Pharmacology Manual: Administrations

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kmariie
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Pharmacology Manual: Administrations
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2013-10-26 16:40:04
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Pharmacology Manual: Administrations
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  1. ADENOSINE: Adult Administration
    • SVT: 6mg rapid (within 1-3 seconds) IVP, followed immediately with 20ml NS rapid IVP bolus. May repeat 12mg rapid IVP in 1-2 minutes x 1.
    • Poorly Perfusing SVT: 12mg rapid (within 1-3 seconds) IVP, followed immediately with 20ml NS rapid IVP bolus. May repeat 12mg rapid IVP in 1-2 minutes x 1.
  2. ADENOSINE: Peds Administration
    0.1mg/kg rapid (within 1-3 seconds) IVP, followed immediately with 10ml NS rapid IVP bolus. May repeat 0.2mg/kg rapid IVP in 1-2 minutes x 1.
  3. ALBUTEROL SULFATE: Adult Administration
    • Bronchospasm: 5mg inhalation by HHN over 5-15 minutes. May repeat as many times as needed.
    • Crush Syndrome: 5mg inhalation, continuous by HHN.
  4. ALBUTEROL SULFATE: Peds Administration
    • 0-1 yr: 2.5mg inhalation by HHN over 5-15 minutes. May repeat as many times as needed.
    • >1yr: Same as adult
  5. AMIODARONE HYDROCHLORIDE: Adult Administration
    Initial dose 300mg rapid IVP or IO. May repeat in 3-5 minutes - 150mg rapid IVP or IO. Max dose = 450mg total.
  6. AMIODARONE HYDROCHLORIDE: Peds Administration
    5mg/kg rapid IVP or IO. May repeat after 3-5 minutes x 2. Max dose= 15mg/kg. Max single dose= 300mg.
  7. AMYL NITRITE: Adult Administration
    • 0.3ml crushable glass ampule. Inhalation of fumes for 30-60 seconds. May repeat as needed. Tape to inside of mask. Replace ampule every 2-3 minutes.
    • Avoid touching skin.
  8. AMYL NITRITE: Peds Administration
    • 0.3ml crushable glass ampule. Inhalation of fumes for 30-60 seconds. May repeat as needed. Tape to inside of mask. Replace ampule every 2-3 minutes.
    • Avoid touching skin.
  9. ASPIRIN: Adult Administration
    81-324mg PO (=1-4 tablets)
  10. ASPIRIN: Peds Administration
    Not recommended for prehospital use.
  11. ATROPINE SULFATE: Adult Administration
    • Bradydysrhythmias: 0.5mg rapid IVP or IO. may repeat dose every 3-5 minutes to a max of 3mg given. Repeat until HR >60 or signs of adequate perfusion.
    • Insecticides: 2mg rapid IVP, IM. May repeat dose every 5 minutes until patient is asymptomatic. Symptomatic: <60, respiratory depression, extreme salivation
  12. ATROPINE SULFATE: Peds Administration
    • >1 month old
    • Bradydysrhythmias: Epi and O2 are the initial meds. If no response to Epi then...
    • Increased Vagal Tone: 0.02mg/kg rapid IVP or IO. Minimum single dose = 0.1mg
    • Insecticides: <12 years:="" max="" single="" dose="1mg<br" total="">->13 years: Max single dose = 1mg. Total dose=2mg
  13. CALCIUM CHLORIDE: Adult Administration
    • Cardiac Arrest: 1gm slowly (over 60 seconds) IVP. May repeat every 10 minutes.
    • Crush Syndrome: 1gm slowly (over 60 seconds) IVP. Same but may not repeat.
  14. CALCIUM CHLORIDE: Peds Administration
    • -Cardiac Arrest: 20mg/kg slowly (over 60 seconds) IVP. May repeat every 10 minutes.
    • -Crush Syndrome: same but may not repeat.
  15. CHARCOAL: Adult Administration
    • 25-50gm PO as tolerated.
    • Use preparation without Sorbitol in LA County
  16. CHARCOAL: Peds Administration
    • -0-2 years: not recommended for prehospital use.
    • ->2 years: Same as adult
  17. DEXTROSE 5% IV SOLUTION: Adult Administration
    Infuse at TKO rate using micro-drip tubing (30 mcgtts/min)
  18. DEXTROSE 5% IV SOLUTION: Peds Administration
    Not recommended for prehospital use.
  19. DEXTROSE 50% IN WATER: Adult Administration
    50ml (=25gm) IVP.
  20. DEXTROSE 50% IN WATER: Peds Administration
    • 0-2 years: Dilute to 25% 2ml/kg slowly (10ml/min) IVP.
    • >2 years: 1ml/kg slowly (10ml/min) IVP.
  21. DEXTROSE ORAL PREPARATIONS: Adult Administration
    • Solution: 75-100 PO, sipped slowly.
    • Paste/ Gel: 1 inch of paste placed between cheek and gum.
  22. DEXTROSE ORAL PREPARATIONS: Peds Administration
    • -Solution: 1gm/kg PO, sipped slowly.
    • -Paste/ Gel: Not recommended for prehospital use.
  23. DIAZEPAM: Adult Administration
    5-10mg SLOWLY IVP at 5mg/min. Titrate to stop seizure activity or until sedation occurs for Cardioversion. May repeat 5mg/min as needed to a max of 20mg.
  24. DIAZEPAM: Peds Administration
    0.1-0.3mg/kg SLOWLY (1mg/min) or 0.5mg/kg per rectum (PR). Titrate IV dose to stop seizure activity or until sedation occurs for Cardioversion. May repeat IVP dose as needed to max of 5mg up to age 5 and a max of 10mg for older pediatric patients.
  25. DIPHENHYDRAMINE: Adult Administration
    50mg slow IVP at 25mg/min or deep IM. May repeat 50mg/15min. Total max=100mg.
  26. DIPHENHYDRAMINE: Peds Administration
    1mg/kg slow IVP over several minutes
  27. DOPAMINE: Adult Administration
    Add 400mg to 500ml of NS as an IVPB. Start at 30mcgtts/min. Titrate to BP of 90-100 systolic and signs of adequate perfusion or to a max of 120mcgtts/min.
  28. DOPAMINE: Peds Administration
    Add 6mg/kg to 100ml NS as an IVPB. Start 10mcgtts/min. Titrate to signs of adequate perfusion or to a max of 20mcgtts/min.
  29. EPINEPHRINE HYDROCHLORIDE: Adult Administration
    • Cardiac Arrest: 1mg (1:10,000) IVP or IO. May repeat every 3-5 min.
    • Asthma/ Allergic Reaction: 0.3mg (1:1,000) SQ. May repeat every 20 min x 2.
    • Anaphylaxis with Shock: 0.1mg (1:10,000) slowly (over 1 min) IVP. May repeat every 3-5 min. OR 0.5mg (1:1,000) IM if unable to obtain venous access.
  30. EPINEPHRINE HYDROCHLORIDE: Peds Administration
    Cardiac Arrest: 0.01mg/kg (1:10,000) IVP or IO. May repeat every 3-5 min. Max single dose is 1mg.

