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145 Cards in this Set

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Adenosine Class
Endegonous Nucleoside
Adenosine Action
Slows electrical conduction through AV node, and inhibits re-entry pathway, converting svt to nsr.
Onset- 30 seconds Duration -1-2 minutes
Adenosine Indications
SVT
Adenosine Dose SVT
6mg rapid ivp, follow with 20ml NS.
12mg rapid ivp, follow with 20ml NS.
if no sinus pause mrx1 in 1-2"
If pt has hx of bronchospasm or COPD. BHO
Adenosine Contraindications
2nd and 3rd degree AV heart blocks
Adenosine Side Effects
"Some chicks may dance naughty tonight"
Sob/Dyspnea
Chest pain
Mild hypotension
Dizziness
Nausea
Transient Arrhythmias
Some Chicks May Dance Naughty Tonight
Albuterol Class
Sympathomimetic
Albuterol Action
Activates beta-2 adrenergic receptors relaxing bronchial smooth muscle
Bronchodilation, relieves bronchospasm, and reduces airway resistance
Albuterol Indications
Respiratory disress with bronchospasm
-respiratory origin
-allergic reaction/anaphylaxis
-burns
Albuterol Contraindications
None
Albuterol Side Effects
"TDT"
Tachycardia
Dizziness
Tremors
TDT
Aspirin Class
Salicylate
Aspirin Action
Inhibits the normal tendency for platelets to accumulate in injured or occluded cardiac arteries.
Aspirin Indications
Discomfort/ pain of suspected cardiac origin.
Aspirin Dose-Discomfort/ pain of suspected cardiac origin.
162mg po two 81 mg tablets
Aspirin Contraindications
None
Aspirin Side Effects
Gi upset
Occult bleeding
"GO"
Atropine Class
Anticholenergic
Atropine Action
Competes with acetylcholine for receptor sites blocking the PNS response at SA and AV nodes
Increases HR by increasing electrical conduction through the heart.
Inhibits secretions by decreasing PNS effect on bronchial, salivary, sweat and GI glands.
Atropine Indications
-PEA with bradycardia <60
-Unstable bradycardia narrow complex or wide complex if pacing unavailable
-Unstable bradycardia pediatrics
-Organophophate poisoning
Atropine Dose- PEA bradycardia <60
1mg IVP MRx2 q 3-5" to max 3mg
or
2mg ET MRx2 q 3-5" to max 6mg administered dose
Atropine Dose- Unstable bradycardia narrow complex or wide complex if pacing unavailable
.5mg IVP for pulse <60bpm mr q 3-5" to max of 3mg
Atropine Dose- unstable bradycardia pediatrics
<9 hr <60 9-14 yo hr <40 PDC IV
Atropine Dose- Organophosphate poisoning
2mg ivp/im mr q 3-5"x2 mr q 3-5" prn bho
or
4mg et mr q 3-5"x2 mr q 3-5" prn bho
Atropine Contraindications
None
Atropine Side Effets
"Freaky Prostitutes Dance Tonight"
Flushed hot dry skins
Pupil dilation
Dry mouth
Tachycardia
"Freaky Prostitutes Dance Tonight"
Atrovent Class
Anticholenergic
Atrovent Action
-Antagonizes the action of acetylcholine preventing the interaction of acetylcholine with muscarinic receptors in bronchial smooth muscle causing bronchodilation.
-bronchodilation site specific
Atrovent Indications
Respiratory distress with bronchospasm
-respiratory origin
-allergic reaction/anaphylaxis
-burns
Atrovent Contraindications
None
Atrovent Side Effects
"Never Give Nicky Big Purple Hickys"
Nausea
Gi distress
Nervous
Blurred vision
Palpitations
Headache
Never Give Nicky Big Purple Hicky's
Benadryl Class
Antihistamine
Benadryl Action
-Binds to histamine receptor sites, supressing histamine induced allergic symptoms
-Does not prevent histamine release
Benadryl Indications
-Allergic reaction/ anaphylaxis
-Extrapyramidal reactions
Benadryl Dose- Allergic reaction/ anaphylaxis
adult
50mg slow ivp/im
peds
pdc im/ivp
Benadryl Dose- Extrapyramidal reactions
adult
50mg slow ivp/im
peds
pdc im/ivp
Benadryl Contraindications
None
Benadryl Side Effects
"Dirty Dogs Hump Pretty Sluts"
Drowsiness
Dry mouth
Hypotension
Palpitations
Seizures
"Dirty Dogs Hump Pretty Sluts"
Calcium Chloride Class
Electrolyte
Calcium Chloride Action
-Increases myocardial contractility
-Enhances ventricular automaticity
-Reverses cardio-electric changes produced by hyperkalemia
-Shifts potassium back into cell to prevent intravascular hyperkalemia
Calcium Chloride Dose- Suspected hyperkylemia in a hemodialysis pt in the presence of widened qrs complex and peaked t wave
500mg IVP BHO mr BHO
Calcium Chloride Indications
-Suspected hyperkalemia in a hemodialysis pt in the presence of widened qrs complex and peaked t waves
-Crush injury with extended compression >= 2 hours of extremity or torso.
