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55 Cards in this Set

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Dextrose 50% in H2O: Classification
Dextrose 50% in H2O: Indications
ALOC due to hypoglycemia
Dextrose 50% in H2O: Administration
50ml (25g) IVP
May rep x1
Dextrose 50% in H2O: Actions/Pharm
Principle form of glucose (sugar) used by the body to create energy
Dextrose 50% in H2O: Pharmacokinetics
Immediate onset < 1min
Peak effect and duration depends upon degree of hypoglycemia
Dextrose 50% in H2O: Contraindications
None known
Dextrose 50% in H2O: Adverse Effects
- Pain or burning at injection site
- Neurological symptoms, can cause Wernicke's/Korsakoff's psychosis if pt is thyamine deficient
Dextrose 50% in H2O: Interactions
Dextrose 50% in H2O: Considerations
- To dilute from D50 to D25, empty 25cc of D50 and fill w/ 25cc NS
- Ensure patent IV line (severe tissue damage w/ extravasationof solution)
- Report/record BG levels before/after administration
- Ensure pts w/ ICP have low BG prior to admin. Can worsen cerebral edema
Glucagon: Classification
Hormone (pancreatic)
Glucagon: Indications
ALOC when hypoglycemia is susp & IV cannot be established
Glucagon: Administration
1 mg IM if known diabetic
May rep q 20 min 2x
Glucagon: Actions/Pharm
- Natural hormone prod by alpha cells of the islets of Langerhans in the pancreas
- When released causes breakdown of glycogen (stored in liver) to glucose & inhibits synthesis of glycogen from glucose
- Both actions increase BG levels
Glucagon: Pharmacokinetics
Onset 5-20 min
Duration 1-1.5 hr
Glucagon: Contraindications
None, if indicated
Glucagon: Adverse Effects
Glucagon: Interactions
Glucagon: Considerations
- After reconstitution of dry powder/solution, use mixture immediately
- PT usually awakens from hypoglycemic coma in 5-20 min after injection
- ASAP after PT regains cons, PO carbohydrate should be given
- After recovery: headache, nausea, weakness
- Effective only if glucagon stores in liver
Calcium Chloride: Classification
Calcium Chloride: Indications
- Cardiac Arrest assoc w/ hyperkalemia or Ca+ channel blocker toxicity
- Crush Syndrome w/ susp hyperkalemia or crush force > 4 hrs
Calcium Chloride: Administration
Cardiac Arrest
1 g (1,000mg) SIVP over 60 sec
May rep every 10 min
Calcium Chloride: Administration
Crush Syndrome
1 g (1,000mg) SIVP over 60 sec
1x only
Calcium Chloride: Actions/Pharm
-Essential regulator for the excitation threshold of nerves and muscles
- Inc in myocardial contractility & ventricular automaticity
- Antidote for some electrolyte imbalances & Ca+ channel blocker toxicity
Calcium Chloride: Pharmacokinetics
Onset/peaks immediate
Duration unknown
Calcium Chloride: Contraindications
Calcium Chloride: Adverse Effects
- Pain & burning at injection site
- Tingling sensation
- Hypotension
- Cardiac arrest
Calcium Chloride: Interactions
- Precipitates to form calcium carbonate (chalk) when used with Sodium Bicarb
- Inactivates or minimizes the effects of catecholamines if not flushed properly
Calcium Chloride: Considerations
- Flush IV line before/after admin
- Ensure IV is patent, necrosis & sloughing in extravasation
Sodium Bicarbonate: Classification
Sodium Bicarbonate: Indications
A) Cardiopulmonary arrest
- Unsuccessful drug therapy & defib
- Susp hyperkalemia
- Susp tricyclic OD

B) Crush Syndrome
- Susp hyperkalemia
- Crush force > 4hrs
Sodium Bicarbonate: Administration
Cardiac Arrest
1 mEq/kg IVP
May rep 0.5 mEq/kg every 10-15 min
Sodium Bicarbonate: Administration
Crush Syndrome
Concentration of 1 mEq/kg added to 1st 1,000 ml NS run IV wide open
Sodium Bicarbonate: Actions/Pharm
- Short-acting, potent, systemic antacid
- Immediately raises pH of blood plasma by buffering excess hydrogen ions (acidosis)
Sodium Bicarbonate: Pharmacokinetics
Onset < 15 min
Duration 1-2 hrs
Sodium Bicarbonate: Contraindications
None, if indicated
Sodium Bicarbonate: Adverse Effects
- May cause extracellular alkalosis
- Severe tissue damage if IV infiltrates
Sodium Bicarbonate: Interactions
- Catecholamines & vasopressors can be deactivated
- When admin w/ CaCl, a precipitate may clog line
Sodium Bicarbonate: Considerations
- Not rec for routine use in cardiac arrest pts
- Infusion stopped immediately if extravasation occurs (severe tissue damage)
- Always flush line following admin
Adenosine: Classification
Adenosine: Indications
- Perfusing SVT unresponsive to valsalva
- Poorly perfusing SVT (if conscious)
Adenosine: Administration
6 or 12mg rapid IVP w/in 1-3 sec f/b rapid NSF 10-20ml
May rep 12mg in 1-2min 1x
Adenosine: Actions/Pharm
- Slows conduction through AV node
- Can interrupt reentry pathways thru AV and SA nodes
Adenosine: Pharmacokinetics
Onset Immediate
Duration < 10 sec
Adenosine: Contraindications
Hx SA node disease
Preexisting 2nd or 3rd degree HB
Adenosine: Adverse Effects
Head Pressure
Blurred vision
Metallic Taste
Throat Tightness
Adenosine: Interactions
Potentiated by: Blockers of nucleoside transport
- Dipypridamole (Persantine) and
- Carbamazepine (Tegretol)

Antagonized by:
- Methylxanthines (caffeine)
- Theophylline
Adenosine: Considerations
- Large vein (18-20 guage)
- IV port closest to PT
- Immed. NSF
- 6 sec strip
- 10 sec of escape beats or asystole
- CP, hypotension, SOB for 1-2 min
- Caution w/ COPD or Persantine/Tegretol
- Could worsen bronchoconstrictive disease
Amiodarone: Classification
Amiodarone: Indications
V-Fib, Pulseless V-Tach
Amiodarone: Administration
300 mg IV/IO over 1 min f/b NSF 10-20 ml
If no conversion, may rep 150 mg IV/IO in 3-5 min 1x
Max 450 mg
Amiodarone: Actions/Pharm
- Acts directly on all cardiac tissue
- Relaxes smooth muscle, dec PVR, inc coronary blood flow
- Blocks effects of sympathetic stim
Amiodarone: Pharmacokinetics
- Rapid distribution following IV admin
- Metabolism & Elimination in liver
Amiodarone: Contraindications
None, if indicated
Amiodarone: Adverse Effects
Amiodarone: Interactions
- Inc digoxin levels
- Enhances anticoagulant effects
- Potentiated by (poss): Beta blockers, Ca+ channel blockers