Non-Cardiac drugs 119
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| show | Carbohydrate
Hypertonic Solution
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| show | Adult: 12.5-25 gm slow IV
Pediatric:
12 and up: D50 25 gm may repeat x1
1 month - 12 years: D25 2ml/kg. May repeat x1
<1 month: D10 5ml/kg
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6-carbon sugar that is principle form of carbohydrate in the body.
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Hypoclycemia
Altered LOC
Coma or seizure of unknown origin
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| Dextrose Precautions | show 🗑
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| show | Intracranial hemorrhage
Increased intracranial pressure
CVA in absence of hypoglycemia
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| Glucagon Class | show 🗑
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| Glucagon Route and Dose | show 🗑
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| show | When administered or released by pancreas, increases breakdown of glycogen to glucose. May be ineffective in chronic states of hypoglycemia.
Also has positive inotropic effect on heart.
Onset within 1 minute
Duration 60-90 minutes.
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Use caution with patients with cardiovascular disease.
Patients with kidney or liver dysfunction.
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| Glucagon Adverse Reactions | show 🗑
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| show | Hypersensitivity to proteins
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| Activated Charcoal Actions | show 🗑
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| show | Continuous duration, as long as it remains in the GI tract and has not become saturated with toxin.
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| Activated Charcoal How supplied | show 🗑
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| show | Ingestion of pills, capsules, and tablets.
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| show | NOT used for ingestion of liquids, corrosives, caustics, or petroleum products.
Patients with ALOC or the possibility of becoming altered.
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| show | Best if administered within 30 minutes of ingestion.
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| Activated Charcoal Dose | show 🗑
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| show | Opioid Antagonist
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| show | Competes for and replaces narcotic molecules in the brain.
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| Narcan (Naloxone) Onset and Duration | show 🗑
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| Narcan (Naloxone) Indications | show 🗑
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| Narcan (Naloxone) Contraindications | show 🗑
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| show | Use caution in narcotic dependent patients who may experience withdrawal.
May cause projectile vomiting and/or VT if given too rapidly.
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| show | .4mg-2mg IV/IM/IN/SQ
Normally .4mg titrated to respiratory rate
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| Diazepam (Valium) Class | show 🗑
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| Diazepam (Valium) Dose and Route | show 🗑
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| show | Central nervous system depressant
Amnesia
Sedation
Muscle relaxation
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| show | 1-5 minutes
Duration 2-4 hours
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| Diazepam (Valium) Indications | show 🗑
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| Diazepam (Valium) Precautions | show 🗑
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| Diazepam (Valium) Side effects | show 🗑
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| Diazepam (Valium) Contraindications | show 🗑
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| show | Romazicon (flumazenil) - Benzodiazepine antagonist
Duration of action 30-60 minutes
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| show | Antihistamine
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| show | Blocks the effects of histamine in the body related to allergic reactions.
Used in adjunctive therapy in anaphylaxis with epinephrine.
Used in the treatment of extrapyramidal (dystonic) reactions.
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| Benadryl Dose | show 🗑
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| show | Max effects in 1-3 hours
Duration is up to 6-12 hours after administration.
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| show | moderate to severe allergic reactions (after epi)
Anaphylaxis
Acute extrapyramidal (dystonic) reactions
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| Benadryl Drug interactions | show 🗑
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| show | Drowsiness
Hypotension
Palpitations
Tachycardia or bradycardia
overexcitement in children
disturbed coordination
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| Benadryl Contraindications | show 🗑
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| show | Phenothiazine and antihistamine with antiemetic, antimotion, and sedative effects.
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| show | SIVP over 1 minute
IM - deep into muscle
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| Promethazine HCL (Phenergan) Dose | show 🗑
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| Promethazine HCL (Phenergan) Action | show 🗑
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| Promethazine HCL (Phenergan) Indications | show 🗑
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| show | Monitor LOC
Avoid antra-arterial or subcutaneous administration. Give slowly in small boluses and flush well, can cause vein irritation, phlebitis, and sclerosis.
Watch for signs/symptoms of excessive sedation and dystonic reaction.
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| show | Marked drowsiness/sedation
Dystonic reaction
Tissue necrosis if IV infiltrates, or if not given deep IM
Dysrhythmias
In children can cause hallucinations, convulsions, and sudden death.
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| show | Hypersensitivity
Comatose states
CNS depression from alcohol, barbituates, or narcotics
Signs associated with Reye's syndrome
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| show | For dystonic reactions, administer diphenhydramine (Benadryl)
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| Ondansetron HCL (Zofran) Class | show 🗑
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| show | Slow IV Push (over 1 minute)
IM
IN
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| show | Adult: For nausea and or vomiting:
2mg IV Push given slowly (over 1 minute) with 10mL saline
Do not exceed 4mg cumulative
Pediatric: for nausea and/or vomiting: 0.1mg/Kg given slowly (over 1 minute)
Do not exceed 4mg cumulative
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| Ondansetron HCL (Zofran) Action | show 🗑
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| show | prevention of nausea and vomiting
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| show | Ondansetron does not work effectively in every patient.
Patients who fail to respond to a single IV dose often do not respond to additional doses.
If valium is used, do not use Zofran.
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| Ondansetron HCL (Zofran) Side effects | show 🗑
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| show | Hypersensitivity
Children under the age of 2 years
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| Methylprednisolone Sodium Succinate (Solu-Medrol) Class | show 🗑
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| show | SIVP (over 5 minutes)
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| show | Adult: 60-125mg IV push for anaphylaxis or airway emergencies; 30mg/kg IV over 15 minutes followed by a maintenance infusion for 23 hours.
