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509 drug protocols
als drugs
| Question | Answer |
|---|---|
| ADENOCARD (adenosine) therapeutic effects | slow conduction through the AV node and can interrupt re-entry pathways through the AV node |
| ADENOCARD (adenosine) indications | conversion to sinus rhythm of PSVT excluding known WPW syndrome |
| ADENOCARD (adenosine) contraindications | 2nd or 3rd degree AV block, sick sinus syndrome, or hypersensitivity to the drug |
| ADENOCARD (adenosine) precautions/side effects | may exacerbate asthma, hypotension, facial flushing, dyspnea, light headedness, nausea |
| ADENOCARD (adenosine) adult dosage | rapid IV bolus 6 mg, 2nd dose of 12mg after 2 min rapid IV infusion, large antecubital vein form admin |
| ADENOCARD (adenosine) pediatric dosage | rapid IV bolus 0.1mg/kg. 2nd dose 0.2mg/kg after 2 min rapid IV infusion. Large antecubital vein for admin |
| AMIODARONE therapeutic effects | prolongs myocardial cell action and potential duration, refactory period, noncompetitively inhibits alpha and beta adrenergic stimulation |
| AMIODARONE indications | recurrent vfib or recurrent pvtach, recurrent hemodynamically unstable vtach, stable vtach in consultation with on line med control |
| AMIODARONE contraindications | hypersensitivity to drug or any of its components, 2nd or 3rd degree av block |
| AMIODARONE precautions/side effects | may prolong qt interval, use with caution if renal failure present, vasodilation and hypotension, negative inotropic effect |
| AMIODARONE adult dosage | rec vfib, pvtach=300mg diluted 20 ml ns ivp, repeat 150mg diluted 10 ml ns ivp in 3-5 min, repeaat every 10 min as needed total dose of 2.2 grams. hemodynamically unstable vtach=150mg in 10ml ns iv over 10 min. stable vtach=150mg 10ml ns 1v over 10 min |
| AMIODARONE peds dosage | rec vfib/pvtach=5mg/kg ivp diluted with 4ml of ns for every 50mg amiodarone, repeat 5mg/kg ivp in3-5 min total dose of 15mg/kg iv. |
| AMIODARONE peds dosage continued | Hemodynamically unstable vtach=5mg/kg in 4ml ns every 50 mg amiodarone, repeat 5mg/kg every ten min total dose of 15mg/kg. stable vtach= 5mg/kg iv in 4ml ns every 50mg amiodarone |
| ATIVAN (lorazepam) therapeutic effects | anticonvulsant |
| ATIVAN (lorazepam) indications | major motor seizures, status epilepticus |
| ATIVAN (lorazepam) contraindications | hypersensitivity, acute narrow angle glaucoma, hypotension, and respiratory failure |
| ATIVAN (lorazepam) precautions/ side effects | respiratory depression, hypotension, sedatioin, nausea, and vomiting |
| ATIVAN (lorazepam) adult dosage | dilute 1:1 = volume ns iv. im(dont dilute) or io 1.0-2.0 mg slowly, repeat 3-5 min total dose of 4.0mg |
| ATIVAN (lorazepam) peds dosage | dilute 1:1 = volume ns iv, im(dont dilute) or io or pr 0.1mg/kg q 3 min max dose of 2.0mg |
| BENADRYL (diphenhydramine) therapeutic effects | inhibits release of histamine, reducing bronchoconstriction and vasodilation |
| BENADRYL (diphenhydramine) indications | anaphylaxis, allergic reaction, uticaria |
| BENADRYL (diphenhydramine) contraindications | lower resp. distress, hypersensitivity |
| BENADRYL (diphenhydramine) precautions/side effects | may induce hypotension, headache, palpitations, tachycardia, sedation, drowsiness, disturbed coordination |
| BENADRYL (diphenhydramine) adult dosage | iv or im 50mg |
| BENADRYL (diphenhydramine) peds dosage | iv or im 1.0mg/kg to max dose of 50mg |
| CALCIUM GLUCONATE therapeutic effects | Essential for transmission of nerve impulses that initiate the contraction of cardiac muscle. |
| CALCIUM GLUCONATE indications | Hyperkalemia associated w/ bradycardiaor unstable cardiac arrhythmia. Calcium channel blocker overdose associated w/ bradycardia and hypotension of unstable arrhythmia. Crush injury symdrome |
