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Drug Review- Ind, Con, Dose > Drug Review- Ind, Con, Dose > Flashcards

Drug Review- Ind, Con, Dose Flashcards

1
Q

Atropine

A

Ind:

  • Hemodynamically Significant Bradycardia
  • OrganoPhosphate Poisoning

Con: None

Dose:

  • Bradycardia
    0. 5mg IVP/IO (may repeat 3-5 min to a max of 3mg)

-Organophosphate Poisoning
2-5mg IV/IO/IM (repeat as needed every 10-15min)

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2
Q

Dextrose

A

Ind:
- To increase blood sugar in hypoglycemia

Con: None

Dose:
-Hypoglycemia
25g D50 IV/IO/PO

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3
Q

Epinephrine

A

Ind:

  • To restore cardiac rhythms in cardiac arrest
  • Allergic reaction/ Anaphylaxis
  • Bradycardia refractory to Dopamine

Con:

  • Hemorrhagic Shock
  • Cardiogencic Shock
  • Hypertension

Dose:
-Cardiac Arrest
1mg IV/IO 1:10,000 (repeat 3-5min PRN)
2-2.5mg ETT 1:1000 (repeat 3-5 min until vascular access is achieved)

  • Allergic Reaction
    0. 3-0.5mg SC/IM 1:1,000 (repeat 5-15min PRN)
    0. 5-1mg IV/IO 1:10,000 if SC/IM dose ineffective

-Bradycardia
2-10mcg/min

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4
Q

Lidocaine

A

Ind:

  • Ventricular Tachycardia or wide-complex tachycardia with pulses
  • Recurrent or Refractory V Fib/ Pulseless V-Tach
  • Following Successful Defibrillation
  • Pre-Intubation in Head Injures (may minimize the rise of ICP associated with intubation)

Con:

  • Not used for Supraventricular Rhythms or Bradycardia
  • Hypersensitivity to any of the “Caines”

Dose:
1-1.5mg/kg IV bolus; may repeat 3-5min at 0.5-0.75mg/kg to a total dose of 3mg/kg.

After Max reached may then start continues infusion of 1-4/mg/min using 4mg/ml concentration.

ETT- use 2-2.5 the loading dose followed by 10ml flush

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5
Q

Oxygen

A

Ind:
-Management of any situation where hypoxia may be suspected.

Con: None

Dose:
-Hypoxia
Nasal Canula 1-6LPM
Simple Mask 8-10LPM
Non-Rebreather 10-15LPM
BVM 15+ LPM
CPAP 20+LPM
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6
Q

Aspirin

A

Ind:
-Inhibits platelet aggregation in chest pain suggestive of AMI

Con:(HAAB)

  • Hypersensitive
  • Active Gi Bleed
  • Acute Asthma Attack
  • Bleeding Disorder

Dose:
160-325mg PO

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7
Q

Dopamine

A

Ind: (CASHBC)

  • Cardiogenic Shock (pulmonary edema with non-hypovelmic hypotension)
  • Anyphlaxis refractory to Epi and Fluid Boluses
  • Shock States with Hemodynamically Hypotension in the absence of Hypovlimia (sepsis, neurogenic shock)
  • Bradycardia refractory to Atropine and Pacing -Crush Injury

Con:

  • Not be given for Hypotension secondary to Hypovolemia (blood loss, dehydration)
  • Not to be given for Hypotension secondary to third spacing fluids prior to sufficient fluid replacement

Dose:
Crush Syndrome 2mcg/kg/min

Cariogenic Shock 5-10mcg/kg/min

Anaphylaxis 20mcg/kg/min

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8
Q

Midazolam (Versed)

A

Ind:

  • Sedation Prior to Cardioversion/Pacing/RSI
  • Seizure Control

Con: (SCH Narrow)

  • Shock
  • Comatose Patients
  • Narrow Angle-Closure Glaucoma
  • Hypotension
  • Use cautiously in CHF patients

Dose:
1-2.5mg Slow IV/IO/IN
0.07-0.08mg/kg IM (typically a max of 5mg)

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9
Q

Morphine Sulfate (Duramorph)

A

Ind:

  • Mangament of Moderate to Sever pain
  • To reduce venous return in Pulmonary Edema/CHF/AMI

Con:(Un,Acute,BA)

  • Undiagnosed head and abdominal injures
  • Hypotension/Hypovolemia
  • Respiratory Depression
  • Acute Bronchial Asthma

