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Lactated Ringers
Class
Isotonic Crystalloid
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Lactated Ringers
Action
Approximates the electrolyte concentration of the blood
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Lactated Ringers
Indication
Hypovolemic shock
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Lactated Ringers
Contraindications
- Congestive heart failure
- Renal failure
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Lactated Ringers
Precaution
Monitor for circulatory overload
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Lactated Ringers
Side effects
Rare
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Lactated Ringers
Dosage
- Hypovolemic shock (systolic less then 90): infuse wide open until a systolic of 100 is attained, Infusion should be slowed to 100 ml/hr
- Other: as indicated by the patients condition
- and situation being treated
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Lactated Ringers
Route
IV
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Lactated Ringers
Ped dose
20 ml/kg repeated as required based on hemodynamic response
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D5W
Action
Glucose nutrient solution
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D5W
Indication
- IV access for emergency drugs
- For the dilution of concentrated
- drugs for IV infusion
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D5W
Contraindication
- Should not be used as fluid replacement for hypovolemic states
- Avoid
- in head injury and stroke
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D5W
Precautions
- Monitor for circulatory overload
- Draw tube of blood before admin to diabetics
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D5W
Dosage
- Generally admin TKO
- Ped dose is the same
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Normal Saline solution
Class
Istotonic electrolyte
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Normal Saline solution
Action
Fluid & sodium replacement
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Normal Saline solution
Indication
- Heat related problems
- Fresh water drowning
- Hypovolemia
- Diabetic ketoacidose
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Normal Saline solution
Contraindication
CHF
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Normal Saline solution
Precaution
Electrolyte depletion can occur following administration of large amounts of NSS
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Normal Saline solution
Side effects
Thirst
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Normal Saline solution
Dosage
- Dependent on PT condition & situation being treated
- In fresh water drowning & heat emergency is usually rapid
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Normal Saline solution
Route
IV
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Normal Saline solution
Ped Dose
dose is dependent on PT size and condition
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O2
Action
Necessary for cellular metabolism
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O2
Contraindication
Non-hypoxic PT
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O2
Precautions
- Avoid hyperoxia
- Use cautiously in pt with COPD
- Humidify when providing high flow rates
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O2
Side effects
Drying of mucous membranes
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O2
Dosage
- Cardiac-arrest: 100%
- Other critical PT: 100%
- Other: only administer enough to correct hypoxia
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O2
Ped dosage
24-100% as required
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Aspirin
Class
Platelet inhibitor & anti-inflammatory
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Aspirin
Action
Inhibits platelet aggregation
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Aspirin
Indications
- New chest pain suggestive of acute myocardial infarction
- Signs & symptoms suggestive of recent stroke
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Aspirin
contraindication
Pt with known hypersensitivity to the med
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Aspirin
Side effects
- Heartburn
- Nausea & Vomiting
- Weezing
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Aspirin
Precaution
Gastrointestinal bleeding & upset stomach
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Aspirin
Dosage
160 or 325 mg by mouth chewed
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Aspirin
Ped dosage
10-15 mg/kg/dose
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Activated charcoal
Class
Adsorbent
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Activated charcoal
Action
Adsorbs toxic substances from the GI tract
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Activated charcoal
Indication
- Most oral poisonings & medication overdoses
- can be used after evacuation of poisons
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Activated charcoal
Contraindication
- Oral admin to comatose PT
- after ingestion of corrosive, caustics, petroleum distillates (ineffective my induce vomiting)
- Simultaneous admin with other oral drugs
- Use caution in pt experiencing abdomen pain or know GI obstruction
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Activated charcoal
Side effects
If aspirated can induce a fatal form of pneumonia
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Ipicac
Actions
Irritates the enteric tract
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Ipicac
Indication
Poisoning in conscious PT
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Ipicac
Contraindication
- Vomiting should not be induced in any PT with impaired consciousness
- Anti-emetic poisonings
- Especially os the phenothiazine type
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Ipicac
Precautions
- Monitor & ensure PT airway
- the risk of aspiration is increased when using
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Ipicac
Dosage
30 ml (1oz) followed by 15 ml/kg of warm water
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Ipicac
Ped dose
- <1 year: 10 ml
- 1-12 years: 15 ml
- >12 years: 30 ml
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D50water
Class
carbohydrate
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D50water
Action
Elevates blood glucose level rapidly
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D50water
Indication
Hypoglycemia
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D50water
Contraindications
None in the emergency setting
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D50water
