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86 Cards in this Set
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Adenosine
Pediatric Dose |
*0.1 mg/kg iv/io rapid push (max 6 mg)
*0.2 mg/kg iv/io rapid push (max 12 mg) Half life <10 sec, very important to push fast followed by saline bolus |
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Adenosine
Indications |
*SVT
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Adenosine
Special considerations |
*fast push Follow immediately by NS flush (5-10ml)
*Theophylline reduces its effectiveness *Brief period (10-15 sec) of bradycardia (asystole or 3rd block) may occur following administration |
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Albumin
Pediatric dose |
*0.5 to 1 g/kg by rapid infusion iv/io
*(10-20 ml/kg of 5% solution) |
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Albumin
Indications |
*shock
*trauma *burns |
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Albumin
Actions |
*expands intravascular space
*more likely to remain longer than crystalloid *pulls water and sodium from extravascular compartment *augments preload and CO |
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Albumin
Special Considerations |
*blood product- transfusion reactions are rare
*use within 4 hours of opening vial *5% albumin generally given undiluted. 25% can be either diluted in NS, or not. |
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Albuterol
Pediatric dose |
*MDI; 4-8 puffs q 20 min prn w/spacer (or ET if intubated)
*Nebulizer; 2.5 mg/dose (<20kg) *5 mg/dose (>20 kg) q 20 min prn *Continuous neb; 0.5 mg/kg per hour (max 20 mg/h) |
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Albuterol
Indications |
*Asthma
*Anaphylaxis (bronchospasm) *Hyperkalemia |
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Albuterol
Actions |
*Bronchodilation
*Tachycardia *Vasodilation *Draws potassium from extracellular to intracelllular space. |
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Albuterol
Special Considerations |
*Contraindicated with severe cardiac disease patients
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Amiodorone
Pediatric Dose |
*SVT/VT w/pulse
5 mg/kg iv/io load over 20-60 min (max 300 mg) Repeat doses of 5mg/kg, up to max 15mg/kg/day *VF/ VT w/o Pulse 5mg/kg iv/io bolus (max 300 mg) Repeat (daily max 15 mg/kg) |
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Amiodorone
Indications |
*Svt
*Vt (with pulses) *Vf/ pulseless Vt |
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Amiodorone
Actions |
*Slows sinus rate
*Prolongs PR and QT intervals |
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Amiodorone
Special Considerations |
rapid administration may cause vasodilation and hypotension, heart block or polymorphic VT.
*Use cautiously with hepatic patients *Has potential to increase concentration and toxicity of multiple drugs *Expert consultation recommended other than cardiac arrest purposes |
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Atropine Sulfate
Pediatric Dose Bradycardia (Symptomatic) |
*0.02 mg/kg iv/io
*Min dose 0.1 mg *Max single dose child; 0.5 mg *Max single dose Adolescent; 1mg |
May repeat once
Max child; 1 mg Max adolescents; 3 mg |
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Atropine Sulfate
Actions |
*Increases heart rate and CO by blocking vagal stim
*Reduces saliva and increases viscosity *Causes mydriasis |
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Atropine
Special Considerations |
*Blocks bradycardia response to hypoxia.
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Atropine
Indications |
*Symptomatic bradycardia
*Toxins/ Overdose |
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Atropine
Pediatric Dose Toxins/ Overdose |
*<12; 0.02-0.05 mg/kg iv/io.
repeat q 20-30 min until muscarinic symptoms reverse. *>12; 2 mg iv/io initially. then 1-2 mg q20-30 min until muscarinic symptoms reverse |
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Calcium Chloride 10%
Pediatric Dose |
*20 mg/kg iv/io SLOW push during arrest.
*Repeat prn |
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Calcium Chloride 10%
Indications |
*Hypocalcemia
*Hyperkalemia *Hypermagnesemia *Calcium channel blocker overdose |
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Calcium Chloride 10 %
Special Considerations |
*Sash flush when used with calcium and sodium bicarb
*Central line admin preferred |
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Dexamethasone
Pediatric Dose |
*0.6 mg/kg po/im/iv (max 16 mg)
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Dexamethasone
Indications |
*Croup
*Asthma |
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Dexamethasone
Actions |
*Widespread effects on inflammatory response
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Dextrose (Glucose)
Pediatric Dose |
*0.5-1 g/kg iv/io
*D25W; 2-4 ml/kg *D10W; 5-10 ml/kg |
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Dextrose (Glucose)
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*Max recommended concentration for bolus is D25W
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Diphenhydramine
Pediatric Dose |
*1-2 mg/kg iv/io/im q4-6 hours.
