Pharmacology - Adult Dosing Flashcards
Acetaminophen
-500-1,000 mg PO (specifically, 15 mg/kg to a maximum of 1,000 mg)
-24-hour maximum: 3 g (3,000 mg)
Acetylsalicylic Acid
-162 mg PO chewed and swallowed
Adenosine
-Initial dose: 6 mg IV rapid push
-Follow-up dose: 12 mg IV rapid push
Amiodarone (Ventricular fibrillation or Pulseless ventricular tachycardia)
-300 mg IV push; may repeat 150 mg IV after 10 minutes if VF/pVT persist
Amiodarone (Unstable ventricular tachycardia or Recurrent ventricular tachycardia following cardioversion)
-150 mg IV over 10 minutes
Atropine (Restoration of heart rate in bradydysrhythmias, Sinus bradycardia (rate < 50/minute) with hemodynamic compromise, Bradycardia secondary to atrioventricular nodal blocks)
-0.6 mg IV push to maximum dose of 0.04 mg/kg (~3 mg in most patients)
Atropine (Treatment of organophosphate poisoning)
-1-2 mg IM/IV; repeat every 5-60 minutes until symptoms resolve
Atropine (Control of secretions in palliative care)
-0.6 mg IM
Calcium Chloride
-1-2 g IV over 10 minutes
-May repeat once in 10 minutes if indications are still present
Clopidogrel
-For patients less than 75 years of age: 300 mg PO
-For patients over 75 years of age: 75 mg PO
Dexamethasone
-All indications: 8 mg IV/IO/IM/PO. PO preferred
Dextrose/D10W
-10-25 g IV (equivalent to 100-250 mL of D10W solution)
DimenhyDRINATE
-25-50 mg IV/IM
-12.5 mg IV/IM in elderly or frail patients
-May repeat dose once after 4-6 hours if required
-Give IM dose as direct injection; IV dose should be diluted with saline; administer medication at rate of 25 mg/min
DiphenhydrAMINE
-50 mg IM/IV or 1 mg/kg to maximum of 50 mg
Enoxaparin
-Immediately prior to administration of tenecteplase: 30 mg IV bolus
-Do not administer IV enoxaparin to patients > 75 years of age
-Following administration of tenecteplase: 1 mg/kg SC
For patients > 75 years of age: 0.75 mg/kg SC
EPINEPHrine (Anaphylaxis IM)
-0.5 mg IM every 5 minutes; may repeat up to 3 times
EPINEPHrine (Severe bronchospasm)
-0.5 mg IM every 5-20 minutes
EPINEPHrine (Pre-arrest anaphylaxis or bronchospasm
-50-100 mcg IV/IO; may repeat as necessary
EPINEPHrine (Cardiac Arrest)
-1 mg IV/IO every 3-5 minutes
EPINEPHrine (Peri-arrest hypotension)
-10 mcg IV/IO slow push every 2-3 minutes as required
EPINEPHrine (Significant bradycardia)
-2-10 mcg/minute IV/IO infusion
FentaNYL
-Loading dose: 0.5-1.0 mcg/kg IM/IV/IO; maximum single dose 100 mcg; may repeat every 5 minutes to a total dose of 300 mcg
-Loading dose: 1.5-2.0 mcg/kg IN; maximum single dose 100 mcg; may repeat every 5 minutes to a total dose of 300 mcg
-Maintenance dose for long conveyances: 50 mcg IM/IV/IO every 10 minutes; maximum total dose of 250 mcg/hour
-Maintenance dose in long conveyances: 50-100 mcg IN every 10 minutes as required; maximum total dose of 250 mcg/hour.
-Consider reducing doses by half in patients > 65 years of age
-If pain is insufficiently relieved after a total of 1-3 mcg/kg, consider use of ketamine
Glucagon
-1 mg IM
-5 mg slow IV push for BB/CCB OD
Hydrocortisone
-100 mg bolus. IV preferred; IM acceptable if IV access is unobtainable or otherwise delayed. For IM administration, a large muscle (e.g., vastus lateralis) is preferred. Administration in the deltoid may cause subcutaneous atrophy.