| CALCIUM GLUCONATE contraindications | should not be used during resuscitation efforts unless hyperkalemia, hypocalcemia, or calcium channel blocker toxicity is suspected. |
| CALCIUM GLUCONATE precautions | Use w/ caution in patients known to take digoxin. Use large secure vein, SQ infiltration can cause tissue necrosis, flush the line before and after use. |
| CALCIUM GLUCONATE adult dosage | IV/IO 10% Calcium Gluconate 20 mL slowly over 1-2 min. onset of action is 1-3 seconds and duration of action is 30-50 min. |
| DOPAMINE (intropin) therapeutic effects | Beta agonist. MAintains renal and mesenteric blood flow while inducing vasoconstriction and increasing blood pressure. |
| DOPAMINE (intropin) indications | cardiogenic shock, hypotension not secondary to hypovolemia. |
| DOPAMINE (intropin) contraindications | hypotension due to hypovolemia w/o aggressive fluid resuscitation. |
| DOPAMINE (intropin) precautions/side effects | Tachydysrhythmias and v-fib or irritability. May be deactivated by alkaline solutions. Reduce dosage if pt is on monoamine oxidase inhibitors (anti-depressant). Blood pressure should be constantly monitored. |
| DOPAMINE (intropin) adult dosage | Mix 400 mg/ 250 ml of D5W (1600 mcg/mL) and indicate IV infusion at 5.0 mcg/kg/min., titrating to blood pressure. |
| DOPAMINE (intropin) peds dosage | same as adult dosage |
| ATROPINE therapeutic effects | Blocks parasympathetic nervous system and its inhibiting effects on heart rate. It does not increase the strength of cardiac contraction. |
| ATROPINE indications | Bradycardia w/ hypotension or escape beats, Asystole, PEA, Nerve agent or organophosphate poisoning, Prior to use os succinylcholine for intubation in childeren. |
| ATROPINE contraindications | None in the emergency setting |
| ATROPINE adult dosage | Bradycardia w/ hypotensioin: IV/IO 0.5 mg q 3-5min, up to total of 0.04mg/kg or 3 mg. Asystole, PEA: IV/IO mg q 3-5min up to total of 0.04 mg/kg or 3 mg. Nerve agent or organophosphate poisoning: MDV or MARK 1 kits, 1-3 doses of atropine(2-6mg). |
| ATROPINE peds dosage | Bradycardia w/ hypotension: IV/IO 0.02mg/kg. repeat once if needed. Asystole, PEA: IV/IO 0.02mg/kg, may repeat in 5 min to max dose of 1.0mg, max is 1.0mg. |
| ATROPINE peds dosage | Nerve agent or organophosphate poisoning: infant:0.05-0.1mg/kg IM/IV/IO, peds atropen or MDV. Child: 1-4mg IM/IV/IO peds atropen, MDV or MARK 1. Prior to use of succinylcholine for intubation: 0.02 mg/kg up to max of 0.5 mg. |
| EPINEPHRINE-ADULT (adrenalin) therapeutic effects | A potent alpha and beta stimulant which is diluted in 1.0 mL(1:1,000) or 1.0 mg in 10.0 mL(1:10,000) of saline. It increases the electrical activity of the heart through its beta activities. |
| EPINEPHRINE-ADULT (adrenalin) indications | V-fib, pulseless v-tach, asystole, PEA, asthma, anaphylaxis (moderate and severe) |
| EPINEPHRINE-ADULT (adrenalin) precautions/side effects | Should be protected from light. Do not infuse with alkaline solutions such as sodium bicarbonate, it will deactivate epinephrine. Drug's actions are of short duration. |
| EPINEPHRINE-ADULT (adrenalin) adult dosage | asystole, PEA, v-fib, pvtach: IV/IO 1:1,000, 1.0 mg q 3-5min as needed. asthma, moderate anaphylaxis: IM 1:1,000 0.01 mg/kg up to 0.5 mg q 5min as needed. Severe anaphylaxis: IV/IO 1:10,000, 0.01 mg/kg slowly up to 0.5 mg q 5 min as needed. |
| EPINEPHRINE-ADULT (adrenalin) adult dosage continued... | Severe anaphylaxis: IM or SL 1:1,000, 0.01 mg/kg up to 0.5 mg q 5 min as needed |
