Pals

Front 1

what is the indication for adenosine?

Back 1

SVT

Front 2

what is the 1st dose dosing for adenosine (IV/IO)?

Back 2

0.1 mg/kg rapid push (max dose 6 mg)

Front 3

what is the 2nd dose dosing for adenosine (IV/IO)?

Back 3

0.2 mg/kg rapid push (max dose 12 mg)

Front 4

which drug is an adenosine receptor antagonist which reduces adenosine effectiveness?

Back 4

theophylline

Front 5

what are the indications for albumin?

Back 5

shock, trauma, burns

Front 6

what are the available forms of albumin?

Back 6

injection 5% (5 g/100 ml)
25 % (25 g/100 ml)

Front 7

what is the dose of albumin IV/IO?

Back 7

0.5 to 1 g/kg by rapid infusion (10 to 20 ml/kg of 5% solution)

Front 8

onset of albumin?

Back 8

15 to 30 minutes

Front 9

MOA and resp SE of albumin?

Back 9

expands intravascular volume through colloid oncotic effect; monitor for signs of pulmonary edema

Front 10

what is the dose of albuterol when pt <20 kg?

Back 10

2.5 mg/dose PRN q20 mins

Front 11

what is the dose of albuterol when pt wt >20 kg

Back 11

5 mg/dose PRN q20 mins

Front 12

what is dose of continuous nebulizer for albuterol?

Back 12

0.5 mg/kg per hour continuous inhalation (maximum dose 20 mg/h)

Front 13

what is MDI dose of albuterol?

Back 13

4 to 8 puffs (inhalation) via ET tube prn q20 mins or with spacer if not intubated

Front 14

what may albuterol be combined with in nebulizer?

Back 14

ipratropium

Front 15

what are the indications of alprostadil?

Back 15

maintain patency of ductus arteriosus for ductal-dependent congenital heart disease

Front 16

what are the IV/IO doses of alprostadil?

Back 16

0.05-0.1 mcg/kg per injection for initial; 0.01-0.05 mcg/kg per minute infusion titrated to response

Front 17

actions of alprostadil?

Back 17

acts through PGE1 receptors to cause vasodilation of all arteries and arterioles (including ductus arteriosus); inhibits platelet aggregation; stimulates uterine and intestinal smooth muscle

Front 18

half life of alprostadil?

Back 18

5-10 minutes

Front 19

what is alprostadil?

Back 19

prostaglandin E1 and vasodilator

Front 20

indications of amiodarone?

Back 20

SVT, VT (with pulses), VF/pulseless VT

Front 21

what is the dose of IV/IO of amiodarone in SVT, VT (with pulses)?

Back 21

5 mg/kg load over 20 to 60 minutes (max dose 300 mg), may give up to 3 doses to max daily dose of 15 mg/kg (2.2 g in adolescents)

Front 22

what is the dose of IV/IO of amiodarone in pulseless arrest (VF/pulseless VT)?

Back 22

5 mg/kg rapid bolus (maximum dose 300 mg), repeat to maximum daily dose of 15 mg/kg (2.2 g in adolescents)

Front 23

what are the indications for amiodarone?

Back 23

SVT
VT (with pulses)
VF/pulseless VT

Front 24

Contraindications for amiodarone?

Back 24

Sinus node dysfunction, second or third degree AV block

Front 25

indications for atropine?

Back 25

symptomatic bradycardia caused by vagal stimulation or primary AV block, toxins/overdose (eg oragnophsophate, carbamate), rapid sequence intubation (RSI) (ie, age<1 year, age 1 to 5 years receiving succinylcholine, age>5 years receiving second dose of succinylcholine)

Front 26

what is the IV/IO dose of atropine symptomatic bradycardia?

Back 26

0.02 mg/kg (minimum dose 0.1 mg, max single dose 0.5 mg). May repeat dose once (maximum total dose for adolescent 3 mg). Larger doses may be needed for treatment of organophosphate poisoning

Front 27

what is the ET dose of atropine for symptomatic bradycardia?

Back 27

0.04 to 0.06 mg/kg

Front 28

what is the IV/IO dose of atropine for toxins/overdose (organophosphates, carbamate)?

