Avsnitt
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Trade: Toradol Class: NSAIDMOA: inhibits the production or prostaglandins in inflamed tissue, which decreases the responsiveness of pain receptors. Indications: Moderately severe acute painContraindications: Patients with a hx of peptic ulcer disease or GI bleed, patients with renal insufficiency, hypovolemic patients, 3rd trimester pregnancy, nursing mothers, allergy to other nsaids, stroke or head trauma, having surgery within the next 7 days. Side effects: headache, drowsiness, dizziness, abdominal pain, dyspepsia, N/V, Diarrhea.Dosing:
Adult
IV 30mg
IM 60mg
Senior (65 and older)/ Pediatric < 50kgs
IV 15mg
IM 30mg
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Trade: MorphineClass: Opiate agonist/Narcotic Analgesic MOA: Binds to the opiate receptors. Reduces stimulation of the sympathetic nervous system caused by pain and anxiety. Reduction of sympathetic stimulation reduces heart rate, cardiac work, and myocardial O2 consumptionIndications: moderate to severe pain including chest pain associated with ACS, CHF, and pulmonary edema.Contraindications: Respiratory depression, shock.Side effects: Respiratory depression, hypotension, N/V, dizziness, lightheadedness, sedation, diaphoresis, euphoria, seizures, cardiac arrest, anaphylactoid reaction.Dosage:
Adult
2-10mg IV/IO/IM
Pediatric
< 110 lbs 0.025 – 0.2mg/kg IV/IO/IM
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Saknas det avsnitt?
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Trade: SublimazeClass: Narcotic Analgesic MOA: Binds to opiate receptors producing analgesia and euphoriaIndication: PainContraindication: Use caution in traumatic brain injury, Respiratory depression Side effects: Respiratory depression, apnea, hypotension, N/V, dizziness, sedation euphoria, Sinus bradycardia, sinus tachycardia, palpitations, HTN, diaphoresis, syncopeDosing
Adult
50-100mcg IM/IV
Pedi
1-2mcg/kg IM/IV
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Trade: Valium Class: BenzodiazepineMOA: Binds to the benzodiazepine receptor and enhances the effects of GABAIndications: Anxiety, Skeletal muscle relaxation, anticonvulsant Contraindications: Children younger then 6 months, acute angle glaucoma, CNS depression, alcohol intoxication. Side effects: Respiratory depression, drowsiness, fatigue, headache, pain at the injection site, confusion, nausea, hypotension, cardiac arrest at high doses•Dosing:
Adult:
Anxiety: 2-10mg IV/IM
Seizure: 5-10mg IV/IO
Pediatric:
Anxiety: 0.2 – 0.3mg/kg IV/IM
Seizure: Older then 5 years: 1mg IV/IO
Older then 30 days less then 5 years: 0.2 to 0.5mg IV/IO
Neonate: 0.1-0.3mg/kg IV/IO
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Trade: Tegretol Class: Anticonvulsant MOA: Binds preferably to voltage gated Sodium channels in their inactive conformation, which prevents repetitive and sustained firing of an action potential.Indications: Partial and generalized tonic – clonic seizures Contraindications: AV Block, bundle branch block, agranulocytosis, bone marrow supression, monoamine oxidase inhibitor therapySide effects: Dizziness, drowsiness, ataxia, N/V, blurred vision, confusion, headache, transient diplopia, visual hallucinations, life threatening rashes.Dosing:
Adult:
200mg PO
Pediatric:
6-12 years old: 100mg PO
Less then 6: 10mg/kg PO
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Trade – Cardene
Class – Calcium Channel blocker
MOA – Blocks calcium movement into the smooth muscle of the blood vessel walls, causing vasodilation.
Indication – Angina, HTN
Contraindication – Aortic stenosis, hypotension, use caution in heart failure, cardiac conduction abnormalities, Cerebrovascular disease, depressed AV node conduction.
