Medication Drug Homework

Wide and narrow tachyarrhythmias

6mg rapid IV; after 1-2 minutes w/ no cardioversion - 12mg rapid IV - repeat 12mg if necessary

asthma, bronchospasm assoc w/ COPD

• MDI: 1-2 sprays
• SVN: 2.5mg in 3.0mL saline

Life-threatening cardiac arrhythmias (ventricular tachycardia/ ventricular fibrillation)

• Vent. fib/pulseless Vent. tachycardia: 300mg - repeat 150mg
• Recurrent/refractory narrow-complex tachycardia: 150mg over 10 min. repeat as necessary

New chest pain suggestive of acute MI; signs & symptoms of recent stroke

324mg  PO

Hemodynamically significant bradycardia; organophosphate poisoning  IV

• Bradycardia: 0.5mg every 3-5 minutes - max dose = 3.0mg
• Organophosphate poisoning: 2-5mg or more IV

Asthma, bronchospasm assoc w/ COPD

• SQ: 0.25mg 
• MDI: 2 inhalations 1 minute apart

CHF; pulmonary edema

0.5 - 1.0mg  IV  IM

Hyperkalemia; hypocalcemia; calcium channel blocker OD; abdominal muscle spasm assoc w/ spider bite & Portugese Man-O-War sting

2-4mg/kg of 10% solution - repeat in 10 minutes

Poisoning

1g/kg mixed in glass of warm water

Anaphylaxis (after epi & dipenhydramine); asthma; COPD

4-24mg  IV  IM

Hypoglycemia

25g  IV

Major motor seizure; status epilepticus; premed before cardioversion; skeletal muscle relaxant; acute anxiety

• Status epilepticus: 5-10mg IV
• Anxiety: 2-5mg IV  IM
• Premed: 5-15mg  IV

Anaphylaxis; allergic reaction; dystonic reaction to phenothiazines

25-50mg slow IV  deep IM

Stable narrow-complex tachycardia uncontrolled by adenosine or vagal maneuvers or recurrent SVTs; control ventricular rate w/ Afib or atrial flutter

0.25mg/kg (15-20mg) IV bolus over 2 min - additional 0.35mg/kg (20-25mg) in 15 minutes if needed

CHF (short term management)

2.5-20mcg/kg/min (250mg in 500mL D5W)

Hypotension (systolic below 70-100mmHg)not from hypovolemia; bradycardia refractory to atropine

2-5mg/kg/min (800mg in 500mL D5W) increase as needed

Asthma, COPD, allergic reaction

0.3 - 0.5mg IM

Cardiac arrest; anaphylactic shock; severe reactive airway disease

• Cardiac arrest: 1mg repeat 3-5min 
• Anaphylaxis: 0.05 - 0.1mg IV  IO

RSI

0.1 - 0.3mg/kg  IM

Severe pain; RSI adjunct; analgesia maintenance

25-100mcg  IV  IN

CHF; pulmonary edema

40-80mg  IV

Hypoglycemia; beta blocker OD

• 0.25 - 0.5 units IV
• 1mg  IM

asthma; reversible bronchospasm assoc w/ chronic bronchitis & emphysema

500mcg  SVN

RSI

• IV: 1.0 - 4.5mg/kg
• IM: 3 - 8mg/kg

Hypovolemic shock (systolic less than 90mmHg)

"wide open" until systolic BP =100mmHg, then 100mL/hr  IV

Ventricular tachycardia & ventricular fibrillation refractory to amiodarone

• Bolus: 1 - 1.5mg/kg - repeat dose @ 0.5-0.75mg/kg @ 5-10min intervals - max 3.0mg/kg
• Maint: 2-4mg/min - reduce dose by 50% in Pt  over 70yrs old

Torsades des pointes; eclampsia

1-2g  IV  IM

Anaphylaxis; asthma; COPD

125-250mg  IV  IM

Premed for cardioversion; acute anxiety

1.0 - 2.5mg  IV

Severe pain

• IV: 2-5mg followed by 2mg every few minutes until pain relieved
• IM: 5-15mg (weight based)

Opiate OD; partial reversal of opiate effects

0.5 - 1.0mg  IV

Narcotic (opiate) OD; rule out narcotic OD in coma of unknown origin

1-2mg  IV  IM  IN

Angina pectoris; chest pain assoc w/ MI

1 tablet - repeat @ 3-5 min up to 3 doses  sublingual

angina pectoris; chest pain assoc w/ MI

1/2 - 1inch  topical

Postpartum vaginal bleeding

• IV: 10-20 units in 500mL D5W - administer according to uterine response
• IM: 3-10 units

Nausea & vomiting; gastroesophageal reflux

• IM: 10-20mg
• IV: 10mg slow IV push over 1-2 minutes

Tricyclic antidepressant OD; severe acidosis refractory to hyperventillation

1mEq/kg followed by 0.5mEq/kg every 10 minutes

RSI; endotracheal intubation

1-1.5mg/kg  IV

Coma of unknown origin; alocholism; delirium tremens

100mg  IV  IM

Narrow-complex tachycardias (if rhythm uncontrolled/unconverted by adenosine or vagal maneuvers or recurrent SVTs); control ventricular rate in atrial fibrillation/flutter

2.5 - 5.0mg - repeat @ 5-10mg after 15-30 min of PSVT not converted - max 30mg in 30 min

RSI; skeletal muscle relaxer; paralyzes skeletal and respiratory muscles

0.08 - 0.1 mg/kg   IV

Nausea; vomiting

4-8mg  IV  IM  PO