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Medic 42 Studying > Drug Indications/Dosages > Flashcards

Drug Indications/Dosages Flashcards

Indications and Dosages

1
Q

Acetaminophen

A

Indications:
Pain Management ADULT
-mild, mod, severe

Dose: 1,000mg slow IV drip over 15 min.

Pain Management PEDS
-mild, mod

Dose:
PDC in 100mL of NS slow IV drip over 15 min.

NOTE:
ADULT/PEDS
-Abdo
-Burns
-Envenomation
-Trauma
ADULT
-Cardiac Pain
-Cardiac Pacing

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2
Q

Adenosine (Adenocard)

A

Indications:
Arrythmias SVT Adult s-127
-stable symptomatic

Dose: 6mg rapid IV/IO followed by 20ml NS rapid IV/IO
12mg rapid IV/IO followed by 20ml NS rapid IV/IO MR x1

Arrhythmias SVT PEDS s-163
-stable symptomatic

Dose: PDC rapid IV/IO, followed with 20ml NS rapid IV/IO MR x2

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3
Q

Albuterol (Proventil, Ventolin)

A

Indications:
Resp. distress*
-suspected non-cardiac Adult
-With bronchospasm Peds
Allergic Reaction/Anaphylaxis*
-Anaphylaxis with resp. involvement
Burns
-resp. distress with bronchospasm

Dose:
Adult- 6ml via neb MR
Peds-PDC via neb MR
*Ipra added to first dose

PEA
-suspected hyperkalemia
PEA/Asystole
-Suspected hyperkalemia
Hemodialysis pt
-suspected hyperkalemia (Widened QRS complex or peaked T waves)
Trauma
-Crush injury requiring extrication with compression of extremity or torse greater/equal to 2 hours
-immediately prior to extremity release

Dose:
Adult-6ml via neb continuous
PEDS-PDC via neb continuous

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4
Q

Amiodarone Hydrochloride (Cardarone, Pacerone, Nexterone)

A

Indications:
CPR/arrhythmias VT adult/peds
-stable vt
Dose:
Adult- 150mg in 100ml of NS over 10 min IV/IO MR x1 in 10min
PEDS- PDC IV/IO BHPO

CPR/Arrhythmias Adjunct cardiac devices adult s-127
-reported witnessed AICD firing greater/equal to 2 and pulse above/equal to 60
Dose:
150mg in 100ml of NS over 10min IV/IO MRx1 in 10min

CPR/Arrhythmias Adjunct cardiac devices PEDS s-163
-reported witnessed AICD firing greater/equal to 2
Dose: PDC IV/IO MR BHPO

CPR/Arrhythmias VF/Pulseless VT
-persistent VF/Pulseless VT after 3 defib attempts
Dose:
Adult
-300mg IV/IO MR 150mg q3-5min
PEDS:
-PDC IV/IO MR PDC x2

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5
Q

Aspirin, ASA (Acetylsalicylic Acid)

A

Indication:
Discomfort pain of suspected cardiac origin (S-126)
Dose:
324mg PO

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6
Q

Atropine Sulfate

A

Arrhythmias: Unstable Bradycardia s-127 Adult
Dose: 1mg IV/IO MR q3-5min to max 3mg
Arrhythmias: Unstable Bradycardia s-163 PEDS
Infant/child <9 years with HR <60
Child 9-14 years HR <40
-after BVM for 30sec, AND
-CPR initiated if unconscious AND
-after 3rd dose of Epi
Dose: PDC IV/IO MR x1 in 5min.
Poisoning OD
-symptomatic organophosphate poisoning for continued s/s of SLUDGE/BBB
Dose:
Adult-2mg IV/IO MR at double previous dose IV/IO q3-5min
PEDs-PDC IV/IO MR at double previous dose IV/IO q3-5min

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7
Q

Calcium Chloride

A

Indications:
CPR/Arrhythmias: PEA Adult
CPR/Arrhythmias: PEA/Asystole Peds
-suspected hyperkalemia
Dose:
Adult-500mg IV/IO (Given before Bicarb) MR x1 in 5min for continued EKG findings of hyperk
PEDS-PDC IV/IO (Given before Bicarb) MR x1 in 5min for continued EKG findings of hyperk

Hemodialysis Pt
-suspected hyperk
-if widened QRS peaked T waves
Dose: 500mg IV/IO

Poisoning OD
-suspected calcium channel blocker OD with SBP<90
Dose: 20mg/kg IV/IO MRx1 in 10min

