Week 14

Question 1

Thiamine (vitamin B1)

Answer 1

Thiamine (vitamin B1) Vitamin B

MOA: combines w/ ATP to form coenzyme Thiamine Phosphate, necessary for carbohydrate metabolism

IND: vitamin B1 deficiency, Wernicke-Korsakoff Syndrome (often seen in alcoholics), malnourishment diabetics w/ alcohol abuse, coma of unknown origin, Delirium tremors

CON: hypersensitivity

Adverse: pain at injection site, nausea, restlessness, weakness, sweating, rash

Dose/Route: IV/Io/PO 100mg IV/IO
Pedi: NO

Special Notes: fetal risk MINIMAL, use w/ caution in burn PTs, prolonged infection, & decreased intestinal absorption. Can be given PO as supplement

Question 2

Lorazepam

Answer 2

Lorazepam Benzodiazepine-Anticonvulsant-Sedative Hypnotic

Brand: Ativan

MOA: Binds to GABA receptor, reducing activity in brain, most potent benzo available

IND: Anxiety, status epilepticus, sedation before anesthesia, premed before cardioversion, chemical restraints

CON: hypersensitivity to benzos, intra-arterial administration, narrow-angle glaucoma, respiratory insufficiency, Hypotension, shock

Adverse: respiratory depression, sedation, dizziness, weakness, unsteadiness, AMS, hypotension, retrograde amnesia

Dose/Route: 0.5-2mg IV/IO
1-4mg IM
Pedi: 0.05-0.1mg/kg IM/IV/IO
Special Notes: Pregnancy Class D, short half-life, don’t mix w/ other CNS depressants

Question 3

Romazicon

Answer 3

Romazicon Benzodiazepine Agonist

Brand: Flumazenil

MOA: It reverses the effects of benzodiazepines by competitive inhibition at the benzodiazepine binding site

IND: Benzo OD, complete or partial reversal of sedative effects of benzos, signs of TCA OD

CON: hypersensitivity, patients given benzo to control life threatening condition

Adverse: Nausea, dizziness, headache, dyspnea, hyperventilation, agitation, vomiting, visual disturbances

Dose/Route: 0.2mg over 30sec IV/IO 2nd dose 0.2mg over 30 sec IV/IO
Pedi: 0.01mg/kg up to 0.2mg IV/IO max of 0.2mg over 15 sec

Special Notes: Pregnancy Class C, short unpredictable half life

Question 4

Haloperidol

Answer 4

Haloperidol Antipsychotic

Brand: Haldol

MOA: CNS depressant, selectively blocks post synaptic dopamine receptors

IND: psychiatric problems, agitation

CON: comatose, hypersensitivity, parkinsons disease, toxic CNS depressions

Adverse: hypotension, blurred vision, prolonged QT interval, sudden cardiac death, torsades, seizure, dystonia

Dose/Route: 0.5mg-5mg PO/IM
Pedi: 0.5mg-5mg PO/IM

Special Notes: Preg Class c

Question 5

Diazepam

Answer 5

Diazepam Benzodiazepine-Sedative

Brand: Valium

MOA: Binds to GABA receptor, reducing activity in brain

IND: anxiety, alcohol withdrawal, sedation, seizure, status epilepticus, chemical restraint

CON: hepatic insufficiency, hypersensitivity to benzos, myasthenia gravis, acute narrow angle glaucoma, pediatrics less than 6mo, respiratory insufficiency, sleep apnea, Retro grade Amnesia, Hypotension

Adverse: hypotension, rash, euphoria, respiratory depression, dizziness, drowsiness

Dose/Route:    IV/IO/PO		2-10 mg	IV/IO
			Seizures: 	5-10mg	IV/IO
			Pacing: 	5-15mg	IV/IO
			Pedi:	0.2-0.5mg/kg	IV/IO
Special Notes: Preg Class D, don’t give IM!