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  1. Activated charcoal actidose class
  2. Activated charcoal actidose action
    adsorbs toxins by chemical binding and prevents gastrointestinal adsorption
  3. Activated charcoal actidose onset
  4. Activated charcoal actidose use
    poisoning following emesis or when emesis is a contrain
  5. Activated charcoal actidose side effect
    dehydration, abdominal cramps, black stool, constipation, nausea, vomiting
  6. Activated charcoal actidose contraindications
    altered mentation (unless given by naso or oro gastric tube) corrosive, caustic or petroleum distillates
  7. Activated charcoal actidose adult does
  8. Activated charcoal actidose pedi dose
  9. Activated charcoal actidose route
    po or slowly by gastric tube
  10. 0.9% sodium chloride NS classs
    isotonic crystalloid solution
  11. 0.9% sodium chloride NS action
    • 1. replaces sodium chloride and water
    • 2.increases circulating volume
  12. 0.9% sodium chloride NS use
    • 1. hypovolemia
    • 2. heat related
    • 3.freshwater drowning
    • 4. diabetic ketoacidosis
  13. 0.9% sodium chloride NS side effects
    cardiovascular- chf pulmonary edema
  14. 0.9% sodium chloride NS contraindications
    absolute- none in life threating emergencies. Relative- chf pulmonary edema renal impairment
  15. 0.9% sodium chloride NS preparations
    250ml 500ml 1L bag
  16. 0.9% sodium chloride NS adult dose
    titrate to effect
  17. 0.9% sodium chloride NS pedi dose
    titrate to effect
  18. 0.9% sodium chloride NS route
    iv infusion
  19. Dextrose 5% in water D5W class
    hypotonic dextrose - containing solution
  20. Dextrose 5% in water D5W action
    provides nutrients in the form of dextrose as well as free water.
  21. Dextrose 5% in water D5W use
    • 1. diluent and vehicle for reconsitttion injection or infusion of most drugs
    • 2. iv access for emergency drugs
  22. Dextrose 5% in water D5W side effects
    cardiovascular- hyponatremia
  23. Dextrose 5% in water D5W contraindications
    absolute- do not use as a mainline for colloid solutions
  24. Dextrose 5% in water D5W preparations
    50ml, 100ml, 250ml, 1L bag
  25. Dextrose 5% in water D5W adult dose
    titrate to effect usually tko
  26. Dextrose 5% in water D5W pedi dose
    titrate to effect
  27. Dextrose 5% in water D5W route
    iv infusion
  28. Diphenhydramine hydrochoride Benadryl class
  29. Diphenhydramine Benadryl action
    • 1. competes for h1 receptors on effector cells thus blocking effects of histamine release.
    • 2. effects in parkinsonism and drug induced extrapyramidal symptoms are apparently related to its ability and to prolong action of dopamine by inhibiting its reuptake and storage.
  30. Diphenhydramine Benadryl use
    • 1. allergic reaction
    • 2.anaphylaxis in conjunction w/ epi
    • 3. phenothiazine reaction
  31. Diphenhydramine Benadryl contraindications
    acute asyhma, cns depression pt. taking MAO inhibitors
  32. Diphenhydramine Benadryl side effect
    • CNS- blurred vision, drowsiness, dizziness, fever, hallucinations, headache, paradoxical excitement in children, seizures
    • CARDIOVASCULAR- change in t waves, hypotension, palpitations, shortened diastole which may cause reflex tachycardia
    • RESPIRATORY- thickening of brochial secreation, tightness in chest, wheezing
    • GASTROINTESTINAL- amorexia, dry mouth, diarrhea, nausea vomiting, anaphylaxis, urinary retention
  33. Diphenhydramine Benadryl preparations
    50mg/ml ampule preload
  34. Diphenhydramine Benadryl adult dose
    25-50mg sivp repeat every 4-6hr p.r.n
  35. Diphenhydramine Benadryl pedi dose
    2-5mg/kg sivp repeat every 4-6hr p.r.n max single dose 50mg
  36. Diphenhydramine Benadryl route
    ivp, deep im
  37. Dextrose 50% class
    carbohydrate hypertonic solution
  38. Dextrose 50% action
    elevates blood glucose levels rapidlty
  39. Dextrose 50% use
    • 1. hypoglycemia
    • 2. coma of unknown origin
  40. Dextrose 50% containdications
    intercranial hemorrhage, increased intracranial pressure, known or suspected CVA in the absence of hypoglycemia
  41. Dextrose 50% side effect
    warmth, pain burning from medication infusion, thrombophlebitis
  42. Dextrose 50% preparations
    • 25g/50ml prefilled syring
    • 500mg/ml
  43. Dextrose 50% adult dose
  44. Dextrose 50% pedi dose
    0.5-1grams/kg slow iv
  45. Dextrose 50% route
  46. Amiodarone Cordarone class
  47. Amiodarone Cordarone action
    prolongs myocardial cell action protential duration and refractory period by direct action on all cardic tissue
  48. Amiodarone Cordarone use
    • 1. v-fib or pulseless v-tach
    • 2.wide complex tachycardia
    • 3. SVT refractory to other treatment
  49. Amiodarone Cordarone contraindications
    high degree av blocks, sinus node dysfunction and marked
  50. Amiodarone Cordarone side effects
    • CNS- parathesias, tremors, ataxia. headache
    • CARDIOVASCULAR- symptomatic bradycardia, heart blocks, hypotension, CHF exacerbation
    • GASTRO- nausea, vomiting, constipation
  51. Amiodarone Cordarone drug interaction
    decreased heart rate when used w/ beta vlockers and or calcium channel blockers.
