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38 Cards in this Set
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ADENOSINE
Adenocard, Adenoscan (Endogenous Nucleotide) for PSVT |
Adult dose (110lb+) 6mg RIVP 1-2 sec20ml flush repeat after 1-2 min if needed /12mg /12mg max total dose 30mg
pedi 0.1-0.2mg/kg max single dose 12mgs CONTRA 2nd 3rd HB A-fib/ A-flutter V-tach S/C monitor |
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AMIODARONE
Cordarone, Pacerone (antidysrhythmic) suppression of V-fib refractory to D-fib V-tach refractory to cardioversion |
dose Unstable VT/VF 300mg in 10ml ns IV/IO over 1-2mins. followed by 150mg if needed in 5min.
stable VT 150mg IV over 10min (15mg/min) may repeat Q 10min as needed. after conversion 1.0mg/min maintenance dose. max dd 2.2g IV/24hr IV drip 0.5-1mg for malignant V-arrhythmias per MD. CONTRA 2nd/3rd HB Hypotension, Bradycardia, Torsades. S/C admin cautiously in pt with heart failure and poor systolic function |
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ATROPINE SULFATE
(Anticholinergic agent) for Bradycardia, Asystole Organophosphate poisoning |
Adult dose Bradydysrhythmias 0.5-1.0mg IV Q 3-5min as needed to max dose 3mg
Asystole / PEA 1mg IV Q 3-5min max dose 3mg ET at 2-2.5 x IV dose with 2ml ns Pedi 0.2mg/kg IV/IO/ET (min single dose 0.1mg max single dose 1.0mg) if ET follow with 2ml NS flush Asystole max dose 0.5mg child 1.0mg adolesent. CONTRA Tachycardia, Narrow-angle glaucoma, acute hemorrhage myocardia ischemia. S/C monitor vs auscultate LS before & after each dose |
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CARDIZEM
(DILTIAZEM HCL) (Calcium channel blocker) for control of rapid V-rates due to A-fib/ A-flutter, PSVT, Angina, Refractory SVT (after Adenosine) |
MOA: Calcium channel blocker prolonges refractory period PRECAUTIONS: BP may drop DO NOT use for wide QRS tachy, WPW with Afib, sick sinus syndrome, or beta blockers. DOSE: 0.25mg/kg IV over 2min if inadequate response may re-bolus in 15min 0.35mg/kg IV over 2min maintenance drip 5-15mg/hour
Pedi not recommended CONTRA hypotension, 2nd 3rd HB, Cardiogenic shock, wide complex tachs S/C use with caution in pt with renal or hepatic dysfunction |
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DOPAMINE
(sympathomimetic, inotropic) for Hypotension, cardiogenic, septic, spinal, distributive shocks increases BP, systemic vascular resistance, cardiac contractility & stroke volume, dilates renal & splanchnic vasculature |
Adult dose 2-20mcg/kg/min (per MD)
Pedi 2-20mcg/kg/min (per MD) CONTRA hypovolemic shock, pheochromocytoma, VF, Tachydysrhythmias D/I MAOIs enhance effect,Beta blockers antagonize effect, when admin with Phenytoin may cause hypotension bradycardia & seizures. |
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DOPAMINE
dose effects. |
S/C Effects are dose dependent
2-4mcg/kg/min dopaminergic dilates vessels in kidneys, inc. urine output. 4-10 mcg/kg/min Beta adrenergic response inc. chronotropy & inotropy. 10-20mcg/kg/min Adrenergic response primarily alpha stimulant/ vasoconstriction. > 20mcg/kg/min reversal of renal effects/ over ride alpha effects. |
