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9 Cards in this Set
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Epinephrine
Class, Mechanism, Indications, Contraindications, Side Effects Adult Dose, Pediatric Dose, Onset/Peak Effects/Duration |
Class: Sympathomimetic, Vasodilator, Adrenergic Agonist
Mechanism: Stimulates alpha and beta adrenergic receptors Indications: Bronchospasm (Allergic Reaction/Anaphylaxis, Bronchiolitis, COPD), Cardiac Arrest (Multiple Rhythms), Pediatric Bradycardia, Profound Hypotension Contraindications (non-absolute): Pulmonary Edema, Hypertension, Hypothermia Precautions: Effects additive w/ sympathmimetics. Alkaline solns. MAOIs, antihistimines, and TCAs can heighten effects. Side Effects: Cardiac dysrhythmia, angina or MI precipitation, headache, anxiety, increased BP |
Adult Dose
Anaphylaxis: 0.3mg of 1:1 IM if under 50yo, 0.15mg of 1:1 IM if 50yo or older Cardiac Arrest: 1.0mg of 1:10 IV/IO x 3-5 minutes Pediatric Dose (0.01mg/kg) Anaphylaxis: 1:1 IM up to 0.3mg Cardiac Arrest/Bradycardia: 1:10 IV/IO up to 0.5mg per dose x 3-5 minutes Adult/Ped Nebulized Dosage: 2mg with 1ml NS Onset/Peak Effects/Duration: Acts immediately, peaks in minutes, and lasts for several minutes |
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Vasopressin
Class, Mechanism, Indications, Contraindications/Precautions Side Effects, Adult Dosage, Onset/Peak Effects/Duration |
Class: Pituitary Hormone, Vasopressor
Mechanism: Peripheral Vasoconstrictor; Works by attaching to smooth muscle 6 receptors by means of the ADH pathway Indications: Cardiac Arrest, Vasodilatory Shock Contraindications: None for Cardiac Arrest. For use in conscious patients, not recommended for patients with CAD, seizures, heart failure, asthma, and chronic renal failure (with elevated BUN). Precautions: Anti-diuretic effect may be decreased with concurrent administration of alcohol, lithium, demeclocycline, heparin, or norepiniphrine. Vasopressor effect may be increased by concurrent administration of ganglionic blocking agents |
Side Effects: Dizziness, Headache, Nausea/Vomiting, Increased Peripheral Vascular Resistance (which may provoke cardiac ischemia and angina)
Adult Dosage: 40 units IV/IO Onset/Peak Effects/Duration: The time of onset and peak effects are unknown, and the duration of it's effects is 2-8 hours |
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Nitroglycerin
Class, Mechanism, Indications, Contraindications Side Effects, Adult Dosage, Onset/Peak Effects/Duration |
Class: Vasodilators, anti-anginal
Mechanism: Vascular smooth muscle relaxant; reduces cardiac workload by increasing peripheral artery dilation, and increases coronary blood supply by coronary vasodilation Indications: ACS, Hypertension, Pulmonary Edema (CHF) Contraindications: Hypovolemia, Hypotension, increased ICP, severe hepatic/renal disease, use of ED medications |
Side Effects: Headache, dizziness, nausea, lightheadedness
Precaution: When used for hypertension or pulmonary edema, do not decrease MAP > 30% Adult Dosage (0.4mg SL) Chest Pain: If SBP > 100, every 5 minutes until pain free (up to 3 doses), followed by 1in of nitro paste if desired Pulmonary Edema: If SBP > 110, every 1-2 minutes Hypertension: Every 1-2 minutes until DBP < 110 Onset/Peak Effects/Duration: Onset is immediate, peak effects occur in 5-10 minutes, and its duration is 1-10 minutes |
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Crystalloids (Normal Saline)
Class, Mechanism, Indications, Contraindications Side Effects/Adverse Reactions, Adult Dosage, Pediatric Dosage Onset/ Peak Effects/Duration |
Class: Crystalloids
Mechanism: Replaces blood plasma volume and ions, provides medication access Indications: Need for IV access or volume infusion Contraindications: No absolute contraindications |
Side Effects/Adverse Reactions: Hydroencephalus, pyrogenic reaction, infiltration, fluid overload, pulmonary edema, hypothermia
