Field Drugs (Name/Class/Dose/Indication/Contra)

Question 1

What drugs can be given for pain management?

Answer 1

Tylenol (1000mg PO or IV 10min)

Fentanyl (1-2 mcg/kg IV/IO)

Morphine (2-4 mg SIVP 30-60 sec)

Ketamine (0.2 - 0.3 mg/kg IV)

Question 2

Tylenol (Acetaminophen)

Class, Dose, Indications, Contraindications

Answer 2

Class: Non opioid Analgesic & Antipyretic

Dose: 1000 mg PO or IV over 10 min (Peds: 15mg/kg)

Indications: Mild/Moderate/Severe Pain

Contraindications: Allergies, Chronic liver failure, Therapeutic dose w/in 6 hrs

Question 3

Fentanyl (Sublimaze)

Class, Dose, Indications, Contraindications

Answer 3

Class: Analgesic (Synth. Opioid)

Dose: 1-2 mcg/kg IV/IO/IM

Indications: Pain control, Und. abdominal pain, MI, Trauma

Contraindications: Head Injury, Systolic BP < 90

Question 4

Morphine

Class, Dose, Indications, Contraindications

Answer 4

Class: Analgesic (Opioid)

Dose: 2-4 mg SIVP (30-60 sec)

Indications: CP cardiac origin; Isolated injuries

Contraindications: Undiagnosed abdominal pain; multisystem trauma

Question 5

Ketamine (pain)

Class, Dose, Indications, Contraindications

Answer 5

Class: Anesthetic (NMDA receptor antagonist)

Dose: 0.25 mg/kg IV/IO or 0.5 IM

Indications: Pain control

Contraindications: relative penetrating eye trauma, relative cardiovascular disease

Question 6

What drugs are Antiemetics?

Answer 6

Droperidol (1.25mg SIVP Elderly: 1/2 dose)

Reglan (10mg IV)

Promethazine (Phenergan) (12.5 - 25 mg IVP)

Zofran (2-4mg IV/IO)

Question 7

Droperidol (Antiemetic)

Class, Dose, Indications, Contraindications

Answer 7

Class: Antipsychotic, Antiemetic

Dose: 1.25 mg SIVP (1/2 dose elderly

Indications: N/V

Contraindications: Suspected acute MI; Systolic BP < 100; Respiratory depression; pregnancy; prolonged QT

Question 8

Reglan (Metroclopramide)

Class, Dose, Indications, Contraindications

Answer 8

Class: Antiemetic

Dose: 10mg IV

Indication: N/V

Contraindications: Hypotension, Taking other Na+ blocker, Prolonged QT

Question 9

Phenegran (Promethazine)

Class, Dose, Indications, Contraindications

Answer 9

Class: Phenothiazine

Dose: 12.5-25 mg IV

Indications: N/V, motion sickness

Contraindications: MI, Hypotension

Question 10

Atropine

Class, Dose, Indications, Contraindications

Answer 10

Class: Anticholinergic

Dose 1mg every 3-5min up to 3mg
OD: 2 mg every 3-5 min until resolved

Indications: Symptomatic Bradycardia & Organophosphate OD

Contraindications: High degree heart block; Glaucoma

Question 11

Adenosine

Class, Dose, Indications, Contraindications

Answer 11

Class: Class V Antidysrhythmic (slows conduction through the AV Node)

Dose: 6 mg/12 mg/12 mg - Fast IVP w/ Flush

Indications: SVT; Fast Narrow complex > 160 (stable pt)

Contraindications: A-Flutter, V-Fib/V-Tach

Question 12

Amiodarone

Class, Dose, Indications, Contraindications

Answer 12

Class: Class III Antidysrhythmic (K+ block) Prolongs refractory period

Dose: 150mg in 50 mL over 10 min (push 10mL every 2 min) x 2
350 mg then 150mg

Indications: V-tach w/ a pulse or Pulseless V-Tach/V-Fib

Contraindications: Cardiogenic shock, hypotension, bradycardia

Question 13

Epinephrine 1:1

Class, Dose, Indications, Contraindications

Answer 13

Class: Sympathomimetic

Dose: 0.3-0.5 mg IM
Drip: 1mg into 250/500/1000mL @ 2-10 mcg/min

Indications:
Asthma after albuterol
Allergic reaction with SOB
Symp Bradycardia after Atropine

Contraindications: Hypovolemic shock (fix first), MIs, MAOIs

Question 14

Epinephrine 1:10

Class, Dose, Indications, Contraindications

Answer 14

Class: Sympathomimetic

Dose: 1 mg (Cardiac arrest)
0.3-0.5 mg IV (Anaphylaxis)

Indications: Pulseless V-Tach, V-Fib, Asystole, PEA
Anaphylaxis Shock

Contraindications: None

Question 15

Dopamine

Class, Dose, Indications, Contraindications

Answer 15

Class: Sympathomimetic

Dose: Mix 400mg in 250mL
2-20mcg/min (low = beta; med = alpha/beta high = alpha)

Indications: Hypotension unable to be controlled

Contraindications: Hypovolemia

Question 16

What treatment can we provide for someone who is symptomatic bradycardic

Answer 16

Provide O2
IV
12 lead
Atropine 1mg up to 3 doses
Pacing @ 80/80 (check for electrical/mechanical capture)
Epi drip if hypotensive after pacing

Question 17

What is sever symptomatic bradycardia usually related to?

Answer 17

MI
Drugs (beta-blocker, calcium channel blocker)
Electrolytes (Hyperkalemia)

Question 18

How should we treat a Stable Sinus Taccyarrhythmia?

Answer 18

Oxygen
IV access
12 lead
Try Valsava maneuver
Adenosine (6mg/12mg/12mg Fast IVP w/ flush)
Give 2mg Versed IV
Cardioversion @ 200J

Question 19

How should we treat an unstable Taccyarrhythmia?

Answer 19

Oxygen
IV access
12 lead if possible
Synchronized cardioversion @ 200J

Question 20

How to treat pulseless V-tach or V-Fib

Answer 20

Start compressions
Pads and cardiovert @ 200J
Oxygen
IV
Epi 1mg (3-5 min)
Amiodarone 300mg/2nd dose: 150mg (3-5min)

Question 21

How to treat V-tach with a pulse

Answer 21

Oxygen
IV
12 lead
Cardiovert @ 200J