  52. Amiodarone Cordarone preparations
    • 1mg/ml ampule
    • 5mg/ml ampule
  53. Amiodarone Cordarone adult does
    • 1. IV-VF/VT 300mg IV/IO in 20-30 ml NS. can follow w/ one dose of 150mg in 3-5 mins if needed
    • 2. 150mg over 10 mins for wide complex tachycardia
  54. Amiodarone Cordarone pedi dose
  55. Amiodarone Cordarone route
    IV, IO
  56. Atropine Sulfate class
    parasympatholytic, vagolytic, anticholinergic
  57. Atropine Sulfate action
    • 1. atropine is a potent parasympatholytic
    • 2. It inhibits actions of acetylcholine at postglionic parasympathetic neuroeffectors sites primarily at muscarinic receptors.
    • 3. samll does inhibit salivary and bronchial secretions, moderate doeses dilate pupils and increases heart rate. Large does decrease GI motility inhibit gastric acid secretion.
    • 4. Blocked vagal effects result in positive chronotropy and positive dromotropy
  58. Atropine Sulfate use
    • 1. hemodynamically significant bradycardias or heart block.
    • 2. asystole
    • 3. PEA under 60 bpm
    • 4. Organophosphate poisoning
    • 5. pretreatment in pediatric pt. receiving RSI
  59. Atropine Sulfate Side effects
    • CNS- Blurred vision, diaphoresis, dilated pupils, headache
    • CARDIO - Hypotensin, PVC, chest pain
    • OTHER - Dry mouth, nausea, flushed hot and dr skin, urinary retention, vomiting
  60. Atropine Sulfate Contraindication
  61. Atropine Sulfate preparations
    • 1mg/10ml preload
    • 0.5mg/5ml preload
    • 1mg/ml ampule
  62. Atropine Sulfate adult dose
    • bradycardia: 0.5mg IVP/IO repeat every 3-5 mins max dose 0.04mg/kg
    • Asystole/Pea: 1mg IVP/IO repeat 3-5min max dose 0.04mg/kg
    • OGP: 1mg initially if no improvement 2-5mg IVP call base
  63. Atropine Sulfate pedi dose
    • Cardiac: 0.02mg/kg IVP/IO repeat 3-5mins max dose 0.04mg/kg
    • Minimim single dose 0.1mg
    • maximum single dose- adolescent 1mg Pedi 0.5mg
    • OGP: 0.02mg/kg IVP/IO repeat 3-5mins w/ 0.5mg/kg titrate to effect call base
  64. Atropine Sulfate route
    IVP, IO
  65. Epinephrine Adrenalin class
    adrinergic agent, catecholamine, sympathomimetic
  66. Epinephrine Adrenalin action
    • 1. Epi stimulates alpha, beta 1 and beta 2 adrenergic receptors in dose related fashion.
    • 2. Rapid injection produces a rapid increase in BP
    • 3. Epi causes vasoconstriction in the arterioles of the skin and mucosa.
    • 4. It antagonizes the effects of histamine by decreasing its release and decreasing membrane permeability
  67. Epinephrine Adrenalin use
    • 1. bronchospasms
    • 2. allergic reaction/ anaphylaxis
    • 3. cardiac arrest
    • secondary vasopressor agent used in conjunction w/ dopamine (IV infusion only)
  68. Epinephrine Adrenalin contraindications
    hypersensitivity, uncorrected tachycardia, hypovolemia
  69. Epinephrine Adrenalin side effects
    • CNS- headache, nervousness, tremors
    • CARDIO- angina, ectopics, hypotension, hypertension, SVT
    • GASTRO-n/v
  70. Epinephrine Adrenalin preparations
    • 1:10,000 1mg/10ml preload
    • 1:1,000 1mg/ml ampule preload
    • 30mg/30ml via
  71. Epinephrine Adrenalin adult dose
    • Asthma: 0.3-0.5mg 1:1,000 SC repeat 5-20mins p.r.n up to 3times 4 doses
    • Allergic reaction: 0.5mg 1:1,000 SC If hypotensive follow w/ 0.1-0.5mg 1:10,000 IVP titrate to effect may repeat once in 5mins
    • Cardiac arrest: 1mg 1:10,000 IVP or 2-2.5mg ET repeat 3-5min
    • High dose: 0.1mg/kg 1:1,000 IVP repeat 3-5mins
    • Infusion: mix: 1mg in 250ml to yield a 4mg/ml solution 2-10mg/min titrate to effect
  72. Epinephrine Adrenalin pedi dose
    • Asthma: 0.01mg/kg 1:1,000 SC repeat 5-20 min p.r.n up to 3 times 4 dose max single dose 0.5mg
    • Cardiac arrest: 0.01mg/kg 1:10,000 IVP 0.1mg/kg 1:1,000 ET
    • Subsequent dose: 0.1mg/kg 1:1,000 via all routes repeat 3-5mins p.r.n
    • Bradycardia: 0.01mg/kg 1:10,000 IVP
    • Infusion: Mix 0.5mg in 250ml to yield 2mg/ml solution 0.1-1mg/kg/min titrate to effect consult base for higher dose
  73. Epinephrine Adrenalin routes
    IVP, ET, SC, IV infusion
  74. diazepam valium action
    • 1. Diazepam potentiates the effects of inhibitory neurotransmitters GABA, hyperpolarising the membrane potential ans raising the seizures threshold in the motor cortex.