Adult Dosage: KVO for IV access, 250-500ml for cardiac, 500-1000ml for volume replacement, 1000ml for burns and electrical injuries Pediatric Dosage: KVO for IV access, 20ml/kg for volume replacement (may be repeated x3) |
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Albuterol
Class, Mechanism, Indications, Contraindications, Precautions Side Effects, Adult Dosage, Pediatric Dosage, Onset/Peak Effects/Duration |
Class: Sympathomimetics
Mechanism: Relaxes bronchial smooth muscle Indications: Bronchospasm (emphysema, asthma, or allergic reaction) Contraindications: Usage with other sympathomimetics Precautions: Diabetes, HTN, hyperthyroidism, CVD; people taking TCAs, MAOIs, beta blockers, or digoxin |
Side Effects: Dysrhythmias, tachycardias, tremors, nervousness, nausea/vomiting, restlessness, dizziness, palpitations, increased BP, hypokalemia
Adult/Pediatric Dosage: 2.5mg in 3ml nebulized Onset/Peak Effects/Duration: Onset is 5-15 minutes, peak effects are in 30 minutes to 2 hours, and effects last from 3-6 hours |
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Ipratroprium
Class, Mechanism, Indications, Contraindications Side Effects, Adult Dosage, Pediatric Dosage, Onset/Peak Effects/Duration |
Class: Anticholinergic
Mechanism: Inhibits cholinergic receptors in bronchial smooth muscle Indications: COPD w/ acute obstruction Contraindications: Allergy to ipratroprium, atropine, soy, bromide, or fluorocarbons |
Side Effects: Dizziness, anxiety, HA, blurred vision, dry mouth, cough, bronchospasm
Adult/Pediatric Dosage: 500mcg in 2.5ml of NS Onset/Peak Effects/Duration: Immediate onset; peak effects and duration vary |
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Naloxone
Class, Mechanism, Indications, Contraindications Side Effects, Adult Dosage, Pediatric Dosage, Onset/Peak Effects/Duration |
Class: Narcotic Antagonist
Mechanism: Competitive inhibitor at narcotic receptor sites Indications: Suspected or actual narcotic overdose Contraindications: None |
Side Effects: Acute withdrawal, combativeness
Adult Dosage: 0.5-2.0mg IV (IM/IN/IO acceptable if no suitable IV site) titrated to respiratory response Pediatric Dosage: 0.1mg/kg IV/IO up to 2mg (can be repeated after 5 minutes) Onset/Peak Effects/Duration: Acts within 2 minutes, peak effects variable, duration is approximately 45 minutes |
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Levalbuterol
Class, Mechanism, Indications, Contraindications, Precautions Side Effects, Adult Dosage, Pediatric Dosage, Onset/Peak Effects/Duration |
Class: Sympathomimetics
Mechanism: Antagonizes B-2 receptors to relax bronchial smooth muscle Indications: Respiratory distress with bronchospasm Contraindications: Allergy to Levalbuterol, MAOI use within 2 weeks Precautions: CAD, HTN, hypokalemia, diabetes, seizures, hypothyroidism, arrythmias, pheochromocytoma |
Side Effects: Dizziness, nervousness, palpitations, tremors, tachycardia, HA, CP, dry mouth, rhinitis
Adult Dosage: 0.63-1.25mg (in 3cc NS) nebulized continuously x 3 doses if no history of cardiac disease and HR < 200 Pediatric Dosage: 0.31-0.63mg (in 3cc NS) nebulized continuously x 3 doses if no history of cardiac disease and HR < 200 Onset/Peak Effects/Duration: Onset is within 5-15 minutes, peak effects reached in 30 minutes, and effects may last up to 6 hours |
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NSAIDs (Toradol)
Class, Mechanism, Indications, Contraindications, Precautions Side Effects, Adult Dosage, Onset/Peak Effects/Duration |
Class: Non-steroidal anti-inflammatory drugs
Mechanism: Non opiate cox-inhibitors Indications: Minor pain, pain from kidney stones, chest pain (ASA only) Contraindications: NSAID allergy, bleeding disorder Precautions: Bleeding risk |
Side Effects: Drowsiness, dizziness, HA, nausea, edema, sweating
Adult Dosage: 30mg IV/IM Onset/Peak Effects/Duration: Acts in 5-10 minutes with peak effects at about an hour. Effects may last up to 10 hours |
