Drugs: Dosages Flashcards
Adenosine (adenocard):
Dose
Special Considerations
Note: should only be given rapid IV bolus with a peripheral vein, preferably the antecubial fossa. Admin should be immediately followed with an IV flush, and elevate extremity after.
Adult: initial dose 6mg rapid IV,IO (over 1-3 sec) immed. Followed w/ 20 ml saline flush. If doesn’t work may admin in 1-2 min a 2nd dose of 12 mg.
Pediatric: <110 lbs (50kg) - same as adult
>110 lbs - initial dose 0.1mg/kg IV, IO (max dose 6mg) followed by rapid flush. May repeat at 0.2 mg/kg (max dose 12mg)
- Use w/ caution in pts w/ preexisting bronchospasm and those with a history of AF
- Older Adults w/ no history of paroxysmal SVT should be carefully evaluated for dehydration and rapid sinus tachycardia, requiring volume fluid replacement rather than simply treated with Adenosine.
- Pregnancy’s class C
Amiodarone (Cordarone):
Dose
Special Considerations
Dose:
Ventricular Fib and pulseless VT:
-Adults- 300 mg IV,IO May be followed by 150 mg in 3-5 min.
-Ped-5mg/kg (max dose 300mg) May repeat 5mg/kg IV,IO up to 15mg/kg
Rel. Stable pt w/ arrhythmias, premature ventricular contraction, or wide complex tachy w/ a strong pulse:
- Adults- 150mg in 100ml D5W IV,IO over a 10 min period. Once return on spont. Circulation, begin infusion of 1mg/min for 6 hours, then decrease to 0.5 mg/min.
- Ped- 5 mg/kg very slow IV,IO (over 20-60 min) may repeat in 5mg/kg up to 15mg/kg (max dose 300 mg)
Pregnancy Class D
Atropine:
Dose
Special Considerations
Dose:
Nerve agent or Organophosphate poisoning:
-Adult- 1 to 6 mg IV,IM; may repeat every 5min until symptoms stop
-Ped- 0.05mg/kg IV,IM every 10-30 min as needed.
-Infant <15lbs- 0.05 mg/kg IV, IM every 5-20 min until needed
Symptomatic Bradycardia:
- Adult- 0.5mg IV,IO every 3-5 min to a max dose of 3 mg
- Pediatric/Adolescent- 0.02 mg/kg (min of 0.1 mg/dose) adolescent max 1mg/dose up to a total dose of 2mg. Pediatric max 0.5/dose up to a total of 1mg
- Pregnancy Class C, possibly unsafe in lactating mothers
- Severe organophosphate poising may require massive amounts of Atropine, well beyond what is carried in EMS vehicles
- Half life is 2.5hrs
MAG Sulfate:
Dose
Special Considerations
Dose:
-Pulseless Ventricular fib/VT
W/ Torsades or hypomagnesemia:
-Adult- 1-2g in 10 ml D5W IV,IO over 15 min or faster w/ Cardiac Arrest.
-Ped- 25-50 mg/kg IV,IO over 10-20 min, may admin faster for Torsades.(Max single dose 2g)
Torsades w/ a pulse or cardiac arrhythmias w/ hypomagnesemia:
- Adult- 1-2 g in 50-100 D5W IV,IO admin over 5-60 min
- Ped- 25-50mg/kg IV,IO over 10-20 min (max single dose 2g)
Eclampsia and seizure prophylaxis In preeclampsia:
- Adult- 4-6g IV, IO over 20-30 min. Followed by an infusion of 1-2 g/hr
Status Asthmaticus:
1.2-2g Slow IV, IO (over 20 min)
Pregnancy Class A
Midozolam (Versed):
Dose
Special Considerations
Dose:
Sedation:
Note: The dose needs to be individualized. Every dose should be admin slowly over a period of 2 min. Allow 2 min to evaluate the effect of dose given
-Adult- 1 mg IV, IO No more than 2.5 should be given over a 2 min interval. If add. Sedation required continue to admin small increments over 2 min period. (Max dose 5mg). If pt received/took a narcotic typically requires 30% less dose to sedate. Slightly less for older/critically ill patients (max dose 3.5 mg).
-cont. infusion- prolonged trans. Of crit. I’ll Pt
Dose of 0.02-0.1 mg/kg per hour (1-7mg/hr)
-Pediatric- typically require higher dose than adults on basis of weight. Younger Ped require higher doses than older peds <6>. 16-6 usually not me wary to exceed 10mg, <6 don’t need to exceed 6 mg.
Pt receiving Midazolam require frequent monitoring of Vitals and SPo2 be prepared to support pt airway and ventilate.
Dextrose:
Dose
Special Considerations
Dose:
Hyperkalemia:
-Adult: 25g of D50% IV, IO
-Ped: 0.5-1g/kg IV IO
Hypoglycemia:
-Adult: 10-25g of D50%
Pregnancy Class C
Glucagon:
Dose
Special Considerations
Dosage:
Hypoglycemia:
-Adult: 1mg IV, IM, IO or Sub Q
Beta Blocker Overdose:
-Adult 3-10mg IV IO over a one minute period, followed by a second dose of 10mg IV.
Diazepam (Valium)
Dose
Special Considerations
Dose:
Anxiety:
-Adult:
Moderate- 2-5 mg slow IV IM
Severe- 5-10mg slow IV IM (admin no faster than 5mg/min)
Low- low dosages are often required for older adults or debilitated pts.
Delirium Tremors:
-Adult: 10mg IV
Seizures:
-Adult:5-10mg slow IV IO every 10-15 min, max total dose 30mg
- Oil based can not be given MAD device
- Make sure that IV IO lines are well screwed. Extravasation of diazepam causes tissue necrosis
- Diazepam is insoluble in water and must be dissolved in propylene glycol. Produces a viscus solution; given slowly to prevent pain on injection.
- Pregnancy Class D
Morphine Sulfate
Dose:
Special Considerations:
Dosage:
- Adult: 2-10 mg IV,IO,IM or Sub Q admin slowly over a period of several minutes. The dose is the same regardless of route.
- Pediatric- <110lbs (50kg): 0.025-0.2 mg/kg IV,IO,IM, or SubQ
S.C.
- Monitor vital signs and O2 closely ne prepared to support pts. airway and ventilation’s
- Pts may report a “flushed” or hot feeling immediately following admin. Assess for signs of allergic reaction; however this is typically a histamine release.
- Overdose should be treated with Naloxone
- Pregnancy Class C
Narcan (Naloxone)
Dose:
Special Considerations:
Dosage:
-Adult: 0.4-2mg IV, IO, ET, IM or Sub Q or 2mg intranasally. Higher doses (10-20mg) may be required for overdoses of synthetic narcotics. A repeat dose of 1/3-2/3 the original dose is often necessary.
-Pediatric: 5 years or older .20kg: 2 mg IV, IO, ET, IM, or SubQ
<5 yearsor <20kg: 0.1 mg/kg IV,IO, ET, IM or SubQ; may repeat every 2-3 minutes
S.C.
Fentanyl
Dose:
Special Consideration
Dosage:
- Note drugs should be individualized
- Adult: 50-100 MCG/dose (micrograms/mikes) (0.05-0.1mg) IM, or slow IV, IO (admin over 1-2 minutes)
- Pediatric: 1.2 mcg/kg IM or slow IV, IO (admin over 1-2 min)
S.C. -Pregnancy class B