Calcium Chloride Contraindications
None
Calcium Chloride Side Effects
Decreased Heart Rate
Hypotension
Metallic Taste
Charcoal Class
Absorbent
Charcoal Action
-Binds and absorbs ingested oxins present in the GI tract
-Inhibits intestinal absorption preventing systemic toxicity
Charcoal Indications
Oral ingestion of poison or overdose
Charcoal Dose- Oral ingestion of poison or overdose
Adult
50gm PO
Peds
PDC PO
Charcoal Contraindication
Isolated alcohol ingestion
Caustic agents ingestions
Heavy metal ingestion
Hydrocarbon ingestions
Iron ingestions
Charcoal Side Effects
Nausea/ Vomiting
Constipation/ Diahrea
Abdominal Cramping
"CAN"
Calcium Chloride Dose- Crush injury with extended compression >= 2 hours of extremity or torso
500mg IVP over 30 seconds BHO
Dextrose Class
Carbohydrate
Dextrose Action
Increases blood glucose by providing free sugar quickly released into the blood stream
Dextrose Indications
-Symptomatic pt with altered loc or unresponsive to oral glucose
-if bs <75 mg/dl
-if pt remains symptomatic and BS remains <75 mg/dl MR
Peds
Symptomatic pt unresponsive to oral glucose agents
-If BS <75 mg/dl infant <60 neonate <45
Dextrose Dose- Symptomatic pt with altered loc or unresponsive to oral glucose agents
25gm IVP
Dextrose Dose- Peds Symptomatic pt unrsponsive to oral glucose agents
-If bs <75 infant <60 neonate <45
PDC 25% solution IVP
Dextrose Contraindications
None
Dextrose Side Effects
Local venous irritation/ infection
Hyperglycemia
Dopamine Class
Sympathomimetic
Dopamine Action
-At low and medium doses selectively dilates blood vessels supplying the brain kidneys heart and gastrointestinal tract
-At medium to high doeses, increases cardiac output by increasing contractility and stroke volume, thereby increasing blood pressure
-At high doses, causes vasoconstriction and increased heart rate
Dopamine Indications
-Discomfort/pain of suspected cardiac origin with associated origin
-Shock normovolemic (anaphylactic, neurogenic, septic)
-Bradycardia (after max atropine or after initiation of TCP)
Dopamine Dose
Adult only
10-40 mcg/kg/min in 250ml NS IV drip titrate to bp >= 90 systolic BHO
Dopamine Contraindications
None
Dopamine Side Effects
-At high infusion rates, hypertension and extreme vasoconstriction may occur
-At low infusion rates, hypotension may occur
-Tachyarrhytmias
-Increased myocardial 02 demand
Epinephrine Class
Sympathomimetic
Epinephrine Action
-On the bronchi bronchodilation
-On the peripheral vasculature vasoconstriction
-On the heart
increased heart rate
increased contractility
increased av conduction
increased automaticity
Epinephrine Indications
-Allergic reaction with respiratory distress/bronchospasm
-Anaphylaxis
-Respiratory distress with bronchospasm
-Respiratory distress with stridor in pediatric pts
-Cardiac arrest
-Newborn deliveries if HR remains <60 after 30 sec CPR
Epinephrine Dose- Allergic reaction with respiratory distress/bronchospasm
Adult
If no known cardiac history and <65yo .3mg IM 1:1000 mr q 10"x2
if known cardiac hx above per BHO
Peds
PDC IM 1:1000 mr q 10"x2
Epinephrine Dose- Anaphylaxis
.3mg IM 1:1000 MR q 10" x2
.1mg IVP 1:10,000 BHO MR q 3-5" x 2 BHO
2mg ET 1:1000 BHO MR q 3-5" BHO
Peds
PDC IM 1:1000 MR q 10"x 2
PDC IVP/IO 1:10000 BHO MR q 3-5"x2 BHO