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EPINEPHRINE 1:10,000
(sympathomimetic) for CARDIAC ARREST, ASYSTOLE, PEA, VF (unresponsive to initial D-fib) increase BP, stroke volume, HR. |
Adult dose Cardiac: Asystole PEA, VF
1.0mg IVP Q3-5min. ET 2.0-2.5mg (1:1000) solution Q3-5min in 10ml NS Pedi doae Cardiac Asystole, PEA, VF IV/ IO 0.01mg/kg ET 0.1mg/kg (1:1000) solution in 0.1ml/kg NS CONTRA HTN, hypothermia, Pulmonary edema, hypovolemic shock, coronary insufficiency. |
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EPINEPHRINE 1:1000
for Anaphylaxis and acute allergic reactions, Asthma |
Adult dose Asthma, Allergic reactions 0.3-0.5mg SC
Anaphylaxis 0.3-0.5mg (3-5ml 1:10,000) IV Pedi dose Allergic reactions, Asthma 0.01mg/kg (0.01ml/kg 1:1000) SC max 0.5mg |
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LIDOCAINE
(Antidysrhythmic) for adult VT, VF, PVCs CONTRA 2nd 3rd HB, stokes adams syndrome, Hypotension |
Adult dose Cardiac arrest VT/VF 1.0-1.5mg/kg IVP Q3-5min max dose 3mg/kg if conversion to NSR drip at 2-4mg/min ASAP
VT with pulse 1.0-1.5mg/kg IVP then 0.50-0.75mg/kg Q 5-10min drip ASAP PVCs with pulse 0.5-1.5mg/kg IVP additional boluses of 0,5-1.5mg/kg Q 5-10min drip ASAP Pedi dose VF pulseless V-tach 1mg/kg IV/IO per dose drip 20-50mcg/kg/min PVCs with pulse 1mg/kg IV/IO per dose drip 20-50mcg/kg/min |
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LIDOCAINE
S/C A/R |
Half drip dose if pt is over 70yo has liver disease or is in CHF or shock.
A/R slerred speach, seizures, altered mental status, blurred vision, bradycardia, |
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THIAMINE
(vitamin B1) for Coma, Delirium tremens, Beriberi, Wernicke's encephalopathy |
Adult dose 100mg slow IV or IM.
Pedi dose 10-25mg slow IV or IM CONTRA NONE S/C large IV dose may cause respiratory difficulties A/R Hypotension from too rapid injection or too high a dose, anxiety, diaphoresis, D/I give before glucose at all times. |
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CALCIUM CHLORIDE/ CALCIUM GLUCONATE
(Electrolyte) for Magnesium sulfate overdose, Calcium channel blocker OD, Hypocalcemia, treatment of insect bites/stings. |
Adult dose 2-4mg/kg of 10% solution slow IV over 5min may repeat in 10min max dose 1gm
Pedi dose 20mg/kg of 10% solution slow IV/ IO may repeat in 10min. max dose 1gm CONTRA Hypercalccemia, VF during cardiac resus. Digitalis toxicity. A/R Bradycardia, asystole, hypotension, peripheral vasodilation, coronary & cerebral artery spasm, local necrosis. D/I may worsen dysrhythmias 2nd to digitalis, may antagonize effects of Verapamil. |
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MAGNESIUM SULFATE
(electrolyte) Seizures of eclampsia, Torsades, TCA OD induced dysrhythmias, Hypomagnesemia, Class IIa agent for refractory VF/VT s/p admin of Lidocaine doses. |
dose seizure activity assoc. with pregnancy 1-4gm IVP over 3min. for Torsades or refractory VF/VT 1-2gm IVP over 1-2min.
