Emergency Medications Flashcards

Practice the Mechanism of Action, Indications and Dosages of prehospital medications

1
Q

Mechanism of action.

Adenosine

A

Slows conduction at the AV node.

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2
Q

Indications and contraindications.

Adenosine

A

Indications:

  • SVT
  • PSVT

Relative Contraindications:

  • High degree heart block
  • COPD
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3
Q

Adult and pediatric dosages.

Adenosine

A

Adult: 6mg, 12mg, 12mg

Pediatric:

First Bolus - 0.1mg/kg
Second Bolus - 0.2mg/kg

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4
Q

Mechanism of action.

Albuterol

A

Beta 2 Agonist that causes bronchodilation.

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5
Q

Indications and contraindications.

Albuterol

A

Indications:

  • Bronchospasm
  • COPD/Asthma

Relative Contraindications:

  • Hypersensitivity
  • Tachycardia
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6
Q

Adult and pediatric dosages.

Albuterol

A

Adult: 2.5mg in 2.5ml Normal Saline

Pediatric:

<20kg = 1.25mg/20min

>20kg = 2.5mg/20min

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7
Q

Mechanism of action.

Alteplase

tPA

A

fibrinolytic

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8
Q

Indications and contraindications.

Alteplase

tPA

A

Indications:

  • STEMI
  • Pulmonary embolism
  • CVA

Contraindications:

  • Internal hemorrhage
  • Recent surgery
  • Aneurysm
  • Significant hypertension
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9
Q

Adult and pediatric dosages.

Alteplase

tPA

A

Adult:

  • Bolus - 15mg/kg bolus/2min
  • Infusion - 0.75mg/kg/30min
  • 2nd Infusion - 0.50mg/kg/60min

Pediatric: N/A

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10
Q

Mechanism of action.

Amiodarone

A

Sodium and potassium channel blocker.

Increases action potential as an antidysrhythmic

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11
Q

Indications and contraindications.

Amiodarone

A

Indications:

  • Ventricular fibrillation
  • Pulseless ventricular tachycardia
  • Symptomatic/Stable ventricular tachycardia

Contraindications:

  • Sinus Bradycardia
  • Cardiogenic shock
  • Sinus node dysfunction
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12
Q

Adult and pediatric dosages.

Amiodarone

A

Adult:

  • V-Fib/Pulseless V-Tach - 300mg Bolus; Q3-5min 150mg Bolus; If conversion, 1mg/min infusion
  • Symptomatic/Stable V-Tach - 150mg/10min; if conversion, 1mg/min infusion

Pediatric:

  • V-Fib/Pulseless V-Tach - 5mg/kg Bolus; Q3-5min 5mg/kg MAX 300mg
  • Symptomatic/Stable V-Tach - 5mg/kg/20-60min
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13
Q

Mechanism of action.

Aspirin

A

Anti-aggregate

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14
Q

Indications and contraindications.

Aspirin

A

Indications:

  • STEMI
  • Angina

Contraindications: Allergies

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15
Q

Adult and pediatric dosages.

Aspirin

A

Adult: 160-325mg PO

Pediatric: N/A

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16
Q

Mechanism of action.

Atropine

A

Inhibits acetycholine, which increases the heart rate.

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17
Q

Indications and contraindications.

Atropine

A

Indications:

  • Symptomatic or Unstable bradycardia
  • Beta blocker OD
  • Ca channel blocker OD

Contraindications:

  • Tachycardia
  • Hypothermic bradycardia
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18
Q

Adult and pediatric dosages.

Atropine

A

Adult: 0.5mg - 1.0mg

Pediatric: 0.02mg/kg

Minimum Dose of 0.1mg

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19
Q

Mechanism of action.

Calcium Chloride

A

Increases cardiac contractility by producing a positive inotropic effect.

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20
Q

Indications and contraindications.

Calcium Chloride

A

Indications:

  • Hypocalcemia
  • Hyperkalemia
  • Beta blocker and calcium channel blocker toxicity

Contraindications:

  • Hypercalcemia
  • Digitalis toxicity
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21
Q

Adult and pediatric dosages.

Calcium Chloride

A

Adult: 500mg - 1000mg

Pediatric: 20mg/kg MAX 1G

3x stronger than Calcium Gluconate; given through a central IV, not peripheral

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22
Q

Mechanism of action.

