Medication Final Flashcards
Adenosine half life
Less than 10 seconds.
Adenosine route
IV/IO
Adenosine dosage adult
6mg rapid bolus over 1 to 3 seconds followed by 20 mL saline flush and elevate extremety. If no response after 1 to 2 minutes administer second dose of 12 mg
Adenosine dosage pediatric
0.1 mg/kg rapid IV/IO, max 6mg followed by 5 to 10 mL saline flush. second dose of 0.2mg/kg max 12 same method
Atropine indications
Hemodynamically unstable bradycardia, organophosphate poisoning, nerve agent exposure, RSI in pediatrics, beta blocker or calcium channel blocker overdose.
Atropine dosage organophosphate poisoning
Extremely large doses(2 to 4 mg or higher) may be needed.
Prochlorperazine (Compazine) indications
Nausea, vomiting
Prochlorperazine (Compazine) actions
By depressing the chemoreceptor trigger zone, severe nausea and vomiting is reduced.
Diazepam indications
Acute anxiety states and agitation, acute alcohol withdrawal, muscle relaxant, seizure activity, sedation for medical procedures(intubation, ventilated patients, cardioversion), chemical restraint, may be helpful in acute symptomatic cocaine overdose.
Diazepam class
Benzodiazepine, long acting: sedative hypnotic; anticonvulsant; schedule IV drug
Diltiazem actions.
Inhibits extracellular calcium ion influx across membranes of myocardial cells and vascular smooth muscle cells, resulting in inhibition of cardiac and vascular smooth muscle contraction and thereby dilating main coronary and systemic arteries; no effect on serum calcium concentrations; substantial inhibitory effects on the cardiac conduction system, acting principally at the AV node, with some effects at the SA node.
Diltiazem dosage adult
initial dose of 0.25 mg/kg IV over 2 minutes. If inadequate response, may rebolus in 15 minutes with 0.35 mg/kg IV over 2 min. Maintenance infusion of 5 to 15 mg/h titrated to physiologically appropriate heart rate.
Diltiazem Class
Calcium channel blocker, antidysrhythmic(Class IV)
Dopamine indications
Cardiogenic and septic shock, hypotension with low cardiac output states, distributive shock, second line drug for symptomatic bradycardia
Dopamine low dose effects
Beta adrenergic response: 5 to 10 mcg/kg per min.
Etomidate indications
Premedication for medication facilitated intubation or procedural sedation
Etomidate class
Nonbarbiturate hypnotic, anesthesia induction agent.
Fentanyl actions
binds to opiate receptors, producing analgesia and euphoria
Lactated Ringers class
Isotonic crystalloid solution
Magnesium sulfate dosage asthma, adult
1 to 2 g IV over 15 to 30 min.
Magnesium sulfate actions
Reduces striated muscle contractions and blocks peripheral neuromuscular transmission by reducing acetylcholine release at the myoneural junction. manages seizures in toxemia of pregnancy. Induces uterine relaxation. Can cause bronchodilation after beta agonist and anticholinergics have been administered.
Magnesium pedi dosage.
status asthmaticus: 30 to 60 mg/kg IV/IO over 15 to 30 min.
Midazolam(Versed) dosage adult
Seizures: 0.2 mg/kg IM or IN max: 10mg
0.1 mg/kg IV, max 4mg.
Sedation: 0.5 to 2.25 mg IV. may be repeated to max 0.1 mg/kg
Chemical restraint: 5mg IV or IN; 5 mg IM
Midazolam (Versed) effects
Headache, somnolence, respiratory depression, respiratory arrest, apnea, hypotension, cardiac arrest, nausea, vomiting, pain at injection site
Narcan dosage adult
0.4 to 2mg IM/IV/IO/subq/ET/IN(diluted);
minimum single dose: 2mg
repeat at 5 min intervals to a maximum total dose of 10 mg
for IN route administer half in each nostril, max of 1 mL per nostril.
Narcan indications
Opiate overdose, complete or partial eversal of CNS and respiratory depression induced by opiods, decreased level of consciousness, coma of unknown origin. Narcotic agonist for the following: morphine, heroin, hydromorphone(dilaudid), methadone, meperidine(demerol), paregoric, fentanyl(sublimaze), oxycodone(Percodan), codeine, propoxyphene(Darvon). Narcotic agonist and antagonist for the following: butorphanol(stadol), pentazocine(Talwin), nalbuphine(Nubain)
Vecuronium(Norcuron) dosage adult
0.1 to 0.2 mg/kg IV push.
Maintenance dose within 45 to 60 min: 0.8 to 1.2 mg/kg IV push
Vecuronium(Norcuron) administration
IV/IO
Procainamide dosage adult
recurrent VF/ pulseless VT: 20 mg/min slow IV infusion until the dysrhythmia is suppressed. max 17mg/kg
other indications: 20mg/min slow IV infusion until: dysrhythmia suppression, hypotension, QRS widens by > 50%, total of 17mg/kg
maintenance infusion: 1 to 4 mg/min
Procainamide class
Antidysrhythmic
Procainamide indications
Stable monomorphic VT with normal QT interval, reentry SVT uncontrolled by vagal maneuvers and adenosine, stable wide complex tachycardia of unknown origin, AF with rapid ventricular rate in patients with Wolff Parkinson white syndrome.
