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ALS Drugs
| Question | Answer |
|---|---|
| Naturally occurring substance that decreases conduction through the AV node | Adenosine (Adenocard) |
| PSVT refractory to vagal maneuvers | Adenosine (Adenocard) |
| 6 mg rapid IV; may repeat 12 mg in 1-2 min; may repeat third dose in 1-2 min Ped: 0.1 mg/kg IV (max 6 mg); may repeat at 0.2 mg/kg (max 12 mg); may repeat third dose of 0.2 mg/kg (max 12 mg) | Adenosine (Adenocard) |
| B2-agonist, bronchodilation | Albuterol (Proventil) |
| Bronchial asthma; anaphylaxis; wheezing | Albuterol (Proventil) |
| 2.5 mg in 3 mL NS nebulizer | Albuterol (Proventil) |
| Prolongs action potential duration in all cardiac tissues | Amiodarone (Pacerone) |
| Life-threatening VT/VF | Amiodarone (Pacerone) |
| VF/pulseless VT: 300 mg IV; may repeat at 150 mg in 5-10 min (max total dose of 450 mg) Peds: 5 mg/kg IV VT: 150 mg in D5W IV over 10 mins; may repeat 150 mg/D5W over 10 mins (max total dose of 450 mg) Peds: 5mg/kg in D5W over 20 min | Amiodarone (Pacerone) |
| Inhibits platelet function | Aspirin |
| Chest pain suggestive of AMI | Aspirin |
| 160-325 mg PO | Aspirin |
| Potent parasympathetic blocker | Atropine Sulfate |
| Bradycardia, asystole, organophosphate poisoning | Atropine Sulfate |
| Bradycardia: 0.5 mg IV; repeat every 3-5 min (max total 3 mg) Asystole: 1 mg IV; repeat every 3-5 min (max total dose 3 mg) Ped: 0.02 mg/kg IV; min dose 0.1 mg (max dose 0.5 if <6 yo or 1 mg if >6 yo) Organophosphate poisoning: 2-4 mg IV every 3-5 min | Atropine Sulfate |
| Supplies supplemental glucose | D50W |
| Hypoglycemia, coma of unknown origin | D50W |
| 25 g (50mL) IV Ped: dilute 1:1 to form D25W; 2 mL/kg (max dose of 1 mg/dose) | D50W |
| Sedation, suppresses seizure activity | Diazepam (Valium) |
| Major motor seizures, status epilepticus, premedication, anxiety/stress | Diazepam (Valium) |
| Seizures: 5-10 mg IV Anxiety: 2-5 mg IV | Diazepam (Valium) |
| Vasodilation, slows conduction through the AV node | Diltiazem (Cardizem) |
| Rapid ventricular dysrhythmias, PSVT refractory to adenosine | Diltiazem (Cardizem) |
| VT: 20 mg IV over 2 min PSVT: 0.25 mg/kg IV over 2 min | Diltiazem (Cardizem) |
| Blocks histamine receptors | Diphenhydramine (Benadryl) |
| Allergic reactions, anaphylaxis | Diphenhydramine (Benadryl) |
| 25-50 mg slow IV/deep IM Ped: 1 mg/kg IV/deep IM | Diphenhydramine (Benadryl) |
| Peripheral vasoconstriction | Dopamine (Intropin) |
| Hemodynamically significant hypotension not caused by hypovolemia | Dopamine (Intropin) |
| 400 mg in 250 mL D5W IV 2-5 ug/kg/min infusion; titrate to BP (max of 20 ug/kg/min) Use microdrip tubing and start at 15 gtt/min; titrate to maintain SBP 90-100 Ped: one drop/5 kg/min IV; titrate to SBP of 80 (<3 yo) or SBP 90-100 (>3 yo) | Dopamine (Intropin) |
| B2-agonist, bronchodilation | Epinephrine 1:1000 |
| Bronchial asthma, anaphylaxis, exacerbation of COPD | Epinephrine 1:1000 |
| 0.3 SQ; every 15 in Ped: 0.01 mg/kg SQ; every 15 min | Epinephrine 1:1000 |
| A and b-agonist, bronchodilation, increases HR, contractility, conduction, BP, automaticity, and vasodilation | Epinephrine 1:10,000 |
| Cardiac arrest (asystole, VF, pulseless VT, and PEA) | Epinephrine 1:10,000 |
| 1 mg IV; repeat every 3-5 min Ped: 0.01 mg/kg IV; repeat every 3-5 min | Epinephrine 1:10,000 |
| Venous dilation, diuretic | Furosemide (Lasix) |
| CHF, pulmonary edema | Furosemide (Lasix) |
| 20-40 mg slow IV; may need to repeat to 80-120 mg in severe cases | Furosemide (Lasix) |
| Causes breakdown of stored glycogen to glucose | Glucagon |
| Hypoglycemia, b-blocker overdose | Glucagon |
| 1 mg IM Ped: 0.03 mg/kg IM (max total 1 mg) | Glucagon |
| Suppresses depolarization and automaticity in the ventricles | Lidocaine (Xylocaine) |
| VT, VF, malignant PVCs | Lidocaine (Xylocaine) |
| 1.0-1.5 mg/kg IV; repeat every 3-5 min at 0.5-0.75 mg/kg (max total dose is 3.0 mg/kg) | Lidocaine (Xylocaine) |
| Calcium channel blocker and neuromuscular transmission blocker | Magnesium Sulfate |
