MD Drugs Dosing Flashcards
1
Q
Acetaminophen (Tylenol) - Dose
A
2-4 - 160mg/5ml
5-12 2x 160mg/5ml
13+ 4x160mg/5ml or 2x 325mg pill w sips of water
2
Q
Acetaminophen (Tylenol) - Indications
A
Pt 2 yo+ mild to moderate pain (1-5)
3
Q
Activated Charcoal - Dose
A
1g/kg PO
4
Q
Adenosine (Adenocard) - Adult Dose
A
1 - 6mg w IV bolus w rapid 20ml flush (wait 2 min)
2 - 12mg IV bolus w rapid 20ml flush (wait 2 min)
3 - 12mg IV bolus w 20 mL flush (wait 1-2 min)
5
Q
Adenosine (Adenocard) - Indications
A
Narrow complex tachycardia (SVT, PSVT w WPW)
No effect on Afib, Aflutter or VT
Pedi wide complex tachycardia (possible VT) can be used w caution
6
Q
Adenosine (Adenocard) - Pedi Dose
A
1 - 0.1mg/kg (max 6mg)
2 - 0.2mg/kg (max 12mg)
3 - 0.2mg/kg (max 12mg)
7
Q
Albuterol - Adult Dose for bronchospasm
A
Inhaler - 2 doses (4 puffs) over 30 min
Neb - 2.5mg w 6-8 lpm. repeat 1x
8
Q
Albuterol - Adult Dose for Hyperkalemia
A
Neb - 20mg w 6-8 lpm
9
Q
Albuterol - Indications
A
1 - bronchospasm
2 - hyperkalemia
10
Q
Albuterol - Pedi Dose for bronchospasm
A
Inhaler - 2 doses (4 puffs) over 30 min
Neb 2yo+ - 2.5mg w 6-8 lpm. repeat 1x
Neb <2yo - 1.25mg w 6-8 lpm. repeat 1x
11
Q
Albuterol - Pedi Dose for Hyperkalemia
A
Neb 2yo+ - 2.5mg w 6-8 lpm.
Neb <2yo - 1.25mg w 6-8 lpm.
12
Q
Amiodarone - Adult Dose
A
- w pulse 150mg in 100ml over 10 min (repeat 1x)
- wo pulse - VF/VT/TdP (after mag w TdP) 300mg IV then 150mg after 3-5 min
13
Q
Amiodarone - Indications
A
- Prevent recurrence of VFib/VT after defib or conversion
- VT
- VF
14
Q
Amiodarone - Pedi Dose (Medical Direction)
A
- w pulse 5mg/kg in 100 ml over 20 min
- w/o pulse 5mg/kg max does 300mg. May repeat twice to max dose of 15mg/kg
15
Q
ASA - Dose
A
81mg x 4 = 324mg or 325 chewed
16
Q
ASA - Indications
A
ACS or STEMI
17
Q
Atropine - Adult Dose - Bradycardia
A
0.5-1mg IVP every 3-5 min. Max dose 0.04mg/kg
18
Q
Atropine - Adult Dose - Organophosphate Poison
A
2-4mg 3-5min (IVP or IM) every 5-10 min
19
Q
Atropine - Indications
A
- Bradycardia
- Organophosphate poison
- Nerve agents
20
Q
Atropine - Pedi Dose - Bradycardia
A
0.02mg/kg. Max single dose 0.5mg - repeat 1x
ET - 0.04-0.06mg/kg dilute in 5mL - repeat 1x
21
Q
Atropine - Pedi Dose - Organophosphate Poison
A
0.02mg/kg IVP or IM every 5-10 min
22
Q
Calcium Chloride - Adult Dose
A
- 0.5 - 1g SLOW IVP over 10 min. Max dose 1g
- 0.5g SLOW IVP for hypotension following
- dilt administration
- Resp depression, decreased reflexes, flaccid
paralysis and apnea following mag sulfate admin
23
Q
Calcium Chloride - Indications
A
- Hypocalcemia
- Hyperkalemia
- CCB OD
- Hypotension due to dilt administration
- Mag sulfate admin complications
24
Q
Calcium Chloride - Pedi Dose
A
20mg/kg SLOW IVP/IO 50mg/min. Max dose 1g
25
Dexamethasone (Decadron) - Adult Dosage
10mg IV or PO
26
Dexamethasone (Decadron) - Indications
- Moderate to severe asthma exacerbation
- Croup
- Anaphylaxis
27
Dexamethasone (Decadron) - Pedi Dosage
Asthma - 0.5mg/kg (PO preferred) or IV to a max of 10mg
- Croup 0.5mg/kg PO/IV/IM max dose of 10mg
28
Dextrose - Adult Dose
- If blood is less than 70mg/dL admin 10% dextrose in 50mL (5g) bolus one min apart to max of 250mL or 25g of D50 IVP until
- Normal mental status
- Blood glucose is grater than 90mg/dL
- or if fully dosed and blood glucose less than
90mg/dL redose
29
Dextrose - Indications
- Hypoglycemia
30
Dextrose - Pedi Dose
NEED TO DO
31
Diazepam (Valium) - Adult Dose
- 2.5mg SLOW IVP/IM
- Medical direction if IM
- Max of 10mg.
