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ED-RX
ED Pharmacist Info
| Question | Answer |
|---|---|
| PALS Epinephrine Dose for Cardiac Arrest | 0.01mg/kg q3-5 min (0.1ml/kg of 1:10,000).Draw it up through stopper in the Abboject) |
| Brevital (methohexital) reconstitution | 500mg vial - Make a 10mg/ml solution by adding 50ml NS or SWI to vial. Label vial 10mg/ml with sharpie. Only stocked in Resus |
| PALS Calcium Chloride dose for Cardiac Arrest | 20mg/kg; MR q 10 min. Draw up through stopper of Calcium chloride 10% syringe (100mg/ml) |
| Pals Sodium Bicarbonate dose for Cardiac Arrest | 1meq/kg - draw up dose through stopper of NaHCO3 Abboject (1mEq/ml). Infants: use the 0.5mEq/ml strength. |
| Esmolol 20mg/100ml - dosing | Loading dose (if desired) 500mcg/kg over 1 min.then 50mcg/kg/min; may increase by 50mcg/kg/min every 4 minutes to max of 200mcg/kg/min |
| Ketamine dosing | 1mg/kg (1-2mg/kg/dose) No faster than 0.5mg/kg/min or no faster than 60 seconds.Onset: 30 sec; duration 5-10 minutes |
| Most common regimen for RSI in adults in our ED | Etomidate 20mg (2mg/ml)(induction agent) followed by succinylcholine 1mg/kg (20mg/ml)(paralytic). Succinylcholine Onset:30-60 seconds;Duration: 4-6 min with single dose. |
| Propofol 10mg/ml | Patient should be intubated prior to administration. 5mcg/kg/min. May increase by 5-10mcg/kg/min every 5-10 minutes. Watch for hypotension, decrease dose. Usual maintenance is 5-80mcg/kg/min. Use 80% dose for elderly,debilitated, ASA-PS 3 or 4 |
| Tromethamine (THAM) for Survival Flight | Survival Flight requests 2 bottles of THAM to transport an ARDS patient. Note the name of the patient. If SF hasn't returned the bottles to us by the time the pt has been admitted for 2 hours-charge to pt in worx & put "used by Survival Flight" |
| Terbutaline for Priapism - Dosing | 5-10mg po. MR 5-10mg in 15 minutes if no response. If no response after 30 minutes consider alternate therapy. May also use 0.25-0.5mg SC |
| Phenylephrine for Priapism - Dosing | 100-500 mcg/dose, max 10 doses; 10-20 mL of20 mcg/mL via intracav inj q5-10min. OR mix 1000 mcg phenylephrine in 100 mL of NS(10 mcg/mL) and infuse 10-20 mL at a time; if unable to infuse, inject directly in 200- to 500-mcg aliquots; Max 1500 mcg |
| Atropine dose in PALS | 0.02 mg/kg IV/IO or 0.03mg/kg ET Repeat once if needed (min dose = 0.1mg) |
| What should follow when a drug is given by ET route in PALS ? | Flush with 5 ml of normal saline and follow with 5 ventilations. |
| What is the dose of epinephrine via ET in PALS? | 0.1mg/kg (0.1mL/kg) of 1:1000 solution |
| What is the conversion ration for IV to PO metoprolol? | 1:2.5 (5mg iv q6h to 25mg po bid).This is an estimated conversion ratio because it is dependent on the individual's first pass effect. |
| Methohexital (Brevital) Adult Dose and Infusion Rate | 1-1.5mg/kg (50-120mg/dose). Make a 10mg/ml solution. Infuse at 1ml/5 seconds. May want to divide dose to minimize hypotension. Provides anesthesia for 5-7 minutes. |
| Clozapine (Clozaril) dispensing procedure for patient already on clozapine | Print off Form B and have physician complete.Check for current WBCs (>3000) and granulocytes (>1500). Tube Form B with copy of order attached to ACP (tube station B2) |
| What dosage form is Suboxone? | Sublingual tablets |
| Recommended infusion time for Levofloxacin 750mg IVPB? | 90 minutes |
| Drugs NOT recommended for treatment of serotonin syndrome | PropranololBromocriptineDantrolene |
| CYPROHEPTADINE USE IN SEROTONIN SYNDROME | Indication: Moderate-to-severe SS or persistent symptoms of SS despite tx with benzodiazepines.MOA: Antagonism at serotonin 5-HT1a and 5-HT2 receptorsAdult dose: 12mg followed by 2mg q2h prnMaintenance dose: 8mg q6h. |
| Drugs used to tx excessive serotonin stimulation in serotonin syndrome | Cyproheptadine - see cyproheptadine flash cardChlorpromazine - concerns include orthostasis, hyperthermia and decreased seizure thresholdOlanzapine - not recommended until it has been studied and evaluated. |
| Treatment of agitation in serotonin syndrome | Benzodiazepines (lorazepam or diazepam) |
| Treatment of hypertension and tachycardia in serotonin syndrome | Use a short-acting agent (nitroprusside , esmolol)Long-acting agents (propranolol) eliminate tachycardia as a marker for the presence of ss and may produce hypotension and shock |
| Treatment of hyperthermia in serotonin syndrome | Need to eliminate muscle rigidity (benzodiazepines). Refractory(temp > 104): nondepolarizing nmb agent and intubation/sedation. Do not use straps to restrain patient - increases hyperthermia from muscle rigidity |
| Typical Sexual Assault Regimen | Plan B (both tabs now),Metronidazole 2gm po x1,Azithromycin 1gm po x1,Cefixime 400mg po x1 |
| What is the normal range for serum potassium level? | 3.5-5.0 mMol/L |
| Drugs to Treat Hyperkalemia | Kayexalate, Calcium Gluconate 1g IVP, Regular Insulin 10 units IVP, Dextrose 50% 1 amp (25g), Sodium Bicarbonate 50meq (1amp) |
| Bell Palsy Treatment - controversial but often given for 1st week | Adult: Acyclovir 400-800mg tid-5xday x 7days.Ped > 2y: 20mg/kg/dose tid x 7 days. Prednisone (adult-60-80mg/day x 4-7 days) (ped-1mg/kg/day x 5-7 days). Taper & DC over 10 days. |
| Alteplase Dosing for acute ischemic stroke | Total dose: 0.9 mg/kg (max total dose 90mg)Load: 10% of 0.9mg/kg (0.09mg/kg) over 1 minute then 90% of 0.9mg/kg (0.81mg/kg) over 60 minutes |
| Magnesium Sulfate dose for bronchodilation in pediatric acute asthma | 25-75mg/kg over 20 minutes. Mix 1gm mag sulfate (2ml) with 8ml D5W (100mg/ml). Draw up calculated dose in a syringe. |
| Convert methadone 15mg po daily to a fentanyl patch. | Start with 12mcg/hr patch.(Global RPh calculator) |
| Avoid nitroglycerin in which MI patients? | Suspected inferior wall MI with possible right ventricular involvement" - need adequate RV preload to avoid hypotension.Ref: Circulation 2005 ACLS supplement |
| Chemoprophylaxis for Neisseria meningitidis | cipro 500mg po x1, ceftriaxone 250mg IM x1 or rifampin 600mg po bid x 2 days |
| What is the starting dose for a labetalol continuous infusion? | 2mg/min. |
Created by:
mshue
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