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24 Cards in this Set
- Front
- Back
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ACTIVATED CHARCOAL
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CLASS: Adsorbent
MOA: adsorbs toxic substances from GI tract INDICATION: poisonings and med overdoses CONTRAINDICATION: Comatose pt; after ingestion of corrosives, caustics or petroleum products DOSAGE AND ADMINISTRATION Adult: 1-2 gm/kg PO/via NGT Pedi: same as adult |
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ADENOSINE
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CLASS: Endogenous Nucleotide
MOA: Slows conduction time through the AV node; slows HR, acts directly on sinus pacemaker cells INDICATION: PSVT, may convert PSVT due to WPW CONTRAINDICATIONS: second or third degree heart block. A-fib/A-flutter, V-tach, and hypersensitivity. DRUG INTERACTIONS: Dipyridamole/Carbamazepine potentiates the effects. May cause bronchoconstriction in Asthma patients. DOSAGE & ADMIN: Adult: 6mg over 1-3 sec. no response in 1-2 min. give 12mg over 1-3 sec MAX 30mgs Pedi: 0.1-0.2mg/kg rapid IV MAX single dose =12 mgs DURATION OF ACTIION: 12 sec. |
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ALBUTEROL
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CLASS: Sympathomimetic, Bronchodilator
MOA: Selective Beta-2 agonist INDICATION: Treatment of bronchospasms in patients with COPD/asthma. CONTRAINDICATION: Hypersensitivity, tachy-dysrhythmias, DRUG INTERACTIONS: Tricyclic antidepressents may potentiate vasculature effects. Beta-blockers are antagonistic May potentiate hypokalemia by diuretics HOW SUPPLIED: Aerolization,MDI, and syrup DOSAGE/ADMIN: Adult: 2.5mg diluted w/ 2.5ml NS via nebulizer admin over 10-15 min. MDI 1-2 inhalations 5 min between each one. Pedi: admin. .01-.03 diluted in 2ml of NS may repeat every 20 min/ 3X. DURATION OF ACTION: Onset in 5-15 min peak effect in 30 min. Duration 3-4 hours. |
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AMINOPHYLLINE
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CLASS: Xanthine bronchodilator
MOA : Respiratory stimulator and bronchodilator INDICATIONS: Limited usefulness in EMS arena although maby used in refractory COPD pts; interfacility transfers;bronchospasms. CONTRAINDICATIONS: Allergy to xanthines, cardiac dysrhythmias. ADVERSE REACTIONS: Tachycardia, palpitations, PVCs, angina pectoris, seizure, N/V. DRUG INTERACTIONS: Beta-blockers may oppose effects; Barbiturates and phenytoin may decrease theophylline levels. DOSAGE/AMDIN: Loading dose (adult): 5-6 mg / kg in 60-100 ml of diluent over 30 min. IV infusion not to exceed 20 mg/min. Loading dose (pedi): 5-6 mg / kg in 50-100 ml of diluent IV infusion. Adult: first 12 hours. 0.5-0.7 mg/kg/hour Pedi: 1.0 mg/kg/hour Duration of Action: Onset less than 15 minutes; Duration 4.5 hours. |
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AMIODARONE
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CLASS: Antidysrhythmic
MOA: Prolongation of Action Potential; non-competitive alpha and beta sympathetic blocking effects; Calcium channel blocking effects INDICATIONS: Suppression of V-fib refractory to defibrillation and lidocaine. Suppression of V-tach refractory to cardioversion and lidocaine. CONTRAINDICATIONS: Second or third degree heart block. Medication induced ventricular dysrhythmias. Hypotension, bradycardia, Torsades de Pointes. Profound Sinus Bradycardia ADVERSE REACTIONS: Hypotension, Bradycardia, PEA, CHF, Nausea, fever, and thrombocytopenia. DRUG INTERACTIONS: Will precipitate with Sodium Bicarbonate. Compatible with dopamine, dobutamine, isoproterenol, lidocaine, NTG, norepinephrine, phenylephrine, KCL, and procainamide. DOSAGE/ ADMIN: Adult: 300 mg slow IV push over 1-2 minutes in 10 ml NS DURATION OF ACTION: Onset within 5-15 min. |
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AMYL NITRATE, SODIUM NITRATE, SODIUM THIOSULFATE (CYANIDE ANTIDOTE KIT)
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CLASS: Antidote
MOA: Reacts with hemoglobin to form methemoglobin (low toxicity) INDICATION: Cyanide or hydrocyanic acid poisoning CONTRAINDICATIONS: Not applicable ADVERSE REACTIONS: Excessive doses can produce life threatening methemoglobinemia DRUG INTERACTIONS: None DOSAGE/ADMIN: Adult: Amyl Nitrate breath 30 sec out every minute. Sodium Thiosulfate and sodium nitrate: IV per antidote kit directions. Pedi: same as adult DURATION OF ACTION: Variable. |
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ASPIRIN
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CLASS: Platelet inhibitor, anti-inflammatory agent.
