SMOs: Drug Doses

Question 1

Adenosine (Adenocard)

Answer 1

IV/IO
Adult
1. SVT: 6mg then 12mg IV/IO
-20ml flush

Peds
1. SVT: .1mg/kg then double dose IV/IO
-max initial dose 6mg
-max subsequent dose 12mg

Question 2

Albuterol (Ventolin)/Ipratropium (Atrovent)

Answer 2

NEB/ET
Adult
1. Duoneb: Albuterol-2.5mg and Ipratropium- .5mg NEB
2. Crush: 5mg NEB

Peds
1. Duoneb: same as adult

Question 3

Amiodarone

Answer 3

IV/IO
Adult
1. VF/Pulseless VTach: 300mg IV/IO
-second dose 150mg

Peds
1. VF/Pulseless VTach: 5mg/kg IV/IO
-may repeat 2 additional does
-max single dose 300mg

Question 4

Aspirin Chew Tab

Answer 4

PO
Adult
1. Suspected cardiac chest pain: 81mg tab x4

Peds
NONE

Question 5

Atropine

Answer 5

IV/IO
Adult
1. Bradycardia: 1mg IV/IO
-q3-5 minutes
-max 3mg
2. Pesticide/Nerve agent: 2mg IV/IO
-every 5 minutes until secretions stop

Peds
1. Bradycardia: .02mg/kg IV/IO
-minimum dose .1mg
-max single dose 1mg
-may be repeated x1 in 5 minutes
2. Pesticide/Nerve agent: .02mg/kg IV/IO
-every 5 minutes until secretions stop

Question 6

Calcium Gluconate

Answer 6

IV/IO
Adult
1. Reversible causes: 1g IV/IO
2. Crush: 1g slow IV/IO with 20ml flush

Peds
NONE

Question 7

Dextrose (D50)

Answer 7

IV/IO
Adult
1. Diabetic Emergency: 50ml IV/IO
-No response, may repeat

Peds
D25: 2ml/kg IV/IO
-ped
D12.5: 4ml/kg IV/IO
-<2months
*Consider hypoglycemia in crush/suspension

Question 8

Diphenhydramine (Benadryl)

Answer 8

IV/IM
Adult
1. Anaphylaxis: 50mg IV slow (over 2-3 minutes)
-No IV, can do IM

Peds
1. 1mg/kg IV slow over 2-3 minutes
-max total 50mg

Question 9

Epinephrine 1:1,000 (1mg/ml)

Answer 9

IM/NEB
Adult
1. Impending Res Failure w/ Wheezing: .3mg IM
-max repeat x1 in 5 minutes
2. Anaphylaxis: .3mg IM

Peds
1. Anaphylaxis: .01mg/kg IM
-Do not exceed .3mg
2. Upper airway disease: 1mg in 2 ml NS NEB
-Per med control
-max of 3 total doses

Question 10

Epinephrine 1:10,000 (1mg/10ml)

Answer 10

IV/IO
Adult
1. VF/Pulseless VTach: 1mg IV/IO
-q 3-5 min
2. PEA/Asystole: 1mg IV/IO
-q 3-5 min

Peds
1. Cardiac Arrest: .01mg/kg q 3-5 min
2. Bradycardia: .01mg/kg IV/IO
-q 3-5 min
3. Newborn resuscitation w/ HR <60: .01mg/kg IV/IO

Question 11

Epi-Pen (adult and junior)

Answer 11

IM
Adult
.3mg IM

Ped
.15mg IM

Question 12

Fentanyl

Answer 12

IV/IO/IM/IN
Adult
1. Pain: 50mcg IV/IO/IM/IN
-q 5 min, max 200mcg
-including burns, crush, trauma
2. Suspected cardiac patient (>110): 50mcg IV/IO/IM/IN
-q 5 min, up to 200mcg

