Meds Flashcards
Acetaminophen Dose
15mg/kg up to max dose 1g PO/PR
Adenosine Dose (adult)
1st: 6mg RIVP followed by 10mL NaCl flush
2nd: 12mg RIVP followed by 10mL NaCl flush
CI’s for Adenosine
2nd or 3rd degree, SSS, WPW.
Albuterol Dose
2.5mg bullet NEB (max 2 doses)
Albuterol Sulfate also known as…
Proventil
Amiodarone Dose (adult VF/PVT)
1st: 300mg IV/IO. Dilute with 20ml saline.
2nd:150mg in 5 minutes.
Max total dose 450mg
Amiodarone Dose (adult VT)
150mg IV/IO. Piggyback with 100ml NACL over 10 minutes.
Max total dose 450mg
Amiodarone Dose (post-cardiac arrest)
900mg mixed into 500ml NACL. Run at 33.3ml/hr (1mg/min)
Amiodarone Dose (ped VF/PVT) 🐥
5mg/kg IV/IO. Diluted with 15ml saline. May repeat in 5 minutes.
Max 15mg/kg
Amiodarone Dose (ped VT) 🐥
5mg/kg IV/IO. Piggyback over 20-60 minutes
Not to be used with Lidocaine, 2nd/3rd Degree heart block, sinus bradycardia
CI’s for Amiodarone
To be used with suspected cyanide exposure
Amyl Nitrate is indicated for this poison…
Method for Amyl Nitrate administration
Adult and Peds:
* Crush pearl between fingers. Wave under nose for 30 seconds with 30 seconds off. Up to three
minutes per pearl. PRN. No max dose.
Cefazolin is also known as…
Ancef is also known as…
Prophylactic coverage for open fractures or presumably contaminated wounds.
Ancef/Cefazolin indication
Cautions for Ancef/Cefazolin
PCN allergy
Hx of seizure disorders
Ancef dose (adult only)
1g IV/IO over 60min infusion
This ACS platelet aggregate inhibitor is not to be used where choking hazard exists, pediatric patients, or in presence of allergies.
CI’s for ASA
Precautions for ASA
Bleeding
Use of other blood thinners
Suspect CVA/Stroke
Ativan is also known as…
Lorazepam is also known as…
Seizures
Anxiety
Combativeness
Skeletal Muscle Spasms
Withdrawal symptoms
Indications for Ativan
Narrow angle glaucoma
Shock
Allergies to Benzo’s
CI’s for Ativan
Caution should be used when giving this medication for ETOH withdrawal…
Ativan should be used for ETOH withdrawal
Ativan dose (adult seizure)
2-6mg IV/IO/IM repeat x 2 prn q 5 mins
Ativan dose (adult other)
1-2mg IV/IO/IM x2 prn q 5 mins
Ativan dose (peds) 🐥
0.05mg/kg IV/IO
May be used for symptomatic bradycardia or nerve agent exposure
Uses for Atropine
Not to be used with A-Fib/A-Flutter, Tachycardia, Glaucoma pt’s
CI’s for Atropine
Atropine dose (adult bradycardia) per ACLS
1mg IV/IO
Atropine dose (adult nerve agent)
1mg IV/IO q 5 min until symptoms resolve. No max.
Atropine dose (peds) 🐥
0.02mg/kg IV/IO (max 0.5mg dose)
Indications for use:
HypoCa
HyperK
HyperMg
Hydrogen Fluoride Toxicity
Ca channel blocker toxicity
Multiple blood transfusion
Calcium Gluconate indications
Do not piggyback this electrolyte medication with sodium bicarbonate…
Contraindicated for V-Fib
CI’s for Calcium Gluconate
Rapid infusion may cause Bradycardia, hypotension, or Asystole
May cause tissue necrosis
May cause V-Fib
Precautions for Calcium Gluconate
Calcium Gluconate dose (adult)
500mg-2g IV/IO over 10 mins q 20 mins prn
Calcium Gluconate (peds) 🐥
60mg/kg IV/IO over 10 mins q 20 mins prn
Diltiazem is also known as…
Cardizem is also known as…
A-Fib with RVR
A-Flutter with RVR
PSVT
Indications for Diltiazem
Do not use with patients who have…
2nd/3rd degree heart blocks
SSS
Severe hypotension
WPW
Rx Beta blockers (may cause profound bradycardia, AV block, depression of contractility)
CI’s for Dilitiazem
This medication should be used cautiously in pt’s with hx of hepatic/renal impairment, or CHF.
