ED Medications/ Dosages

Question 1

Treatment of SCAPE

Answer 1

NIPPV initially, plenty of peep, at least 6-8 cmh20
Nitro drip
loading dose of 2mg or 400mcg/min drip
then a healthy dose via drip titrated as tolerated to reduce BP. Probably at least 100mcg.

Question 2

Status epilepticus inital tx

Answer 2

10 mg IM versed or 4mg IV ativan

Question 3

Initial vanc dose

Answer 3

15-20 mg/kg…. but really dont need to go much over 1.5 grams unless they are huge muscular AA

Question 4

Hypertensive Urgency

Answer 4

10-20 mg labetalol

Cardene drip

Question 5

Second line AE drugs for Status Epilepticus

Answer 5

Phenytoin 20mg/kg load
Keppra 1000-2000mg loading dose
Valproic acid
Sedation with Ketamine, Propofol, Ativan

Question 6

Ketamine sedation

Answer 6

at least 0.8-1.0 mg/kg
30-40 min duration
avoid the 0.4-0.8 dose range ( emergence and crazy shit)
SE : hypertension, salivation/secretions, emergence phenomenon

Question 7

RSI

Answer 7

Paralytics 
       Succinylcholine 1-2 mg/kg 
       Rocuronium 
       Vecuronium 
Sedative
       Etomidate 
       Ketamine
       Versed 
Maintenance

Question 8

Afib with RVR

Answer 8

Diltiazem 1mg/ml soln start at 5 ml/hr, titrate up with max of 15ml/hr. or loading dose of 0.25 mg/kg
Oral Carvedilol as tolerated, 6.25, 12.5, 25, 50 bid

Question 9

Two important components of a neuroprotective induction , say for use in SAH.

Answer 9

Lidocaine - 1mg/kg, or just a 10cc syringe full of 1%
Fentanyl ( for pain control) - 50-100 mcg
0.7-10 mcg/kg/hr

Question 10

Versed dosage for continuous sedation

Answer 10

20-100 mcg/kg/hr IV

Question 11

Ketamine for continuous sedation

Answer 11

5-20 mcg/kg/min IV

Question 12

Propofol for continuous sedation

Answer 12

50-100 mcg/kg/min IV

Question 13

Etomidate (amidate) for induction

Answer 13

0.3 mg/kg IV…. somewhere around 15-30 mg total IVP .

Usually comes in 2mg/cc soln

Question 14

Ketamine for induction

Answer 14

2 mg/kg IVP

Question 15

Propofol for induction

Answer 15

2 mg/kg IVP (same as ketamine)

Question 16

Versed for induction

Answer 16

0.3 mg/kg IVP ( same as etomidate)

Question 17

Succinylcholine for paralysis during RSI

Answer 17

1-2 mg/kg IVP ( usually 100-150 will do it)

Question 18

Onset and duration of succs?

Answer 18

about a minute onset, 10 min duration

Question 19

Rocuronium for paralysis

Answer 19

1 mg/kg IVP ( 50-100 usually adequate)

Question 20

Onset/ duration of ROC?

Answer 20

onset 1-2 min, duration about an hour

Question 21

Anaphylaxis medications

Answer 21

Epinephrine (1:1000) 
        0.3 ml IM adult
        0.01 mg/kg sub U for peds
Solumedrol 125 mg IVP or 2 mg/kg peds
Benadryl 50 mg IVP or 1 mg/kg peds
Famotidine 20 mgIVP or 1 mg/kg peds

Question 22

Ancef

Answer 22

1 gram IV

Question 23

Rocephin

Answer 23

1-2 g IVP

Peds 50 mg/kg

Question 24

Rocephin peds dose for meningitis

Answer 24

100 mg/kg

Double the normal dose

Question 25

Clindamycin dose

Answer 25

600-900 mg IV

Question 26

Unasyn (amp/sulbactam)

Answer 26

3 g IV

Question 27

Vancomycin

Answer 27

15-20 mg/kg

1g for ED sheet

Trough after 4th dose (10-15 mcg)

Question 28

Heparin for acute coronary syndrome or PE

Answer 28

60 U/ kg Bolus (acs)
80 U/kg bolus (PE)

Maintenance
12-18 U/kg/HR

Max 5000 U bolus, 1200/ HR maintenance

Question 29

Dysrhythmia meds

Adenosine
Atropine
Diltiazem
Epinephrine
Lidocaine 
Amiodarone??

Answer 29

6 mg adenosine, can go to 12 mg

0.5 atropine for bradycardia

Diltiazem 20 mg IVP over 2 min
Then 25 mg IV and 5-15 cc/hr drip

Epi 1 mg of 1:10000

Lidocaine 1mg/kg load then 0.5 mg/kg
MAX 3000 mg

Amiodarone 200-400 mg

Question 30

Labetolol for HTN emergency

Answer 30

20 mg slow IV push, then 40-80 mg IV q10 min

Question 31

Esmolol for HTN urgency

Answer 31

500 mcg/kg IV over 1 min , then titrate from 50-200 mcg/kg/min

Question 32

Lopressor for HTN urgency

Answer 32

5 mg, repeat up to 3 doses

Question 33

Nitroglycerine for HTN emergency

Answer 33

10-20 mcg/min IV

Titrate to 200 /min

Question 34

Nitroprusside for HTN emergency

Answer 34

0.3 mcg/kg/min infusion up to 10 mcg/kg/min

Question 35

Pediatric emergency medications

Answer 35

Atropine 0.02 mg/kg ( need at least 0.1 mg)

Epinephrine 0.01-0.03 mg/kg IV of 1:10,000 soln

Question 36

Peds naloxone dose

Answer 36

0.1 mg/kg (max 2 mg)

Question 37

Adult naloxone dose

Answer 37

0.4-2 mg SC/ IV/ IM

Question 38

Levophed , dobutamine, dopamine for vasopressors

Answer 38

Dobutamine/Dopamine 2-20

Norepi 0.05-0.5 mcg/kg/min