Paramedic Pharmacology Doses Flashcards
Diltiazem (Cardizem) Adult/Pediatric Doses
Adult Dose: 15-20 mg IV/IO
Pediatric Dose: Not recommended
Adenosine (Adenocard) Adult/Pediatric Doses
Adult Doses: SVT: 6 mg rapid IV/IO push followed by 10-20 ml flush-12 mg after 1-2 min
Poorly perfusing SVT: 12 mg rapid IV/IO push followed by 10-20 ml flush-12 mg after 1-2 min
Pediatric Dose: 0.1 mg/kg rapid IV/IO push followed by 10 ml flush may repeat with 0.2 mg/kg after 1-2 min
Amiodarone (Cordone) Adult/Pediatric Doses
Adult Dose: VF/pulseless VT: 300 mg IV/IO push initial dose can be followed once in 3-5 min at 150 mg IV/IO push. Other indications: loading dose of 150 mg IV/IO over 10 min, may repeat every 10 min if needed. After conversion, follow with a 1 mg/min infusion for 6 hours and then a 0.5 mg/min maintenance infusion over 18 hours. Max cumulative dose: 2.2 g IV/IO per 24 hours
Pediatric Dose: Refractory VF/pulseless VT: 5 mg/kg IV/IO bolus. Can repeat the 5 mg/kg IV/IO bolus up to a total dose of 15 mg/kg per 24 hours. Max single dose: 300 mg. Perfusion ventricular or atrial dysrhythmias: loading dose 5 mg/kg IV/IO over 20-60 min. Can repeat to max dose of 15 mg/kg per day
Lidocaine Hydrochloride (Xylocaine) Adult/Pediatric Doses
Adult Dose: Cardiac arrest/pulseless VT/VF: initial dose: 1-1.5 mg/kg IV/IO. Repeat dose: 0.5-0.75 mg/kg IV/IO repeated in 5-10 min. Max total dose: 3 mg/kg stable VT, and wide-complex tachycardia of unknown etiology: maintenance infusion: 1-4 mg/min: can dilute in D5W or normal saline. Local anesthetic dose varies depending on procedure and location
Pediatric Dose: IV/IO dose: 1 mg/kg rapid IV/IO push. Max dose 100 mg. Continuous IV/IO infusion: 20-50 mcg/kg per minute. Repeat bolus dose when infusion is initiated if bolus has not bee given within previous 15 min. Local anesthetic dose varies depending on procedure and location
Procainamide hydrochloride (Pronestyl) Adult/Pediatric Doses
Adult Dose: Recurrent VF/pulseless VT: 20 mg/min slow IV infusion until the dysrhythmia is surpassed. Max dose: 17 mg/kg. In urgent situations, up to 50 mg/min may be administered. Max dose: 17 mg/kg. Other indication: 20 mg/min slow IV infusion until any one of the following occurs: dysrhythmia supression, hypotension, QRS widens by > 50% of its pretreatment width, or total dose of 17 mg/kg has been given. Maintenance infusion: 1-4 mg/min. Reduce dose in presence of renal infusfiency
Pediatric Dose: Loading dose 15 mg/kg IV/IO over 30/60 min
Digoxin ( Lanoxin) Adult/Pediatric Dose
Adult dose: loading dose: 4-6 mcg/kg over 5 min. Second and third: bolus of 2-3 mcg/kg to follow at 4-8 hour intervals
Pediatric Dose: Not recommended in prehospital setting
Aspirin (acetylsalicylic acid) Adult/Pediatric Doses
Adult Dose: 160-324 mg (4 baby aspirin)
Pediatric Dose: Not recommended
Nitroglycerin (Nitrostat) Adult/Pediatric Doses
Adult Dose: 0.4 mg SL: may repeat in 3-5 min to max of 3 doses. NTG IV infusion: being at 10 mcg/min: increases by 10 mcg/min every 3-5 min until desired effect. Max dose 200 mcg/min
Pediatric Dose: Not recommended
Nitroprusside (Nitropress) Adult/Pediatric Doses
Adult/Pediatric Dose: 0.3-10 mcg/kg per min
Hydralazine (Apresoline) Adult/Pediatric Doses