Precautions for Diltiazem
Diltiazem dose (adult only)
0.25mg/kg IV/IO over 2 mins.
Repeat prn in 15 mins @ 0.35mg/kg IV/IO
Clonidine is also known as…
Catapres is also known as…
Clonidine is indicated for…
This medication is used to treat symptomatic hypertension
This hypertension medication is not to be used in pt’s with…
CVA
2nd/3rd degree heart blocks
Hypotension
CI’s for Clonidine
Clonidine dose (adult only)
0.1-0.2mg PO x 1 dose
Used to treat hypoglycemia
Dextrose
Questionable or unstable IV
Hyperglycemia
CI’s for dextrose
Dextrose dose (D10 infusion)
10-50g IV infusion. Titrate to effect.
Diphenhydramine is also known as…
Benadryl is also known as…
Indicated for…
anaphylaxis
dystonic reactions
severe combative subjects
Indications for Benadryl
This antihistamine is not to be used in breastfeeding or pregnant mothers…
Contraindications for Benadryl
Benadryl dose (adult)
25-50mg IV/IM/IO
Benadryl dose (peds) 🐥
1-2mg/kg IV/IO/IM (max total dose 25mg)
Duoneb is also known as…
Combivent is also known as…
Indications for this medication include…
-Asthma
-COPD
-CHF
-Smoke Inhalation
-Epiglottitis
-Infection process of lung/airway
Duoneb indications
What does a Duoneb bullet consist of?
2.5mg Albuterol Sulfate
0.5mg Ipratropium Bromide in 3.0ml NS
Indications for this medication include…
-Pulseless arrest (VF, pVT, PEA, Asystole)
-Bronchospasm
-Anaphylaxis
-Hypotension
Indications for Epi
Hypertension
Labor
Contraindications for Epi
Caution should be used with epinephrine as it will precipitate this medication…
Sodium bicarbonate will be precipitated from this medication.
Epinephrine dose (adult anaphylaxis)
0.3mg 1:1,000 (1mg/mL) SQ/IM q 3-5 minutes
Epinephrine dose (peds anaphylaxis) 🐥
0.01mg/kg 1:1,000 (1mg/mL) SQ/IM q 3-5 min
Epinephrine dose (adult cardiac arrest)
1mg 1:10,000 (1mg/10ml) IV/IO q 3-5 min
Epinephrine dose (peds cardiac arrest) 🐥
0.01mg/kg 1:10,000 (1mg/10ml) IV/IO q 3-5 min
Epinephrine dose (adult hypotension)
“Push Dose Pressor” 5-10mcq/1ml of diluted concentration IV/IO q 3 minutes
until desired effect.
Epinephrine dose (adult infusion)
0.5-1.0 mcg/kg/min
Etomidate is also known as…
Amidate is also known as…
This medication is used for general anesthesia to facilitate intubation…
Etomidate is used as general anesthesia to facilitate intubation.
Side effects of etomidate..
Can cause uncontrolled skeletal muscle activity.
Etomidate dose (adult)
0.4mg/kg IV/IO
Etomidate dose (peds) 🐥
> 10 yrs old 0.4mg/kg IV/IO
Fentanyl is also known as…
Sublimaze is also known as…
This medication is contraindicated for use in pt’s who are…
<2 yrs of age
bradycardic
ALOC
Head injury w/suspected ICP
Contraindications of fentanyl use
Fentanyl dose (adult/peds pain)
1-2mcg/kg SIVP/IO/IM/IN (may repear prn at 1/2 initial dose)
Fentanyl dose (adult/peds post-sedation)
1-2mcg/kg/hr IV/IO
True or false. The doses mcg/kg for fentanyl are the same for adult and pediatrics?
True. Fentanyl doses for adult and pediatrics are the same.
GlucaGen is also known as…
Glucagon is also known as…
Hypoglycemia (if dextrose unavailable)
Beta Blocker Overdose
and Calcium Toxicity
Indications for Glucagon
The effects of this medication are inhibited by Dilantin
Glucagon is inhibited by Dilantin
Glucagon dose (adult hypoglycemia)
1mg SQ/IM (may repeat every 20 mins, Total max dose 4mg)
True or false. Glucagon is indicated in pediatric patients?
False, glucagon is not indicated for pediatric patients.
Indications for this medication…
Minor hypoglycemia with patent airway
Oral glucose
True or false. Oral glucose may be used in patients with ALOC or non-patent airway?
