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General(Trade): Adenosine (Adenocard)MOA or PCOL: Atypical AntiArrythmic/edogenous nucleoside/prevents or term reentry/dec. automaticityOnset/duration: imm 10-30secIndications: PSVT/WPW/WCTachContraindications: KnownVtach/hypersens/Afib/Aflut/av blocksAdverse Effects: /metalic tst/hypotens/asystole/dizzi/cpDose: rapid 6mg q2 repeat 12mg q2 12mg PED: 0.1-0.2mg/kg doubleNotes: Methylxanthines antagonize actions of adenosine General(Trade): Lidocaine (Xylocaine)MOA or PCOL: Class1 antiarry/k+ channel block/neg dromo/dec auto/prev or term reentry/local anestheticOnset/duration: 30-90s/10-20mIndications: PVCs/Vfib/plvtach/vent_tach/wctach/prophylContraindications: /adv_av_blk/brady/wpwAdverse Effects: depress/cns depres (seizure/tinni/drowsi)Dose: IV-vfib 1.5mg/kg q3 repeat half/other 1-1.5mg/kg repeat half q5-10 max 3mg/kg inf: 1g in 250cc at 2-4mg/min PED:1mg/kg inf:20-50mcg/kg/mnNotes: Beta blck increase effect/flush between drug lido changes pH General(Trade): Procainamide (Pronestyl/Procard)MOA or PCOL: Na+ channel block/works to depress excitability/neg dromo/ dec automaticity/inc fibrill thresOnset/duration: 30-90sIndications: PVC/Vtach/Vfib/plvtach all refract lido/WPW/Afib/wctachContraindications: hypersens/torsades/adv_av_blk/bradyAdverse Effects: myocard depress/av blk/ekg changeDose: IVP 20-30mg/min 17m or arryth gone or hypotension or widened qrs/ inf 1g in 250ml @1-4mg/min PED: IV 3-6mg/kg inf: 20-80 mcg/kg/minNotes: add to General(Trade): Tosylate (Bretylol)MOA or PCOL: Class 3 antiarryth/inc fibr / slight bp increase at first/prev or term reentryOnset/duration: 2-3m for Anit Fib/20min for anti-arryth/last 6-24hrIndications: Vfib/plvtach/wctach refract to classIContraindications: adv_av_blk/brady/digoxin toxicity/Adverse Effects: hypotens/brady/bp & hr increase/N/volatile vomitingDose: IVP 5mg/kg (very slow IVP 8 min) repeat 10mg/kg q5-15 MAX 30 infuse: 1-2mg/mn 1g in 100mlNotes: General(Trade): Amiodarone (Cordarone)MOA or PCOL: K+channelblock/antidisrythmic/relax vascular smooth muscle/alpha β blockadeOnset/duration: 5-15min/varIndications: Vfib/plvtach/Afib/unstableVtachContraindications: Adv_av_blk/brady/hypotens/torsades/iodine or shellfish allergy/TCA Adverse Effects: PEA/Hypotens/Brady/CHG/Naus/Abnormal /Fever/ThrombocytopeniaDose: Vfib 300mg/Vtach 150-300mg over 5-10min/max 2.2g in 24hr/INF: 300mg in 250ml D5W @1mg/min for 6minNotes: Nabicarb precipitate/increase digoxin/enhance other antiarryth General(Trade): Verapamil (Isoptin/Calan)MOA or PCOL: Class 4 antiarry/Ca+channelblk/neg dromo/prev & end /dec automat/decreas02/dilate coronary art/inhibit vasospasmOnset/duration: 5-10mIndications: Stable PSVT/decrease ventricular rate n Afib or Contraindications: CHF/Adv_av_blk/Hypotens/wctach/vtach/WPW/BradyAdverse Effects: Hypotens/brady/av_blk/dizzi/headach/OD:Ca+Dose: 2.5-5mg (slow IV 2min)/repeat 5-10mg q15-30 MAX 20mg PED: 0.1-0.3mg/kgNotes: beta blck increase effect lower dose General(Trade): Diltiazem (Cardizem/Lyoject)MOA or PCOL: Ca+channelblk/prev vasospasm/dilate cor art/dec /neg dromo/dec O2Onset/duration: 2-5m for 1-3hrIndications: PSVT/Afib/AflutContraindications: /Adv_av_blk/Brady/Hypo/CHF/wctachAdverse Effects: Brady/Hypotens/CHF/AV_blk/dizzi/PVC OD:Ca+Dose: 0.25mg/kg over 2m repeat 0.35mg/kg over 15min/ Inf: 125mg in 100ml @ 5-15mg/hr supplied 25or 50mg bottleNotes: Beta blockers increas effect General(Trade): Nifedipine (Procardia/Adalat)MOA or PCOL: Ca+channelblk/prev vasospasm/decr after and preload/decr platelet aggr/dec O2/no effect on conductionOnset/duration: 15-30m fro 6-8hIndications: Hypotensive Emerg/AnginaContraindications: /HypotensionAdverse Effects: /Flush/dizzi/Hedache OD:Ca+Dose: 10-20mg capsule puncture and squeeze under tng/bite capsule swallow NOPEDINotes: Beta blockers increas effect/ CNS depress increas eff General(Trade): Calcium Chloride (CaCl)MOA or PCOL: Electrolyte/pos inotropic/import blood and nerve and muscle functOnset/duration: 5-15min/varIndications: Hyperkalemia/Hypocalcemia/Ca+channelblk OD/MagSulf Contraindications: Vfig/suspect digoxin toxicity (bradycardia/halo vision)Adverse Effects: metal tst/hypotension/tissue necrosis on infiltrationDose: 2-4mg/kg q10 PED: 20mg/kgNotes: Sodium Bicarb precipit General(Trade): Sulfate (Atropine)MOA or PCOL: Anticholergenic (comp blk of Ach)/+ chrono/+drom/+ automat/+ elect act/+afterload/inc O2 demandOnset/duration: Immidiate for 3-5minIndications: Symptomatic Brady/some AV_blk/Asystole/PEA/Organophosphate poisonContraindications: none in cardiac arrest/tachycardiaAdverse Effects: decrease bodily fluid/inc O2 demand/tachycardia/blurred vision/OD: Cholergenic (physostigmine)Dose: dead 1mg q3 MAX 3mg/Brady: 0.5-1mg q3 titrate to HR>60/Organic: 2-5mg IV or IM or both q5-15 PEDI 0.02mg/kg q3 Max 0.5mgNotes: General(Trade): Magnesium SulfateMOA or PCOL: Electrolyte/cofactor of enzyme/cns depressant/block neuromuscular/periph & coron dilation/bronchodilation/dec plate agr/dec fatal MIOnset/duration: Indications: toxemia/Refract Vfib/plvtach/torsades/mi/asthmaContraindications: AV Block OD: can kill due to HypovolAdverse Effects: Brady/Hypotens/flush/cns depress/sweating/ OD:Ca+Dose: Toxemia 1-4mg over 3min (watch BP)/Other: 1-2mg in 10-100mls over 1to2 minNotes: CNS Depress increas effect General(Trade): Isoproterenol (Isuprel)MOA or PCOL: Synth catecholamine/sympathomimetic/beta agonist (b1 most)/inc chrono ino dromo/bronchodil/periph dilation/significant O2 increaseOnset/duration: ImmediateIndications: Symptomatic Brady/some AV_blk/Torsades refract otherContraindications: Hypersens/tachycardia/cardiac arrest/vtachAdverse Effects: rapid massive incr O2 /sweats/flush/tachycardia OD: beta blockersDose: Infusion only 1mg in 250ml @2-10mcg/min to HR>60 or PVC occurNotes: Beta blockers decrease effect/ Bretylium inc effect/TCA incr effect General(Trade): (Adrenaline)MOA or PCOL: Alpha & Beta catecholamine/beta1 +inotropic and beta2 bronchodilation/alpha makes vasoconstriction afterload inc/inc elect actOnset/duration: Immediate (1-2min CPR)/5-10min SC lasts 3-10minIndications: Vfib/plvtach/asystole/pea/anaphalaxys or severe allergenic/asthma or severe croup/symptomatic bradycardiaContraindications: none in cardiac arrest or anaphylaxis/hypersens to sulfite/unresolved hypovolemia/angina/hypertension/CHFAdverse Effects: Increase O2 dem/Hypertension/Tremors/ OD: alpha and