Medications
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| Etomidate class | hypnotic, anesthesia induction
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| Etomidate or | Amidate
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| Etomidate action | Effects seem to be similar to GABA
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| Etomidate indications | Rapid Sequence Intubation sedation,pharacological assisted intubation, Induction of anesthesia
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| Etomidate Adverse Effects | May cause hypotension, respiratory depression, pain at the site of injection, temporary involuntary muscle movements, and frequent nausea/vomiting on emergence, adrenal insufficiency, hyperventilation, apnea of short duration, laryngospasm, snoring.
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| Etomidate Contraindications | Known sensitivity, use in pregnancy if the potential benefits justify the potential risks of the fetus, and labor/delivery.
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| Etomidate Dosage: Adult: | 0.2-0.6mg/kg IV, IO (over 30-60 seconds) a typical intubation dose is 20mg slow IV, consider less (e.g. 10mg) in elderly or patients with cardiac conditions.
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| Etomidate Dosage: Pedi: | >10 years, same as adult, <10 years, safety has not been established.
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| Etomidate Special Considerations | Personnel and equipment must be present to manage the patient's airway before administration, pregnancy class C.
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| Midazolam | Versed
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| Midazolam Class | Benzodiazepine schedule C-IV
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| Midazolam Action | Binds to benzodiazepine and enhances the effects of the brain chemical, GABA. Benzodiazepines act at the level of the limbic, thalamic, and hypothalamic regions of the CNS-provides short CNS depression (including sedation, skeletal muscle rela
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| Midazolam Indications | Sedation, anxiety, skeletal muscle relaxation.
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| Midazolam Adverse Effects | Respiratory depression, respiratory arrest, hypotension, nausea/vomiting, headache, hiccups, cardiac arrest.
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| Midazolam Contraindications | Acute narrow angle glaucoma, pregnancy, known sensitivity.
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| Midazolam Dosage Sedation: Adult: Healthy and < 60 years | 1mg IV, IO. No more than 2mg should be given over a 2 minute interval. (Max dose 5mg).
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| Midazolam Dosage Sedation: Adult: >60 years, or debilitated or chronically ill: | 1mg IV, IO and no more than 1.5mg given over a 2 minute period. Additional should be given at a rate of no more than 1mg oer a 2 minute period. (Max dose 3.5mg).
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| Midazolam Dosage Pedi: 12-16 years | Same as adult.
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| Midazolam Dosage Pedi: 6-12 years: | 0.025-0.05mg/kg IV, IO up to a total of .4mg/kg. Exceeding 10mg total dose usually not necessary.
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| Midazolam Dosage Pedi: 6mos-5 years: | 0.05-0.1mg/kg IV, IO up to a total dose of 0.5mg/kg. Exceeding 6mg as a total dose usually not necessary.
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| Midazolam Dosage Pedi: <6 mos | Because this age group is especially vulnerable to airway obstruction and hypoentilation, use small incriments with frequent clinical evaluation. Dose: 0.05-0.1mg/kg IV, IO.
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| Midazolam Special Considerations | Frequent monitoring of vital signs and pulsoximetry. Be prepared to support the patient's airway and ventilation. Pregnancy class D.
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| Succinylcholine also known as | Anectine
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| Succinylcholine Class | Neuromuscular blocker, depolarizing
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| Succinylcholine Action | It competes with acetylcholine receptor of the motor end plate on the muscle cell, resulting in muscle paralysis.
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| Succinylcholine Adverse Effects | Anaphylactic reactions, respiratory depression, apnea, bronchospasm, cardiac arrhythmias, malignant hyperthermia, hypertension, muscle fasciculation, post procedure m uscle pain, hypersalivation, rash.
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| Succinylcholine Contraindications | Malignant hyperthermia, burns, trauma. Caution in children, cardiac, hepatic, renal, and peptic ulcer disease, cholinesterase-inhibitor tox., pseudocholinesterase dfncy, digitalis tox., glaucoma, hyperkalemia, hypothermia, rhabdomyolysis, myathenia gravis
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| Succinylcholine Dosage: Adult: IV: | 0.6mg/kg IV, IO (range 0.3-1.1mg/kg).
