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94 Cards in this Set
- Front
- Back
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Chemical name for ASPIRIN
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Acetylsalicylate Acid
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Route for ASPIRIN
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Oral (Chewed)
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Dose for ASPIRIN
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One (325 mg) adult ASA or 4 (81 mg) baby ASA
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Drug Action for ASPIRIN
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Decreases platelet stickiness
Blocks pain impulses in the CNS Reduces fever and inflammation |
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Indications for ASPIRIN
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Chest pain believed to be of cardiac origin
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Precautions for ASPIRIN
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Any significant bleeding
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Side effects for ASPIRIN
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None for pre-hospital
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Contraindications for ASPIRIN
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ASA allergy
ASA induced asthma |
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Trademark name for IPRATROPIUM BROMIDE
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Atrovent
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Class of IPRATROPIUM BROMIDE
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Topical Anticholinergic
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Route of IPRATROPIUM BROMIDE
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Inhalation (nebulized)
ETT (alternate route) |
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What are all doses of IPRATROPIUM BROMIDE combined with?
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2.5 mg of ALBUTEROL
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Adult dose for IPRATROPIUM BROMIDE
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Nebulizer: 0.5 mg in 2.5 mL Normal Saline
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Pediatric dose for IPRATROPIUM BROMIDE
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Nebulizer: Less than 1 Year Old - 0.25 mg in 2.5mL Normal Saline
1 Year or Older - 0.5 mg in 2.5 mL Normal Saline |
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Drug Action for IPRATROPIUM BROMIDE
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Bronchodilation
Dries respiratory tract secretions |
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Indications for IPRATROPIUM BROMIDE
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Bronchospasm associated with asthma or COPD that does not respond to the first dose of ALBUTEROL
Bronchospasm from chemical toxins: i.e. nerve agents, cyanide, blistering agents, choking agents |
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Precautions for IPRATROPIUM BROMIDE
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Use caution if patients have a history of glaucoma, prostatic hypertrophy, or bladder neck obstruction
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Side Effects of IPRATROPIUM BROMIDE
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Dry mouth
Cough, worsening of symptoms Skin rash |
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Contra-indications for IPRATROPIUM BROMIDE
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Sensitivity to soy lecithin products (soybeans, peanuts)
Sensitivity to ATROPINE Bronchoconstriction that is caused by allergic reaction |
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Trademark names for ALBUTEROL
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Ventolin
Proventil |
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Drug Class for ALBUTEROL
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Sympathomimetic
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Route for ALBUTEROL
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Inhalation (nebulized)
ETT (alternate route) May be administered via either lumen of the Combitube |
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Format ALBUTEROL is supplied in
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Liquid
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Adult dose of ALBUTEROL
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Nebulizer: 2.5 mg over 5 to 15 minutes at 2 to 15 liters per minute (Lpm)
Preferred rate is 8 liters per minute |
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Pediatric dose of ALBUTEROL
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Same as adult
Nebulizer: 2.5 mg over 5 to 15 minutes at 2 to 15 liters per minute (Lpm) Preferred rate is 8 liters per minute |
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What can you do if patient is improving after the first dose of ALBUTEROL?
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You may give two additional doses of ALBUTEROL
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What should you do if there is no improvement after the first ALBUTEROL dose?
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Combine the 2nd and 3rd doses of ALBUTEROL with IPRATROPIUM BROMIDE (if there are no contra-indications for IPRATROPIUM BROMIDE)
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Drug Action for ALBUTEROL
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Bronchodilation (Beta 2)
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Indications for ALBUTEROL
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Bronchospasm associated with asthma and COPD
Bronchospasm from chemical toxins: i.e. nerve agents, cyanide, blistering agents, choking agents, allergic reactions unresponsive to EPINEPHRINE or DIPHENHYDRAMINE (Benadryl) |
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Precautions for ALBUTEROL
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Known heart disease
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Side effects of ALBUTEROL
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Restlessness
HTN Tachycardia - palpations |
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Contraindications for ALBUTEROL
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Pregnancy, except in life-threatening situations
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Trademark name for NITROGLYCERIN
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Nitrostat
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Drug Class of NITROGLYCERIN
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Vasodilator
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Route of NITROGLYCERIN
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Sublingual
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Adult dose of NITROGLYCERIN
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1 spray (0.4 mg) or tablet
May be repeated twice at 5 minute intervals (if protocol allows) Additional doses may be given if ok'd by medical control |
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Pediatric dose of NITROGLYCERIN
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Not used in the pre-hospital setting
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Drug action of NITROGLYCERIN
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Coronary and systemic (veins and arteries) vasodilator.
