Nuero

Question 1

Dextrose

Answer 1

Classification
Carbohydrate

MOA
Caloric supplement in patients who can’t maintain adequate oral intake. Raises the sugar level

Indications
Low blood sugar

Contraindications
Hypersensitivity, corn allergy, interspinal bleed intracranial bleed

Dosage/ Route of administration
12.5-25g slow IV push

Question 2

Diazepam / Valium

Answer 2

Classification
Benzodiazepine

MOA
Binds to the GABA receptor to reduce arousal and affects emotions. Raises threshold for seizures

Indications
Acute anxiety, muscle relaxation, seizures,Sedation for RSI

Contraindications
Hypersensitivity, Myasthenia Gravis, Respiratory insufficiency, Coma, Head injury

Dosage:
5-10 mg max of 30 mg IV seizure

5-15 mg IV over 10 to 15 mins prior to cardioversion sedation/ RSI

Question 3

Fentanyl / Sublimaze

Answer 3

Classification
Narcotic

MOA
Stimulates opioid receptors in the brain to create an analgesic effect and also binds to the kappa receptors. Used for pain management, RSI sedation, also used as a general anesthetic

Indications
Pain management, RSI sedation

Contraindications
Hypersensitivity, shock, respiratory depression, less than 2 years old

Cautions
50 to 100 times more powerful than morphine can absorb through the skin, drug is abused frequently

Dosage
Pain management 1 mcg/kg up to 300 mcg IM, IV, IO

RSI sedation 2-5 mcg/kg

Question 4

Ketamine / Ketalar

Answer 4

Classification
Anesthetic, Sedative

MOA
Antagonist for the N-methyl-D aspartate receptor found in the nerve

Indications
RSI sedation, pain management, behavioral emergencies, surgical sedation

Contraindications
Hypersensitivity, Severe HTN, intracranial mass, depression, glaucoma, hypertension, tachycardia, thyroid disorder, coronary artery disease

Dosage
Behavioral emergency 4 mg/kg IM up to 400mg

Pain management IV/IO 0.1- 0.2 mg/kg IV/IO diluted in equal volume of saline 20 mg max

Pain management IM/IN 0.4 - 0.8 mg/kg IM/IN 40-60mg max

RSI sedation 1 to 2 mg/kg IV/ 3-8 mg/kg IM

Maintenance dose 0.1 to 0.5 mg/min

Question 5

ketorolac / Toradol

Answer 5

Classification
Anti-inflammatory, Non-steroidal

MOA
An anti-inflammatory non-narcotic analgesic by inhibiting prostaglandin synthesis used for pain management

Indications
Pain management,Sedation

Contraindications
Peptic ulcer disease, gastrointestinal bleeding, labor and delivery, advance renal impairment, nursing mothers, hypersensitivity, cerebrovascular bleeding

Dosage/ Route of administration
30 mg IM

15 mg slow IV

Question 6

Lidocaine / Xylocaine

Answer 6

Classification
Anesthetic, Antiarrhythmic

MOA
Sodium channel blocker increases depolarization recovery period suppresses automaticity and depolarization of ventricles

Indication
Cardiac arrest, ventricular arrhythmias, MI, Cardioversion, digital poisoning

Contraindication
Hypersensitivity, AV node block, adam stokes syndrome. Wolff parkinson white syndrome

Dosage/ Route of administration
Px mgmt for IO: 40 mg SIVP
Pulsless VT: 0.5mg /kg up to 1.5 mg/kg every 5-10 min to a MAX 3 mg/kg
Maintenance dose: 1-4 mcg/min IV 1 g in 250 ml D5W or NS

Question 7

Lorazepam / Ativan

Answer 7

Classification
Benzodiazepine

MOA
binds GABA receptors decreasing cerebral irritability, sedation, & stops generalized seizures

Indication
Status Epilepticus, anxiety relief, Delirium tremens

Contraindication
Hypersensitivity, respiratory impairment, hypotension, shock

Side effects
Fatigue, drowsiness, amnesia, confusion, disorientation, euphoria

Untoward effects
Respiratory depression, coma, nausea, jaundice, unsteadiness

Dosage/ Route of administration
2-4 mg IV diluted in an equal volume of saline

Question 8

Midazolam / Versed

Answer 8

Classification
Sedative

MOA
Binds to the GABA receptor acting as short cns depressant, calming & relaxing the skeletal muscle and inducing sleep, which can be used to help with seizures

Indications
pre-cardioversion, seizure control, sedation post intubation, anxiolysis, amnesia

Contraindications
Hypersensitivity, respiratory arrest and difficulty, chronic heart failure, coma shock acute renal failure, hypotension

Dosage
RSI sedation 0.1-0.3 mg/kg max of 10 mg

Infusion 0.5 mg/ml Bolus 0.01-0.05 mg/kg

Maintenance 1-7 mg/hour

Behavioral 1-2.5 mg slow IV push

Seizure 2-6 mg IV,IM,IO

Question 9

Morphine / Duramorph

Answer 9

Classification
Opioid, narcotic

MOA
Binds to the opioid receptor directly affects the central nervous system to decrease the feeling of pain used for pain management

Indications
Pain management

Contraindications
Hypersensitivity Respiratory insufficiency, head injuries, increased intracranial pressure,

Side effects
Abdominal pain, blurred vision, nausea, vomiting, cough, fainting, decreased urination

Untoward effects
Chest pain, irregular heart rate, nervousness, bradycardia, pounding in the ears

Dosage/ Route of administration
0.1 mg/kg max of 10 mg

Question 10

Ibuprofen / Advil

Answer 10

Classification
Analgesic, non-steroidal anti inflammatory

MOA
Anti inflammatory and antipyretic reversible inhibitor of COX 1 and COX 2

Indication
Fever, Moderate pain, Kidney pain, swelling

Contraindication
Hypersensitivity, asthma, urticaria, idiosyncratic, peptic ulcer, active GI bleed

Side effects
Upset stomach, heartburn, nausea, vomiting, bloating, gas, diarrhea, nervousness,

Untoward effect
Ringing in the ears, changes in vision, slurred speech, coughing up blood, shortness of breath

Dosage/ Route of administration
300-800 mg PO

Question 11

Acetaminophen / Tylenol

Answer 11

Classification
Non-narcotic, analgesic, Antipyretic

MOA
Antipyretic Activity, Analgesic Activity - Inhibition of central & peripheral prostaglandin synthesis

indications
Fever, pain

Contraindications
Hypersensitivity

Side effects
Drowsiness, nausea, vomiting, itching, rash

Untoward effects
Dark urine, jaundice, abdominal pain, trouble breathing, severe dizziness

Dosage/ Route of indication
325-1000 mg PO, PR