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52 Cards in this Set

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Tx for Mild Allergic Reaction
Benadryl 50 mg IM
Tx for Moderate to Severe Allergic Reaction
Bronchospasm: Albuterol 5mg in 6ml NS
Epi 1:1,000 .01mg/kg SQ (.5mg max)
IV NS TKO
Benadryl 1mg/kg IV or IM max 50mg
Tx for Anaphylaxis
Epi 1:1,000 .01 mg/kg SQ or SL. (.5mg max)
Benadryl 1 mg/kg IM 50mg max.
IV NS fluid challenge, 10ml/kg. Recheck v/s every 250ml
Tx for unresponsive and no palpable BP (allergic reaction)
Epi (1:10,000) 0.01mg/kg, 0.5mg max IV.
IV NS fluid challenge, 10ml/kg. Recheck v/s every 250 ml.
If BP improves, Benadryl 1mg/kg IM. Max 50mg
If hypotension persists after two fluid challenges
Dopamine, IV. 10mcg/kg/min. Use 400mg/250ml NS. Monitor BP q 3-5m.
Tx for Pulmonary Edema
Nitro 0.4mg SL, may repeat q 5m if BP>100s.
Lasix 40mg IV(10mg/min). 80mg if pt on Lasix.
CPAP
Consider Morphine 2-5mg IVP
Tx for ALOC
AEIOUTIPS
BS<80mg/dl, Dextrose 50% 25g IV. Glucagon 1mg IM,SQ if no IV
OD: Narcan IV,SQ,IM,SL. Titrate, max 2.0mg.
Routine ALS Care
BSI
BLS
ECG
02, >96%
IV access
Glucose determination
Transport
Albuterol
A/M
Selective direct acting B2 agaonist
Albuterol
Indications
Bronchial Asthma, emphysema, chronic bronchitis, allergic bronchospasm, reversible bronchospasm
Albuterol
Contra
Known hypersensitivity
Caution: Cardiovascular disease, HTN, elderly
Albuterol
Side effects
CNS: tremor, anxiety, dizziness, seizure
CV:headache,HTN, tachycardia, CP
R:Bronchospasm
GI:Nausea, vomiting drymouth
ASA
A/M
Reduces rate of nonfatal reinfarction/nonfatal stroke.
Platelet aggregator, arterial constrictor
ASA
Indications
Inhibit clot formation @ onset of new chest pain suggestive of MI/CVA
ASA
Contra
Hypersensitivity to salicylates
Relative: Active ulcer disease, asthma.
Caution: Bleeding disorders NSAID allergies.
ASA
SE
CV:Prolonged bleeding
R:Wheezing, bronchospasm
GI:Nausea, vomiting, heartburn, GI BLeed
ASA
Dose
324mg PO. 4 * 81mg chewable after onset of chest pain.
Atropine
A/M
-vagal tone, + chronotrophy & AV conduction. Competitive antagonist for ACH @ muscarinic receptors. Bronchodialates via parasympatholytic mech.
Atropine
Indication
Hemodynamically significant bradycardia & aystole.
Cholinergic poisoning by mushrooms, insecticides/nerve gas.
Atropine
Contra
0 significant.
May worsen bradycardia,heart block.
Caution: Pt w/myocardial ischemia
Atropine
SE
CNS:pupil dilation, confusion, seizure
CV:tachy,paradoxical brady
R:mucous plugs
Gi:Dry mouth
Atropine
Dose
Brady: 0.5-1.0mg IVP MRA 3-5m to max 0.04mg/kg
Asystole & PEA:initial 1.0mg IV MRA 3-5m max 3mg.
Poison: Initial 2.0mg, max 5mg
Ped: 0.05mg/kg IV,IM,IO every 10-15m
Atrovent
A/M
Inhibits ACH @ muscarinic receptors. Bronchodilation, reduces dries respiratory tract secretions.
Atrovent
Indication
Relieve bronchospasm associated w/ chronic bronchitis, asthma, emphysema
Atrovent
Contra
Hypersensitivity to Atropine/derivatives. Not used as 1* trtmnt. Caution: CV disease, HTN, elderly, PG or nursing moms
Atrovent
SE
CNS: anxiety, dizziness, nervousness
CV: palp, headache, HTN
GI: dry m/m n+ v
Atrovent
Dose
500 mcg 3ml NS via HHN.
