DRUGS Flashcards
Epinephrine uses 1:1000
- anaphylaxis
- epi infusion for allergic reaction not responding to IM
Epinephrine 1:1000 dose allergic reaction
(1mg/ml)
adult: 0.3mg/3ml IM
peds: 0.15mg/1.5ml IM
Epinephrine 1:1000 infusion dose
- 1mg/250ml D5W = 4mcg/ml start at 2mcg/min and can titrate up to 10 mcg/min
epinephrine 1:10,000 uses
- cardiac arrest (VFIB, PVTACH, PEA, TORSADES, ASYSTOLE)
- racemic epi
epinephrine 1:10,000 doses
cardiac arrest:
(0.1mg/ml)
adult: 1mg/10ml every 3-5 minutes IV/IO
pediatric: 0.01 mg/kg every 3-5 minutes IV/IO
racemic epinephrine:
(0.1mg/ml)
adult: 0.3mg of 1:10,000 3mls in neb @6lpm (bronchial asthma)
Pediatric: 0.5mg of 1:10,000 5mls in neb @6lpm blow by (croup)
amiodarone uses
- VT/VF cardiac arrest (push)
- Vtach with a pulse (drip)
amiodarone dose cardiac arrest
50mg/ml
adult: 300mg/6ml IV/IO push first dose, 150mg/3ml IV/IO second dose
Pediatric: 5mg/kg IV/IO push, 15mg/kg max
amiodarone Vatch with a pulse dose
(50mg/ml)
adults: 150mg/50ml 10gtts/ml set @1 drop a second
pediatric: 5mg/kg –> buretrol @20mls 1gtts/sec
lidocaine uses
- cardiac arrest, alternate to amiodarone
- RSI with ICP, pair with mannitol
lidocaine cardiac arrest dose
adult: 1-1.5 mg/kg repeat up to three times max 3mg/kg VT/VF IV/IO
pediatric: 1mg/kg repeat after 15 minutes VF/VT IV/IO
maintenance infusion:
adult: 1-4 mg/min (1mg if liver issues)
pediatric: 20-50 mcg/kg/min
lidocaine rsi w/ icp dose
adult: 1-1.5 mg/kg
pediatric: 1 mg/kg
pair with mannitol
adenosine uses
SVT
adenosine dose
3mg/ml
adult: 6mg, second dose 12mg
pediatric: 0.1mg/kg (max 6mg), seconds dose 0.2mg/kg (max 12 mg)
aspirin uses
- chest pain suggestive of ACS
aspirin dose
81mg tablets
adult: up to 4 doses 324mg
pediatric: X
* do not give to pts with stomach ulcers or asthma*
atropine uses
- bradycardia
- RSI in pediatrics
- organophosphate poisoning
atropine bradycardia doses
(1mg/10ml)
bradycardia:
adults: 0.5 mg IV 3-5 minutes max dose 3mg
pediatrics: 0.02 mg/kg minimum 0.1mg maximum single dose 0.5mg, total max 1mg
atropine RSI in pediatrics
(1mg/10ml)
0.02 mg/kg minimum 0.1mg maximum 0.5mg
atropine organophosphate poisoning dose
(1mg/10ml)
2mg+ as much needed to stop symptoms.