    • 2. Onset of action is within 1-5 minutes for IVP and immediate for rectal
  75. diazepam valium class
    benzodiazepine, anticonvulsant, sedative, tranquilizer
  76. diazepam valium use
    • 1. Drug if choice for seizures.
    • 2. Sedation prior to cardioversion of aconscious pt.
  77. diazepam valium side effects
    hypotension, reflex tachycardia, respiratory depression, ataxia, psychomotor impairment, confusion, nausea.
  78. diazepam valium contraindications
    hypersensitivity to the drug, substance abuse, coma, shock
  79. diazepam valium preparations
    • 20mg/ 2ml ampule preload
    • 10mg/ 2ml ampule preload
  80. diazepam valium adult dose
    IVP only: 2-10mg slowly. repeat 5-15 minutes p.r.n max dose 30mg
  81. diazepam valium pedi dose
    • IVP: 0.1-0.2mg/kg slowly. repeat 5-15 minutes p.r.n max dose 20mg
    • rectal: 0.5mg/kg flush w/ 2-3ml saline
  82. diazepam valium route
  83. Furosemide Lasix class
    loop diuretic
  84. Furosemide Lasix action
    • 1. Decreases preload by vasodilation effects in less than 5 minutes.
    • 2. Inhibits electrolyte reabsorption in the distal loop of Henle, and promotes the excretion ofsodium, potassium, hydrogen, magnesium, and chloride to decrease circulating blood volume by its diuretic effect within 5-30 minutes.
  85. Furosemide Lasix use
    • 1. Cardiogenic pulmonary edema
    • 2. CHF
  86. Furosemide Lasix contraindications
    Anuria, hypersensitivity, hypovolemia/dehydration, known hypersensitivity to sulfonamides, states of severe electrlyte depletions.
  87. Furosemide Lasix side effects
    • CNS: Dizziness, headache, tinitus, vertigo
    • CARDIO: Arrhythmias, hypotension
    • GASTRO: Diarrhea, n/v
    • OTHER: Hypovolemia, hypokalemia, hyponatremia, metabolic acidosis
  88. Furosemide Lasix Drtug interaction
    • 1. Digitalis toxicity may be potentiated due to potassium depletion which can result from furosemide administration.
    • 2. Lithium toxicity may be potentiate die to sodium depletion
  89. Furosemide Lasix preparations
    • 20mg/ 2ml ampule preload
    • 40mg/ 4ml ampule preload
    • 100mg/ 10ml vial preload
  90. Furosemide Lasix adult dose
    • Pt. taking lasix: 40-80mg
    • Pt. not taking lasix: 20-40mg
    • may repeat p.r.n to a max of 2mg/kg max 20mg/min
  91. Furosemide Lasix pedi dose
    • 1mg/kg slowly. may repeat p.r.n to a max of 2mg/kg
    • note: usually not given to pedi in prehospital
  92. Furosemide Lasix route
  93. Ondansetron Zofran Class
  94. Ondansetron Zofran Action
    Helps to prevent nausea and vomiting by blocking 5-HT3 receptors so that serotonin is not able to bind to the receptors sites and initiate a vomiting reflex.
  95. Ondansetron Zofran Use
    Pt. experiencing nausea and vomiting
  96. Ondansetron Zofran Contraindications
  97. Ondansetron Zofran Side Effects
    Diarrhea, headache, fever, angina chest pain, seizures, akathisia, acute dystonic reaction.
  98. Ondansetron Zofran Preparations
    0.5MG IN 2.5ML NS
  99. Ondansetron Zofran Adult dose
    4mg IV/IM
  100. Ondansetron Zofran Pedi dose
    • 2mg 2-6 years old
    • 4mg 6 years or older
    • IV/IM
  101. Magnesium Sulfate class
    anticonvulsant, Electrolyte, Antiarrhythmic
  102. Magnesium Sulfate action
    • 1. Mag reduces striated muscle contractions and blocks peripheral neuromuscular transmission by reducing acetylcholine released at the myoneural junction
    • 2. In emergency care, mag is used in the management of seizures associated with toxemia of pregnancy.
  103. Magnesium Sulfate use
    • 1. To correct hypomagnessmia in the following:
    • Torsade de pointes
    • Severe refractory v-fib pulseless v-tach
    • 2. Seizures accompanying eclampsia
  104. Magnesium Sulfate contraindications
    heart blocks
  105. Magnesium Sulfate side effects
    • CNS: Drowsiness
    • CARDIO: Arrhythmias, bradycardia, hypotension
    • Respiratory: Depression
    • Other: Skin rash, hypothermia
  106. Magnesium Sulfate Special notes
    • 1. CNS depressents effects may be enhanced if the pt. is taking other CNS
    • 2. Serious changes in cardiac function may occur with cardiac glycosides.
  107. Magnesium Sulfate preparations
    • 1g/2ml vial (50% solution)
    • 5g/10ml vial (50% solution)
  108. Magnesium Sulfate adult dose
    • cardiac arrest: dilute 1-2g over 1-2 minutes
    • Torsades: 1-2g diluted in 100ml and adminsister over 5-60 minutes
    • Eclampsia: 2-4g over 3 minutes followed by an iv infusion of 1-2g/hr
  109. Magnesium Sulfate pedi dose
    not recommended
  110. Magnesium Sulfate route
    IVP, IV infusion
  111. Metoprolol Lopressor class
    Beta Blocker
  112. Metoprolol Lopressor action
    selectively blocks beta 1 receptors, slowing sinus heart rate, decreasing cardiac output, and decreasing BP
  113. Metoprolol Lopressor Use
    • 1. Administration to all Pt. with suspected MI or unstable angina, absent contraindications
    • 2. 2nd line agent for SVT refractory to adenosine.
