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16 Cards in this Set
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Fentanyl Citrate (Sublimaze)
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CLASS: Narcotic Analgesic, Schedule C-II
ACTION: Binds to opiate receptors, producing analgesia & euphoria. INDICATION: Pain ADVERSE: Respiratory depression, apnea, hypotension, N/V, dizziness, sedation, euphoria, sinus bradycardia, palpitations, HTN, diaphoresis, syncope, pain @ injection site. CONTRA: Known sensitivity. Caution in traumatic brain injury, respiratory depression. DOSE: Adult: 50 - 100mcg/dose (0.05 - 1.0mg) IM or slow IV, IO (admin over 1 - 2 min) Ped: 1 - 2mcg/kg IM or slow IV, IO (admin over 1 - 2 min) |
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Meperidine (Demerol)
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CLASS: Narcotic analgesic, Schedule C-II
ACTION: Binds to opiate receptors, producing analgesia & euphoria INDICATION: Moderate to severe pain ADVERSE: Respiratory depression, N/V, sinus bradycardia, sinus tachycardia, palpitation, HTN, Hypotension, vomiting, sinus bradycardia, sinus tachycardia, palpitations, hypertension, hypotension, orthostatis hypotension, diaphoresis, syncope, shock, cardiac arrest CONTRA: Patients who have taken an MAOI in the past 2 weeks, use of other CNS depressants or ETOH, known sensitivity. Caution in pts with chronis respirator conditions (asthma or COPD), pregnant or nursing women, atrial flutter. DOSE: Adult:50 - 150mg IV, IO, IM or SQ. Elderly: 50mg IV, IO, IM or SQ Ped:1-2mg/kg IV, IO, IM, or SQ |
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Butorphanol (Stadol)
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CLASS: Opiod agonist-antagonist; Schedule C-IV controlled substance
ACTION: Produces analgesia by binding to the opiod receptor. INDICATION: Moderate to severe pain. ADVERSE: Drowsiness, dizziness, confusion, respiratory depression, N/V, bradycardia, hypotension CONTRA: Pts with active substance abuse, sensitivity to opiate agonist. Caution in kidney, liver, or pulmonary problems. DOSE: Adult: 0.5 - 2mg IV, IO q 3 - 4 hours Ped: Not recommended |
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Nalbuphine (Nubain)
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CLASS: Synthetic opiod agonist-antagonist
ACTION: Produces analgesia by binding to the opiod receptor INDICATION: Moderate to severe pain ADVERSE: Drowsiness, diaphoresis, headache, N/V, dry mouth, respiratory depression, hypotension, bradycardia CONTRA: Known sensitivity DOSE: Adult: 10mg IV, IO, IM or SQ ** Not recommended in pediatrics. |
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Ibuprofen
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CLASS: NSAID
ACTION: Inhibits prostaglandin synthesis by inhibiting cyclooxygenase (COX) isoenzymes, resulting in analgesic, antipyretic, and autoinflammatory effects INDICATIONS: Mild to moderate pain, fever, oseoarthritis, RA ADVERSE: Anorexia, N/V, epigastric / ABD pain, dyspnea, constipation, diarrhea, gastritis, melena, flatulens, headache, dizziness CONTRA: Sensitivity to NSAID or salicylate. Caution in Asthma, hepatic disease, renal disease, CHF, HTN cardiac disease, cardiomyopathy, cardiac arrythmias, significant CAD, PVD, cerebrovascular disease, fluid retention, or edema DOSE: MILD TO MODERATE PAIN: Adult: 400mg PO q 4 hr PRN, not to exceed 1200mg/ day Ped (6 months - 12 yrs) 5 - 10mg/kg PO q 6 - 8 hrs PRN, not to exceed 40mg/kg/day FEVER: Adult: 200 - 400mg PO q 4 - 6 hr PRN, Max 1200mg/day Ped (6months - 12 yrs): 5 mg/kg PO if baseline temp is < 102.5, or 10mg/kg PO if baseline temp is greater than 102/5 (Max dose: 40 mg/kg/day) OSTEOARTHRITIS or RA: Adult: 400 - 800mg PO BID or QID, Max 3200mg/day Ped (1 - 12yrs): 30 - 40mg/kg/day PO in 3 - 4 different doses. Max 50 mg/kg/day. |
