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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
Calcium Chloride contraindications
VF during cardiac resuscitation Digitalis OD
26
Calcium chloride dosage
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)
27
Aspirin Contraindications
GI bleeding Active ulcer disease Hemorrhagic stroke Peds with flulike symptoms
28
Nitroglycerin Indications
Ischemic CP Heart failure Acute MI Hypertensive emergencies w/ ACS Pulmonary edema
29
Nitro contraindications
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
Morphine Indications
Pain Chest pain associated with ACS Acute cardiogenic pulmonary edema
31
Morphine contraindications
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
Morphine dosage
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
Naloxone Dosage
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
Methylprednisolone (Solumedrol) Indications
Anaphylaxis Respiratory distress
35
Solumedrol Contraindication
TBI
36
Solumedrol dosage
2mg/kg up to 125mg IV; 40-125mg IV PEDS: 2mg/kg IV loading dose (60mg max)
37
Albuterol Indications
Respiratory distress Hyperkalemia
38
Albuterol Dosage
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
Albuterol Peds dosage
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
Ipatropium Dosage
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
Ipatropium Peds dosage
250-500 mcg (by nebulizer or MDI) q 20 minutes times 3 doses
42
Glucagon indications
Hypoglycemia Symptomatic bradycardia from beta blocker or calcium channel blocker OD
43
Glucagon hypoglycemia dosage
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
Glucagon Calcium or Beta blocker OD dosage
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
Dextrose Indications
Hypoglycemia ALOC Seizure or coma of unknown origin
46
Dextrose contraindications
Intracranial or intraspinal hemorrhage Stroke in the absence of hypoglycemia Dehydrated w/ delirium Can cause tissue necrosis if extravasated
47
Dextrose dosage
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
Diphenhydramine Indications
Allergic reactions dystonic reactions from antipsychotics
49
Diphenhydramine contraindications
Newborns Nonselective MAO inhibitors Caution in pts w/ CNS depression or asthma
50
Diphenhydramine dosage
1mg/kg IV SLOW/IM/oral *50mg max dose PEDS: 1mg/kg IV/IM/oral *25mg max dose
51
Ondansetron contraindications
Prolonged QT <1 month Liver disease GI obstruction Apomorphine
52
Ondansetron dosage
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
Midazolam Indications
Seizures Sedation Agitation/excited delirium Uncontrolled shivering (hypothermia) Painful procedures
54
Midazolam contraindications
Respiratory/CNS depression Shock Depressed vitals Downers (drugs/etoh or meds) Severe glaucoma
55
Midazolam dosage
*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
Ketamine Indications
Pain/painful procedures Severe agitation/exited delirium
57
Ketamine contraindication
Angina CHF Cardiac decompensation Severe hypertension Stroke Increased ICP Pregnancy Schizo hx
58
Ketamine dosage
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
TXA contraindications
HX of: Coagulopathy PE DVT Ischemic cerebrovascular accident Acute myocardial infarction Ischemic retinopathy
60
TXA dosage
10mg/kg IV; 15mg/kg in certain situations PEDS: 10mg/kg IV
61
Sodium Bicarb Indications
Hyperkalemia Rhabdomyolysis Acidosis: -DKA -TCA OD -Aspirin OD -Cocaine OD -Diphenhydramine OD
62
Sodium Bicarb contraindications
Cardiac Arrest & CPR w/out intubation Alkalosis Abdominal pain of unknown origin Severe vomiting Severe pulmonary edema Hypernatremia Hypocalcemia Hypokalcemia
63
Sodium Bicarb Dosages
1 mEq/kg IV bolus PEDS: Same as adult, just infuse slowly & only if ventilations are adequate
64
Oxytocin Indications
Postpartum hemorrhage (after baby & placenta delivery)
65
Oxytocin Contraindications
Hypertonic or hyperactive uterus Presence of 2nd baby Fetal distress
66
Oxytocin Dosage
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
Thiamine Indications
Coma of unknown origin (w/ D50 or naloxone) Delirium tremens Wernicke encephalopathy
68
Thiamine Dosage
100mg slow IV/IM PEDS: 10-25mg IV/IM

Pharma (11 decks)

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