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46 Cards in this Set
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Adensosine
(Adenocard) |
Class: Antidysrythmic
Ind: Symptomatic PSVT SVT > QRS .12 sec if regular and monomorphic (wide complex tach) Contra: 2nd or 3rd degree heart blocks, sick sinus syndrome Prec: Dysrythmias (including blocks) common at time of conversion, caution w/asthma Pt Side: Facial flush, headache, SOB, dizziness, N/V Dose: 6 mg 1-2 sec push flush 12 mg same Route:IV Slows atrioventricular conduction |
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Albuterol
(Proventil) |
Class: Sympathomimetic
B2 selective Ind: Asthma, bronchospasm from COPD, hypokalemia, anaphylaxis chronic bronchitis, emphaysema Contra: Symptomatic tachy Prec: High BP, HR and ECG, Pt. w/heart disease Side: Palp, anxiety, headache, dizziness, sweating Dose: A: 2.5 mg/3 ml P: 0.15 mg/kg (0.03 ml/kg) Route:Inhalation Bronchodilation |
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Amiodaron
(Cordarone) |
Class: Antidysrhythmic (Group III)
Ind: Life threatening dysrhythmias (V-tach, v-fib) Contra: 2nd, 3rd blocks, atrioventricular block, sinus brady Prec: heart failure Side: Hypoten, N/V, anxiety, vent ectopic beats, malaise Dose: A: Loading dose 150 mg over 10 min Drip 1 mg/kg for 6 hours then 0.5 mg/min P: 5mg/kg or 15mg/kg Route: IV/oral Slows sinus rate, raises PR and QT intervals, lowers vascular resistance |
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Aspirin
(ASA) |
Class: Platelet inhibitor
Ind: New onset CP from MI, S/S recent stroke Contra: Hypersensitivity Prec: GI bleed, upset stomach Side: Heart burn, N/V, wheezing Dose: 160 or 325 mg P: not recommended Route: Oral |
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Atropine
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Class: Parasympatholytic
Anticholinergic Ind: Hemodynamically bradycardia, Hypotension secondary to brady, organophospate poisoning Contra: Tachy, Anterior MI, heart transplant Prec: Side: dilated pupils, palp, blurred vision, anxiety, headache, dizziness, urinary retention Dose: A: Bradycardia : 0.5 mg every 3-5 min max of 3 mg or 0.4 mg/kg Organo: 2-5 mg (0.5 - 1 mg boluses titrating to effect) P: Bradycardia: 0.02 mg/kg Route: IV, IM, ET (2x dose) Blocks acetylcholine receptors, raises HR, raises AV conduction, lowers GI secretions |
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Bumetanide
(Bumex) |
Class: Diuretic
Ind: CHF, pulm edema Contra: preg, dehydration Prec: dehydration Side: None Dose: A: 0.5 - 1.mg Route: IV/IM Prevents reabsorption of NaCL (sod chloride), slight vasodilater |
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Calcium Chloride
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Class: Electrolyte
Ind: Hyperkalemis, hypocalcemia, CCB OD, muscle spasm due to spider bite and portuguese man-of-war stings Contra: Digitalis, VF, hypercalemia Prec: IV flush between calcium chlor and sodium bicarb Side: Dysrhythmias (bradcardia, asystole), hypoten Dose: A: 2-4 mg/kg of 10% solution, repeat every 10 min OR 500 - 1,000mg over 5-10 min P: 5 - 7 mg/kg of 10% solution OR 20 mg/kg per dose Route: IV Raises contractility CL- fluid balance and renal funct Ca+ myocard conduct, contraction, nervous impulse trans |
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Chlorpromazine
(Thorazine, Largactil) |
Class: Tranquilizer (Phenothiazine)
Ind: Psychotic episodes, alcohol withdrawal Contra: Comatose states, presence of sedatives, Prec: Ortho hypotension Side: Phys and mental impairment, drowsiness Dose: A: 25- 50 mg P: 0.5 mg/kg Route: IM Blocks dopamine receptors |
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Dextrose 50%
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Class: Carbohydrate
Ind: Hypoglycemia Contra: None Prec: Blood sample prior to admin, ICP or intracranial hemorrhage Side: Venous irritant Dose: A: 25g/50ml P: 0.5g/kg diluted 1:1 water to make 25% solution Route: IV Raise blood glucose |