Precaution
A blood sample should be drawn before administering
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D50water
Side effects
Local venous irritation
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D50water
Dosage
25g (50 ml)
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D50water
Ped dosage
- 0.5g/kg slow iv
- Should be diluted 1:1 with sterile water to form a 25% solution
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Glucagon
Class
Hormone (antinypolyglycemic agent)
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Glucagon
Actions
- Causes breakdown of glycogen to glucose
- Inhibits glycogen systhesis
- Elevates blood glucose level
- Increase cardiac contractile force
- Increases heart rate
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Glucagon
Indication
- Hypoglycemia
- Beta-blocker overdose
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Glucagon
Contraindications
Hypersensitivity to the medication
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Glucagon
Precaution
- effective only if there are sufficient stores of glycogen within the liver
- Draw blood for glucose test before administering
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Glucagon
Side effects
Few in the emergency situation
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Glucagon
Dosage
- IV: 0.25 - 0.5 units
- IM: 1mg
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Glucagon
Ped dosage
.03 mg/kg
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Albuterol (Proventil)
Class
Sympathomimetic (B2 selective)
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Albuterol (Proventil)
Action
Bronchodilation
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Albuterol (Proventil)
Indications
- Asthma
- Reversible bronchospasm associated with copd
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Albuterol (Proventil)
Contraindications
- Known hypersensitivity to the med
- Symptomatic tychycardia
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Albuterol (Proventil)
Precaution
- Blood pressure, pulse & ecg should be monitored
- Use caution in pt with known heart disease
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Albuterol (Proventil)
Side effects
- Palpitations
- Anxiety
- Headache
- Dizziness
- Sweating
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Albuterol (Proventil)
Dosage
- Meter dose inhaler: one to two sprays (90mcg per spray)
- Small volume nebulizer: 0.5 ml (2.5-5.0 mg) in 2.5 ml nss over 5-15 min
- Rotoinhaler: one 200 mcg roto cap should be placed in the inhaler and breathed by the pt
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Albuterol (Proventil)
Route
Inhalation
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Albuterol (Proventil)
Pediatric dosage
- < 1 year: 0.05-0.15 mg/kg dose
- 1-5 years: 1.25-2.5 every 4 to 6 hr
- 5-12 years: 2.5 mg dose every 4 to 6 hr
- >12 years: 2.5-5.0 mg dose every 6 hours
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Nitrous oxide
Action
Cns depressant
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Nitrous oxide
Indication
- Pain of musculoskeletal origin particularly fractures & burns
- Suspected ischemic chest pain
- States if severe anxiety including hypervilation
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Nitrous oxide
Contraindications
- Pt who cannotcomprehend verbal instructions
- Pt intoxicated with alcohol or medication
- Head injury
- Pt who exhibits an altered mental status
- Copd
- Increased Oxygen con may cause resp depression
- Thoracic injury suspicous of pheumothorx
- Abdominal pain and distension suggestive of bowel obstruction
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Nitrous oxide
Precaution
- Use only in well ventilated area
- Gas scavenging system is recommended
- May not operate properly in low temperature
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Nitrous oxide
Side effects
- Headache
- Dizziness
- Giddiness
- Nausea
- Vomiting
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Nitrous oxide
Dosage
Self administered only using 50% Nitrous oxide & 50% oxygen blender
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Nitrous oxide
Route
Inhalation only
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Nitrous oxide
Ped dosage
Self administered only
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Isoetharine (bronkosol)
Class
Sympathomimetic (b2 selective)
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Isoetharine (bronkosol)
Actions
- Bronchodilation
- Increases heart rate
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Isoetharine (bronkosol)
Indications
- Asthma
- Reversible bronchospasm associated with chronic bronchitis & emphysema
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Isoetharine (bronkosol)
Contraindications
Pt with history of hypersensitivity to medication
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Isoetharine (bronkosol)
Precaution
Blood pressure, pulse &ecg must be constantly monitored
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Isoetharine (bronkosol)
Side effects
- Palpitations
- Tachycardia
- Anxiety
- Tremors
- Headache
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Isoetharine (bronkosol)
Dosage
- Hand nebulizer: four inhalations
- Small volume nebulizer: 0.5 ml(1:3 with saline)
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Isoetharine (bronkosol)
Route
Inhalation only
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Isoetharine (bronkosol)
Ped dosage
0.25-0.5 ml diluted with normal saline
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Ipratropium (atrovent)
Class
Anticholinergic
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Ipratropium (atrovent)
Actions
- Causes Bronchodilation
- Dries respiratory tract secretions
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Ipratropium (atrovent)
Indications
- Bronchial Asthma
- reversible broncospasm associated with chronic bronchitis & emphysema
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Ipratropium (atrovent)
Contraindications
- Hypersensitivity to the meds
- should not be used as primary acute treatment of brohchospasm
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Ipratropium (atrovent)
Precaution
Monitor vital signs
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Ipratropium (atrovent)
Side effects
- Palpitations
- Dizziness
- Anxiety
- Headache
- Nervousness
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Ipratropium (atrovent)
Dosage
- 500 mcg Placed in a small volume nebulizer
- (typically administered with a B-agonist)
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Ipratropium (atrovent)
Route
Inhaled
