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Relevant Flashcards

1
Q

Epinephrine Indications

A

Cardiac arrest (PEA, VF & Pulseless VT)

Anaphylaxis & Bronchial asthma

Symptomatic Bradycardia

Hypotension

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2
Q

Epi Pulseless Arrest Dosage

A

1mg IV/IO push (follow w/ flush);
Repeat q 3-5 minutes

0.2mg/kg in beta or calcium channel blockers OD; poison/drug induced shock

PED: 0.01mg/kg q 3-5 minutes;
1mg Max dose

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3
Q

Epi Infusion for Bradycardia or hypotension

A

2-10mcg/min; titrate to response

PED: 0.01mg/kg

Continuous: 0.1-1mcg/kg/minute

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4
Q

Epi ET dose

A

0.1mg/kg

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5
Q

Epi Anaphylaxis or bronchoconstriction dosage

A

0.3-0.5mL IM (1:1); repeat q 5-15 min

0.5mcg/kg/minute Rapid Fluid Bolus (if shock persists)

PED: 0.01mg/kg (0.1ml/kg of 1:1) IM;
0.3mg max single dose; repeat q15 minutes prn

0.1-1 mcg/kg/minute IV infusion (if shock persists)

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6
Q

Nebulized Epi dosage

A

3mg/3mL NS

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7
Q

Amiodarone Indications

A

VF
VT (monomorphic & Torsades)
Cardiac arrest

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8
Q

Amiodarone contraindications & considerations

A

Pulmonary congestion

Cardiogenic shock

2nd or 3rd degree AV blocks (if no pacemaker present)

Severe sinus node dysfunction

Hyperkalemia

(Give slowly)

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9
Q

Amiodarone Dosages

A

Cardiac Arrest:
300mg IV/IO push
150 mg 2nd dose

Deadly arrhythmias:
Rapid infusion: 150mg IV over 1st 10 minutes; repeat q 10 minutes prn up to 3 doses

2.2g IV/ 24 hours (Adolescents included)

PEDS:
5mg/kg IV/IO bolus, repeat to daily max 15mg/kg (300mg max); over 20-60 minutes in SVT, VT w/ pulses

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10
Q

Adenosine Indications

A

SVT

Junctional Tach

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11
Q

Adenosine Contraindications

A

Drug induced tachycardia

2nd or 3rd degree AV block

Sick sinus syndrome

Dipyridamole & Carbamazepine (potentiated effects)

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12
Q

Adenosine dosage

A

6mg rapid IV push followed by 20mL saline bolus; may double dose in 1-2 minutes

PEDS: 0.1mg/kg IV/IO followed by 5-10mL saline flush, may double dose in 2nd attempt

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13
Q

Atropine Indications

A

Bradycardia

Organophosphate or nerve gas poisoning

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14
Q

Atropine contraindications

A

Glaucoma

Obstructive GI tract disease
Obstructive uropathy

Thyrotoxicosis

Unstable cardiovascular status in acute hemorrhage w/ Myocardial ischemia

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15
Q

Atropine dosage

A

1mg bolus, repeat q 3-5 minutes
3mg max

PEDS: 0.02mg/kg; repeat q 3-5 min
Max single dose: 0.5mg
Max total dose: 1mg; 3mg adolescents

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16
Q

Atropine SLUGDE dosing

A

1-4mg q 15 min until effects are observed, then q 1-4 hrs for 24hrs

PEDS:
<12 years: 0.05mg/kg IV/IO initially;
Then repeated and doubled dose q 5 minutes until effects reversed

> 12 years: 1mg IV/IO (Same as above)

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17
Q

Diltiazem Indications

A

A fib & w/ RVR
A flutter
Junctional tach
SVT

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18
Q

Diltiazem Contraindications

A

Wide QRS tachs of unknown origin

Poison/drug induced tach

WPW > A fib or flutter

VT

Sick sinus syndrome

2nd or 3rd degree AV block (except w/ a functioning pacemaker)

Hypotension

cardiogenic shock & acute MI

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19
Q

Diltiazem Dosage

A

0.25mg/kg IV over 2 minutes;

  • may repeat in 15 minutes-

0.35mg/kg over 2 minutes

Maintenance infusion:
5-15 mg/hour, titrate to response
(D5W or NS)

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20
Q

Mag Sulfate indications

A

Eclampsia seizures

Torsades

Respiratory distress

Hypomagnesemia

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21
Q

Mag sulfate contraindications

A

Heart block or myocardial damage

Diabetic coma

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22
Q

Mag dosage

A

Seizure (eclampsia):
4g dilutes in D5W or NS for IV piggy back over 15 minutes; followed by continuous load over 15-20 minutes of 1-2g/hr (30-40g/day Max)

