NREMT drug cards Flashcards
Epinephrine
Indications: Cardiac arrest, anaphylaxis, bronchospasms
Class: vasopressor/sympathomimetic
Side effects: tachycardia, anxiety, tremors, arrhythmia’s, hypertension
Dose:
Cardiac Arrest-
adult dose- 1mg of 1:10,000 IV/IO push q3-5min until ROSC
Peds dose-0.01mL/kg of 1:10,000 IV/IO push, then 0.01mL /kg IV/IO q 3-5 min
Anaphylaxis-
Adult dose- 0.3-0.5mL SQ/IM 1:1000 q 5-15 min
Peds dose- 0.15-0.3 mg IM less than 30 kg .01mg/kg
Contraindications: none in the emergency setting
Epi Drip- 2-10 mcg/min 1mg in 250mL using 60gtts 4mcg/min-60gtts 3mcg/min-45gtts 2mcg-min-30gtts 1mcg-min-15gtts
Atropine
Indications: Bradycardia, organophosphate poisoning
Class: parasympatholytic ( anticholinergic)
Side effects: palpations, tachycardia, anxiety
Dose:
adult dose-
bradycardia- 0.5-1mg IV q3-5 min max 3mg
poisoning- 1-2mg until effects are reversed
Peds dose:
bradycardia- 0.01-0.03 mg/kg IV
posioning- 0.05 mg/kg IV q10 min PRN to reverse effects
Adenosine (adenocard)
indications: symptomatic tachycardia/ SVT
Class: Antiarrhythmic
Side effects: headache, SOB, dizziness, nausea
Dose:
adult dose- 6mg IV- 12 mg IV 1-2 min later
Peds dose- 0.1mg/kg- 0.2mg/kg repeated in 1-2 min
Amiodarone
Indications: Vtach/ Vfib
Class: Antiarrhythmic
Side effects: dizziness, nausea/vomiting
Dose:
adult dose- 300mg 1st dose followed by 150mg alternating with epi at shocks in cardiac arrest
Peds dose- 5mg/kg IV/IO 15mg max
Lidocaine
Indications: ventricular arrhythmia, PVC’s, V tavh/Vfib
Class: antiarrhythmic
Side effects: bradycardia, hypotension
Dose:
cardiac arrest: 1.0-1.5 mg/kg IV/IO repeat PRN at 0.5-0.75mg/kg up to 3mg/kg
Maintenance dose: 1g mixed in 250 mL bag using a 60gtts set-
4mg/min-60gtts
3mg/min-45gtts
2mg/min-30gtts
1mg/min-15gtts
Mag Sulfate
Indications: Torsades/pre-eclampsia, severe asthma
Class: electrolyte
Side Effects: resp depression, diarrhea, hypothermia, muscle weakness
Dose:
Cardiac Arrest: adult dose 1-2g IV push before v tach algorithm
peds dose: 25-50mg/kg/dose IV
Preeclampsia- 4g loading dose followed by 1-4g/hr infusion
Solu-medrol (Methylprednisolone)
Indications: anaphalyxis, asthma/COPD, spinal cord injury
Class: Steroid
Side effects: GI bleeding, prolonged wound healing
Dose:
Adult: anaphylaxis/status asthmaticus- 125-150mg IV
Spinal cord injury - 30mg/kg then infuse 5.4 mg/kg/hr
peds: anaphylaxis/status asthmaticus- 1-2mg/kg/dose
Benedryl ( Diphenhydramine)
Indications: allergic reactions/ anaphylaxis
Class: antihistamine
Side effects: sedation, dries bronchial secretions, headache, palpations
Dose:
adult dose: 25-50mg
Peds dose: 12.5 mg
Dexamethasone (Decadron)
indications: anaphylaxis( after epi and benedryl), asthma, COPD, Cerebral edema
Class: Steroid
Side effects: GI bleeding, prolonged wound healing
Dose:
Adult dose: 4-24mg
peds dose: 0.2-0.5mg/kg
Dopamine (Inotropin)