Pedi dose NOT RECOMMENDED. CONTRA Heart blocks, Renal diseases. A/R Respiratory & CNS depression, hypotension, Circulatory collapse, cardiac arrest and asystole may occur, Facial flushing, diaphoresis, depressed reflexes. S/C recommended drug not given 2hr before delivery, CALCIUM GLUCONATE OR CALCIUM CHLORIDE SHOULD BE AVAILABLE AS ANTAGONIST IF NEEDED |
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NALOXONE
(Narcotic antagonist) for Opiate OD, Coma Morphine, heroin, hydromorphone (Dilaudid) , Methadone, Meperidine (Demerol), Paregoric, Fentanyl (sublimase), Oxycodone (percodan), Codeine, propoxyphene (darvon), Narcotic agonist & anatagonist Butorphanol (stadol), Pentazocine (Talwin), Nalbuphine (Nubain) |
Adult dose 0.4-2.0mg IV,IM,SC Nasal via atomizer or ET (diluted) min recommended =2.0mg Q at 5min intervals to 10mg max (med control may request higher amounts) infusion 2mg in 500ml of D5W (4mcg/ml) infuse at 0.4mg/hr (100ml/hr)
Pedi dose 0.1mg/kg dose IV, IM, SC, ET (diluted) max of 0.8mg if no response in 10min admin 0.1mg/kg dose. |
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NITROGLYCERIN
(vasodilator) for CHF, Angina, HTN, Chest pain |
Adult dose Tab 0.3-0.4mg SL may repeat in 3-5min to max of 3 doses Spray 0.4mg SL 1-2 sprays Q 5min max 3 doses. drip 5ug/min increase by 5-10ug/min Q 5min until desired effect. Paste 1in
Pedi NOT RECOMMENDED CONTRA. hypotension, hypovolemia, head injury, intracranial bleeding, D/I Vasodilators, drugs used to treat erectile dysfunction such as Viagra (sildenafil), Cialis (tadalafil), Levitra (vardenafil). |
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PROCAINAMIDE
(Antidysrhythmic Class Ia) for Suppress PVCs/ VT with a pulse refractory to Lidocaine, PSVTs with wide-complex tach of unknown origin, drug of choice when associated with WPW. |
Adult dose 20-30mg/min max 17mg/kg. infusion 1-4mg/min
Pedi dose 2-6mg/kg IV/IO at less than 20mg/min max 17mg/kg infusion 20-80mcg/kg/min. CONTRA 2nd & 3rd HB, Torsades, Lupus, Digitalis toxicity, Myasthenia gravis. A/R PR, QRS, & QT widening, AV block, Cardiac arrest, hypotension, seizures, Reflex tach, PVCs, VT, VF, CNS depression, Confusion. S/C Potent vasodilating & inotropic effects, Discontinue if hypotension developes, the QRS widens by 50%, hypotension with to rapid an infusion, Carefully monitor VS & ECG, |
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ACTIVATED CHARCOAL
(Absorbent) for oral poisons |
Adult dose 1-2gm/kg PO or NGT
Pedi dose same CONTRA comatose pt, after ingestion of corrosives, caustics, petroleum distillates. S/C often used in conjunction with Magnesium citrate. |
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ALBUTEROL
(sympathomimetic, bronchodilator) for COPD ASTHMA |
Adult dose 2.5mg dilute 0.5ml of 0.5% solution for inhalation with 2.5ml NS in neb over 10-15min. MDI 1-2 puffs (90-180mcg) 5min between inhalations.
Pedi dose 0.01-0.03ml (0.05-0.15mg/kg dose in 2ml NS Q 20min x3. D/I Beta-blockers are antagonistic, Tricyclic antidepressants may potentiate vasculature effects. S/C only admin by inhalation pre-hospital. |
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AMINOPHYLLINE
(Xanthine bronchodilator) theophylline derivative for limited usefulness in EMS may be used inrefractory COPD, interfacility transfers, bronchospasm. |
Adult dose loading 5-6mg/kg in 60-100ml diluent over 30min IV infusion not to exceed 20mg/min. maintenance infusion first 12hrs 0.5-0.7mg/kg/hr (lower dose for elderly, CHF liver disease)
Pedi dose 5-6mg/kg in 50-100ml diluent IV infusion. Maintenance infusion first 12 hrs 1.0mg/kg/hr. S/C Therapeutic to toxic ratio is narrow! dose should be halved in pt already taking theophylline preparation. |
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IPRATROPIUM BROMIDE
(Bronchodilator) used in bronchospasm associated with COPD< Emphysema |
Adult dose 2-3 puffs via MDI 3-4xday max 12 puffs/day. ALT 500mcg NEB q 6-8hrs (may mix with Albuterol if used within 1hr)
Pedi dose <12yo 1-2 puffs MDI max 8 puffs/day ALT 250mcg NEB q6-8hrs (may mix with Albuterol if used within 1hr) CONTRA Hypersensitivity to Atropine or its derivatives. |
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DEXAMETHASONE SODIUM PHOSPHATE
(Corticosteroid) for Anaphylaxis, Asthma, Spinal cord injury, Croup, Elevated ICP (prevention and treatment) as an adjunctto treatment for shock. |
Adult dose 10-100mg IV(1mg/kg slow IV bolus) call med control for variance.