    • 3. To reduce myocardial ischemia in MI Pt. with elevated heart rate and or BP
    • 4. Emergency antihypertensive therapy for acute hemorrhagic or ischemic stroke
  114. Metoprolol Lopressor contraindication
    • 1. Hemodynamically unstable pt. should not recieve:
    • signs of heart failure
    • low cardiac output
    • increased risk for cardiogenic shock
    • 2. Relative contraindications: 1st 2nd 3rd degree blocks, active asthma, reactive airway disease, severe bradycardia, hypotension <100
  115. Metoprolol Lopressor Side Effects
    • Chest pain, pounding heartbeats or fluttering in your chest.
    • Feeling light headed, fainting
    • Swelling of your hands or feet
    • Nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stool, jaundice.
    • Easy bruising, unusual bleeding, purple or red pinpoint spots under skin.
    • Wheezing, trouble breathing.
    • Depression, confusion, memory problems, hallucinations
    • Cold feeling in your hands and feet
  116. Metoprolol Lopressor special notes
    • 1. Concurrent administration of calcium channel lockers can cause serious hypotension
    • 2. Monitor cardiac and pulmonary status throughout
  117. Metoprolol Lopressor preparations
    5mg/5ml vial
  118. Metoprolol Lopressor adult dose
    5mg IV/IO >110 bp hr >60
  119. Metoprolol Lopressor pedi dose
    not reccomended
  120. Metoprolol Lopressor route
    IV, IO
  121. Nitroglycerine Nitrostat Class
    coronary vasodilator
  122. Nitroglycerine Nitrostat Action
    • 1. vasodilation of coronary & cerebral arteries resulting in increased oxygen availability with decreased workload & myocardial oxygen demand thereby relieving coronary vasospasms.
    • 2. Peripheral vasodilation
    • 3. Decreased afterload
  123. Nitroglycerine Nitrostat Use
    • 1. Ischemic chest pain
    • 2. CHF/ Pulmonary Edema
    • 3. Hypertension
  124. Nitroglycerine Nitrostat Contraindications
    cardiac tamponade, head injury, hypotension, hypovolemia, hypersensitivity, viagra use within 24 hours
  125. Nitroglycerine Nitrostat Side effects
    • CNS: Dizziness, headache, nervousness, syncope
    • CARDIO: Bradycardia, flushed skin, hypotension, palpitations, reflex tachycardia
    • GASTRO: Bitter taste, burning under tongue, dry mouth n/v
  126. Nitroglycerine Nitrostat Drug interaction
    • 1. use w/ viagra within 24 hours result in uncontrollable hypotension & can result in cardiac arrest
    • 2. use w/ calcium channel blockers can result in symptomatic orthomatic hypotension
  127. Nitroglycerine Nitrostat Adult dose
    .4mg repeat every 5min to a max of 3 doses SL
  128. Nitroglycerine Nitrostat Pedi dose
    not recommended
  129. Albuterol Ventolin Proventil Class
    Sympathomimetic, bronchodilator
  130. Albuterol Ventolin Proventil Decription
    Primarily Beta 2 selective sympathomimetic. Relaxes smooth muscles of the bronchial tree & peripheral vasculature.
  131. Albuterol Ventolin Proventil Onset
    5- 15 minutes after inhalation
  132. Albuterol Ventolin Proventil Duration
    3-4 hours after inhalation
  133. Albuterol Ventolin Proventil Use
    • 1. Relief of bronchospasm
    • 2. Beta blocker overdose
    • 3. hyperkalemia
  134. Albuterol Ventolin Proventil Preparations
    2.5mg in 2.5ml ampule nebulizer solution
  135. Albuterol Ventolin Proventil Adult dose
    2.5mg in 2.5ml saline nebulized
  136. Albuterol Ventolin Proventil Pedi dose
    0.15mg in 2.5ml saline nebulized
  137. Ipratropium Bromide Atrovent Class
    Anticholinergic, bronchodilator
  138. Ipratropium Bromide Atrovent Action
    Anticholinergic agent appears to inhibit vagally- mediated reflexes by antagonizing the action of acetylcholine. The transmitter released from the vagal nerve.
  139. Ipratropium Bromide Atrovent Use
    Treatment of bronchospasm associated w/ COPD. To be used either alone or in combination w/ other bronchodilators especially beta adrenergics.
  140. Ipratropium Bromide Atrovent Contraindications
    hypersensitivity or to atropine & its derivatives
  141. Ipratropium Bromide Atrovent Side effects
    coughing, increased sputum, dizziness, insomnia, tremors, nervousness, nausea
  142. Ipratropium Bromide Atrovent Preparations
    0.5mg in 2.5ml NS
  143. Ipratropium Bromide Atrovent Adult dose
    0.5mg in 2.5ml NS via nebulizer
  144. Ipratropium Bromide Atrovent Pedi dose
    0.5mg in 2.5ml NS via nebulized
  145. Midazolam Versed Class
    Benzodiazepine sedative hypnotic
  146. Midazolam Versed Action
    enhances the inhibitory effects of GABA receptors on chloride channels in CNS hyperpolarizing membrane. Induces sleep decreases anxiety & impairs memory retention.