magnesium sulfate uses
- hypomagnesemia
- eclampsia
- torsade’s de pointes
- asthma
magnesium sulfate hypomagnesemia doses
(0.5mg/ml)
adult: 1g IV
pediatric: 20-50 mg/kg IV/IO
magnesium sulfate eclampsia dose
(0.5mg/ml)
4g/50ml D5W @2gtts/min
magnesium sulfate torsade’s de pointes dose
(0.5mg/ml)
adults: 1-2g push pulseless
pulses: infusion 1g/100ml NS macro drip, if unstable defibrillate
Pediatrics: 25-50 mg/kg Iv push if pulseless max 2g
magnesium sulfate asthma/status asthmaticus dose
(0.5mg/ml)
adult: 2g/50ml NS over 10 minutes
pediatrics: 30-60 mg/kg/50ml NS over 15 minutes
D10 drip
(100mg/ml)
adults: 25g/250ml over 5-10 minutes (macro drip set)
pediatrics: 6ml/kg/250ml over 5-10 minutes (macro drip set)
dextrose
adult: 25g D50
pediatrics: 0.5/1g/kg of D25
infant: 200-500mg/kg D10
dopamine drip uses
- hypotension/ hypotension with low cardiac output
states - cardiogenic shock
- septic shock and distributive shock
- second line for symptomatic bradycardia
dopamine drip dose
(400mg/250ml)
adults and pediatrics:
5-20mcg/kg/min titrated to patient response, use the clock method to determine gtts/min
calcium gluconate gel uses and dose
- hydrofluoric burns
- black widow bites (use with a benzodiazepine in case patient has a seizure)
2.5% paste use all
albuterol uses
- bronchospasm (COPD, Asthma, allergic reaction)
- hyperkalemia
albuterol dose
adults: 2.5 mg 3mls neb
pediatrics: 1.25 mg neb for <20kg above 20kg get adult dose
Atrovent use and dose
bronchospasm with albuterol treatment
adult and pediatric: 0.5 mg in 3 mls
Duo dote single pen use
organophosphate posioning
duo dote drugs and dose
atropine, pralidoxime chloride
adults: 1 duodote pen injector IM for mild symptoms; 2 more pens may be administered for more severe symptoms. Max 3 pens
pediatrics: for pts weighing over 41kg (90lbs) three pens may be used as well
ryanodex uses.
malignant hyperthermia
ryanodex dose
250mg per vial
adults and peds: 2.5 mg/kg IV over 1 minute
glucagon uses
- hypoglycemia
- beta blocker OD
- steakhouse syndrome
glucagon dose hypoglycemia
(1mg/unit)
adults: 0.5-1 mg IM may be repeated twice
pediatrics: <20kg; 0.02mg/kg IM pts over 20kg adult dose
glucagon dose beta blocker OD
(1mg/unit)
adults: 3-10mg Iv bolus over 1-2 minutes, rebolus if no response
pediatric: 0.05-0.15 mg/kg
followed by infusion:
adult: 3-5mg/hr
pediatric: 0.05-0.1 mg/kg hr
glucagon steakhouse syndrome
(1mg/ml)
adults: 1 mg IV/IM
pediatrics: for peds >20kg ; 0.02 mg/kg IM Pts over 20kg 1 mg IM
Plavix uses
- blood thinner in the event of a heart attack or stroke
plavix dose
75mg per pill
adults: 300mg lading dose PO
pediatrics: 1mg/kg max 75mg/day PO
methylene blue uses
- methemoglobin levels above 20% need to be treated, caused by nitrate inhalant or benzocaine topical
methylene blue dose
(5mg/ml)
adult: 0.1-0.2 mg/kg slow IV push, repeat dose if level is higher than 30% @1 mg/kg
pediatrics: 0.1-0.2 mg/kg slow IV push, repeat dose if level is higher than 30% @1mg/kg
Pitocin use
- postpartum bleeding
- labor induction
Pitocin dose postpartum bleeding
(10u per ml)
10-40u max 40u IV push
Pitocin labor induction
(10u per ml)
0.5-1u/min titrate 1-2m until normal contractions
Haldol use and dose
acute psychotic episode
adults: 2-5mg IM
phentolamine use
- dopamine, epi, norepinephrine, and phenylephrine