MOA: Prostaglandin inhibitors INDICATION: New onset chest pain suggestive of AMI, and signs and symptoms suggestive of recent cerebrovascular accident. CONTRAINDICATIONS: Hypersensitivity and GI bleed ADVERSE REACTIONS: Heartburn, GI bleeding, N/V, wheezing in allergic pts, and prolonged bleeding. DRUG INTERACTIONS: Use with caution in pts allergic to NSAIDS. DOSAGE/ADMIN: 160 mg or 325 mg PO. DURATION OF ACTION: Onset: 30-45 minutes SPECIAL CONSIDERATION: Pregnancy safety: category D Not recommended in pedi population. |
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ATROPINE SULFATE
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CLASS: Anticholinergic agent
MOA: Parasympatholytic: inhibits the action of acetylcholine at postganglionic parasympathetic neuroeffector sites. Increases heart rates in life threatening bradydysrhythmias. INDICATIONS: Hemodynamically significant bradycardia, Asystole, Drug of choice for organophosphate poisoning. Bronchospatic pulmonary disorders. CONTRAINDICATIONS: Tachycardia, Hypersensitivity, Unstable cardiovascular status in acute hemorrhage and myocardial ischemia narrow angle glaucoma ADVERSE REACTIONS: Headache, dizziness, palpitations, N/V, tachycardia, dysrhythmias, anticholinergic effects Paradoxical bradycardia when pushed slowly, and flushed dry hot skin. DRUG INTERACTIONS: Potential adverse effects when administerd with digoxin, cholinergics, physostigmine. Effects enhanced by antihistamines, prcainamide, quinidine, antipsychotics, benzodiazepines and antidepressants. DOSAGE/ADMIN. Adult Bradydysrhythmias: 0.5-1.0 mg IV every 3-5 minutes as needed to MAX 0.04 mg/kg may be given ET 2.0 mg. Asystole: 1.0 mg IV push every 3-5 minutes as needed MAX 0.04mg/kg may be given ET 2.0 mg followed by 2.0 ml NS Pedi: Bradydysrhythmias 0.2 mg/kg IV/ET/IO minimum dose 0.1 mg MAX single dose 1.0 mg may ET tube followed by 2.0 ml NS Asystole-Same as bradydysrhythmias DURATION OF ACTION: Onset- immediate Peak effect-rapid to 1-2 min Duration- 2-6 hours |
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CALCIUM CHLORIDE/CALCIUM GLUCONATE
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CLASS: Electrolyte
MOA: Increases cardiac contractile state (+ inotropic effect), may enhance ventricular automaticity. INDICATIONS: Hypocalcemia, magnesium sulfate overdose, hyperkalemia, calcium channel blocker toxicity. Adjunctive therapy in treatment of insect bites and stings. CONTRAINDICATIONS: Hypercalcemia, VF during cardiac resuscitation; digitalis toxicity. ADVERSE REACTIONS: Bradycardia, asystole, hypotension, peripheral vasodilation, metallic taste, local necrosis, coronary and cerebral artery spasm, N/V. DRUG INTERACTIONS: May worsen dysrhythmias secondary to digitalis. May antagonize effects of Verapamil. Flush line after the use of Sodium Bicarbonate. HOW SUPPLIED: Ampules, vials, and prefilled syringes (100mg/ml) DOSAGE/ADMIN. Adult: 2-4 mg/kg of 10% solution over 5 min. may repeat in 10 min. MAX 1 gm dose. Pedi: 20 mg/kg/dose of 10% solution slow IV/IO may repeat 10 min MAX dose 1 gm DURATION OF ACTION: Onset: 5-15 minutes Peak effects: 3-5 minutes Duration: 15-30 minutes but may persist for 4 hours Spec. Consideration: Pregnancy safety C |
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DEXAMETHASONE SODIUM PHOSPHATE