PDC ET 1:1000 BHO MR q 3-5"x2 BHO
Epinephrine Dose- Respiratory Distress with bronchospasm
if no known cardiac hx and <65yo .3mg SC 1:1000 MR q 10"x2
if known cardiac hx BHO
Peds
PDC IM 1:1000 MR q 10"x2
Epinephrine Dose- Respiratory distress with stridor in pediatric pts
1:10000 PDC via nebulizer MRx1
Epinephrine Dose- Cardiac arrest
1mg IVP 1:10000 mr q 3-5"
2mg ET 1:1000 mr q 3-5"
10mg ETAD 1:1000 mr q 5"
Peds
PDC ivp/io 1:10000 mr q 3-5"x2 mr q 3-5" BHO
PDC et 1:1000 mr q 3-5"x2 mr q3-5"BHO
PDC etad 1:1000 mr q5"x2 mr q 5" BHO
Epinephrine Dose- Newborn deliveries if HR remains <60 after 30 seconds CPR
PDC ivp/io 1:10000 mr q 3-5"x2 mr q 3-5"BHO
PDC et 1:1000 mr q 3-5"x2 mr q3-5"BHO
Epinephrine Contraindications
None
Epinephrine Side Effects
Anxiety
Palpitations
Ventricular irritability
Hypertension
Angina
Headache
Nausea
"All perfect vaginas have absolutely no hair"
Glucagon Class
Pancreatic Hormone
Glucagon Action
Increases blood glucose by convertine glycogen stored in the liver to glucose
Glucagon Indications
-Symptomatic pt with altered loc or unresponsive to oral glucose agents
if no iv if bs <75mg/dl
Peds
-Symptomatic pt unresponsive to oral glucose agents
if no iv if bs <75 infant <60 neonate <45
Glucagon Dose- Symptomatic pt with altered loc or unresponsive to oral glucose agents
1ml (1unit) IM
Glucagon Dose- Pediatric
symptomatic pt unresponsive to oral glucose agents
PDC IM
Glucagon Contraindications
None
Glucagon Side Effects
Nausea/Vomiting
Tachycardia
Lidocaine Class
Amide Derivative
Lidocaine Action
Decreases ventricular excitability by supressing automaticity in the his perkinje system
Lidocaine Indications
Vtach
Vfib/ Pulseless Vtach
Post conversion Vfib/ Vtach with pulse >=60
Lidocaine Dose- Vtach
1.5mg/kg slow IVP mr .5mg/kg IVP q8-10" to max 3mg/kg admnistered dose
3mg/kg ET mr 1mg/kg q8-10" to max 6mg/kg administered dose
Lidocaine Dose- Vfib/ pulseless Vtach
1.5mg/kg IVP mrx1 in 3-5"
If no IV
3mg/kg ET MRx1 in 3-5" to max 6mg/kg administered dose
Peds
PDC IVP/IO MRx2 q3-5"
if no iv
PDC ET mrx2 q3-5"
Lidocaine Dose- Post conversion Vfib/ Vtach with pulse >=60
1.5mg/kg IVP MR .5mg/kg IVP q8-10" to max 3mg/kg administered dose
Peds
PDC IVP/IO mrx2 q 8-10"
if no iv
PDC ET mrx2 q8-10"
Lidocaine Contraindications
-2nd and 3rd degree heart blocks
-Idioventricular rhythms
Lidocaine Side Effects
Early
Anxiety
Euphoria
Combative
Nausea
Twitching
Numbness

Late
Seizure
Decreased BP
Coma
Widening QRS
Prolonged PRI
Vfib
Morphine Class
Opioid
Morphiine Action
-Cns depressant acting on opiate receptors in the brain
-Potent pain reliever and sedative
-Relaxes respiratory effort
-Decreases myocardial workload through peripheral vasodilation lowering preload and afterload
Morphine Indications
-Pain or discomfort of suspected cardiac origin if NTG ineffective or contraindicated
-Respiratory distress with rales of suspected cardiac origin
-Pain management
pain >=5 on pain scale and bp >=100 systolic
burns
trauma
envenomation
-Pain associated with external cardiac pacing after capture occurs
Morphine Dose- Pain or discomfort of suspected cardiac origin if NTG ineffective or contraindicated
If bp >= 100 systolic
2-4mg ivp to max of 10mg mr to max 20mg BHO
If bp <100 BHO
