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13 Cards in this Set
- Front
- Back
Activated Charcoal
(Aqua, Actidose, Liqui-char) |
Class: Adsorbent, antidote
Desc: fine black powder, binds with toxins, excreted in feces. Inda: oral poisoning, OD Contra: corrosives, caustics, petroleum distillates(ineffective, may induce vomiting) Adverse Rx: nausea, vomiting, diarrhea Onset: immediate duration: continual dose: 1-2g/kg body mass(larger w/food present) adult:30-100g ped(1-12): 15-30g infant(less 1 yr.): 1g/kg consider: Preg. Cat. C, does not adsorb all drugs |
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Adenosine
(Adenocard) |
Class: Antidysrhythmic
Desc: slows tachycardia, decreases heart activity. Inda: narrow complex paroxysmal supraventricular tachycardia, dysrhythmias Contra: 2nd or 3rd degree Atrioventricular block Adverse Rx: transient dysrhythmias, facial flushing dyspnea, chest press. HTN headache nausea Onset:immediate duration: 10 sec. dose: Adult: initial- 6mg rapid IV bolus over 1-3 sec, followed by 20mL saline flush(elevate extremity) Adult repeat-if no response after 1-2 min, admin. 12mg in same manner(may repeat once in 1-2 min. max sing. dose 12mg) Ped: initial-0.1mg/kg; may be doubled once(max 1st dose 6mg);rapid IV bolus,followed by 5mL saline flush Consider:Preg. Cat. C,place pt. in mild trendelenberg pos. before admin. asystole will be present up to 15 sec. following admin. Monitor ECG during admin. |
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Albuterol
(Proventil) |
Class: Bronchodilator
Desc:relaxes smooth muscles of bronchial tree Inda:Bronchospasm Contra:dysrhythmias associated with tachycardia Adverse Rx:restlessness, dizziness tachycardia, dysrhythmias Onset:5-15 min. duration:3-4 hrs. dose:Bronchial asthma Adult:MDI:1-2 inhalations(90-180mcg)q4-6 hr.(wait 5min.between inhalations, max 12/day) Solution:2.5mg(0.5mL of 0.5%sol.)dilute to 3mL w/0.9%NS(0.083%sol.) admin. over 5-15 min. 3-4x/day nebulizer. Ped:MDI: same as adult Solution:0.01-0.03mL(0.05-0.15mg)/kg dose to max 0.50mL/dose diluted in 2 mL f 0.9%NS, may repeat q20min 3x consider:Preg. Cat. C |
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Amiodarone
(Cordarone) |
Class: Class 3antidysrhythmic
Desc:prolongs duration of action potential & effective refractory period Inda:initial tx of recurring v-fib &hemodynamically unstable tachycardia, refractory paroxysmal supraventricular tachycardia in conjunctionw/cardioversion Contra:Pulmonary Congestion, cardiongenic shock, headache, hypotension,bradycardia, sensitivity to Amiodarone Adverse Rx:Hypotension, headache, dizziness, bradycardia, Atrioventricular conduction abnormalities, flushing, abnormal salivation Onset:minutes duration:variable dosage: Adult: Pulseless arrest: 300mg IVpush(dilute in 20-30mL NS or D5W. Consider repeat 150mg IVpush in 3-5min.(max total dose 2.2g IV/24hr) Wide Complex tachycardia: may give as rapid infusion 150mgIV over 1st 10 min.(15mg/min)repeat every 10 min. PRN, or by slow infusion 360mgIV over 6hr. (1mg/min) maintenance infusion 540mgIV over 18hr.(0.5mg/min pediatric: pulseless arrest:5mg/kgIV bolus perfusing tachycardias: loading dose 5mg/kgIV/IO over 20-60min.(max dose 15mg/kg/dayIV consider: Preg. Cat. D, ECG monitoring req.slow infusion or DC if bradycardia or atrioventricular block occurs. |
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Aspirin
(A.S.A., Bayer, Ecotrin, St. Josephs) |
Class:analgesic,antipyretic, antiinflammatory, antiplatlet
Desc:decreases inflammation, blocks pain impulses, dilates peripheral vessels, decreases platlet aggregation RECCOMENDED IN acute MI Inda:mild-moderate pain/fever prevention of platelet aggregation in ischemia & thromboembolism, unstable angina, prevention MI or reinfarction Contra:GI bleed,ulcer disease hemmorhagic stroke, bleeding disorders,hypersensitivity to salicylates, Peds w/flulike syptoms Adverse Rx:stomach irritation heartburn/indigestion,nausea vomiting, allerigic rx. Onset:15-30 min. duration:4-6 hrs. dose: Adult: mild pain/fever:325-650mg/PO q 4hr. MI:160-325mg/PO(chewble pref) Ped:(over12)mild pain/fever:40-100mg/kg/day divided doses Consider:Preg. Cat. D ASAP in poss. MI |