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| Succinylcholine Dosage: Adult: IM: | 3-4mg/kg (max dose 150mg).
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| Succinylcholine Dosage: Pedi: IV: Adolescent and older children: | 1mg/kg IV, IO
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| Succinylcholine Dosage: Pedi: IV: Small children and infants: | 2mg/kg IV, IO
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| Succinylcholine Dosage: IM: | 3-4mg/kg (max dose 150mg).
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| Succinylcholine Special Considerations: IV administeration: | Results in neuromuscular blockade in 0.5-1 minute.
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| Succinylcholine Special Considerations:IM administeration: | Results in neuromuscular blockade in 2-3 minutes.
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| Succinylcholine Special Considerations: IV administeration in infants and children: | Can potentially result in profound bradycardia, and in shome cases, asytole. The incidents of bradycardia are greater after the 2nd dose. Occurrence of bradycardia can be reduced w ith pretreatment of Atropine.
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| Succinylcholine Special Considerations | Can have a s ignificant prolonged effect in the setting of poisoning with nerve gas agents organophosphate pesticides. Pregnancy class C.
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| Vecuronium also known as | Norcuron
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| Vecuronium Class | Neuromuscular blocker, non-depolarizing
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| Vecuronium Action | It antagonizes acetylch9oline at the motor end plate, producing skeletal muscle paralysis.
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| Vecuronium Indications | To induce meuromuscular blockade for facilitation of ET intubation.
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| Vecuronium Adverse Effects | Muscle paralysis, apnea, dyspnea, res piratory depression, sinus tachycardia, urticaria.
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| Vecuronium Contraindications | Known sensitivity to bromides. Caution with heart disease and liver disease.
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| Vecuronium Dosage: Adult: | 0.08-0.1mg/kg IV< IO.
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| Vecuronium Dosage: Pedi: | Dosage is individualized.
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| Vecuronium Special Considerations | Pregnancy class C
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| How do you spell the other name of Vecuronium? | Norcuron
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| How do you spell the other n ame of Norcuron? | Vecuronium
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| Calcium Chloride/Gluconate Class | Electrolyte solution
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| Calcium Chloride/Gluconante Action | Counteracts the toxicity of a hyperkalemia patient by stabilizing the me mbranes of the cardiac cells, reducing the likelihood of fibrillation.
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| Calcium ChlorideGluconate Indications | Hyperkalemia, hypocalcemia, hypomagnesemia.
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| Calcium Chloride/Gluconate Adverse Effects | Soft tissue necrosis, hypotension, bradycardia (if administered too rapidly).
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| Calcium Chloride/Gluconate Contraindications | VI, Digitalis toxicity, hypercalcemia.
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| Calcium Chloride/Gluconaate Recommended Dose: | Supplied as a 10% solution; therefore, each ml contains 100mg of Calcium Gluconate
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| Calcium Chloride/Gluconate Dosage: Adult: | 500-1000mg IV, IO administered slowly at a rate of a pprox 1-1.5ml/minute. (Max dose 3g IV, IO).
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| Calcium Chloride/Gluconate Dosage: Pedi: | 60-100mg/kg IV, IO slowly over a 5-10 minute period. (Max dose 3g IV, IO).
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| Calcium Chloride/Gluconate Special Considerations | Do not administer by IM or subQ routes w hich causes significant tissue necrosis. Pregnancy class C.
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| Pancuronium, also known as | Pavulon
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| How do you spell the other name for Pancuronium? | Pavulon
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| How do you spell the other name f or Pavulon? | Pancuronium
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| Pancuronium Class | Non-depolarizing neuromuscular blocker
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| Pancuronium Action | Antagonized acetycholine at the motor end plate, producing skeletal muscle paralysis.
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| Pancuronium Indications | To induce neuromuscular blockage for the facilitation of ET intubation.
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| Pancuronium Adverse Effects | Muscle paralysis, a pnea, dyspnea, respiratory depression, cutaneous flushing, sinus tachycardia.
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| Pancuronium Dosage: Adult: | 0.04-0.1mg/kg IV, IO; repeat dosing is 0.01 mg/kg every 25-60 minutes.