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CLASS: Corticosteroid
MOA: Suppresses acute and chronic inflammation; immunosuppresive effects INDICATION: Anaphylaxis, asthma, spinal cord injury, croup, elevated intracranial pressure, as an adjunct to treatment of shock. CONTRAINDICATIONS: Hypersensitivity to drug. ADVERSE REACTIONS: Hypertension, sodium and water retention, GI bleeding, TB. None from single dose. DRUG INTERACTIONS: Calcium and Metaraminol DOSAGE/ADMIN.: Adult: 10-100 mg IV (1 mg/kg slow IV bolus). Pedi: 0.25-1.0 mg/kg/dose IV,IO, IM. DURATION OF ACTION: Onset: Hours Peak effect: 8-12 hours Duration of Action: 24-72 hours |
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DEXTROSE
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CLASS: Carbohydrate, hypertonic solution
MOA: Rapidly increases serum glucose levels. Short term diuresis INDICATIONS: Hypoglycemia, AMS, coma of unknown etiology, seizure of unknown etiology. CONTRAINDICATIONS: Intracranial hemorrhage, delirium tremens, ineffective without thiamine ADVERSE REACTIONS: Extravasation leads to tissue necrosis. Warmth, pain, burning, thrombophlebitis, rhabdomyotitis. DRUG INTERACTIONS: Sodium Bicarbonate, coumadine. HOW SUPPLIED: 25 gm/ 50 ml pre-filled syringes (500 mg/ml) DOSAGE AND ADMINISTRATION: Adult: 12.5-25 grams slow IV; may be repeated as necessary. Pediatric: 0.5-1 gm/kg/dose Slow IV; may be repeated as necessary. DURATION OF ACTION: Onset: less than 1 min. Peak effects: Variable Duration: Variable SPEC. CONS: Administration thiamine prior to D50 in known alcoholic patients. Draw blood sugar before administration. Do not administer in patients with CVA unless hypoglycemia is documented. |
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DIAZEPAM
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CLASS: Benzodiazepine, sedative-hypnotic, anticonvulsant.
MOA: Potentiates the effects inhibitory neurotransmitters. Raises seizure threshold. Induces amnesia and sedation. INDICATION: Acute anxiety states, acute alcohol withdrawal, muscle relaxant, seizure activity, agitation, analgesia for medical procedures (Fx, cardioversion), Delirium tremens. CONTRAINDICATIONS: Hypersensitivity, glaucoma, coma, shock, substance abuse, head injury. ADVERSE REACTIONS: Respiratory depression, hypotension, drowsiness, ataxia, relfex tachycardia, nausea, confusion, thrombosis and phlebitis. DRUG INTERACTIONS: Incompatible with most drugs. HOW SUPPLIED: 10 mg/ 5 ml prefilled syringes, ampules, vials and tubex. DOSAGE AND ADMINISTRATION: Seizure activity adult: 5-10 mg IV every 10-15 minutes when necessary(5 mg over 5 min).MAX 30 mgs. Seizure activity: Pedi: 0.2-0.3 mg/kg/dose IV every 15-30 minutes (no faster than 3 mg over 5 min.) MAX 10mg/kg Rectal diazepam:0.5 mg/kg via 2 inch rectal catheter and flush with 2-3 ml air after admin. Sedation for Cardioversion: 5-15 mg IV over 5-10 min prior to cardiovert. DURATION OF ACTION: Onset: 1-5 min Peak effect: minutes Duration: 20-50 min SPEC. CONS.: Pregnancy safety D. Short duration of anticonvulsant effect. Reduce dose 50% in elderly pt. |
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DIAZOXIDE
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CLASS: VASODILATOR