Decreases peripheral vascular resistance, preload, and afterload Decreases cardiac workload and oxygen demand |
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Indications for NITROGLYCERIN
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Chest pain of cardiac origin
Pulmonary edema associated with CHF (peripheral vasodilation) |
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Precautions for NITROGLYCERIN
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Monitor blood pressure closely
Assure patient is sitting or lying down during administration Must have 12 lead EKG prior to administration to rule out inferior wall MI IV needs to be established prior to administering with suspected inferior wall MI's |
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Side effects of NITROGLYCERIN
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Hypotension
Headache Postural Hypotension/syncope Reflex tachycardia |
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Contraindications for NITROGLYCERIN
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Systolic BP of less than 90
Pulse less than 50 or greater than 100 Increased ICP Erectile dysfunction drugs used within the following time frames Viagra - 24 hours Levitra - 24 hours Cialis - 48 hours |
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Trademark name for FUROSEMIDE
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Lasix
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Drug class of FUROSEMIDE
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Loop Diuretic
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Drug Action for FUROSEMIDE
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Affects sodium and chloride reabsorption at the Loop of Henle
Decreased osmotic gradient Basically, potassium and sodium are filtered out of the blood and into the urine. The difference in osmotic gradient causes water from the body to be drawn in also. |
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Onset and duration of FUROSEMIDE
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The onset occurs in 15-20 minutes
Lasts up to 2 - 6 hours |
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Indications for FUROSEMIDE
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Pulmonary edema
Renal disease Hyperkalemia |
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Contraindication for FUROSEMIDE
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Dehydration
Hypovolemia Pregnancy |
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Adverse reactions for FUROSEMIDE
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Hypotension
Electrolyte Imbalance Ototoxicity |
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Drug Interactions for FUROSEMIDE
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Digitalis toxicity
Increased ototoxicity when used with some antibiotics |
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How is FUROSEMIDE supplied?
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Liquid - 10 mg/mL
Comes in 2, 4, 8, and 10 mLs |
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Dose for FUROSEMIDE
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20-40 mg Slow IV Push (20mg/min)
Double the usual daily single dose up to 100 mg |
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Other important information to know about FUROSEMIDE
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Sometimes referred to by patients as a "water pill"
May be prescribed to patients as an oral medication DIFFERENTIATE FROM PNEUMONIA BEFORE GIVING FUROSEMIDE Patient most likely also taking potassium supplements as FUROSEMIDE is a non-potassium sparing diuretic. |
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Drug class of EPINEPHRINE
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Sympathomimetic
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What does 1:1000 EPINEPHRINE mena?
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Based on concentration of mixture of 1 gram Epi per 1000 mL
This is equivalent to 1000 mg/1000 mL which equals 1 mg per 1 mL |
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Indications for EPINEPHRINE
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Allergic reaction / anaphylaxis
Bronchospasm refractory to inhaled beta agonists To make Epi infusion for adult refractory bradycardia |
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Route for EPINEPHRINE 1:1000
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Subcutaneous (use TB syringe) or IV infusion
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Adult dose of EPINEPHRINE 1:1000 for allergic reaction
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0.3 mg (mL) - 0.5 mg (mL) SQ - repeat in 15-20 minutes if indicated
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Pediatric dose of EPINEPHRINE 1:1000 for allergic reaction/anaphylactic shock
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0.01 mg/kg (max 0.3 mg per dose)
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Adult dose of EPINIEPHRINE 1:1000 for asthma
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0.3 mg (mL) - 0.5 mg (mL) SQ
Administer for bronchospasm unresponsive to nebulizers or magnesium sulfate |
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Adult dose of EPINEPHRINE 1:1000 for bradycardia
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Mix 1 mg in 250 or 500 mL of Normal Saline. Run at 1-10 mcg/min titrated to effect
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Pediatric dose of EPINEPHRINE 1:1000 for bronchospasm unresponsive to inhaled beta-agonists
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0.01 mg/kg (max 0.3 mg per dose) SQ
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Pediatric dose of EPINEPHRINE 1:1000 for IV infusion
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0.1 - 1 mcg/kg/min
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Drug actions for EPINEPHRINE 1:1000
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Alpha effects produce peripheral vasoconstriction which:
- Increases coronary and cerebral perfusion -Increases blood pressure in anaphylaxis Beta 1 effects: - Increases heart rate - Improves force of ventricular contractions Beta 2 effects produce bronchodilation |
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Onset and duration of EPINEPHRINE 1:1000
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Onset in 5 - 10 minutes
Duration of 5 - 10 minutes |
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What should you do after an IV dose of EPINEPHRINE 1:1000