32
Diazepam (Valium) - Indications
- Seizures
- Severe nerve agent exposure
33
Diazepam (Valium) - Nerve agent exposure
- No consult
- Adult 10mg IM
- Pedi if greater than 30kg - 0.1mg/kg max of 10mg
34
Diazepam (Valium) - Pedi Dose
- 0.1 mg/kg SLOW IVP/IM.
- max single dose 2.5mg.
- Max total dose 5mg
- Rectal dose 0.2mg/kg max dose of 10mg
35
Diltiazem (Cardizem) - Adult Dose
- 0.25 mg/kg (max 20mg) over 2 min
- 15 min
- 0.35 mg/kg (max 25mg) over 2 min
- IF PT over 50yo w borderline BP, known renal failure, or CHF consider 5-10mg over 2 min
36
Diltiazem (Cardizem) - Indications
Afib and Aflutter
37
Diltiazem (Cardizem) - OD
- If hypotensive and clear lungs - fluid bolus of 20mL/kg of LR - titrate to systolic of 100
- If hypotensive and rales - max fluid bolus of 250mL of LR stop if obtain systolic of 100
- Calcium Chloride 500mg SLOW IVP
- If bradycardic consider 1mg of Atropine
- If unstable consider pacing
38
Diltiazem (Cardizem) - Pedi Dose
Consult
39
DIPHENHYDRAMINE (Benadryl) - Adult Dosing
25-50mg SLOW IVP or IM
40
DIPHENHYDRAMINE (Benadryl) - Indications
- Allergic reaction
- Anaphylaxis
- Dystonic reactions
41
DIPHENHYDRAMINE (Benadryl) - Pedi Dosing
1mg/kg SLOW IVP or IM
42
Dopamine (Intropin) - Adult Dose
5-20 mcg/kg/min. Start at 5mcg. Titrate to 100 systolic
43
Dopamine (Intropin) - Indications
(1) Cardiogenic shock
(2) Septic shock
(3) Anaphylactic shock
(4) Hypovolemic shock (after sufficient volume
replacement)
44
Dopamine (Intropin) - Pedi Dose
2-20 mcg/kg/min Start at 2mcg. Titrate to age appropriate BP
45
Epinephrine (0.1mg/mL and 1mg/mL) - Indications
(1) Medical cardiac arrest and pediatric traumatic arrest
(2) Moderate to severe allergic reaction/anaphylaxis
(3) Epinephrine infusion (IV/IO) should be reserved for patients in shock refractory to fluid bolus or for patients in anaphylactic shock
(4) Severe asthma
(5) Respiratory stridor (suspected croup)
46
Epinephrine - Bradycardia Adult Dose
1mg in 100ml = COH of 10mcg/mL. Administer 10mcg/min on a 60 drop set
Infusion - 2-10 mcg/min
47
Epinephrine - Bradycardia Pedi Dose
(0.1mg/mL) - 0.01mg/kg IV/IO every 3-5 min (KEY for PEDS.....0.1mL/kg so 10kg kid gets 1mL of 0.1mg/mL)
48
Epinephrine - Cardiac Arrest Adult Dose
1mg 0.1mg/mL IVP/IO every 4 min (max dose of 4). If arrest after ROSC max dose of 2 more
49
Epinephrine - Cardiac Arrest Pedi Dose
0.01mg/kg of 0.1mg/mL IV/IO every 4 min (max dose of 4) if arrest after ROSC max dose of 2 more (KEY for PEDS.....0.1mL/kg so 10kg kid gets 1mL of 0.1mg/mL
50
Epinephrine - Croup Pedi Dose