    Asthma/ Allergic Reaction:0.01mg/kg (1:1,000) SQ. Max single dose is 0.3mg. May repeat every 20 min x 2.

    Anaphylaxis with Shock: 0.01mg/kg (1:10,000) slowly (over 1 min) IVP. Max single dose is 0.1mg. May repeat every 3-5 min.

    Bradydysrhythmia: 0.01mg/kg (1:10,000) IVP. Max single dose is 0.1mg. May repeat 0.02mg/kg IVP every 3-5 minutes.

    • Stridor with Croup:
    • <1 yr="2.5mg" 1:1000="" diluted="" with="" 5ml="" ns="" via="" hhn=""
    • >1 yr=5mg (1:1,000) diluted with 5ml NS via HHN
  31. FUROSEMIDE: Adult Administration
    0.5-1mg/kg slow IVP over 1-2 minutes
  32. FUROSEMIDE: Peds Administration
    Not recommended for prehospital use.
  33. GLUCAGON: Adult Administration
    • -Hypoglycemia: 1mg IM. May repeat every 20 min x 2.
    • -Overdose: 3mg IVP.
  34. GLUCAGON: Peds Administration
    1mg IM if known diabetic, May repeat every 20 minutes x 2.
  35. LIDOCAINE HYDROCHLORIDE: Adult Administration
    • -Cardiac Arrest: V-Fib/ PVT: 1-1.5mg/kg slowly (over 1 min) IVP or IO. If no conversion after defibrillation, repeat 0.5-0.75mg/kg every 5-10 min. Max = 3 doses or total of 3mg/kg
    • -Ventricular Ectopy/ Post Defibrillation or Cardioversion for Ventricular Tachycardia: 1mg/kg slowly (50mg/min) IVP or IO. May repeat 0.5-0.75mg/kg slow IVP every 5-10 min. Max = 3mg/kg.
  36. LIDOCAINE HYDROCHLORIDE: Peds Administration
    -Cardiac Arrest: V-FIB/ PVT: 1mg/kg slowly (over 1 min) IVP or IO. Max= 100 mg.
  37. MIDAZOLAM HYDROCHLORIDE: Adult Administration
    • -Cardioversion/ TC Pacing: 1-2 mg IVP slowly at 1mg/min. 2.5 mg IM/IN. Max dose = 10mg. Titrate for sedation.
    • -Seizure Activity: 2-5 mg IVP slowly at 1mg/min. Repeat IVP 3-5 min PRN. 5mg IM/IN. Repeat IM/IN after 5 min x 1. Max dose= 10 mg. Titrate to suppress seizure activity.
    • -Agitated Delirium: 2-5 mg IVP slowly at 1mg/min. 5mg IM/IN. Repeat IM/IN dose x 1. Max dose= 10mg. Titrate until sedation occurs.
  38. MIDAZOLAM HYDROCHLORIDE: Peds Administration
    • -DO NOT ADMINISTER TO PEDS < 6 months
    • -Cardioversion: 0.1mg/kg IVP/IM/IN. IVP slowly at 1mg/min. Max dose = 5mg. Titrate IV to sedation. Repeat IVP/IM/IN x 1 PRN.
    • -Seizures: 0.1mg/kg IVP/IM/IN. IVP slowly at 1mg/min. Max dose= 5mg. Titrate IV to suppress seizure activity. Repeat IVP/IM/IN every 3-5 min.
  39. MORPHINE SULFATE: Adult Administration
    Pain control: 2-12mg slow IVP at 2mg/min. Titrate to relief of pain. May repeat IVP dose as needed to max of 20mg.
  40. MORPHINE SULFATE: Peds Administration
    0.1mg/kg slow (at 1mg/min) IVP. Titrate to relief of pain.
  41. NALOXONE: Adult Administration
    0.8-2mg IVP, IM, or IN. May repeat dose for all routes every 5 minutes as needed. Titrate IV dose to adequate respiratory rate and tidal volume.
  42. NALOXONE: Peds Administration