| Severe refractory VF/pulseless VT; Torsades de Pointes | Magnesium Sulfate |
| VF/VT: 1-2 g diluted in 10 mL of D5W over 1-2 mins Torsades: 5-10 g diluted in 1- mL of D5W at 1 g/min | Magnesium Sulfate |
| CNS depressant, providing both analgesia and sedation | Meperidine (Demerol) |
| Moderate to severe pain | Meperidine (Demerol) |
| 25-50 mg IV; 50-100 mg IM | Meperidine (Demerol) |
| Causes sedation and amnesia, suppresses seizure activity | Midazolam (Versed) |
| Premedication before cardioversion and other painful procedures, seizures | Midazolam (Versed) |
| Premed: 2 mg slow IV Seizure: 0.05 mg/kg IV over 2 min (max dose 5 mg) Conscious Sed: 0.05 mg/kg IV (max total 3 doses or 10 mg) Ped: 01 mg/kg IV over 2 min (max dose 5 mg); 0.2 mg/kg IM (max dose 7 mg) | Midazolam (Versed) |
| Acts on opiate receptors in the brain; increases peripheral venous capacitance and decreases myocardial oxygen demand | Morphine Sulfate |
| Severe pain, pulmonary edema | Morphine Sulfate |
| 2-10 mg IV; repeat every 5-15 min as needed Ped: 0.1 mg/kg (max dose 5 mg); repeat every 15 min as needed | Morphine Sulfate |
| Competes for opiate receptors, reverses respiratory depression associated with narcotic overdose | Naloxone (Narcan) |
| Respiratory depression caused by narcotics, treatment of coma of unknown origin | Naloxone (Narcan) |
| 1-2 mg IV , may repeat in 5 min Ped: 0.1 mg/kg IV (max dose of 2 mg) | Naloxone (Narcan) |
| Dilates coronary arteries, reduces cardiac workload | Nitroglycerin |
| Chest pain associated with angina pectoris or AMI | Nitroglycerin |
| 0.4 mg (one spray or tablet) sublingually; may repeat to max 3 doses in 15 min | Nitroglycerin |
| Reduces automaticity of various pacemaker sites, slow intraventricular conduction | Procainamide (Pronestyl) |
| VF/VT refractory to amiodarone or Lidocaine | Procainamide (Pronestyl) |
| 20 mg/min until dysrhythmia suppressed, hypotension occurs, QRS widens by 50%, or total of 17 mg/kg has been given | Procainamide (Pronestyl) |
| Electrolyte that buffers metabolic acidosis | Sodium Bicarbonate |
| Tricyclic antidepressant overdose, severe acidosis refractory to hyperventilation, known hyperkalemia | Sodium Bicarbonate |
| 1 mEq/kg IV; repeat 0.5 mEq/kg every 10 min | Sodium Bicarbonate |
| Hypertonic solution; draws fluids into vascular system | Sodium chloride 3% (Hypertonic Saline) |
| Head or spine injury | Sodium chloride 3% (Hypertonic Saline) |
| 5 mL/kg over 30 if signs of elevated ICP | Sodium chloride 3% (Hypertonic Saline) |
| Immediate bronchodilation with minimal cardiac effects, suppression of premature labor | Terbutaline (Breathine) |
| Bronchial asthma, bronchospasm, premature labor | Terbutaline (Breathine) |
| 0.25-0.5 mg SQ; may repeat in 15-30 min | Terbutaline (Breathine) |
| Vitamin required for metabolism | Thiamine (Vitamin B1) |
| Coma of unknown origin, especially if alcohol is involved, delirium tremens | Thiamine (Vitamin B1) |
| 100 mg IV/IM | Thiamine (Vitamin B1) |
| Non-a-adrenergic vasoconstrictor through direct stimulation of smooth muscle receptors, alternative to epinephrine in cardiac arrest | Vasopressin (Pitressin) |
| Cardiac arrest (asystole, VF, pulseless VT, and PEA) | Vasopressin (Pitressin) |
| 40 units IV (single dose only) | Vasopressin (Pitressin) |
| Vasodilation and slows conduction through the AV node | Verapamil (Calan, Isoptin) |
| PSVT refractory to adenosine | Verapamil (Calan, Isoptin) |
| 2.5-5 mg IV over 2-3 min; may repeat at 5-10 mg in 15-30 min (max total dose of 30 mg in 30 min) | Verapamil (Calan, Isoptin) |
| Prevents nausea and vomiting by blocking serotonin peripherally in vagal nerve terminals and centrally in the CTZ | Zofran (Ondansetron) |
| Nausea and vomiting associated with disease processes or as a result of different medication administration | Zofran (Ondansetron) |
| 4 mg slow IV over 2-5 mins; may repeat every 4-6 hrs Ped: 0.15 mg/kg over 2-5 min every 4-6 hrs | Zofran (Ondansetron) |
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