Side effects – Edema, headaches, flushing, sinus tachycardia, hypotension
Dosages :
Adult: 5mg/hr IV/IO
Pedi: 0.5 – 5 mcg/kg/min
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Trade – CyanokitMOA: Antidote, cyanide poisoning adjunct Binds with cyanide to form nontoxic cyanocobalamin, preventing its toxic effects; excreted renallyIndications: Treatment of known or suspected cyanide poisioning.Contraindications: None is the emergency settingSide Effects: Hypertension, allergic reactions, GI bleeding, nausea, vomiting, dyspepsia, dyspnea, dizziness, headache, injection site reactions.Dosage:
Adult: 5 g IV infusion over 15 minutes at a rate of 15 mL/min.
Pedi: 70 mg/kg IV one time, may be repeated one time at the same dose.
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Trade – IsoptinClass – Calcium Channel blockerMOA – Blocks calcium from moving into the heart muscle cell, which prolongs conduction of the electrical impulses through the AV node.Indications – AF, HTN, paroxysmal SVT, Paroxysmal SVT prohylaxisContraindications – 2nd or 3rd degree AV block, Hypotension, cardiogenic shock, Sick sinus syndrome, WPW.Side effects – Sinus bradycardia, 1st, 2nd, or 3rd degree AV blocks, CHF, reflex tachycardia, transient asystole, hypotension.Dosing
Adult
2.5-10mg IV/IO over 2 minutes. May repeat at 5-10mg every 15-30 mins to a maximum dose of 30mg
Pedi
1-16 years old: 0.1mg/kg IV/IO max single dose 5mg over 2mins may repeat in 30 mins to a max dose of 10mg
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Trade – PlavixClass – Antiplatelet MOA – Blocks platelet aggregation by antagonizing the IIb/IIIa receptors Indications – ACS, chronic coronary and vascular disease, ischemic stroke.Contraindications – Hx of intracranial hemorrhage, GI bleed or trauma.Side effects – Nausea, Abdominal pain, hemorrhage. Dosing :
Unstable angina pectoris or non Q wave AMI.
Adult – Loading dose 300-600mg PO
Pedi – Not recommended for pedi patients
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Trade – PhenerganClass – Antiemetic MOA - Decreases nausea and vomiting by antagonizing H1 receptors Indications – Nausea/Vomiting Contraindication – Altered level of consciousness, jaundice, bone marrow suppression, Use caution in seizure disorder.Side effects – Paradoxic excitation in children and older adults. Dosing:
Adult - 12.5 - 25mg IV, IO, IM
Pedi - 2years and older 0.25 – 1 mg/kg IV, IO, IM
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Trade – CortefClass – Corticosteroid MOA – Reduces inflammation by multiple mechanisms. As a steroid it replaces the steroids that are lacking in adrenal insufficiency.Indications – Adrenal insufficiency, allergic reactions, anaphylaxis, asthma, COPDContraindications – Cushing Syndrome, known sensitivity to benzyl alcohol, Use with caution in diabetes, HTN, CHF, known systemic fungal infection, renal disease, idiopathic thrombocytopenia, psychosis, seizure disorder, GI disease, glaucoma. Side effects – Leukocytosis, hyperglycemia, increased infection, decreased wound healing, increased rate of death from sepsis. Dosing
Anaphylactic shock
Adult 100-500mg IV,IO, or IM
Pedi 2-10 mg/kg per day IV,IO, or IM max 500mg
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Trade – Nipride Class – Antihypertensive agentMOA – Causes direct relaxation of both arteries and veins Indication – HTN emergencies Contraindications – Hypotension, increased ICP, cerebrovascular disease, coronary artery disease, hepatic disease, renal disease, pulmonary disease.Side effects – Cyanide or thiocyanate toxicity, N/V, dizziness, headache, restlessness, abdominal pain, methemoglobinemia.Dosing
Adult 0.3-10mcg/kg/min
Pedi 0.5 – 10mcg/kg/min
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Trade – ApresolineClass – Vasodilator MOA – Directly dilates peripheral blood vesselsIndication – HTN associated with preeclampsia and eclampsia, HTN crisis Contraindication – Patients taking diazoxide or MAOI’s, coronary artery disease, stroke, angina, dissecting aortic aneurism, mitral valve and rheumatic heart disease. Side effects – Headache, angina, flushing, palpitations, reflex tachycardia, anorexia, N/V, diarrhea, hypotension, syncope, peripheral vasodilation, peripheral edema, fluid retention, pareshesias. Dosing