Adult Doses: 5-10 mg IV/IO, 10-50 mg PO
Pediatric Doses: 0.1-0.2 mg/kg IV, 0.75 mg/kg per day in divided dose PO
Magnesium Sulfate Adult/Pediatric Doses
Adult Dose: seizure activity associated with pregnancy: 1-4 g of a 10% solution IV/IO over 3 min. Max dose 30-40 g/day. Cardiac arrest due to hypomagnesemia or tornadoes de pointes: 1-2 of 10% solution IV/IO over 5-20 min. Torsades de pointes with pulse: loading dose of 1-2 g in 50-100 ml of D5W over 5-60 min IV. Follow with 0.5-1 g IV. Status asthmatics 1-2 g IV over 15-30 min. Severe bronchoconstriction/ impending respiratory failure: 40 mg/kg iV, max dose is 2 g
Pediatric Dose: pulseless V-tach with tornadoes de pointes: 25-50 mg/kg IV/IO bolus of a 10% solution. Max dose 2 g. Torsades de pointes with pulses or hypomagnesemia: 25-50 mg/kg IV/IO of a 10% solution over 10-20 min. Max dose 2 g. Status asthmatics 30-60 mg/kg IV/IO of 10% over 5-30 min. Max dose 2 g
Dopamine (Intropin) Adult/Pediatric Dose
Adult Dose: add 400 mg into 250 ml normal saline solution (creating 1600 mcg/ml solution). Low dose: 1-5 mcg/kg/min, moderate dose: 5-10 mcg/kg/min, high dose: 10-20 mcg/kg/min
Pediatric Dose: Add 400 mg into 250 ml normal saline solution (Creating 1600 mcg/ml solution). Low dose: 1-5 mcg/kg/min, moderate dose: 5-10 mcg/kg/min, high dose: 10-20 mcg/kg/min
Vasopressin (Pitressin) Adult/Pediatric Doses
Adult Dose: 0.02-0.07 unit/min IV infusion
Pediatric Dose: Safety and efficiency not established
Morphine Sulfate (Roxanol) Adult/Pediatric Doses
Adult Dose: Stemi: Initial dose: 2-4 mg slow IV (over 1-5 min). Repeat dose: 2-8 mg at 5-15 min intervals. Not STEMI/unstable angina: 1-5 mc IV push if symptoms not relieved by nitrates use with caution
Pediatric Dose: 0.1-0.2 mg/kg per dose IV,IO,IM, SQ. Max dose 5 mg
Fentanyl Citrate (Sublimaze) Adult/Pediatric Doses
Adult Dose: 50-100 (1 mcg/kg) IM,IV, or IN slow push (over 1-2 min).
Pediatric Dose: 1-2 mcg/kg Im,IV, or IN slow push over 1-2 min. Safety and efficiency in children younger than age 2 years has not been established
Meperidine Hydrochloride (Demerol) Adult/Pediatric Doses
Adult Dose: 50-100 mg IM, SQ. 25-50 mg slow IV
Pediatric Dose: 1-2 mg/kg per dose IV/IO, Im, SQ
Naloxone Hydrochloride (Narcan) Adult/Pediatric Doses
Adult Dose: 0.4-2 mg IM/IV/IO/SQ/ET/IN minimum single dose recommended: 2 mg. Repeat at 5 min intervals to a max total dose of 10 mg. For In route administer half the dose in each nostril max dose is 1 ml per nostril: max 1 ml pernostral
Pediatric Dose: 0.1 mg/kg per dose IV/IO/IM/ET ever 2 min as needed. Max total dose of 2 mg. If no response in 10 min administer an additional 0.1 mg/kg per dose
Ketamine (Ketalar) Adult Doses
Adult/Pediatric Dose: 1-2 mg/kg iV push over 1-2 min
Etomidate (Amidate) Adult/Pediatric Doses
Adult Dose: 0.2-0.6 mg/kg IV over 30-60 seconds (typical adult dose 20 mg)
Pediatric Dose: 0.2-0.4 mg/kg IV/IO over 30-60 seconds for RSI (older than 10 years old) one time only. Max dose: 20 mg
Haloperidol Lactate (Haldol) Adult/Pediatric doses
Adult Dose: 2-5 mg Im only ever 30-60 min until sedation is achieved
Pediatric Dose: Not recommended
Thiamine (Vitamin B1) Adult/Pediatric Doses
Adult Dose: 10-100 mg IV,IO, IM
Pediatric Dose: 10-25 mg IV, IO, IM
Phenytoin (Dilatin) Adult/Pediatric Doses