MOA: Non-diuretic antihypertensive; arteriolar vasodilation. INDICATIONS: Hypertensive crisis, especially in pre-eclampsia. CONTRAINDICATIONS: Hypotension, dissecting aortic aneurysm, labor. ADVERSE REACTIONS: Reflex tachycardia, angina, cerebral ischemia, CVA, dysrhythmias, hyperglycemia, N/V. DRUG INTERACTIONS: Incompatible with heat, light or acid solutions. HOW SUPPLIED: 5 mg/ml 20 ml ampules. DOSAGE AND ADMINISTRATION: Adult: 5 mg/kg IV push over 10-30 seconds. Pediatric: 5mg/kg IV push over 10-30 seconds DURATION OF ACTION: Onset: immediate Peak effect: 5 minutes Duration of Action: 3-12 hours |
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DILTIAZEM
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CLASS: Calcium Channel Blocker
MOA: Block inlux of calcium ions into cardiac muscle. Prevents spasm of coronary arteries. Arterial and venous vasodilator. Reduces preload and afterload. Reduces myocardial oxygen demand INDICATIONS: Control of rapid ventricular rates due to atrial flutter, atrial fibrillation, PSVT. Angina pectoris. CONTRAINDICATIONS: Hypotension, sick sinus syndrome, second or third degree heart blocks, cardiogenic shock. Wide complex tachycardias. ADVERSE REACTIONS: Bradycardia, 2nd or 3rd degree hear blocks, chest pain, CHF, syncope. V-fib, V-tach, N/V, dizziness, dry mouth, dyspnea, headache. DRUG INTERACTIONS: Caution in patients that take meds that effect cardiac contractility. Do not use on patients with beta blockers. HOW SUPPLIED: 25 mg/5ml vial; 50 mg/ 10 ml DOSAGE AND ADMINISTRATION: Adult dose: Initial bolus: 0.25 mg/kg (average dose 20 mg) IV over two minutes. If inadequate response may rebolus in 15 minutes. 0.35 mg/kg Iv over two minutes. Maintenance infusion: 5-15 mg/hour. Pedi: not recommended! DURATION OF ACTION: Onset: 2-5 minutes Peak effect: variable Duration: 1-3 hours SPECIAL CONSIDERATION: Pregnancy safety C. Use caution in patients with renal or hepatic dysfunction. PVCs may be noted at time of conversion of PSVT to sinus rhythm. |
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DIPHENHYDRAMINE
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CLASS: Antihistamine; Anticholinergic
MOA: Blocks cellular histamine receptors; decreases vasodilation; decreases motion sickness. Reverses extrapyramidal reactions. INDICATIONS: Symptomatic relief of allergies, allergic reactions, anaphylaxis, acute dystonic reactions (phenothiazines). Motion sickness and hay fever. CONTRAINDICATIONS: Asthma, glaucoma, pregnancy, hypertension, infants, patients taking Monoamine Oxidase Inhibitors. ADVERSE REACTIONS: Sedation, hypotension, seizures, visual disturbances, vomiting, urinary retention, palpitations, dysrhythmias, dry mouth and throat. DRUG INTERACTIONS: Potentiates effects of alcohol and other anticholinergics, may inhibit corticosteriod activity, MAOIs prolong anticholinergic effects of diphenhydramine. HOW SUPPLIED: Tablet; 25, 50 mg; Capsules: 25, 50 mg; Prefilled syringes 50 or 100 mg, Vials (IM or IV) DOSAGE AND ADMINISTRATION: Adult: 25-50 mg IM or IV, P.O. Pediatric:1-2 mg/kg IV, IO slowly or IM. IF given IO 5 mg/kg/24 hours. DURATION OF ACTION: Onset: 15-30 minutes Peak effect: 1 hour Duration: 3-12 hours SPEC. CONS.Not used in infants or pregnancy. Category B. If used in anaphylaxis, will be used in conjunction with epi, steroids. |
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DOPAMINE
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CLASS: SYMPATHOMIMETIC, INOTROPIC AGENT.