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Ketorolac (Toradol)
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CLASS: NSAID
ACTION: Inhibits the production of prostoglandins in inflamed tissue, which < the responsiveness of pain receptors. INDICATIONS: Moderate to severe pain ADVERSE: HA, drowsiness, dizziness, ABD pain, dyspepsia, N/V, diarrhea. CONTRA: Pts with Hx of peptic ulcer disease or GI bleed, renal insufficiency, hypovolemic pts, pregnancy (3rd trimester), nursing mothers, allergy to ASA or other NSAIDS, CVA or suspected CVA, head trauma, need for major surgery in immediate or near future (7 days) DOSE: (NOTE: the following dose regimen applies to single-dose admin only. IV, IO Admin should occur over at least 15 seconds.) Adult: < 65yrs: 30mg IV, IO or 60mg IM >65yrs: 15mg IV, IO or 30 mg IM Ped: 0.5mg/kg IV, IO max dose of 15mg, or 1mg/kg IM to max of 30 mg |
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Nitrous Oxide
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CLASS: Inorganic gas, inhaled anesthetic
ACTION: Exact mechanism is unknown INDICATION: Mild to severe pain ADVERSE: Delerium, hypoxia, respiratory depression, N/V CONTRA: Caution in head trauma, > ICP, pneumothorax, bowel obstruction, Pts with COPD that require a hypoxic drive. DOSE: Inhaled: 20% - 50% concentration mixed with O2 ** Ensure safety of HCP's. |
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Ketamin (Ketalar)
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CLASS:General anesthetic
ACTION: Produces a state of anesthesia for procedures of short duration ADVERSE: Emergence phenomena, HTN & sinus tachycardia, hypotension & sinus brady, other cardiac arrhythmias (rare), respiratory depression, apnea, laryngospasms & other forms of airway obstruction (rare), tonic and clonic movements, vomiting. CONTRA: Pts in whom a significant elevation in BP would be hazardous (HTN, CVA, head trauma, > intracranial mass or bleeding, MI). Caution in Pts with > ICP or increased intraoccular pressure (glaucoma), Pts with hypovolemia, dehydration, or cardiac distease, (esp angina & CHF) DOSE (Admin slowly over a period of 60 seconds) IV, IO: Adult: 1- 4,5 mg/kg IV, IO. 1 - 2 mg/kg produces anesthesia usually within 30 seconds that typically last 5 - 10 min Ped: 0.5 - 2mg IV, IO over 1 min IM: Adult: 6.5 - 13mg/ikg IM. 10mg/kg IM inset within 3 - 4 min, duration 12 - 25 min. In adult admin of 5 - 15mg of diazepam reduces incident of emergence phenomena. Peds: 3 - 7mg IM |
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Etomidate (Amidate)
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CLASS: Hypnotic, anesthesia induction agent
ACTION: GABA-like effects INDICATION: Induction for RSI & Pharmocologic0assisted intubation, induction of anesthesia ADVERSE: Hypotension, respiratory depression, injection site pain, temporary involuntary muscle movement, frequent N/V on emergence, adrenal insufficiency, hyperventilation, apnea of short duration, hiccups, laryngospasms, snoring, tachypnea, HTN, cardiac arrhythmias CONTRA: Known sensitivity. Use in pregnancy only if potential benefits justify potential risk to fetus. Do not use in labor & avoid in nursing mothers. DOSE: Adult: 0.2 - 0.6 mg/kg slow IV, IO (over 30 - 60 seconds). a typical adult intubating dose of etomidate is 20mg slow IV. Consider less (10mg) in elderly of Pts with cardiac conditions Peds: >10yrs: Same as adult dosing < 10yrs: Safety not yet established. |