Pediatric: 1-2 mg/kg/IV
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| Methylprednisolone Sodium Succinate (Solu-Medrol) Action | show 🗑
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| show | Controls symptoms, suppresses acute and chronic inflammation for asthma, COPD, allergies, but does not cure the underlying disease.
In asthma, increases the number of beta receptors and increases responsiveness to beta bronchodilators.
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| show | An adjunct to, but not a substitute for bronchodilators during:
wheezing associated with refractory asthma and status asthmaticus.
Wheezing associated with COPD
Allergic reactions/anaphylaxis
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| Methylprednisolone Sodium Succinate (Solu-Medrol) Precautions | show 🗑
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| show | Hypertension
Sodium and water retention
Headache
Hypokalemia
Alkalosis
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| Methylprednisolone Sodium Succinate (Solu-Medrol) Contraindications | show 🗑
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| Proparacaine HCL (Alcaine) Class | show 🗑
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| show | Dropped into the affected eye or eyes
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| Proparacaine HCL (Alcaine) Dose | show 🗑
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| Proparacaine HCL (Alcaine) Action | show 🗑
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| show | Burns to the eyes or corneal abrasions.
Patient comfort prior to irrigation of eyes exposed to chemicals such as pepper spray or mace.
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| show | Caution patient not to rub eye.
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| Proparacaine HCL (Alcaine) Side effects | show 🗑
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| Proparacaine HCL (Alcaine) Contraindications | show 🗑
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| Nitrous Oxide:Oxygen (50:50) (Nitronox) Class | show 🗑
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| Nitrous Oxide:Oxygen (50:50) (Nitronox) Route | show 🗑
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| show | Adult: Instruct patients to inhale deeply as they hold the mask.
Pediatric: Same as above.
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| Nitrous Oxide:Oxygen (50:50) (Nitronox) Action | show 🗑
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| show | Patients who are alert and complaining of pain caused by the following:
Musculoskeletal injuries/fractures
Kidney stones
Suspected AMI (if NTG or Morphine are ineffective or contraindicated)
Active labor during an uncomplicated delivery.
Thermal burn
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| show | Must be self administered
Check machine gauges daily for proper concentrations.
Monitor blood pressure and pulse oximetry values.
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| Nitrous Oxide:Oxygen (50:50) (Nitronox) Side effects | show 🗑
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| Nitrous Oxide:Oxygen (50:50) (Nitronox) Contraindications | show 🗑
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| Furosemide (Lasix) Class | show 🗑
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| Furosemide (Lasix) Action | show 🗑
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| Furosemide (Lasix) Onset and Duration | show 🗑
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| show | Pulmonary edema
Renal disease
Hyperkalemia
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| show | Dehydration
Hypovolemia
Pregnancy
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| show | Hypotension
Electrolyte imbalance
Ototoxicity
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| Furosemide (Lasix) Drug interactions | show 🗑
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| show | 10mg/mL
2,4,8,10mL
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| show | 20-40mg SIVP
(20mg/min)
Double the usual daily single dose
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| Ipratropium Bromide (Atrovent) Class | show 🗑
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| show | Inhalation (nebulized)
ETT (alternate route)
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| Ipratropium Bromide (Atrovent) Dose | show 🗑
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| Ipratropium Bromide (Atrovent) Action | show 🗑
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| Ipratropium Bromide (Atrovent) Indications | show 🗑
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| Ipratropium Bromide (Atrovent) Precautions | show 🗑
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| show | Dry mouth
Cough, worsening of symptoms
skin rash
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| show | Sensitivity to soy lecithin products (soybeans, peanuts)
Sensitivity to Atropine
Bronchoconstriction that is caused by allergic reaction.
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| Albuterol (Ventolin, Proventil) Class | show 🗑
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| Albuterol (Ventolin, Proventil) Route | show 🗑
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| Albuterol (Ventolin, Proventil) Supplied | show 🗑
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| show | Nebulizer: 2.5mg over 5-15minutes 2-15 Liters per minute - preferably 8 lpm.
Pediatric: same as adult
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| Albuterol (Ventolin, Proventil) Action | show 🗑
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| Albuterol (Ventolin, Proventil) Indications | show 🗑
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| show | Known heart disease
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| show | Restlessness
Hypertension
Tachycardia - palpations
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| Albuterol (Ventolin, Proventil) Contraindications | show 🗑
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| Midazolam (Versed) Class | show 🗑
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| Midazolam (Versed) Midazolam (Versed) Actions | show 🗑
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| show | Active seizure/status epilepticus
Procedural sedation
Chest pain or tachy following an overdose or ingestion of a stimulant or hallucinogen (cocaine, amphetamine, extacy, LSD, PCP, ketamine)
Sedation in struggling patients when med restraints applied.
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| show | Adult: Sedation, combative pts, CP from SNS.
Seizures: 1-2.5mg titrated up to 10mg SLOW IV/IO/IN push.
PAI: 0.1mg/kg IV/IO to achieve effect with max dose 5.0mg.
Pediatric: 0.5mg/mg rectal up to 10mg or 0.1mg/kg IN up to 10mg or 0.1mg/kg IV
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| Midazolam (Versed) Action | show 🗑
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| show | Onset: 1-3 minutes
Duration: 15 minutes to 6 hours (dose dependent)
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| show | Titrate in small doses to avoid side effects
Monitor respiratory status closely
Monitor B/P closely
Administer at site closest to IV catheter, flush well before and after.
Do not mix with other drugs or solutions.
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| Midazolam (Versed) Side effects | show 🗑
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| Midazolam (Versed) Contraindications | show 🗑
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| show | Romazicon (flumazenil) benzodiazepine antagonist
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