Emergency Medications Flashcards
Practice the Mechanism of Action, Indications and Dosages of prehospital medications
Mechanism of action.
Adenosine
Slows conduction at the AV node.
Indications and contraindications.
Adenosine
Indications:
- SVT
- PSVT
Relative Contraindications:
- High degree heart block
- COPD
Adult and pediatric dosages.
Adenosine
Adult: 6mg, 12mg, 12mg
Pediatric:
First Bolus - 0.1mg/kg
Second Bolus - 0.2mg/kg
Mechanism of action.
Albuterol
Beta 2 Agonist that causes bronchodilation.
Indications and contraindications.
Albuterol
Indications:
- Bronchospasm
- COPD/Asthma
Relative Contraindications:
- Hypersensitivity
- Tachycardia
Adult and pediatric dosages.
Albuterol
Adult: 2.5mg in 2.5ml Normal Saline
Pediatric:
<20kg = 1.25mg/20min
>20kg = 2.5mg/20min
Mechanism of action.
Alteplase
tPA
fibrinolytic
Indications and contraindications.
Alteplase
tPA
Indications:
- STEMI
- Pulmonary embolism
- CVA
Contraindications:
- Internal hemorrhage
- Recent surgery
- Aneurysm
- Significant hypertension
Adult and pediatric dosages.
Alteplase
tPA
Adult:
- Bolus - 15mg/kg bolus/2min
- Infusion - 0.75mg/kg/30min
- 2nd Infusion - 0.50mg/kg/60min
Pediatric: N/A
Mechanism of action.
Amiodarone
Sodium and potassium channel blocker.
Increases action potential as an antidysrhythmic
Indications and contraindications.
Amiodarone
Indications:
- Ventricular fibrillation
- Pulseless ventricular tachycardia
- Symptomatic/Stable ventricular tachycardia
Contraindications:
- Sinus Bradycardia
- Cardiogenic shock
- Sinus node dysfunction
Adult and pediatric dosages.
Amiodarone
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
Mechanism of action.
Aspirin
Anti-aggregate
Indications and contraindications.
Aspirin
Indications:
- STEMI
- Angina
Contraindications: Allergies
Adult and pediatric dosages.
Aspirin
Adult: 160-325mg PO
Pediatric: N/A
Mechanism of action.
Atropine
Inhibits acetycholine, which increases the heart rate.
Indications and contraindications.
Atropine
Indications:
- Symptomatic or Unstable bradycardia
- Beta blocker OD
- Ca channel blocker OD
Contraindications:
- Tachycardia
- Hypothermic bradycardia
Adult and pediatric dosages.
Atropine
Adult: 0.5mg - 1.0mg
Pediatric: 0.02mg/kg
Minimum Dose of 0.1mg
Mechanism of action.
Calcium Chloride
Increases cardiac contractility by producing a positive inotropic effect.
Indications and contraindications.
Calcium Chloride
Indications:
- Hypocalcemia
- Hyperkalemia
- Beta blocker and calcium channel blocker toxicity
Contraindications:
- Hypercalcemia
- Digitalis toxicity
Adult and pediatric dosages.
Calcium Chloride
Adult: 500mg - 1000mg
Pediatric: 20mg/kg MAX 1G
3x stronger than Calcium Gluconate; given through a central IV, not peripheral
Mechanism of action.
Calcium Gluconate
Increases cardiac contractility.
3x less potent than Calcium Chloride.
Indications and contraindications.
Calcium Gluconate
Indications:
- Hyperkalemia
- Hypocalcemia
- Beta blocker and Ca channel blocker toxicity
Contraindications:
- Hypercalcemia
- Digitalis toxicity
Adult and pediatric dosages.
Calcium Gluconate
Adult: 500mg - 1000mg
Pediatric: 60-100mg/kg/5-10min
Mechanism of action.
Dexamethasone
Decreases airway inflammation by suppressing acute inflammation.
Corticosteroid
Indications and contraindications.
Dexamethasone
Indications:
- Anaphylaxis
- Asthma/COPD
- Croup
- Spinal cord injury
Relative Contraindications: Sepsis
Adult and pediatric dosages.
Dexamethasone
Adult: 10-100mg
Pediatric: 0.25 - 1.0mg/kg MAX 16mg
Mechanism of action.
Diazepam
Valium
CNS depressant and anticonvulsant/sedative.
Benzodiazepine
Indications and contraindications.