Pedi dose 0.25-1mg/kg dose IV,IO,IM |
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DEXTROSE
(Carbohydrate, hypertonic solution) for Hypoglycemia, altered level of consciousness, coma, seizure, |
Adult dose 12.5-25gm slow IV as needed.
Pedi dose 0.5-1gm/kg dose slow IV as needed. CONTRA intracranial hemorrhage, Delirium tremens, ineffective without Thiamine. S/C admin Thiamine before D50 in known alcoholic pt, Draw blood sugar before admin, do not admin to pt with CVA unless hypoglycemia is documented. |
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DIAZEPAM
Valium, Diastat (Benzo, sedative, anticonvulsant) for Seizure activity, Acute anxiety, Acute alchohol withdrawal, muscle relaxant, agitation, |
Adult dose Seizure activity 5-10mg IV q10-15 prn max 30mg
for cardioversion 5-15mg IV over 5-10min prior to. Pedi dose seizure 0.2-0.3mg/kg dose IV q 15-30min (no faster than 3mg over 5min)max 10mg/kg Rectal 0.5mg/kg via 2" rectal cath & flush with 2-3mlair S/P admin CONTRA Glaucoma, head injury. A/R hypotension, respiratory depression, ataxia, tachycardia, thrombosis, phlebitis |
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DIAZOXIDE
(Vasodilator) for Hypertensive crisis, especially in pre-clampsia |
Adult dose 5mg/kg IVP over 10-30sec.
Pedi dose same. CONTRA hypotension, Labor, dissecting aortic aneurysm. A/R CVA, tachycardia, angina, dysrhythmia, cerebral ischemia, hyperglycemia. S/C admin to pt only in supine position, Extravasation can cause necrosis. |
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DIPHENHYDRAMINE
BENADRYL (Antihistamine, Anticholinergic) for Allergies, Allergic reactions, Anaphylaxis, Motion sickness, hay fever |
Adult dose 25-50mg IV,IM,PO
Pedi dose 1-2mg/kg IV,IO slow IM if given PO 5mg/kg in 24hrs. CONTRA Asthma, glaucoma, Pregnancy, Hypertension, infants, pt taking MOIs A/R Sedation Hypotension, Seizures, Palpations, Dysrhthmias, |
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FUROSEMIDE
LASIX (loop diuretic) for CHF, Pulmonary edema, Hypertensive crisis |
Adult dose 0.5-1.0mg/kg slow IV
Pedi dose !mg/kg IV/IO CONTRA must be able to pea Anuria, Hypovolemia, Hypotension S/C Ototoxicity & deafness can occur with rapid admin. |
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GLUCAGON
(Hypoglycemic agent, pancreatic hormone, insulin antagonist) for Hypoglycemia, Beta-blocker overdose |
Adult dose 0.5-1mg IM,SC, slow IV q20min prn
Pedi dose 0.03-0.1mg/kg (dose not to exceed 1mg) q20min IM,IO,SC, slow IV. CONTRA Hyperglycemia. S/C should always be used in conjunction with D50 whenever possible. if pt not responding to 2nd dose must admin D50 |
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GLYCOPROTIEN IIb/IIa INHIBITORS
Blocks platelet aggregation & thrombus formation. for Unstable angina not responsive to conventional med therapy, & within 24hrs of planed angioplasty. |
Dose variable depending on brand used. CONTRA hemorrhage, surgery, trauma within last 6 weeks, Intracranial tumor, A/R Major bleeding, Intracranial bleeding, Thrombocytopenia.