(1mg/mL) 2.5mL via neb. (2 dose max)
Resp Distress/eminent failure - 0.01mg/kg IM (max dose of 0.5mg)
51
Epinephrine - Reaction/Anaphylaxis/Asthma Adult Dose
(1mg/mL) 0.5 mg every 5 min - (max dose 3x)
52
Epinephrine - Reaction/Anaphylaxis/Asthma Pedi Dose
(1mg/mL) \> 5 yo 0.15mg every 5 min (3 dose max)
\< 5yo 0.5mg every 5 min (3 dose max)
53
Fentanyl - Adult Dosage
(1) 1mcg/kg IV/IO/IM - Max 200mcg
(2) reassess in 5-10 min.
(3) one more dose at 1mcg/kg - max 200mcg
(4) med control for more
54
Fentanyl - Indications
(1) The patient reports moderate to severe pain.
(2) In the clinician’s judgment the patient will benefit
from treatment with an opioid analgesic, including
patients who are MOLST and/or EMS/DNR patients
or being pre-medicated for a procedure.
55
Fentanyl - Pedi Dose
1) 1mcg/kg IV/IO/IM - Max 200mcg
(2) reassess in 5-10 min.
(3) one more dose at 1mcg/kg - max 200mcg
(4) med control for more
56
Glucagon - Adult Dose - CCB OD
1mg IVP every 5 min
57
Glucagon - Adult Dose Hypoglycemia
1mg IM/IN max 3mg
58
Glucagon - Indications
(1) Patients with altered mental status who are
suspected of being hypoglycemic where IV access
is not obtainable
(2) Beta blocker overdose
59
Glucagon - Pedi Dose - CCB OD
\>5yo 0.5mg IVP every 5 min
5yo or \< adult dose 1mg IVP every 5 min
60
Glucagon - Pedi Dose Hypoglucemia
\>5yo 0.5mg IM/IN max of 3mg
5yo or \< adult dose 1mg IM/IN max 3mg
61
Haloperidol (Haldol) - Adult Dose
\>69yo - 5mg IM
\<68yo - 2.5 mg IM
62
Haloperidol (Haldol) - Adverse Effects
(1) Dystonic reaction - Benadryl 25-50mg (adult) 1mg/kg - max 25mg
(pedi)
(2) Hypotension and tachycardia - LR fluid bolus
(3) TdP
63
Haloperidol (Haldol) - Contraindications
(1) Children under 5 years of age
(2) Parkinson’s disease
(3) CNS depression
(4) Acute CNS injury
(5) Severe agitation (see midazolam and ketamine)
64
Haloperidol (Haldol) - Indications
```
Moderate agitation (defined as behavior that puts the patient or clinician at risk of harm) due to suspected psychiatric emergency (e.g., schizophrenia) or medical
delirium
```
65
Haloperidol (Haldol) - Pedi Dose
\>5yo contraindicated
5-12 yo 0.05mg/kg IM max of 2.5mg IM
13yo+ 2.5-5mg IM
66
Haloperidol (Haldol) - Pharmacokinetics
Onset of action is within 10 minutes of the IM administration
67
Haloperidol (Haldol) - Pharmacology
Antipsychotic
68
Haloperidol (Haldol) - Precautions
(1) Violent patients may require physical restraint while
the medication is administered.
(2) Patients receiving haloperidol should be placed on
cardiac monitor to evaluate for dysrhythmias.