Diazepam
Valium
Indications:
- Seizures
- Anxiety
- Cocaine OD
Relative Contraindications:
- Decreased respiratory function
- Head injury
Adult and pediatric dosages.
Diazepam
Valium
Adult: 5 - 10mg
Pediatric: 0.2 - 0.5 mg/kg
Mechanism of action.
Diltiazem
Calcium channel blocker
Blocks calcium influx during depolarization.
Indications and contraindications.
Diltiazem
Indications: Atrial Fibrillation/Flutter
Contraindications:
- Hypotension
- Cardiogenic shock
Adult and pediatric dosages.
Diltiazem
Adult:
- First Bolus - 0.25mg/kg MAX 20mg
- Second Bolus - 0.35mg/kg MAX 25mg
- Infusion: 5-15mg/hr
Pediatric: N/A
Mechanism of action.
Dobutamine
Increases myocardial contractility, stroke volume and cardiac output
Indications and contraindications.
Dobutamine
Indications: Cardiogenic shock, CHF
Contraindications:
- Tachydysrhythmias
- Severe hypotension (initially causes hypotension)
Adult and pediatric dosages.
Dobutamine
Adult & Pediatric:
2-20mcg/kg/min
Mechanism of action.
Dopamine
Increases inotropic and chronotropic effects.
Indications and contraindications.
Dopamine
Indications:
- Cardiogenic shock
- Septic shock
- Distributive shock
- Bradycardia
Contraindications:
- Hypovolemic shock
- V-Fib
Adult and pediatric dosages.
Dopamine
Adult & Pediatric:
2-20mcg/kg/min
Mechanism of action.
Epinephrine
- Alpha 1 agonist
- Beta 1 agonist
- Beta 2 agonist
Indications and contraindications.
Epinephrine
Hint: Cardiac
Indications:
- Asystole
- PEA
- V-fib
- Pulseless V-tach
- Bradycardia
Contraindications:
- Hypertension
- Hypothermia
- Pulmonary edema
Adult and pediatric dosages.
Epinephrine
Hint: Cardiac
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
Mechanism of action.
Furosemide
Inhibits absorption of chloride and sodium at proximal and distal tubules and loop of Henle.
Causes increased urine output.
Indications and contraindications.
Furosemide
Indications:
- CHF
- Pulmonary edema
- Hypertensive crisis
Contraindications:
- Hypovolemia
- Hypotension
- Electrolyte imbalances
Adult and pediatric dosages.
Furosemide
Adult: 0.5 - 1mg/kg; no response, double the dose
Pediatric: 1mg/kg
Mechanism of action.
Labetalol
Alpha and beta antagonist
Decreases blood pressure
Indications and contraindications.
Labetalol
Indication: Severe hypertension
Contraindications:
- Asthma
- CHF
- Shock
- Bradycardia
Adult and pediatric dosages.
Labetalol
Adult:
- 10mg IV; Repeat or double Q10min
- Infusion: 2-8mg/min
Pediatric: N/A
Mechanism of action.
Lidocaine
Sodium channel blocker
Decreases automaticity
Indications and contraindications.
Lidocaine
Indication:
- V-Tach
- V-Fib
Contraindication:
- High degree heart block
- Bradycardia with wide complexes
Adult and pediatric dosages.
Lidocaine
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
Mechanism of action.
Metoprolol
Decreases HR, conduction, contractility, and cardiac output.
Selective Beta-1 agonist
Indications and contraindications.
Metoprolol
Indications:
- PSVT
- A-Flutter
- A-Fib
Reduces oxygen demand in STEMI patients.
Contraindications:
- Heart failure
- High degree heart block
- Bradycardia
Adult and pediatric dosages.
Metoprolol
Adult:
- STEMI: 2-4mg
- NSTEMI/Unstable Angina: 1-5mg
Pediatric: 0.1 - 0.2mg/kg MAX 5mg
Mechanism of action.
Nitroglycerine
- Dilates peripheral arteries.
- Decreases preload and afterload.
- Vasodilator
Indications and contraindications.
Nitroglycerine
Indications:
- Acute Angina
- NSTEMI
- STEMI
- CHF
- Pulmonary Edema
- Hypertension
Contraindications:
- Hypotension
- Head Injury
- Bradycardia
- RV Infarction (relative)
Adult and pediatric dosages.
Nitroglycerine
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
Adult and pediatric dosages.
Nitropaste
Adult: ½’’ to ¾’’ (15-30mcg); cover with wrap and secure MAX 5’’ (75mg)
Pediatric: N/A