    0.1mg/kg IVP, IM, or IN. May repeat dose for all routes every 5 minutes as needed.
  43. NITROGLYCERIN SPRAY: Adult Administration
    • -Chest Pain: 1 spray (metered to 0.4mg=1/150th grain) SL or Transmucosal. May repeat every 3-5 minutes x 2.
    • -CHF/Pulmonary Edema: 0.4mg SL or transmucosal (1puff) if SBP is >100. 0.8mg SL or transmucosal (2puffs) is SBP is >150. 1.2mg SL or transmucosal (3puffs) if SBP is >200. May repeat dose x 2.
  44. NITROGLYCERIN SPRAY: Peds Administration
    Not recommended for prehospital use.
  45. ONDANSETRON HYDROCHLORIDE: Adult Administration
    • 4mg Orally - with oral disintegrating tablets
    • 4mg IV or IM - a single injection into a well developed muscle up to 4mg IVP, undiluted. Inject slowly, over at least 30 seconds. (3-5 min. preferred). Max dose is 4mg all routes.
  46. ONDANSETRON HYDROCHLORIDE: Peds Administration
    Does not specify
  47. OXYGEN: Adult Administration
    ...
  48. OXYGEN: Peds Administration
    ...
  49. POTASSIUM CHLORIDE: Adult Administration
    • MONITOR infusions only. Prehospital care providers are not allowed to start or add KCl to IV solutions.
    • Usual dose is 10-40 mEq added to main IV solution and should be administered at a TKO rate during transport.
  50. POTASSIUM CHLORIDE: Peds Administration
    Does not specify
  51. PRALIDOXIME CHLORIDE: Adult Administration
    Given in conjunction with Atropine in DuoDote (MARK I) Auto-Injector (600mg) IM. 1-3 auto-injectors depending on severity of signs and symptoms. Use upper-outer thigh or upper-outer aspect of the buttocks.
  52. PRALIDOXIME CHLORIDE: Peds Administration
    0.05mg/kg IM or IVP
  53. RINGER'S LACTATE IV SOLUTION: Adult Administration
    • Flow rate dependent on patient's condition. Infuse until return of signs of adequate perfusion.
    • Fluid Challenge: 10ml/kg given over 20-30 minutes run in IV wide open
    • Fluid Resuscitation: 3 times the fluid loss- run in IV wide open
  54. RINGER'S LACTATE IV SOLUTION: Peds Administration
    • Flow rate dependent on patient's condition. Infuse until return of signs of adequate perfusion.
    • Fluid Challenge: 20ml/kg within 10 minutes run in IV wide open
    • Fluid Resuscitation: 20ml/kg may repeat as necessary
  55. SODIUM BICARBONATE: Adult Administration
    • -Cardiac Arrest: 1mEq/kg IVP. May repeat 0.5mEq/kg IVP every 10-15 minutes
    • -Crush Syndrome: 1mEq/kg IVPB, added to first 1000ml of NS
  56. SODIUM BICARBONATE: Peds Administration
    • -Cardiac Arrest: 1mEq/kg SLOW IVP at 10ml/min. May repeat 0.5mEq/kg IVP every 10-15 minutes. (rarely indicated)
    • -Crush Syndrome: same as adult
  57. SODIUM CHLORIDE 0.9% IV SOLUTION: Adult Administration
    ...
  58. SODIUM CHLORIDE 0.9% IV SOLUTION: Peds Administration
    ...

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