Trauma
-Crush injury requiring extrication with compression of extremity or torso greater/equal to 2 hours
Dose:
Adult-immediately prior to anticipated release 500mg IV/IO over 30 sec MR x1 in 5min for continued EKG findings consistent with hyperk
(PDC for PEDS)

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8
Q

Charcoal (Activated Charcoal)

A

Indications:
Poisoning / OD s-134
-ingestion with ANY of the following and within 60 min.s “SOAPBACCS” OR poison control
Dose: 50gm PO

Poisoning / OD s-165
-if ingestion within 60 min.s and recommended by poison control

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9
Q

Dextrose / Glucose (50%, D50 / 10%, D10, D10W)

A

Indications:
Altered Neurologic s-123 / s-161
-symptomatic hypoglycemia: with altered LOC or unresponsive to oral glucose agents
Doses:
Adult- D50 25gm IV, if pt remains symptomatic and BS remains <60mg/dl, MR
PEDS (<60, <45 for neonates)- D10 PDC IV, if pt remains symptomatic and BS remains <60mg/dl (<45 neonates), MR

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10
Q

Diphenhydramine (Benadryl)

A

Indications:
Allergic Reaction / Anaphylaxis s-122, s-162
-Allergic reactions (skin signs only)
-Anaphylaxis Treatment (after 1st Epi IM)

Poisoning / OD
-Extrapyramidal reactions

Dose:
ADULT- 50mg Slow IV/IM
PEDS- PDC slow IV/IM

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11
Q

Epinephrine Push-Dose

A

Indications: “D/PCRAnaSS”
Discomfort / pain of suspected cardiac origin with associated shock
-if BP is refractory to second bolus
CPR/Arrythmias Bradycardia
-if SBP <90 after atropine or initiation of pacing
ROSC s-127, s-163
-adult: SBP <90
-PEDS: unresponsive to fluid bolus and hypotensive for age
Shock s-138, s-168
-Adult: if BP <90 after second bolus
-Peds: hypotension for age after second fluid bolus
Sepsis s-143, s-177
-Adult: if BP<90 after fluid boluses
-Peds: if hypotensive for age after fluid bolus
DOSE:
adult- titrate to maintain BP >90, 1ml slow IV/IO MR q3 min
Peds- titrate to maintain adequate perfusion, PDC slow IV/IO MR q3 min

Anaphylaxis Adult/Peds
-severe anaphylaxis or inadequate response to treatment
Adult-titrate to maintain SBP >90 or improvement in status, 1ml slow IV/IO MR q3 min
PEDs- titrate to adequate perfusion or improvement in staus, PDC slow IV/IO MR q3 min

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12
Q

Epinephrine (Adrenalin, Epi)

A

Indications:
Anaphylaxis
-anaphylaxis treatment
Respiratory Distress
-severe resp. distress / failure OR inadequate response to neb treatments (ADULT: hx of asthma or suspected allergic reaction)
DOSE:
Adult- 0.5mg IM (1:1,000) MR x2 q5 min
Peds (Lat Thigh)- PDC IM (1:1,000) MR x2 q5 min

Resp Distress PEDS
-with stridor at rest
Burns PEDS
-resp. distress with stridor
DOSE:
PDC(1:1,000) via nebulizer (combined with 3ml NS) MR x1
if no improvement after Epi via neb x2 OR impending resp/airway compromise:
PDC(1:1,000) IM, MR x2 q3-5 min

CPR/arrhythmias
-cardiac arrest
DOSE:
adult-1mg IV/IO (1:10,000), MR q3-5min
Peds-PDC IV/IO (1:10,000), MR q3-5min
CPR/Arrhythmias PEDS s-163
-unstable bradycardia: if no increase in HR after 30 sec of BVM ventilations
DOSE: PDC IV/IO (1:10,000), MR x2 q3-5 min, MR q3-5 BHO
Newborn with HR <60
-with chest compression and BVM ventilations
DOSE: PDC IV/IO 1:10,000, MR q3-5 min

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13
Q

Fentanyl Citrate

A

Pain Management: Adults
-for mod or severe -for mild (1-3) if pt refuses or has contraindications to acetaminophen
-abdominal
-burns
-envenomation
-trauma
-discomfort/pain of suspected cardiac origin if BP greater/equal to 100
-external cardiac pacing with capture and BP greater/equal to 100
DOSE:
ADULT IV:
up to 100mcg IV
MR up to 50mcg IV q5 x2
Max total IV 200mcg

