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85 Cards in this Set

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Epinephrine 1:1000

Trade Name & Generic Name
Trade- Adrenalin

Generic- Epi 1:1000
Epinephrine 1:1000

Classification and Route of Administration
class- sympathomimetic/endogenous catcholamine

roa- IV, IM, IO, IV INFUSION, ETT
Epinephrine 1:1000

Actions
alpha and beta properties, potent bronchodilator, + inotropic/chronotropic
Epinephrine 1:1000

indications
acute bronchial asthma, life threatening anaphylaxis, may be a repeat dose for cardiac pts per protocol
Epinephrine 1:1000

contraindications
tacharrthymias, hypertension, asthma patient > 35 years
Epinephrine 1:1000

Side Effects

Special considerations
palpitations, anxiousness, headache, tachyarrthymias, hypertension, vomiting

special- keep out of direct sunlight
Epinephrine 1:1000

Adult dosage
anaphylaxis/asthma- 0.01 mg/kg usually 0.3-0.5mg IM ETT-2mg in 8cc NS DRIP-1mg in 500cc NS INFUSION- 2-10mcg/min starting @ 30gtts/min (repeat-5mg IVP or 0.1mg/kg IVP)
Epinephrine 1:10,000

Trade name
Generic Name
Classification
trade- adrenalin

generic-Epinephrine 1:10,000

class-sympathomimetic/endogenous catecholamine
Epinephrine 1:10,000

Route of Administration

Actions
ROA- IV/IO

Actions- alpha and beta properties, increase in HR, BP, automaticity, myocardial O2 consumption and PVR
Epinephrine 1:10,000

Indications
pulseless patients in vfib, asystole, vtach and PEA, severe anaphylaxis
Epinephrine 1:10,000

contraindications
none
Epinephrine 1:10,000

side effects

special considerations
tachyarrthymias, nausea/vomiting

special-light sensitive, dont mix with sodium bicarb, follow with flush
Epinephrine 1:10,000

adult dosage
pulseless vfib,vtach,PEA,asystole- 1 mg IVP every 3-5 mins

anaphlyaxis refractory to 1:100-0.01 mg/kg up to 5mg
Sodium Bicarbonate

trade name

generic name
trade- none

generic-Sodium Bicarbonate
Sodium Bicarbonate

classification

route of administration
class-alkalinizing agent, electrolyte replacement

ROA-IV, IV infusion
Sodium Bicarbonate

Actions
neutralizes excess acid in the blood/interstitial fluid returning blood to normal physciologic pH by increasing availability of bicarbonate ion
Sodium Bicarbonate

indications
antidepressant overdose, crush injuries, prexsisting metabolic acidosis w/ cardiac arrest, shock, DKA, promote excretion of barbiturate & salicylate overdoses
Sodium Bicarbonate

contraindication
hypokalemia, CHF/renal failure, metabolic acidosis
Sodium Bicarbonate

side effects
increases intravascular volume, increases arterial carbon dixoide levels, decrease serum potassium, inactivates catecholamines, necrosis if infiltrated
Sodium Bicarbonate

adult dosage
IV- 1 mEq/kg repeated every 10 minutes of half the initial dose

crush injuries- add 50 mEq in 1000cc NS (0.45%) and infuse
Sodium Bicarbonate

special considerations
flush IV line when using before or after epi, calcium chlroide, dont overuse in cardiac arrest, follow with flush, metabolic alkalosis is hard to counteract in the field
Diazepam

trade name
generic name
classification
trade- valium

generic-Diazepam

class-anticonvulsant/benzodiazpine
Diazepam

Route of adminstration

Actions
ROA-slow IVP

actions-crosses the blood/brain barrier into cerebral motor cortex to suppress seizure activity and cause CNS slowing, stops active seizures, - analgesic properties
Diazepam

indications
uncontrolled major seizures, status epileticus acute anxiety, sedation prior to cardioversion or sedation while using transcutaneous pacing
Diazepam

contraindications
hypotension, hypersenstivity, respiratory depression, alcohol intoxication
Diazepam

side effects

special considerations
side- respiratory depression/arrest, hypotension

special-airway equipment ready, monitor BP during/after, avoid small veins, closest IV port, flumazenil to reverse side effects
Verapamil