Sodium bicarbonate action
Buffers metabolic acidosis and lactic acid buildup in the body caused by anaerobic metabolism secondary to severe hypoxia by reacting with hydrogen ions to form water and carbon dioxide.
Sodium bicarbonate class
systemic hydrogen ion buffer, alkalizing agent
Sodium bicarbonate pedi dosage
1mEq/kg slow IV, IO push(dilute in small children to 4.2%)
Solu-medrol contraindications
Premature infants, systemic fungal infections, use with caution in patients with GI bleeding
Solu-medrol administration
IV/IO/IM
Toradol(Ketorolac) dosage adult
30 to 60 mg IM, 15 to 30 mg IV
Zofran (Ondansetron) dosage
4mg
Amiodarone indications
Stable, regular narrow complex tachycardia if the rhythm persists despite vagal maneuvers or adenosine or the tachycardia is recurrent; to control the ventricular rate in stable, irregular narrow complex tachycardia; to control the ventricular rate in preexcited atrial dysrhythmias with conduction over an accessory pathway; stable monomorphic VT, polymorphic VT with a normal QT interval; cardiac arrest resulting from VF or pulseless VT after CPR, defibrillation, and vasopressor.
Amiodarone class
Antidysrhythmic (ClassIII)
Amiodarone dosage
300mg IV/IO then to 150mg for VF/VT
others: 150mg
Norepinephrine actions
Potent alpha agonist resulting in intense peripheral vasoconstriction, positive chronotropic and increased inotropic effect (from 10% beta effect) with increased cardiac output. Alpha adrenergic activity resulting in peripheral vasoconstriction and beta drenergic activity leading to inotropic stimulation of the heart and coronary artery vasodilation.
Norepinephrine adult dosage
0.1 to 0.5 mcg/kg per minute
Norepinephrine class
sympathomimetic, vasopressor
Phenergan actions
H-1 receptor antagonist; blocks action of histamine; possesses sedative, anti motion, antiemetic, and anticholinergic activity; potentiates the effects of narcotics to induce analgesia
Propranolol actions
Nonselective beta adrenergic blocker that reduces chronotropic, inotropic, and vasodilator response to beta adrenergic stimulation.
Propranolol contraindications
Sinus bradycardia(if no pacemaker), second or third degree AV block(if no pacemaker present), bronchial asthma, sick sinus syndrome(if no pacemaker present), cardiogenic shock, heart failure, and acute pulmonary edema.
Racemic epinephrine actions
Stimulates beta 2 receptors in lungs: bronchodilation with relaxation of bronchial smooth muscles. Reduces airway resistance. Useful in treating laryngeal edema: inhibits histamine release.
Racemic epinephrine dosage
dilute 5 mL (1%) in 5 mL saline, administer over 15 min.
Activated charcoal class
adsorbent, antidote
Aspirin class
Platelet inhibitor, anti inflammatory agent.
Benadryl dosage
adult: 25 to 50mg IM/IV/PO
Benadryl pedi dosage
1 to 2 mg/kg IV/IO slowly/IM/ if PO: 5mg/kg per 24 hours.
Epinephrine 1:10000 pedi dose
IV/IO 0.01 mg/kg of a 0.1 mg/mL(1:10000) every 3 to 5 min.
Epinephrine 1:10000 class
sympathomimetic
Furosemide action
blocks adsorption of sodium and chloride at the distal and proximal tubules and the loop of Henle, causing increased urine output
Glucagon indications
Altered level of consciousness when hypoglycemia is suspected. May be used as a reversal agent in beta blocker and calcium channel clocker overdoses
Glucagon class
hyperglycemic agent, pancreatic hormone, insulin antagonist.
Morphine dosage
SEMI: 2 to 4 mg slow IV, repeat: 2 to 8mg at 5 to 15 intervals
NSTEMI/unstable angina: 1 to 5 mg IV if symptoms are not relieved by nitrates, use with caution
Nitroglycerin actions
Smooth muscle relaxant acting on vasculature, bronchial, unterine, intestinal smooth muscle. Dilation of arterioles and veins in the periphery. Reduces preload and afterload, decreasing workload of the heart and thereby myocardial oxygen demand.
Nitroglycerin contraindications
Hypotension, hypovolemia, intracranial bleeding or head injury, pericardial tamponade, severe bradycardia or tachycardia, RV infarction, previous administration in the last 24 hours: sildenafil(viagra) or 48 hours: cardenafil(levitra) or tadalafil(cialis)
Succinylcholine onset/duration
onset: 1 minute
peak: 1 to 3 min
duration: 5 to 10 min
Succinylcholine indications
RSI
Oxytocin indications
Postpartum hemorrhage after infant and placental delivery
Oxytocin actions
increases uterine contractions