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Propofol (Diprivan)
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CLASS: Anesthetic
ACTION: Produces rapid & breif state of general anesthesia. INDICATION: Anesthesia induction. ADVERSE: Apnea, cardia arrhythmia, asystole, hypotension, HTN, injection site pain CONTRA: Hypovolemia, known sensitivity (including soybean oil, eggs) DOSE: A general induction dose used to produce a state of unconsciousness rapidly is 1.5 - 3mg/kg IV, IO. After induction bolus, the pt must be given intermittent boluses or a maintenence infusion. For an average adult, an intermittent dose @ 20 - 50mg PRN. Maintenence of anesthesia with a propofol infusion can be acheived by following the following protocol. Adult Pt: 25 - 75mcg/kg/min IV, IO Elderly, debilitated, or head-injured pt: use approx 80% of normal adult dose Ped: 125 - 300mcg/kg/min IV, IO |
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Diazepam (Valium)
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CLASS: Benzodiazapine; Schedule C-IV
ACTION: Binds to the benzo receptor & enhances the effect of GABA. Benzo at level of the limbic, thalamic, & hypothalamic regions of the CNS & can produce any level of CNS depression required (including sedation, skeletal muscle relaxation, & anticonvulsant activity) INDICATION: Anxiety, skeletal muscle relaxation, ETOH withdrawal, seizures. ADVERSE:Respiratory, depression, drowsiness, fatigue, HA, injection site pain, confusion, nausea, hypotension, over sedation. CONTRA: Children <6 months, acute-angle glaucoma, CNS depression, ETOH intoxication, known sensitivty DOSE: Adult: Moderate: 2 - 5mg slow IV, IM / Severe: 5 - 10mg slow IV, IM (admin no faster than 5mg/min) / Low Dosages are often required for elderly or debilitated pts. Ped: 0.04 - 0.3mg/kg/dose IV, IM q 4 hrs to a max dose of 0.6mg/kg DT'S FROM ACUTE ETOH WITHDRAWAL: Adult: 10mg IV SEIZURE: Adult: 5 - 10mg slow IV, IO q 10 - 15 min; max total dose 30mg Ped: IV, IO ->5yrs: 1mg over a 3 min period q 2 - 5 min to max total of 10 mg. - >30 days - < 5yrs: 0.2 - 0.5mg over a 3 min period; may repeat q 2 - 5 min to a max total dose of 5mg - Neonate: 0.1 - 0.3mg/kg/dose given over a 3 - 5 min period; may given q 15 - 30 min to a max of 2mg. (not a first line agent d/t sodium benzoic acid in injection) Rectal Admin: If vascular access is not obtained, diazepam may be admin rectally to children. >12 yr: 0.2mg/kg / 6 - 11 yr: 0.3mg/kg / 2 - 5 yr: 0.5mg/kg ** Extravasation causes tissue necrosis ** Insoluable in H2O & must be dissolved in propylene |
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Midazolam (Versed)
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CLASS: Benzodiazapine, Schedule C-IV
ACTION: Binds to the benzo receptor & enhances the effects of the brain chemical GABA. Benzos act at the level of the limbic, thalamic, & hypothalamic regions of the CNS to produce short-acting CNS depression (including sedation, skeletal muscle relaxation, and anti-convulsant activity) INDICATION: sedation, anxiety, skeletal muscle relaxation. ADVERSE: Respiratory depression, respiratory arrest, hypotension, N/V, HA, Hiccups, cardiac arrest. CONTRA: Acute-angle glaucoma, pregnant women, known sensitivity DOSE: Dosing extensive throughout protocol. Read PDR or Drug info sheet prior to administration. |
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Lorazepam (Ativan)
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CLASS: Benzodiazapine, Schedule C-IV