  147. Midazolam Versed Use
    • 1. Premedication prior to cardioversion
    • 2. Sedation of intubated Pt.
    • 3. To achieve sedation to facilitate intubation
  148. Midazolam Versed Contraindications
    hypersensitivity, depressed vital signs, concomitant ise of barbiturates, Alcohol narcotics CNS depressants
  149. Midazolam Versed Side effects
    • CNS: altered mental states, amnesia, dizziness, insomnia nervousness, nightmares, parasthesia, seizures, visual disturbances
    • CARDIO: bradycardia, cardiac arrest hypotension, tachycardia, PVC
    • RESP: bronchospasms, laryngospasms, respiratory arrest & depression
    • GASTRO: acid taste, excessive salivation, n/v
  150. Midazolam Versed Special notes
    • 1. midazolam is 3 to 4 times more potent than diazepam
    • 2. respiratory depression & arrest may be reversed w/ flumazenil
  151. Midazolam Versed Preparation
    • 1mg/ml ampule
    • 5mg/ml ampule
  152. Midazolam Versed Adult dose
    iv 2.5-5mg slow push (over 2-3 min) max 0.1mg/kg iv, im
  153. Midazolam Versed Pedi dose
    0.03mg/kg iv, im
  154. Glucagon Class
    Pancreatic hormone, insulin antagonist
  155. Glucagon Action
    • 1. Protein secreted by the alpha cells of the pancreas.
    • 2. when released it results in blood glucose elevation by increasing the breakdown of glycogen to glucose & inhibiting glycogen synthesis
    • 3. Exerts positive inotropic action on the heart & decreases renal vascular resistance. used in managing Pt. w/ beta blockers cardiotoxication
  156. Glucagon Use
    • 1.Hypoglycemia/ Insulin overdose when IV can not be established
    • 2. Beta Blocker overdose
  157. Glucagon contraindications
  158. Glucagon Side effects
    • CNS: dizzinesss
    • CARDIO: hypotension hypertension ectopics, tachycardia
    • GASTRO: n/v
    • OTHER: Possible allergic reaction
  159. Glucagon preparations
    1 unit of white powder in one vial & 1ml of fluid dilutent in another vial
  160. Glucagon Adult dose
    • Hypoglycemia: 1 unit IM repeat in 10 min
    • Beta blocker: 1 unit IV repeat in 20 min
  161. Glucagon Pedi dose
    • Hypoglycemia: 1 unit IM repeat 20 min
    • Beta blocker: 0.25 u/kg IV max 1 unit
  162. Sodium Bicarbonate Class
    alkalotic agent, antacid, electrolyte
  163. Sodium Bicarbonate Action
    • reacts w/ hydrogen ions to form water & carbon dioxide thereby can act to buffer metabolic acidosis
    • 2. By increasing the plasma concentration of bicarbonate blood ph rises
  164. Sodium Bicarbonate Use
    • 1. known pre existing bicarbonate responsive acidosis
    • 2. intubated Pt. w/ continued long arrest interval
    • 3. ROSC after long arrest interval, tricyclic antidepressant overdose
    • 4. alkalization for treatment of specific intoxications
  165. Sodium Bicarbonate Side effects
    • CNS: seizures
    • CARDIO: arrhythmia, exacerbation of CHF/ pulmonary edema, fluid retension,
    • OTHER: hypokalemia, hypocalcemia, hypoxia, metabolic & respiratory alkalosis
  166. Sodium Bicarbonate preparations
    • 50 meq/ 50ml 8.4% preload
    • 50 meq/ 10ml 4.2% preload
  167. Sodium Bicarbonate Adult dose
    1meq/kg of a 8.4% solution repeat 10 min @ 0.5 meq/kg ivp
  168. Sodium Bicarbonate Pedi dose
    • 1meq/kg of a 8.4% solution repeat 10 min @ 0.5 meq/kg ivp
    • note: 4.2% solution for infants less than 3 months
  169. Morphione Sulfate Class
    Narcotic, analgesic, opiate
  170. Morphione Sulfate Action
    Natural opium alkaloid that increases peripheral venous capacitance & decreases venous return. It promotes analgesia euphoria & respiratory & physical depression
  171. Morphione Sulfate Use
    • 1. Cardiac chest pain
    • 2. severe pain
    • 3. acute pulmonary edema
    • 4. isolated extremity fractures
  172. Morphione Sulfate contraindications
    altered mentation, head injury, hypersensitivity, hypotension, hypovolemia, undiagnosed abdominal pain, MAO inhibitors within 14 days
  173. Morphione Sulfate Side effects
    • CNS: altered mentation, headache, paradoxical CNS system stimulation
    • CARDIO: bradycardia hypotension
    • RESP: respiratory depression & arrest
    • GASTRO: n/v
    • OTHER: skin rash, urinary retention, pupil constriction
  174. Morphione Sulfate preparations
    10mg/ml ampule preload
  175. Morphione Sulfate Adult dose
    • cardiac: 2-5mg SIVP @ 1mg/min repeat 3-5 min until pain is relieved or respiratory depression occurs
    • Pain relief: 0.1mg/kg loading dose titrate to effect ivp
  176. Morphione Sulfate Pedi dose
    0.1-0.2mg/kg over 5 min ivp
  177. Dilitazem Cardizem route
    IV, IO
  178. Dilitazem Cardizem Class
    Calcium Channel Blocker, Antidysrhythmic
  179. Dilitazem Cardizem Action
    • 1. Inhibits calcium movement across cell membrane of cardiac and smooth muscle.
