Emergency Medications Flashcards
Adenosine
Adenocard
Class: Antidysrhythmic
MOA: slows conduction through AV node and interrupt reentry pathways. Drug choice for reentry SVT. Can be used for vtach after two doses of lidocaine
Indications: SVT. Not effective in afib or a flutter
Contraindications: high degree heart block, sick sinus syndrome,
Side Effects: headache, dizziness, brief asystole
Dosage: 6,12,12mg WBD of .1mg- .2mg/kg
Duration of Action: Onset is seconds and last twelve seconds
Special Considerations: may cause bronchoconstriction, consider pathological reason for SVT first
Albuterol
Proventil, Ventolin
- Class: sympathomimetic, bronchodilator
- MOA: beta 2 Agonist that stimulates adrenergic receptors of sympathetic nervous system, results in smooth muscle relaxation of bronchial tree
- Indications: bronchospasm, COPD, asthma
- Contraindications: hypersensitivity, tachycardia, dysrhythmia,
- Side Effects: tachycardia
- Dosage: Adult: 2.5-5mg Ped: 1.25-2.5mg
- Duration of Action: 5-15 min and last 3-4 hours
- Special Considerations: cause Angina pectoris
Alteplase
rTPA
- Class: Fibrinolytic
- MOA: enzyme binds to fibrin bound plasminogen at the clot site and converts plasminogen to plasmin. Plasmin digests the fibrin stands of clot, restoring perfusion
- Indications: AMI, STEMI, PE, CVA
- Contraindications: Internal Bleeding, recent surgery, aneurysm, uncontrolled hypertension
- Side Effects: Head bleed, chest pain, hypotension
- Dosage: 15mg
- Duration of Action: Onset within 30 minutes
- Special Considerations: observe for bleeding and monitor vitals
Amiodarone
Cordarone, Pacerone
- Class: Antidysrhythmic
- MOA: blocks sodium and potassium channels, increases duration of action potential
- Indications: v fib, pulseless v tach,
- Contraindications: none other than indications
- Side Effects: prolonged QT interval
- Dosage: Adult: 300-150mg bolus, 150mg/10min with pulse Ped: 5mg/kg bolus, 5mg/kg/20-60 minutes
- Duration of Action: Onset is immediate, last 30-45 minutes
- Special Considerations: monitor for hypotension
Amyl Nitrate
- Class: antidote for cyanide poisoning
- MOA: converts hemoglobin to methemoglobin which reacts with cyanide
- Indications: cyanide poisoning
- Contraindications: none
- Side Effects: headache, dizziness, weakness
- Dosage: 1-2 ampules crushed and inhaled for 30 seconds
- Duration of Action: 3-5 minutes
- Special Considerations: highly flammable
Aspirin
Asa, Bayer, Ecotein
- Class: platelet inhibitor
- MOA: prevents platelets from clumping together or aggregating and forming emboli
- Indications: chest pain suggestive of MI
- Contraindications: Hypersensitivity, stomach ulcer disease or asthma
- Side Effects: bronchospasm, prolonged bleeding, Reye’s syndrome
- Dosage: 81-324mg tablets, 1-2” paste
- Duration of Action: 30-45minutes
- Special Considerations: GI bleeding
Atenolol
Tenormin
- Class: beta blocker, antidysrhythmic
- MOA: decreases heart rate, myocardial contractiility, inhibits dilation of bronchial smooth muscle
- Indications: reduce myocardial ischemia, parosymsimal svt, a flutter, a fib, hypertension
- Contraindications: heart failure, cardiogenic Shock, Bradycardia, hypotension, high degree heart block
- Side Effects: dizziness, headache, hypotension
- Dosage: 5mg/5minutes
- Duration of Action: Onset 5 min, last 2-4 hours
- Special Considerations: given slowly, given with ca channel blockers causessevere hypotension
Atropine Sulfate
- Class: Anticholinergic