ACTION: Binds to the benzo receptor & enhances the effects of the brain chemical GABA. Benzos act at the level of the limbic, thalamic, & hypothalamic regions of the CNS to produce short-acting CNS depression (including sedation, skeletal muscle relaxation, and anti-convulsant activity) INDICATION: Preprocedure sedation induction, anxiety, status epilepticus ADVERSE: HA, drowsiness, ataxia, dizziness, amnesia, depression, dysarthria, euphoria, syncope, fatigue, tremor, vertigo, respiratory depression, paradoxical CNS stimulation. CONTRA: Known sensitivity to Lorazapam, Benzo's, polyethylene glycol, propylene glycol, of benzyl alcohol; COPD; sleep apnea; shock; coma;acute-closed angle glaucoma. DOSE: (IV, IM should be slow admin) ANALGESIA & SEDATION: Adult: 2mg or 0.44mg/kg IV, IO (smallest dose), should not be exceeded in pts over 50 Ped: 0.05mgmg/kg IV, IO. Each dose should not exceed 2mg IV, IO SEIZURES: Adult: 4mg iV, IO over 2 - 5 min, may repeat in 10 - 15 min (max dose 8mg in 12 hr period. Ped: -Adolescent: 0.07mg/kg slow IV, IO over 2 - 5 min, (max single dose 4mg). May repeat in 5 - 10 min (max 8mg in 12 hr period) -Children / infant: 0.1mg/kg slow IV, IO over 2 - 5 min (max single dose 4mg). May repeat @ 1/2 original dose in 10 - 15 min if seizure activity resumes. Neonate: 0.05mg/kg slow IV, IO over 2 - 5 min. May repeat in 5 -1- min. |
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Flumazenil (Romazicon)
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CLASS: Benzo receptor antagonist, antidote
ACTION: competes with benzodiazepines for binding at the benzodiazepine receptor, reverse the sedative effects of benzo's. INDICATION: Benzodiazapine oversedation ADVERSE: Resedation, seizures, dizziness, injection site pain, N/V, diaphoresis, HA, visual impairment CONTRA:Cyclic antidepressant OD; life-threatening conditions that require Tx with Benzos, such as status epilepticus & intracranial HTN; known sensitivity to flumazenil or benzos. Caution where there is the possibility of unrecognized dependence & in pts who have a Hx of substance abuse. DOSE: Adult: Initial dose 0.2mg IV, IO over a 15 second period. Admin second dose after 45 seconds if desired effect not observed. Dan be repeated up to 4 times max dose of 1mg. Ped: (>1 yr) 0.01mg/kg IV, IO over 15 second period. May repeat in 45 seconds and then q min to a max dose of 0.05mg/kg of 1mg, whichever is the lowest dose. |
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Naloxone (Narcan)
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CLASS: Opioid antagonist
ACTION: Binds to the opioid receptor & blocks the effects of Narcotics INDICATION: Narcotic OD, reversal of Narcotics used for procedure-related anesthesia ADVERSE: N/V, restlessness, diaphoresis, tachycardia, HTN, tremulousness, seizure, cardiac arrest, narcotic withdrawal. Combativeness CONTRA: Known sensitivity to Naloxone, nalmefene, or naltrexone. Caution in pts with WVT arrhythmia's or other cardiac disease, head trauma, brain tumor DOSE: Adult: 0.4 - 2mg IV, IO, ET, IM, or SQ. Alternatively admin 2mg intranasally. Higher doses (10-20 mg) may be required for OD's of synthetic narcotics. A repeat dose of 1/3 to 2/3 original dose is often necessary Ped: >5 yrs / >20kg: 2mg IV, IO, ET, IM, SQ <5yrs / <20kg: 0.1mg/kg IV, IO, ET, SQ. May repeat q 2 - 3 min. |
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Promethazine (Phenergan)
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CLASS: Antiemetic
ACTION: < N/V by antagonizing H1 receptors. INDICATION: N/V ADVERSE: Paradoxical excitation in children and elderly pts CONTRA: Altered LOC, jaundice, bone marrow suppression, known sensitivity. Caution in seizure disorder. DOSE: Adult: 12.5 - 25mg IV, IO, IM Ped: (>2yr): 0.25 - 1mg/kg IV, IO, IN (max rate of IV, IO admin is 25mg/min) |