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Diazepam
(Valium) |
Class: Tranquilizer
(Bensodiazipine) Ind: Seizures, status epilepticus, anxiety, premed to cardioversion Contra: hypersensitivity Prec: Venous irritation, short duration, CNS depressant Side: Drowsiness, hypotension, respiratory depress and apnea Dose: A: Status epil- 5-10 mg IV anxiety - 2-5 mg IM/IV premed cardioversion - 5-15 mg IV P: status epil - 0.1 - 0.2 mg/kg Route: Slow IV, IM, rectal Anticonvulsant, skeletal muscle relaxant, sedative |
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Digoxin
(Lanoxin) |
Class: Cardiac glycoside
Ind: CHF, rapid atrial dysrhythmias (a-fib, a-flutter) Contra: Digitalis od, V-fib Prec: recent MI, Side: N/V, dysrhythmias, yellow vision Dose: A- 0.25 - 0.50 mg Route: IV Increases cardiac contractility, card output, reduces edema, slows atrioventricular conduction |
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Diphenhydramine
(Benadryl) |
Class: Antihistamine
Ind: Anaphylaxsis, allergic reaction, dystonic reaction from phenothiazines Contra: Asthma, nursing mothers Prec: Hypotension, CNS depressants, ETOH Side: Sedation, dries bronch secretion, blurred vision, headache, palp Dose: A: 25-50mg P: 1-2mg/kg Route:IV, IM, IO Blocks histamine receptors |
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Diltiazem
(Cardizem) |
Class: Calcium Channel Blocker
Ind: Control A-fib, Flutter and CP Contra: Hypoten, wide complex tachy, WPW, preggers, Digoxin Prec: Other CCB, keep cool Side: Hypoten, N/V, dizziness Dose: 15 min interval between 1st and 2nd dose 1st Dose: 0.25 mg/kg bolus (20mg) in 2 min 2nd Dose: 0.35 mg/kg bolus (25 mg) 2-3 min Maint drip 5-15 mg/kg in 1 hour Route: IV, Drip Slows AV node, vasodilator, lowers mycardio O2 demands |
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Dopamine
(Inotropin) |
Class: Sympathomimetic
Ind: hypotension from cardiogenic shock Contra: hypovolemic shock Prec: presence of tachy dysrhythmias (V-vib, v-tach) Side: Vent tachydysrhythmias, HTN, palp Dose: A: Intial 2-5 mcg/kg up to 800 mg/500ml of D5W giving 1,600 mcg/kg P: 2-20 mcg/kg 2-5 mcg vasodialation in renal 5-10 mcg anti-diuretic, contractility/conductility/automacticity 10-20 mcg raises myocardial contractility, vasoconstriction Route:IV drip Raises cardiac contractility, peripheral vasoconstriction |
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Epinenphrine 1:1,000
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Class: Sympathomimetic
Ind: Bronch asthma, COPD, allergic reaction, ped card arrest after initial epi dose Contra: Pt w/underlying cardiovascular disease, HTN, preggers, tachy dysrythmias Prec: High BP, P, ECG, protect from light Side: Palp, tachy, anxiety, headache Dose: A: 0.3- 0.5 mg P: 0.01 mg/kg max .3 mg Route: Sub Q Drip: 1 mg/250 ml (1-5 mcg 1 min) Bronchodilator |
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Epinephrine
1:10,000 |
Class: Sympathomimetic
Ind: Card arrest, anaphylactic shock, severe reactive airway disease Contra: Used in Pts. that do not need extensive resuscitative efforts Prec: Keep out of light, can be neutralized by alkaline solutions Side: palpitations, anxiety, N/V Dose: A: Cardiac arrest: 0.5- 1.0 mg every 3-5 min Anaphylaxis : 0.3 - 0.5 P: 0.01 mg/kg. 1/1,000 used subsequent dosages 0.1 mg/kg Route: IV, IV drip, ET Raises HR, contractile force, myocardial electrical activity, sys vascular resistance, BP and bronchodilator |
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Etomidate
(Amidate) |
Class: Sedative, Hypnotic
Ind: Induction agent RSI, Addison's disease Contra: Hypersensivity Prec: Hypotension, severe asthma or cardiovascular disease Side: Apnea, laryngospasm Dose: A: 0.1-0.3 mg/kg over 15-30 sec P: Over 10 same as A Under 10 not indicated Route: IV Lower ICP |