Dosage:
-Pain Managment 2.5-15mg IV/IO
5-20mg IM/SC

-Pulmonary Edema/CHF/AMI
1-2mg IV/IO every 6-10min

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10
Q

Narcan

A

Ind:

  • Narcotic Overdose
  • Coma of an Unknown Origin

Con: None

Dose:

  • 0.4-2mg IV/IO/IM/IN (may repeat every 2-3 min PRN)
    2. 0-2.5mg ETT
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11
Q

Zofran (Ondansetron)

A

Ind:
-Prevention of Nausea and Vomiting

Con:

  • Hypersensitivity
  • Prolonged QT Syndrome

Dose:
4mg IVP/PO Max dose of 8mg

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12
Q

Albuterol (Proventil, Ventolin)

A

Ind: (BCH)

  • Bronchospasm
  • Crush Syndrome
  • Hyperkalemia

Con:

  • Hypersensitivity and symptomatic Tachycardia (absolute)
  • Cardiac Arrhythmias and Hypertension (relative)

Dose:
2.5-5mg via Nebulizer (repeat PRN)

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13
Q

Diazepam (Valium)

A

Ind: (SPAM)

  • Sizures, Status Epilepticus
  • Premedication before Cardioversion
  • Acute Anxiety Attack
  • Muscle Tremors due to Injury

Con:

  • Shock
  • Coma
  • Depressed Vital Signs
  • Neonates

Dose:

  • Anxiety 2-5mg IV/IM
  • Seizures 5-10mg IV/IO/IM
  • Premedication 5-15mg IV/IO
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14
Q

Ipratropium Bromide (Atrovent)

A

Ind:

  • Asthma (in combination with other Bronchodilators
  • COPD

Con:

  • Hypersenstivity to atrovent, atropine or atropine derivatives
  • Not to be used as primary treatment for Bronchospasm

Dose:
-500mcg in 3ml saline via Nebulizer

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15
Q

Nitroglycerine

A

Ind:

  • Angina
  • Chest Pain suggestive of MI
  • Pulmonary Edema

Con:

  • Hypotension
  • Chest/Head Trauma
  • Cerebral Bleeding
  • Use of ED drugs within 24-72hrs
  • Hypersensitivity

Dose:
0.4mg SL/Tablet/Spray (may repeat every 5min for pain relief)

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16
Q

Vasopressin

A

Ind:

  • Cardiac Arrest
  • Esophageal Varices

Con: (ICP1)

  • Ischemic Heart Disease
  • Chronic Nephritis with Nitrogen Retention
  • PVC’s
  • 1st Stage of Labor

Dose:
-Cardiac Arrest
40u IV/IO

  • Esophageal Varices
    0. 2-0.4u/min IV Drip
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17
Q

Activated Charcoal

A

Indications:
- Acute ingested poisoning

Contraindications:
- Uncontrolled airway
- Ingestion of(CCOMMIE) cyanide, mineral acids, caustic alkalis, organic solvents, iron, ethanol
or methanol

Dosage:
-1 g/kg mixed with 6 – 8 ounces water PO or NG tube

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18
Q

Digoxin (Lanoxin)

A

Indications:
-Increase cardiac output in CHF and to stabilize supraventricular tachy dysrhythmias.

Contraindications:

  • Ventricular fibrillation
  • Ventricular tachycardia except due to CHF

Dose:

  • Adult
    0. 25 to 0.5mg slow IVP
19
Q

Diphenhydramine (Benadryl)

A

Indications:
Anaphylaxis, allergic reactions, and dystonic reactions

Contraindications:
Asthma and other lower respiratory diseases

Dose:
-Adult
25 – 50mg IV/IM/PO

20
Q

Furosemide (Lasix)

A

Indications:

  •  Congestive heart failure
  •  Pulmonary edema

Contraindications:
- Hypersensitivity to sulfonamides
- Hepatic coma
- Pregnancy (except in life threatening emergencies)

Dose:
40 – 120 mg slow IV

21
Q

Vecuronium (Norcuron)

A

Indications:
-To maintain muscular paralysis following successful (RSI) intubation

Contraindications:

  • Hypersensitivity
  • Inability to control the airway (non-intubated patients)
  • Not to be used as initial Paralytic

Dosage:

  • Adult
    0. 1 mg/kg, max single dose of 10mg. May repeat in 30 – 40 minutes as needed to maintain paralysis
22
Q

Amyl Nitrite

A

Indications:
- Cyanide poisoning

Contraindications:
- None when used to manage an acute cyanide poisoning

Dosage:

  • Adult
    0. 3ml ampule crushed every minute and inhaled for 15 – 30 seconds
23
Q

