Medications for Exams

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Medications for Exams
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2013-06-23 17:15:29
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Medication Exam Study
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  1. Atrovent / Ipratropium

    Class
    Indication
    Dose
    Anticholinergic (Parasympatholytic)

    • Bronchial Asthma
    • Reversible bronchospasm assoc with COPD & Emphysema

    500 mcg/dose (typically with a B-agonist) via small volume nebulizer
  2. Terbutaline / Brethine

    Class
    Indication
    Dose
    Sympathetic Agonist - B2 selective

    • Reversible bronchospasm assoc with COPD
    • Bronchial Asthma
    • Preterm Labor

    Labor: 0.25 mg subcutaneously (initial) may repeat in 30 - 60 minutes as needed

    IV drip (labor): 5 mg in 500 mL Lactated Ringers or NS.  30 mL/hr (5 mcg/min).  Slowly increase rate to max of 80 mcg/min as needed.
  3. Albuteral / Proventil / Salbutamol / Ventolin

    Class
    Indication
    Dose
    Sympathomimetic - B2 selective

    • Asthma
    • Reversible bronchospasm assoc with COPD

    2.5 - 5.0 mg in 2.5 mL NS over 5 - 15 minutes via small volume nebulizer
  4. Glucagon / GlucaGen

    Class
    Indication
    Dose
    Hormone - Anti-hypoglycemic Agent

    • Hypoglycemia
    • Beta Blocker OD
    • Calcium Channel Blocker OD

    • 0.25 - 0.5 mg IV
    • OR
    • 1.0 mg IM
  5. Thiamine / Vitamin B1

    Class
    Indication
    Dose
    Vitamin

    • Coma of unknown origin - esp is ETOH may be involved
    • Delirium Tremens (DT's)

    100 mg IV or IM
  6. Dextrose / D50W / D25W / D10W

    Class
    Indication
    Dose
    Carbohydrate

    • Hypoglycemia
    • Coma of unknown origin

    • 25 g (50 mL) IV
    • 2nd dose (same) may be given if 1st dose is ineffective
  7. Propofol / Diprovan

    Class
    Indication
    Dose
    Sedative / Hypnotic

    Induction and maintenance of sedation

    2 mg/kg IV followed by 25 - 75 mcg/kg/min
  8. Ketamine / Ketalar

    Class
    Indication
    Dose
    Sedative / Hypnotic / Analgesic

    Induction agent for rapid sequence intubation

    • 0.5 - 1.0 mg/kg IV over 30 - 60 seconds
    • OR
    • 2 - 4 mg/kg IM
  9. Etomidate / Amidate

    Class
    Indication
    Dose
    Sedative / Hypnotic

    Induction agent for rapid sequence intubation

    0.1 - 0.3 mg/kg IV over 15 - 30 seconds
  10. Lidocaine / Xylocaine

    Sodium Channel Blocker / Antiarrhythmic

    V-Tach
    V-Fib refractory to Amiodarone
    Cardiac Arrest

    Initial - 1.0 - 1.5 mg/kg
    Additional - 0.5 - 0.75 mg/kg every 5 - 10 minutes as needed until max dose of 3.0 mg/kg
    *Reduce dose by 50% for Pts >70 yo or with liver disease
  11. Procainamide / Pronestyl

    Class
    Indication
    Dose
    Sodium Channel Blocker / Antiarrhythmic

    • V-Tach with a pulse
    • Pre-excited A-Fib

    20 - 50 mg/minute until arrhythmia suppressed

    • D/C if:
    • Arrhythmia suppressed
    • Hypotension
    • QRS widened by 50%
    • Max dose of 17 mg/kg administered
  12. Amiodarone / Cordarone

    Class
    Indication
    Dose
    • V-Tach
    • V-Fib
    • A-Fib
    • Cardiac Arrest
    • Stable narrow-complex tachycardia (to control ventricular rate)

    V-Fib / Pulseless V-Tach:  300 mg IV or IO over 10 minutes.  Repeat at 150 mg over 10 minutes.

