Pharmacology acp1

Question 1

Amiodarone (Cordarone)

Answer 1

Classification: Antiarrhythmic class 3
cardiac arrest VF or pulseless VT
Adult: 300mg IV/IO, 2nd dose 150mg IV/IO
Adolescent: 5mg/kg IV/IO (max300mg) 
2nd dose 5mg/kg (max 150mg)

Indications: Vent arrythmias,
Contra: sick sinus, second & third degree heart block, radiogenic shock

Question 2

Atropine

Answer 2

Classification: Anticholinergic (antimuscarinic)
Symptomatic bradycardia

Adult: 0.5 - 1mg IV q3 (max 3mg total)

Indications: symptomatic bradycardia, systole, nerve agent exposure, organophosphate poisoning

Contra: Acute MI, myasthenia graves, closed angle glaucoma, sensitivity

Question 3

Combivent (Albuterol / Ipratropium)

Answer 3

Classification: Combination bronchodilator
Asthma / COPD

Adult: 1 amp x3 or continuous if near death
Adolescent: 1 amp x3 or continuous if near death

Indications: COPD, asthma

Contra: sensitivity, soybean or peanut allergy, closed angle glaucoma

Question 4

D50W

Answer 4

Classification: Antihypoglycemic

Adult: 50cc IV, repeat once after 10min if BS < 4mmol/L
Adolescent: 50cc IV, repeat once after 10min if BS < 4mmol/L

Indications: hypoglycaemia

Contra: intercranial and intraspinal hemorrhage, delirium tremens

Question 5

Dimenhydrinate (Gravol)

Answer 5

Classification: Antiemetic
Nausea & Vomitning

Adult: 25mg IV over 2 min, repeat in 15-30 min if required
Additional dose of 25-50mg IV q6 hrs if needed

Question 6

Diphenhydramine (Benadryl)

Answer 6

Classification: Antihistamine
Anaphylaxis

Adult: 25mg IV, repeat once in 15 min if required
Adolescent: 1mg/kg IV (max 25mg), repeat once in 15 min if needed

Indications: anaphylaxis

Contra: sensitivity, acute asthma

Question 7

Epinephrine

Answer 7

Classification: Adrenergic agent, inotropic
Asthma, cardiac arrest, anaphylaxis

Adult:
Arrest asystole/PEA/VF or pulseless VT
1mg IV/IO q 4 min
2mg ET q 4 min (dilute to 10ml)

Asthma
0.3 mg (1:1000) IM

Anaphylaxis
0.03 mg IM repeat once q 10min

Adolescent:
Arrest asystole/PEA/VF or pulseless VT
0.01mg/kg (1:10:000) IV/IO q 4 min
0.1mg/kg ET q 4 min (dilute to 10ml)

Asthma
0.3 mg (1:1000) IM

Anaphylaxis
5-16 yrs 0.03mg IM (1:1000) repeat once q 10min
1-4 yrs 0.02 mg IM (1:1000) repeat once q 10min
up to 1 yr 0.01mg IM (1:1000) repeat once q 10min

Question 8

Glucagon

Answer 8

Classification: Hormone
Hypoglycemia

Adult: 1mg IM (if IV unsuccessful)
Adolescent: 1mg IM (if IV unsuccessful)

Indications: hypoglycaemia, beta blocker overdose

Contra: phetochromocytoma, insulinoma, sensitivity

Question 9

Lidocaine (Xylocaine)

Answer 9

Classification: Antiarrhythmic class 1B
Cardiac arrest VF or pulseless VT, Wide complex tachycardia

Adult:
Arrest
1.5mg/kg IV/IO, if VF/pVT persists or reoccurs 0.75 mg/kg q 4min (max 3 mg/kg)
3mg/kg ET (max 2 doses)
Wide complex tachycardia
1.5mg/kg IV repeat once win 10 min if required

Adolescent:
Arrest
1mg/kg IV/IO, if VF/pVT persists or reoccurs 0.75 mg/kg q 4min (max 2 doses)
2mg/kg ET (max 2 doses)
Wide complex tachycardia
1mg/kg IV repeat once win 10 min if required

Question 10

Midazolam (Versed)

Answer 10

Classification: Benzodiazepine, schedule c-4
seizures

Adult: 2.5mg IV q 5min (max 10 mg)

Adolescent:
over 20kg 2.5 mg IV q 5 min (max 10mg)
under 20kg 0.15 mg/kg IV q 5 min (max 10mg)

Indications: sedation, anxiety, skeletal muscle relaxation

Contra: acute angle glaucoma, sensitivity, pregnancy

Question 11

Naloxone (Narcan)

Answer 11

Classification: Opioid antagonist

Adult: 0.4 - 2mg IV/IM prn
Adolescent: 0.4 - 2mg IV/IM prn

Indications: Narcotic overdose
Contra: sensitivity, head trauma, brain tumour

Question 12

Sodium Bicarbonate

Answer 12

Classification: Electrolyte replacement
TCA overdose (with wide QRS or arrest

Adult: 100 mEq IV/IM
Adolescent: 2 mEq/kg IV/IO (max 100 mEq)

Question 13

Cholinergic (parasympathetic)

Answer 13

Drugs which mimic the the actions of the parasympathetic nervous system

Question 14

Cholinergic blocking (parasympatholytic)

Answer 14

Drugs which block the actions of the parasympathetic nervous system

Question 15

Adrenergic (sympathomimetic)

Answer 15

Drugs which mimic the actions of the sympathetic nervous system or the adrenal medulla

Question 16

Adrenergic blocking (sympatholytic)

Answer 16

Drugs which block the actions of the sympathetic nervous system or the adrenal medulla