    • 2. causes vasodilation, decreases heart rate and contractility, slow SA and AV conduction
  180. Dilitazem Cardizem Use
    A-fib, A-flutter, Multifocal atrial tachycardia, PSVT
  181. Dilitazem Cardizem Contrainsications
    Sick sinus syndrome, Second or third degree heart block. WPW or other pre excitation syndrome. VT or wide complex tach or unknow origin. severe hypotension. hypersensitivity to diltiazem. concomitant use of IV beta blockers
  182. Dilitazem Cardizem Side Effects
    A-flutter, first or second degree heart av blocks, bradycardia, chest pain, CHF, syncope,, ventricular dysrhthmias, sweating, n/v, dizziness, dry mouth, dyspnea, headache
  183. Dilitazem Cardizem Adult dose
    • Bolus:
    • 0.25mg/kg (20mg for the average pt.) IV over 2 minutes. May be repeated in 15 min (0.35mg/kg; 25mg for the av. pt) IV over 2 min
    • Maintenance:
    • Dilute 125mg (25ml) in 100ml of solution; infuse 5-15mg/hr titrate to heart rate.
  184. Dilitazem Cardizem pedi dose
    not reccomended
  185. Calcium Chloride Class
  186. Calcium Chloride Action
    • 1. Positive inotrope
    • 2. Increases myocardial automaticity
    • 3. Increases nerve transmission capabilities
    • 4. Relieves muscle spasms low calcium blood levels
    • 5. Onset of action is immediate
  187. Calcium Chloride Use
    • Hyperkalemia: Hypocalcemia (after multiple blood transfusions)
    • calcium channel blocker toxicity; hypermagnesemia: to prevent hyotensive effects of calcium channel blocking agents
  188. Calcium Chloride Contraindications
    Absolute: Pt. receving digitalis
  189. Calcium Chloride Side Effects
    Decreases in heart rae (may cause asystole) and blood pressure. Metallic taste; severe local necrosis and sloughing following IM use or IV infiltration
  190. Calcium Chloride Adult Dose
    2-4mg/kg over 5 minutes. Repeat every 10 minutes P.R.N max dose 1g
  191. Calcium Chloride Pedi dose
    • 5-7mg/kg @ 100mg/min. May repeat once in 10 minutes Max dose 300mg
    • Note: usually not given
  192. Calcium Chloride Route
  193. Procainamide Pronestyl Class
    class 1-A antiarrhythmic
  194. Procainamide Pronestyl Action
    • 1. supresses phase 4 depolarization in normal ventricular muscle and purkinje fibers, reducing the automaticity of ectopic pacemakers bt decreasing sodium influx.
    • 2. supresses reentry of dysrhythmias by slowing intraventricular conduction .
  195. Procainamide Pronestyl Use
    • 1. PVCs when refractory to lidocaine
    • 2. ventricular tachycardia with pulse when refractory to lidocaine
    • 3. PSVT's wide complex tach of unknown origin (drug of choice when associated w/ WPW)
  196. Procainamide Pronestyl Contraindications
    high degree heart blocks, PVCs in conjuction w/ brady, QT prolongation, torsade de pointes, digitalis toxicity, TCA induced arrhythmia
  197. Procainamide Pronestyl Side effects
    • CNS- cns depression, hallucinations, seizures
    • CARDIO- asystole, brady, ectopics, hypotension, heart blocks, reflex tach, v-fib, v-tach, wide QRS complex
    • GASTRO- n/v
    • OTHER- fever
  198. Procainamide Pronestyl Adult dose
    • 20mg/min until the arrhythmia is abolished, hypotension ensures, the QRS widens by 50% of it's original width, or a total of 1g or 17mg/kg has been given
    • Maintenance infusion: mix 1g in 250ml to yeild 4mg/ml run @ 1-4 mg/min
  199. Procainamide Pronestyl Pedi dose
    • 2-6mg/kg @ 20mg/min until you see any of the four qualifiers as seen in the adult
    • Maintenance infusion: mix 100mg in 250ml to yeild 400ug/ml run @ 20-80 ug/min
  200. Procainamide Pronestyl Route
    IVP, IV infusion
  201. Oxytocin Pitocin pedi dose
    not given
  202. Oxytocin Pitocin Class
    pituitary hormone
  203. Oxytocin Pitocin Action
    • 1. stimulates uterine smooth muscle contraction indirectly, and helps expedite the normal contractions of a spontaneous labor.
    • 2. transient reduction in uterine blodd floe
    • 3. stimulates the mammary glands to increase lactation without increasing the production of milk.
  204. Oxytocin Pitocin Use
    postpartum hemorrhage after infant and placental delivery
  205. Oxytocin Pitocin Conttraindication
    presence of a second fetus
  206. Oxytocin Pitocin Side effects
    • Mother:
    • CNS- seizures
    • RESP- dyspnea
    • CARDIO- chest pain, hypertension, increased cardiac output, PVCs, tachycardia
    • GASTRO- n/v
    • OTHER- anaphylaxis, severe uterine cramping, uterine rupture
    • Fetal:
    • CNS- intracranial hemorrhage
    • RESP- asphyxia, hypoxia
    • CARDIO- bradycardias, ectopics
  207. Oxytocin Pitocin adult dose
    • IM: 3-10 units only if unable to start an IV
    • IV: mix 10-20 units in 1000 ml to yeild 10-20 mU/ml administer @ 100-125 ml/hr titrated to the severity of hemorrhage and uterine response
  208. Asprin Class
    Antpyretic, NSAID, Platelet inhibitor
  209. Asprin Action
    • 1. Powerfully inhibits Platelet aggregation by inhibiting thrombonxane A2 production.