    A-Fib: 150 mg IV or IO over 10 minutes.  Repeat as needed.
  13. Adenosine / Adenocard

    Class
    Indication
    Dose
    Antiarrythmic

    Tachyarrhythmias refractory to vagal maneuvers

    • 1st Dose: 6 mg rapid IV or IO over 1 - 2 seconds followed by rapid saline flush
    • 2nd Dose: 12 mg IV or IO over 1 - 2 seconds followed by rapid saline flush
  14. Retavase / Reteplase Recominant

    Class
    Indication
    Dose
    Fibrinolytic

    • Acute coronary syndrome
    • Acute MI

    • 10 units IV over 2 minutes
    • Repeat in 30 minutes (20 units total)
  15. Heparin

    Class
    Indication
    Dose
    Anticoagulant

    • Acute coronary syndrome
    • Pulmonary embolism

    • Acute STEMI & unstable angina:
    • 60 units/kg IV (max 4000 units) followed by 12 units/kg/hour

    • NSTEMI & unstable angina:
    • 60 - 70 units/kg IV (max 5000 units) followed by 12 - 15 units/kg/hour.
  16. Plavix / Clopidogrel

    Class
    Indication
    Dose
    Platelet Aggregation Inhibitor

    • Acute coronary syndrome
    • Recent MI
    • Stroke
    • Peripheral vascular disease (PVD)

    • Acute coronary syndrome & NSTEMI:
    • 300 mg loading dose followed by 75 mg daily
  17. Cardizem / Diltiazem

    Class
    Indication
    Dose
    Calcium Channel Blocker

    Narrow-complex tachycardias (SVT, PSVT)

    • 0.25 mg/kg IV over 2 minutes - initial dose
    • 0.35 mg/kg IV over 2 minutes as needed
  18. Verapamil / Isoptin / Calon

    Class
    Indication
    Dose
    Calcium Channel Blocker

    Narrow-complex tachycardias

    • 2.5 - 5 mg IV or IO over 2 minutes
    • Repeat dose at 5 - 10 mg in 15 - 30 minutes if needed.
  19. Aspirin / Bayer / St. Joseph's Baby Aspirin

    Class
    Indication
    Dose
    Antipyretic / Platelet Inhibitor / Anti-Inflammatory

    • New CP suggestive of acute MI
    • Active MI

    160 - 325 mg orally - chewed
  20. Atropine / Atropine Sulfate

    Class
    Indication
    Dose
    Parasympatholytic

    • Symptomatic bradycardia
    • Organophosphate Poisoning

    0.5 mg IV every 3 - 5 minutes to max dose of 3.0 mg
  21. Dobutamine / Dobutrex

    Class
    Indication
    Dose
    Sympathetic Agonist

    Short term management of CHF when increased cardiac output without increased HR is desired

    2 - 20 mcg/kg/min

    • Dilute 250 mg in 500 mL D5W (0.5 mg/mL)
    • OR
    • 250 mg in 1L D5W (0.25 mg/mL)
  22. Dopamine / Intropin

    Class
    Indication
    Dose
    Sympathetic Agonist

    • Hemodynamically significant hypotension (systolic 70 - 100 mmHg) NOT resulting from hypovolemia.
    • Cardiogenic Shock
    • Symptomatic bradycardia

    2 - 10 mcg/kg/minute.  Increase until BP imporoves or mad dose of 20 mcg/kg/min

    Dilute: 400 mg in 250 mL D5W= 1600 mcg/mL
  23. Norepinephrine / Levophed

    Class
    Indication
    Dose
    Hypotension NOT due to hypovolemia

    0.1 - 0.5 mcg/min per AHA, however higher doses may be needed to maintain BP.