infiltration - nonselective adrenergic antagonist
phentolamine dose
(5mg/vial)
adults: 5mg IV
pediatrics: 0.1-0.2 mg/kg max 10 mg
TXA uses
- bleeding control
- hemorrhagic shock
cannot be used for intracranial bleeding
TXA dose
(100mg/ml)
adult: 1g bolus in 100mls over 10 minutes
pediatric: 20 mg/kg IV bolus over 10 minutes
vasopressin uses
- hypotension
vasopressin doses
(20u/ml)
adults: 40 units IV push
pediatric: 0.4u/kg MAX 40 units
oral glucose dose
adults: 15g = 1 tubes
pediatric: 15g = 1 tube for children older than 2
versed uses
- seizure control
- sedation post et tube
- sedation in general
versed dose seizure control IM/IN
(1mg/ml)
adults: 0.2 mg/kg IM/IN w/ 10mg MAXIMUM
pediatric: 0.1-0.2 mg/kg IN/IM (2mg per max dose, may be repeated once
max 1cc per nostril
versed sedation for intubation IV
(1mg/ml)
adult: 2-4mg IV 2.5
pediatric: 0.05-0.5 mg/kg IV
fentanyl uses
- pain management
fentanyl dose
(50mcg/ml)
adults: 50mcg per IV push max 150mcg
pediatrics: 1-2mcg/kg IV push my be repeated max 4mcg/kg cumulative
labetalol use
hypertension
labetalol dose
adult: 10mg IV; infusion 2-8 mg/min
valium use
- alcohol withdraw
- seizures
- anxiety
valium dose
adults: 5mg
pediatric: 0.2-0.5 mg
ketamine uses
- RSI
- excited delirium
- pain management
ketamine dose RSI
(50mg/ml)
adults: 1-2 mg/kg IV
pediatric: 1-2 mg/kg max 100 mg
Avoid use in hypertension
ketamine dose excited delirium
(50mg/ml)
adult: 400mg IM/IV slow iv
ketamine dose pain management
(50mg/ml)
adults and pediatric: 0.5 mg/kg IN or 1-2 mg/kg IV/IO, dilute with 10ml NS
max single dose 25 mg
etomidate uses
- RSI
etomidate dose
(2mg/ml)
adults: 0.2-0.6 mg/kg IV/IO (20-30mg)
pediatrics: 0.2-0.4 mg/kg IV/IO max dose 20mg
rocuronium uses
- RSI with head trauma or suspected ICP
rocuronium dose
(1mg/ml)
adult: 1 mg/kg IV push
pediatrics: 0.6 mg/kg (1st dose), 0.075-0.125 mg/kg (second dose)
succinylcholine use
- RSI paralytic
- myasthenia gravis (communication between nerves and muscles break down)
succinylcholine doses
(20mg/ml)
RSI:
adults: 1.5 mg/kg IV; 4 mg/kg IM
pediatric: 1mg/kg max 150 mg
myasthenia gravis:
2 mg/kg IV
vecuronium uses
- RSI non depolarizing paralytic
vecuronium dose
adult: 0.1-0.2 mg/kg IV/IO
pediatrics: 0.1-0.3 mg/kg IV/IO
morphine uses and dose
- pain management
adult: 1-5mg IV push
pediatrics: 0.1-0.2 mg/kg IV MAX DOSE 5 mg IV/IO/IM
cyanokit uses and dose.
- cyanide poisoning
adult: 5g IV over 15 minutes
pediatrics: 70mg/kg
zantac use and dose
- ulcers, acid reflux
adults: 50 mg IV/IM
pediatrics: 2-4 mg/kg. IV max 50 mg
acetaminophen (Tylenol) use and dose
- fever
adults: 1000mg/100mls
pediatrics: 15 mg/kg PO one-time max dose 650mg
ondansetron (Zofran) use and dose
- antiemetic, N/V
(4mg/2ml)
adult: 4mg IV/IM
pediatric: 6 months and 14years: 0.15 mg/kg IV/PO max dose 4mg
diphenhydramine (Benadryl) uses
- allergic reaction
- dystonic reactions
- phenothiazine OD (antipsychotic med_)
- hyperemesis gravidarum (first trimester pregnant woman)
diphenhydramine dose for allergic, dystonic and phenothiazine OD
(50mg/ml)
adult: 25-50 mg IV/IM
pediatric: 1-2 mg/kg IV/IM max 50 mg
diphenhydramine dose for hyperemesis gravidarum
25-50 mg IV/IM
nitroglycerin uses
- chest pain related to ACS (to not give to RV infarction)
- pulmonary edema
nitroglycerin dose
(0.4mg/tablet/spray)
adults: 0.4 mg can be repeated x3
furosemide (lasix) uses