Morphine Dose- Respiratory distress with rales of suspected cardiac origin
If bp >=100 systolic
2-4mg ivp to max of 10mg
if bp <100
2-4mg ivp BHO
Morphine Dose- Pain management
pain >=5 on pain scale and bp >=100 systolic
burns
trauma
envenomation
2-4mg ivp to max 10mg mr to max of 20mg BHO
5mg IM mr to max 10mg BHO
10mg PO mr to max 30 mg BHO
Peds
PDC ivp/im/po mr BHO
Morphine Dose- Pain associated with external cardiac pacing after capture occurs
if bp >=100 systolic
2-4mg to max of 10mg BHPO
Morphine BHPO "Use with caution"
"CIA DAMS"
-Chronic pain states
-Isolated head injuries
-Acute onset severe headache
-Drug/etoh intoxication
-Abdominal pain
-Multiple trauma with gcs of <15
-Suspected active labor
Morphine Contraindications
None
Morphine Side effects
"RDTPNP"
-Respiratory distress
-Decreased LOC
-Transient hypotension
-Palpitations/arythmias
-Nausea/Vomiting
-Pinpoint pupils
"RDTPNP"
Narcan Class
Opioid Antagonist
Narcan Action
Reverses respiratory depression, sedation and hypotension effects of opioid overdose by occupying opiate receptor sites
Narcan Indications
-Symptomatic suspected opioid OD excluding opioid dependent pain management patients
-Suspected symptomatic opioid OD in opioid dependent pain managment pts
Narcan Dose- Symptomatic suspected opioid OD excluding opioid dependent pain management patients
with rr< 12
2mg ivp/divp/im mr titrate iv dose to effect
if pt refuses tx give additional 2mg im
Peds
PDC ivp/divp/im mr
Narcan Dose- Suspected symptomatic opioid OD in opioid dependent pain managment pts
.1mg increments titrate up to 2mg ivp/divp or 1-2mg im mr BHO
Peds
PDC ivp/divp or im titrate iv dose to effect mr BHO
Narcan Contraindications
None
Narcan Side Effects
"ANT"
Acute withrawl syndrome
Nausea/vomiting
Tachycardia/hypertension
"ANT"
Nitroglycerin Class
Nitrate
Nitroglycerin Action
-Relaxes systemic venous and arterial vessels causing vasodilation thereby
decreasing preload & afterload
decreasing myocardial workload
decreases myocardial o2 consumption
-Dilates coronary arteries
Nitroglycerin Indications
-Pain or discomfort of suspected cardiac origin
-Respiratory distress with rales of suspected cardiac origin
Nitroglycerin Dose- Pain or discomfort of suspected cardiac origin
if bp >=100
.4mg sl mr q 3-5"
topical ointment paste 1"
if bp<100
BHO mr BHPO
Nitroglycerin Dose- Respiratory distress with rales of suspected cardiac origin
If bp >=100
topical ointment paste 1"

If bp >=100 but <150
.4mg sl mr q3-5"

If bp >=150
.8mg sl mr q 3-5"x3 mr BHO

If bp <100
.4mg sl BHO mr BHPO
Nitroglycerin Contraindications
Suspected intracranial bleed
Pt has taken a sexual enhancement medication such as viagra/ cialis/ levitra within 48 hours
Nitroglycerin Side Effects
Orthostatic hypotension
Temporary pulsating headache
Dizziness
Facial flushing
Reflex tachycardia
Normal Saline Class
Electrolyte/Isotonic Crystalloid
Normal Saline Action
-Equivilent osmotically to blood
-Increases the circulating volume in the vascular system (2/3 infused volume leaves vascular space within 1 hour)
Normal Saline Indications
-Definitive therapy or anticipated
-Shock hypovolemia
Suspected intra-abdominal catastrophe or aortic aneurism
Shock normovolemic
Anaphylaxis
-Shock cardiac origin/septic
Dysrhthmias
