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Calcium Chloride (Calcium Chloride)
Calcium Chloride increases myocardial contractile force and increases ventricular automaticity.
Hyperkalemia, Hypocalcemia, Hypermagnesemia, and calcium channel blocker toxicity.
Ventricular fibrillations, hypercalcemia, and possible digitalis toxicity
It may precipitate toxicity in patients taking digoxin. Ensure IV line is in large vein and flushed before and after using calcium.
- - Dosage/Route: 5-10cc of (10% solution/ 1g - 10 cc)/ 10 min, as needed or 2-4 mg/Kg
- -Pedi: 20 mg/Kg IV (10% solution) repeat at 10 min, as needed
- Osmotic diuretic
Mannitol is an osmotic diuretic that draws water into the intravascular space through its hypertonic effects, then causes diuresis.
Hypersensitivity, Pulmonary edema or severe dehydration.
Must give slow with filter tubing.
- - Dosage/Route: 1.5-2 g/kg slow IV
- - Pedi: 0.25-0.5 g/kg over 60 min
Phenytoin is a derivative related to phenobarbitol that reduces the spread of electrical discharges in the motor cortex and inhibits seizures. It also has antidysrhythmic properties that counteract the effects of digitalis.
Seizures, status epilepticus, or cardiac dysrhythmias secondary to digitalis toxicity.
Seizures due to hypoglycemia, sinus bradycardia, heartblock, and Adams-Stokes syndrom
Hepatic or renal impairment, alcoholism, cardiogenic shock, elderly, bradycardia, and respiratory depression
- - Dosage/Route:
- - Seizures/Status epilepticus: 10-15 mg/kg slow IV no more than 50 mg/min
- - Pedi: 8-10 mg/kg slow IV
- - Dysrhythmias: 100 mg slow IV (over 5 mins) to a maximum of 1,000 mg
- - Pedi: 3-5 mg/kg slow IV
- Description: After topical application to the eye, local anesthetics penetrate to the sensory nerve endings in the corneal tissue. These medications block both the initiation and conduction of nerve impulses by decreasing the neuronal membrane's permeability to Na ions. This reversibly stabilizes the membrane and inhibits depolarization, resulting in the failure of a propagated action potential and subsequent conduction blockade
- Indications: Eye injury or Foreign body
- Contraindications: Hypersensitivity
- Precautions to be monitored: Hyperthyroid disease, cardiac diseases
- Dosage/Route: 1-2 drops in each eye
- BETA Blocker
- Description: Timponic is a non-selective beta-adrenergic receptor blocking agent.
- Indications: HTN, MI, Increased ocular pressure
- Contraindications: asthma, severe COPD, sinus bradycardia, 2nd or 3rd degree heart AV block, cardiogenic shock
- Precautions: Readily absorbed
- Dosage/Route: ophthalmic: one drop per eye BID
Sodium Bicarbinate (NaHCO3)
- Alkalizing Agent
Sodium Bicarbinate provides vascular bicarbinate to assist the buffer system in reducing the effects of metabolic acidosis and in the treatment of some overdoses.
Tricyclic antidepressant and barbituate overdose, refractory acidosis, or hyperkalemia.
None when used in severe hypoxia or late cardiac arrest.
May cause alkalosis if given in too large a quantity. It may also deactivate vasopressors and may precipitate with calcium chloride.
- - Dosage/Route: 1 mEq/kg IV, then 0.5 mEq/10min
- Pedi: same as adult
Thiamine is vitamin B1
, which is required for glucose to be converted to energy. It is not manufactured by the body and must be constantly provided by ingested foods.
Coma of unknown origin, chronic alcoholism with associated coma, and delerium tremens.
Known hypersensitivity to the drug
- - Dosage/Route: 100 mg IV/IM
- - Pedi 10-25 mg IV/IM