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Ipratropium (atrovent)
Ped dose
350-500 mcg/dose
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Aminophylline
Class
Xanthine bronchodilator
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Aminophylline
Action
- Smooth muscle Relaxant
- Causes bronchodilation
- Has mild diuretic properties
- Increases heart rate
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Aminophylline
Indications
- Bronchial Asthma
- Reversible bronchospasm associated with chronic bronchitis & emphysema
- CHF
- Pulmonary edema
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Aminophylline
Contraindication
- Hypersensitivity to the med
- Hypotension
- Pt with peptic ulcer disease
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Aminophylline
Precautions
- Monitor for arrhythmias
- Monitor BP
- Do not administer to Pt on chronic theophylline preparations until the Theophyiline blood level has been determaned
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Aminophylline
Side effects
- Convulsions
- Tremor
- Anxiety
- Dizziness
- Vomiting
- Palpitations
- PVC
- Tachycardia
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Aminophylline
Dosages
Method #1: 250-500 in 90 or 80 ml of D5W infused over 20-30 min (Approximatly 5-10 mg/kg/hr)
Method #2: 250-500 mg (5-7mg/kg) in 20ml D5W infused over 20-30 min
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Aminophylline
Route
Slow IV
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Aminophylline
Ped dose
6 mg/kg loading dose to be infused over 20-30 min max dose not to exceed 12 mg/kg over 24 hours
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Salbutamol (ventolin)
Class
Sympathometic (B2 selective)
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Salbutamol (ventolin)
Action
Bronchodilation
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Salbutamol (ventolin)
Indication
- Asthma
- Reversible bronchospasm associated with COPD
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Salbutamol (ventolin)
Contraindication
- Hypersensitivity to the med
- Symptomatic tachycardia
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Salbutamol (ventolin)
Precautions
- Blood pressure
- Pulse &ecg should be monitored
- use caution in patients with known heart disease
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Salbutamol (ventolin)
side effects
- Palpitations
- Anxiety
- Headache
- dizziness
- sweating
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Salbutamol (ventolin)
doses
- metered dose inhaler: One to two sprays ( 90 MCG pre spray )
- small volume nebulizer: 0.5 ml (2.5mg) in 2.5 ml normal saline over 5 to 15 minutes
- roto inhaler: one 200 MCG Radio cab should be placed an inhaler and breathe by patient
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Salbutamol (ventolin)
Route
Inhalation
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Salbutamol (ventolin)
Ped dose
0.15 mcg/kg (0.03 ml/kg) in 2.5 ml of normal saline
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Dimenhydrinate (Gravol, Dramamine)
Class
Antihistamine
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Dimenhydrinate (Gravol, Dramamine)
Action
Antiemetic
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Dimenhydrinate (Gravol, Dramamine)
Indication
- Nausea and vomiting
- Motion sickness
- to potentiate the effects of analgesics
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Dimenhydrinate (Gravol, Dramamine)
Contraindication
Comatose states
Patients who have recevived a large amounts of depressants (including alcohol
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Dimenhydrinate (Gravol, Dramamine)
Precautions
use with caution in patients with sezure disorders
Asthma
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Dimenhydrinate (Gravol, Dramamine)
side effects
May impair mental and physical ability
Drowsines
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Dimenhydrinate (Gravol, Dramamine)
Dosage
Slow Intravenous: 12.5-25.0 mg
Intramuscular or oral: 50-100 mg
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Dimenhydrinate (Gravol, Dramamine)
Routes
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Dimenhydrinate (Gravol, Dramamine)
Ped dose
Data Unavailable
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Racemic Epinephrin
Class
Sympathomimetic
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Racemic Epinephrin
Actions
- Bronchodilation
- Increases heart rate
- Increases cardiac contractile force
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Racemic Epinephrin
indication
Croup (laryngotracheobronchitis)
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Racemic Epinephrin
Contraindication
- Epiglottitis
- Hypersensitivity to med
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Racemic Epinephrin
Precaution
- Vital signs should be constanly monitored
- Should be used only once in the prehospital setting
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Racemic Epinephrin
Side Effects
- Palpitations
- Anxiety
- Headache
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Racemic Epinephrin
Dosage
0.25-0.75 ml of a 2.25% solution in 2.0 ml normal saline
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Racemic Epinephrin
Route
Inhalation only (small volume nebulizer)
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Racemic Epinephrin
Ped dose
0.25-0.75 ml of a 2.25% solution in 2.0 ml normal saline
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Epinephrine 1:1000
Class
Sympathomimetic
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Epinephrine 1:1000
Action
Bronchodilation
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Epinephrine 1:1000
Indications
- Bronchial asthma
- Exacerbation of COPD
- Allergic Reaction
- Ped cardiac arrest ( after initial epi dosage)
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Epinephrine 1:1000
contraindications
- PT with underlying cardiovascular disease
- Hypertension
- Pregnancy
- Pt with tachyrrhythmias
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Epinephrine 1:1000
Precautions
- Should be protected from light
- Blood pressure, Pulse, and ecg should be monitored
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Epinephrine 1:1000
Side effects
- Palpatation and tachycardia
- Anxiousness
- Headache
- Tremor
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Epinephrine 1:1000
Dosage
0.3-0.5 mg
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Epinephrine 1:1000
Route
IM
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Epinephrine 1:1000
Ped Dosage
0.01 mg/kg up to 0.3 mg
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Epinephrine 1:10000
Class