Pain Management: PEDS
-with signs of adequate perfusion
-for pain: mod or severe
-abdominal
-burns
-envenomation
-trauma
DOSE:
PEDS: <10kg
PDC IV/IN
MR BHO
PEDS: >10kg
PDC IV/IN
MR SO

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14
Q

Glucagon

A

Indications:
Altered Neurologic
-Unable to start IV in symptomatic hypoglycemia with altered LOC or unresponsive to oral glucose agents.
DOSE:
Adult BS<60- 1ml(1 unit) IM
PEDS BS <60 <45 neonates- PDC IM

Poisoning / OD
-suspected beta blocker OD with cardiac effects (e.g. bradycardia, with hypotension)
DOSE:
Adult- 1-5mg IV MR 5-10min for a total of 10mg

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15
Q

Ipratropium Bromide (Atrovent)

A

Indications:
Resp Distress
-suspected non cardiac adult
-with bronchospasm Peds
Allergic Reaction / Anaphylaxis
-anaphylaxis with resp. involvement
DOSE:
Adult- 2.5ml (0.02%) via nebulizer added to first dose of albuterol
Peds- PDC via nebulizer added to first dose of albuterol

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16
Q

Ketamine (Ketalar)

A

Indications:
Pain Management: Adults
-for mod or severe -for mild (1-3) if pt refuses or has contraindications to acetaminophen
-abdominal
-burns
-envenomation
-trauma
-discomfort/pain of suspected cardiac origin if BP greater/equal to 100
-external cardiac pacing with capture and BP greater/equal to 100

*Requirements for Ketamine
-over/equal to 15 YO
-AND GCS 15
-AND not pregnant
-AND no known or suspected alcohol or drug intoxication
DOSE:
IV Dosing: 0.3 mg/kg in 100ml of NS slow IV drip over at least 10 minutes (Max single IV dose 30mg)
MR x1 in 15 min if pain remains mod to severe
-total IV dose not to exceed 60mg
IN Dosing: 0.5mg/kg IN (50mg/kg concentration)
max dose for IN 50mg
MR x1 in 15 min if pain remains mod to severe
-Total IN dose not to exceed 100mg

17
Q

Lidocaine (2% Xylocaine)

A

Indications:
>CPR/arryhthmias: VT (AdultPeds) - Stable VT
>Dose:
Adult - 1.5mg/kg slow IV/IO MR 0.5mg/kg IV/IO q8-10min to max 3mg/kg
Peds - PDC IV/IO BHPO
>CPR/arryhthmias: VF/Pulseless VT (AdultPeds) - Persistant after 3 defib attempts
>DOSE:
Adult - 1.5mg/kg slow IV/IO MR 0.5mg/kg IV/IO q5min to max 3mg/kg
Peds - PDC IV/IO MR PDC x1 q5min
>CPR/arryhthmias Adjunct Cardiac Devices Adult - Reported/witnessed AICD firing >2 with pulse >60
Adult - 1.5mg/kg slow IV/IO MR 0.5mg/kg IV/IO q8-10min to max 3mg/kg
>CPR/arryhthmias Adjunct cardiac devices Peds - reported/witnessed AICD firing >2
Peds - PDC IV/IO, MR BHPO
>ALS skills - Conscious patient prior to IO infusion
Adult Only - 40mg slow IO prior to fluid admin

18
Q

Midazolam (Versed)

A

Indications:
>Altered Neurologic - Status epilepticus (generalized ongoing & recurrent seizures w/ no lucid interval)
Adults - Pt’s >40kg = 10mg IM Pt’s <40kg = 0.2mg/kg IM
if vascular access present = 0.2mg/kg IV/IO to max of 5mg MR x1 in 10min, max 10mg total, d/c if stops
Peds - PDC IM
if vascular access present = PDC IV/IO, MR x1 in 10min
>Altered Neurologic Seizures - Partial seizure lasting >5min
>Obstetrical Seizures - Eclampsia seizures
Adults - 0.2mg/kg IN/IM/IV/IO to max 5mg. MR x1 in 10min, max 10mg total. d/c if seizure stops
Peds - PDC IN/IM/IV/IO MR x1 in 10min
>Unstable Bradycardia - pre pacing
>Unstable SVT - pre sync cardioversion
>Unstable Afib/Aflutter - rate of >180, pre sync cardioversion
Adults - 1-5mg IV/IO
Peds - PDC IV/IO BHO for pacing, PDC IV/IO SO for cardioversion
>Pre-existing medical interventions - intubated pt’s with agitation and potential for airway compromise
Adults - 2-5mg IM/IN/IV, MR x1 in 5-10min