Pulseless Torsades: 1-2g (2-4ml of a 50% solution) diluted in 10mL of D5W IO/IV push

Torsades w/ pulse & Respiratory distress:
Loading dose: 1-2g in 50-100mL of D5W over 5-60 minutes IV; followed w/ 0.5-1g/hr IV

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23
Q

Mag PEDS dosage

A

PEDS: 25-50mg/kg IV/IO over 10-20 min; 2g max dose

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24
Q

Calcium Chloride Indications

A

Hyperkalemia (except if its from Digitalis)

Hypocalcemia (multiple blood transfusions)

Calcium channel blocker OD

Hypermagnesemia

Prevent hypotension from calcium channel blockers (diltiazem or verapamil)

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25
Q

Calcium Chloride contraindications

A

VF during cardiac resuscitation

Digitalis OD

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26
Q

Calcium chloride dosage

A

500-1000mg (5-10mL of a 10% solution); may be repeated prn

PEDS: 20mg/kg (0.2ml/kg) IV of 10% solution slow IV/IO; may be repeated if indications persist (shouldnt exceed adult dose)

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27
Q

Aspirin Contraindications

A

GI bleeding

Active ulcer disease

Hemorrhagic stroke

Peds with flulike symptoms

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28
Q

Nitroglycerin Indications

A

Ischemic CP

Heart failure

Acute MI

Hypertensive emergencies w/ ACS

Pulmonary edema

29
Q

Nitro contraindications

A

Volume depletion

Hypotension (<90 or 30 below baseline)

Head injury

Extreme bradycardia

Extreme tachycardia in the absence of heart failure

Right ventricular infarction

Cerebral hemorrhage

PDE5 inhibitors

Aortic stenosis

30
Q

Morphine Indications

A

Pain

Chest pain associated with ACS

Acute cardiogenic pulmonary edema

31
Q

Morphine contraindications

A

Hypersensitivity

Hypovolemia

Hypotension

Head injury/ increased ICP

Severe respiratory depression

MAO inhibitors w/in 14 days

Caution in right ventricular infarction

May worsen heartblock in inferior MI

32
Q

Morphine dosage

A

STEMI: 2-4mg IV; may repeat in doses of 2-8mg IV @ 5-15 minute intervals

Unstable angina/NSTEMI: 1-5mg IV

Pain: 0.1mg/kg IM (15mg Max dose); 10mg max dose IV/IO

PEDS: 0.1-0.2 mg/kg dose IV (15mg max total)

33
Q

Naloxone Dosage

A

IV: 0.4mg until adequate ventilations;
2mg for complete OD reversal; up to 6-10mg in under 10 minutes

PEDS: up to 5yrs or 44lbs (20kg) = 0.1mg/kg

> 5yrs or >44lbs (20kg) = 2mg

34
Q

Methylprednisolone (Solumedrol)
Indications

A

Anaphylaxis

Respiratory distress

35
Q

Solumedrol Contraindication

A

TBI

36
Q

Solumedrol dosage

A

2mg/kg up to 125mg IV; 40-125mg IV

PEDS: 2mg/kg IV loading dose
(60mg max)

37
Q

Albuterol Indications

A

Respiratory distress

Hyperkalemia

38
Q

Albuterol Dosage

A

Solution: 2.5-5 mg (0.5-1 mL of 0.5% solution) diluted to 3ml w/ 0.9% NS (0.083% solution); administer over 5-15 minutes; 3-4x /d by nebulizer

39
Q

Albuterol Peds dosage

A

Solution: 0.1-0.2 mg/kg per dose diluted in 2 mL of 0.9% NS; may be repeated q 20 minutes.

Nebulized: <44 lbs (20 kg): 2.5 mg/dose (inhalation)
>44 lbs (20 kg): 5 mg/dose (inhalation)

40
Q

Ipatropium Dosage

A

0.5 mg nebulized; repeated twice. Nebulized ipratropium can be simultaneously administered w/ the first 3 doses of Albuterol or after the first dose of Albuterol. Can be administered as 1-2 inhalations via MDI

41
Q

Ipatropium Peds dosage

A

250-500 mcg (by nebulizer or MDI) q 20 minutes times 3 doses

42
Q

Glucagon indications

A

Hypoglycemia

Symptomatic bradycardia from beta blocker or calcium channel blocker OD

43
Q

Glucagon hypoglycemia dosage

A

1mg IM/IN, may be repeated in 7-10 minutes

PEDS: >44lb or >5yr = same as adult
<44lb or <5yr = 0.5mg IM/IN

44
Q

Glucagon Calcium or Beta blocker OD dosage

A

3-10mg SLOW IV over 3-5 minutes, followed by a 3-5mg/hr infusion

PEDS: 25-40kg = 1mg IV push q 5 minutes prn
<25kg = 0.5mg IV push q 5 minutes prn