-Crush injury with extended entrapment >=2 hours extremity or torso
-Burn pts with >=20% 2nd degree or >=5% 3rd degree
-Respiratory distress with croup-like cough
Normal Saline Dose- Definitive therapy or anticipated
Iv so adjust prn
Normal Saline Dose- Shock hypovolemia
Suspected intra-abdominal catastrophe or aortic aneurism
Shock normovolemic
Anaphylaxis
Iv 500ml fluid bolus
mr to maintain bp >90 systolic
Peds non cardiogenic
Iv/io PDC
mr to maintain bp >= 70+20xage
Normal Saline Dose- Shock cardiac origin/septic
Dysrhthmias
Iv 250ml with clear lungs mr to maintain bp 90 systolic
Peds cardiogenic
Iv/io PDC with clear lungs
mrx1 to maintain bp >=70+2xage
Normal Saline Dose- Crush injury with extended entrapment >=2 hours
500ml fluid bolus just prior to extremity release
Peds
Iv PDC just prior to extremity release BHO
Normal Saline Dose- Burn pts with >=20% 2nd degree or >=5% 3rd degree
>=15 yo 500ml fluid bolus then tko
Peds
5-14yo 250ml fluid bolus then tko
<5yo 150ml fluid bolus then tko
Normal Saline Dose- Respiratory distress with croup-like cough
5ml via nebulizer
Normal Saline Contraindications
Rales for fluid boluses
Normal Saline Side Effects
None
Normal Saline Contents?
154 meq na/liter
154 meq cl/liter
Sodium Bicarb Class
Eletrolyte
Sodium Bicarb Action
Reduces acidosis or causes alkalosis by direct release of bicarbonate ion in the blood stream
Sodium Bicarb Indications
-PEA
-Hyperkylemia in a hemodyalysis pt
-Tricyclic OD with cardiac effects
-Crush injury with extended entrapment >=2 hours of extremity or torso when extremity released
Sodium Bicarb Dose- PEA
1meq/kg ivp mr .5meq/kg ivp q10" BHO
Sodium Bicarb Dose- Hyperkylemia in a hemodyalysis pt
1meq/kg ivp BHO
Peds
PDC ivp x 1 BHO
Sodium Bicarb Dose- Tricyclic OD with cardiac effects
1meq/kg ivp BHO
Peds
PDC ivp x 1 BHO
Sodium Bicarb Dose- Crush injury with extended entrapment >=2 hours of extremity or torso when extremity released
1meq/kg ivp BHO
Peds
PDC ivp x 1 BHO
Sodium Bicarb Contraindications
None
Sodium Bicarb Side Effects
Electrolyte/Ph imbalances
Versed Class
Benzodiazepine
Versed Action
-Cns depressant
-Causes retrograde amnesia then sedation
-Stops and prevents seizures
Versed Indication
-Seizures
Generalized seizures lasting >=5 minutes
Focal seizures with respiratory compramise
Recurrent seizures without lucid interval
Eclamptic seizures of any duration
-Precardioversion
concscious VT
-Precardioversion
SVT
-Precardioversion if rhythm refractory to rx or symptoms are severe
Afib aflutter
-Pacemaker insertion with capture after morphine
Versed Dose- Seizures
Generalized seizures lasting >=5 minutes
Focal seizures with respiratory compramise
Recurrent seizures without lucid interval
Eclamptic seizures of any duration
.1mg/kg ivp 1mg/min to max 5mg mr x1 in 10"
if no iv
.2mg/kg im to max 10mg mrx1 in 10"
Peds
pdc iv/im
Versed Dose- Precardioversion
concscious VT
1-5mg slow ivp 1mg/min
Versed Dose- Precardioversion
SVT
1-5mg slow ivp BHO
Peds
PDC slow ivp BHPO
Versed Dose- Precardioversion if rhythm refractory to rx or symptoms are severe
Afib aflutter
1-5mg slow ivp 1mg/min BHPO
Versed Dose- Pacemaker insertion with capture after morphine
1-5mg slow ivp 1mg/min BHPO
Versed Contraindications
None
Versed Side Effects
Respiratory depression
Drowsiness
Hypotension