-
lorazepam
- Ativan
- Seizure
- 0.5-2mg IV
- 1-4mg IM
-
diazepam
- Valium
- Seizure
- 5-10mg IV/IM q 5-15 min
- Procedural Sedation
- 5-15mg IV q 5-15 min
- Anxiety
- 2-5mg IM
-
midazolam
- Versed
- Seizure
- 1-2.5 mg SIVP q 2-3 min
- RSI (ACLS)
- 0.1-0.3mg/kg q 2-5 min
- max 10mg single dose
-
flumazenil
- Anexate
- benzodiazepine antagonist
- 0.2mg q 1 min to max 1mg
-
phenobarbital
- Phenobarb
- Sedation
- LD 100-250mg SIVP
- MD 10-20mg/kg q 20 min
- Max 1-2 g
-
phenytoin
- Dilantin
- Seizures
- 10-15mg/kg IV
- infuse <50mg/min
-
methylprednisolone
- Solu-Medrol
- Respiratory Distress
- 125-250mg IV/IM
- Spinal Cord Injury
- 30mg/kg IV over 15 min
- 45 min later
- 5.4mg/kg/hr
-
aminophylline
- Theophylline
- Bronchospasm
- 5-6mg/kg infusion
- Pulmonary Edema
- 2-5mg/kg infusion
- Peds
- 6mg/kg slow infusion over 20-30 min
- Max 12mg/kg/24hr
-
atropine sulfate
- Atropine
- Sympotmatic Bradycardia
- 0.5mg q 3-5 min
- max 3mg [0.04mg/kg]
- Bronchospasm
- 0.5-1mg in 2-3ml NS NEB
- Failed RSI
- 0.1mg/kg
- Min 0.5mg / Max 0.04mg/kg
-
halperidol
- Haldol
- Sedation
- 2-5mg IM q 60 min
- consider 10mg with violent pts
-
droperiol
- Inapsine
- Sedation
- 2.5-5mg IM q 30min
-
chlorpromazine
- Largctil
- Sedative
- 25-100mg IM
-
dimenhydrinate
- Gravol
- Nausea/Vomiting
- Motion sickness
- Prophylactic narcotic Admin
- 12.5-50mg SIVP q 4 hrs
- 50-100mg IM/PO
-
metoclopromide
- Maxeran
- Nausea/vomiting
- 5-10mg IV
-
morphine sulfate
MS Contin
- Moderate to Severe Pain
- 2-10mg SIVP
- in 2.5mg increments q 2-3 min
- 5-15mg IM
-
nalbuphine hydrochloride
- Nubain
- Moderate to severe pain
- 5-10mg IV
- 2mg increments q 5-10 min
-
meperidine hydrocholoride
- Demerol
- Moderate to severe pain
- 25-50mg IV
- Diluted & SIVP over 2-3 min
50-100 mg IM q 3-4 hrs
-
fentanyl citrate
- Sublimaze
- Moderate to severe pain
- 25-100mcg
-
naloxone
- Narcan
- Opiod Overdose
- 0.4-2mg IV/IM q 2-3 min
- in 0.4 mg increments
-
ketamine
- Ketelar
- Dis-associative agent
- 1-1.5mg IV
- repeat
- 0.5mg/kg IV
ketorolac tromethamine
- Toradol
- Moderate to severe pain
- 10-30mg IV/IM q 4-6hrs
- 10mg PO
- Max 120mg
-
succinylcholine chloride
- Quelicin, Anectine
- Muscular Depolarizing Paralytic
- 1-1.5mg/kg
- Repeat
- 1mg/kg
-
pancuronium bromide
- Pavulon
- Non-muscular depolarizing paralytic
- 0.06-0.1 mg/kg
- Redose
- 0.01-0.02 mg/kg q 20-40 min
-
vecuronium
- Norcuron
- RSI
- 0.08-0.1mg/kg SIVP
- Redose
- 0.01-0.015mg/kg q 25-40 min
- Infusion
- 0.6-1.8mcg/kg/min
-
rocuronium
- Zemuron
- Short action non-muscular depolarizing Paralytic
- 0.6-1.2mg/kg
- Repeat
- 0.5mg q 10min
-
neostigmine
Prostigmin
- Paralytic antagonist
- 0.5-2mg
- with .6-1.2mg atropine