45
Q

Dextrose Indications

A

Hypoglycemia

ALOC

Seizure or coma of unknown origin

46
Q

Dextrose contraindications

A

Intracranial or intraspinal hemorrhage

Stroke in the absence of hypoglycemia

Dehydrated w/ delirium

Can cause tissue necrosis if extravasated

47
Q

Dextrose dosage

A

12.5 - 25g SLOW IV
*25-50mL of 50%
*50-100mL of 25%
*125-500mL of 10%

may repeat up to max dose

PEDS:
0.5-1g/kg IV/IO (*25% max recommended concentration)

2-4mL/kg 25%
5-10mL/kg 10%

*use 10% for infants >1month & neonates

48
Q

Diphenhydramine Indications

A

Allergic reactions

dystonic reactions from antipsychotics

49
Q

Diphenhydramine contraindications

A

Newborns

Nonselective MAO inhibitors

Caution in pts w/ CNS depression or asthma

50
Q

Diphenhydramine dosage

A

1mg/kg IV SLOW/IM/oral
*50mg max dose

PEDS: 1mg/kg IV/IM/oral
*25mg max dose

51
Q

Ondansetron contraindications

A

Prolonged QT

<1 month

Liver disease

GI obstruction

Apomorphine

52
Q

Ondansetron dosage

A

IV: up to 4mg may be given undiluted (inject over 30-150 seconds)

up to 16mg max (chemotherapy)

Infusion: dose diluted in 50mL of D5W over 15 minutes

IM: 4mg in well developed muscle

PEDS: 0.15mg/kg per dose IV /oral
*4mg max

53
Q

Midazolam Indications

A

Seizures

Sedation

Agitation/excited delirium

Uncontrolled shivering (hypothermia)

Painful procedures

54
Q

Midazolam contraindications

A

Respiratory/CNS depression

Shock

Depressed vitals

Downers (drugs/etoh or meds)

Severe glaucoma

55
Q

Midazolam dosage

A

*10mg Max total/ 5mg PEDS

IV: 0.1mg/kg
IM: 0.2mg/kg
PEDS: 0.05mg/kg per dose

Exited delirium:
5mg IV/IM
PEDS: IV= 0.05-0.1mg/kg
IM= 0.1-0.15mg/kg

56
Q

Ketamine Indications

A

Pain/painful procedures

Severe agitation/exited delirium

57
Q

Ketamine contraindication

A

Angina

CHF

Cardiac decompensation

Severe hypertension

Stroke

Increased ICP

Pregnancy

Schizo hx

58
Q

Ketamine dosage

A

Pain: *100mg max cumulative dose
IM/IV/IO: 0.25mg/kg; 25mg max dose

Exited delirium:
IV: 2mg/kg over 1 minute
IM/IN: 4mg/kg

PEDS (>2yr):
IV: 1mg/kg over 1 minute
IM: 3mg/kg

59
Q

TXA contraindications

A

HX of:
Coagulopathy
PE
DVT
Ischemic cerebrovascular accident
Acute myocardial infarction
Ischemic retinopathy

60
Q

TXA dosage

A

10mg/kg IV; 15mg/kg in certain situations

PEDS: 10mg/kg IV

61
Q

Sodium Bicarb Indications

A

Hyperkalemia

Rhabdomyolysis

Acidosis:
-DKA
-TCA OD
-Aspirin OD
-Cocaine OD
-Diphenhydramine OD

62
Q

Sodium Bicarb contraindications

A

Cardiac Arrest & CPR w/out intubation

Alkalosis

Abdominal pain of unknown origin

Severe vomiting

Severe pulmonary edema

Hypernatremia

Hypocalcemia

Hypokalcemia

63
Q

Sodium Bicarb Dosages

A

1 mEq/kg IV bolus

PEDS: Same as adult, just infuse slowly & only if ventilations are adequate

64
Q

Oxytocin Indications

A

Postpartum hemorrhage (after baby & placenta delivery)

65
Q

Oxytocin Contraindications

A

Hypertonic or hyperactive uterus

Presence of 2nd baby

Fetal distress

66
Q

Oxytocin Dosage

A

3-10 units IM after delivery of placenta

Bleeding following Incomplete or Elective Abortion:
Mix 10-40 units (1-4ml) in 1000ml of NS/LR solution;
Infuse @ 10-40 milliunits/min via microdrip tubing, titrate to bleeding or uterine response

67
Q

Thiamine Indications

A

Coma of unknown origin (w/ D50
or naloxone)

Delirium tremens

Wernicke encephalopathy

68
Q

Thiamine Dosage

A

100mg slow IV/IM

PEDS: 10-25mg IV/IM

Pharma (11 decks)

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