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- Actions:Binds and Absorbs ingests toxins in gastrointestinal tract
- Indications:Posions and medication overdose after stomach has been emptied or without vomiting
- Contraindications:ALC, unless admin by nasgastric tube and airway is protected by tube. cyanide, methanol, organophosphate toxicity
- Nausea, vomiting, abdominal cramping, constipation with black stools.
- Adult: 1g/kg mix with water
- Peds: 1g/kg mix with water
- Actions:Blocks cellular histamine receptors, decreases vasodilation
- Indications:Relief of allergies, allergic reactions, acute dystonic reactions, blood admin reactions.
- Contraindications:Asthma, glaucoma, pregs, hypertension, infants, pt taking monamine oxides inhibiters
- Reactions:Sedation, hypotension, seizures, vomiting, urinary retention, palpitations, arrhythmias
- Adult: 25-50 mg IV or 50 mg deep IM. (max 400mg per day)
- Peds: 1mg/kg (max 50mg/300mg per day) dilute w/9ml NS to equal 50mg/10ml
- Actions:Metabolic precursor to norepi. increase vascular resistance, dilate renal, increases myocardial contractility and stroke volume
- Indications:Cardiogenic, septic, spinal shock, hypotension/low cardiac output states. distributive shock
- Contraindications:Hypovolemic shock, coma, tachyarrhythmias, V-fib
- Reactions:Arrhythmias, hypertension, increased myocardial oxygen demand, may cause tissue necrosis
- Dosage:Adult: 2-20mcg/kg/min (max 20mcg)
- Peds: same as above
- Actions:Depresses CNS, produces sedation, relieves anxiety, cause lack of recall, relief muscle spasms.
- Indications:Adjunct to seizure control, control violent pt
- Narrow-angle glaucoma, coma, shock, suspected drug abuse
- Reactions:Respiratory depression, apnea, drowsiness, sedation, ataxia, psychomotor impairment, confusion, restlessness, hypotension, bradycardia
- Dosage:1-2mg IV or IM
- Actions:Inhibits CNS catecholamine receptors, strong antidopaminergic, weak anticholinergic, depresses subcurtical, mid brain, RAS
- Indications:Acute psychotic episodes
- Contraindications:Agitation secondary to shock or hypoxia, parkinson, seizures disorders, coma, alcoholism, cocaine overdoes
- Reactions:Restlessness, spasms, parkinson like symptoms, drooling, dystonia, hypotension, blurred vision.
- Dosage:5-10mg IM peds not recommended
- Actions:Reverse respiratory depression secondary to depressant drugs, inhibits effect of morphine
- Opiate overdose, coma, agonist for: morphine, heroin, methadone, meperidine(Demeral) paregoric, fentanyl(Sublimase) oxycodone(percodon) codeine
- Contraindications:Narcotic dependent pt, neonates of narcotic dependent mothers
- Reactions:Withdrawal symptoms, tachycardia, hypertension, arrhythmias, diaphoresis
- Adult: Initial 2mg IV,IM,SC,ET, repeat 2-3mins, no response after 10mg its not a narcotic. fentanyl requires large dose
- Peds: .1mg/kg IV,IM,IO,ET,SC repeat .1mg/kg
- Actions:Decrease vent automaticity and raises vent fib threshold
- V-tach and V-fib
- Contraindications:2nd and 3rd AV block, morbitz II, stones-adams syndrome, ventricular dysrhythmias associated with tricyclic antidepressant overdoes
- Reactions:Slurred speech, seizures, AMS, confusion, lightheadedness, blurred vision, bradycardia
- Adult: 1-1.5mg/kg IV, repeat .5-.75mg/kg 5-10mins, total of 3mg/kg. repeat every 3mins for vent ectopy
- Peds: 1mg/kg IV
- Parasympathetic agent binds to receptors and diminishes actions of acetylcholine .
- Indications:Unstable bradycardia(<60 beats) PEA, organophosphate poisoning, brochospastic disorders Contraindications:Tachycardia, myocardial ischemia, narrow-angle glaucoma
- Reactions:Flushing, pupil dilation, dry mouth, tachycardia, nausea, vomiting.
- Adult: .03mg/kg IV, repeat 5-10mins
- Peds: .05mg/kg (max 3mg/kg) IV, repeat 5-10mins
- Blocks sodium channels and myocardial potassium channels, vasodilator
- Indications:V-fib/ pulseless V-tach, SVT, instable V-tach in pt refractory to other therapy
- Contraindications:Hypersensitivity, cardiogenic shock, sinus bradycardia, 2nd or 3rd degree AV block
- Hypotension, Bradycardia, fever, CHF, V-tach, nausea, abnormal liver function
- Adult: VT/pulse and SVT: 150mg IV in 50ml D5W over 10 mins and repeat. VF and pulseless VT: 300mg IV
- Peds: VT/pulse and SVT: 5mg/kg in 50ml D5W IV over 20 mins. VF and Pulseless VT: 5mg/kg IV
- Decreases conduction through AV node, slows HR
- Indications:SVT, wolff-parkinson-white syndrome
- Contraindications:2nd and 3rd degree AV block, sick sinus syndrome, known hypersensitivity to adenosine, artial flutter, V-tach
- Reactions:Flushing, shortness of breathe, chest pain, headache, paresthsia, diaphoresis, palpitations, hypotension, metallic taste
- Adult: 6ml rapid IV/followed by 20ml NS flush, repeat 2 mins, 12mg IV/ 20ml NS flush
- Peds: 0.1mg/kg rapid IV/ 6ml NS flush(max 6mg)
- repeat in 2mins, 0.2mg/kg, 6ml NS flush(max 12mg)
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