Calcium Gluconate

A

Increases cardiac contractility.

3x less potent than Calcium Chloride.

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23
Q

Indications and contraindications.

Calcium Gluconate

A

Indications:

  • Hyperkalemia
  • Hypocalcemia
  • Beta blocker and Ca channel blocker toxicity

Contraindications:

  • Hypercalcemia
  • Digitalis toxicity
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24
Q

Adult and pediatric dosages.

Calcium Gluconate

A

Adult: 500mg - 1000mg

Pediatric: 60-100mg/kg/5-10min

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25
Q

Mechanism of action.

Dexamethasone

A

Decreases airway inflammation by suppressing acute inflammation.

Corticosteroid

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26
Q

Indications and contraindications.

Dexamethasone

A

Indications:

  • Anaphylaxis
  • Asthma/COPD
  • Croup
  • Spinal cord injury

Relative Contraindications: Sepsis

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27
Q

Adult and pediatric dosages.

Dexamethasone

A

Adult: 10-100mg

Pediatric: 0.25 - 1.0mg/kg MAX 16mg

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28
Q

Mechanism of action.

Diazepam

Valium

A

CNS depressant and anticonvulsant/sedative.

Benzodiazepine

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29
Q

Indications and contraindications.

Diazepam

Valium

A

Indications:

  • Seizures
  • Anxiety
  • Cocaine OD

Relative Contraindications:

  • Decreased respiratory function
  • Head injury
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30
Q

Adult and pediatric dosages.

Diazepam

Valium

A

Adult: 5 - 10mg

Pediatric: 0.2 - 0.5 mg/kg

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31
Q

Mechanism of action.

Diltiazem

A

Calcium channel blocker

Blocks calcium influx during depolarization.

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32
Q

Indications and contraindications.

Diltiazem

A

Indications: Atrial Fibrillation/Flutter

Contraindications:

  • Hypotension
  • Cardiogenic shock
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33
Q

Adult and pediatric dosages.

Diltiazem

A

Adult:

  • First Bolus - 0.25mg/kg MAX 20mg
  • Second Bolus - 0.35mg/kg MAX 25mg
  • Infusion: 5-15mg/hr

Pediatric: N/A

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34
Q

Mechanism of action.

Dobutamine

A

Increases myocardial contractility, stroke volume and cardiac output

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35
Q

Indications and contraindications.

Dobutamine

A

Indications: Cardiogenic shock, CHF

Contraindications:

  • Tachydysrhythmias
  • Severe hypotension (initially causes hypotension)
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36
Q

Adult and pediatric dosages.

Dobutamine

A

Adult & Pediatric:

2-20mcg/kg/min

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37
Q

Mechanism of action.

Dopamine

A

Increases inotropic and chronotropic effects.

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38
Q

Indications and contraindications.

Dopamine

A

Indications:

  • Cardiogenic shock
  • Septic shock
  • Distributive shock
  • Bradycardia

Contraindications:

  • Hypovolemic shock
  • V-Fib
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39
Q

Adult and pediatric dosages.

Dopamine

A

Adult & Pediatric:

2-20mcg/kg/min

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40
Q

Mechanism of action.

Epinephrine

A
  • Alpha 1 agonist
  • Beta 1 agonist
  • Beta 2 agonist
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41
Q

Indications and contraindications.

Epinephrine

Hint: Cardiac

A

Indications:

  • Asystole
  • PEA
  • V-fib
  • Pulseless V-tach
  • Bradycardia

Contraindications:

  • Hypertension
  • Hypothermia
  • Pulmonary edema
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42
Q

Adult and pediatric dosages.

Epinephrine

Hint: Cardiac

A

Adult:

  • Asystole/PEA/Pulseless V-Tach/V-Fib: 1mg IV/IO
  • Bradycardia/Hypotension: 2-10mcg/min
  • Anaphylaxis: 0.3 - 0.5mg IM

Pediatric:

  • Asystole/PEA/Pulseless V-tach/V-Fib: 0.01mg/kg IV/IO
  • Bradycardia: 0.01mg/kg IV/IO
  • Infusion: 0.1 - 1mcg/min
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43
Q

Mechanism of action.

Furosemide

A

Inhibits absorption of chloride and sodium at proximal and distal tubules and loop of Henle.

Causes increased urine output.

