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Drugs
Atropine, Epi, Furosemide, Lidocaine, Vasopressin
Question | Answer |
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What is the class of atropine sulfate? | Anticholinergic agent |
What drug's MOA is a parasympatholythic: inhibits action of acetylcholine at postganglionic parasympathetic neuroeffector sites. Inceases heart rate in life-threatening bradyarrhythmias. | Atopine Sulfate |
What are the indications for administering atropine sulfate? | Hemodynamically unstable bradycardia, asystole, bradycardic (<60 beats/min) pusleless electrical activity (PEA), organophosphate poisoning,bronchospastic pulmonary disorders. |
Which drug has contraindications of...tachycardia, hypersensitivity, unstable cardiovascular status in acute hemorrhage and myocardial ischemia, narrow-angle glaucoma? | Atropine Sulfate |
What is the dosage (IV/IO) of atropine for an adult who is experiencing asystole or bradycardia PEA? | 1 mg IV/IO push. May repeat every 3-5 minutes (if asystole of PEA persists) to a maximum of 3 doses (3 mg). |
What is the dosage (ET) of atropine for an adult experiencing asystole or bradycardia PEA? | 2-3 mg diluted in 10 mL of water or normal saline. |
What is the adult dosage (IV/IO)of atropine for a patient with unstable bradycardia? | 0.5 mg every 3-5 minutes as needed, not to exceed total dose of 3 mg. Use shorter dosing interval (3 min)and higher dose in severe clinical conditions. |
What is the adult dosage of atropine for a patient with organophosphate poisoning? | Extremely large doses (2-4 mg or higher) may be needed. |
What is the pediatric dosage (IV/IO) of atropine? | 0.02 mg/kg; may be double this dose for second IV/IO push. |
What is the pediatric minimum single dose and maximum single dose of atropine? | Minimum single dose: 0.1 mg. Maximum single doses: child single dose: 0.5 mg, child total dose: 1 mg, adolescent single dose: 1 mg, adolescent total dose: 2 mg. |
What is the ET adminisration dose of atropine? (Pediatric) | 0.03 mg/kg (absorption may be unreliable) |
What drug has a class of a sympathomimtic? | Epinephrine (Adrenalin) |
What is the MOA if epinephrine? | Direct-acting alpha and beta agonist. Alpha: vasoconstriction. Beta 1: positive inotropic, chronotropic, and dromotropic effects. Beta 2: bronchial smooth muscle relaxtion and dilation of skeletal vasculature. |
Allergic reactions, anaphylaxis, and asthma are all indications for this drug? | Epinephrine |
Cardiac arrest (V-fib/pulseless V-tach, asystole, PEA), symptomatic bradycardia as an alternative infusion to dopamine, severe hypotension secondary to bradycardia when atropine and tansscutaneous pacing are unsuccessful are indications for this drug? | Adrenalin (epinephrine) |
What are the contraindications of epinephrine? | Hypertension, hypothermia, pulmonary edema, myocardial ischemia, hypovolemic shock. |
What is the adult doasge for mild allergic reactions? (Epinephrine) | 0.3-0.5 mg (0.3-0.5 mL of 1:1,000) SC. |
What is the adult dosage for anaphylaxis? (Epinephrine) | 0.1 mg (1 mL of 1:10,000) IV/IO over 5 minutes. |
What is the adult dosage for cardiac arrest?(Epi by IV/IO) | 1 mg (10 mL of 1:10,000 solution) every 3-5 minutes during resuscitation. Follow each dose with 20 mL flush and elevate arm for 10 to 20 seconds after dose. |
When will higher dose of epi be indicated in an adult patient and what is the doasge during cardiac arrest? | Beta blocker or calcium over dose. Up to 0.2 mg/kg. |
What is the adult dosage for cardiac arrest using continuous infusion? (Epi) | Add 1 mg (1 mL of 1:1,000) to 500 mL normal saline or D5W. Initial infusion rate of 1 mcg/min titrated to effect (typical dose: 2-10 mcg/min). |
What is the adult dosage for cardiac arrest with with the ET route? (Epi) | 2-2.5 mg diluted in 10 mL normal slaine. |
What is the adult dosage for profound bradycardia or hypotension? (Epi) | 2-20 mcg/min; titrate to patient response. |