Adult Dose: Seizures: 10-20 mg/kg slow IV, not to exceed 1 g or rate of 50 mg/min. Dysrhythmias: 50-100 mg slow IV every 5-15 min PRN. Max 1 g
Pediatric Dose: Seizure: 10-20 mg/kg slow IV (1-3 mg/kg per min). Dysrhythmias: 5 mg/kg slow IV. Max 1 g loading dose
Carbamazepine Adult/Pediatric Doses
Adult/Pediatric Dose: 100 mg, 100 mg/5 ml: 200 mg: 400 mg: 300 mg
Phenobarbital (Luminal) Adult/Pediatric doses
Adult Dose: 100-250 mg slow IV or Im. May repeat as needed in 20-30 min
Pediatric Dose: 10-20 mg/kg slow IV/IO/IM. Repeat as needed in 20-30 min
Metoclopremide (Reglan) Adult/Pediatric Dose
Adult Dose: 10 mg IV over 1-2 min, 10 mg PO
Pediatric Dose: 0.1 mg/kg over 1-2 min
Dobutamine Hydrochloride (Dubutex) Adult/Pediatric Doses
Adult Dose: IV infusion at 2-20 mcg/kg per min titrated to desired effect. Initial dose of 5-10 mcg/kg per min may be used in severe cardiogenic shock or immediately post cardiac arrest management. Max dose: 40 mcg/kg per min
Pediatric Dose: IV infusion at 2-20 mcg/kg per min titrated to desired effect
Ketorolac Tromethamine (Torado) Adult/Pediatric Doses
Adult Dose: 30-60 mg IM, 15-30 mg IV
Pediatric Dose: Not recommended
Verapamil (Isoptin) Adult/Pediatric Doses
Adult Dose: 2.5-5 mg IV/IO with a 2nd dose of 5-10 mg iV/IO in 15-30 min to a max dose of 30 mg
Pediatric Dose: Infant: 0.1-0.2 mg/kg with a max dose of 2 mg. Children: 0.1-0.3 mg/kg with max dose of 5 mg
Furosemide (Lasix) Adult/Pediatric Doses
Adult Dose: 20-120 mg slow IVP (20 mg/min)
Pediatric Dose: 1 mg/kg slow IVP (20 mg/min)
Rocuronium Bromide (Zemuron) Adult/Pediatric Doses
Adult Dose: 0.6-1.2 mg/kg IV/IO Pediatric Dose (older than 3 months): 0.6-1.2 mg/kg IV/IO
Succinylcholine Chloride (Anectine) Adult/Pediatric Doses
Adult/Pediatric Doses: 1-2 mg/kg rapid IV. Repeated once if needed
Methylprednisolone Sodium Succinate (Solu-Medrol) Adult/Pediatric doses
Adult/Pediatric Dose: Asthma, COPD, anaphylaxis: 1-2 mg/kg IV. Status asthmatics/anaphylaxis: 2 mg/kg per dose IV/IO/IM to max dose of 60 mg/24 hours
Dexamethasone Sodium Phosphate (Decadron) Adult/Pediatric Doses
Adult Dose: 10-100 mg IV (1 mg/kg slow IV bolus).
Pediatric Dose: 0.25-1 mg/kg IV/IO.IM. Given one time with max dose of 16 mg
Calcium Chloride Adult/Pediatric Doses
Adult Dose: calcium channel blocker over dose and hyperkalemia: 500 mg-1000mg (5-10 ml of 10% solution) IV push. May repeat as needed
Pediatric Dose: calcium channel blockers overdose and hyperkalemia: 20 mg/kg (0.2 ml/kg) slow IV push. Max 1 g dose: may repeat in 10 min
Calcium Gluconate Adult/Pediatric Doses
Adult Dose: hyperkalemia: 500-1000 mg slow IV/IO push (1-1/5 ml/min) to max of 3 g. Beta-blocker and calcium channel blocker overdose: 3-6 g (30-60 ml) IV/IO followed by a continuous hourly infusion of some doses
Pediatric Dose: Hyperkalemia: 60-100 mg/kg IV/IO slow over 5-10 min to a max of 3 g. Beta-blocker and calcium channel blocker over dose: 60 mg/kg (0.6 ml/kg) IV/IO followed by a continuous hourly infusion of the same dose
Parlidoxime (2-PAM) Dosages
Dosages: Consult with medical direction: dosage recommendations vary depending not eh degree of exposure and patients age and weight. Commercially avaliable auto injectors contain 600 mg of pralidoxime chloride.