- pulmonary edema
- CHF
furosemide dose
(10mg/ml)
adults: 0.5-1 mg/kg IV (40mg)
pediatrics: 1mg/kg max 6mg/kg
narcan use and dose
- opioid overdose
adults: 0.4-2 mg IV/IN/IO/IM/ET can be repeated 3 times max 10mg
pediatrics: 0.1 mg/kg max 2 mg per dose
solumedrol uses
- allergic rections
- asthma, copd, (reactive airway)
- status asthmaticus
solumedrol dose (same for all conditions)
(125mg/vial)
adults: 125 mg IV
pediatrics: 1-2 mg/kg IV max 60 mg
cardizem uses
- afib
-aflutter
Cardizem doses
adult: 0.25 mg/kg IV over 2 minutes, epeated dose 0.35 mg/kg after 15 minutes
PUSH OVER 2 MINUTES
flumazenil (romazicon) use and dose
- benzodiazepine OD
adults: 0.01 mg/kg max single doe 0.2 mg
max total 0.5-1mg
mannitol uses
- cerebral edema
- rhabdomyolysiss
- blood transfusion
mannitol doses (all the same)
adult: 0.5-1g/kg IV infusion over 30 minutes
pediatric: 0.5-1g/kg IV infusion over 30 minutes
calcium chloride uses
- hypocalcemia
- calcium channel blocker OD
-hypermagnesemia - hyperkalemia
calcium chloride hypocalcemia dose
(1g/10ml)
adult: 500-1g IV over 5-10 minutes
pediatric: 10-20 mg/kg Iv
calcium chloride calcium channel blocker OD dose
(1g/10ml)
adults: 500-1g IV
pediatrics: 20 mg/kg IV
calcium chloride hypermagnesemia dose
(1g/10ml)
adults: 500-1g IV
pediatrics: 10-20 mg/kg IV
calcium chloride hyperkalemia dose
(1g/10ml)
adults: 500-1g IV
pediatrics: 20mg/kg max 1 gram
thiamine uses
- alcohol intoxication
- Wernicke Kosoff syndrome (alcohol abuse)
- beriberi (thiamine defficency)
thiamine alcohol abuse dose
(100mg/ml)
adults: 100mg IV
thiamine beriberi dose
(100mg/ml)
adults: 10-20 mg IM
pediatrics: 10-25 mg IV/IM
activated charcoal use and dose
- oral, medication poisoning
adults: 1-2 g/kg PO/NG tube
peds is same
acetylcysteine (mucomyst) use and dose
- acetaminophen overdose
adults & pediatrics: 300 mg/kg over 3 portions, loading dose is 150mg/kg over one hour
second dose 50 mg/kg given over 4 hours
third dose is 100mg/kg infused over 16 hours
norepinephrine (levophed) uses and dose
- septic shock, hypotension
adults: 0.1-0.5 mcg/min IV infusion
pediatrics: 0.1-2 mcg/kg IV
sodium bicarbonate uses
- metabolic acidosis
-Tricycliticantidepressant overdose - aspirin OD
-phenobarbital OD - hyperkalemia
- crush injuries
sodium bicarbonate dose (all the same)
adult & pediatric: 1 mEq/kg *dilute to 4.2% for kids)
terbutaline sulfate use and dose
adult: 0.24 mg subq
not recommended for pediatrics under 12
Toradol use and dose
- pain management
-NSAID
adult: 30-60 mg IM/ 15-30 mg IV
pediatric: x
Ativan uses
- status epilepticus
- anxiety sedation
Ativan status epilepticus dose
adult: 0.1 mg/kg *max 4 mg IV/IM
pediatric: 0.05 mg/kg IV/IM
Ativan anxiety sedation dose
adult: 2mg IV, 4 mg IM
metoprolol uses and considerations
- hypertension
- paroxysmal supraventricular tachycardia
- myocardial ischemia and damage in pts w/ AMI
- do not give to patients with heart failure 2nd, 3rd HB, bradycardia, or in cardiogenic shock*
captopril use and dose
- ace inhibitor
- hypertension
- left ventricular dysfunction following stemi, diabetic neuropathy
adults: 12.5-25 mg PO
pediatrics: 0.3-0.5, infants 0.15-0.3, neonates 0.05-0.1 mg PO
pralidoxime uses and dose
- organophosphate poisoning
adults: 600 mg IM X3/ 1-2g IV infusion 100ml
pediatrics: 15 mg/kg IM dose <40kg x3 max 45 mg/kg