False, oral glucose is contraindicated for these patients.
Oral glucose (adult dose)
15g (1 tube) buccal
-repeat prn to maintain glucose levels
Oral glucose (peds dose) 🐥
> 2 years old, 7.5-15g buccal
-repeat prn to maintain glucose levels
Haloperidol is also known as…
Haldol is also known as…
Indications for this medication include…
Hallucinations
Tourette syndrome
Combative subjects
Psychotic disorders
Indications for haldol
True or false. Haldol may be used for Parkinson’s disease?
False, Haldol is contraindicated in the presence of Parkinson’s disease.
May cause extrapyramidal effects
May cause arrythmias
May cause orthostatic hypertension
Side effects of Haldol
Haldol dose (adult)
5mg IM (may repeat q 15 minutes. Max dose 10mg)
Haldol dose (ped) 🐥
> 3 yrs old 0.05mg/kg IM
Deep Vein Thrombosis
Pulmonary Emboli
STEMI
DIC
Indications for Heparin
Past heparin-induced thrombocytopenia
Active GI bleed
Contraindications for Heparin
Bleeding ,petechiae, hematuria, hypotension, epistaxis
side effects of heparin
Heparin dose (adult STEMI)
60 u/kg SIVP (max 5000 units, followed by continuous infusion)
Infusion rate 12 u/kg/hr (max 1000u/hr)
Heparin dose (peds) 🐥
No indicated pediatric dose for heparin
Hydralazine is also known as…
Apresoline is also known as…
Hypertension and Pre-eclampsia
Indications for Hydralazine
Mitral Valvular Rheumatic Disease is an absolute contraindication for which medication?
Hydralazine is contraindicated in MVRD Pt’s.
Hx of heart disease
Hx of CVA
Hx of Renal impairment
precautions for hydralazine
Hydralazine dose (adult only)
20-40mg IV
<2 years of age
Acute pulmonary edema
contraindications for Ketamine
0.1mg-0.3mg/kg is the pain management dose for…
Ketamine dose (adult pain management)
4mg/kg IM or 2mg/kg IV
Ketamine dose (adult combative/excited delirium)
2mg/kg IVP
Ketamine dose (adult sedation)
1-2mg/kg/hr infusion
Ketamine dose (adult post RSI)
0.1mg-0.3mg/kg IV/IM/IN🐥
Ketamine dose (peds pain management)
True or False. Ketamine may be used for combative patients <17yo?
False. Ketamine may NOT be used for combative patients <17yo.
Trandate is also known as…
Labetalol is also known as…
This beta blocker is indicated for use in hypertensive crisis…
Indication for Labetalol
2mg-5mg q 5 minutes. Total max dose 20mg
Morphine dose (adult cardiac/ACS)
0.05-0.1mg/kg IV/IO q 5minutes. Total max dose 20mg
Morphine dose (pain management)
2mg IV/IO q 5 minutes. Total max dose 20mg.
Morphine dose (pulmonary edema)
4mg ODT. Allow to dissolve. Repeat prn q 10 mins. Max dose 8mg.
Zofran dose ODT (adult)
> 5 years old, 4mg ODT. Max dose 4mg 🐥
Zofran dose ODT (peds)
4mg IV/IM. Max dose 12mg
Zofran dose (adult IV/IM)
> 2 years old 0.05mg-0.15mg/kg IV/IM 🐥
Zofran dose (peds IV/IM)
Oxytocin is also known as…
Pitocin is also known as…
-Stimulates uterus to stop vaginal hemorrhage
-Profuse vaginal bleeding with signs of shock
Indications for Pitocin
40 units added to 1000mL NaCl, rapidly infused and titrated to control bleeding
10 units IM if unable to establish IV
Pitocin dose (adult only)
Promethazine is also known as…
Phenergan is also known as…
N/V
Narcotic Enhancement
Sedation
Vertigo
Indications for Phenergan
Phenergan is NOT to be used in patients _ years or younger.
Promethazine is NOT to be used in patients 2 years or younger.