- MOA: inhibits acetylcholine at receptor sites, increasing heart rate in Bradycardia
- Indications: hemodynamically unstable bradycardia, organophosphate poisoning, RSI in pediatrics, beta or calcium channel blocker OD
- Contraindications: Tachycardia, glaucoma, hypothermic bradycardia
- Side Effects: drowsiness, confusion, palpitations, paradoxical bradycardia when pushed too slow or at
Bumetanide
Bumex
- Class: loop diuretic
- MOA: loop diuretic that inhibits reabsorption of sodium and Chloride in ascending loop of henle
- Indications: pulmonary edema, CHF
- Contraindications: hypovolemia, diabetes
- Side Effects: dizziness, headache, nsaids reduce diuretic effect
- Dosage: .5-1mg IV
- Duration of Action: onset is immediate and last 2-4 hours
- Special Considerations
Calcium Chloride
- Class: Electrolyte (anion)
- MOA: increases cardiac contractile state (positive inotropic effect)
- Indications: hypocalcemia, hyperkalemia, hypermagnesia, beta blocker and calcium channel blocker overdose
- Contraindications: hypercalcemia, v fib, digitalis toxicity
- Side Effects: syncope, cardiac arrest, dysrhytmias, hypotension, nausea, vomiting
- Dosage: 500mg-1G Ped: 20mg/kg
- Duration of Action: Onset is 1-3 minutes and lasts up to 4 hours
- Special Considerations: none
Calcium Gluconate
- Class: electrolyte
- MOA: same as Chloride
- Indications: s/a
- Contraindications: s/a
- Side Effects: s/a
- Dosage: 500mg-1G to Max of 3G Ped: 60-100mg/kg
- Duration of Action: onset is immediate and lasts up to 2 hours
- Special Considerations: Do not administer IM OR SQ
Clopidogrel
Plavix
- Class: antiplatelet
- MOA: inhibits platelet aggregation by blocking activation of glycoproteins
- Indications: MI, substitute for aspirin unable to take aspirin
- Contraindications: active GI bleed, intracranial hemmorage, hypersensitivity
- Side Effects: GI bleeding, Steven Johnson syndrome
- Dosage: 300-600mg tablet
- Duration of Action: Onset immediate and lasts 7-10 days
- Special Considerations: none
Dexamethasone
Decadron
- Class: corticosteroid
- MOA: suppresses acute and chronic inflammation; immunosuppressive effects
- Indications: anaphylaxis, asthma, COPD, spinal cord injury
- Contraindications: systemic sepsis
- Side Effects: headache, restlessness, hypertension
- Dosage: 1mg/kg Ped: .25-1mg/kg
- Duration of Action: onset takes hours and lasts 24-72 hours
- Special Considerations: none
Dextrose
- Class: carbohydrate antihypolglycemic
- MOA: increases serum glucose levels with short term osmotic dieresis
- Indications: hypoglycemia, ams, seizures of unknown
- Contraindications: intracranial hemmorage
- Side Effects: tissue necrosis innapropiately applied, hyperglycemia
- Dosage: 25G mixtures D25 for >1yr and D10 <1 year
- Duration of Action: less than 1 minute onset, variable duration
- Special Considerations: administer thiamine for vitamin B1 deficiency in alcoholics
Diazepam
Valium
- Class: benzodiazepine, sedative, anticonvulsant
- MOA: potentiates effects of inhibitory neurotransmitters, induces Amnesia and sedation
- Indications: seizures, anxiety, dt’s, sedation, cocaine od
- Contraindications: hypotension, hypopnea, head injury
- Side Effects: drowsiness, hypotension, resp depression
- Dosage: Seizure: 5-10mg, Cardioversion: 5-15mg/5-10min, Ped: Seizure: .2-.5mg/kg max of 10mg/kg, Rectal: .5mg/kg with rectal catheter, and flush with 2-3ml of air
- Duration of Action: Onset 1-5 minutes and last 20-50 minutes
- Special Considerations: reduce dose by 50% for elderly patients