trade name
generic name
classification
trade-calan, isoptin

generic-Verapamil

class-calcium ion antagonist
Verapamil

actions
blocks the entry of calcium into both cardiac and smooth muscle causing prolonged refractory periods, controlling re-entry arrythmias such as afib/aflutter, increase coronary artery perfusion, decrease afterload, decrease BP, negative inotropic drug, decrease myocardial O2 consumption
Verapamil

indications
second line drug after adenosine for narrow complex supraventricular tachycardias with stable BP

in absence of WPWS, drug of choice for symptomatic afib/aflutter with rapid ventricular response
Verapamil

contraindications
pts with beta blockers, WPWS, sick sinus syndrome, any wide complex tachycardia, heart failure/blocks
Verapamil

side effects

route of administration
ROA-slow IVP over 1-3 minutes

side-hypotension, asystole, vfib
Verapamil

adult dosage
2.5-5mg initial dose, may repeat at 5-10mg every 15-30 minutes. pts over 70 years should receive smaller doses (2-4mg over 3-4mins)
Verapamil

special considerations
monitor BP before/after admin, avoid conjuction with sodium bicarb or theopyline, calcium chloride to reverse hypotensive effects of overdose
Procainamide

trade name

generic name

classification
trade- pronestyl, procan, promine

generic-Procainamide HCl

class-antiarrythmic
Procainamide

actions
same as lidocaine/bretylium, some antiarrhythmic effects on supraventricular rhythms and atrial ectopic pacemakers
Procainamide

indications
PVCs and ventricular tachycardia refractory to lidocaine, SVT not responding to adenosine
Procainamide

contraindications
heart blocks
Procainamide

side effects

special considerations
side-hypotension, dizziness, bradycardias, torsades de pointes

special-takes a long time to completely administer
Procainamide

adult dosage
loading-20mg/min by adding 1gm to 40cc NS to equal 20mg/cc infuse with 60 dropper @ 60 gtts/min until arrythmia suppressed, hypotension develops, QRS widens by or total 17mg/kg admin.
drip-1gm in 500cc NS
maintenance- 1-4mg/min
Nitroglycerin

trade name
generic name
classification
trade-nitrobid, nitrol, nitrostat, nitrolingual
generic-Nitroglycerin

class-antiaginal/nitrate
Nitroglycerin

actions
relaxes smooth muscle of coronary arteries and veins, decrease preload, increase perfusion to ischemic myocardial tissue
Nitroglycerin

indications
chest pain due to angina pectoris, CHF, PE
Nitroglycerin

contraindications
increased ICP, hypotension
Nitroglycerin

Side effects

Route of Administration
side-headache, hypotension, syncope

special-expires rapidly, dont get it on you, dont shake spray, BP before/after admin, remove nitro patch before defib, light sensitive
Nitroglycerin

adult dosage
tablets-0.3-0.4mg every 5mins up to 3 doses
sprays-1 spray every 5mins up to 3
infusion- 5-10 mcg/min (3-6 gtts/min) using 60 dropper slowly titrating to pain relief or hypotension ensues
drip-25mg in 250cc NS
Magnesium Sulfate

trade name
generic name
classification
trade-none
generic-Magnesium Sulfate
class-anticonvulsant/electrolyte replacement
Magnesium Sulfate

actions
anticonvulsant, CNS depressant, bronchodilation, increase blood magnesium levels
Magnesium Sulfate

indications
seizures accompanying eclampsia, documented hypomagnesemia, treatment of choice for torsades de pointes, can be used in refractory vfib, vtach and asthma
Magnesium Sulfate

contraindications
heart blocks, recent MIs, hypotension, respiratory depression, pts on digitalis/cardiac glycosides
Magnesium Sulfate

side effects

special considerations
side-hypotension, hypermagnesemia, heart blocks, respiratory and neurological depression

special-calcium chloride as antidote for respiratory depression, dont mix sodium bicarb
Furosemide

trade name
generic name
classification
trade-lasix

generic-Furosemide

class-diuretic
Furosemide

actions
inhibits reabsorption of soduym and chloride in the kidneys promoting rapid diuresis of excess body fluids causing venous vasodilation which reduces preload on the heart
Furosemide

indications
to reverse fluid overload associated with CHF/PE, temporarily control hypotensive crisis in certain situations
Furosemide

contraindications
pregnancy, hypotension, hypokalemia, electrolyte imbalances, volume depletion
Furosemide

side effects
hypotension, nausea/vomiting, dehydration, potassium depletion
Furosemide