MOA: Immediate metabolic precurser to Norepinephrine. Increase systemic vascular resistance, dilate renal and splanchnic vasculature. Increases myocardial contractility and stroke volume. INDICATIONS: cardiogenic, septic or spinal shock, hypotension with low cardiac output states. Distributive shock. CONTRAINDICATIONS: Hypovolemic shock, pheochromocytoma, tachydysrhythmias, VF. ADVERSE REACTIONS: Cardiac dysrhythmias, hypertension, increased myocardial oxygen demand. Extravasation may cause tissue necrosis. DRUG INTERACTIONS: Incompatible in alkaline solutions. MAOIS will enhance effects of dopamine. Beta blockers may antagonize effects of dopamine. When administered with Phenytoin; may cause hypotension, bradycardia and seizures. HOW SUPPLIED: 200 mg/ 5 ml - 400 mg/5 ml prefilled syringes, ampules for IV infusion. 400 mg in 250 ml D5W premixed solution. DOSAGE AND ADMINISTRATION: Adult: 2-20 mcg/kg/min (rate determined by physician). Pediatric: 2-20 mcg/kg/min (rate determined by physician). DURATION OF ACTION: Onset: 1-4 minutes Peak effect: 5-10 minutes Duration: Effects cease almost immediately after infusion shut off. SPECIAL CONSIDERATIONS: Pregnancy safety not established. Effects are dose dependent. Dopaminergic response 2-4 mcg / kg / min. Dilates vessels in kidneys. Beta-adrenergic response: 4-10 mcg / kg / min. Increased chronotropy and inotropy. Adrenergic response: 10-20 mcg/ kg / min. Primarily alpha stimulant / vasoconstriction. Greater than 20 mcg / kg / min. reversal of renal effects / override alpha effects. |
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EPINEPHRINE
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CLASS: Sympathomimetic
MOA: Direct acting alpha and beta agonist. Alpha: bronchial, cutaneous, renal and visceral arteriolar vasoconstriction. Beta 1: positive inotropic and chronotropic actions, increases automaticity. Beta 2 bronchial smooth muscle relaxation and dilation of skeletal vasculature. Blocks histamine response. INDICATIONS: Cardiac arrest, asystole, PEA, VF unresponsive to initial defib. Severe bronchospasm, asthma, bronchiolitis, Anaphylaxis, acute allergic reactions. CONTRAINDICATIONS: Hypertension, hypothermia, pulmonary edema, anxiety, psychomotor agitation, nausea, angina, headache, restlessness. DRUG INTERACTIONS: Potentiates other sympathomimetics. Deactivated by alkaline solutions. MAOIs may potentiate effects of epi. DOSAGE AND ADMINISTRATION: Adult: Allergic reactions and asthma: 0.3-0.5 mg (0.3-0.5 ml 1:1,000) SC Anaphylaxis: 0.3-0.5 mg (3-5ml 1:10,000) IV. Cardiac: (asystole, PEA, VF) 1mg IV push (1:10,000) ervery 3-5 minutes. Endotracheal: 2.0-2.5 mg (1:1,000) every 3-5 minutes in 10ml NS Pediatric: Allergic reactions and asthma: 0.01mg/kg (0.01ml/kg 1:1,000) SC to MAX of 0.5 mg. Cardiac: (asystole, PEA, VF) standard initial dose 0.01 mg/kg IV push (1:10,000) every 3-5 minutes. Endotracheal: 0.1 mg/kg (1:1,000) every 3-5 minutes. second and subsequant doses 0.1 mg/kg (1:1,000, 0.1ml/kg). |
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FENTANYL CITRATE
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CLASS: Narcotic analgesic
MOA: A dose of 100 mcg (0.1 mg) (2ml) is approximately equivalent in analgesic activity to 10 mg of morphine or 75 mg of meperidine. INDICATIONS: IV; -for analgesic action of short duration during anesthetic periods, premedications, induction and maintenance, and in the immediate postoperative period (recovery room) as the need arises. -for use as a narcotic analgesic supplement in general or regional anesthesia. -for admninistration with a neuroleptic such as droperidol injection as an anesthetic premedication, for the induction of anesthesia and as an adjunct in the maintenance of general and regional anesthesia. -for use in those in selected high risk pts(open heart