Ped
1. Pain: 1mcg/kg IV/IO/IM/IN
-q 5 min, up to 150mcg

Question 13

Furosemide

Answer 13

IV
Adult
1. P.E due to heart failure >110mmHg: 20-40 mg IV

Peds
None

Question 14

Glucagon

Answer 14

IM/IN
Adult
1. Diabetic emergency: 1mg IM/IN

Peds
1. Diabetic emergency: .03mg/kg IM/IN
-max total 1mg

Question 15

(oral) Glucose

Answer 15

PO
Both adults and peds can take

Question 16

Ketamine

Answer 16

IV/IO/IM/IN
Adult
1. Excited Delirium: 2mg/kg IM
2. Medication Assisted Intubation: 2mg/kg IV/IO/IM/IN
-may repeat one time

Peds
1. Medication Assisted Intubation 2mg/kg IV/IO/IM/IN
-may repeat one time

Question 17

Magnesium Sulfate

Answer 17

IVPB
Adult
1. Asthma/COPD w/ wheezing: 2g IVPB mixed with 250ml NS bag over 20 minutes
2. Pre-Eclampsia: 4g IVPB mixed with 250ml NS bag over 20 minutes

Question 18

Methylprednisolone (Solu-Medrol)

Answer 18

IV
Adult
1. Asthma/COPD w/ Wheezing and prolonged transport: 125mg IV
2. Anaphylaxis and prolonged transport: 125mg IV

Peds
1. Anaphylaxis and prolonged transport: 2mg/kg IV

Question 19

Midazolam (Versed)

Answer 19

IV/IO/IM/IN
Adult
1. Seizure: 5mg IV/IO/IM/IN
-may repeat 1x in 5 minutes
2. Sedation: 2.5mg slow IV/IO/IM/IN
3. Medication Assisted Intubation: 5mg increments slow IV/IO/IM/IN
-max 10mg

Peds
1. Seizure: .2mg/kg IV/IO/IM/IN
-max total dose of 6mg
2. Sedation: .05mg/kg IV/IO/IM/IN
-max total dose of 6mg
3. Medication Assisted Intubation: .1mg/kg IV/IO
-q 2 min up to 5 mg
-.15mg/kg IM/IN up to 2.5mg (may repeat x1)

Question 20

Morphine

Answer 20

IV/IO/IM
Adult
1. Pain 2. Suspected Cardiac Patient (>110): 2mg IV/IO/IM
-q 5 minutes
-max 10mg
-can go straight to 5mg for crush/burn

Peds
1. Pain: .1mg/kg IV/IO/IM
-q 5 minutes up to 10mg

Question 21

Naloxone (Narcan)

Answer 21

IV/IO/IM/IN
Adult
1. Narcotic OD: 2mg IV/IO/IM/IN
-repeat q 5, max 6mg

Ped
1. Reversible cause/narcotic exposure: .1mg/kg IV/IO/IM/IN
-max single dose 2mg

Question 22

Nitroglycerin

Answer 22

SL
Adult
1. Suspected cardiac patient (>110), P.E due to heart failure(>110): .4mg
-q 5 min, up to 3 doses

Question 23

Nitrous Oxide

Answer 23

INH
Adult
1. Pain/burns/kidney stones: 50/50 with O2

Question 24

Sodium Bicarbonate

Answer 24

IV/IO
Adult
1. Pea/Asystole: 50mEq IV/IO
-Per med control
2. Crush/Suspension: 50mEq IV/IO
-followed by 20ml flush

Question 25

Tetracaine

Answer 25

Eye drop
Adult and Peds
Hazmat eyes: 1-2 drops per eye
-globe intact

Question 26

Tranexamic Acid (TXA)

Answer 26

IVPB
Adult
1. Hemorrhagic shock with BP <70: 1g in 100ml IVPB over ten minutes

Question 27

Ondansetron (Zofran)

Answer 27

ODT/IV
For adult and pediatrics ≥ 4 years old experiencing nausea, consider Zofran 4mg ODT/IV x1 dose

Question 28

.9% Sodium Chloride (Normal Saline)

Answer 28

IV/IO
Adult
1. Fluid resus: 200ml increments
-max 1L

Peds
1. Fluid resus: 20ml/kg
2. Cardiogenic shock: 10ml/kg

Question 29

Ped ZOL

Answer 29

DFib: 2J/kg then 4J/kg then 4J/kg

Cardiovert: .5J/kg then 1J/kg then 2J/kg