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Flush with 20 mL Normal Saline
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Precautions for EPINEPHRINE 1:1000
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Monitor EKG closely
Patients on beta blockers may need glucagon or higher doses of EPINEPHRINE 1:1000 |
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Side effects of EPINEPHRINE 1:1000
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- HTN
- Tachycardia/tachyarrhythmis - Flushing - Headache - Nausea/vomiting - Chest pain |
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Contraindications for EPINEPHRINE 1:1000
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No contraindications if used for allergic reaction
Refractory bronchospasm: - Heart disease - Past medical history of AMI - Greater than 45 years old - Arrhythmias - Labor |
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Indications for EPINEPHRINE 1:10,000
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- Cardiac Arrest
- Anaphylaxis - Beta Blocker or Calcium Channel Blocker Overdose - Pediatric bradycardia unresponsive to other treatment |
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Route for EPINEPHRINE 1:10,000
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IV or IO
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Adult dose of EPINEPHRINE 1:10,000 for Cardiac Arrest
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1 mg/IO push q (every) 3-5 minutes
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Adult dose of EPINEPHRINE 1:10,000 for Anaphylaxis
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0.1 mg (1 mL) - 0.2 mg (2mL) slow push over 1 minute
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Pediatric dose of EPINEPHRINE 1:10,000 for Cardiac Arrest
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0.01 mg/kg rapid push every 3 - 5 minutes
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Pediatric dose of EPINEPHRINE 1:10,000 for Anaphylaxis
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0.01 mg/kg slow push (maximum is 0.3 mg per dose)
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Onset and duration of EPINEPHRINE 1:10,000
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Onset is 1 - 2 minutes
Duration of 5 - 10 minutes |
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Precautions for EPINEPHRINE 1:10,000
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- Monitor EKG closely
- Patients on beta blockers may need glucagon or higher doses of epinephrine - DO NOT mix with SODIUM BICARBONATE |
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Side effects of EPINEPHRINE 1:10,000
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- HTN
- Tachycardia/tachyarrhythmias - Flushing - Headache - Nausea/vomiting -Chest pain |
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Contraindications for EPINEPHRINE 1:10,000
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None
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Drug class of AMIODORONE
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- Sodium, potassium, and calcium channel blocker
- Antiarrhythmic - Sympatholytic |
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Trademark names for AMIODORONE
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- Cordarone
- Pacerone |
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Drug action of AMIODORONE
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- Alters movement of sodium, potassium, and calcium through normal channels in all cardiac tissue
- Has alpha and beta blocking properties - These actions increase the refractory period of all cardiac tissue, slow repolarization, and decrease automaticity |
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Onset and duration of AMIODORONE
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Half-life lasts up to 40 days
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Indications for AMIODORONE
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- V-fib/V-Tach cardiac arrest unresponsive to CPR, Shock, and Vasopressor
- Recurrent, hemodynamically unstable V-Tach - Option in stable wide QRS Tachycardia |
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Contraindications for AMIODORONE
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- The ONLY absolute contraindication is allergic reaction to AMIODORONE
- Don't administer with other drugs that prolong the QT interval - Trauma patients |
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Adverse reactions to AMIODORONE
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- Rapid infusion may lead to hypotension
- Bradycardia - Hypotension - Heart block |
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Drug interactions for AMIODORONE
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DO NOT administer with other drugs that prolong the QT interval
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How is AMIODORONE supplied?
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IV ampules and vials - typically in 150 mg increments
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Route of AMIODORONE
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IV or IO
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Dose of AMIODORONE
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- First dose is 300 mg IV/IO
- Second dose (if needed) is 150 mg IV/IO - Maximum cumulative dose is 2.2 grams IV over 24 hours |
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Dose of AMIODORONE in stable wide QRS Tachycardia
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- First dose is 150 mg over 10 minutes.
- Repeat as needed if V-Tach recurs. - Follow this with a maintenance infusion of 1 mg/min for the first 6 hours |
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Special Notes for AMIODORONE
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- With expert consultation, AMIODORONE may be used for treatment of some atrial and ventricular arrhythmias
- DO NOT shake or draw up medication with a large gauge needle - Protect from light - Avoid contact with plastic - Administer at the closest IV port - Frequently check BP, HR, and EKG |
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Trademark name for LIDOCAINE
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Xylocaine
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Drug class of LIDOCAINE
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Ventricular Anti-arrhythmic
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