beta blok/sulfitesDose: Standard 1mg q3/Intermediate 2-5mg q3/Escalating 1-3-5mg q3/Severe Croup 5mg 1:1000 in 5ml NS via nebulizer every 30min/Other 0.1-0.5mg 1:1000 SC or 0.1-1mg (1:10000)IVP/Inf: 1mg of 1:1000 in 250mlNotes: Bretylium and TCA increase/Beta decrease General(Trade): Dopamine (Intropin)MOA or PCOL: Sympathomimetic/catecholamine/vassopressor/stimulates release of NE/Alpha beta dopaminergic effects/ mod dose: most beta +inotropic some alpha/high dose 10-20mcg/kg more alpha +vasoconstrOnset/duration: <5m for 5-10minIndications: Cardiogenic shock/neurogenic /hemodynamic signifi hypotension w/o hypovolemiaContraindications: Hypersens/tachycardia/unresolved hypovolemia/phenochromocytoma (adrenal tumor)Adverse Effects: Tachycardia/Palpation/Hypertension/Increase O2/Tissue necrosisDose: Infusion only 400mg in 250ml @2-20mcg/min titrate to HR>90 PEDI 2-20mcg/kg/min titrate to bp90Notes: Beta blockers decrease effect/Bretylium increases General(Trade): Dobutamine (Dobutrex)MOA or PCOL: Sympathomimetic/synth catecholamine/vassopressor/Alpha beta effects/ inotropic/some renal dilation/minimal impact on HR/increase cardiac output coronary blood flowOnset/duration: 1-2m 2-10m peakIndications: cardiogenic shock/hypotension after return of spontaneous circulation/hemodynamic signifi hypotension w/o hypovolemia/left heart failureContraindications: Hypersens/unresolved hypovolemia/tachydisrythmiaAdverse Effects: Hypotens/Tachycardia (dose )Dose: Infusion only 250mg in 250cc @2-20mcg/kg/min titrate to 90bpm PEDI: 2-20mcg/kg/min to BPNotes: Beta blockers decrease effect General(Trade): Norepinephrine (Levophed)MOA or PCOL: Sympathomimetic/Catecholamine/vassopressor/mostly Alpha with beta effects/vaso renal constriction/increase O2/ +chrono +inoOnset/duration: immediateIndications: Cardiogenic shock/neurogenic shock/hemodynamic signifi hypotension w/o hypovolemiaContraindications: Hypersens/unresolved hypovolemiaAdverse Effects: Hypertension/reflex brady/inc 02/tissue necrosis Dose: Infusion only 4mg in 250cc @0.5-30mcg to BP 90Notes: Beta blockers decrease effect/ inc effect General(Trade): Nitroglycerin (nitrostat/nitroliqual )MOA or PCOL: vasodilator/relax smooth (vaso)/inc coron blood flow/stop vasospam/dec pulm vasc res/dec pre & afterload/decrease O2 dem/inhibit platelet aggr/decrease bpOnset/duration: SL-1-3m/TD 15-30m/IV immed lasts SL-30/TD 2-12hIndications: Ischemic Hrt Fail/Left Hrt Fail/MI/?hypertens?Contraindications: Hypersens/Hypotension/Head trauma (ICP increase)Adverse Effects: hedach/flush/hypotens/dizzi/reflex tachycardia/postural syncopeDose: SL:0.3mg /0.4mg/0.6mg q5 x 3/ TD 1/2 to 2in (15mg/in)/Infusion: 5mcg/min and increas 5-10mcg q5 titrate for effectNotes: CNS Depress increas effect General(Trade): Amyl MOA or PCOL: Same as Nitro/causes oxidation of hemoglobin for methemoglobin/Methemoglobin reacts with cyanide and creates a molecule with less affinity than oxygen lowering toxicityOnset/duration: 30s for 3-20mIndications: Cyanide poisoningContraindications: noneAdverse Effects: hedach/hypertension/dizziDose: crush 3ml ampule breath in for 30sec of each minute/ repeat as neededNotes: General(Trade): (Acetacylic Acid ACA)MOA or PCOL: