Meds Flashcards
RSI meds for adult
Etomidate 0.3 mg/kg Succinylcholine 2mg/kg Rocuronium 1mg/kg In rapid succession Propofol 2 mg/kg Ketamine 1mg/kg Vecuromium 0.1 mg/kg
What RSI drug would you NOT use if your pt was hyperkalemic, has a burn/crush injury, spinal cord injury or a myopathy?
Succinylcholine. You would want to use rocuronium 1mg/kg
For RSI if you have no succs or roc what drug would you use?
Vecuromium 0.1 mg/kg
For a hypotensive pt what drug would you use in RSI?
Ketamine 2mg/kg
For RSI if you have NO etom and pt bp good what drug would you use?
Diprivan 2mg/kg
RSI atropine dose for pt <8 yrs old?
Atropine 0.02 mg/kg
For RSI you want to pre-oxygenate w/NRB for 1-3 min and have NC on how many liters/min?
5
What is mallampati score?
Classification of ease of intubation.
Class 1: full visualization of tonsils, uvula, n soft palate
Class 2: visual of hard n soft palate n upper portion of tonsils n uvula.
Class 3: only soft n hard palate n base of uvula visible.
Class 4: only hard palate visible.
Airway assessment
LEMON
Look Evaluate 3-3-2 Mallampati Obstruction Neck mobility
What does LEMON stand for?
Look Evaluate (3-3-2, mouth opening 3 finger widths, norm mandible dimension, notch of thyroid cartilage 2 finger breadths below hyoid bone) Mallampati Obstruction Neck mobility
For RSI; in the septic pt you would use what drug in place of etomidate?
Ketamine 2mg/kg
What drug in RSI would you want to promedicate with for an actual or potential head injury pt?
Fentanyl 3-5 mcg/kg ivp
Lidocaine 1.5 mg/kg ivp
Allergic reaction..what drugs would you use?
Benadryl 50 mg ivp/im
Albuterol 5mg
NS bolus up to 2L
EPINEPHRINE (1:1,000) 0.3mg or 0.3 ml IM
If severe life threatening and IM not working; mix 10 ml of 1:10,000 (1mg) in 1L of NS start at 60 ml/hr and increase by 60 ml/hr every min
Drugs to use for combative pt?
Ativan (lorazepam) 1-2 mg IVP
Versed (midazolam) 2 mg IVP/IM
Ketamine (ketalar) 5 mg/kg IM or 1-2 mg/kg I’VE
COPD/asthma, bronchospasm..what meds would you give?
Albuterol 5mg Atrovent (ipratropium bromide) 0.5mg Epinephrine (if life threatening) 0.3 mg (0.3 ml) of 1;1,000 IM (avoid if heart dx tachyarrhythmias or age >50 Solu-medrol 125 mg IVP Epi aerosol 5 ml (or racemic epi 0.5ml)
Bradycardia
Atropine 0.5 mg IVP
Dopamine 5-20mcg/kg/min if pacing is ineffective
Epinephrine gtt 2-10 mcg/min
Transcutaneous pace for type 2 second degree or 3rd degree av block
Chest pain
Asa 81 mg
Nitro gtt 5 mcg/min titrate 5-10 mcg/min q 3 min
Fentanyl 50 mcg IV
Tachycardia >150 unstable
Immediate synchronized cardioversion w/ 150 joules
Tachycardia wide qrs
Adenosine (adenocard) 6mg
Amiodarone (cardarone) 150 mg IV over 10 min, repeat 150mg IV over 10min
Tachycardia narrow qrs
Vagal maneuver
Adenosine (adenocard) 6mg rapid push, may repeat 12 mg dose once
Tachycardia afib/flutter
Diltizem (cardizem) 0.25 mg/kg IVP over 2 min
May repeat 0.35 mg/kg in 15 min
Maintenance 5-15 mg/hr gtt
If unresponsive Amiodarone 150mg IVP over 10min
CHF
Cpap
Nitro 50 mcg/min titrate 5-10 mcg/min q 3 min up to 200 mcg keep sbp >100
Lasix (furosemide) 0.5-1.0 mg/kg IVP
Hypoglycemia
D50 25grams repeat in 10 prn
Glucagon 1mg IM
Hyperglycemia
BS. >300 w/change in LOC, increased resp
250 ml NS bolus
Heat emergency
NS 500 ml bolus
Ativan (lorazepam) 1-2 mg for shivering prn
What meds would u use for a K greater then 7, or >5.5 w/ EKG changes..loss of P wave, widening QRS, tall peaked T waves, or arrhythmias..weakness or paralysis?