    • Dilute: 8 mg in 500 mL D5W = 16 mcg/mL
    • OR
    • 4 mg in 250 mL D5W = 16 mcg/mL
  24. Epinephrine / Adrenalin

    Class
    Indication
    Dose
    Sympathetic Agonist

    • 1:1000:
    • Bronchial Asthma
    • COPD exacerbation
    • Allergic Reaction

    0.3 - 0.5 mg

    1:10 000:

    • Cardiac Arrest = 1.0 mg every 3 - 5 minutes
    • Anaphylaxis = 0.05 - 0.1 mg IV or IO
    • Bradycardias refractory to Atropine = 2 - 10 mcg/min
  25. Labatalol / Trandate / Normodyne

    Class
    Indication
    Dose
    Non selective Beta Blocker

    Hypertensive emergency: markedly elevated BP with end-organ failure.  (HA & anxiety with increased BP are NOT indications

    20 mg slow IV over 10 minutes.  Monitor BP prior and 5 - 10 minutes after administration.

    Additional doses of 40 mg every 10 minutes until desired supine BP is reached
  26. Sotolol / Sotacor / Betapace

    Class
    Indication
    Dose
    Non-selective Beta-Blocker, Antiarrhythmic

    Hemodynamically stable monomorphic V-Tach (Stable V-Tach)

    1.5 mg/kg infused over 5 minutes (slower is preferred)
  27. Metoprolol / Lopressor

    Class
    Indication
    Dose
    Selective Beta-Blocker, Antiarrhythmic

    • Suspected or aute MI who are also hypertensive
    • Stable narrow-complex tachycardia if rhythm remains uncontrolled or unconverted by Adenosine or vagal maneuvers, or if SVT is recurrent.

    5 mg slow IV every 2 - 5 minutes, to max of 3 doses.  Reassess vitals in between and re-administer only if Pt remains stable.
  28. Nitroglycerin / Nitro BID / Nitrostat

    Class
    Indication
    Dose
    Nitrate

    • CP assoc with MI
    • Angina

    0.4 mg sublingual spray or tablet every 3 - 5 minutes.
  29. Oxygen

    Class
    Indication
    Dose
    Gas

    Hypoxia

    Cardiac arrest & critical Pt - 100%.  Other titrate SpO2: 94 - 99%

    • NC: 2 - 6 lpm  24 - 44%
    • Simple: 8 - 10 lpm  40 - 60%
    • Venturi: 4 - 12 lpm  24 - 50%
    • Partial:  6 - 10 lpm  35 - 60 %
    • NRB: 6 - 10 lpm  60 - 95%
    • BVM: 10 - 15 lpm  40 - 90%
  30. Vecuronium / Norcuron

    Class
    Indication
    Dose
    Nondepolarizing Neuromuscular Blocking Agent (Paralytic)

    To achieve paralysis to facilitate endotracheal intubation when muscle tone or seizure activity prevents it.

    0.08 - 0.1 mg/kg IV
  31. Magnesium Sulfate

    Class
    Indication
    Dose
    Anticonvulsant / Antiarrhythmic

    Torsade de pointes:  1 - 2 g (in 10 mL D5W)

    Eclampsia: 2 - 4 g (in 10 mL D5W)
  32. Sodium Bicarbonate

    Class
    Indication
    Dose
    Alkalinizing Agent

    • Tricyclic antidepressant overdose.
    • Severe acidosis refractory to hyperventilation.

    1 mEq/kg initial followed by 0.5 mEq/kg every 10 minutes as indicated by blood gas studies
  33. Calcium Chloride

    Class
    Indication
    Dose
    Calcium Supplement

    • Hyperkalemia
    • Hypocalcemia
    • Calcium Channel Blocker Toxicity (Cardizem, Verapamil)

    2 - 4 mg/kg IV every 10 minutes as needed
  34. Morphine

    Class
    Indication
    Dose
    Narcotic  (schedule II)

    Severe pain with MI, kidney stones, etc.

    • 2 - 10 mg IV - initial dose
    • Additional doses of 2 mg every few minutes until pain is relieved or respiratory depression occurs.
  35. Fentanyl / Sublimaze

    Class
    Indication
    Dose
    Narcotic

    • Severe pain
    • Adjunct to rapid sequence intubation (RSI)
    • Maintenance of analgesia

    25 - 100 mcg IV slowly over 1 - 3 minutes
  36. Narcan / Naloxone

    Class
    Indication
    Dose
    Narcotic Antagonist

    Narcotic overdoses including: morphine, hydromorphone (Dilaudid), Fentanyl, Demeral, Methadone, Heroin, Oxy, Percocet, etc.