69
Ipratropium (Atrovent) - Adult Dose
(1) Single dose only
(2) 0.5mg (2.5mL) in combination w 2.5mg of Albuterol
70
Ipratropium (Atrovent) - Indications
(1) Allergic reactions/anaphylaxis
(2) Bronchial asthma
(3) Reversible bronchospasms associated with chronic
bronchitis and emphysema
71
Ipratropium (Atrovent) - Pedi Dose
(1) Single dose only
(2) less than 1yo - Contraindicated
(3) b/t 1 & 2 yo 0.25mg w Albuterol
(4) 3yo+ Adult dose
72
Ketamine - Adult Dose CPR Induced Awareness
1mg/kg IV/IO. Additional dose require medical consult
73
Ketamine - Adult Dose Pain
(1) 0.2mg/kg IV/IO over 2 min. Max 20mg - Reassess
after 5-10 min. If still pain, same dose as before over
2 min
(2) If IV unavailable 0.5mg/kg IM/IN. - Reassess after 15
min. If still pain same dose as before
74
Ketamine - Adult Dose Severe Agitation
(1) IV/IO - 1mg/kg. Max dose 100mg. If agitation
persists same dose as before. Max total dose
200mg
(2) IM/IN 4mg/kg max dose 400mg. Additional dose
requires medical consult.
75
Ketamine - Adult Dose Vent Bucking
2mg/kg IV/IO over 60 seconds. 2 additional doses at 1mg/kg
76
Ketamine - Indications
(1) Moderate to severe pain; musculoskeletal, extremity,
and back pain
(2) Severe agitation
(3) Ventilatory difficulty secondary to bucking or
combativeness in intubated patients
(4) CPR-induced awareness
77
Ketamine - Pedi Dose CPR Induced Awareness
Need to consult
78
Ketamine - Pedi Dose Pain
SAME AS ADULT
(1) 0.2mg/kg IV/IO over 2 min. Max 20mg - Reassess
after 5-10 min. If still pain, same dose as before over
2 min
(2) If IV unavailable 0.5mg/kg IM/IN. - Reassess after 15
min. If still pain same dose as before
79
Ketamine - Pedi Dose Severe Agitation
SAME AS ADULT
(1) IV/IO - 1mg/kg. Max dose 100mg. If agitation
persists same dose as before. Max total dose
200mg
(2) IM/IN 4mg/kg max dose 400mg. Additional dose
requires medical consult.
80
Ketamine - Pedi Dose Vent Bucking
SAME AS ADULT
2mg/kg IV/IO over 60 seconds. 2 additional doses at 1mg/kg
81
Ketorolac (Toradol) - Adult Dose
```
15mg IV (1 dose)
30mg IM (1 dose)
```
82
Ketorolac (Toradol) - Indications
a) Management of moderate to severe acute pain
b) Consider as a first line medication for renal
stones/colic
c) Burns - mild to moderate
d) Non-traumatic neuromuscular pain
83
Ketorolac (Toradol) - Pedi Dose
0.5mg/kg IV - max 15mg (1 dose)
1mg/kg IM - max 30 mg (1 dose)
84
Lactated Ringers - Adult Dose Multiple/Sever Trauma w Head Injury
(1) Small boluses (max of 250mL) bf BP ck.
(2) Titrate to BP of 110 mmHg
(3) max dose of 2L
85
Lactated Ringers - Adult Dose Multiple/Sever Trauma wo Head Injury
(1) Small boluses (max of 250mL) bf BP ck.