Etomidate

A

Class:
-General anesthetic

Indications:
- First line anesthetic for RSI

Contraindications:

  •  Hypersensitivity
  •  Sepsis in pediatric patients
24
Q

Glucagon

A

Class:
-Hormone, anti-hypoglycemic

Indications:

  •  To increase blood sugar levels in hypoglycemia without vascular access
  •  Beta-blocker overdose

Contraindications:

  •  Hypersensitivity to glucagon or protein compounds
  • No glycogen stores in the liver

Dosage Adult:

  • Hypoglycemia
    1. 0 unit IM/SC (may repeat as needed 5 – 20 minutes)

-Beta-blocker OD
2 – 3 units IV/IO over 2 – 5 minutes

25
Heparin
Class: -Anticoagulant Indications: - To prevent thrombus formation in acute MI Contraindications: - Active bleeding - Pregnancy - Hemophilia
26
Nitrous Oxide
Class: -General anesthetic and analgesic ``` Indications: (BSI-M) - Musculoskeletal injury/pain - Burns - Severe anxiety including -hyperventilation - Ischemic chest pain ``` ``` Contraindications: - ALOC - COPD - Pneumothorax - Bowel obstruction ``` Dosage: -Adult Self administered until pain is relieved or the patient drops the mask
27
Succinylcholine
Class: -Depolarizing neuromuscular blocker Indications: - Facilitated endotracheal intubation ``` Contraindications: (FGLPS) - Family history of malignant hyperthermia - Glaucoma - Penetrating eye trauma - Liver disease - Significant burns older than 24 hours ``` Dosage: -Adult 1.0 – 1.5mg/kg IV/IM
28
Amiodarone (Cordarone)
Class: -Antiarhythmic Indications: - VF/Pulseless V tach - Wide complex tachycardia with a pulse ``` Contraindications: (ABCH) X2 - Hypersensitivity - Cardiogenic shock - Bradycardia - A V blocks ``` Dosage: Adult -VF/Pulseless Vtach 300mgIV/IO repeat at 150mg after 3–5minutes -Wide complex tachycardia: 150mg IV/IO over 10 minutes -Post resuscitation maintenance: 1mg/min over 6 hours Max dose: 2.2g IV/IO over 24 hours
29
Magnesium Sulfate
Class: Electrolyte ``` Indications: (ETHA) - Hypomagnesaemia - Torsades de pointes - Eclamptic seizure - Adjunctive treatment in moderate to severe acute asthma ``` ``` Contraindications: (HHMA) - Hypocalcaemia - Heart block - Myocardial damage - Anuria ``` Dosage: Adult -Torsades de pointes: 1 – 2g IVP over 1 – 2 minutes - Eclamptic seizure: 4-5g IVP concurrently with up to 5g IM in each Buttock followed by 4-5g every 4 hours - Bronchodilation: 2g IVP
30
Pralidoxime (2 PAM)
Class: Cholinesterase reactivate Indications: - Organophosphate poisoning ``` Contraindications: - Severe cardiac disease - Peptic ulcer - Asthma - Myocardial infarction - Hypersensitivity to procainamide/procaine ``` Dosage: Adult -1 – 2g in 250 – 500ml NS infused over 15 – 30 minutes; if no IV access is available then 1 – 2g IM/SC
31
Sodium Bicarbonate
``` Class: Alkalinizing agent (KTRP) ``` Indications: -  Prolonged cardiac arrest -  Known hyperkalemia -  Tricyclic antidepressants/barbiturates OD -  Refractory metabolic acidosis Contraindications: - None in the emergency setting Dosage: Adult -1mEq/kg IV/IO, may repeat at half dose every 10 minutes
32
Verapamil (Calan, Isoptin)
Class: Calcium channel blocker Indications: - SVT refractory to adenosine - Atrial flutter - Atrial fibrillation ``` Contraindications: - Hypotension - Cardiogenic shock - Heart block - Congestive heart failure - WPW syndrome with atrial fib ``` Dosage: Adult -2.5 – 5.0mg pushed over 2 – 3 minutes may repeat at double dose every 15 – 30 minutes to a max total dose of 20mg
33
Adenosine (Adenocard)
Class: Antiarrhythmic Indications: - PSVT (Refractory to Vagal maneuvers) - Stable wide complex Tachycardia thought to be reentry SVT Contraindications: - 2nd or 3rd Degree AV Heart Block - Poison or Drug induced Tachycardia Dose: Adult -6mg rapid IVP followed imimeatily by a 10ml flush. Can be repeated once at 12mg. Use Closest IV port using a large catheter.