- Myasthenia Gravis
- 1mg q 1 hr prn
-
nitroglycerin
- Nitrostat, Nitrodur,Nitrol
- chest pain/pulmonary Edema
- 0.3-0.4 mg SL spray
- max 3 sprays
- IV infusion:
- Unstable angina
- CHF associated with MI
- 10-20mcg/min,
- + 5-10mcg/min q 3-5min
- titrate to desired clinical response
- max 200mcg/min
-
lidocaine
- Xylocard, Xylocaine
- VF/pulseless VT
- 1-1.5mg/kg q 5-10 min
- [max 3mg/kg]
- VT with pulse/ significant PVCs/ wide complex tachycardia(symptomatic)
- 1-1.5mg/kg q 5-10 min
- 0.5-0.75 mg/kg PRN
- to max 3mg/kg
- ROSC/Tarhycardia conversion
- drip 1-4 mg/min
- rate:
- gave< 1mg/kg -> 1mg/min
- gave 1mg/kg -> 2mg/min
- gave 1.5-2mg/kg -> 3mg/min
- gave 2-3mg/kg -> 4mg/min
-
procainamide
- Pronestyl
- lidocaine contraindicated
- Wide Complex tachycardia not distinguishable from VT
- Suppress recurrent VF not controlled by lidocaine
- refractory pulseless VT/VF
- 20-30mg/min IV bolus
- infusion 1-4 mg/min
- max 17/mg/kg
- Discontinue if:
- - arrhythmia suppressed
- - Hypotension occurs
- - QRS lengthens by 50%
- - reach max dose of 17mg/kg
-
atenolol
- Tenormin
- Atrial tachycardia
- Consider in SVT
- Hypertensive crisis
- Decrease VF in post MI pts who did not get thrombolytics
- Decrease non-fatal infarction and ischema 4hrs post throbolytics
- 5-10mg IV over 5 min
- repeat 5mg after 10 min if arrhythmia returns
-
metoprolol tartate
- Lopressor
- Atrial tachycardia
- Consider in SVT
- Hypertensive crisis
- Decrease VF in post MI pts who did not get thrombolytics
- Decrease non-fatal infarction and ischema 4hrs post throbolytics
- 5-10mg SIVP q 5min
- max 15mg
-
propanolol
- Inderal
- Atrial tachycardia
- Consider in SVT
- Hypertensive crisis
- Decrease VF in post MI pts who did not get thrombolytics
- Decrease non-fatal infarction and ischema 4hrs post throbolytics
- 0.1mg/kg SIVP
- divide into 3 doses &
- give @ 2-3 min intervals
-
esmolol
- Brevibloc
- Atrial tachycardia
- Consider in SVT
- Hypertensive crisis
- Decrease VF in post MI pts who did not get thrombolytics
- Decrease non-fatal infarction and ischema 4hrs post throbolytics
- LD 500mcg/kg over 1 min
- MD 50mg/kg/min over 4 min
-
isoproterenol
- Isuprel
- Refractory torsades de pointes
- Refractory symptomatic bradycardia
- 2-10mcg/min
- titrated to desired response
- HR 60bpm
-
verapamil
- Isoptin
- Narrow Complex SVT
- Atrail Fibrilation with RVR
- Wide Complex tachyarrythmia with know Super Ventricular origin
- 2.5-5mg over 2 min
- if no response
- 5-10mg q 15-30 min
- max 20mg
-
diltiazem
- Cardizem
- Multifocal Atrial Tachycardia
- Atrial Fibrillation
- 0.25mg/kg (15-20mg) IV over 2 min
- 15 min later
- 0.35mg/kg (20-25mg) IV over 2 min