    1 - 2 mg IV or IO
  37. Rocuronium / Zemuron

    Class
    Indication
    Dose
    Nondepolarizing Neuromuscular Blocker (Paralytic)

    Induction of skeletal muscle paralysis

    • 600 mcg/kg initial (0.6 mg/kg)
    • followed by: 100 - 200 mcg/kg/min continuously (0.1 - 0.2 mg/kg/min)
  38. Vasopressin / Patressin

    Class
    Indication
    Dose
    Vasopressor

    • Cardiac arrest
    • Organophosphate Poisoning

    40 units IV or IO - may replace 1st or 2nd dose of Epi during cardiac arrest
  39. Succinylcholine / Anectine

    Class
    Indication
    Dose
    Depolarizing Neuromuscular Blocking Agent (Paralytic)

    To achieve paralysis to facilitate endotracheal intubation when muscle tone or seizure activity prevent it.

    1.0 - 1.5 mg/kg IV
  40. Phenobarbitol / Luminal

    Class
    Indication
    Dose
    Barbituate

    • Major motor seizures
    • Status epilepticus
    • Acute anxiety state

    Status epipecticus: 100 - 250 mg slow IV
  41. Mannitol / Osmotrol

    Class
    Indication
    Dose
    Osmotic Diuretic

    • Acute cerebral edema
    • Blood transfusion reactions

    1.5 - 2.0 g/kg slow IV bolus or infusion
  42. Toradol / Ketorolac

    Class
    Indication
    Dose
    Non-Steroidal Anti-inflammatory Agent (NSAID)

    Mild to moderate pain

    • 30 mg IV 
    • OR
    • 30 - 60 mg IM and then 1/2 original dose after 6 hours

    * 1/2 dose in elderly Pts
  43. Captopril / Capoten

    Class
    Indication
    Dose
    • Angiotensin-Converting Enzyme
    • (ACE Inhibitor)

    • HTN
    • CHF

    12.5 - 25 mg sublingually if BP is between 90 - 110 systolic
  44. Enalapril / Vasotec / Enalaprilat

    Class
    Indication
    Dose
    • Angio-tensin Converting Enzyme
    • ACE Inhibitor

    • HTN
    • CHF

    1.25 - 5 mg (typically 1.25 mg) IV over 5 minutes.  Can be repeated every 6 hours.
  45. Decadron / Dexamethasone / Hexadrol

    Class
    Indication
    Dose
    Corticosteroid / Anti-Inflammatory

    • Anaphylaxis (after Epi & Benadryl)
    • Asthma
    • COPD

    Anaphylaxis: 4 - 10 mg IV - single dose prehospitally

    4 - 24 mg IV
  46. Benadryl / Diphenhydramine

    Class
    Indication
    Dose
    Anti-Histamine

    • Allergic reactions
    • Anaphylaxis
    • Extrapyramidal symptoms

    25 - 50 mg slow IV push or deep IM
  47. Solu-Medrol / Methylprednisolone

    Class
    Indication
    Dose
    Corticosteroid / Anti-Inflammatory

    • Severe anaphylaxis
    • Asthma
    • COPD

    125 - 250 mg IV - single dose prehospitally
  48. Zofran / Ondansetron

    Class
    Indication
    Dose
    Antiemetic

    Nausea & Vomiting

    4 - 8 mg IV
  49. Phenergan / Promethazine

    Class
    Indication
    Dose
    Phenothiazine Antihistamine (H1 antagonist)

    • Nausea & Vomiting
    • Motion Sickness
    • Sedation
    • To potentiate the effects of analgesics

    12.5 - 25 mg IV or deep IM
  50. Reglan / Metoclopramide

    Class
    Indication
    Dose
    Phenothiazine Antiemetic

    • Nausea & Vomiting
    • Gastroesophageal reflux

    • 10 mg slow IV push over 1 - 2 minutes
    • or
    • diluted in 50 mL NS over 15 minutes

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