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72 Cards in this Set

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Butorphanol - Names
Stadol
Butorphanol - Classification
synthetic narcotic analgesic
Butorphanol - Indications
moderate to severe pain
Butorphanol - Contraindications
hypersensitivity
head injury
undiagnosed abdominal pain
Butorphanol - Side Effects
may cause withdrawal in narcotic dependant patients

respiratory depression

palpitations

increased or decreased BP

headache
Butorphanol - Dose
1 mg IV

or

3 - 4 mg IM/3 - 4 hours
Butorphanol - Action
unknown

has both agonist and antagonist effects on opioid receptors

has analgesic effects similar to morphine
Droperidol - Names
Inapsine
Droperidol - Classification
antiemetic
Droperidol - Action
antagonizes emetic properties of morphine-like analgesics
Droperidol - Indications
N/V

to produce tranquilizing effects

in some cases, may be used as an antipsychotic
Droperidol - Contraindications
intolerance
Droperidol - Side Effects
drowsiness
lightheadedness
rapid heart rate
Droperidol - Adult Dose
2.5 - 10 mg IV
Droperidol - Peds
0.088 - 0.165 mg/kg IV
Droperidol - Notes
use with caution in elderly patients and in patients with hypotension, Parkinson's disease, and hepatic, renal, and cardiac impairment
Glucagon - Names
Glucagon
Glucagon - Classification
pancreatic hormone
insulin antagonist
Glucagon - Action
increases breakdown of glycogen to glucose and stimulates glucose synthesis, elevating blood glucose levels

exerts positive inotropic action on the heart and decreases renal vascular resistance
Glucagon - Onset
within 1 minute
Glucagon - Duration
60 - 90 minutes
Glucagon - Indications
persistent hypoglycemia despite glucose supplementation

calcium channel blocker or beta-blocker toxicity
Glucagon - Contraindications
hypersensitivity
Glucagon - Side Effects
hypotension
N/V
tachycardia
urticaria
Glucagon - Notes
effects of anticoagulants may be increased if given with glucagon

do not mix with saline

not a first line choice for hypoglycemia
Glucagon - Pregnancy Class
Class B
Glucagon - Adult Dose, Hypoglycemia
0.5 - 1 mg/IM, may repeat in 7 - 10 minutes
Glucagon - Adult Dose, Calcium Channel Blocker/Beta-Blocker Toxicity
1 - 5 mg over 2 - 5 min IV
Glucagon - Peds Dose, Hypoglycemia
0.025 - 1 mg IM, may repeat in 7 - 10 minutes
Epinephrine - Names
Adrenaline
Epi - Classification
sympathomimetic
Epi - Action
Beta-1 stimulation increases contractility, increases heart rate, and increases AV conduction.

Beta-2 stimulation results in bronchodilation and vasodilation of vessels in skeletal muscle.

Stimulation of Alpha-1 receptors causes vasoconstriction.

Low doses decrease peripheral resistance and decreases blood pressure.

Higher doses increase vascular resistance and increases blood pressure.
Epi - Onset
SQ: 5 - 10 minutes
IV/ET: 1 - 2 minutes
Epi - Duration
5 - 10 minutes
Epi - Indications
anaphylaxis
asystole
bronchial asthma
cardiac arrest
PEA
profound symptomatic bradycardia
V-fiv & pulseless V-tach unresponsive to initial defibrillation
Epi - Contraindications
hypovolemic shock
Epi - Side Effects
dysrhythmias
headache
hypertension
nausea
precipitation of angina pectoris
restlessness
tachycardia
weakness
Epi - Pregnancy Class
Class C
Epi - Notes
may increase myocardial oxygen demand

MAOI may potentiate effects

may be deactivated by alkaline solutions (sodium bicarb, furosemide)
Epi - Adult Dose, Bradycardia/Hypotension
30 mg 1:1000 in 250 mL NS, run at 100 cc/hr and titrate to response
Epi - Adult Dose, Pulseless Arrest
1 mg 1:10,000 IV push or ET (2 - 2.5 mg diluted in 10 cc NS) every 3 - 5 minutes, followed by 20 cc flush
Epi - Adult Dose, Anaphylaxsis
(2)
mild: 0.3 - 0.5 mL 1:1000 SQ

moderate to severe: 1 - 2 mL 1:10,000 slow IV over 10 minutes
Epi - Peds Dose, Bradycardia/Hypotension
0.01 mg/kg 1:10,000 (0.1 cc/kg) IV/IO
Epi - Peds Dose, Pulseless Arrest
0.01 mg/kg 1:10,000 IV/IO (ET 0.1 - 0.2 mg/kg 1:1000) may repeat every 3 - 5 minutes with up to 10 times the dose
Epi - Peds Dose, Anaphylaxsis
(2)
mild: 0.01 mL/kg 1:10,000 SQ, max 0.3 cc

moderate to severe: 0.05 - 0.15 mcg/kg/minute IV infusion
Diazepam - Names
Valium
Diazepam - Class
benzodiazepine
Diazepam - Action
raises seizure threshold in the motor cortex
Diazepam - Indications
acute anxiety
acute alcohol withdrawal
premedication for countershock or pacing
seizure activity
skeletal muscle relaxation
Diazepam - Contraindications
CNS depression resulting from head injury

coma (unless seizing or having severe muscle rigidity)

respiratory depression

shock

substance abuse (use w/caution)
Diazepam - Side Effects
(7)
a,c,h,n,p,2r
ataxia
confusion
hypotension
nausea
psychomotor impairment
reflex tachycardia (rare)
respiratory depression
Diazepam - Adult Dose, Seizures
5 mg over 2 min (up to 10 mg) IV q 10 - 15 minutes PRN (max dose 30 mg)
Diazepam - Adult Dose, Premedicate Cardioversion & Pacing
5 - 15 mg IV, 5 - 10 minutes before procedure
Diazepam - Peds Dose, Seizures
(2)
30 days - 5 yo: 0.2 to 0.5 mg slow IV q 2 - 5 min to max 5 mg

5 yo+: 1 mg q 2 - 5 min to max 10 mg slow IV
Diazepam - Pregnancy Class
Class D
Diazepam - Onset
IV: 1 - 5 min
IM: 15 - 30 min
Diazepam - Duration
15 min - 1 hour
Diazepam - Notes
reduce dose by 50% in elderly patients
Dopamine - Names
Intropin
Dopamine - Classification
sympathomimetic
Dopamine - Action
(3)
low dose: acts on dopaminergic receptors, causing renal, mesenteric, & cerebral vascular dilation

moderate dose (cardiac doses): stimulates beta adrenergic receptors, causing enhanced myocardial contractility, increased cardiac output, & rise in BP

high dose (vasopressor dose): has alpha-adrenergic effect, producing peripheral, arterial, & venous constriction
Dopamine - Indication
hemodynamically significant hypotension in the absence of hypovolemia
Dopamine - Contraindications
tachycardia
V-fib
Dopamine - Side Effects
dose related tachydysrhythmias
increased myocardial oxygen demand
hypertension
Dopamine - Adult Low Dose
1 - 5 mcg/kg/min
Dopamine - Adult Moderate (Cardiac) Dose
5 - 10 mcg/kg/min
Dopamine - Adult High (Vasopressor) Dose
10 - 20 mcg/kg/min
Dopamine - Peds Dose
2 - 20 mcg/kg/min IV/IO titrated to patient response, max dose 20 mcg/kg/min
Dopamine - Pregnancy Class
Class C
Dopamine - Onset
2 - 4 minutes
Dopamine - Duration
10 - 15 minutes
Dopamine - Notes
correct hypovolemia

use large stable vein