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HEPARIN SODIUM
(Anticoagulant) for Venous thrombosis, Pulmonary embolus, Coronary occlusion, Disseminated intravascular coagulation, |
Adult dose loading dose 80units/kg IV Maintenance dose 18units/kg/hr IV
Pedi dose loading 50units/kg IV Maintenance dose 7.5units/kg/hr IV CONTRA pt on antiplatelet drug. A/R Hemorrhage, Thrombocytopenia. |
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LORAZEPAM
Ativan (Benzo, Sedative, Anticonvulsant) for Status epilepticus, Seizures, severe anxiety, Sedation Dose |
Adult dose when given IV/IO must dilute with = amount NS IM not to be diluted 2-4mg slow IV 2mg/min or IM may repeat in 15-20min max 8mg. for sedation 0.05mg/kg up to 4mg IM
Pedi 0.05-0.2mg/kg slow IV,IO IM may repeat in 15-20min max 0.2mg/kg |
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LORAZEPAM
Ativan (Benzo, Sedative, Anticonvulsant) for Status epilepticus, Seizures, severe anxiety, Sedation CONTRA S/C A/R |
CONTRA Glaucoma, Shock, Coma. S/C Monitor BP & respiratory rate, have advanced airway equipment ready,
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ASPIRIN
(platelet inhibitor, Anti-inflammatory agent) for CP |
Adult dose 160-325mg tabs chewable.
CONTRA GI bleeding, not for Pedi pt |
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METOPROLOL
(Antianginal, antihypertensive, Beta-blocker) for Hypertension, Angina, A-fib/A-flutter |
Adult dose IV Hypertension 1.25-5mg q6-12hrsin pt unaable to take PO
Myocardial infarction (acute) IV 5mg q5-10min up to 3 doses CONTRA Sinus brady, 2nd or 3rd HB except in pt with pacer, Cardiogenic shock, pregnancy 2nd or 3rd trimesters A/R CHF, Bradycardia, |
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MIDAZOLAM
VERSED (short acting Benzo, CNS depressant) for ET or Nasotracheal intubation |
Adult dose 0.5-2.5mg slow IVP may be repeated to a max of 0.1mg/kg
Pedi dose (6 months to 5yo) 0.05-0.1mg/kg IV max dose 5mg (6-12yo) 0.1mg/kg IV max dose 8mg CONTRA OD, Shock, coma, alcohol intoxication, other Benzo's or Narcotics S/C admin ASAP to intubation, monitor VS, Never admin as IV bolus |
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MORPHINE SULFATE
(opioid analgesic) for Pain |
Adult dose 1-3mg IV, IM, SC q5min max 10mg
Pedi 0.1-0.2mg/kg IV q5min max 5mg CONTRA Head injury, hypotension, COPD, Undiagnosed ABD pain S/C Naloxone should be readily available as antidote A/R Respiratory depression, Hypotension, Bradycardia, syncope |
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SODIUM BICARBONATE 8.4%
(Buffer Alkalinizer) for Acidosis, S/P long arrest, TCA overdose, Hyperkalemia, Phenobarbital OD, |
Adult dose 1mEq/kg IV may repeat with 0.5mEq/kg q10min
Pedi same as adult CONTRA Alkalosis, Hypocalcemia, Hypokalemia, Hypocloremia S/P GI loss & vomiting S/C must ventilate pt after admin, may worsen CHF A/R tetany, seizures, Metabolic alkalosis, Hypokalemia, Tissue sloughing at injection site |
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VASOPRESSIN
(Pitressin) alternitive pressor to EPI for any CARDIAC ARREST/VF/ PULSELESS VT/ASYSTOLE/PEA can replace 1st or 2nd dose of EPI also used for hemodynamic support in septic shock |
MOA: non-adrenergic peripheral vasoconstrictor increase in blood flow to heart and brain PRECAUTIONS half life 10 to 20sec not recommended in CAD DOSE pulseless pt 40u IV single dose 1 time only TO REPLACE 1st or 2nd DOSE EPI can defib every 2min after admin ET dose 2-2.5 times IV dose
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VERAPAMIL
CLASS: calcium channel blocker INDICATIONS: alternative drug after Adenosine for SVT CONTRA: left ventricular dysfunction cardiogenic shock, 2nd or 3rd degree AV block, severe hypotension, severe heart failure. |
MOA: systemic vasodilation negative Inotropic effect Prolongs AV nodal conduction time. PRECAUTIONS: expect decrease in BP can be counteracted with calcium do not use with wide complex. DOSE: 2.5 to 5.0mg IV bolus over 2min with BP and ECG monitoring 2nd dose 5.0 to 10.0mg in 15 to 30min.
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