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Pharmicology > PALS > Flashcards

PALS Flashcards

1
Q

epinephrine (Croup)

PALS

A

vasopressor

Alpha and beta adrenergic receptor stimulate

DOSE:
0.5ml/kg 1:1000 epi
Max 5ml, dilute in 3 ml NS via neb

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2
Q

dexamethasone

PALS

A

Corticosteroid

Decadron

Indications
Croup , Asthma

Contraindications
None in the emergency setting

DOSE:
Croup-0.6mg/kg PO/IM/IV (max 16mg) one dose only

Asthma- 0.6mg/kg PO/IM/IV (max 16mg) every 24 hours

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3
Q

epinephrine (anaphylaxis)

PALS

A

Vasopressor

Alpha and beta stimulation

Dose
•IM dose -0.01mg/kg (0.01ml/kg) 1:1000 IM q15min PRN (single dose max 0.3mg)
•IM auto injector 0.3mg for child >30kg or IM junior 0.15mg for 10-30kg
•IV/IO dose - 0.01mg/kg (0.1ml/kg) 1:10000 q3-5min (max single dose 1mg) use if hypotensive
• infusion 0.1-1mcg/kg/min IV/IO if hypotension persists despite fluids and IM injection

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4
Q

diphenhydramine (anaphylaxis)

PALS

A

(Benadryl)

•Antihistamine

Actions
•Competes with histamine for H1 receptor sites
•Decreases allergic response by blocking histamine

Contraindications

DOSE:
1-2mg/kg IV/IO/IM to a max of 50mg q 4-6

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5
Q

methylprednisolone (anaphylaxis)

PALS

A

(Solu-Medrol)

Classification
•Corticosteroid

Actions
•Inhibit substances that cause inflammation(cytokines, interleukin , interferon)

Contraindications:
Acute psychoses
Cushing’s syndrome
Systemic fungal infections, inactive tuberculosis, herpes simplex keratitis, vaccinia, varicella
Hypersensitivity to methylPREDNISolone or other corticosteroids

DOSE:
Loading dose-2mg/kg IV/IO/IM to a max of 60mg
Maintenance dose-0.5mg/kg q 6hr or 1mg/kg q 12hr to a max of 120mg//day
Specific Management Recommendations for Upper Airway Obstruction

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6
Q

salbutamol

PALS

A

Ventolin

  • Bronchodilator
  • Stimulates B2 adrenergic receptors

Contraindications
•Severe tachyarrythmias , cardiac disease, sensitivity

DOSE:
20kg 5mg q 20min

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7
Q

ipratropium bromide (asthma)

PALS

A

(Atrovent)

Anticholinergic, bronchodilator

Inhibits secretions, blocks acetylcholine at the parasympathetic sites in bronchal smooth muscle

Contraindications
Hypersensitivity, not a stand alone first line drug

DOSE:
250-500mcg neb q 20 min x 3 doses

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8
Q

dexamethasone (asthma)

PALS

A

(Decadron)

Corticosteroid

Croup , asthma

Not IV compatible with MgS04

DOSE:
Croup-0.6mg/kg PO/IM/IV (max 16mg) one dose only
Asthma- 0.6mg/kg PO/IM/IV (max 16mg) every 24 hours

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9
Q

Magnesium Sulphate (asthma)

PALS

A

(MgSO4)

Electrolyte

Causes smooth muscle relaxation by inhibiting calcium uptake

Contraindications
Renal failure

DOSE:
25-50mg/kg infusion over 15 -30 minutes ( max 2 g)
Calcium chloride is the treatment for MgSO4 toxicity.

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10
Q

Epinephrine (asthma)

PALS

A

0.01mg/kg 1:1000 SQ q 15min , max single dose 0.3mg

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11
Q

dopamine

PALS

A

(Intropin)

Inotrope, Sympathomimetic , vasopressor

Increases cardiac contractility, peripheral vasoconstriction

Indications
Cardiogenic shock, normotensive distributive shock

Contraindications
Do not use as the sole treatment of hypovolemia, bolus first with NS

DOSE:
2-20mcg/kg /min ( titrate to effect)

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12
Q

norepinephrine

PALS

A

(Levophed)

Inotrope/ Vasopressor

Hypotension of less than 70 (distributive or warm shock)

Contraindications: hypovolemic hypotension

DOSE:
0.1-2mcg/kg/min IV/IO (same as adult)

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13
Q

acetaminophen

PALS

A

(Tylenol)

Antipyretic

Contraindications:
Hypersensitivity
Liver disease or impairment

DOSE:
15mg/kg PO NO REPEAT

Do not give if tylenol given in 4 hrs

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14
Q

morphine

PALS

A

Pain

Contraindications:
BP less than 70+(2*age)

DOSE:
0.1mg/kg SIVP/IM/IO single max 2.5mg q 5min max 15mg

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15
Q

fentanyl

PALS

A

(Sublimaze)

Contraindications:
MAOI therapy within 14 days
BP less than 70+(2*age)

DOSE:

1mcg/kg SIVP/IM/IO to a single max of 25mcg q5min total max 100mcg

OR

2mcg/kg INTRANASAL single max 100mcg divided between nares q 15 min 0.5-1mcgkg x1

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16
Q

ondansetron

PALS

A

(Zofran)

Nausea and vomiting

4 or younger: 2mg PO
Older than 4: 4mg PO

OR

0.1 mg/kg IV/IO single max of 4mg in 50ml NS over 15min NO REPEAT

17
Q

ketamine

PALS

A

(Ketalar)

Pain with hypotension or refractory to morphine and fentanlyl

CONTRAINDICATIONS:
Conditions where elevated BP is harmful

DOSE:
mandatory OLMC 0.2 mg/kg SIVP/IO

Repeat only with OLMC

18
Q

D50W

PALS

A

> 40 kg

1-2ml/kg

19
Q

D25W

PALS

A

10-40kg

2-4 ml/kg (infants, children)

20
Q

D10W

PALS

A

Less than 10kg

5-10 ml/kg

21
Q

D5W

PALS

A

10-20 ml/kg

22
Q

Dimenhydrinate

PALS

A

1 mg/kg SIVP/IM/IO to a single maximum dose of 50mg

Pharmicology (6 decks)

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