(2) Titrate to BP of 90 mmHg
(3) max dose of 2L
86
Lactated Ringers - Adult Dose wo Multiple/Sever Trauma
(2) Titrate to 90 mmHg
(3) max dose of 2L
87
Lactated Ringers - Indications
(1) Hypovolemia (limitation in multiple/severe trauma
without head injury)
(2) Keep vein open
(3) Fluid boluses
88
Lactated Ringers - Pedi Dose
(1) KVO
(2) For hypotension 20mL/kg IV/IO unless
neonate/volume sensitive than 10mL/kg
(3) If BP does not improve second bolus
(4) 3+ bolus need med consult
89
Lidocaine (Xylocaine) - Adult Dose IO Infusion
20-40mg of 2% lidocaine (1-2mL)
90
Lidocaine (Xylocaine) - Adult Dose Nasal Pharyngeal Anesthesia
4mL of 4% (40mg/mL) and 2mL up each nares w atomizer
91
Lidocaine (Xylocaine) - Pedi Dose IO Infusion
(1) 13 or older - Adult dose 20-40mg of 2%
(2) Younger than 13 - med consult
92
Lidocaine (Xylocaine) - Pedi Dose Nasal Pharyngeal Anesthesia
1) 13 or older - 4mL of 4% (40mg/mL) and 2mL up each
nares w atomizer
(2) Younger than 13 - med consult
93
Lidocaine (Xylocaine) - Indications
(1) Anesthesia for IO infusions
(2) Nasal tracheal intubation
94
Mag Sulf - Adult Dose - Pregnancy Seizure
4g IV/IO mixed w 50-100mL over 10 min
95
Mag Sulf - Adult Dose - Refractory VT/VF
1-2g IV/IO over 2 min
96
Mag Sulf - Adult Dose - Severe Asthma/Bronchospasm
1-2g IV/IO mixed 50-100mL over 10-20min (MED DIRECTION)
97
Mag Sulf - Adult Dose - TdP
1-2g IV/IO over 2 min
98
Mag Sulf - Pedi Dose - Pregnancy Seizure
4g IV/IO mixed w 50-100mL over 10 min
99
Mag Sulf - Pedi Dose - Severe Asthma/Bronchospasm
50mg/kg (max 2g) IV/IO mixed 50-100mL over 10-20min (MED DIRECTION) - Also think about LR fluid bolus of 20mL/kg to support BP
100
Mag Sulf - Pedi Dose - TdP
25mg/kg (max 2g) IV/IO over 2 min
101
Mag Sulfate - Indications
(1) Torsades de pointes
(2) Seizures with pregnancy
(3) Refractory VF and VT after amiodarone
administration
(4) Moderate to severe asthma/bronchospasm
exacerbation
102
Midazolam (Versed) - Adult Dosing
(1) 0.1 mg/kg in 2mg increments SLOW IVP over 1-2 min per increment w max dosage of 5mg
(2) If IV unavailable 5mg IN/IM - IN max 1mL per nare
(3) Additional doses to 10mg require med control
103
Midazolam (Versed) - Adult Dosing - Agitation
(1) 18-69 yo 5mg IM/IV
(2) \>69 yo 2.5 mg IM/IV
(3) if you gave ketamine first 2.5mg IV/IO after med direction
104
Midazolam (Versed) - Adult Dosing - Nerve Agent Exposure
5mg IM wo Med Control
105
Midazolam (Versed) - Indications
(1) Sustained and/or recurrent seizures
(2) Precardioversion to reduce anxiety
(3) Awake patient requiring transcutaneous pacing (TCP)
(4) Nasal Tracheal Intubation
(5) Implanted Cardioverter Defibrillator (ICD) Malfunction
(6) Nerve/organophosphate exposure
(7) Bucking Endotracheal Intubated patient
(8) Moderate to severe stimulant toxicity
(9) Moderate or severe agitation
106
Midazolam (Versed) - Pedi Dosing
(1) 0.1mg/kg in 2mg increments SLOW IVP over 1-2 min per increment w max dosage of 5mg
(2) If IV unavailable 0.2 mg/kg (Max 5mg) IN/IM - IN max 1mL per nare
107
Midazolam (Versed) - Pedi Dosing - Agitation
Med Direction required
(1) 13-18 if you gave ketamine first 2.5mg IV/IO
(2) 13-18 yo if IV/IO unavail and ketamine admin IM, give 5mg IM
108
Midazolam (Versed) - Pedi Dosing - Nerve Agent Exposure
5mg IM wo Med Control
109
Morphine - Adult Dose
(1) 0.1 mg/kg max 20mg - IV/IM
(2) reassess 5-10 min
(3) 0.05 mg/kg max 10mg
(4) med control for more
110
Morphine - Indications
(1) The patient reports moderate to severe pain.
(2) In the clinician’s judgment the patient will benefit
from treatment with an opioid analgesic, including
patients who are MOLST and/or EMS/DNR patients
or being pre-medicated for a procedure.