inhibitor/decrease inflamation/inhibit prostaglandinsOnset/duration: 30-45m lasts 4hrIndications: New onset CP or AMI no signs or symptons of CVAContraindications: GI Bleeding/Hypersensitive to Aspirin not coatingAdverse Effects: GI Bleed/nausea/Increase PT & PTTDose: Oral only chew 2-4 (81mg each) tablets 324mg/ use 2 if patient already on anticoagualantsNotes: Increased effects with other anti-coagualants General(Trade): Heparin SodiumMOA or PCOL: anti-coagulant/prevents conversion of fibrogen into clot/affect active clotting process IX/XI/XIIOnset/duration: immediateIndications: Acute Myocardial infarction (Integrillin the super aspirin)Contraindications: Hypersens/Active bleed/recent surgeryAdverse Effects: bleeding/chills/fever/backpain due to reactionDose: IV: 70u/kg ma 14-17u/kg/hr/ PEDI: 50u/kg then 7.5u/kg/hr can be used IV/Infursion/SCNotes: Beta blockers increas effect General(Trade): Morphine MOA or PCOL: Schedule 2 narcotic opiod/analgesic/decrease pulmon edema via pooling/vasodilation/decr pre & afterload/anti-anxiety/decr O2/depress resp centerOnset/duration: immediate for 10-60mIndications: ischemic Chest Pain/Lft Hrt fail/?maybe single system trauma (anxiety)Contraindications: Hypersens/hypotens/resp depr/alter LOC/asthma/COPD/abd pain/head inj/hypovolemiaAdverse Effects: resp Depr/NV/Altered LOC/CNS Depr/Flushin/Hypotens/OD: NaloxoneDose: IVP/IM/SC/IO/ 1-3mg q5 (give over 2min) PEDI: 0.1mg/kgNotes: effect wih other CNS depress General(Trade): (Narcan/Vitamin N)MOA or PCOL: Narcotic /comp inhibition of opiod rec/prevents some opiod effect/no effect if opiod not presentOnset/duration: 1-2m IVP/3-5m IM or SC last 30-60m IV or 3-6hrs IM/SCIndications: Narcotics OD/coma of unknown origin/?use in alcohol coma?Contraindications: HypersensitiveAdverse Effects: NV/Acute Abstinence Syndrome/sweats/arrythmiaDose: IVP/IM/SC/ET/IO 0.4 - 2mg q5 titrated to response/ Pedi <5yr 0.1mg/kg q5 titrateNotes: Beta blockers increas effect General(Trade): Furosemide (Lasix)MOA or PCOL: Loop Diuretic/inhibits reabsorb of fluid in loop of Henley/peripheral vasodilationOnset/duration: 5m vaso 10-20 for 2-4hrsIndications: Lft Hrt Fail/Cerebral /?hypertensive crisis?Contraindications: Hypersens/Hypovolemia/Dehydration/HypotensiveAdverse Effects: NVD/Tinnitus/Hypotension/ loss of electrolytes OD: FluidsDose: IVP/IM/IO 20-100mg over 2m/ PEDI : 1mg/kgNotes: increased effect wih other CNS depress General(Trade): Diazepam (Valium)MOA or PCOL: Sched 4 controlled/CNSdepressant/anticonvulsant(block spread)/sedative effects/muscle relax/induce retrograde amnesia/anti-anxietyOnset/duration: imm(IV)/ 5-15(IM) for 15-60mIndications: Status Epilectipus/seizure/pre-cardiovert/pre-transcutaneous /induction agentsContraindications: Hypersensitive/Hypotension/Respiratory Depress/Altered Adverse Effects: CNS Depression/Hypotension OD: Romazicon (awaken RSI patient)Dose: /IV IM IO ET Rectal/2-10mg q 5-10m MAX 30mg PEDI: 0.25mg/kg (IV) 0.5mg/kg (PR)Notes: CNS Depress increas effect General(Trade): Lorazepam (Ativan)MOA or PCOL: Sched 4 controlled/CNSdepressant/anticonvulsant(block spread)/sedative effects/muscle relax/induce retrograde amnesia/anti-anxietyOnset/duration: 1-5mIndications: Status