19
Q

Morphine Sulfate

A

Indications:
>Pain Management Adult if Fent unavailable
>~For pain mod or severe
>~mild if pt has contraindications or refuses acetaminophen
>~Abdo, Burns, envenomation, trauma, cardiac pain if BP>100, Pacing pain w/ capture and BP >100
Adult IV - up to 0.1mg/kg IV, MR in 5 min at half initial IV dose(0.05mg/kg) MR in additional 5 min at half initial BHO
Adult IM - up to 0.1mg/kg IV, MR in 15 min at half initial IV dose(0.05mg/kg) MR in additional 15 min at half initial BHO
>Pain Management Adult if Fent unavailable
>~with signs of adequate perfusion
>~For pain mod or severe
>~Abdo, Burns, envenomation, trauma
Peds <10kg - PDC IV/IM, MR BHO
Peds >10kg - PDC IV/IM, MR

20
Q

Naloxone (Narcan)

A

Indications:
>Poisoning OD and Altered Neurologic ADULT
>~Symptomatic suspected opiod OD with respiratory depression: (RR <12, SpO2 <96%, OR ETCO2 >40)
>Poisoning OD and Altered Neurologic Peds
>~Symptomatic suspected opioid OD with respiratory depression: (RR low for age, SpO2 <96%, OR ETCO2 >40)
DOSE:
Adult - 2mg IN/IM/IV, MR titrate IV dose to effect, to drive the resp. effort, titrate slowly in opioid dependant pain pt’s
OR 4mg IN nasal spray preloaded single dose device, MR, admin full dose in one nostril.
ADULT: If pt refuses transport
2mg IM additional dose OR 4mg IN nasal spray preloaded single dose device, admin full dose in one nostril.

*For pt’s and/or other individuals suspected of opioid use disorder, provide Leave behind naloxone kit with education per S-145, treat per S-145 participating agencies
Peds - PDC IN/IM/IV, MR, for opioid dependant pt’s, dilute and titrate slowly PDC

21
Q

Nitroglycerin (NTG, Nitro)

A

Indications:
>Discomfort/pain of suspected cardiac origin S-126
Adult Only - If SBP >100 = 0.4mg SL MR q3-5min
>Resp distress: Suspected cardiac/CHF
>Hemodialysis: Fluid overload with Rales S-131
Adult Only - if SBP ≥100 but <150 = 0.4mg SL, MR q3-5min
if SBP ≥150 = 0.8mg SL, MR q3-5min

22
Q

Ondansetron (Zofran)

A

Indications:
>ADULT Abdominal discomfort non-traumatic - for nausea and vomiting
Adult Only - 4mg IV/IM/ODT, MR x1 in 10min
>PEDS Abdominal discomfort GI/GU - for nausea and vomiting
Peds - ≥6 months IV/IM/ODT PDC

23
Q

Sodium Bicarbonate (Bicarb, NaHCO3)

A

Indications:
>Adult CPR/Arrythmias: PEA - suspected hyperkalemia
>Peds CPR/Arryhthmias: PEA/Asystole -suspected hyperkalemia
Adult - 1mEq/kg IV/IO (After Calcium Chloride given)
Peds - PDC IV/IO (After Calcium Chloride given)
>Hemodialysis Pt - suspected hyperkalemia (Widened QRS or peaked T waves)
Adult - 1mEq/kg IV/IO (After Calcium Chloride given)
>Poisoning OD (Adults/Peds) - Suspected tricyclic antidepressant OD with cardiac effects (hypotension, heart block, or widened QRS)
Adult - 1mEq/kg IV/IO
Peds - PDC IV
>Trauma (Adults/Peds) - Crush injury requiring extrication with compression of extremity or torso ≥2 hours, immediately prior to anticipated release
Adult - 1mEq/kg IV/IO
Peds - PDC IV/IO

24
Q

Tranexaic Acid (TXA, Cyklokapron, Lysteda)

A

Indications:
>Adult Trauma associated hemmorhage - Trauma associated hemorrhage <3 hours prior and at least one of the following: 1. SBP <90 2. Shock index ≥1 (HR ≥ SBP) 3. Uncontrolled external bleeding
Adult - 1gm/10ml IV/O, in 50-100mL NS, over 10min
>Post partum hemorrhage - if estimated blood loss ≥500mL, AND within 3 hours of delivery
Adult - 1gm/10ml IV/O, in 50-100mL NS, over 10min

Medic 42 Studying (6 decks)

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