Back 28

<12 0.02 to 0.05 mg/kg initially, then repeated q20-30 mins until muscarinic symptoms reverse
>12 yrs: 2 mg initially, then 1 to 2 mg q20-30 mins until muscarinic symptoms reverse

Front 29

what are the atropine doses for rapid sequence intubation (RSI) IV/IO and IM?

Back 29

IV/IO: 0.01-0.02 mg/kg (minimum dose 0.1 mg, maximum dose 0.5 mg)

IM: 0.02 mg/kg

Front 30

MOA of atropine?

Back 30

blocks acetylcholine and other muscarinic agonists at parasympathetic neuroeffector sites; increase heart rate + cardiac output by blocking vagal stimulation; reduces saliva production + increase saliva viscosity; causes mydriasis

Front 31

precautions re: atropine?

Back 31

doses <0.1 mg may cause paradoxical bradycardia; document clearly if used for pts with head injury b/c atropine causes the pupil to dilate

Front 32

what is the dose of calcium chloride for hypocalcemia, hyperkalemia, hypermagnesemia, calcium channel blocker overdose?

Back 32

cardiac arrest: 20 mg/kg (0.2 mL/kg) IV/IO bolus into a central venous line; may repeat if documented of suspected clinical indications persist
in a noncardiac situation: infuse over 30-60 minutes into a central line if available

Front 33

what are the available forms of calcium chloride?

Back 33

injection 100 mg/ml (10%)

Front 34

calcium chloride versus calcium gluconate?

Back 34

20 mg/kg dose of calcium chloride 10% (0.2 mL/kg) IV or IO provides 5.4 mg/kg of elemental calcium. If only calcium gluconate is available, the equivalent dose is 0.6 mL/kg of a 10% solution (60 mg/kg)

Front 35

what is dexamethasone indicated for?

Back 35

croup and asthma

Front 36

what is the dexamethasone dose for croup po/IM/IV?

Back 36

0.6 mg/kg x1 (max dose is 16 mg)

Front 37

what is the po/IM/IV dose for dexamethasone- asthma?

Back 37

0.6 mg/kg q24h (max dose is 16 mg)

Front 38

what is the dose of dextrose for hypoglycemia?

Back 38

IV/IO: 0.5 to 1 g/kg

D50W: 1-2 ml/kg
D25W: 2-4 ml/kg
D10W: 5-10 ml/kg

Front 39

what is the dose of diphenhydramine in anaphylatic shock?

Back 39

1-2 mg/kg q4-6 hrs (max dose - 50 mg)

Front 40

class of dobutamine?

Back 40

selective B1 adrenergic agent

Front 41

what is the indication of dobutamine?

Back 41

ventricular dysfunction

Front 42

what is the dose of dobutamine for congestive HF, cardiogenic shock?

Back 42

2 to 20 mcg/kg per minute infusion (titrate to desired response)

Front 43

what are the actions of dobutamine?

Back 43

stimulates B1 receptors (predominant effect): increases HR (SA node effect), increases myocardial contractility, automaticity, and conduction velocity (ventricular effect)
stimulates B2 receptors, producing increased HR + vasodilation
b/c dobutamine has intrinsic alpha adrenergic blocking effects, it increases risk of hypotension in pts w/shock complicated by excessive vasodilation (e.g. septic shock)

Front 44

what is the class of dopamine?

Back 44

catecholamine, vasopressor, inotrope

Front 45

what are the indications for dopamine?

Back 45

ventricular dysfunction, including cardiogenic shock, distrubituve shock

Front 46

what are the doses of dopamine for cardiogenic shock, distributive shock?

Back 46

2 to 20 mcg/kg per minute infusion (titrate to response)

Front 47

what are the actions of dopamine?

Back 47

stimulates alpha-adrenergic receptors (>15 mcg/kg per minute): increases SVR via constriction of arterioles
stimulates B1 adrenergic receptors (5 to 15 mcg/kg per minute): increases HR (SA node effect), increases myocardial contractility, automaticity, + conduction velocity (ventricular effect)
stimulates B2-adrenergic receptors (5 to 15 mcg/kg per minute): increases HR, decreases SVR

Front 48

what is the class of etomidate?