May cause sedation, confusion, disorientation
Caution with HTN, CNS depressants, and epilepsy
Caution with IV narcotic therapy
Precautions for Phenergan
12.5-25mg IM
Phenergan dose (adult)
> 2 years old 6.25-12.5 mg IV piggyback over 10 minutes 🐥
Phenergan dose (peds)
Croup
Epiglottitis
May also be used in conjunction with SQ Epinephrine in acute anaphylaxis if IV/IO is unobtainable
Indications for Racemic Epinephrine
Caution in patients with coronary insufficiency and HTN
Contraindications for Racemic Epinephrine
Zemuron is also known as…
Rocuronium is also known as…
1mg/kg IV/IO is the dose for this paralytic
Rocuronium dose (adult only)
Patients with hepatic dysfunction
Patients with neuromuscular disease
Not recommended for pediatric patients
Precautions for Rocuronium
Acidosis
Hyperkalemia
TCA overdose
Indications for Sodium Bicarbonate
Alkalosis
Do not give with catecholamines or Calcium
Contraindications for Sodium Bicarbonate
May cause alkalosis
May cause excessive intravascular volume or worsen CHF
Extravasation may cause tissue necrosis
Precautions for Sodium Bicarbonate
1mEq/kg IV/IO (may repeat prn q10 minutes)
Sodium bicarbonate dose (adult/ped)
Cyanide exposure
Severe smoke inhalation secondary to structure fire
Indications for Sodium Nitrate
May cause hypotension if infused too quickly
Remember to decon patient prior to administration
Precautions for Sodium Nitrate
300mg IV piggyback over no less than 5 mins
Sodium Nitrate dose (adult)
0.12ml-0.33ml/kg up to 10ml piggyback over 5-10 mins 🐥
Sodium Nitrate dose (peds)
Solu-Medrol is also known as…
Methylprednisolone is also known as…
Severe Anaphylaxis
Asthma
COPD
Indications for Solu-Medrol
May cause GI bleeding, prolonged wound healing, suppression of natural steroids
Precautions for Solu-Medrol
125mg-250mg IV/IO/IM
Solu-Medrol dose (adult)
2mg/kg IV/IO/IM 🐥
Solu-Medrol dose (peds)
Solu-Medrol has no contraindications. True or False?
True. Solu-Medrol has no contraindications.
Terbutaline is also known as…
Breathline is also known as…
Asthma
Bronchospasm
Preterm labor (27-36 weeks gestation to stop contractions)
Indications for Breathline
True or False. Terbutaline is not to be used with other sympathomimetic agents.
True. Terbutaline is not to be used with other sympathomimetic agents.
Caution with hx of diabetes, HTN, hypothyroidism
May cause tachycardia, hypotension, lightheadedness, flushing, pulmonary chest pains, hyperglycemia
Precautions for Terbutaline
0.25mg SQ. Repeat once prn if no improvement in 15 minutes.
Terbutaline dose (adult and/or preterm labor)
Cyanide exposure (IV medication secondary to Sodium Nitrate)
Indications for Sodium Thiosulphate
12.5g IV piggyback over 10-20 mins
Sodium Thiosulphate dose (adult)
1.65ml/kg IV piggyback over 10-20 mins 🐥
Sodium Thiosulphate dose (peds)
Ocular pain relief
Temporary numbing of eye for irrigation
Indications for Alcaine
Alcaine is also known as…
Tetracaine is also known as…
1-2 drops pf solution per affected eye prn 5-10 mins. Max 3 doses.
Tetracaine dose (adult and peds)
Toradol is also known as…
Ketorolac is also known as…
Short term management of mild to severe pains
Indications for Toradol
Obvious fractures (delays healing process)
Recent GI bleeding
Active ulcer
Advanced Renal Impairment
Contraindications for Toradol
30mg IV or 60mg IM over no less than 30 seconds
Toradol dose (adult <65yrs of age)
> 65yrs of age or weight less than 50kg: 30mg MAX
Toradol dose (adult >65yrs of age)
1mg/kg IM up to 30mg max OR 0.5mg/kg IV up to 15mg max
Toradol dose (peds)
Thiamine is also known as…
Vitamin B1 is also known as…
Alcoholic Polyneuropathy (S/S: nystagmus, opthalmoplegia, ataxia)
Indications for Vitamin B1
Administration of glucose may precipitate symptoms of thiamine deficiency. Therefore, in patients whose Thiamine status is suspect, Thiamine should be given prior to dextrose.
Precautions for Thiamine
100mg is the dose for this vitamin.
Thiamine dose (adult dose)
Hemorrhagic shock secondary to trauma
ACE Inhibitor Inducted Angioedema
Indications for TXA
Patients <12 years old
Suspected CVA, MI, or PE
Contraindications for TXA
May cause diarrhea, N/V or blurred vision
Precautions for TXA
Administer early with signs of internal/external hemorrhage or provider judgement. Ideally administration is performed before patient presents with shock (hypotension and tachycardia).