Sympathomimetic
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Epinephrine 1:10000
Action
- Increases heart rate and automaticity
- Increases cardiac contractile force
- Increases Myocardial electrical activity
- Increases Sys
- Increases
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Epinephrine 1:10000
indications
- Cardiac arrest
- Anaphylactic Shock
- sever reactive airway disease
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Epinephrine 1:10000
Contraindications
- Epi 1:10000 is for IV or et use
- Should not be used in pt who do not require resuscitative efforts
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Epinephrine 1:10000
Precautions
- Protect from light
- Can be deactivatied by alkaline solutions
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Epinephrine 1:10000
Side effects
- Palpitaions
- Anxiety
- Tremulousness
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Epinephrine 1:10000Dosage
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Epinephrine 1:10000Routes
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Epinephrine 1:10000Ped Dose
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KetamineContraindications
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Meperidine (Demerol)Class
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Meperidine (Demerol)Actions
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Meperidine (Demerol)Indications
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Meperidine (Demerol)Contraindacations
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Meperidine (Demerol)Precautions
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Meperidine (Demerol)Dosage
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Meperidine (Demerol)Side Effects
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Meperidine (Demerol)Routes
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Meperidine (Demerol)
Ped dose
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Midazolam (versed)Actions
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Midazolam (versed)Indications
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Midazolam (versed)Contraindications
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Midazolam (versed)Precautions
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Midazolam (versed)Side Effects
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Midazolam (versed)Ped Dose
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Pancuronium Bromide (pavulon)Class
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Pancuronium Bromide (pavulon)actions
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Pancuronium Bromide (pavulon)indication
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Pancuronium Bromide (pavulon)Contraindication
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Pancuronium Bromide (pavulon)precautions
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Pancuronium Bromide (pavulon)side effects
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Pancuronium Bromide (pavulon)dosage
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Pancuronium Bromide (pavulon)Route
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Pancuronium Bromide (pavulon)pediatric dosage
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Rocuronium bromide (Zemuron)class
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Rocuronium bromide (Zemuron)action
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Rocuronium bromide (Zemuron)indication
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Rocuronium bromide (Zemuron)Contraindication
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Rocuronium bromide (Zemuron)precaution
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Rocuronium bromide (Zemuron)side effects
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Rocuronium bromide (Zemuron)dosage
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Rocuronium bromide (Zemuron)Route
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Rocuronium bromide (Zemuron)pediatric dosage
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Succinylcholine (anectine)Class
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Succinylcholine (anectine)actions
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Succinylcholine (anectine)indication
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Succinylcholine (anectine)contraindications
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Succinylcholine (anectine)precautions
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Succinylcholine (anectine)side effects
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Succinylcholine (anectine)dosage
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Succinylcholine (anectine)Route
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Succinylcholine (anectine)RouteIV
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Succinylcholine (anectine)pediatric dose
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Vecuronium (Norcuron)class
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Vecuronium (Norcuron)action
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Vecuronium (Norcuron)indication
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Vecuronium (Norcuron)contraindications
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Vecuronium (Norcuron)precautions
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Vecuronium (Norcuron)side effects
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Vecuronium (Norcuron)dosage
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Vecuronium (Norcuron)Route
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Vecuronium (Norcuron)pediatric dosage
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Plasma Protein Fraction (Plasmanate)Class
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Plasma Protein Fraction (Plasmanate)Action
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Plasma Protein Fraction (Plasmanate)Indication
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Plasma Protein Fraction (Plasmanate)Contraindication
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Plasma Protein Fraction (Plasmanate)Precautions
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Plasma Protein Fraction (Plasmanate)Side effects
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Plasma Protein Fraction (Plasmanate)Dosage
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Plasma Protein Fraction (Plasmanate)Route
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Plasma Protein Fraction (Plasmanate)Pediatric Dosage
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