Preeclampsia and eclampsia:
Adult : 5-10mg IV repeat every 20-30mins until Systolic pressure of 90-105mmhg
Acute HTN ( not associated with preeclampsia )
Adult :10-20mg IV/IM
Pedi : 1mo – 12yr 0.1-0.2 mg/kg IV/IM max 20mg per dose
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Trade – HaldolClass – Antipsychotic agent MOA – Selectively blocks postsynaptic dopamine receptorsIndications – Psychotic disorders, agitation Contraindications – Depressed mental status, Parkinson diseaseSide effects – extrapyramidal symptoms, drowsiness, tardive dyskinesia, hypotension, hypertension, VT, sinus tachycardia, QT prolongation, torsades de pointes. Dosing
Adult:
Mild agitation : 0.5-2mg PO/IM
Moderate agitation : 5-10mg PO/IM
Severe agitation : 10mg PO/IM
Pedi:
1-5mg IM/PO
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Trade: TetraViscClass: Anesthetic MOA: Short acting pain suppressantIndication: Topical anesthetic for eye injuriesContraindication: allergySide Effects: numbness, blurred vision in treated eye, mild short burning sensationDose:
Adult: 1-2 drops every 5 minutes, repeat as needed
Pediatric1-2 drops every 5 minutes, repeat as needed
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Trade – Diprivan Class – Anesthetic MOA – Produces rapid and brief state of general anesthesia. Indication – Anesthesia inductionContraindication – HypovolemiaSide effects – Apnea, Cardiac arrhythmias, asystole, hypotension, hypertension.Dosing
Initial induction:
1.5-3mg/kg IV/IO followed by a maintenance infusion.
Adult maintenance infusion
25-75 mcg/kg/min IV/IO
Pedi maintenance infusion
30-300 mcg/kg/min IV/IO
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Trade – Dilantin Class – AnticonvulsantMOA – Depresses seizures by affecting the movement of sodium and calcium into neural tissue. Indication – Generalized tonic – clonic seizures.Contraindication – sinus bradycardia, sinoatrial block, second and third degree heart block, adam stokes syndrome, known sensitivity to hydantoins. Side effects – N/V, depression of cardiac conduction, sedation, nystagmus, tremors, ataxia, dysarthria, gingival hypertrophy, hirsutism, facial coarsening Dosing:
Adult: 15-20mg/kg IV/IO ( not to exceed a push rate of 50mg/min)
Pedi: 15-20mg/kg IV/IO ( at a rate of 1-3 mg/kg/min)
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Trade – ALTEPLASE RECOMBINANT-TPAClass– Thrombolytic Agent MOA – Dissolves thrombi plugs in the coronary arteries and reestablishes blood flow.Indication – ST segment elevation greater then 1mm in 2 or more contiguous leads, New or presumed new left bundle branch block. Contraindications – ST segment depression, Cardiogenic shock, Recent major surgery, cerebrovascular disease, recent (within 10 days) GI bleeding, recent trauma, severe HTN Systolic greater then 180 diastolic greater then 110. High likely hood of left heart thrombus, acute pericarditis, severe renal or liver failure with bleeding complications, significant liver dysfunction, diabetic hemorrhagic retinopathy, septic thrombophlebitis, Patients older then 75, patients already taking Coumadin. Side effects – Bleeding, intracranial hemorrhage, stroke, cardiac arrhythmias, hypotension, bruisingDosing
Adult
Per medical direction.
Pedi
Not recommended
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Trade – Unfractionated Heparin Class – Anticoagulant MOA – Acts on antithrombin III to reduce the ability of the blood to form clots, thus preventing clot deposition in the coronary arteries. Indication – ACS, acute pulmonary embolism, DVTContraindication – Predisposed to bleeding, aortic aneurism, peptic ulcer. Dosing:
Adult
Cardiac indications – 60 units/kg
Pulmonary embolism/ DVT – 80 units/kg
Pedi
Cardiac indications – 75 units/kg
Pulmonary embolism/DVT 75 units/kg
- Visa fler