Notes for TXA
2g mixed with 100-250 ml dilutant given over 10 mins
TXA dose (adult or peds >13yrs)
Midazolam is also known as…
Versed is also known as…
Sedation (both short and long term)
Acute alcohol withdrawals
Seizures
Post intubation sedation
Indication for Versed
Narrow angle glaucoma
Shock
Alcohol intoxication
Contraindications for Versed
Patients with ALOC
Patients hemodynamically unstable
Recent opiate administration
Will cause respiratory depression
May cause hypotension
Precautions for Versed
2mg-10mg IV/IM/IN/IO (may repeat q 2 mins at 1 mg until desired effects achieved) IN limited to 1ml per nostril max
Versed dose (adult)
5-15mg/hr IV titrated to effect
Versed infusion dose (adult)
0.05mg/kg/hr
Versed Post Intubation Sedation infusion dose (adult)
0.1mg/kg IV/IO/IN or 0.2mg/kg IM max 5mg 🐥
Versed dose (peds)
In place of Albuterol for patient with known sensitivity:
Asthma
Allergic Reaction
COPD
CHF
Smoke Inhalation
Infectious process involving lung/airway
Indications for Xopenex
True or false. Xopenex may be used in patients <12 yrs of age.
False, Xopenex is NOT to be used in patients <12 yrs of age.
1.25mg bullet via NEB
Xopenex dose (adult or ped >12yrs of age)
Stroke/CVA
Asthma
2nd/3rd Degree Heart block
Bradycardia
Contraindications for Labetalol
10mg-20mg IVP over 2 mins (may repeat initial or double initial dose q10 mins. Max total dose 150mg
Labetalol dose (adult only)
Significant PVC’s
R on T
V-Tach
V-Fib
Conscious IO placement
Indications for Lidocaine
2nd or 3rd degree heart block
Bradycardia
Contraindications for Lidocaine
Decreases myocardial contractility
May cause dizziness and/or confusion
Precautions for Lidocaine
1mg-1.5mg/kg IV/IO (may repeat at 3-5min at 1/2 dose. Max dose 3mg/kg or 300mg)
Lidocaine dose (adult)
2g/500ml infusion at 2-4mg/min (4mg/ml @ 30-60ml/hr)
Lidocaine post conversion infusion dose (adult)
1mg-1.5mg/kg IV/IO. Repeat at 3-5mins. Max dose 3mg/kg or 300mg
Lidocaine dose (peds)
0.5mg/kg IV/IO 🐣
Lidocaine dose (infant)
Lopressor is also known as…
Metoprolol is also known as…
Hypertensive crises
Indication for Lopressor
Stroke/CVA
Asthma
2nd or 3rd degree heart block
Bradycardia
Contraindication for Metoprolol
May cause bradycardia
Caution with hx of 1st degree heart block
Caution with hx of CHF
Precautions for metoprolol
5mg SIVP q 5-10 mins. Max total dose 15mg
Lopressor dose (adult only)
Severe asthma
Ventricular arrythmias
Torsades de Pointes
Pre-Eclampsia
Pre-Term Labor
Indications for Magnesium Sulphate
May cause prolonged QT interval (stop infusion)
May cause facial flushing
Precautions for Magnesium Sulfate
1g-2g IV/IO piggyback over 5 mins
Magnesium Sulfate dose (Cardiac Arrest/Torsades adult only)
2g piggyback over 10 mins
Magnesium Sulfate dose (Status Asthmaticus adult only)
4g piggyback IV/IO over 10 mins
Magnesium Sulfate dose (Pre-eclampsia adult only)
Levophed is also known as…
Norepinephrine is also known as…
Hypotension (non-hypovolemic)
Indication for Levophed
Incompatible with:
Heparin
Insulin
Lidocaine
Sodium Bicarbonate
Packed RBC
Hypovolemia
Contraindications for Levophed
Hypotension <90mmHg
Rx usage of Viagra, Levitra, Cialis in past 24 hours
Contraindications for NTG
Chest pains, including suspected ACS symptoms
Pulmonary edema
Indications for NTG
Establish IV access prior to adminstration
Caution in patients with suspected or confirmed STEMI with reciprocal changes
Precautions for NTG
0.5-1.0” paste along anterior chest wall
NTG paste dose (adult only)
5mcg/min, slowly titrated to effect
NTG infusion dose (adult only)
0.5ml mixed with 3ml normal saline via neb or blow by 🐥
Racemic epinephrine dose (peds only)