Emergency Pharm 1

Question 1

Epinephrine (Adrenalin)

Class: Sympathomimetic

Answer 1

-Action: Stimulates alpha and beta 1 & 2 receptors.
•Vasoconstriction and bronchodilator
•Increased cardiac contractile force, rate, & CO

• Indications: Anaphylaxis (plus many others)
• Contraindications: Hypovolemic shock

-Dose/ Route:
•Adult: 0.3 – 0.5 mg SQ/ IM 1:1,000
Peds: 0.01 mg/kg 1:1,000 SQ/ IM. Max single dose of 0.3 mg

•Side Effects: Tachycardia, HTN, anxiety, dysrhythmias, tremors, dyspnea

Question 2

Diphenyldramime (Benadryl)

Answer 2

Adult dose-25-50mg IV/IM/PO max 400mg

Peds - 1mg / kg IV Max 300mg/ Day

Question 3

Methylprednisolone (soIu-medrol)

Answer 3

Adult: 40-125mgIV
Peds: 1-2mg /kg IV

Question 4

Ibuprofen (motrin)

Answer 4

200 to 800mg Po every 4-8 h

Max 0F 3200mg/ Day -

Question 5

Acetaminophen (tylenol)

Answer 5

325 to 650mg PO every4-6 hr

Peds 15mg/kg PO every 4-6 hr

Question 6

Acetazolamide (Diamox)

Answer 6

AMS/HACE Prevention125mg PO every 12h

Treatment 250mg PO every12 h

Question 7

Dexamethasone (Decadron)

Answer 7

Anti inflammatory

0. 75mg to 9mg PO per day
1. 5mg to 9mg IV / IM Per day every 12h

Altitude
AMS - 4mg PO/Iv/IM every 6 h
HACE-8mg PO/IV/IM once Followed by 4my PO / IV/IM Every 6 h

Question 8

Nifedipine (Procardia)

Answer 8

30mg ER version every 12h OR

20mg ER version every 8h

Question 9

Oxygen (O2)

Answer 9

nasal cannula 1-4Ipm

NRB- 10-15 LPM

Question 10

Naloxone (narcan)

Answer 10

Adult 0.4- 2mg MAY Repeat up to 10mg

Pead O.1 kg Max dose of 2mg per dose

Question 11

Flumazenil (Romazicon)

Answer 11

Adult: 0.2 mg IV over 15 sec, may repeat at 0.3mg IV over 30 sec, then 0.5mg IV over 30 secs given at 1 min intervals until adequate response or a max dose of 3 mg given

Peds: Not recommended in the pre-hospital setting

Question 12

Pralidoxime (2- PAM)

Answer 12

Adult: 600mg IM or 1-2 g IV over 15-30 min
Peds: 20-50mg/kg IV over 15-30 min

Question 13

Atropine Sulfate

Answer 13

Adult: 1 to 5mg IV/IM/IO repeated 3-5 min until cessation of bronchial secretions

Peds: < 12 yrs old - 0.02 - 0.05mg/kg IV/IM/IO may be repeated every 20-30 mins until cessation of bronchial secretions.

Nerve Agent Treatment: 2.1 mg in each ATNAA autoinjector and 2 mg in each separate atropine autoinjector; initial dose 6.1 mg (3 ATNAAs)

Question 14

Activated Charcoal

Answer 14

• Adult: 1 g/kg PO

* Peds: 1-2 g/kg PO

Question 15

Calcium chloride

Answer 15

Adult: 500-1000 mg slow IV of 10% solution
Peds: 20 mg/kg slow IV of 10% solution

Question 16

Sodium Bicarb

Answer 16

Adult: 1mEq/kg IV
Peds: Same as adult but infuse slowly and only if ventilations are adequate

Question 17

Glucagon

Answer 17

Adult: 3 - 10 mg IV over 3-5 min followed by an infusion at 3-5 mg/hr
Peds: >20 kg at 0.5 - 1.0 mg IM.

Question 18

Ondansetron (zofran)

Answer 18

Adult: 4 – 8 mg IV/IO/IM every 8 hrs
Peds: 0.15 mg/kg IV/IO/IM

Question 19

promethazine (phenergan)

Answer 19

Adult: 12.5 – 25mg IV diluted in 10cc Normal Saline with doses of 25 mg or less given over 10-15 min. IM doses can be given undiluted
Peds: Not recommended in prehospital setting

Question 20

Loperamide (Imodium)

Answer 20

Adult: 4 mg orally after the first loose stool, then 2 mg orally after each unformed stool; Maximum dose: 16 mg per day

Question 21

Metaclopramide (Reglan)

Answer 21

Adult: 10 mg IV over 1-2 minutes; 10 mg PO
Peds: 0.1 mg/kg over 1-2 minutes (Max 10 mg/ dose IV)

Question 22

Omeprazole (prilosec)

Answer 22

Dose/ Route: Multiple, look it up