What is the pediatric dosage for mild allergic reactions and asthma? (Epi) | 0.01 mg/kg (0.01 mL/kg) of 1:1,000 solution SC (maximum of 0.3 mL). |
What is the pediatric dosage for cardiac arrest? (IV/IO and ET of Epi) | IV/IO: 0.01 mg/kg (0.1 mL/kg) of 1:10,000 solution every 3-5 minutes during arrest.ET: 0.1 mg/kg (0.1 mL/kg) of 1:1,000 solution. |
What is the pediatric dosage for symptomatic bradycardia? (IV/IO and ET of EPI) | IV/IO: 0.01 mg/kg (0.1 mL/kg) 1:10,000 solution.ET: 0.1 mg/kg (0.1 mL/kg) of 1:1,000 solution. |
What is the pediatric dosage for a continuous IV/IO infusion? (Epi) | Begin with rapid infusion, then titrate to response. Typical initial infusion: 0.1-1 mcg/min. Higher doses may effective. |
What drug is a loop diuretic? | Furosemide (Lasix) |
What is the MOA for furosemide? | Inhibits electrolyte reabsorption and promotes excretion of sodium, potassium, chloride. |
CHF, pulmonary edema, and hypertensive crisis are indications for use of what drug? | Furosemide (Lasix) |
Hypovolemia, anuria, hypotension (relative condtraindication); hyersensitivity, and hepatic coma are all contraindications for this drug. | Furosemide (Lasix) |
What is the adult dosage for furosemide? | 0.5-1.0 mg/kg injected IV over 1 to 2 minutes. If no response, double the dose to 2mg/kg over 1 to 2 minutes. |
What is the pediatric dosage for furosemide? | 1 mg/kg/dose IV/IO. |
What is the class of lidocaine hydrochloride (Xylocaine)? | Antiarrhythmic |
Decreases automaticity by slowing the rate of phase 4 deplorzation is the MOA of this drug... | Lidocaine Hydrochloride (Xylocaine) |
What are the indications for lidocaine? | Alternative to amiodarone in cardiac arrest from V-fib/pulseless V-tach, stable monomorphic V-tach, stable polymorphic V-tach with normal baseline QT interval. |
Contraindications for lidocaine are...? | Hpyersensitivity, second and third degree AV blocks in the absence of artificial pacemaker, Strokes-Adams syndrome, prophylactic use in AMI, wide-complex ventricular escape beats with bradycardia. |
What is the adult IV/IO dosage for lidocaine in cardiac arrest from V-fib/pulseless V-tach? | Initial dose: 1-1.5 mg/kg. Repeat dose: 0.5-0.75 mg/kg, repeated in 5-10 minutes to maximum dose of 3 mg/kg. |
What is the adult ET dosage for lidocaine in cardiac arrest from V-fib/pulseless V-tach? | 2-4 mg/kg |
What is the adult dosage for stable V-tach, wide-complex tachycardia of certain type, significant ectopy? (Lido) | Doses ranging from 0.5-0.75 mg/kg eery 5-10 minutes. Maximum total dose is 3 mg/kg. |
What is the adult maintenance infusion dose of lidocaine? | 1-4 mg/min (30-50 mcg/kg/min); can dilute in D5W or normal saline. |
What is the pediatric IV/IO dosage of lidocaine? | 1 mg/kg rapid IV/IO push. Maximum dose: 100 mg. |
What is the pediatric continuous IV/IO infusion for lidocaine? | 20-50 mcg/kg/min. Administer bolus dose (1 mg/kg) when infusion is initiated if bolus has not been given within previous 15 minutes. |
What is the dosage for pediatrics using ET route? (Lido). | 2-3 mg/kg |
What class is vasopressin (Pitressin synthetic)? | Antidiuretic hormone |
What drug has an MOA being stimulation of V1 smooth muscle receptors, potent vasoconstrictor when given in higher doses? | Vasopressin (Pitressin synthetic) |
Alternate vasopressor to the first or second dose of epinephrine in cardiac arrest, may be useful in cases of vasodilatory shock (i.e. septic shock) are indications for what drug? | Vasopressin (Pitressin synthetic) |
What are the contraindications for vasopressin? | Responsive patients with coronary artery disease. |
What is the adult dosage for vasopressin? | 10 mg bolus IV over 2 minutes; then 50 mg over 1 hour, then 20 mg over the second hour and 20 mg over the third hour, for a total dose of 100 mg (other doses may be prescribed through medical direction). |
Is vasopressin indicated in pediatrics? | Saftey not established. |