(3) Pulmonary Edema/Congestive Heart Failure (Pediatric only)
111
Morphine - Pedi Dose
Same as adult
(1) 0.1 mg/kg max 20mg - IV/IM
(2) reassess 5-10 min
(3) 0.05 mg/kg max 10mg
(4) med control for more
112
Morphine - Pedi Dose - Pulmonary Edema/CHF
(1) 0.1 mg/kg max 5 mg.
(2) SLOW IV/IO/IM push 1-2 mg/min
113
Naloxone (Narcan) - Adult Dosage
(1) 0.4-2mg IVP/IO/IN - TITRATE
(2) max 1mL/nare
114
Naloxone (Narcan) - Pedi Dosage
(1) 0.1 mg/kg IV/IO/IN 2 mg max - TITRATE
(2) max 1mL/nare
115
Nitroglycerin - Adult Dose - Chest Pain
(1) w HX of Nitro use - 0.4mg SL 3x
(2) 3-5 min between
(3) no HX establish IV first that dose normally
116
Nitroglycerin - Adult Dose - Pulmonary Edema/CHF
(1) low dose - 0.4 mg SL 3x
(2) high dose (until CPAP or CPAP not tollerated)
(a) 0.4mg SL and 1 " of NTG paste
(b) 0.8mg SL
(c) continue 0.8 mg SL until 20% reduction of BP
117
Nitroglycerin - Indications
(1) For treatment of angina
(2) Congestive heart failure, acute pulmonary edema
118
Nitroglycerin - Pedi Dose
Med Consult
119
Ondansetron (Zofran) - Adult Dosing
(1) 8mg SLOW IV over 2-5 min
(2) 4-8mg IM
(3) 8mg orally disintegrating
(4) may repeat once wo Med Consult
120
Ondansetron (Zofran) - Indications
Prevention and control of nausea and/or vomiting
121
Ondansetron (Zofran) - Pedi Dosing
(1) 28 days to 12 - 0.1 mg/kg SLOW IV (2-5 min)
(2) 13-18 yo same as Adult except IM
(a) 8mg SLOW IV over 2-5 min
(b) 8mg orally disintegrating
(c) 0.1 mg/kg max of 8 mg IM
(3) may repeat once wo Med Consult
122
Sodium Bicarb - Adult Dosage
(1) after airway is secured
(2) 1mEq/kg IVP bolus w 0.5 mEq/kg at 10 min intervals
123
Sodium Bicarb - Adult Dosage - HyperK
(1) 50mEq SLOW over 5 min then
(2) 100mEq in 1L LR over 30-60 min
124
Sodium Bicarb - Indications
(1) Cardiac arrest (last try)
(2) Hyperkalemia
(3) Tricyclic and phenobarbital overdose
(4) Pretreatment for patients with decreased renal
function who will be receiving IV contrast dye
125
Sodium Bicarb - Pedi Dosage
(1) after airway is secured
(2) older than 1yo. Adult dose- 1mEq/kg IVP bolus w 0.5 mEq/kg at 10 min intervals
(3) if \<1yo Adult dose diluted 1:1 w LR
126
Sodium Bicarb - Pedi Dosage - HyperK
(1) 1mEq/kg IV over 5 min
(2) if \<1yo then 1mEq/kg diluted 1:1 w LR
127
Verapamil (ISOPTIN) - Adult Dosage
(1) 2.5–10 mg slow IV over 2 minutes
(2) may repeat same dose in 15 min w Med Consult
128
Verapamil (ISOPTIN) - Indications
AFib & AFlutter
129
Verapamil (ISOPTIN) - OD
(1) Monitor Vitals and Admin O2
(2) Hypotension
(a) Lungs clear 20mL/kg fluid bolus of LR titrate to
100mmHG
(b) if rales present admin max of 250mL of LR titrate
to 100mmHg
(c) Admin Calcium Chloride 500mg SLOW IVP
(3) Brady Cardia
(a) Atropine 0.5 - 1mg
(b) pacing
130
Verapamil (ISOPTIN) - Pedi Dose
NONE