Epilectipus/seizure/pre-cardiovert/pre-transcutaneous pacing/induction agentsContraindications: Hypersensitive/Hypotension/Respiratory Depress/Altered LOCAdverse Effects: CNS Depression/Hypotension OD: (awaken RSI patient)Dose: IVB IM IO /2-4mg q15 to MAX 8mg PEDI: 0.05mg/kg - 0.2mg/kg q15m MAX 0.2mg/kgNotes: CNS Depress increas effect General(Trade): Midazolam (Versed)MOA or PCOL: Sched 4 controlled/CNSdepressant/anticonvulsant(block spread)/sedative effects/muscle relax/induce retrograde amnesia/anti-anxietyOnset/duration: 1-3m for 2-6hrIndications: Status Epilectipus/seizure/pre-cardiovert/pre-transcutaneous pacing/induction agentsContraindications: Hypersensitive/Hypotension/Respiratory Depress/Altered LOCAdverse Effects: CNS Depression/Hypotension OD: Romazicon (awaken RSI patient)Dose: 2-2.5mg slowly may to MAX 0.1mg/kg (IV only)Notes: CNS Depress effect General(Trade): (Benadryl)MOA or PCOL: Antihistamine/comp antagaonist fo hist/ block rec not release/prevent initiation and tranof sensory nerve impulse/sedative/antichlinergic/antiemeticOnset/duration: immediate(IV) 5-10m(IM) for 1-2hrsIndications: Allergic reaction/anaphylaxis/phentothiazine ODContraindications: Hypersens/Asthma/Alterd LOC/Cardiac HistoryAdverse Effects: Drowsi/Dizzi/Hedache/Excitable(child)/wheez/thick secretion bronchial/chest tight/palpation/hypotens/blurred vision/dry mout/NVDDose: IVP IO IM/ 10-100mg or 1mg/kg PEDI(2-12) 1-1.25mg/kgNotes: Beta blockers effect General(Trade): Dexamethasone Sodium Phosphate (Decadron)MOA or PCOL: Adrenal Corticosteroid (glucocoticoid type)/ Decreases Inflammation by decreasing leukocyte concetration (leukocyte fight infect)Onset/duration: 4-8hrsIndications: Allergic Reaction/Anaphylaxis/Asthma (inc. )/ Spinal cord inj/cerebral edema/?use in shock?Contraindications: Hypertension/ None in doseAdverse Effects: HypertensionDose: IVP/IM/IO 10-100mg or 1mg/kg PEDI: 0.25 - 1 mg/kgNotes: not General(Trade): Sodium BiCarbMOA or PCOL: Electrolyte/ Increase free buffer to decrease acidosis/Increase pH/ Reverses metabolic acidosisOnset/duration: onset : 5-10m durat: 30-60mIndications: metabolic acidosis/ Barbituate OD(helps eliminate drup faster in urine)/TCA OD/HyperkalemiaContraindications: /Hypocalcemia/HypokalemiaAdverse Effects: Alkalosis/Hypokalemia/Hypoxemia/Tissue Necr/Tetany - /conv/muscle twitch/joint flexionDose: IVP IO 1meq/kg repeat 0.5meq/kg q10 PEDI: 1meq/kgNotes: General(Trade): ThiamineMOA or PCOL: Vitamin B1/water soluble vitamin/needed for conversion of glucose to energy/ required for metabolismOnset/duration: Indications: coma of unk /delerium tremens/beriberi- B1 vitamin def/wernicke's encephalopathy/korsakoff's syndromeContraindications: HypersensitivityAdverse Effects: HypotensionDose: IVP IM 50-100mg PEDI: none Notes: none General(Trade): Dextrose 50%MOA or PCOL: Nutrient/Carbohydrate/Increases circulating available glucoseOnset/duration: Indications: Hypoglycemia/coma of unk etiology/status /diabetic codeContraindications: in CVA/hyperglycemiaAdverse Effects: Tissue NecrosisDose: IVP 25-50g PEDI: <2yr: D25 125-250mg/kgNotes: General(Trade): HCLMOA or PCOL: Hormone prodcd by alpha cells of pancreas/ insulin antagonist/inc liver