckel Scan. This usually comes in 3 flavors: H2 Blockers (cimetidine, famotidine, or ranitidine… something that ends in the word “dine”) to block the release of the tracer from ectopic mucosa. Pentagastrin to enhance the uptake of the tracer Glucagon to decrease small bowel motility The classic dosing for cimetidine is 20 mg/kg per day x 2 days.
HIDA scan for biliary atresia. Drug and dosing
phenobarbital 2.5 mg/kg twice a day for 5 days Many centers will attempt to improve the study by first “priming the liver” with 5-7 days of phenobarbital therapy, 2.5 mg/kg orally twice a day. “5 for 5” — 2.5 x 2 = 5 for 5 days This is supposed to ramp up hepatocyte function and stimulate better excretion of the tracer – improving visualization of the biliary tree. Would be awful to go the OR when the kid has hepatitis because you fucked the study up.
morphine dose for HIDA
0.04 mg/kg IV
phenobarbital dose
5 mg/kg/day orally for 5-7 days before examination used to prime hepatic enzymes to increase IDA excretion in distinguishing between biliary atresia and neonatal hepatitis
sincalide dosing
sincalide (CCK) dosing: 0.02 mcg/kg in 10 mL of saline SINCALIDE is MICROgrams MORPHINE is MILIgrams 0.04 mg/kg IV
During a chemical stress test using Dipyridamole, the patient develops chest discomfort, headache, dizziness, flushing, and nausea – next step ?
given them IV aminophylline 100-200mg
aminophylline dosing for reversal of dipyridamole
IV aminophylline 100-200mg.
particle size TcDTPA (VQ scan)
0.1 to 0.5 um
MICROmeters
particle size of TcMAA (perfusion)
10-90 um
MICROmeters
pt with Hives after IV contrast, treatment?
25 to 50mg diphenhydramine PO, IM or IV
or
fexofenadine 180 mg PO
Pt with diffuse erythema and hypotension, treatment?
considered anaphylaxis with the combo of both
IM dose: 0.3 mg (inject 0.3 mL of 1 mg/mL)
IV dose: 0.1 mg (inject 1 mL of 1mg/10mL)
IM dose epinephrine
IM dose: 0.3 mg (inject 0.3 mL of 1 mg/mL)
IV dose epinephrine
IV dose: 0.1 mg (inject 1 mL of 1mg/10mL)
1:10,000
atropine dosing in hypotension with bradycardia
0.6 to 1.0 mg IV into a running infusion of IV fluids
may repeat atropine up to a total dose of 3 mg
patient is pulseless, how much epi?
1 mg IV
follow ACLS protocol on this one. pt is dead.
Pediatric dosing for isotonic fluid in a contrast rxn
10-20 mL/kg of 0.9% normal saline or Lactated Ringers up to a maximum volume of 500-1,000 mL
Pediatric dosing for benadryl, contrast rxn
1 mg/kg up to a maximum of 50 mg
albuterol pediatric dosing
2 puffs (90 mcg/puff) for a total of 180 mcg = adult dose; can repeat up to three times
PEDIATRIC epinephrine dosing, IM
(up to 30 kg): 0.15 mg
(over 30 kg): 0.01 mL/kg of 1:1000 dilution (maximum single dose of 0.3 mL [0.3 mg]); repeated every 5-15 minutes needed up to a maximum dose of 1 mg (1 mL)
PEDIATRIC epinephrine dosing, IV
0.1 mL/kg (0.01 mg/kg) of 1:10,000 dilution (maximum single dose of 1 mL [0.1 mg]), repeated every 5 – 15 minutes, as needed up a maximum dose of 1 mg (1 mL)
patient with wheezing after IV contrast. treatment and dosing
wheezing = bronchospasm
Two puffs of beta-2 agonist inhaler (albuterol); repeat x 3
protocol for minimizing risk of PC-AKI
IV volume expansion with isotonic fluids, such as 0.9% saline or Lactated Ringer’s solution.
suggested protocol: give IV 100 mL/h for 6 to 12 hours before and continued for 4 to 12 hours after.
rapid premedication protocol (for the ED)
IV 200 mg of hydrocortisone every 4 hours until the study is performed, preferably deferring imaging until at least two doses of hydrocortisone have been administered.
50 mg of diphenhydramine is also administered 1 hour before contrast media injection
typical premedication protocol, PEDIATRICS
- oral prednisone 0.5- 0.7 mg/kg; 13, 7, and 1 hours prior
- oral diphenhydramine (Benadryl ®) 1.25 mg/kg; 1 hour prior
(BOTH up to a maximum dose of 50 mg.)
typical premedication protocol, ADULT
- Oral prednisone 50mg; 13, 7, and 1 hour(s) prior
- Oral Benadryl 50 mg; 1 hour prior
or
Oral methylprednisolone 32 mg; 12 and 2 hrs prior
Radionuclide purity Mo-99/Tc-99m generator in Ci
- 15 uCi Mo-99/ 1 mCi Tc-99m
(0. 15 kBq Mo99/ MBq Tc-99m)
Radionuclide purity Mo-99/Tc-99m generator in Bq
- 15 kBq Mo99/ MBq Tc-99m
(0. 15 uCi Mo-99/ 1 mCi Tc-99m)
chemical purity threshold Mo-99m/Tc-99m generator
<10 ug/mL of aluminum
Papillary thryoid cancer <1.5cm and no invasion of the thyroid capsule
<30 uCi I-131
When do you treat with I-131 <30 mCi
Low risk patient: tumor <1.5cm and no invasion of the thyroid capsule
typical treatment and dose for treatment of multinodular goiter
25mCi
typical # of MAA particles (normal patient)
200-600k
Patient with known right to left shunt
V/Q scan MAA particle dose
100k particles
(normal range is 200k-600k)
Patient with known mild pulmonary HTN
V/Q scan MAA particle dose
100k particles
(normal range is 200k-600k)
pediatric V/Q scan MAA particle dose
100k particles
(normal range is 200k-600k)
preggo patient V/Q scan MAA particle dose
100k particles
(normal range is 200k-600k)