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44
Q

Indications and contraindications.

Furosemide

A

Indications:

  • CHF
  • Pulmonary edema
  • Hypertensive crisis

Contraindications:

  • Hypovolemia
  • Hypotension
  • Electrolyte imbalances
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45
Q

Adult and pediatric dosages.

Furosemide

A

Adult: 0.5 - 1mg/kg; no response, double the dose

Pediatric: 1mg/kg

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46
Q

Mechanism of action.

Labetalol

A

Alpha and beta antagonist

Decreases blood pressure

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47
Q

Indications and contraindications.

Labetalol

A

Indication: Severe hypertension

Contraindications:

  • Asthma
  • CHF
  • Shock
  • Bradycardia
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48
Q

Adult and pediatric dosages.

Labetalol

A

Adult:

  • 10mg IV; Repeat or double Q10min
  • Infusion: 2-8mg/min

Pediatric: N/A

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49
Q

Mechanism of action.

Lidocaine

A

Sodium channel blocker

Decreases automaticity

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50
Q

Indications and contraindications.

Lidocaine

A

Indication:

  • V-Tach
  • V-Fib

Contraindication:

  • High degree heart block
  • Bradycardia with wide complexes
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51
Q

Adult and pediatric dosages.

Lidocaine

A

Adult:

  • Pulseless V-tach/V-Fib: 1-1.5mg/kg; Repeat .5-.75mg MAX 3mg/kg
  • Stable V-Tach: 1-1.5mg/kg; Repeat .5-.75mg/kg Q5-10min MAX 3mg/kg
  • Infusion: 1-4mg/min

Pediatric:

  • Pulseless V-tach/V-Fib: 1mg/kg MAX 100mg
  • Infusion: 20-50mcg/kg/min
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52
Q

Mechanism of action.

Metoprolol

A

Decreases HR, conduction, contractility, and cardiac output.

Selective Beta-1 agonist

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53
Q

Indications and contraindications.

Metoprolol

A

Indications:

  • PSVT
  • A-Flutter
  • A-Fib

Reduces oxygen demand in STEMI patients.

Contraindications:

  • Heart failure
  • High degree heart block
  • Bradycardia
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54
Q

Adult and pediatric dosages.

Metoprolol

A

Adult:

  • STEMI: 2-4mg
  • NSTEMI/Unstable Angina: 1-5mg

Pediatric: 0.1 - 0.2mg/kg MAX 5mg

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55
Q

Mechanism of action.

Nitroglycerine

A
  • Dilates peripheral arteries.
  • Decreases preload and afterload.
  • Vasodilator
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56
Q

Indications and contraindications.

Nitroglycerine

A

Indications:

  • Acute Angina
  • NSTEMI
  • STEMI
  • CHF
  • Pulmonary Edema
  • Hypertension

Contraindications:

  • Hypotension
  • Head Injury
  • Bradycardia
  • RV Infarction (relative)
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57
Q

Adult and pediatric dosages.

Nitroglycerine

A

Adult:

  • Tablet: 0.4mg
  • Spray: 1-2 Sprays MAX 3
  • Infusion: 10mcg/min; Increase by 10mcg/min Q 3-5 MAX 200mcg/min

Pediatric: N/A

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58
Q

Adult and pediatric dosages.

Nitropaste

A

Adult: ½’’ to ¾’’ (15-30mcg); cover with wrap and secure MAX 5’’ (75mg)

Pediatric: N/A

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59
Q

Mechanism of action.

Norepinephrine

A

Vasopressor; Alpha and Beta agonist causing peripheral vasoconstriction

Positive inotropic effect and dilates coronary arteries.

60
Q

Indications and contraindications.

Norepinephrine

Hint: Cardiac

A

Indications:

  • Cardiogenic shock
  • Significant Hypotension

Contraindications: Pregnancy (relative)

61
Q

Adult and pediatric dosages.

Norepinephrine

A

Adult: 0.1 - 0.5mcg/kg/min

Pediatric: 0.1 - 0.2mcg/kg/min

62
Q

Mechanism of action.

Diphenhydramine

A

H1 histamine antagonist

Decreases inflammatory response.

63
Q

Indications and contraindications.

Diphenhydramine

A

Indications:

  • Allergic reaction
  • Anaphylaxis

Contraindications:

  • Asthma (relative)
  • Hypertension (relative)
64
Q

Adult and pediatric dosages.