Ca Gluconate 10ml of 10% in 5 min(do not use if dig tox) NA bicarbonate 50 meq (no if chf) Insulin 10units IVP Glucose 25 G IVP Consider albuterol 5mg/5ml nebs
HTN >200/120
Ntg gtt 10 mcg/min titrate q 3 min
Nicardipine (cardene) bolus 5mg/hr increase by 2.5 mg q 5-15 min max 15 mg/hr..when bp improved, quick ween to 3 mg/hr
Labetalol (trandate) 10-20 mg IVP q5-10 min max 150 mg
OD..what drugs and dose?
Narcan (naloxone) 0.4 mg IV/im/in
Tricyclics 8.4%NA bicarbonate
Organophosphate atropine
Pain mgmt meds
Diludid 0.5-1 mg IV/IM q10 min
Fentanyl (sublimaze) 1mcg/kg q5 (no more then 100mcg per dose)
MS up to 4mg q5
Sedation
Versed (midazolam) 2-5mg
Ativan (lorazepam) 1-2 mg
Cardioversion sedation meds?
Fentanyl (sublimaze)1mcg/kg
And
Etomidate (amidate) 0.1 mg/kg
Immediately prior if pt awake
Sedation for intubated pt?
Ativan (lorazepam) 1-2 mg Versed (midazolam) 2-5 mg Fentanyl (sublimaze) 1mcg/kg q5min Propofol (Diprivan) 20-40mg bolus q2min...gtt 5-50 mcg/kg/min Ketamine (ketalar) 1mg/kg over 1min
Seizure meds?
Check BS
Versed (midazolam) 0.1 mg/kg max dose of 5 mg
Ativan (lorazepam) 2mg q10 slow push
Non-traumatic shock meds?
250 NS bolus prn
Dopamine 5-20 mcg/kg/min
Dobutamine 2-20 mcg/kg/min
Sepsis: norepinephrine (levophed) 0.5-12 mcg/min
N/V?
Zofran (ondansetron) 4mg
NS bolus 250 ml
Reglan (metoclopride) 10mg IVP/IM
Benadryl (diphenhydramine) 25 mg IVP for restlessness
Adenocard (adenosine)..what’s it for and adult dose?
Narrow tachycardia
6 mg rapid IVP then
12 mg rapid IVP x1 prn
Albuterol (Proventil)..what’s it for and adult dose?
Allergic reaction, bronchospasm, wheezing
5mg nebs, repeat prn
Amiodarone (cordarone)..what’s it for and adult dose?
Antiarrhythmic..wide tachycardia
300mg IVP n repeat 150 mg-arrhythmias
150 mg IVP over 10 min-tachycardia
Amiodarone kit…what’s it for and how is it dosed?
Antiarrhythmic n wide tachycardia
1mg/min
Atropine…what’s it for and adult dose?
Asystole, PEA, 1mg IVP q 3-5 min
Symptomatic bradycardia 0.5 mg q3-5 min
Atrovent (ipratropium)..what’s it for and the adult dose?
Bronchospasm or wheezing
0.5 mg nebs
Benadryl (diphenhydramine) what’s it for and the adult dose?
Allergic reaction and anaphylaxis 50mg IVP/IM
Akathisa (restlessness) 25 mg IVP
Calcium Gluconate..,what’s it used for and the adult dose?
Hyperkalemia 10 ml of 10% IVP over 5 min
Dextrose (D50W)..what’s it for and the adult dose?
Glucose <70
25gm IVP
Dilaudid (hydromorphone HCL)…adult dose and what’s it for?
Pain mgmt
0.5-1 mg IVP q10 min
>65 yo..0.5 mg IVP q10
Diltiazem 25mg/ml (cardizem)…what’s it for and adult dose?
Tarcardia
0.25 mg/kg IV over 2 min
May repeat 0.35 mg/kg in 15 min
Diltiazem 125mg/25ml (cardizem)…gtt..
What’s it for and adult dose?
Tachycardia
5-15 mg/hr titrate for hr
Dopamine (intropin)…what’s it for and the adult dose?
Shock..non-traumatic, n bradycardia
5-20 mcg/kg/min
Keep bp >100
Dobutamine…what’s it for and adult dose?
Non-traumatic shock
2.5-20 mck/kg/min
Titrate keep bp >100
Epinephrine (1:1000, 1:10,000)..what’s it for and the adult dose?
Vfib, pulseless VT, PEA, asystole, asthma, anaphylaxis, shock
Card arrest: 1mg of 1:10,000 q3-5min
Anaphylaxis/asthma.. 0.3 mg 1:1000 sq/im q5-10 min x2
Severe; 1:10,000 (1 ml IV)
Epi gtt: 2-10 mcg/min
Etomidate..when do we use it and adult dose?