34
Calcium Chloride
Class: Electrolyte ``` Indications: (H3C)  Hyperkalemia  Hypocalcemia  Hypermagnesemia  Calcium channel blocker OD ``` Contraindications: (DHV) - Vfib - Hypercalcemia - Digitalis toxicity Dosage: Adult 2 – 4mg/kg IV/IO every 10 minutes as needed
35
Fentanyl Citrate
Class: Narcotic analgesic Indications: -Pain management Contraindications: - Myasthenia graves - MAO inhibitors within 14 days Dosage: Adult -25 – 100mcg slow IV/IO over 2 – 3 minutes 1.0mcg/kg slow IV/IO over 2 – 3 minutes
36
Isoproterenol
Class: Sympathomimetic Indications: -  Symptomatic bradycardia refractory to atropine, pacing and dopamine -  Severe status asthmatics Contraindications: - Cardiogenic shock - Acute myocardial infarction Dosage: Adult -2 – 10mcg/min Status asthmaticus: 1 – 2 sprays MDI
37
Labetolol
Class: Beta Blocker Indications: - Management of an acute hypertensive crisis ``` Contraindications: (ABC-H)  Asthma  Heart blocks  Cardiogenic shock  Bradycardia ``` Dosage: Adult -20mg slow IV/IO, repeat at 40 – 80mg every 10 minutes as needed up to a total dose of 300mg. -2mg/min up to a total dose of 300mg
38
Procainamide
Class: Anti arrhythmic Indications: (WARPS) -  PSVT uncontrolled by vagal maneuvers and adenosine -  Recurrent VF/VT -  Stable wide complex tachycardia of unknown origin -  Atrial fibrillation with rapid ventricular rate -  WPW syndrome ``` Contraindications: (SDTT) - Second or third degree A V block - Digitalis toxicity - Torsades de pointes - TCA overdose ``` Dosage: Adult -Recurrent VF/VT: 20 - 50mg/minute IV (total dose 17mg/kg) -Other indications: 20mg/min IV (total dose of 17mg/kg)
39
Alteplase Recombinant | TPA
Class: Fibrinolytic Indications: - Fibrinolysis in acute myocardial infarction - Acute ischemic shock - Pulmonary embolism ``` Contraindications: - Internal bleeding - Aortic emergencies - Increased intracranial pressure - Hemorrhagic stroke within the past 6 months - Uncontrolled Hypertension ``` Dosage: Adult -MI/CVA: 15mg followed by 0.75mg/kg over 30 minutes, max dose of 50mg,then provide 0.5mg/kg over 60 minutes, max of 35mg. -Pulmonary embolism: 100mg infusion over 2 hrs
40
Decadron
Class: Steroid Indications: -  Anaphylaxis -  Asthma -  COPD -  Acute spinal cord edema Contraindications: - No absolute contraindications in the emergency setting Dosage: Adult 4 – 24mg IV/IO/IM
41
Mannitol (Cystosol, Osmitrol)
Class: Osmotic diuretic Indications: -To reduce acute cerebral edema and increased intracranial pressure ``` Contraindications: (CAPS-U) - CHF - Shock - Pulmonary edema - Active intracranial bleeding - Use with renal failure may result in fluid overload ``` Dosage: Adult -0.5 – 2g/kg over 5 – 10 minutes through an inline filter Additional doses of 0.25 – 2g/kg can be given every 4 – 6 hours as needed
42
Oxytocin | Pitocin
Class: Hormone Indications: - To control post part bleeding Contraindications: -  Prior to delivery of the baby -  Hypersensitivity Dosage: Adult -3 – 10 units IM after the delivery of the placenta -10 – 20 units in 1000cc D5W or NS IV infusion, titrate to the severity of the bleeding
43
Propranolol
Class: Beta blocker Indications: - PSVT not controlled by vagal maneuvers and adenosine Contraindications:(C3HA) -  High degree A V blocks -  CHF -  Cardiogenic shock -  Asthma -  COPD Dosage: Adult -1 – 3mg slow IVP over 2 – 5 minutes, not to exceed 1mg/min (may repeat in 2 minutes) max dose of 0.1mg/kg
44
Thiamine
Class: Vitamin Indications: (CAD) - Coma of unknown origin - Alcohol induced coma - Delirium tremens Contraindications: - Hypersensitivity Dosage: Adult -50 – 100mg IV/IO/IM

Drug Review- Ind, Con, Dose (1 decks)

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