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Flumazenil
(Romazicon) |
Class: Benzodiazipine antagonist
Ind: Reverse resp depression and sedative effects from Benzo OD Contra: Prec:Short duration, do not give for Tricylclic (Cocaine) OD, seizure Side: Dose: 0.2 mg IV over 30 sec (max 1 mg) 0.3 mg IV over 30 sec 0.5 mg IV in a min max 3 mg Route: IV bollus |
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Furosemide
(Lasix) |
Class: Diuretic
Ind: CHF, pulm edema Contra: pregnancy, dehydration Prec: protect from light, dehydration Side: None Dose: A: 40-80 mg 0.5 - 1.0 mg/kg IV push max 2 mg/kg P: 1 mg/kg Route: IV Inhibits reabsorption of NaCL, vasodilater |
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Glucagon
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Class: Hormone, Antihypoglycemic agent
Ind: Hypoglycemia, Beta blocker OD (2nd round if CaCl doesn't work) Contra: Hypersentivity Prec: Must be sufficient glycogen stored in liver, caution with cardiac and renal PT, blood sugar before and after admin Side: Tachy, Hypotension, N/V, Uticaria Dose: A: IM 1.0 mg (Max 3 mg) P: Under 6 0.5 mg Over 6 1.0 mg Route:IV, IM Breaks down glycogen into glucose Raises blood glucose, card contractility and HR |
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Haloperidol
(Haldol) |
Class: Tranquilizer (Butyrophenone)
Ind: psychotic episode Contra: Not with other sedatives Prec: Orthostatic hypotension Side: phys and mental impairment Dose: A: 2-5 mg P: .05 - .15 mg/kg Route: IM Antiemetic, blocks dopamine receptors |
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Ipratropium
(Atrovent) |
Class: Anticholinergic
Ind: Bronchospasm from asthma, emphysema Contra: Soy allergy, peanut allergies Prec: monitor vitals, narrow angle glacoma Side: Palp, dizziness, anxiety, headache Dose: 0.5 in 2.5mls via neb Route: Inhalation Bronchodilator |
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Labetalol
(Trandate, Normodyne) |
Class: Sympathetic blocker
Ind: HTN Contra: Broncho asthma, CHF, heart block, bradycardia, cardiogenic shock Prec: ECG, monitor BP, pulse, atropine on hand Side: Bradycardia, heart block, CHF, bronhospasm, hypoten Dose: A: 10 mg slow IV push over 2 min 40 mg repeated in 10 min until supine BP obtained OR max out at 300 mg 200mg/500ml D5W to get 2mg/min Route: IV infusion, IV bolus slow Selectively blocks A receptors and nonselectively blocks B receptors |
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Lidocaine
(Xylocaine) |
Class: Antidysrhythmic
Ind: PVCs, Vtach, Vfib, local anesthetic Contra: High degree heart blocks, PVCs w/bradycardia Prec: Do not exceed 300mg/HR, Half dose for PT over 70 Side: Anxiety, dizziness, N/V, widening QRS Dose: A: Initial bolus 1-1.5 mg/kg (3 mg/kg) add bolus 0.5-0.75 mg/kg every 3-5 min P: 1mg/kg Local Anesthetic: .25 mg/kg IO Route: IV bolus Suppresses ventricular ectopic activity, raises Vfib threshold, slows impulse through conduction sys |
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Lorazepam
(Ativan) |
Class: Tranquilizer (Benodiazipine)
Ind: Seizures, status elipticus, premed for cardioversion, acute anxiety Contra: Hypotension, narrow angle glaucoma, head injuries Prec: Short duration, Flumazenil should be avail, Side: Drowsiness, hypoten, resp depression, apnea Dose: A: 2-4 (4.0mg max) seizures 0.05 mg/kg (max 4 mg) anxiety P: 0.05 - 0.2 mg/kg (max 2 mg) Route: IV, IM, Rectal Anticonvulsant, sedative |
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Magnesium Sulfate
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Class: Anticonvulsant, Antidysrhythimc
Ind: Torsades, severe refactory v-fib or pulseless V-tach, eclampsia Contra: Shock, hear block Prec: Not used with digitalis, antidote should be avail for resp failure, caution with renal fail pt Side: resp depression, flushing, drowsiness Dose: 1-4g Route: IV, IM CNS depressant, anticonvulsant, antidepressant |