surgery). CONTRAINDICATIONS: Pts with tolerance to the drug. ADVERSE REACTIONS: Aswith other narcotic analgesic it can cause respiratory depression, apnea, rigidity and bradycardia, untreated it could lead to respiratory arrest, circulatory depression or cardiac arrest could occur. Other adverse effects that have occured are hypotension, dizziness, blurred vision, N/V, laryngospasm and diaphoresis. HOW ITS SUPPLIED: IV: 10, 20, 30, 50 ML SINGLE DOSE VIALS. DOSAGE AND ADMINISTRATION: Adult: 1 mcg/ kg MAX 150 mcg. Slow iv push. Pediatric: not yet established DURATION OF ACTION: Onset: Almost immediate (analgesic and respiratory depression may be noted for several minutes there after). Peak effect: The peak respiratory depression is between 5-15 minutes. Duration: 30 to 60 minutes SPEC. CONS. Pregnancy category C |
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FUROSEMIDE
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CLASS: Loop diuretic
MOA: Inhibits the electrolyte reabsorption and promotes excretion of sodium, potassium, chloride. INDICATIONS: CHF, Pulmonary edema, hypertensive crisis. CONTRAINDICATIONS: Hypovolemia, anuria, hypotension, hypersensitivity, hepatic coma. ADVERSE REACTION: May exacerbate hypovolemia, hypokalemia, ECG changes, dry mouth, hypochloremia, hyponatremia, hyperglycemia. DRUG INTERACTIONS: Lithium toxicity may be potentiated by sodium depletion. Digitalis toxicity may be potentiated by potassium depletion. HOW SUPPLIED: 100 mg/ 5 ml, 20 mg/ 2 ml, 40 mg/ 4 ml vials. DOSAGE AND ADMINISTRATION: Adult: 0.5-1.0 mg / kg injected slowly IV. Pediatric: 1 mg/ kg dose IV,IO. DURATION OF ACTION: Onset: 5 minutes Peak effect: 20-60 minutes Duration: 4-6 hours SPEC. CONS. Pregnancy safety category C. Ototoxicity and deafness can occur with rapid administration. Protect from light. |
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GLUCAGON
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CLASS: Hyperglycemic agent, pancreatic hormone, insulin antagonist.
MOA: Increases blood glucose by stimulating glycogenesis. Unknown mechanism stabilizing cardiac rhythm in beta blocker toxicity. Minimal positive inotropic and chronotropic. Decreases GI motility and secretions. INDICATIONS: AMS when hypoglycemia is suspected. May be used as inotropic agent in beta blocker overdose. CONTRAINDICATIONS: Hyperglycemia and sensativity. ADVERSE REACTIONS: N/V, Tachycardia, hypertension. DRUG INTERACTIONS: Incompatible in solutions with most other substances. HOW SUPPLIED: 1 mg ampules requers dilution. DOSAGE AND ADMINISTRATION: Adult: 0.5-1 mg IM, SC, or slow IV; may repeat every 20 minutes. Pediatric: 0.03-0.1 mg / kg/ dose not to exceed 1 mg every 20 min. IM, IO, SC, slow IV. DURATION OF ACTION: Onset: 1 minute Peak effect: 30 minutes Duration: Variable (9-17 min) SPEC. CONS. Pregnancy safety Cat. C. Ineffective if glycogen stores depleted. Should always be in conjunction with 50% dextrose. |
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GLUCOSE - ORAL
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CLASS: Hyperglycemic
MOA: Provides quick absorption of glucose to increase blood glucose levels. INDICATIONS: Conscious patients with suspected hypoglycemia. CONTRAINDICATIONS: Decrease level of consciousness, N/V. ADVERSE REACTIONS: N/V DRUG INTERACTIONS: NONE HOW SUPPLIED: Glucola 300 ml bottles. Glucose pastes and gels. DOSAGE AND ADMINISTRATION: Adult: should be sipped until clinical improvement. Pediatric: same as adult. ONSET OF ACTION: Onset: immediate. Peak effect: variable. Duration: Variable SPEC: CONS. Pt must be conscious. |
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GLYCOPROTEIN 2b / 3a INHIBITORS
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CLASS: Chimeric monoclonal antibody fragment specific for platelet glycoprotein receptors.
