Hormones and Related Agents (7) Flashcards
Vasopressin
Brand Name: Pitressin
Classification: Hormone (analog of antidiuretic hormone)
Action: Non-adrenergic vasoconstrictor; promotes fluid retention in the kidney
Indications: Normovolemic hypotension
Contraindications: Few in the emergency setting
Dose: 40 units
Routes: IV
Adverse: Blanching of the skin, abdominal cramping, nausea, hypertension
Other: Benefits in cardiac arrest are questionable
Oxytocin
Brand Name: Pitocin
Classification: Hormone (oxytocin)
Action: Oxytocic; caused uterine contractions and lactations
Indications: Postpartum vaginal bleeding, Induction/augmentation of labor
Contraindications: Anything other than postpartum bleeding (in the prehospital setting)
Dose: 10-20 units in 500 mL IV; 3-10 units IM
Routes: IV, IM
Adverse Effects: Anaphylaxis and Arrhythmias
Other: Ensure placenta (and possible additional baby) has delivered before administering
Glucagon
Brand Name: Glucagon
Classification: Hormone (glucagon)
Action: Elevates blood glucose levels through conversion of glycogen to glucose and other factors
Indications: Hypoglycemia and Beta-blocker overdose
Contraindications: Hypersensitivity
Dose: 0.25-0.5 units (IV); 1.0 mg (IM)
Routes: IV, IM, IO
Adverse Effects: Few in the emergency setting
Other: Less effective in patients with decreased glycogen stores (e.g., alcoholics)
Insulin
Brand Name: Humulin, NovoLog, Novolin
Classification: Hormone (insulin)
Action: causes glucose uptake by the cells thus lowering blood glucose levels
Indications: Diabetes, hyperglycemia, diabetic ketoacidosis
Contraindications: Hypoglycemia, normoglycemia
Dose: Varies
Routes: IV, SQ
Adverse: Few in the emergency setting
Other: Dosage of the various insulin types vary significantly
Dextrose 50%
Brand Name: Dextrose, 50%
Classification: Carbohydrate
Action: Substrate for carbohydrate metabolism
Indications: Hypoglycemia
Contraindications: None in the emergency setting
Dose: 12.5-25.0 g
Routes: IV, PO
Adverse Effects: Local venous irritation common, Tissue injury
Other: Less concentrated solutions (e.g., 10%) equally effective with fewer side effects
Dextrose 10%
Brand Name: Dextrose, 10%
Classification: Carbohydrate
Action: Substrate for carbohydrate metabolism
Indications: Hypoglycemia
Contraindications: None in the emergency setting
Dose: 100 mL
Routes: IV, IO
Adverse Effects: Local venous irritation common, Tissue injury
Other: Preferred over D50W due to improved safety profile and cost
Methylprednisolone
Brand Name: Methylprednisolone
Classification: Hormone (analog of corticosteroid)
Action: anti-inflammatory; suppresses immune response
Indications: asthma, COPD, anaphylaxis
Contraindications: hypersensitivity
Dose: 125-250mg
Routes: IV, IO
Adverse: GI bleeding, increases blood glucose levels
Other: effects are delayed and not typically seen in the prehospital setting