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Manitol
(Osmotrol) |
Class: Osmotic Diurectic
Ind: Acute cerebral edema, blood transfusion reactions Contra: Pulm edema, dehydrated PTs Prec: Rapid admin Side: Pulm congestion, sodium depletion Dose: A: 1.5 - 2 g/kg P: 0.25 - 5 g/kg over 1 hour Route: IV Lowers cellular edema Raises urinary output |
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Methylprednisone
(Solumedrol) |
Class: Steroid
Ind: Anaphylaxsis, Asthma, COPD Contra: None Prec: Maint dose 2-6 hours after onset Side: GI bleed, prolonged wound healing Dose: A: 125-250 mg P: 30 mg/kg Route: IV, IM Anti inflammatory, suppresses immune response |
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Midazolam
(Versed) |
Class: Tranquilizer (Benzodiazipine)
Ind: Premed for cardioversion, acute anxiety Contra: Shock, narrow angle glaucoma Prec: Dilute in D5W, Resp depression common w/other benzo, keep Flumazenil avail Side: Drowsiness, hypoten, amnesia, resp depression and apnea Dose: A: 1.0 - 2.5 mg or 0.1 - 0.3 mg/kg P: 0.03 mg/kg Route:IV, Oral Hypnotic, Sedative |
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Morphine
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Class: Narcotic
Ind: Severe pain, Pulm edema Contra: Head injury, vol depletion, ab pain Prec: Resp depress, hypoten, nausea, Narcan should be avail Side: Dizziness, alt LOC Dose: A: IV: 2-5mg followed by 2 mg until pain gone or resp depression ensues IM: 5-15mg based on wt P: 0.1 - 0.2 mg/kg Route: IV, IM CNS depressant, peripheral vasodilation, lowers sensitivity to pain |
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Narcan
(Naloxone) |
Class: Narcotic agonist
Ind: Narcotic OD, synthetic analgesic OD Contra: Hypersensitivity Prec: Short lasting, cause withdrawal and should be augmented every 5 min. NO coma cocktail Side: None Dose: A: 1 -2 mg P: under 5 0.1 mg/kg over 5 2.0 mg Route: |
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Nitroglycerin
(Nitrostat) |
Class: Antianginal
Ind: Angina Contra: Children under 12, Hypotension Prec: Protect from light, short shelf life, syncope may occur Side: Headache, dizziness, hypotension Dose: 1 Tablet every 3-5 min max 3 Spray SL 0.4 mg every 3-5 min max 3 in 15 min Route: SL Smooth muscle relax, reduces card work, dilates coronary and sys arteries |
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Norepinephrine
(Levophed) |
Class: Sympathomimetic
Ind: BP less than 70 refactory to other sympathomimetics, neurogenic shock Contra: Hypotensive do to hypovolemia Prec: counter acted by alkaline solutions, monitor BP, necrotic Side: Anxiety, palp, headache, HTN Dose: A: 0.5 - 30 mcg/kg P: 0.01 - 0.5 mcg/kg Route: Placed in 500 ml of D5W giving a concentration of 16 mcg/ml peripheral vasoconstriction |
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Nubain
(Nalbuphine) |
Class: Narcotic agonist
Ind: CP, burns, frostbite, sickle cell, extremity injury Contra: None Prec: Pts under 18, other depressants have additive effects Side: N/V, Hypoten, HTN, sweaty, sedation Dose: A: 2.5 mg over 2 min Under 50kg max 5 mg Over 50 kg max 10 mg P: 0.1 mg/kg Route: IV Acts within 2-3 min lasts 3-6 hours |
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Oxytocin
(Pitocin) |
Class: Hormone
Ind: Postpartum vag bleeding Contra: Any other than Post vag bleed Prec: Placenta deliver first, no other fetus Side: Anaphylaxsis, cardiac dysrhythmia Dose: IV 10-20 units in 500ml of D5W IM 3-10 units Route: IV, IM Causes uterine contraction, stops vag bleed postpartum |
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Procainamide
(Pronestyl) |
Class: Calcium channel blocker, antiarrhythmic
Ind: A-fib RVR w/rate over 150 and QRS greater than .12, WPW, wide complex tachy (refractory to Lido) Contra: 2nd and 3rd blocks, hypoten Prec: Hypoten, MI Pts, widening QRS Side: Hypoten, N/V, dizziness, arrhythmias Dose: A: 20mg/min Maint 1-4 mg/min Max (reasons to stop me): QRS widens by 50% Max dose 17mg/kg Rhythm abolished Hypoten P: 15mg/kg Route: IV bolus, Drip Raises ventricular fib threshold, suppress ventricular ectopy, increases refractory period of atria |