Diphenhydramine

A

Adult: 25 - 50mg

Pediatric: 1 - 2mg/kg

65
Q

Mechanism of action.

Racemic Epinephrine

A

Beta-2 agonist for receptors in lungs and relaxes bronchial smooth muscle.

66
Q

Indications and contraindications.

Racemic Epinephrine

A

Indications:

  • Croup
  • Laryngeal edema

Contraindications: Epiglottitis

67
Q

Adult and pediatric dosages.

Racemic Epinephrine

A

Adult: 5ml in 5ml NS

Pediatric:

  • 0.25ml in 2.5ml NS (<20kg)
  • 0.5ml in 2.5ml NS (20-40kg)
  • 0.75ml in 2.5ml NS (>40kg)
68
Q

Mechanism of action.

Methylprednisolone

A

Corticosteroid that decreases airway inflammation.

69
Q

Indications and contraindications.

Methylprednisolone

A

Indications:

  • Anaphylaxis
  • Asthma
  • COPD

Contraindications: Systemic fungal infections

70
Q

Adult and pediatric dosages.

Methylprednisolone

A

Adult: 125mg

Pediatric: 1 - 2mg/kg

71
Q

Mechanism of action.

Rocuronium

A

Antagonizes acetylcholine at synaptic cleft.

Non-depolarizing paralytic.

72
Q

Indications:

Rocuronium

A

Rapid Sequence Intubation

RSI

73
Q

Adult and pediatric dosages.

Rocuronium

A

Adult: 0.6 - 1.2mg/kg

Pediatric: 0.6 - 1.2mg/kg

Typical is 1mg/kg

74
Q

Mechanism of action.

Succinylcholine

A

Bind with acetylcholine at synaptic cleft and creates fasciculations.

Depolarizing paralyti

75
Q

Indications:

Succinylcholine

A

Rapid Sequence Intubation

RSI

76
Q

Adult and pediatric dosages.

Succinylcholine

A

Adult & Pediatric: 1.5mg/kg

Infant: 2mg/kg

77
Q

Mechanism of action.

Terbutaline

A

Beta 2 agonist

Relaxes smooth muscle of the bronchioles.

78
Q

Indications and contraindications.

Terbutaline

A

Indications:

  • Asthma
  • COPD

Contraindications: Tachydysrhythmias

79
Q

Adult and pediatric dosages.

Terbutaline

A

Adult: 0.25mg SC

Pediatric: N/A <12 years old

80
Q

Mechanism of action.

Vecuronium

A

Competes with acetylcholine at the synaptic cleft.

Non-depolarizing paralytic

81
Q

Indication:

Vecuronium

A

Rapid Sequence Intubation

RSI

82
Q

Adult and pediatric dosages.

Vecuronium

A

Adult: 0.1mg/kg

Pediatric: 0.1mg/kg

83
Q

Mechanism of action.

Etomidate

A

Induction agent; hypnotic.

84
Q

Indications and contraindications.

Etomidate

A

Indications: Induction for RSI

Contraindications: Adrenal compromised patient’s

85
Q

Adult and pediatric dosages.

Etomidate

A

Adult and Pediatric:

0.2 - 0.4mg/kg

0.3mg/kg typical dose.

86
Q

Mechanism of action.

Fentanyl

A

analgesic/opiate

87
Q

Indications and contraindications.

Fentanyl

A

Indications: Pain management

Contraindications: Head injury (relative - use caution)

88
Q

Adult and pediatric dosages.

Fentanyl

A

Adult and Pediatric:

1 - 2mcg/kg

89
Q

Mechanism of action.

Glucagon

A

Produces glycogenolysis within the liver to access the glycogen stores to be used as energy.

90
Q

Indications and contraindications.

Glucagon

A

Indications:

  • Hypoglycemia
  • Beta blocker OD
  • Ca channel blocker OD

Contraindications: Hyperglycemia

Be cautious in patients with liver failure as the drug may not be efficient.

91
Q

Adult and pediatric dosages.

Glucagon

A

Adult: 0.5 - 1mg IM

Pediatric: 0.03 - 0.1mg/kg IM

92
Q

Mechanism of action.

Haldol

A

Antipsychotic that is a CNS depressant.