Back 48

ultra short-acting nonbarbituate, nonbenzodiazepine sedative-hypnotic agent with no analgesic properties

Front 49

indications for etomidate?

Back 49

sedation for rapid sequence intubation
sedative of choice for patients with hypotension, cardiovascular disease, and multiple trauma, agent of choice for pts with head trauma

Front 50

dose of etomidate for RSI?

Back 50

0.2-0.4 mg/kg IV/IO (max: 20 mg) infused over 30-60 seconds produces rapid sedation that lasts 10-15 minutes

Front 51

what is a precaution in regards to etomidate?

Back 51

may suppress cortisol production after a single dose, consider administration of stress dose hydrocortisone (2 mg/kg; max 100 mg)

may cause myoclonic activity (coughing, hiccups) and may exacerbate focal seizure disorders

Front 52

what are the indications for furosemide?

Back 52

pulmonary edema + fluid overload

Front 53

what are the doses of furosemide for pulmonary edema, fluid overload?

Back 53

1 mg/kg (typical max dose is 20 mg for pts not chronically on loops)

Front 54

what are the indications + doses for hydrocortisone?

Back 54

adrenal insufficiency (may be associated with septic shock) + IV/IO dose is 2 mg/kg bolus (max dose is 100 mg)

Front 55

actions of hydrocortisone?

Back 55

widespread effects on inflammatory response
increases expression of B-adrenergic receptors to improve catecholamine responsiveness

Front 56

what class is inamrinone (Amrinone)?

Back 56

phosphodiesterase inhibitor, inodilator

Front 57

indications of inamrinone?

Back 57

myocardial dysfunction + increased SVR (eg, cardiogenic shock, post-cardiac surgery CHF)

Front 58

what are the doses of inamrinone for myocardial dysfunction + increased SVR?

Back 58

loading dose: 0.75 to 1 mg/kg slow bolus over 5 to 10 minutes (give over longer period if pt is unstable); may repeat twice (max total loading dose is 3 mg/kg)
5 to 10 mcg/kg per minute infusion

Front 59

what are the actions of inamrinone?

Back 59

increases myocardial contractility
reduces preload and afterload by relaxation of vascular smooth muscle

Front 60

what is the dose of ipratropium for asthma?

Back 60

250-500 mcg (inhaled) every 20 minutes x 3 doses

Front 61

what are the indications for lidocaine? class IB antiarrhythmic

Back 61

VF/pulseless VT
wide-complex tachycardia (with pulses)
rapid sequence intubation (RSI); administer before laryngoscopy to blunt increase in ICP

Front 62

what are the IV/IO of lidocaine for VF/pulseless VT, wide-complex tachycardia (with pulses)

Back 62

initial: 1 mg/kg loading bolus; repeat bolus dose if infusion initiated more than 15 minutes after initial bolus
maintenance: 20 to 50 mcg/kg per minute infusion (to follow bolus therapy)

Front 63

what are the ET dose of lidocaine for VF/pulseless VT, wide-complex tachycardia (with pulses)

Back 63

2 to 3 mg/kg

Front 64

what is the IV/IO dose of lidocaine for RSI?

Back 64

1 to 2 mg/kg

Front 65

what are the indications for magnesium sulfate?

Back 65

asthma (refractory status asthmaticus)
torsades de pointes
hypomagnesema

Front 66

what are the doses for IV/IO for asthma, torsades de pointes, hypomagnesemia?

Back 66

status asthmaticus: 25 to 50 mg/kg by slow infusion (15 to 30 minutes) (maximum dose 2 g)
pulseless VT with torsades: 25 to 50 mg/kg bolus (max dose 2 g)
VT with pulses associated wtih torsades or hypomagnesemia; 25 to 50 mg/kg over 10 to 20 minutes (max dose 2 g)

Front 67

special considerations with magnesium?

Back 67

have calcium chloride (or gluconate) available if needed to reverse magnesium toxicity

Front 68

what are the doses for methylprednisolone IV/IO/IM load for asthma + anaphylactic shock

Back 68

load: 2 mg/kg (max 60 mg)

Front 69

what is the IV maintenance dose for methylprednisolone for asthma, anaphylactic shock?

Back 69

0.5 mg/kg every 6 hours or 1 mg/kg every 12 hours up to 120 mg/day