Sodium Bicarbonate Adult/Pediatric Doses
Adult Dose: 1 mEq/kg slow IV/IO push, may repeat at 0.5 mEq/kg every 10 min
Pediatric Dose: 1 mEq/kg slow IV/IO push (dilute in small children to 4.2%)
Atropine Adult/Pediatric Doses
Adult Dose: bradycardia: 0.5-1 mg IV/IO push or 1/2 mg ET MR every 3-5 min max 3 mg. Systole/PEA: 1 mg IV/IO push or 2 mg ET MR every 3-5 min-max 3 mg
Pesticides: 2 mg IV/IO/IM push or 4 mg ET MR every 5 min until patients is asymptomatic or shows signs or atropinzation
Pediatric Dose: all cardiac: 0.02 mg/kg IV/IO push minimum single dose is 0.1 mg and max single dose 0.5 mg MR x1 in 5 min 0.04 mg/kg ET with no repeat. Pesticides: 0.05 mg/kg IV/IO/Im or 0.1 mg/kg ET MR every 5 min until patient is asymptomatic
Ondansetron Hydrochloride (Zofran) Adult/Pediatric Doses
Adult Dose: 4 mg IV/IM/PO/SL, may repeat once in 10 min. Acute mountain sickness: 4 min IV/PO/SL every 6 hours
Pediatric Dose: between age 6 months and 14 years: 0.15 mg/kg IV/PO: may dose is 4 mg
Albuterol Adult/Pediatric Doses
Adult Dose: Bronchospasm: 5 mg via HHN over 5-15 min may repeat as needed. Crush syndrome: 5 mg via HHN continuous
Pediatric Dose: 0-1 years: 2.5 mg via HHN over 5-15 min may repeat as needed. Over 1 years old=same as adult
Ipratrpium Bromide (Atrovent) Adult/Pediatric doses
Adult Dose: 0.5 mg mixed with 2.5 mg albuterol via HHN
Pediatric Dose: 0.5 mg mixed with 5 mg albuterol via HHN and then administer only half the volume
Levalbuterol (Xopenex) Adult/Pediatric Doses
Adult Dose: 1.25-2.5 mg in 3 ml administered by nebulizer every 20 min to a max of 3 doses
Pediatric Dose: 0.075 mg/kg (minimum of 1.25) administered by nebulizer every 20 min to a max of 3 doses
Terbutaline Sulfate (Breathine) Adult/Pediatric Doses
Adult Dose: 0.25 mg sub-q, may repeat in 15-30 min. Max dose 0.5 mg in a 4 hour period
Pediatric Dose: not recommended for children under 12 yo
Recemid Epinephrine Adult/Pediatric Doses
Adult Dose: HHN: 0.25-0.75 ml of 2.25% racemic epinephrine solution diluted in 3 ml NS every 1-4 hours
Pediatric Dose: 0.25-0.75 ml of 2.25% racemic epinephrine solution diluted in 3 ml NS every 1-4 hours
Epinephrine (Adrenalin) Adult/Pediatric Dose
Adult Dose: Cardiac Arrest: 1 mg (1:10,000) IV/IO push of 2 mg (1:1,000) ET 3-5 min. Asthma/Allergic reaction: 0.3 mg-0.5 mg (1:1,000) SQ every 20 min x2
Pediatric Dose 1: Cardiac arrest: 0.01 mg/kg (1:10,000) IV/IO push or 0.1 mg/kg (1:1,000) ET. 0.01 mg/kg IV/IO/ET every 3-5 min SQ dose may switch to a 1:1,000 concentration
Pediatric Dose 2: Althma/Allergic reaction: 0.01 mg/kg (1:1,000) SQ/IM to a max single dose of 0.3 mg every 20 min x2. Anaphylaxis with shock: 0.01 mg/kg (1:10,000) slow IV/IO (over 1 min) to a max single dose of 0.1 mg every 3-5 min
Pediatric Dose 3: bradydysrhythmia: (less than 60 hr for neonate/infant or less than 60 HR for child with poor perfusion) Neonate/Infant 0.01 mg/kg (1:10,000) IV/IO or 0.1 mg/kg (1:1,000) Et 0.1 mg/kg IV/IO/ET every 3-5 min
Pediatric dose 4: Bradydysrhythmia: (Less than 60 Hr for neonate/infant or less than 60 HR for child with poor perfusion). Child 0.01 mg/kg (1:10,000) IV/IO or 0.1 mg/kg (1:1,000) ET if no response, consider atropine
Norepinephrine Bitartrate (Levophed) Adult/Pediatric Doses