indications: vasopressor support, shock, severe CHF Class: Vasopressor, sympathomimetic Side effects: tachycardia, hypertension, headaches Dose: Adult dose: 400mg in 250mL bag using 60 gtts set 1600mcg/min-60gtts 120mcg/min-45gtts 800mcg/min-30gtts 400mcg/min-1gtts
Norepinepherine (levophed)
indications: Shock, hypotension Class: Vasopressor, alpha/bets agonist Side Effects: hypertension, anxiety, metabolic acidosis Dose: adult dose: 0.5-1 mcg/min IV peds dose: 0.1-0.2mcg/kg/min
Versed (Midazolam)
indications: intubation, sedation, seizures
Class: Benzodiazepine
Side effects: drowsiness, headache, apnea, arrhythmias
Dose:
Adult dose: 1-5mgIV PRN q 5 min
Peds: sedation-0.05-0.2mg/kg IV
Seizure- 0.1-0.5mg/kg
Etomidate
indications: RSI
Class: Anesthetic, hypnotic
Side effects: myoclonic skeletal movements, post op nausea
Dose: 0.3mg/kg
Ketamine
indications: Anesthesia, analgesia Class: Asesthetic, anelgesic Side effects: sedation, hallucinations, increased ICP Dose: Adult: anesthesia-1-4.5mg/kg IV over 1 min Pain- 1-2mg/kgIV over 1min Peds: IV-1-2mg/kg IM-3-5mg/kg
Valium (Diazepam)
indications: Seizures, anxiety, muscle relaxant
Class: Benzodiazepine
Side effects: drowsiness, resp depression, hypotension
Dose:
Adult dose:
status epilepticus: 5-10mg IV
anxiety- 2-5mg IV
premedication for cardioversion- 5-15mgIV
Peds Dose: -.1-0.2 mg/kg
Albuterol
indications: Asthma, bronchospasms
Class: sympathomimetic (B2 selective)
Side effects: palpations, anxiety, tachycardia, headache
Dose: 1.25-5mg in 2-3mL NS
Atrovent (Ipratropium)
indications: bronchiospasm, chronic bronchitis, emphysema
class: Anticholinergic bronchiodilator
Side effects: palpations, dizziness, anxiety, tremors
Dose:
>12y/o- 500mcg in 2.5-3.0mL NS
peds- 124-250mcg in 2.5-3mL NS
Racemic Epi
indications: croup, bronchospasm, laryngeal edema
Class: bronchodilator, sympathomimetic
Side effects: palpations, anxiety, headache, tachycardia
Dose:
adult dose: 5mL 1% in 5mL NS over 10 min neb
0.25-0.5mL 1% in 2.5mL NS neb
Morphine
indications: Pain
Class: Narcotic/ Opioid
Side effects: ALOC, resp depression, dizziness, drowsiness
Dose:
Adult dose: 1-4mg IV, 5-10mgIM PRN max 0.2mg/kg
Peds- 0.1-0.2mg/kg
Fentanyl
indications: Pain, RSI Class: Opioid analgesic Side effects: confusion, apnea, resp depression, laryngospasm, N/V Dose: 25-100 mcg IV/IM RSI- 1-3 mcg/kg Peds: 1-2 mcg/kg IV/IM
Dilaudid ( Hydromorphone)
indications: Pain Class: Narcotic analgesic Side effects: Resp depression, dizziness, drowsiness, GI upset Dose: Adult dose: 0.5-4.0 mg q3-4 hours Peds dose: 0.015 mg/kg
Haldol
indications: acute psychosis, severe agitation
class: anti psychotic, sedative
Side effects: extrapyramidal symptoms, hypotension, dystonia
Dose:
Adult- 2-5mg IM
Peds- 0.05-0.15 mg/kg
Ativan (Lorazepam)
indications: anxiety, alcohol withdrawl, seizures, status epilepticus. premedication for cardioversion,
Class:Bendodiazepine, anxiolytic