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Promethazide
(Phenagran) |
Class: Phenothiazine, antihistamine, H1 antagonist
Ind: N/V, sedation to potentiate analgesics Contra: Comatose states, alcohol or other depressants Prec: Avoid interstitial inject Side: Drowsiness, impair phys and ment Dose: A: 12.5 - 25mg P: 0.5mg/kg Route:IV, IM Anticholinergic, antimetic |
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Sodium Bicarbonate
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Class: Alkalizing agent
Ind: Late cardiac agent, Tricyclic OD, acidosis refractory to hyperventilation Contra: Alkalotic state Prec: Correct dose needed, can deactivate catechlamines, gives high sodium level Side: Alkalosis Dose: A: 1mEq/kg followed by 0.5 mEq/kg every 10 min P: Same Route: IV Raise pH |
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Sodium Nitrate
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Class: Nitrate, Cyanide antidote
Ind: Cyanide poisoning Contra: Not to asymptomatic Pt Prec: Hypotension w/rapid admin Side: hypotension Dose: A: 300 mg IV, 1/2 orig dose as needed for 30 min P: 10 mg/kg IV, 1/2 Same Route: IV Converts hemoglobin to methemoglobin |
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Succinylcholine
(Anectine) |
Class: Neuromuscular Blocking agent (polarizing)
Ind: paralysis for RSI Contra: hypersensitivity Prec: O2/airway tools avail Side: paralysis, bradycardia, hypotension Dose: A: 1 - 1.5mg/kg (40-100mg) P: 1mg/kg Route: IV paralysis of skeletal muscle |
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Tagamet
(Cimedtidine) |
Class: Histamine H2, receptor antagonist
Ind: Hypersensitivity Contra: None Prec: Arrhythmias Side: Hypotension Dose: A: 300 mg Piggy back over 5-10 min P: 5-10mg/kg over 5-10 min Route: IV, IM Inhibits action Histamine at H2 receptors |
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Terbutaline
(Brethine) |
Class: Sympathomimetic
Ind: Bronch asthma, COPD, pre-term labor Contra: Hypersensitivity Prec: Monitor ECG, BP, Pulse Side: Palp, tachy, PVCs, anxiety, headache, tremors Dose: A: MDI 2 puffs 1 min apart Sub Q 0.25 repeat 15-30 min 0.25mg/0.25ml P: 0.01mg/kg Sub Q Route:Inhalation, IV Drip, Sub Q Bronchodilator, Raises HR |
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Thiamine Hydrochloride
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Class: Vitamin B1
Ind: AMS, DTs, Wernickes or Korsakoff's Contra: None Prec: Admin prior to D50 Side: None Dose: A: 100mg Route: IV, IM |
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Vasopressin
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Class: Hormone
Vasoconstrictor Ind: Card arrest Contra: None Prec: None Side: Blanching of skin, raise BP, bradycardia Dose: 40 units (single dose only) Works well in acidic environment (good for prolonged downtime) Potent vasoconstrictor, Antidiuretic hormone Route: |
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Vecuronium
(Norcuron) |
Class: Neuromuscular blocking agent
Ind: Paralysis for intubation Contra: hypersensitivity Prec: paralysis occurs in 1 min and last 30 Side: hypotension, bradycardia Dose: A: 0.08-0.1 mg/kg P: 0.1 mg'kg Route: IV skeletal muscle relaxant |
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Verapamil
(Isoptin, Calan) |
Class: Cal Chan Block
Ind: PSVT Contra: Heart block, conduction sys disturb Prec: Pt on Beta blockers, Hypoten Side: N/V, dizziness, hypoten Dose: A: 2.5 - 5mg, repeat 5-10 mg after 15 min, max is 30mg in 30 min P: 0-1 years: 0.1 - 0.2 mg/kg (max 2.0mg) 1 - 15 years 0.1 - 0.3 mg/kg (max 5.0 mg) Route: IV Slows conduction through AV node Inhibits reentry during PSVT Lower rate of ventricular response Lower myocardial O2 demand |