Peds: 125-250 mcg 2.5 - 3 ml NS
Diazepam (Valium)
A/M
Uncertain. Interacts @ GABA receptors. Produces sedation, amnesia, decreases anxiety. Increases seizure threshold.
Diazepam (Valium)
Indications
Prolonged seizure activity.
Premed b4 cardioversion.
Acute anxiety states.
Skeltal muscle spasm
Diazepam (Valium)
Contra
Hypersensitivity. Avoid in non-life threat emergencies when other CNS depressants.
Diazepam (Valium)
SE
CNS: Drowsy, ataxia, confusion, blurred vision
CV: headache, hypotension
R: depression, apnea
GI: N+V
Diazepam (Valium)
Dose
5-10 mg slow IVP. Titrate to relieve seizure. Repeat prn, max 20mg.
Ped: .5-2.0 mg IV/R/IM (.2-.5mg/kg IV)
Benadryl
A/M
Blocks Histamine by H-1 receptors antagonism. Reverses extrapyramidal reactions via anticholinergic effect
Benadryl
Indications
Mild to moderate allergic reaction. As an adjunct to Epi in anaphylaxis.
Phenothiazine induced dystonic reactions
Benadryl
Contra
Hypersensitivity
Avoid/Caution: acute asthma attack
Benadryl
SE
CNS: Drowsiness, confusion, coma, seizure
R: Dry mouth, dry bronchial secretions
GI: Urinary retention
Benadryl
Dose
50-100 mg slow IVP @ 25mg/min or deep IM
Ped: 1mg/kg IVP @ 25mg/min
Dopamine
A/M
Acts directly on dopaminergic, alpha, beta receptors. Action dose related.
Dopamine
Indication
Hypotension not resulting from hypovolemia
Cardiogenic shock
Dopamine
Contra
Sole agent in hypovolemia, significant tachycardia, dysrhythmia, pheochromocytoma.
Dopamine
SE
CNS: Nervousness
CV: headache, dysrhythmia, palp, cp
R: dyspnea
GI: n + v
Dopamine
Dose
Initial: 2-5 mcg/kg/min. Increase to raise BP. Max dose typically 20mcg/kg/min, never past 50mcg/kg/min
Epi
A/M
Directly agonizes beta and alpha recepters. Inhibits release of histamine from mast cells. inhibits uterine smooth muscle contraction
Epi
Indication
Cardiac arrest(asystole, VT, VF, PEA)
Severe active airway disease
Moderate to severe allergic reactions
EPI
Contra
None in cardiac arrest
Relative: Hemorrhagic, hypovolemic, traumatic, cardiogenic shock.
Caution: CAD, +35, diabetes.
Do not use in 2nd stage labor.
EPI
SE
CNS:restlessness, anxiety, tremor, dizziness, CVA, syncope
CV: angina, palp, HTN, MI, SVT, VF, VT, pallor
GI: N + V
EPI
Dose
Cardiac Arrest; 1mg IV q 3-5m(1:10,000)
Bronchospasm, Allergic Rxn, Anaphylaxis:.01mg/kg (1:1000) SQ. Max .5mg
Anaphylaxis 0 AVPU, 0 BP, .01mg/kg (1:10,000) IV, max .5mg
Nitro
A/M
Relaxes vascular smooth muscle, decreases preload & some afterload, O2 demand. Decreases BP.
Nitro
Indications
Relieve cp in myocardial origin. Reduce preload in CHF/cardiogenic pulmonary edema.
Nitro
Contra
Head trauma, neuro deficit, Increase ICP, shock, hypersensitivity, pts on viagra type drugs w/in 24hrs.
Nitro
SE
CNS: dizziness, syncope
CV: hypotension, palp, tachy, headache, flushed skin, +angina, circulatory collapse.
GI:n+V, dry mouth, sublingual burning
Nitro
Dose
0.4mg SL. MRA 3-5m up to 3 doses.