- A. Fib with RVR
- infuse 5-15mg/hr
-
adenosine
- Adenocard
- SVT
- 6mg RIVP
- Repeat x2 @ 12mg RIVP
- contraindicated:
- Carbamazepine/Tegretol
-
magnesium sulphate
- Magnesium Sulphate
- Pulselss VT/VF
- 2g in 10ml admin over 1-2 min
- Acute MI, hypomagnesemia
- LD 1-2g mixed in 50-100ml
- admin over 45-60 min
- Torsades de Pointes
- 2g iv in 10 ml over 5 min
- Bronchospasm
- 2g in 50 ml infused over 10 min
-
amiodarone hydochloride
- Cordarone
- Cardiac Arrest
- 300mg IVP
- repeat 150mg q 3-5 min
- max 2.2g IV/24hr
- Stable Wide Complex tachycarida
- Rapid infusion
- 150mg IV over 10 min (15mg/min)
- repeat q 10 min as needed
- Slow infusion
- 360mg IV over 6 hrs (1mg/min)
- Maintenance infusion
- 540mg over 18hrs (0.5mg/min)
-
epinephrine
- Adrenalin
- Anaphylaxsis
- 1:1000
- 0.3-0.5mg IM q 10-15 min
- Refractory Anaphylaxis/Bronchospasm
- 1:10,000
- 0.3-0.5mg IV
- in 0.1 mg increments
- Peds
- 1:1000
- 0.01mg/kg IM
- Max 0.5mg
- Laryngospasm
- 1:100 (recemic epi)
- 0.25-2.5ml of 2.25% solution NEB
- Repeat x1 after 5min
- Peds
- 0.25-0.5ml of 2.25% solution NEB
- Cardiac Arrest
- 1:10,000
- 1mg IV q 3-5 min
- Profound Hypotension
- 2-10mcg/min
- ROSC + Hypotension
- 0.1-0.5 mcg/kg/min
-
norepinephrine
- Levophed
- Cardiogenic shock
- Severe hypotension SBP<70mmHg
- 0.5-30mcg/min
- titrate to effect
- ROSC + hypotension SBP< 90mmHg
- 0.1-0.5mcg/kg/min
-
dopamine
- Intropin
- Symptomatic Bradycardia with Hypotension
- Cardiogenic shock
- 2-20mcg/kg/min
- titrate to pt response
- taper slowly
- ROSC + hypotension SBP <90mmHg
- 5-10mcg/kg/min
-
dobutamine
- Dobutrex
- Refractory CHF SBP>100mmHg
- Cardiogenic Shock
- 2-20mcg/kg/min
-
calcium choloride
- Calcium Chloride
- hyperkalemia
- Hypocalcemia
- 2-4mg/kg (500mg-1g) slow iv bolus
- repeat q 10 min prn
- Calcium channel blocker toxicity
- 4x regular dose
- 8-16mg/kg
- in 2-4 mg increments
-
digitalis
- Lanoxin, Digoxin
- Control A.Fib
- CHF
- SVT
- 0.25mg SIVP every 2hrs
- up to of LD 1.5mg
-
sodium nitroprusside
- Nipride
- Heart Failure
- Hypertension
- 0.1-5mcg/kg/min
- may need 10mcg/kg/min
-
sodium bicarbonate
- Sodium Bicarbonate
- Hyperkalemia
- Long arrest period
- 1mEq/kg initially
- 0.5mEq/kg q 10 min prn
-
furosemide
- Lasix
- Acute Pulmonary Edema
- Cerebral Edema post cardiac arrest
- 0.5-1mg/kg
- - 20mg for pt not taking furosemide
- - 40mg for pt on oral Lasix
if not effective in 20 min, double initial dose
-
vasopressin
- Vasopressin, Pitressin
- Alternate to Epi 1st/2nd round Cardiac Arrest
- 40 units IV single dose, 1 time only
-
acetylsalicylic acid
- Aspirin
- ACS Chest Pain
- 160-320mg PO chewed
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