glycogenolysis/Increase brkdwn of glycogen to glucose/inhbt glycogen synthetase/rlx smoth muscle of gi tract/may incr cardiac contratilityOnset/duration: onset : 5mIndications: Hypoglycemia/Beta Blocker ODContraindications: HypersenseAdverse Effects: N/V OD: supportDose: IVP IM SC IO 0.5-1mg q15m PEDI sameNotes: INT General(Trade): Activated CharcoalMOA or PCOL: Absorbent/binds & adsorbs toxins present in gi tract/once toxin excreted thru bowelOnset/duration: Indications: Ingested Contraindications: HypersensitivityAdverse Effects: N/V Abdominal cramping/ConstipationDose: ORAL NG tube: bottles of 25g & 50gNotes: INT Don't administer w/ Syrup of Ipecac / Don't adminster to Pt with Alt LOC (use NG tube inst) General(Trade): OxygenMOA or PCOL: Facilitates energy metabolismOnset/duration: Indications: Hypoxia/Ischemic Chest Pain/Respiratory Dist/Suspect CO /Trauma/ShockContraindications: Known paraquat PoisoningAdverse Effects: non but CO2Dose: 1- 6L low/15L highNotes: General(Trade): Bronchodilators (broad for all bronchodilator)MOA or PCOL: Beta2 Agonist/ Sympathomimetic/Bronchodilation/smooth muscle relax of bronchiole/inhibit histamine release/mild vasodilationOnset/duration: on 5-15m dur: 3-4hrIndications: Asthma/COPD/Pulmonary EdemaContraindications: Hypersens/relative in tachycard or MIAdverse Effects: Tachycardia/Palpation/Tremors/N/V/Arrythmia OD: Beta /SupportiveDose: on specificNotes: Increased effect wih TCA/ Decrease effect with Beta blocker General(Trade): Sulfate (Proventil/Ventulin)MOA or PCOL: Beta2 Agonist/ Sympathomimetic/Bronchodilation/smooth muscle relax of bronchiole/inhibit histamine release/mild vasodilationOnset/duration: on 5-15m dur: 3-4hrIndications: Asthma/COPD/Pulmonary EdemaContraindications: Hypersens/relative in tachycard or MIAdverse Effects: Tachycardia/Palpation/Tremors/N/V/Arrythmia OD: Beta /SupportiveDose: 2.5-5mg PEDI: 1.25-2.5mgNotes: General(Trade): Sulfate (Alupent)MOA or PCOL: Beta2 Agonist/ Sympathomimetic/Bronchodilation/smooth relax of bronchiole/inhibit histamine release/mild vasodilationOnset/duration: on 5-15m dur: 3-4hrIndications: Asthma/COPD/Pulmonary EdemaContraindications: Hypersens/relative in tachycard or MIAdverse Effects: Tachycardia/Palpation/Tremors/N/V/Arrythmia OD: Beta Blockers/SupportiveDose: 15mg PEDI: 7.5mgNotes: General(Trade): Terbutaline Sulfate (Brethine/Brethaire)MOA or PCOL: Beta2 Agonist/ Sympathomimetic/Bronchodilation/smooth muscle relax of bronchiole/inhibit histamine release/mild vasodilationOnset/duration: on 5m dur: 1-4hrIndications: Asthma/COPD/Pulmonary EdemaContraindications: Hypersense/relative in Tachy/ MIAdverse Effects: /Tremors/N/V/Palpitations/ArrythmiaDose: SC 0.25mg q15-30/Inhaler 0.2-0.4mg (1-2 )Notes: Increased effects TCA/Decreased effect Beta Blocker General(Trade): Methylpredisolone Sodium Succinate (Solu-Medrol)MOA or PCOL: Corticosteroid-type Glucocorticoid/Decrease inflammation/Alters airway hyperactivityOnset/duration: on 1-2hrsIndications: Anaphylaxis/Severe Allergic /Asthma/Spinal Cord Trauma/Cerebral Edema/?use in shock?Contraindications: NONEAdverse Effects: Hypertens/CHF OD: supportiveDose: 40-125mg Asthma: 1-2mg/kg Spinal Cord Inj: 30mg/kg over 30min PEDI: sameNotes: Furosimide could increase K loss/ General(Trade): Ipratropium Bromide (Atrovent)MOA or PCOL: Anticholergenic/Parasympatholytic/Dries respiratory tract secretions/Block Acetylcholine Receptors (inhibit parasympathetic)Onset/duration: peak 1.5-2hr / : 4-6hrsIndications: /COPDContraindications: HypersenseAdverse Effects: Palpitation/Anxiety/Dizzi/N/V/HeadacheDose: 500mcg in 2.5ml saline usually deliver w/ Beta agonistNotes: General(Trade): MOA or PCOL: Short acting synth /inhibits formation of histamine/increases response to circulating catecholaminesOnset/duration: on immediat/ peak 4-8hr dur 1-1.5 daysIndications: Reduce Inflamation due to allergic reaction/severe anaphylaxis/asthma/COPDContraindications: Cushings Synd/ Benzyl Alcohol sensitiveAdverse Effects: Leukocytosis/hyperglycemia/incrased infection/decreased wound healing/Increase rat of death in sepsisDose: Anaph shk: IV IO IM 100-500mg PEDI: 2-4mg/kg/day (MAX: 500mg)/Adrenal Insuff: same PEDI: 1-2mg/kg/ Asthma: same PEDI 1mg/kgNotes: General(Trade): Citrate (Sublimaze)MOA or PCOL: Narcotic analgesic/chemically unrelated to morphin but similar reaction/50 to 100 more potent than Morphine/ less emetic effect/duration of actionOnset/duration: Immediate(IV) Peak 5-15m(IV) Duration: 30-60m halflife 6-8hrIndications: Pain Mgmt/RSI Adjunct/Maintenace of AnalgesiaContraindications: Severe Hemorrhage/Shock/HypersenseAdverse Effects: CNS: sedation/euphoria/dizzi/diaphoresis/delirium CV: hypotension/bradycardia/circulatory depression/ Eyes: Miosis/blurrredDose: 1mcg/kg MAX 150mcg slow IV 1m (2-3 better)/ same can be used nasaly can dilute with NS for easy administration PEDI: 1.7 - 3.3 mcg/kg 2-12yrNotes: General(Trade): Ondansetron (Zofran)MOA or PCOL: Onset/duration: ON 30m for 3-6hr 2-3hr childIndications: Use to prevent nausea & vomiting (typically given to help with pain med)Contraindications: HypersensitiveAdverse Effects: >10% cardiovasc (malaise/ fatigue)/CNS: HeadacheDose: Adult: 4mg IV/Child: <30kg 1mg/>30kg 2mgNotes: General(Trade): Vassopressin (Pitressin)MOA or PCOL: Hormone Vassopressor/polypeptide hormone extracted from posterior pituitary glands of animals/ Possess Pressor and anitdiuretic propertiesOnset/duration: Onset: variable/peak: variable/duration: 30-60min/half: 10-20Indications: Need for increase in peripheral vascular resistance cprContraindications: non CPR/chronic nephritis/ischemic Hrt dis/PVCsAdverse Effects: skin blanch/abdominal cramps/nausea/hypertension/bradycardia/minor disrythmiaDose: 40 units IV (replaces EPI during CPR 2nd) PEDI: sameNotes: None in ACLS General(Trade): METOPROLOL (Lopressor)MOA or PCOL: Selective Beta Antagonist/Block both B1 and B2 but B1Onset/duration: Onset Immediate - Peak 20m- Duration 13-19hr 3-4hrIndications: Used in patients with MI/ or suspect MI that are hemodynamically stableContraindications: HR<45bpm/SysBP<100/CHF/early or late signs of shock/advanced av block/ 1st block PR wave >0.24sAdverse Effects: Bradycardia/Hypotens/lethargy/CHF/Dyspnea/wheezing/weaknessDose: 5mg IVP slow if stable vitals still can give 5mg/ total 15mg MAXNotes: NOT to be given to a patient that has received Verapamil |
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