RSI, 0.3 mg/kg IV
Sedation, 0.1 mg/kg for cardioversion
Fentanyl (sublimaze)..what’s it for and adult dose?
Pain, airway, sedation
1mcg/kg IVP q5 min..(max single dose 100 mcg)
Glucagon..what’s it for and adult dose?
Glucose <70 and no IV site
1 mg IM, repeat in 20 min
Haloperidol (haldol)…what’s it for and adult dose?
Combative pt
10 mg IVP
When would we use insulin and what adult dose?
Hyperkalemia 10 units of reg. IV
Ketamine (ketalar)..what’s it for and adult dose?
Sedation
Induction 2mg/kg IV over 1 min
Sedation 1mg/kg IV over 1min
Labetalol (trandate)..what’s the dose and what’s it for?
Hypertension
10-20 mg q5-10 min IVP
Max dose 150 mg
Lasix (furosemide) ..what’s the adult dose and what’s it for ?
CHF/pulm edema
0.5-1.0 mg/kg IV
Lidocaine 2% (xylocaine)…what’s the adult dose and what’s it for?
RSI (consider), arrhythmia: 1-1.5 mg/kg IV
EZ IO insertion; 40-60 mg IO slowly before fluid bolus
Lidocaine 1% (xylocaine)…what’s it for and adult dose?
Local anesthesia; prn up to 4.5 mg/kg
Lorazepam (Ativan)..what’s the adult dose and what’s it for?
Behavioral, heat emergency, seizure, sedation; 1-2 mg IVP
Magnesium sulfate..what’s it for and the adult dose?
Torsades de pointes…1-2 gm IV
Morphine sulfate..what’s it for adult dose?
Pain, sedation, airway;
4mg IV q5 min prn
Geriatric; up to 2 mg IV q5min prn
Narcan (naloxone)..what’s it for and adult dose?
Narc OD
0.4 mg IV may repeat up to 2 mg
Nicardipine (cardene)…what’s it dot and adult dose?
Hypertension
Begin 5 mg/hr titrate q5-10 min 2.5 mg up to max of 15 mg/hr. when goal bp reached change to 3 mg/hr
Nitroglycerin (tridil)..what’s it for and the adult dose?
CHF; begin w/ 10 mcg/min, titrate to 50 mcg /min keeping bp >100
CP; begin at 5 mcg/min, titrate by 5mcg/min q5 min
Nitro spray..what’s it for and adult dose?
CP or pulm edema; 0.4 sl q5 min keep sbp >100
Norepinephrine (levophed)..when do we use it and what’s the dose?
Septic shock
0.5 mcg/min titrate up to 30 mcg/min
Oxytocin (pitocin)..what’s it for and what’s the dose?
OB emergencies, postpartum hemorrhage
10 units
Plavix (clopidogrel)..what’s it for and dose?
CP w/ allergy to asa; 300 mg
Procainamide (pronestyl)..what’s it for and adult dose?
Antiarrhythmic; 15mg/kg @ 20-30 mg/min to a total loading dose of 1000 mg
Propofol (Diprivan)..what’s it for and adult dose?
Sedation..bolus of 2mg/kg and gtt 5-50 mck/kg/min
Reglan (metoclopride)..whats it for and adult dose?
N/V; 10 mg IV/IM
Rocuronium bromide (zemuron)..what’s it for and adult dose?
Neuromuscular relaxant..
1mg/kg IV
Defasiculating (muscle twitching) dose 0.1 mg/kg IV
Nitroprusside..adult dose and use?
Acute CHF
0.3 mcg/kg/min
Sodium bicarbonate 8.4%…what’s it for and adult dose?
Prolonged cardiac arrest, hyperkalemia; 1meq/kg IV
Solu-medrol..what’s it for and adult dose?
Bronchospasm (asthma/copd) 125mg IV
Succinylcholine (anectine)..adult dose and use?
Neuromuscular relaxant (short term) 2mg/kg IV
Valium (diazepam)..use and adult dose?
Sedation, airway,
Up to 5 mg IV may repeat as needed
Vecuronium (norcuron)..adult dose and use?
Neuromuscular relaxant: 0.1 mg/kg IV
Defasciulating (twitching) dose; 0.01 mg/kg IV
Versed (midazolam)..use and adult dose?
Sedation, airway, burns, seizures;
2mg IV increments up to 10mg
2-5 mg IV q10 severe burn
discomfort
Zofran (ondansetron)..use and adult dose?
Vomiting; 4 mg IV slow 2-5 min
Or
4mg oral disintegrating tab (ODT)