    • 2. Major action apprears to be associated primarily w/ inhibiting the formation of prostaglandins involved in the production of inflammation, pain & fever.
    • 3.Lowers body temp. by indirectly causing centrally mediated peripheral vasodilation and sweating.
  210. Asprin Onset
    10 min
  211. Asprin Use
    • 1. Acute Myocardial infartion
    • 2. S/S suggestive of recent stroke
  212. Asprin Side Effects
    • CNS: confusion, convulsion, dizziness, flushing
    • CARDIO: Heartburn, hypotension, prolonged bleding
    • GASTRO: GI bleed, n/v
    • RESP: Respiratory alkalosis, wheezing
    • OTHER: Anorexia, rash
    • OVERDOSE: Depression, diarrhea, respiratory acidosis, tachycardia, tinitus
  213. Asprin Contraindications
    Hypersensitivity, children under 12, pregnancy
  214. Asprin Preparations
    81mg chewable tablets
  215. Asprin Adult dose
  216. Asprin Pedi dose
    not given
  217. Asprin Route
  218. Oxygen Class
  219. Oxygen Action
    • 1. Increases the concentration of oxygen delivered to the alveoli which in turn increases the amount of oxygen on the blood available for transport to the tissuse.
    • 2. Reverses hypoxia & hypercapnea ( too much carbion dioxide)
    • 3. Oxidizes glucose to produce ATP
    • 4. Onset of action is immediate
  220. Oxygen Use
    • 1. Any respiratory difficulty
    • 2. ischemic chest pain
    • 3. Spo2 less than 97% w/ a symptomatic pt.
    • 4. Cardiac arrest
  221. Oxygen Side Effects
    • Respiratory: Reduces respiratory drive in COPD pt.
    • Drying of mucous membrane w/ prolonged use
  222. Oxygen Contraindications
    none in prehospital
  223. Oxygen Adult dose
    • titrate to effect. should be given @ highest available.
    • moderate to severe: high flow 8-15 lpm
    • mild distress: medium flow 4-6 lpm
    • mild distress (copd): low flow 1-2 lpm
  224. Oxygen Pedi dose
    • titrate to effect. should be given @ highest available.
    • moderate to severe: high flow 8-15 lpm
    • mild distress: medium flow 4-6 lpm
    • mild distress (copd): low flow 1-2 lpm
  225. Oxygen Route
    • inhalation
    • nasal canula: 2-6 lpm
    • simple face mask: 8-15 lpm
    • non rebreather mask: 10-15 lpm
    • hand held nebulizer: 8-10 lpm
  226. Adenosine Adenocard Class
  227. Adenosine Adenocard Action
    • 1. Slows impulse formation in the SA node
    • 2. Slows conduction time through AV node
    • 3. Depresses left ventricular function and restores NSR
  228. Adenosine Adenocard Use
    • 1. 1st drug for stable, narrow complex, regular SVT
    • 2. May consider for unstable SVT while preparing for cardioversion.
    • 3. Wide complex tach thought to be or determined to be reentry SVT
    • 4. Does not convert A-Fib, A-Flutter, or VT
    • 5. Diagnostic maneuver, stable narrow- complex SVT
  229. Adenosine Adenocard Side Effects
    • CNS: Apprehension, blurred vision, dizziness, facial flushing, headache, numbness, tingling in arms, sweating
    • RESP: SOB, tightness in throat
    • CARDIO: burning sensation, chest pain, hypotension, palpitations
    • GASTRO: n/v metallic taste
    • OTHER: back pain, heaviness in arms and neck, pressure in groin
  230. Adenosine Adenocard Contraindication
    2nd or 3rd degree heart block
  231. Adenosine Adenocard Adult dose
    6mg over 1-3 sec ( rapid bolus), followed by a rapid saline flush. may repeat @ 2 min intervals with 12mg over 1-3 sec max dose of 30mg
  232. Adenosine Adenocard pedi does
    0.1mg/kg up to 6mg, followed by a rapid saline flush. may repeat once by doubling dose if no effect in 2min max dose 12mg
  233. Adenosine Adenocard route
  234. Dopamine Hydrocholoride Class
    sympathomimetic, Catecholamine
  235. Dopamine Hydrocholoride Action
    • 1. Alpha 1, beta 1 adrenergic receptors in dose dependant fashion.
    • 2. At low dose (renal dose) has a dopaminergic effect that causes renal, mesenteric, and cerebral vascular dilation.
    • 3. At moderate dose (cardiac dose) has a beta 1(heart) adrenergic effect, causing enhanced myocardial contractility, increased cardiac output, and a rise in BP
    • 4. At high dose ( vasopressor dose) has a alpha 1 (smooth muscle contraction) adrenergic effects, producing periphral arterial and venous condtriction.
  236. Dopamine Hydrocholoride Use
    • 1. cardiogenic shock
    • 2. shock states with hemodynamically significant hypotension in the absence of hypovolemia.