Adult Dose: 0.1-0.5 mcg/kg per min (in 70 kg adult, 7-35 mcg/min)
Pediatric Dose: begin at 0.1-2 mcg/kg per min IV infusion, adjust rate to acheive desired change in Bp and systolic perfusion
Diphenhydramine (Benadryl) Adult/Pediatric Doses
Adult Dose: 25-50 mg IM, IV, PO
Pediatric Dose: 1-2 mg/kg IV, IO slowly, or IM. If PO: 5 mg/kg preday
Oxytocin (Pitocin) Adult/Pediatric Doses
Adult Dose: IM administration: 10 units IM following delivery of placenta. IV administration: mix 10-40 units in 1,000 ml non hydrating diluent, infused at 20-40 milliunits/min. Titrated to severity of bleeding and uterine response
Pediatric Dose: Not applicable
Midazolam Hydrochloride (Versed) Adult/Pediatric Doses
Adult Dose: Seizures: 0.2 mg/kg IM or IN, max dose is 10 mg: 0.1 mg/kg IV, max dose is 4 mg. Procedural sedation: 0.5-2.5 mg IV. May be repeated to total max: 0.1 mg/kg. Chemical restraint: 5 mg IV or IN: 5 mg IM
Pediatric Dose: Seizures: 0.1-0.3 mg/kg IV/IM (max single dose: 10 mg), 0.2 mg/kg IN. Procedural sedation: 0.05-0.1 mg/kg IV: 0.1-0.15 mg/kg IM: 0.3 mg/kg IN
Lorazepam (Ativan) Adult/Pediatric Doses
Adult Dose: Anxiety/sedation: 2 mg IV: 4 mg IV. Seizures: 0.1 mg/kg IV, max dose of 4 mg
Pediatric Dose: 0.05 mg/kg IV or IM
Diazepam (Valium) Adult/Pediatric Doses
Adult Dose: Seizure activity: 5 mg IV over 5 min or 10 mg IM. Anxiety: 2-10 mg IM/IV. Premedication for cardioversion: 5-15 mg IV over 5-10 min prior to cardioversion
Pediatric Dose: Seizure activity: 0.05-0.1 mg/kg slow IV or 0.1-2 mg/kg IM
Flumazenil (Romazicon) Adult/Pediatric Doses
Adult Dose: First dose: 0.2 mg IV/IO over 15 seconds. Second dose: 0.3 mg may be given over 30 seconds: if no response, give third dose. Third dose: 0.5 mg IV/IO over 30 seconds: if no response repeat once every minute until adequate response or total of 3 mg is given
Pediatric Dose: Not recommended
Propofol (Diprevan) Adult/Pediatric Dose
Adult Dose: Indication dose: 1.5-3 mg/kg IV/IO. Maintenance infusion: 25-75 mcg/kg per min IV/IO
Pediatric Dose: Indication dose: 2.5-3.5 mg/kg IV/IO. Maintenance infusion: 125/300 mcg/kg per min IV/IO
Prochlorperazine (Compazine) Adult/Pediatric Doses
Adult Dose: 5-10 mg IV/IM/PO
Pediatric Dose: Over age 2 or greater than 9 kg: 0.1 mg/kg slow IV or keep IM: max dose 10 mg
Dextrose Adult/Pediatric Doses
Adult Dose: 25 g slow IV push 50% dextrose (D50), or infuse 10% dextrose (250ml). May be repeated as necessary.
Pediatric Dose: 1 year and older: 0.5-1 g/kg or 25% dextrose (D25) slow IV/IO push. May b repeated as necessary. Neonates and infants: 200-500 mg/kg slow IV push. May be repeated as necessary. May concentration of 12.5%
Glucagon (Glucagen) Adult/Pediatric Doses
Adult Dose: Hypoglycemia: 1 mg IM/IN, may repeat in 7-10 min. Calcium channel blocker or beta-blocker overdose: 3-10 mg IV slowly over 3-5 min initially, followed by a 3-5 mg/h infusion as necessary
Pediatric Dose: hypoglycemia: 1 mg IM/IN if 20 kg or greater, 0.5 mg IM/IN if 20 kg or younger than 5 yo. Calcium channel blocker or beta blocker toxicity: 0.05-0.15 mg/kg IV.IO over 3-5 min initially, followed by a 0.05-0.1 mg/kg per hour infusion as necessary
Insulin Adult/Pediatric Doses
Adult/Pediatric Dose: Dosages vary widely depending on patients blood glucose level and the indication