| EPINEPHRINE-PEDS (adrenalin) therapeutic effects | A potent alpha and beta stimulant which is diluted in 1.0 mL(1:1,000) or 1.0 mg in 10.0 mL(1:10,000) of saline. It increases the electrical activity of the heart through its beta activities. |
| EPINEPHRINE-PEDS (adrenalin) indications | BRadycardia, v-fib, asystole, PEA, asthma, anaphylaxis (moderate and severe) |
| EPINEPHRINE-PEDS (adrenalin) precautions/ side effects | Should be protected from light. Do not infuse with alkaline solutions such as sodium bicarbonate, it will deactivate epinephrine. Drug's actions are of short duration. |
| EPINEPHRINE-PEDS (adrenalin) pediatric dosage | Bradycardia, vfib, asystole, PEA, severe anaphylaxis: IV or IO (1:10,000), 0.01 mg/kg q 3-5min. ET: (1:1,000), 0.1 mg/kg diluted in 3 ml NS q 3-5min. |
| EPINEPHRINE-PEDS (adrenalin) pediatric dosage coninued | Asthma and moderate anaphylaxis: SQ or SL (1:1,000), 0.1 mg/kg up to 0.5 mg |
| ETOMIDATE therapeutic effects | a short acting sedative hypnotic that has GABA effects. Reduces subcortical inhibition at the onset of hypnosis while inducing neocortical sleep. Minimal cardiovascular and respiratory depressant. No analgesic action. |
| ETOMIDATE duration action | Dose dependent, but usually 3-5 min with an average dose 0.3mg/kg , may be prolonged by a sedative premedication or a repeat dose. |
| ETOMIDATE indications | To induce sedation prior to endotracheal intubation particularly to patients at risk for hypotension. Sedation for emergent cardioversion for patients with BP<90. |
| ETOMIDATE contraindications | sensitivity to drug. safety and efficacy have not been determined for childeren <10 years of age |
| ETOMIDATE precautions/ side effects | May depress respirations. nausea and vomiting, myoclonus may occur. May cause adrenal suppression when used on patients with septic shock. Other sedative agents should be considered in this situation. |
| ETOMIDATE adult dosage | induce sedation prior to et intubation: 0.3 mg/kg IV/IO over 30-60 sec. Sedation for cardioversion w/ BP<90: 0.1mg/kg IV/IO over 30-60 sec |
| ETOMIDATE peds dosage | induce sedation prior to et intubation: childeren 10 years and older 0.3 mg/kg IV/IO over 30-60 sec. Sedation for cardioversion w/ BP<90: chideren 10 years and older 0.1mg/kg IV/IO over 30-60 sec |
| FENTANYL therapeutic effects | a potent analgesic |
| FENTANYL indications | severe pain including cardiac chest pain, burns, extremities, chest and abdominal injuries, abdominal pain |
| FENTANYL contraindications | should not be given on patients in altered mental status, hypersensitivity to the drug, hypotension, volume depletion, or respiratory depression |
| FENTANYL precautions/side effects | may cause respiratory depressioin, use narcan to counteract, do not use if systolic BP<90 or Sp02 <90% |
| FENTANYL adult dosage | 0.5-1 mcg/kg IV/IO/IM. Dose may be repeated in 10 min and should be titrated to relieve pain up to a total dosage of 3mcg/kg |
| FENTANYL peds dosage | use for childeren over the age of two. 0.5-1mcg/kg IV/IO/IM. dose may be repeated in 10 min and should be titrated to relieve pain up to a total dose of 3 mcg/kg |
| GLUCAGON therapeutic effects | Converts liver glycogen to glucose. Also produces relaxation of smooth muscle of stomach, duodenum, small bowel and colon. |
| GLUCAGON indications | Hypoglycemia |
| GLUCAGON contraindications | pheochromocytoma (vascular tumor of adrenal gland) or hypersensitivity to drug. |
| GLUCAGON precautions/side effects | occasional nausea and vomiting |
| GLUCAGON adult dosage | IM or SQ 1mg if blood glucose <60 and unable to establish an IV |
| GLUCAGON peds dosage | IM or SQ, 0.05 mg/kg up to 1.0mg if blood glucose <60 mg and unable to establish an IV. |
Created by:
cuik89
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