drugcards.txt

- Oxidizing agent

- Class: Gas

Indications: To manage any situation where hypoxia may be suspected

Contraindications: None in the emergency setting

• - Dry mucous membranes
• - Irritation of the upper respiratory tract

Hypoxia 100% by inhalation

• Nasal Cannula 1-6 LPM
• Simple Mask 8-10 LPM
• Non-rebreather 10-15 LPM
• BVM 15+ LPM
• CPAP 20+ LPM

Brand Name: Xylocaine

Class: Antidysrhythmic and Class 1 B Sodium Channel Blocker

- Depresses automaticity of Prukinje Fibers; therefore RAISES stimulation threshold in ventricular fibers (makes fibers less likely to fibrillate)

- Little antidysrhythmic affect on atrial muscle at subtoxic level

• - Cardiovascular effects:
• - Decreases conduction rate and force of contraction, mainly at toxic levels
• - Prolongs phase 4 depolarization and shortens action potential

• - CNS Stimulation:
• - Tremors, restlessness, clonic convulsions followed by respiratory depression and respiratory failure

• - Onset of action: less than 3 min

Enters into the body via the respiratory system. Transported by hemoglobin/RBC; essential gas to sustain life

• Indications:
• - Ventricular tachycardia or wide-complex tachycardia with pulses
• - Recurrent or refractory ventricular fibrillation/pulseless V-tach
• - Following successful defibrillation
• - Pre-Intubation in head injuries (minimizes the rise in ICP)

• Contraindications:
• - Not used for Supraventricular Rhythms: (the electrical impulse originates at or above the AV node )
• - Hypersensitivity - to any of the "caines"

• - CNS disturbances:
• - Sleepiness, dizziness, disorientation, confusion and convulsions

• - Cardiovascular:
• - Hypotension, bradycardia, decreased myocardial contractability and increased AV blocks at toxic levels only

• Adult:
• - V-Fib/pulseless V-tach:
• 1-1.5 mg/kg
• IO/IV
• repeat in 3-5 minutes at 0.5-0.75 mg/kg (half of initial dose). Max dose is 3mg/kg.

• - Pulsing V-Tach:
• 1 mg/kg
• IO/IV
• repeat every 5-10 minutes at 0.5 mg/kg.
• Max dose is 3mg/kg.

• - Maintenance drip (hang after successful conversion of rhythm with lidocaine to a pulsing sinus rhythm >60 bpm)
• 2-4 mg/min (usually start at 2mg/min and titrate up as nec)
• Use 4 mg/mL concentration
• - Pre-Intubation - head injury only:
• 1 mg/kg
• IV/IO

• - V-Fib/pulseless V-tach:
• 1 mg/kg
• IO/IV
• repeat in 3-5 minutes
• Max dose is 3mg/kg.

• - Pulsing V-Tach:
• 1 mg/kg
• IO/IV
• repeat at 0.5 mg/kg every 5-10 minutes.
• Max dose is 3mg/kg.

• - Maintenance drip (hang after successful conversion of rhythm with lidocaine to a pulsing sinus rhythm >60 bpm)
• 20-50 mcg/min

• - Pre-Intubation - head injury only:
• 1 mg/kg
• IV/IO

• - 100 mg in 5 mL pre-load syringe (2% solution)
• - 1 g in 250 mL pre-mixed bag OR 2g in 500 mL pre-mixed bag (20% solution)
• - 1g in 5cc vials (20% solution) for mixing - NOT TO BE USED AS BOLUS

Brand name: Adrenalin

Class: Sympathomimetic (nervous system)

Epinephrine is a naturally occurring catecholamine that increases heart rate, cardiac contractile force, myocardial electrical activity, systemic vascular resistance and systolic blood pressure.

It decreases overall airway resistance and automaticity.

It also, through bronchial artery constriction, may reduce pulmonary congestion (edema) and increase tidal volume and vital capacity.

** Jump starts the Sympathetic Nervous System!! Be careful in older people - they have older hearts

• Indications:
• - To restore cardiac rhythms in cardiac arrest event
• - Allergic reaction/ anaphylaxis
• - Refractory (resistant) to dopamine in bradycardia event
• - Severe asthma

• Contraindications:
• - None in cardiac arrest
• - Hemorrhagic shock
• - Cardiogenic shock
• - Hypertension

• - Weakness
• - Headache/Dizziness
• - Syncope
• - Hypertension
• - MI/CVA
• - Tachycardia

• Cardiac Arrest:
• 1 mg - IVP/IO - 1:10,000 (repeat as needed 3-5 min)
• 2-2.5 mg - ET - 1:1000 (repeat as needed 3-5 min)*
• (* It is not as much volume, but a higher concentration. Too much volume will put fluid in lungs)

• Allergic Reaction/ Anaphylaxis:
• 0.3 - 0.5 mg - SC/IM - 1:1000 (repeat as needed 5-15 min)*
• 0.5-1.0 mg - IVP/IO if SC ineffective - 1:10,000
• (*Same dose as with severe asthma)

• Bradycardia:
• 2-10 mcg/min

• Cardiac Arrest:
• - 0.01 mg/kg - IVP/IO - 1:10,000
• - 0.1 mg/kg - ET - 1:1000

• Allergic Reaction / Anaphylaxis:
• - 0.01 mg/kg - SC/IM - 1:1000
• - 0.01 mg/kg - IVP/IO 1:10,000

Carbohydrate

• Indications:
• - To increase blood sugar levels in documented hypoglycemia

• Contraindications:
• - Causing patients with s/s of ICP (Inter-cranial pressure)

• - Pain at site of injection
• - Necrosis (death of living cells or tissues)
• - Hyperglycemia

- 25 grams of D50 - IV/IO/PO

- 0.5 g/kg of D25 - IV/IO/PO (28 days to 8 years old)

- 0.2 g/kg of D10 - IV/IO/PO (Neonate)

Parasympatholytic / Anticholinergeic

• P: "rest and digest"
• A: Inhibits the transmission of parasympathetic nerve impulses

- Atropine blocks the parasympathetic ("rest and digest") nervous system, specifically the vagal effects on the heart.

- It does not increase contractibility but may increase myocardial oxygen demand.

- Decreases airway secretions.

- Increases HR

• Indications:
• - Hemodynamically significant bradycardia (Symptomatic bradycardia: not normal for them specifically) I
• - Bradyasystolic arrest (slow...heart not working)
• - Organophosphate poisoning (Pesticides) - Cholinergic (makes everything leak..SLUDGE)

• Contraindications:
• - None in the emergency setting

• - Headache/Dizziness
• - ALOC
• - Weakness
• - Hypertension/Hypotension (Not good for an M.I b/c hypertension side effect)
• - A Fib / V Fib
• - Doubles the size of MI

• Symptomatic Bradycardia:
• 0.5 mg - IVP/IO (may repeat as needed every 3-5 min)
• Max dose 3.0 mg IVP/IO
• PEDIATRIC: 0.02 mg/kg - IV/IO

• Asystole/PEA (below 60 bpm):
• 1 mg - IVP/IO (may repeat as needed every 3-5 min)
• Max dose 3.0 mg IVP/IO (2mg ET)
• PEDIATRIC: 0.02 mg/kg - IV/IO (if vagal induce)

• Organophosphate poisoning:
• 2.5 mg IV/IO/IM (repeat as needed every 10-15 min)
• PEDIATRIC: 0.05 mg/kg IV/IO/IM