MOA: Blocks platelet aggregation and thrombus formation. INDICATIONS: Adjunct to percutaneous transluminal angioplasty. Adjunct to thrombolytic agents. Unstable angina not responsive to conventional medical therapy when percutaneous angioplasty is planned within 24 hours. CONTRAINDICATIONS: Active internal hemorrhage (GI, GU) within last 6 weeks. Cerebrovascular accident within the past two years. Bleeding disorder. Thrombocytopenia. Major surgery or trauma in last 6 weeks. Intracranial tumor/aneurysm. Severe hypertension, vasculitis. ADVERSE REACTIONS: Major bleeding. Inracranial bleeding. Thrombocytopenia. DRUG INTERACTIONS: Oral anticoagulants contraindicated. Concurrent Dextran contraindicated. Concurrent Heparin will increase risk of bleeding. HOW SUPPLIED: IV doses bolus/ infusion. DOSAGE AND ADMINISTRATION: Variable depending upon brand. DURATION OF ACTION: Onset: variable 1.5-2.5 hours Peak effect: 2-3 hours Duration: 2 hours - 2 days. SPEC. CONS: Bleeding from catheter site and pregnancy safety C |
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HEPARIN SODIUM
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CLASS: Anticoagulant
MOA: Prevents conversion of fibrinogen to fibrin and affect clotting factors 9, 11, 12, and plasmin. Does not lyse existing clots. INDICATION: Prophylaxis and treatment of: Venous thrombosis, pulmonary embolus, coronary occlusion, disseminated intravascular coagulation (DIC), post-operative thrombosis. To maintain the patency of IV injection devices and indwelling catheters. CONTRAINDICATIONS: Hypersensitive. Patients on antiplatelet drugs. Adverse Reactions: Hemorrhage, thrombocytopenia, allergic reactions (chills, fever, back pain). DRUG INTERACTION: Salicylates, some antibiotics and quinidine may increase the risk of bleeding. HOW ITS SUPPLIED: Heparin lock flush solutions in 10 and 100 unit/ml ampules and prefilled syringes. DOSAGE AND ADMINISTRATION: Adult: Loading dose: 80 units / kg IV; Maintenance dose: 18 units / kg / hour IV. Pediatric: Loading dose: 50 units / kg / hour IV. DURATION OF ACTION: Onset: immediate Peak Effect: Variable Duration: 4 hours after discontinuation. SPEC. CON. May be neutralized with protamine sulfate at 1 mg protamine / 100 units Heparin give slowly IV over 1-3 minutes. |
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INSULIN
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CLASS: Antidiabetic
MOA: Allows glucose transport into cells of all tissues; converts glycogen to fat. produces intracellular shift of potassium and magnesium to reduce elevated serum levels of these electrolytes. INDICATIONS: Not used in emergency prehospital setting. Diabetic ketoacidosis or other hyperglycemic state. Hyperkalemia CONTRAINDICATIONS: Hypoglycemia, hypokalemia ADVERSE REACTIONS: Hypokalemia, hypoglycemia, weakness, fatigue, confusion, headache, tachycardia, nausea, diaphoresis. DRUG INTERACTIONS: Incompatable in solutions with all other drugs. Alcohol and salicylates may potentiate the effects of insulin. HOW SUPPLIED: 10 ml vials of 100 units / ml. DOSAGE AND ADMINISTRATION: Dosage adjusted relative to blood sugar levels. May be given SQ, IM, or IV. Standard doses for diabetic coma. Adult: 10-25 units regular insulin IV. followed by infusion of 0.1 units / kg/ hour. Pediatric: 0.1-0.2 units / kg / hour IV or IM followed by infusion of 50 units of regular insulin mixed in 250 ml NS (0.2 units / ml). at a rate of 0.1-0.2 units / kg / hour. DURATION OF ACTION: Onset: minutes Peak effect: 1 hour short acting; 3-6 hours intermediate acting; 5-8 long acting. SPEC. CON.: Insulin is drug of choice for control of diabetes in pregnancy. Injection in the abdominal wall. |
