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Epinephrine Description
- Catecholamine
- ^ tropic properties, systemic vascular resistance, systolic BP, vital capacity, tidal vol
- May reduce pulmonary congestion
- Decreases airway resistance & automaticity
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Epi Indications (2)
- Cardiac arrest
- Severe allergic reactions
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Epi contraindications (3)
- Narrow Angle Glaucoma
- Hemmoragic, Traumatic or Cardiac shock
- Labor
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Epi Dosages
- Arrest-- 1mg 1:10 IV 3-5 mins (ET 2-2.5 1:1) NO MAX
- Allergy-- 0.3-0.5 mg 1:1 sub q 5-15 min as needed 0.5-1 1:10 IV if sub q ineffective
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Magnesium Sulphate Description
- Electrolyte acts as CCB, CNS depressant & anticonvulsant
- Depresses function of smooth, skeletal & cardiac muscles
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Magnesium Sulphate Indications (3)
- Refractory V-Fib & pulseless V-Tach
- AMI
- Eclamptic Seizures
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Magnesium Sulphate Contraindications (5)
- Heartblock
- Myocardial Damage
- Shock
- Persistent Hypertension
- Hypocalcemia
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Magnesium Sulphate Precautions (2)
- Other CNS depressants
- Neuromuscular blocking agents
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Magnesium Sulphate Dosages
- V-Fib/Tach -- 1-2 g IV over 2 mins
- Torsade de pointes -- 1-2 g IV followed by infusion of 0.5-1 g/hr IV
- AMI -- 1-2 g IV over 5-30 mins
- Eclampsia -- 2-4g IV/IM
- Asthma -- 1-2 g IV drip
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Dopamine C & T
- Sympathomimetic
- Inotropin
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Dopamine Description
- Natl catecholamine ^ cardiac output w/o ^ myocardial O2 consumption
- Maintains renal & mesenteric blood flow while inducing vasoconstriction & ^ systolic BP
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Dopamine Indications (2)
- Nonhypovolemic hypotension
- Cardiogenic shock
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Dopamine Contraindications (3)
- Tachydysrhythmias
- V-Fib
- Pheochromocytoma
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Dopamine Precautions
Ensure adequate fluid resuscitation of the hypovolemic pt
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Dopamine dosages
2-5 mcg/kg/min up to 20 mcg/kg/min, titrated to effect
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Methylprednisolone C & T
- Corticosteroid/ Antiiflammatory
- Solu-medrol
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Methylprednisolone Description
- Synthetic adrenal corticosteroid used for inflammation, mgmt of allergic reactions & in some cases shock
- Sometimes used for treatment of spinal cord inj
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Methylprednisolone Indications (4)
- Spinal Cord Inj
- Asthma
- Severe Anaphylaxis
- COPD
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Methylprednisolone Contraindications
None in emergency setting
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Methylprednisolone Precautions
Only a single dose should be given in prehospital setting
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Methylprednisolone Dosages
- Asthma/COPD/Anaphylaxis -- 125-250 mg IV/IM
- Spinal Cord Inj -- 30 mg/kg IV over 15 min, aft 45min an infusion of 5.4 mg/kg/hr
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Atropine C & T
- Parasympatholytic
- Atropine
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Atropine Description
- Blocks vagal effects on HR
- ^ myocardial O2 demand
- Decrease airway secretions
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Atropine Indications
- Hemodynamically significant Bradycardia
- Bradyasystolic Arrest
- Organophosphate Poisoning
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Atropine Contraindications
None in EMS setting
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Atropine Dosages
- Symptomatic Bradycardia--0.5mg IV/1mg ET 3-5 mins to 3 mg
- Asystole--1mg IV/ 2mg ET 3-5 min to 3 mg
- Poisoning--2-5 mg IV/IM/IO to 15 min
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Furosemide Description
- Rapid acting potent diuretic & antihypertensive
- Inhibits Na reabsorption by kidneys
- Reduces venous return & cardiac workload
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Furosemide Indications (2)
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Furosemide Contraindications (3)
- Fluid & electrolyte depleted states
- Hepatic coma
- Pregnancy
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Furosemide Precautions (8)
- Infants
- Elderly
- Hepatic Impairment
- Nephrotic Syndrome
- Cardiogenic Shock assoc w/ MI
- Gout
- Pts receiving digitalis
- K depleting steroids
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Furosemide Dosage
40-120 mg slow IV
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Butorphanol C & T
- Snythetic Narcotic Analgesic
- Stadol
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Butorphanol Description
- Centrally acting synthetic narcotic analgesic
- 5x more potent than morphine
- Schedule IV Narc
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Butorphanol Indications
Pain
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Butorphanol Contraindications (2)
- Head Inj
- Undiagnosed Abd pain
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Butorphanol Precautions
none
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Butorphanol Dosage
1 mg IV or 3-4 mg IM
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Nalbuphine C & T
- Narcotic Analgesic
- Nubain
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Nalbuphine Description
Equivalent to morphine w/o ^ resp depression w/ higher doses
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Nalbuphine Indications
Pain
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Nalbuphine Contraindications
Undiagnosed Head or abd inj
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Nalbuphine Precautions
none
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Nalbuphine Dosages
5 mg IV/IM/sub q repeat 2mg dose as needed to 20 mg
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We use Interferon to treat ____?
Hepatitis
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Haloperidol Indications
Acute Psychotic Episodes
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Haloperidol Contraindications (6)
- Parkinson's
- Seizure Disorders
- Coma
- Alcohol Depression
- CNS depression
- Thyrotoxicosis
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Haloperidol Precautions
Anticonvulsant, Anticoagulant or Lithium Therapy
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Haloperidol Dosages
2-5 mg IM
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What allergies must we be cautioned by with atrovent?
Soybean & nut allergies
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Rectal valium is called ____?
Diastat
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What is the C & G for Ultram?
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Ketorolac C & T
- Nonsteroidal Anti-inflammatory (NSAID)
- Torado
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Ketorlac description
Injectable NSAID that exhibits analgesic, anti-inflammatory, & antipyretic properties w/o sedative effects
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Ketorlac indications
Mild or moderate pain
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Etomidte Description
Ultra short acting nonbarbituate hypnotic
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Etomidate Indications (1)
Sedation for RSI
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Etomidate Contraindications
None
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Etomidate Precautions (3)
- Hypotension
- Asthma
- Cardiovascular Disease
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Etomidate Dosage
0.1-0.3 mg/kg IV over 15-30 secs
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Phenytoin Description
- Related to phenobarbital that reduces spread of elec discharges in motor cortex & inhibits seizures
- Antidysrhythmic props counter effects of digitalis
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Phenytoin Indications (3)
- Seizures
- Status Epilepticus
- Cardiac dysrhythmias secondary to digitalis toxicity
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Phenytoin Contraindications (3)
- Sinus Bradycardia
- Heart Block
- Adams-Stokes syndrome
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Phenytoin Precautions
None
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Phenytoin Dosages
- Seizure/Status Epilepticus -- 10-15 mg/kg slow IV
- Dysrhythmia -- 100 mg slow IV (over 5 min) to a max of 1000 mg
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What is propofol's C & T?
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What are 3 indications for propofol?
- General Anesthesia
- Mechanically Ventilated Adults
- Procedural sedation
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