Ibuprofen
-300-400 mg PO; may repeat every 4-6 hours; maximum daily dose 1,200 mg/day
Ipratropium
-500 mcg via nebulizer
-160 mcg via metered-dose inhaler (8 x 20 mcg sprays)
MDI and spacer use is strongly recommended for patients with signs of influenza-like illness, or other infectious respiratory conditions
KetAMINE (Analgesia)
-Intravenous/Intraosseous
0.3 mg/kg slow push
May repeat 0.15 mg/kg after 5 minutes
Maximum cumulative dose 0.6 mg/kg in 45 minutes
-Intramuscular
0.5 mg/kg
May repeat 0.3 mg/kg after 45 minutes
KetAMINE (Procedural Sedation)
-Intravenous/Intraosseous
0.1-0.5 mg/kg slow push every 60 seconds to effect
-Consider starting at 0.5 mg/kg; use subsequent doses of 0.25 mg/kg or less as needed
-Titrate to effect
KetAMINE (Anesthesia Induction and maintenance)
-Intravenous/Intraosseous: 2 mg/kg if shock index < 1
-Intravenous/Intraosseous: 1 mg/kg if shock index ≥ 1
-Half of required induction dose every 10-15 minutes as required
KetAMINE (Excited Delirium)
-Intramuscular
4-5 mg/kg bolus
-Maximum single/cumulative dose 500 mg
CliniCall consultation required if appropriate sedation is not achieved
-Maximum volume of administration
-Deltoid: 2 mL
-Lateral thigh: 4-5 mL
-Gluteal: 5 mL
Lidocaine (Ventricular Rhythm Control)
-1.0-1.5 mg/kg IV bolus
-May repeat at 0.5-1.0 mg/kg; total maximum dose 3 mg/kg
Lidocaine (Local anesthesia during intraosseous cannulation (in conscious patients))
-Administer lidocaine, 40 mg
Instill the lidocaine slowly, over 120 seconds, making sure to flush the appropriate amount of lidocaine through the extension; allow it to dwell in the bone marrow cavity for 60 seconds
-Slowly flush the IO catheter with 5-10 mL normal saline following the administration of lidocaine
Lidocaine (Local anesthesia for awake intubation)
-There is no consensus on a maximum permissible dose; avoid exceeding 5 mg/kg topically where possible
Magnesium Sulfate (Control of ventricular arrhythmias (including Torsades de Pointes))
-For perfusing rhythms: 2 g IV over 15 minutes
-In cardiac arrest: 4 g IV push
Magnesium Sulfate (Bronchospasm refractory to bronchodilation)
-2 g IV over 20 minutes
Magnesium Sulfate (Management of seizures in pregnancy associated with hypertension)
-Cardiac monitoring is required with magnesium administration
-Administer the initial dose of 4-6 g intravenously over 20 minutes as a loading dose followed by 1-2 g per hour; otherwise, 5 g can be given intramuscularly (use bilateral buttocks) followed by 5 g IM every four hours
-If seizures persist following the loading dose of magnesium, up to 4 g IV can be given over five minutes
Methoxyflurane (Penthrox)
-Self-administered relief from moderate to severe pain in conscious, hemodynamically stable patients
-3 mL self-administered via inhaler; may repeat after 20 minutes; maximum total volume 6 mL
Patients must self-administer as needed under direct EMR or paramedic supervision
MIDAZOLam
-2-5 mg IV/IO in increments to effect
-5-10 mg IM
-May repeat as required in small increments
-Maximum dose from all sources is 30 mg
MORPHine
-CliniCall (or palliative care team) consultation required prior to selecting a dosing strategy.
-0.1 mg/kg SC OR
2.5-5 mg SC
-May repeat every 10-30 minutes as required based on blood pressure (> 100 mmHg) or as per CliniCall/palliative care team plan
Naloxone
-First dose:0.4 mg IM/IV
-Second dose: 0.4 mg IM/IV if required
-Third dose: 0.8 mg IM/IV if required
-Fourth dose: 2 mg IM/IV if required (IV preferred)
-4 mg IV
-CliniCall consultation required prior to administration of further doses
-10 mg IV
Nitroglycerin
-0.4 mg SL every 3-5 minutes
Ondansetron
-4 mg PO as a single dose
Do not repeat dose
PhenyLEPHRine
-100 mcg IV slow push every 2-5 minutes to maximum of 500 mcg
-Administer dose over 20-30 seconds
Salbutamol (Bronchospasm)
-5 mg nebulized; repeat doses back to back as necessary
-4 x 100 mcg via metered dose inhaler with spacer; repeat as required
Salbutamol (Adjunctive management of hyperkalemia)
-10-20 mg via nebulizer; may require multiple doses back-to-back to reach total dose
-4 x 100 mcg via metered dose inhaler with spacer; repeat as required
Sodium Bicarbonate
-1 mEq/kg IV/IO slow push
May repeat 0.5 mEq/kg IV/IO slow push every 10-15 minutes as required
-Tricyclic overdoses may require doses as high as 2-3 mEq/kg IV/IO
Tenecteplase
-0.5mg/kg IV (follow table)
Tranexamic Acid
-2 g IV push over 1 minute