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Atropine Sulfate
(Atropine) |
class:Antichlinergic agent
Desc:potent parasympatholytic,inhibits actions of acetylcholine at postganglionic parasympathetic neuroeffector sites, primarily at muscarinic receptors,inhibits salivary and bronchial secretions,dilates pupils,increases heart rate,decrease GI motility, inhibit gastric acid secretion,Blocked vagal effects result in positive chronotropy & positive dromotropy (limited or no inotropic effect) Inda: Hemodynamically significant bradycardia,Asystole,PEA,Organophosphate poisoning,Pretreatment in ped patients receiving RSI Contra:Tachycardia,Hypersensitivity,Unstable cardiovascular status in acute hemorrhage w/myocardial ischemia Adverse Rx: Tachycardia,Poss.paradoxical bradycardia when pushed slowly or when used at doses less than 0.5mg,Palpitations,dysrhythmias,headache,dizziness,nausea/vomiting,flushed/dry skin,allergic rx,dry mouth/nose,photophobia,blurred vision,urine retention Onset:rapid duration:2-6hrs dose:Bradydysrhythmias Adult:0.5–1.0mg/IV,may repeat5min intervals until desired rate.(max0.03-0.04mg/kg) Pediatric:0.02mg/kgIV,IO,ET(dilute to3-5ml)Min dose0.1mg;max single dose for0.5mg for child;1.0 mg for adolescent;may repeat in 5min for a max total of 1.0mg for child and 2.0mg for adolescent Asystole Adult:1.0mg/IV,ET,(1-2mg diluted to total of10ml);may repeat every3-5min(max0.03–0.04mg/kg) Pediatric:unknown efficacy PEA Adult:1mg/IV(if bradycardic),repeat every3-5min,max 0.03–0.04mg/kg Pediatric:unknown efficacy Anticholinesterase Poisoning Adult:2mgIV push every 5-15min to dry secretions No max Pediatric 0.05mg/kg/dose(usual dose1-5mg)IV,may repeat in 15 min Consider:Preg. Cat. C Pos. pressure ventilate in ET admin |
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Dextrose 50%
(D50) |
Class:Carbohydrate,Hypertonicsolution
Desc:term "dextrose" used to describe the six carbon sugar d-glucose,principal form of carbohydrate utilized by body for energy production,D50 used in emergency care to treat hypoglycemia,and in management of coma of unknown origin Inda:Hypoglycemia,Refractory cardiac arrest(controversial) Contra:Intracranialhemorrhage Increased intracranial pressure Known or suspected CVA in absence of hypoglycemia Adverse Rx: Warmth, pain, burning from medication infusion,thrombophlebitis Onset:less than 1 min. duration:depends on degree of hypoglycemia dose:Adult 12.5-25g slow IV push,may repeat once Pediatric dilute 1:1 with saline for concentration of 25%dextrose in water;administer0.5–1.0g/kg/dose(2-4cc/kg)slow IV,may repeat once. consider:no preg. cat., draw bloodpriorto admin. |
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Diazepam
(Valium) |
Class:benzodiazepine,sedative,anticonvulsant
Desc:used to treat alcohol withdrawal and grand mal seizure activity,used in conscious patients during cardioversion and TCP to induce amnesia and sedation Inda:Acute anxiety states,Acute alcohol withdrawal,Sedation,Seizure activity,Premedication prior to countershock or TCP Contra:Hypersensitivity,Substance abuse,Coma,Shock Adverse Rx:Hypotension,Reflex tachycardia,Respiratory depression,Ataxia,Psychomotor impairment,Confusion,Nausea onset:IV-rapid,IM15-30min.ET-rapid duration:15min-1hr. dose:Seizure Adult 5mg over 2min(up to 10mg most adults)IV every10–15min prn Pediatric 0.2–0.3mg/kgIV/IO(no faster than 1mg/min)every 2-5min prn;0.5mg/kg rectal dose Max dose 5mg Premedication prior to Cardioversion/TCP Adult 5-15mg/IV,5-10min prior to procedure consider:preg. cat. D, may cause venous irritation,reduce dose by 50%in elderly,resuscitative equip. should be ready |
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Diphenhydramine
(Benadryl) |
Class:Antihistamine
Desc:significant anticholinergic effect,high incidence of drowsiness,Competes for H1 receptors on effector,does not effect H2 receptors,has no effect on gastric acid secretion. Inda:allergic reactions (after epinephrine)Anaphylaxis (after epinephrine)Acute extrapyramidal reactions Contra:Acute asthma,CNS depression,MAO inhibitors,hypersensitivity Adverse Rx:Dose-related drowsiness,Sedation,Disturbed coordination,Hypotension,Palpitations,Tachycardia,bradycardia,Thickening of bronchial secretions,Dry mouth/throat onset:max effect 1-3hrs duration:6-12hrs dose:adult 25-50mgIM/IV Pediatric 1-2mg/kgIV/IM(max 50mg) consider:preg. cat. B |