Max single dose 50mg |
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Diphenhydramine
Indications |
*Anaphylaxis (after administration of epi)
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Diphenhydramine
Special considerations |
*May exacerbate glaucoma, hyperthyroidism, peptic ulcer and urinary tract obstruction.
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Dobutamine
Pediatric Doses |
*2-20 mcg/kg per min iv/io infusion. titrate to desired effect
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Dobutamine
Indications |
*Ventricular dysfunction
*Congestive heart failure *Cardiogenic shock |
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Dobutamine
Special Considerations |
Drug is inactive in alkaline solutions
*Do not mix with Sodium Bicarb *May produce exacerbate hypotension or tachyarrhythmias. |
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Epineprine
IM Anaphylaxis doses |
0.01 mg/kg q 15 min prn (max 0.3mg)
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Epineprine
IV Anaphylaxis doses |
0.01 mg/kg q 3-5 min (max 1mg) if hypotension is present.
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Epineprine
Asthma |
0.01 mg/kg q 15 min (max 0.3)
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Epineprine
Bradycardia (Symptomatic) |
0.01 mg/kg q 3-5 min (max 1mg)
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Epinephrine
Croup Doses |
*0.25 ml racemic epi mixed in 3 ml NS
*up to 0.5 ml for older children *0.5 ml/kg of 1:1000 epi (max 5ml) diluted in 3 ml of NS. |
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Epinephrine
Cardiac Arrest Doses |
*IO/IV; 0.01 mg/kg every 3-5 min (max dose 1mg)
*ET; 0.1 mg/kg endotracheally every 3-5 min |
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Epinephrine
Shock Doses |
*IV/IO; 0.1-1 mcg/kg per minute infusion (consider higher doses if needed)
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Epinephrine
Toxins/ overdose |
*IV/IO 0.01 mg/kg (mas 1mg dose) If no response, consider higher doses up to 0.1mg/kg
*IV/IO Infusion; 0.1-1 mcg/kg per minute infusion (May consider higher doses) |
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Epinephrine
Special considerations |
* IM; best absorption is in thigh rather than deltoid.
*Central line preferred. SQ not recommended *Tissue necrosis may result from IV infiltration. |
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Epinephrine
Actions |
*Increases heart rate, myocardial contractility, automaticity, and conduction velocity
*Bronchodilation *Arterioles dilation |
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Etomidate
Pediatric Dose |
*0.2-0.4 mg/kg IV/IO (max 20mg) infused over 30-60 seconds.
*Sedation lasts 10-15 minutes |
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Etomidate
Indications |
*Sedation for rapid sequence intubation
*Sedative of choice for; hypotension, cardiovascular disease, head injuries and multiple trauma. |
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Etomidate
Actions |
*No analgesic properties
*Decreases intracranial pressure, cerebral blood flow and cerebral metabolic rate. |
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Etomidate
Special considerations |
*Avoid routine use in septic shock
*May cause hiccups, coughing and exacerbate seizure disorders *Benzodiazepines or opioids may decrease myoclonus activity. |
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Etomidate
Contraindications |
*Dont use with known adrenal insufficiency or history of focal seizure disorder
*Do not continue to use once intubation is successful. |
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Furosemide (lasix)
Pediatric doses |
*1mg/kg (max 20mg dose)
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Hydrocortisone
Pediatric dose |
*2mg/kg iv bous (Max 100 mg)
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Hydrocortisone
Indications |
*Adrenal insufficiency
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Inamrinone (Amrinone)
Pediatric dose |
IV/IO; Loading dose of 0.75-*1mg slow bolus over 5-10 min (give over longer period if pt is unstable)
*Infusion; 5-10 mcg/kg per min. |
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Inamrinone (Amrinone)
Special Considerations |
*drug has hypotensive effects and may worsen hypovolemia
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Ipratropium Bromide (Atrovent)
Pediatric dose |
*250-500 mcg every 20 minutes X 3 doses
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Ipratropium Bromide (Atrovent)
Indications |
*Asthma
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Ipratropium Bromide (Atrovent)
Special considerations |
*Min cardiovascular effects.
