Medication Exam Flashcards
Acetaminophen
Indications:
Mild, moderate, severe pain.
Contraindications:
Allergic, chronic liver disease, therapeutic dose in last 6 hours or 3gm+ in last 24 hours.
- *Dose:**
- *1000mg** PO
Adenosine
Adenocard
Indications:
Narrow complex SVT
Contraindications:
Irregular/wide tachycardia, heart transplants
- *Dose:**
- *12 mg** IV bolus, 12 mg IV bolus for second dose
Albuterol
Proventil
Indications:
Bronchospasms, known or suspected hyperkalemia with peak T waves/wide QRS
RELATIVE Contraindication:
Sever tachycardia
- *Dose:**
- *2.5mg in 3cc**, 3 total dosages.
Amiodarone
Cordarone
Indications:
Pulseless arrest patients with recurrent/refractory VFib/VTach, Wide complex tachycardia not immediately requiring cardioversion.
Contraindications:
2nd or 3rd degree AV heart blocks
Cardiogenic shock
Dosages:
PULSELSS VTACH/VFIB = 300mg then 150mg if shock refractory
SYMPTOMATIC VTACH and undifferentiated wide complex tach w/pulse = 150 mg over 10 minutes.
Aspirin
Indications:
Suspected acute coronary syndrome
Contraindications:
ACTIVE GI bleed
Aspirin allergy
- *Dose:**
- *324 mg** PO
Atropine Sulfate
Indications:
Symptomatic Bradycardia
2nd and 3rd degree heart blocks
Organophosphate poisoning
Contraindications:
PRECAUTIONS ONLY
Should not be used w/o medical control for stable bradycardia
Closed angle glaucoma
Dosages:
Unstable bradycardia = 1.0 mg IV/IO, repeat 3-5 minutes max 3 mg
Poisoning = 40 kg and up 2mg IV/IM
Calcium Gluconate
Indications:
Adult pulseless arrest associated with:
-known hyperK+
-Renal failure
-CCB overdose
CCB overdose with hypotension and bradycardia
Crush injury w/HyperK+
Renal failure with known or suspected hyper K
Contraindications:
Known hypercalcemia
Suspected digoxin toxicity
Dose:
Pulseless arrest = 3gm slow IV
Renal failure w/known or suspected hyper K = 3 gm IV/IO over 5 mine
CCB overdose w/shock = 3 gm IV/IO over 5 min, 3 total doses CONTACT BASE
Dextrose 10%
Indications:
Hypoglycemia
Unconscious or AMS w/unknown etiology
Contraindications:
NONE
- *Does:**
- *25gm** (250mL of 10% IV solution)
Versed
Midazolam
- *Indication:**
- Status epilepticus
- Sedation of the severely agitated/combative patient
- Sedation for cardioversion or TCP
- Severe pain (back spasms) in adults that is uncontrolled by fentanyl CALL IN ONLY
- *Contraindication:**
- Hypotension
- Respiratory depression
Dosages:
Seizure or sedation for cardioversion
- 2mg IV/IO
2 times total, 5 minutes apart.
-10mg IN/IM
2 times total, 5 minutes apart
CONTACT BASE for more than 2 doses.