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Dopamine
(Inotropin) |
class:sympathomimetic
Desc:acts on alpha1,beta1, adernergic receptors,low doses causes renal and vascular dilation,moderate doses causes enhanced myocardialcontractility, increased cardiac output, rise in BP, high dose causeperipheral venous/arterial constriction. Inda:Hemodynamically significant hypotension in absence of hypovolemia Contra:VF/VT,hypovolemia, pts.w/pheochromocytoma Adverse Rx:dose related tachydysrhythmias, HTN, Increased myocardial O2 demand Onset:2-4min duration:10-15min after cessation of infusion dose:Adult Dopaminergic response:1-5mcg/kg/min Beta Adrenergic response:5-10mcg/kg/min Alpha Adrenergic response:10–20mcg/kg/min Pediatric dilute 6mg/kg in solution to total of 100mg;begin infusion at 10mcg/kg/min IV/IO,titrate to effect (max 20mcg/kg/min) consider:no preg. cat. infuse thorough large vein, monitor for decreased circulation |
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Epinephrine
(Adrenalin) |
Class:sympathomimetic
Desc:stimulates alpha,beta 1,and beta 2 adrenergic receptors in dose-related fashion Rapid injection produces rapid increase in BP,ventricular contractility,and heart rate. vasoconstriction in arterioles of skin and mucosa,It antagonizes effects of histamine by decreasing release and decreasing membrane permeability Inda:Bronchoconstriction Anaphylaxis,All forms of cardiac arrest,Profound symptomatic bradycardia Contra:Hypersensitivity,Hypovolemic shock,Coronary insufficiency,Hypertension Adverse Rx:Headache,nausea,restlessness,Weakness,dysrhythmias,HTN,Precipitation of angina pectoris Onset:SQ5-10min,IV/ET 1-2min duration:5-10min. Dose:Cardiac Arrest (all rhythms) Adult 1mg/IV or 2–2½ times the IV dose via ET,repeat every 3-5min Pediatric Initial Dose: IV/IO 0.01mg/kg(1:10,000) ET dose is 0.1ml/kg(1:1,000)diluted to 3-5ml Repeat Doses: IV/IO/ET 0.1ml/kg(1:1,000) every 3-5min Allergic Reactions/Bronchoconstriction Adult Moderate allergice reaction/bronchoconstriction 0.3-0.5mg(1:1,000)SQ Anaphylaxis (Severe allergic reaction) 1mg(1:10,000)slow IV Pediatric Moderate allergice reaction/bronchoconstriction 0.01 ml/kg(1:1,000)SQ Anaphylaxis(Severe allergic reaction) 0.05-0.5mcg/kg/min INFUSION Infusion Adult 2-10mcg/min titrated to increased HR/BP Suggested concentration: mix 1mg in 500ml solution to get 2mcg/ml concentration Pediatric 0.1mcg/kg/min titrated to increase HR/BP Suggested concentration: mix 0.6mg/kg to create a 100ml solution. consider:Cat. C preg., no prefilled syringes for epi infusions,Syncope can occur in asthmatic children |
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Furosemide
(Lasix) |
Class:loop diuretic
Desc:inhibits reabsorbtion of sodium & chloridein loop of henle. Inda:Cardiogenic pulmonary edema,CHF Contra:Anuria,Hypersensitivity,hypovolemia/dehydration Adverse Rx:Hypotension,dry mouth,hypochloremia,hypokalemia,hyponatremia,hyperglycemia Onset:diuretic effects in 15-20min.,vasodilatoryeffects within 5min/IV Duration:4-6hrs Dose:Adult 20-40mg(0.5-1.0mg/kg)slow IV over 1-2min(not to exceed 20mg/min)or twice the pts. daily PO dose Pediatric 1mg/kg/dose Consider:Preg. Cat. C,known to cause fetal abnormalities,protect from light |
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Glucagon
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Class:pancreatic hormone, insulin antagonist
Desc:results in Blood glucose elevation by increasing glycogen breakdown Inda:Hypoglycemia with altered LOC,Beta-blocker overdose Contra:hypersensitivity Adverse Rx:tachycardia,nausea/vomiting,HTN Onset:within 1min Duration:9-17min. Dose:Hypoglycemia Adult 1 mg/IM,may repeat in 10min Pediatric 0.5mg/IM,may repeat in 10min Beta-blocker Toxicity Adult 1-5mg slow IV(over 2-5min) Pediatric 0.0015-.1mg/kg slow IV Consider:Preg. Cat. B,not 1st line choice for hypoglycemia,primary use when IV unestablished for50%dextrose,IV glucose will need administered if no rx from pt. |