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| Pancuronium Dosage: Pedi: | Same as adult dosing.
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| Pancuronium Special Considerations | Pregnancy class C.
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| Magnesium Sulfate, also known as | MgS04
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| How do you spell the other name for MgS04? | Magnesium Sulfate
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| Magnesium Sulfate Class | Electrolyte, tocolytic, mineral
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| Magnesium Sulfate Action | Required for normal physio function. MgS04 is a cofactor in n eurochemical transmission and muscular excitability. Controls s eizures by blocking peripheral neuromuscular transmission. Also a peripheral vasodialator and inhibitor of platelet function.
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| Magnesium Sulfate Indications | Torsades de Pointes, cardiac arrhythmias associated with hypomagnesemia, eclampsia, and seizure prophylaxis in preeclampsia, status asthmaticus.
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| Magnesium Sulfate Adverse Effects | Magnesium toxicity (signs include flushing, diaphoresis, hypotension, muscle paralysis, weakness, h ypothermia,and cardiac,, CNS or respiratory depression).
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| Magnesium Sulfate Contraindications | AV block, GI obstruction. Use with caution in renal impairment.
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| MgS04 Dosage: Ventricular fibrillation/pulsel4ess ventricular tachycardia with Torsades de Pointes or hypomagnesemia: Adult: | 1-2g in 10ml D5W IV, IO administered over 5-10 minutes.
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| Magnesium Sulfate Dosage: Ventricular fibrillation/pulseless ventricular tachycardia with Torsades de Paontes or hypomagnesemia: Pedi: | 25-50mg/kg IV, IO over 10-20 minutes. May administer faster for Torsades de Pointes (max single dose 2g).
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| Magnesium Sulfate Dosage: Torsades de Pointes witha pulse or chardiac arrhythmias w ith h ypomagnesemia: Adult: | 1-2g in 50-100ml D5W IV, IO administered over 5-60 minutes. Follow with 0.5-1g/hr IV, IO titrated to control Torsades de Pointes.
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| Magnesium Sulfate Dosage: Torsades de Pointes w ith a pulse or cardiac arrhythmias with hypomagnesemia: Pedi: | 25-50mg/kg IV, IO over 10-20 minutes (max single dose 2g).
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| Magnesium Sulfate Dosage: Eclampsia and seizure prophylaxis in preeclampsia: Adult: | 4-6g IV, IO over 20-3- minutes, followeeed by infusion of 1-2g/hr.
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| Magnesium Sulfate Dosage: Status asthmaticus: Adult: | 1.2-2g slow IV, IO (over 20 minutes).
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| Magnesium Sulfate Dosage: Status asthmatius: Pedi: | 25-50mg/kg (diluted in D5W) slow IV, IO (over 10-20 minutes).
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| Magnesium Sulfate Special Considerations | Pregnancy class A
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| Terbutaline Sulfate, also known as | Brethine
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| How do you spell the other name for Terbutaline Sulfate? | Brethine
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| How do you spell the ot her name for Brethine? | Terbutaline Sulfate
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| Terbutaline Sulfate Class | Adrenergenic agonist
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| Terbutaline Sulfate Action | Stimulates the beta 2 receptor, producing relaxation of bronchial smooth muscle and bronchodialation.
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| Terbutaline Sulfate Indications | Prevention and reversal of bronchospasm.
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| Terbutaline Sulfate Adverse Effects | Cardiac arrhythmias, arrhythmia exacerbation, angina, anxiety, headache, tremor, palpitations, dizziness.
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| Terbutaline Sulfate Contraindications | KNown sensitivity to sympathomimetics. Use caution in hypertension, cardiac disease, cardiac arrhythmias, diabetes, elderly, MAOI therapy, phenochromocytoma, thyrotoxicosis, seizure disorders.
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| Terbutaline Sulfate Dosage: Adult: | 0.25mg subQ every 20 minutes for 3 doses. The usual site for subQ injections is the lateral deltoid.
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| Terbutaline Sulfate Dosage: Pedi: | 0.01mg/kg subQ every 20 minutes for 3 doses.
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| Terbutaline Sulfate Special Considerations | Pregnancy class B
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