Mildly combative (RASS +3) -**5mg** x2 IN/IM, give second dose after 5 min. OR SWITCH TO VERSED
Extreme combative (RASS +4)
- *-10mg** x1 IM
- *CONTACT BASE FOR ADDITIONAL**
Diphenhydramine
Benadryl
- *Indications:**
- Allergic reaction
- Dystonic medication reactions or akathisia (inability to remain still, psychomotor restlessness)
- *Contraindications:**
- *PRECAUTIONS ONLY**
- Asthma or COPD as it thickens bronchial secretions
- Narrow-angle glaucoma
- ½ dose for patients 65+
- *Dose:**
- *50mg** IV/IO/IM
Droperidol
- *Indications:**
- Sedation of severely agitated or combative patient
- Nausea/vomiting
- Combative head injury
- *Contraindications:**
- Suspected MI
- BP less that 100
- Respiratory/CNS depression
- Pregnancy
Dose:
Sedation mildly combative
-5mg IV/IM x2
Hyperactive delirium
-10mg IM CONTACT BASE FOR MORE
N/V
-1.25mg slow IV/IO push
Epinephrine
Adrenalin
- *Indications:**
- Pulseless arrest
- Anaphylaxis
- Asthma
- Bradycardia w/poor perfusion
Contraindications:
NONE
Dose:
Pulseless arrest
- 1mg 1:10,000 IV/IO repeat 3-5 minutes
Bradycardia w/poor perfusion
-Vasopressor infusion
Asthma
-0.3 mg 1:1,000 IM repeated once
Systemic allergic reaction
-0.3 mg 1:1,000 IM repeated once
Anaphylaxis, (hypotensive)
-Vasopressor infusion
Fentanyl
Indications:
Hemodynamically stable patients with moderate to severe pain, trauma or medical
- *Contraindications:**
- Hypotension, hemodynamically unstable, shock
- Respiratory depression
- Start low and titrate in the elderly
Dose:
IV/IO/IM = 1 - 2 mcg/kg max 3 mcg/kg
IN = 1-2 mcg/kg repeat after 5 minutes, max dose of 3
Glucagon
- *Indication:**
- AMS where hypoglycemia is suspected and no IV access
- Hypotension, bradycardia from beta blocker or calcium channel blocker OD
Contraindications:
NONE
Dose:
Hypoglycemia - 1mg IM
BB or CCB OD - CONTACT BASE 2 mg IV
Ipatropium Bromide
Atrovent
Indications:
Bronchospasm
Contraindications:
Children under 2
Soy/peanut allergy is in propellent of MDI
- *Dose:**
- *0.5 mg** in 2.5cc neb
Lidocaine
Indications:
Analgesic for IO insertion
contraindication:
NONE
- *Dose:**
- *0.5mg/kg** IV/IM
Ketamine
Indications:
Pain management
RELATIVE contraindication:
Penetrating eye trauma
- *Dose:**
0. 25 mg/kg IV/IM
Magnesium sulfate
- *Indications**
- *Antiarrythmic** - TDP with prolonged QT
- *Respiratory -** Severe bronchospasm unresponsive to AA neb, IM epi.
- *OB -** Eclampsia >20 weeks or post partum w/seizures
Contraindications:
NONE
Dose:
TDP - 2gm IV bolus
Bronchospasm - 2gm IV bolus over 2 min
Eclampsia - 2 gm IV bolus slowly
Mix 4gm in 50cc over 15-30 min.
Methylprednisolone
Solumedrol
- *Indications:**
- Anaphalyxis
- Severe asthma
- COPD
- Suspected addisonian crisis
- *Contraindication**
- Evidence of severe active GI bleeding
- *Dose**
- *- 125 mg** IV/IO over 2 min
Naloxone
Narcan
- *Indications:**
- Reversal of suspected opioid induced CNS or respiratory depression
-Coma of unknown etiology w/respiratory depression
Contraindications:
NONE
Dose:
0.5 mg IV/IO/IM/IN
Titrate to desired effect up to 2mg
Nitroglycerin
- *Indications**
- Pain or discomfort due to suspected ACS
- Pulmonary edema due to CHF
- *Contraindications**
- Suspected right ventricular STEMI
- Hypotension SBP < 100
- Recent use of ED meds
- *Dose:**
- *CP -** 0.4mg SL every 5 minutes
- *Pulmonary Edema** - 0.4 mg every 5 minutes PRN titrated to symptoms or BP
Ondansetron
Zofran
Indications:
Nausea and Vomiting
Contraindications:
NONE. but used in caution in first trimester of pregnancy and reserved for only those patients with severe dehydration and intractable vomiting
Dose:
4mg IV/IM/PO/ODT
Racemic Epinephrine
Indications:
Stridor at rest
Contraindications:
NONE
- *Dose:**
0. 5ml mixed in 3 cc saline neb
Sodium Bicarbonate
Indications:
- TCA OD with arrhythmia, widened QRS complex or hypotension
- Suspected Hyper K cardiac arrest (dialysis patient)
- Crush or suspension injury with known or suspected hyper K
Contraindication
- Metabolic and respiratory alkalosis
- Hypocalcemia
- Hypokalemia
Dose
-1 meq/kg slow IV push, repeated x2 q 5 minutes if needed.