*May cause pupil dilation if solution gets in the eye |
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Lidocaine
Pediatric Dose VF/ Pulseless VT, Wide complex Tach (w/pulses) |
*Initial 1mg/kg loading dose
*Repeat if infusion is started more than 15 min after initial bolus. *Maintenance; 20-50 mcg/kg per min. *ET; 2-3 mg/kg |
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Lidocaine
Pediatric Doses rapid sequence intubation |
*IV/IO 1-2mg/kg
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Lidocaine
Indications |
*VF/ Pulseless VT
*Wide complex tachycardia (w/ pulses) *Rapid Sequence intubation; before laryngoscopy to blunt increase in intracranial pressure. |
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Magnesium Sulfate
Pediatric dose |
*25-50 mg/kg iv/io bolus (max 2g) pulseless VT.
*Over 10-20 minutes (Vt w/pulses) *Over 15-30 min (Status asthmaticus) |
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Magnesium Sulfate
Indications |
*Asthma (refractory status asthmaticus)
*Torsades de pointes *Hypomagnesemia |
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Magnesium Sulfate
Special considerations |
*Rapid bolus may cause severe hypotension and bradycardia
*Calcium chloride (or calcium gluconate) for reversal of magnesium toxicity *Contraindicated in renal failure |
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Methylprednisolone
Pediatric dose |
*Load; 2 mg/kg iv/io/im (max 60 mg) Only use acetate salt IM
*Maintenance; 0.5 mg/kg iv/io q 6 hrs (max 120 mg/day) |
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Methylprednisolone
Indications |
*Asthma (status asthmaticus)
*Anaphylactic shock |
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Milrinone
Pediatric dose |
*Load; 50 mcg/kg iv/io over 10-60 min.
*Followed by 0.25-0.75 mcg/kg per min infusion |
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Milrinone
Indications |
*Myocardial dysfunction with increased systemic vascular resistance/ pulmonary vascular resistance.
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Milrinone
Special considerations |
*Longer infusion times reduces the risk of hypotension
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Naloxone (Narcan)
Pediatric dose |
*Narcotic toxicity 2º overdose; 0.1 mg/kg iv/io/im/sq/ q 2 min prn (max 2mg)
*Respiratory depression 2º narc use; 1-5 mcg/kg iv/io/im/sq. (titrate to desired effect) *Continuous infusion iv/io; 2-160 mcg/kg per hr |
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Nitroglycerin
Pediatric Dose |
*Initiate; 0.25-0.5 mcg/kg per min. Titrate by 1mcg/kg per min q 15-20 min as tolerated. Typical dose range 1-5mcg/kg per min. (max dose 10 mcg/kg per min)
*Teens; start with 5-10 mcg per min, and increase to max 200 mcg/min. |
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Nitroglycerin
Indications |
*Congestive heart failure
*Cardiogenic shock |
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Nitroglycerin
Precautions |
*Hypotension posible in hypovolemic pt
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Nitroprusside
Pediatric dose |
*0.3-1 mcg/kg per min.
*Then titrate up to 8 mcg/kg per min. |
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Nitroprusside
Indications |
*Cardiogenic shock
*Hypertension (Severe) |
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Nitroprusside
Special Considerations |
*Use immediately after preparation
*May have a very faint brownish tint *May react with a variety of substances |
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Norepinephrine
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*0.1-2 mcg/kg per min infusion. (titrate to desired effect)
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Norepinephrine
Indications |
*Hypotensive shock (Usually distributive)
*Low SVR and fluid refractory |
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Norepinephrine
Special considerations |
*Do not mix with Sodium Bicarb
*Central line preferred *Inactive in alkaline solutions *Infiltration will cause ischemia and necrosis. Phentolamine may reduce toxic effects. |
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Procainamide
Pediatric dose |
*Load; 15 mg/kg iv/io over 30-60 minutes
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Procainamide
Indications |
*SVT
*Atrial Flutter *VT (with Pulses) |
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Procainamide
Special considerations |
*Administering with Amiodarone is not recommended
*Reduce doses for renal and cardiac patients. |
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Sodium Bicarb
Indications |
*Metabolic acidosis (severe)
*Hyperkalemia *Sodium channel blocker overdose (antidepressant) |
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Sodium Bicarb
special considerations |
*Do not use ET tube
*Sash before and after each dose |
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Terbutaline
Indications |
*Asthma
*Hyperkalemia |
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Vasopressin
Indications |
*Cardiac arrest
*Catecholamine-resistant hypotension (septic shock) |
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Vasopressin
Special considerations |
*Use cautiously with asthma and cardiovascular disease
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