side effects: resp depression, hypotension, diziness, drowsiness, lethargy,N/V
Dose:
Adult dose- 2-4mg IM -0.5-2.0mg IV
Peds dose- 0.3-0.1 mg/kg for preprocedure sedation
0.1mg/kg slow IV push seizures
Succinycholine
indications: RSI
Class: paralytic
Side effects: bronchospasm, hypotension, excessive salvation
Dose- 1-2 mg/kg IV over 10-30 sec
maintenance- 0.04-0.07 mg/kg PRN max dose 150 mg
Rocuronium
indications: RSI Class: paralytic Side effects: bronchospasm, hypotension, excessive salvation Dose: 0.6-1.2 mg/kg maintenance-0.1-0.2 mg/kg/hr
Vecuronium
indications: RSI Class: Paralytic Side effects: bronchospasm, hypotension, excessive salvation dose: 0.1mg/kg maintenance- 0.01-0.05 mg/kg/hr
Aspirin
indications: chest pain, signs of recent ischemic stroke
Class: platelet inhibitor, anti-inflammatory
side effects- heartburn, vomiting, wheezing
Dose- 150-325mg PO chewed
not recommended for children
D50, D25, D10
indications: hypoglycemia
class: carbohydrate
side effects: local venous irritation
Dose:
adult dose- 25g 50mL
peds dose- 2mL of 25% solution slow IV
Glucagon
indications: hypoglycemia, beta blocker overdose
class: hormone
Side effects: nausea, vomiting, hypotension
Dose:
Adult- 0.5-1mg IM PRN q 20 min
beta blocker OD- 3mg IV PRN q 10 min
Peds dose: 0.03-0.1mg/kg PRN q 20 min 1 mg max
Sodium Bicarb
indications: prolonged cardiac arrest, metabolic acidosis, antidepressant, barbiturate or aspirin OD,
Class: antacid
Side effects: alkalosis, edema, hypernatremia
Dose: 1mEq/kg IV followed by 0.5mEq 10 min
TXA
indications:
Narcan
indications: narcotic OD Class narcotic antagonist Side effects: GI upset, pulmonary edema, hypotension, tachycardia Dose: 0.4-2mg peds dose: 0.01-0.1mg/kg
Nitro
indications: chest pain, CHF
Class: antianginal, nitrate
side effects: dizziness, headache, hypotension
Contraindicated for right ventricular infarct
Dose:
sublingual: 1 tab/spray- 0.4mg q5min
topical: 1-2cm on hair free skin (chest)
infusion: mix 50mg in 500mL NS/D5W (100mcg/mL)
Phenergan (promethazine)
indications: Nausea/vomiting, sedation to potentiate analgesics
Class: antihistamine, anti emetic, sedative
Side effects: drowsiness, resp depression
Dose:
adult dose: 12.5-25mg
peds dose- 0.5mg/kg
Zophran (ondansteron)
indications: nausea/vomiting
Class: anti-emetic
side effects: diarrrhea, headache, fever, constipation
Dose: 4mg slow IV push
Furosemide (lasix)
indications: pulmonary edema, CHF
Class: diuretic
side effects: hypotension, hyperglycemia, hypokalemia
Dose: 0.5-1mg.kg (typically 40-100mg) IV
Mannitol
indications: acute cerebral edema
class: osmotic diuretic
side effects: headache, confusion, pulmonary edema, tachycardia
dose: 0.5-2g/kg slow IV
Oxytocin
indications: postpartum vaginal bleeding
class: hormone
side effects: arrhythmia, H2O intoxication
dose: 3-10 units IM post delivery
drip-mix 10-40 units with 1000mL NS or D5W and infuse at 10-40mcg/min titrate to uterine response