Route of administration

adult dosage
ROA- slow IVP

dose- 1mg/kg slow IVP
Furosemide

special considerations
protect from light, hypokalemia suspected in pts on chronic diuretic therapy, incompatible in IV line with dopamine/epi, dont mix with valium or benadryl
Adenosine

trade name
generic name
classification
trade- adenocard

generic-Adenosine

class-anitarrythmic
Adenosine

actions
transiently blocks conduction through the AV Node
Adenosine

indications
converts SVT, including WPWS, doesnt convert afib, aflutter, or ventricular arrythmias
Adenosine

contraindications
sick sinus syndrome, heart blocks, bradycardias, pts on persantine, caution with heart transplants
Adenosine

side effects
chest pain, SOB, facial flushing, transient heart block and potential transient arrythmias during conversion from PSVT to sinus rhythm including vtach or asystole, half life < 10 secs
Adenosine

Route of administration

special considerations
ROA-Rapid IVP

Special- use closest port, rapid flush following, patient on monitor, ekg before administration
Adenosine

adult dosage
6mg rapid IVP followed by 20cc NS flush, repeat 12mg if not converted, may repeat 12mg one time
Amiodarone

trade name
generic name
classification
trade-coradone

generic-Amiodarone HCl

class-anitarrythmic
Amiodarone

actions
blocks sodium, potassium, and calcium channels of the cardiac conduction cycle that slow conduction and prolongs the refractoriness of the heart
Amiodarone

indications
vfib, pulseless vtach and some atrial dysrrythmias
Amiodarone

contraindications
none in pulseless cardiac arrest, hypotension, bradycardia or AV blocks
Amiodarone

side effects
non dose dependent side effects of bradycardia, AV block and hypotension
Amiodarone

adult dosage
vfib, pulseless vtach- 300 mg, repeat 150mg IVP

vtach with pulse- 150mg in 100cc NS over 10 mins
Dopamine

trade name
generic name
classification
trade-dopastat, intropin

generic-Dopamine

class-endogenous catecholamine
Dopamine

actions
vasopressive agent that stimulates the dopaminergic receptors at a low dose, stimulates the beta receptors at a medium dose and stimulation the alpha receptor at a high dose
Dopamine

indications
hypotension after volume depletion as been reestablished, post cardiac w/stable BP & HR, may be used to increase bradycardia refractory to adenosine, TCA overdoses with hypotension
Dopamine

contraindications
tacharrthymias, hypovolemia, vfib
Dopamine

side effects
hypertensions, nausea/vomiting, ventricular tacharrthymias
Dopamine

adult dosage
2-20 mcg/kg/min usually 2-5mcg/kg/min with 30 gtts/min tiltrating until systolic BP of 90

drip-400mg in 500cc NS or 200mg in 250cc NS
Dopamine

Route of Administration

Special Considerations
ROA- IV infusion

Special-dont mix w/sodium bicarb, use caution w/ caution, very potent agents
Morphine Sulfate

trade name
generic name
classification
trade-duramorf, infumorf

generic-Morphine Sulfate

class-narcotic/analgesic
Morphine Sulfate

actions
powerful pain killer, arterial and venodilator, decreases preload and afterload, decrease workload of the heart, decrease myocardial O2 demand, CNS depressant
Morphine Sulfate

indications
chest pain unrelieved by nitro, PE, severe non-cardiac pain
Morphine Sulfate

contraindication
hypotension, head injury, abdominal injury/pain
Morphine Sulfate

Side effects
respiratory depression, hypotension, nausea/vomiting
Morphine Sulfate

Route of administration
slow IVP/IM
Morphine Sulfate

adult dosage
small increments of 1-3 mg every 3-5mins, lower doses in elderly
Morphine Sulfate

special considerations
narcan to reverse side effects