  237. Dopamine Hydrocholoride contraindications
    cardiac arrest, hypovolemia, pheochromocytoma (tumor in the adrenal glands. too much epi) uncorrected tachycardia
  238. Dopamine Hydrocholoride Side Effects
    • CNS: headache, tremor
    • CARDIO: angina, ectopics, hypotension ( low dose), hypertension (high dose), tachycardia
    • Resp: dyspnea
    • OTHER: dilated pupils n/v
  239. Dopamine Hydrocholoride Adult dose
    • mix 400mg in 250ml to yeild a 1600ug/ml solution
    • standard dose is 2-20ug/kg/min titrated to effect. max dose 50ug/kg/min. rarely should you go over 20ug/kg/min
  240. Dopamine Hydrocholoride Pedi dose
    • Mix 200mg in 250ml to yeild a 800ug/ml solution
    • standard dose is 2-20ug/kg/min titrated to effect. max dose 50ug/kg/min. rarely should you go over 20ug/kg/min
  241. Dopamine Hydrocholoride Route
    iv infusion
  242. Lidocaine Hydrochloride Class
    class 1-B antiarrhythmic
  243. Lidocaine Hydrochloride Action
    suprresses automaticity in his-purkinje system & by elevating electrical stimulation threshold of ventricles during diastole. this occurs by blocking fast sodium channels & depressing pathogenic phase 4 diastolic depolarization
  244. Lidocaine Hydrochloride Use
    • 1. VF/VT
    • 2. Wide complex tach of unknown origin
    • 3. Significant ventricular ectopy in the setting of myocardial ishchemia/ infarction
    • 4. premedication prior to RSI in Pt. w/ closed head injury
  245. Lidocaine Hydrochloride Contraindications
    Brady w/ PVC, high degree heart blocks, hypersensitivity, hypotension, stroke adams syndrome (sudden fainting, seizures), wolf parkinson- white syndrome WPW ( disorder of the heart the ventricules contract premature)
  246. Lidocaine Hydrochloride Side Effects
    • CNS: Anxiety, blurred vision, dizziness, drowsiness, tinitus, seizures
    • CARDIO: Arrhythmias, brady, cardiac arrst, hypotension
    • RESP: depression, arrest
    • GASTRO: n/v
    • OTHER: anaphylaxis
  247. Lidocaine Hydrochloride Adult Dose
    • cardiac arrest: 1-5mg/kg IVP every 3-5 mins max of 3mg/kg
    • Suppression of PVC & pulsing V-Tach: 1.5mg/kg SIVP repeat 3-5min @ .75mg/kg max of 3mg/kg
    • maintenance infusion: mix 1g in 250ml to yeild a 4mg/ml solution. admin @ 2-4mg/min
    • 1st dose- 2mg/min
    • 2nd dose- 3mg/min
    • last dose- 4mg/min
  248. Lidocaine Hydrochloride Pedi dose
    • boulus: 1mg/kg followed by IV infusion
    • Maintenance Infusion: mix 300mg in 250ml 1ugtt/kg/min= 20ug/kg/min admin 20-50 ug/kg/min
  249. Lidocaine Hydrochloride Route
    • Bolus: IVP, ET
    • Maintenance: IV infusion
  250. Naloxone Narcan Class
    Synthetic opioid competitive antagonist
  251. Naloxone Narcan Action
    • 1. competitive narcotic antagonist that is used in the management and reversal of overdose caused by narcotics and sythetic narcotic agent.
    • 2. Compared with other narcotic antagonists which do not completely inhibit the analgesic properties of opiates, naloxone antagonizes all action of morphine.
  252. Naloxone Narcan Use
    • 1. For the complete or partial reversal of CNS and respiratory depression induced y opioids.
    • 2. Coma of unknown etiology/ Seizures of unknown etiology.
    • 3. Decreased LOC
  253. Naloxone Narcan Side Effects
    • CARDIO: hypertension, V-Tach, V-Fib
    • GASTRO: n/v
    • Withdrawl symptoms: Diaphoresis, hypotension, nausea, tach, seizures
  254. Naloxone Narcan Contraindications
    hypersensitivity, use with caution in narcotic dependent Pt. who may experience withdrawl syndrome.
  255. Naloxone Narcan Adult Dose
    2mg titrate to effect. repeat every 2-3 min p.r.n if no effect within 10mg consider another cause
  256. Naloxone Narcan Pedi Dose
    • Less than 5 years old: 0.1mg/kg titrate to effect. repeat p.r.n
    • 5 years old or greater: same as adult
  257. Naloxone Narcan Route
    IVP, ET, IM
  258. Vasopressin Class
    Nonadrenergic peripheral vasoconstrictor
  259. Vasopressin Action
    causes coronary and renal vasoconstriction w/ reduced blood flow, increasing core perfusion during cardiac arrest
  260. Vasopressin Use
    no different than epi in cardiac arrest, a single does of vasopressin may replace either the first or second dose of epi in VF/VT. Also used as an alternative to epi in adult PEA/Asystole
  261. Vasopressin Side Effect
    • CARDIO: cardiac arrest, circumoral pallor (palness around the mouth), arrhythmias, decreased cardiac output, angina, myocardial ischemia, peripheral vasoconstriction and gangrene.
    • GASTRO: abdominal cramping, n/v
    • CNS: tremors, vertigo, pounding in head
    • SKIN: sweating, urticaria, cutaneous gangrene
  262. Vasopressin Adult dose
    IV: 40 units in cardiac arrest
  263. Vasopressin Pedi dose
    not reccomended
  264. Vasopressin Route
    IV, IO
Card Set:
2011-11-19 19:40:50

medic drugs
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