Top ED Drugs Flashcards
Mucomyst
aka NAC
for: APAP OD
dose: if IV, 150 mg/kg in 200mL D5W x 1h, then 50 mg/kg in 500mL D5W x 4h, then 100mg/kg in 1000mL D5W x 16h (for 21hr total). If hypersensitivity, switch to po 70 mg/kg q4h x 17 (72hr total)
Adenosine
for: SVT
dose: 6mg IV rapid push, then 12mg IV q2min x 2 PRN
Albuterol
aka Ventolin, ProAir
for: acute bronchospasm; hyperK+
dose: 2.5 to 5mg q20min x 1 hr; or 2.5 to 10mg q1-4h PRN
avoid: hypoK+, hypergly, tachy
Amiodarone
for: pulseless vtach/vfib; wide-complex tachy
dose: 300mg IV rapid push, then 150mg IV rapid push PRN q2min
avoid: hypotensive, preg
Atropine
for: brady
dose: 0.5mg IV (3mg max); 0.02 mg/kg IV (1mg max) peds
CaCl/gluconate
for: hyperK+ or scary hypoCa2+
dose: 10% IV soln (1 g/10 mL)
note: CaCl is 3x stronger than CaGluc
Diazepam
aka: Valium
for: seizure, agitation, spasm, EtOH withdrawal
dose: 2-10mg (po, IV, or IM) q6h PRN
avoid: bradypnea, hypotension, preg
Diltiazem
for: SVT, stable afib with RVR
dose: 0.25 mg/kg IV x 1, or continuous infusion 5-15mg/hr
Dobutamine
for: refractory hypotension; decompensated heart failure
dose: 2-20 mcg/kg/min IV
Dopamine
for: hypotension; decompensated heart failure
dose: 5-10mcg/kg/min CENTRAL LINE for b-adrenergic, or 10-20mcg/kg/min CENTRAL LINE for a-adrenergic
Lovenox
aka: enoxaparin
for: DVT/PE; NSTEMI/unstable angina
dose: 1 mg/kg SQ q12h, or 1.5 mg/kg SQ q24h
BBW: using in someone with spinal anesthesia/analgesia or LP
Etomidate
for: RSI
dose: 0.3 mg/kg IV
Fosphenytoin
for: status epilepticus
dose: 15-20mg/kg IV at 150mg/min
avoid: preg, unmonitored pts
Haldol
aka Haloperidol
for: psychosis, agitation
dose: 5-10 mg (po, IV, or IM) q2h (max 100mg/d)
Dilaudid
aka: hydromorphone
for: pain
dose: 1-2 mg IV 13-6h
Labetalol
for: HTN emergency
dose: 20-80mg IV q10 bolus + 1-8 mg/min continuous infusion
Mannitol
for: inc ICP
dose: 1 g/kg IV x 1
avoid: dehydrated
Reglan
aka Metoclopramide
for: N/V
dose: 10mg IV q6h PRN
Nimodipine
for: SAH
dose: 60mg pa q4h
Norepi
aka Levophed
for: hypotension that IVF isn’t fixing
dose: 1-30 mcg/min CENTRAL LINE
Zofran
aka Ondansetron
for: N/V
dose: 4-8mg IV q4-6h PRN
avoid: long QTc
Propofol
for: RSI, procedural sedation
dose: RSI - 1.5-2.5 mg/kg IV x 1; procedural - 1 mg/kg bolus + 0.5 mg/kg q3min to effect
Bicarb
aka Sodium bicarbonate
for: hyperK+, TCA/ASA tox, maybe metabolic acidosis
dose (for hyperK+): 50 mEq IV x 1 (aka one amp)
avoid: hyperNa+, CHF
Droperidol
for: migraines, nausea
dose: 1.25-2.5 mg IV q4h PRN
avoid: long QT; might cause NMS/extrapyramidal Sx
Esmolol
for: aortic dissection
dose: 500 mcg/kg loading then continuous infusion 50-300 mcg/kg/min
Fentanyl
for: pain
dose: 1 mcg/kg IV q 1-2h
Lasix
aka Furosemide
for: CHF exacerbation, pulm edema, non-anuric hyperK+
dose: 20-40mg IV to start; max single dose 200mg
avoid: metabolic alkalosis
Heparin
for: VTE, ACS, afib
dose: VTE - load 80 U/kg IV, then 18 U/kg/hr; ACS/afib - load 60 U/kg IV, then 12 U/kg/hr
Insulin R
