Rx Box

Question 1

Adenosine

Answer 1

Ind - SVT/PSVT
Con - active bronchoconstriction; poly/irreg wide tachy
Dos - 6mg (2min) 12mg (2min) 12mg

Question 2

Droperidol

Answer 2

Ind - Moderate agitation; anti-emetic (migraine, cannabinoid hyperemesis, secondary to Zofran)
Con - agitation <13; emetic <18; pregnancy; Parkinson’s; depressed CNS
Dos - Agitation 13-68 2.5mg IM; 1.25mg for older; Emetic 1.25mg slow IV

Question 3

Ondansetron / Zofran

Answer 3

Ind - Anti-emetic
Con - <28 days old
Dos - 12yo < 4-8mg IV, IM, PO; 12yo> 1mg/kg

Question 4

Dyphenhydramin

Answer 4

Ind - Allergic reaction; Dystonic reaction
Dos - Adult 25-50mg IV, IM; Ped >6mo 1mg/kg IV,IM

Question 5

Ketoralac / Tremadol

Answer 5

Ind - Acute pain (muscles, renal stones) and mild burns
Con - NSAIDs within 6hr; anticoagulants; bleeding disorder; GI bleeds; suspected internal bleeding; severe headache/injury; renal insufficiency or transplant; pregnancy; breast feeding;
Dos - 15mg IV or 30mg IM - no repeats; Peds 2-18 0.5mg/kg IV or 1mg/kg IM - no repeat

Question 6

Epi 1mg/1ml

Answer 6

Ind - Anaphylaxis; severe asthma; stridor (croup)
Con - Hypertension; tachydysrhythmia with pulse
Dos - 5yo< 0.5mg IM every 5 min x3; 5yo>0.15mg IM every 5 min x3; hypotensive OR impending respiratory failure use DRIP
croup 2.5ml via neb x2; severe croup 0.01mg/kg IM max 0.5mg

Question 7

Albuterol / Ventolin

Answer 7

Ind - Bronchospasm (wheezing); Hyperkalemia
Con - known hypersensitivity
Dos - Neb: 2.5mg, repeat as needed (1.25mg <2yo); Hyperkalemia 20mg

Question 8

Amiodarone

Answer 8

Ind - VT; Vfib; Afib & Aflutter w/aberrancy HR >130 & SBP >100
Con - Bradycardia various; hypotension; Iodine hypersensitivity
Dos - With pulse, mix in dilutant, 150mg over 10 min; w/o pulse, 300mg, repeat once 150mg

Question 9

Atrovent / Ipratropium

Answer 9

Ind - Allergic reaction; Asthma; Bronchospasms from bronchitis & emphysema
Con - 1yo>
Dos - Above 2yo - 500mcg (2.5ml) by Neb with Albuterol - no repeat
1-2yo 1.25ml

Question 10

Nitroglycerin

Answer 10

Ind - Angina; CHF w/acute pulmonary edema
Con - <13yo; ED meds; BP >90 systolic; HR <60/>150
Dos - Chest pain 0.4mg SLx3/x3-5min IF BP & HR still in range. If no prescription must have IV first
Pulmonary edema - goal to reduce SBP by 20%.
SL - pre-CPAP OR if CPAP not tolorated, raise to 0.8mgSL dosing until 20% reduction
Infusion - 100mcg/ml in dilutant; administer 400mcg IV every 5 min (or pump)

Question 11

Tranexamic Acid (TXA)

Answer 11

Ind - Suspected hemorrhage shock from trauma/postpartum; injury within hour; SBP <90 [70+(2xage) if <12yo]
Con - Known embolism (PE, DVT)
Dos - 12yo< 1g in 100ml / 10 min; 5-12yo 500mg in 100ml /10min; 5yo> consultation req

Question 12

Aspirin

Answer 12

Ind - Suspected ACS
Con - Received 324mg prior to EMS arrival; Peds
Dos - 324mg = 4x 81mg

Question 13

Atropine

Answer 13

Ind - Bradycardia, organophosphate poisoning
Con - (relative) 2nd type II; 3rd degree block; AMI
Dos - Bradycardia IV 0.5-1mg every 3-5 min up to 0.04mg/kg
Organophosphate - 2-4mg IV/IM every 5-10 min