93
Q

Indications and contraindications.

Haldol

A

Indications: Psychotic episodes

Contraindications:

  • AMS
  • Shock
  • Hypoxia
94
Q

Mechanism of action.

Heparin

A

Anticoagulant that prevents fibrogen to turn into fibrin.

95
Q

Indications and contraindications.

Heparin

A

Indication:

  • STEMI
  • Pulmonary embolism
  • DVT

Contraindications:

  • Bleeding
  • Recent surgery
  • Severe hypertension
96
Q

Adult and pediatric dosages.

Heparin

A

Adult:

  • Bolus 60IU/kg
  • Infusion 12IU/kg/hr

Pediatric: N/A

97
Q

Mechanism of action.

Insulin

A

Allows the transport of glucose into the cells.

98
Q

Indications and contraindications.

Insulin

A

Indications:

  • DKA
  • Hyperkalemia

Contraindications:

  • Hypoglycemia
  • Hypokalemia
99
Q

Adult and pediatric dosages.

Insulin

A

Adult:

  • Bolus 10-25IU SC, IM, IV
  • Infusion 0.1 IU/kg/hr

Pediatric: 0.1 - 0.2 IU/kg/hr

100
Q

Mechanism of action.

Atrovent

Ipratropium

A

Anticholinergic that produces bronchodilation and decreases mucus production.

101
Q

Indications and contraindications.

Atrovent

Ipratropium

A

Indications:

  • COPD
  • Asthma

Contraindications: Allergic

102
Q

Adult and pediatric dosages.

Atrovent

Ipratropium

A

Adult and Pediatric:

250 - 500mcg Neb

103
Q

Mechanism of action.

Toradol

A

NSAID that causes analgesia.

104
Q

Indications and contraindications.

Toradol

A

Indications: Minor to moderate pain

Contraindications:

  • Asthma
  • Bleeding disorders
  • Renal/liver failure
105
Q

Adult and pediatric dosages.

Toradol

A

Adult: 30 - 60mg IM

Pediatric: N/A

106
Q

Mechanism of action.

Lorazepam

Ativan

A

Benzodiazepine that is a CNS depressant.

107
Q

Indications and contraindications.

Lorazepam

Ativan

A

Indications:

  • Seizures
  • Anxiety

Contraindications: Shock (relative)

108
Q

Adult and pediatric dosages.

Lorazepam

Ativan

A

Adult: 2 - 4mg IM/IV

Pediatric: 0.05 - 0.20 mg/kg IM/IV

Typically 0.1mg/kg

109
Q

Mechanism of action.

Magnesium Sulfate

A

Smooth muscle relaxer.

110
Q

Indications and contraindications.

Magnesium Sulfate

A

Indications:

  • Eclampsia
  • Pre-term labor
  • Torsades de pointes
  • Severe asthma/COPD

Contraindications: Myocardial insufficiency

111
Q

Adult and pediatric dosages.

Magnesium Sulfate

A

Adult:

  • Eclampsia: Bolus 2 - 4G; Infusion 2G/30min
  • Torsades: 1 - 2G/5-20min

Pediatric:

  • Torsades: 25 - 50mg/kg bolus MAX 2G
  • Status Asthmaticus: 25 - 50mg/kg/15-30min MAX 2G
112
Q

Mechanism of action.

Mannitol

A

Diuretic that decreases fluid within the intracellular space and increases within the extracellular space.

113
Q

Indications and contraindications.

Mannitol

A

Indications:

  • Head Injury (herniation)
  • Cerebral edema
  • Blood transfusion reactions

Contraindications:

  • Hypotension
  • Pulmonary edema
  • CHF
114
Q

Adult and pediatric dosages.

Mannitol

A

Adult: 0.5 - 1G/kg/10min

Pediatric: 0.5 - 1G/kg/30-60min

115
Q

Mechanism of action.

Methylprednisolone

A

Corticosteroid that decreases airway inflammation.

116
Q

Indications and contraindications.

Methylprednisolone

A

Indications:

  • Anaphylaxis
  • Asthma
  • COPD

Contraindications: Systemic Fungal Infections

117
Q

Mechanism of action.

Midazolam

Versed

A

Benzodiazepine that causes CNS depression.

118
Q

Indications and contraindications.