for: hyperK+, DKA/HHS, CCB tox
dose: hyperK+ - 5-10 U IV x1; DKA/HHS - 0.1 U/kg bolus + continuous infusion of the same
avoid: hypoK+, hypoglycemia
Lorazepam
aka: Ativan
for: agitation, delirium tremens, status epilepticus, 5-HT syndrome
dose: 1-2mg IV bolus + 1-10 mg/hr continuous infusion
Methohexital
for: procedural sedation
dose: 1 mg/kg IV + 0.5 mg/kg q2-5min PRN
avoid: resp issues
Midazolam
aka: Versed
for: procedural sdation, RSI, seizures
dose: procedural - 0.02-0.04 mg/kg IV; RSI - 0.1 mg/kg IV; other - 1-10mg/hr continuous infusion
NTG
for: angina, CHF
dose: 5-200mcg/min, inc 10mcg q3-5min to effect
avoid: with PDE5i
Octreotide
for: esophageal varices rupture, SU tox
dose: varices - 50 mcg IV bolus + 50 mcg/hr IV; SU tox - 50 mcg subQ q6h PRN
Phenobarb
for: status epilepticus
dose: 20 mg/kg IV x 1, then 5-10mg/kg in 20min PRN. Max dose 30 mg/kg. Max infusion rate 50 mg/min.
Protamine Sulfate
for: UFH-bleeding
dose: 1 mg per 100 U UFH (max 50mg) administered at a rate of 5mg/min
avoid: fish allergies
Succinylcholine
for: RSI paralytic
dose: 1.5 mg/kg IV, or 3-4 mg/kg IM
avoid: hyperK+, burns/crush injuries, inc IOP, inc ICP
Epi
for: ACLS, PALS, anaphylaxis, peds severe asthma, IVF-refractory hypotension
dose:
ACLS - 1mg 1:10,000 IV
PALS - 0.01 mg/kg 1:10,000 IV
IVF-refractory hypotension - 1-10 mcg/min IV
Anaphylaxis - 0.1-0.5 1:1,000 IM (or SQ if needed)
Peds anaphylaxis/asthma - 0.01 mg/kg 1:1,000 IM/SQ
avoid: peripheral lines, dosing errors
Esomeprazole
aka: Nexium
for: non-variceal UGIB
dose: 80 mg IV bolus + 8 mg/hr
Fomepizole
for: methanol or ethylene glycol tox
dose: load 15 mg/kg IV, then 10 mg/kg q12h x 4, then 15 mg/kg q12h til levels <20mg/dL and ASx and normal pH
Glucagon
for: hypoglycemia, beta-blocker/CCB tox
dose: hypoglycemia - 1 mg IV/SQ/IM; tox - load 3-10mg IV then 1-10 mg/hr continuous infusion
avoid: aspiration of emesis
Hydrocortisone
for: pressor-refractory septic shock, status asthmaticus, acute adrenal insufficiency
dose: shock - 50mg IV q6h; asthma - 1-2 mg/kg IV q6h x 24h then maintenance; adrenal - 100mg IV bolus + 50mg IV q6h x 24h then taper
Ketamine
for: RSI, procedural sedation, analgesia (dissociation)
dose: RSI - 2 mg/kg IV; procedural - 0.5-1 mg/kg IV
Mag Sulfate
for: TdP, eclampsia, ventricular dysrhythmias, status asthmaticus
dose: TdP - 2g IV push; eclampsia - 2-4g IV over 5min; asthma - 2g IV over 15min
Methylpred
for: asthma, acute hypersensitivity rxn, PCP PNA with inc A-a or paO2 <70
dose: 1 mg/kg IV; PNA - 30mg IV bid x 5d then taper off
Morphine
for: pain
dose: 2-10mg IV q2-6h PRN (recommended 0.1 mg/kg)
Nitropress
for: HTN emergency
dose: 0.3 mcg/kg/min IV titrating to effect (max 10 mcg/kg/min). d/c after trying 10min without success.
avoid: cyanide tox
Olanzapine
for: psychosis/agitation
dose: 5-10mg IM (max 30mg/d)
Prednisone
for: asthma, allergic rxn, PCP PNA with A-a gradient >35 or paO2 <70
dose: 1 mg/kg/d
avoid: GI perf/ulcer, hyperglycemia
Rocuronium
for: RSI paralytic
dose: 1 mg/kg IV