Midazolam

Versed

A

Indications:

  • Seizure
  • Sedation

Contraindications: Shock

119
Q

Adult and pediatric dosages.

Midazolam

Versed

A

Adult: 2 - 2.5mg

Pediatric: 0.1 - 0.3mg/kg

Typically 0.1mg/kg

120
Q

Mechanism of action.

Morphine

A

Opioid that causes analgesia.

121
Q

Indications and contraindications.

Morphine

A

Indications:

  • Pain management
  • CHF
  • STEMI

Contraindications:

  • Hypotension
  • Decreased respiratory drive
122
Q

Adult and pediatric dosages.

Morphine

A

Adult: 2 - 4mg

Pediatric: 0.1 - 0.2mg/kg

123
Q

Mechanism of action.

Nalaxone

A

Binds to narcotic receptor sites inhibiting the effects of opioids.

124
Q

Indications and contraindications.

Nalaxone

A

Indications: Opiate OD

Relative Contraindications: Caution in narcotic dependent patients

Potentially may cause seizures.

125
Q

Adult and pediatric dosages.

Nalaxone

A

Adult: 0.4 - 2mg

Pediatric: 0.1mg/kg

126
Q

Mechanism of action.

Ondansetron

Zofran

A

Serotonin antagonist, which naturally causes nausea/vomiting.

127
Q

Indications and contraindications.

Ondansetron

Zofran

A

Indications: Nausea/vomiting

Contraindications: Long QT interval

128
Q

Adult and pediatric dosages.

Ondansetron

Zofran

A

Adult: 4mg

Pediatric: 0.1mg/kg

129
Q

Mechanism of action.

Oral Glucose

A

Glucose distribution through the GI tract and buccal vasculature.

130
Q

Indications and contraindications.

Oral Glucose

A

Indications: Hypoglycemia

Contraindications:

AMS

unconscious

131
Q

Adult and pediatric dosages.

Oral Glucose

A

Adult: 15G PO

Pediatric: 5-15G PO

132
Q

Mechanism of action.

Oxytocin

Pitocin

A

Increases contractions within the uterus.

133
Q

Indications and contraindications.

Oxytocin

Pitocin

A

Indications: Postpartum hemorrhage

Contraindications: N/A

134
Q

Adult and pediatric dosages.

Oxytocin

Pitocin

A

Adult: 10IU IM; Infusion: 20-40mIU/min

Pediatric: N/A

135
Q

Mechanism of action.

Propofol

A

general anesthesia

136
Q

Indications and contraindications.

Propofol

A

Indications:

  • Anesthesia
  • Induction
  • Sedation

Contraindications:

  • Hypovolemia
  • Allergic to eggs, soy, and peanuts
137
Q

Adult and pediatric dosages.

Propofol

A

Adult: Bolus: 1.5 - 3mg/kg; Infusion: 25-75mcg/kg/min

Pediatric: Bolus: 2.5 - 3.5mg/kg; Infusion: 125-300mcg/kg/min

138
Q

Mechanism of action.

Sodium Bicarbonate

A

Hydrogen ion buffer.

139
Q

Indications and contraindications.

Sodium Bicarbonate

A

Indications:

  • Metabolic acidosis
  • Tricyclic antidepressant OD
  • Hyperkalemia
  • Prolonged crush injuries

Contraindications: Respiratory/metabolic alkalosis

140
Q

Adult and pediatric dosages.

Sodium Bicarbonate

A

Adult: 1mEq/kg

Pediatric: 1mEq/kg

141
Q

Mechanism of action.

Thiamine

A

Vitamin B, essential for energy metabolism.

142
Q

Indications and contraindications.

Thiamine

A

Indications:

  • Delirium Tremens
  • Wernicke encephalopathy

Contraindications: N/A

143
Q

Adult and pediatric dosages.

Thiamine

A

Adult: 100mg

Pediatric: 10 - 25mg

144
Q

Mechanism of action.

Vasopressin

A

Vasoconstrictor that utilizes ADH for fluid retention.

145
Q

Indications and contraindications.

Vasopressin

A

Indications: Second or third choice of vasopressor

Contraindications: N/A

146
Q

Adult and pediatric dosages.

Vasopressin

A

Adult:

  • Bolus: 40 IU
  • Infusion: 0.02 - 0.04 IU/min

Pediatric: Bolus: 0.4 - 1 IU/kg