Code meds

6 mg rapid IV push (1-3 seconds) followed immediately by 20 ml bolus (NS) using a 3 way stopcock. 

May repeat: 12 mg rapid IV push if no effect in 1-2 minutes.

Slows conduction time through the AV node, interrupting the re-entry pathways through the AV node, restoring normal sinus rhythm.

• Carbamazapine - 3 mg initial dose
• Central line - 3 mg initial dose, 6 mg repeat dose
• Dipyridamole - 3 mg initial dose
• Heart transplant pt - 3 mg initial dose
• Theophylline - 12 mg initial dose.

• PSVT (paroxysmal supraventricular tachycardia)
• Regular and monomorphic wide-complex tachycardia

• Cardiac arrest with recurrent VF/pulseless VT unresponsive to shocks, CPR, epi
• Hemodynamically stable VT

• Initial dose - 300 mg rapid IV push
• May repeat - 150 mg if arrhythmia recurs
• May give undiluted

• Initial dose - 1 mg/min IV x 6 hours
• Following with continuous infusion - 0.5 mg/min IV x 18 hours.

• Initial dose - 150 mg IV over 10 min
• Follow with continuous infusion - 1 mg/min IV x 6 hours
• Follow with continuous infusion - 0.5 mg/min IV x 8 hours

Decrease AV conduction and sinus node function, prolongs action potential and refractory period in myocardial tissue

• Bradycardia
• Organophosphate poisoning

• Initial dose - 0.5 mg IV push
• May repeat - 0.5 mg Iv push every 3-5 minutes
• Max 0.04 mg/kg or 3 mg total

• Severe hyperkalemia with cardiac manifestations
• Symptomatic hypocalcemia or hypermagnesemia
• Calcium channel blocker or beta blocker overdose with hypotension.

• Initial dose: 0.5-1 gram IV over 10 minutes
• May repeat: 0.5-1 gram IV every 5 to 10 minutes

• Initial dose: 1 gram IV over 10 minutes
• May repeat: 1 gram IV every 2-3 minutes
• May follow with continuous infusion: when HR > 60

Usual dose: 20-40 mg/kg/hour IV (1-2 meq/kg/hr) (Dose is elemental calcium)

• Early acute respiratory distress syndrome (ARDS) with P/F ratios < 150
• Prevention of shivering during targeted temperature management

• Initial dose: 3 mcg/kg/min IV
• Titrations: increase 1 mcg/kg/min IV every 15 minutes (Max 10 mcg/kg/min)

Add 200 mg (20ml of 10mg/ml) to 480 mg NS of D5W. final concentration 0.4mg/ml

• Initial dose: add 150 mg to 100 ml D5W of NS
• Maintenance dose: add 900 mg to 500 ml D5W or NS

Hypertnesion

• Initial: 2 mg/hour IV
• Titrations: Dose may be doubled every 90 seconds, as BP approaches goal, dose increases should be less than double and time between dose adjustments should be every 5-10 minutes
• Taper: decrease no faster than 1 mg/hr every 5-10 min as tolerated
• Max dose: 32 mg/hour

• ICU sedation
• Alcohol withdrawal syndrome (AWS) when there is concern for respiratory depression with escalating doses of benzodiazepines

• initial: 0.2 mcg/kg/hr IV
• Titrations: increase by 0.2 mcg/kg/hr IV every 30 minutes
• Max dose: 1.5 mcg.kg/hr
• Taper: decrease by 10% every 3 hours as tolerated

• Hyperkalemia (when administered with insulin)
• Hypoglycemia

Initial: 10 units regular insulin mixed in 50 ml D50W

• Ventricular rate control in atrial fibrillation or flutter
• Refractory SVT after adenosine in pt with adequate blood pressure and narrow QRS complex

• Initial: 15-20 mg (0.25 mg/kg) IV push over 2 minutes
• May repeat 20-25 mg (0.35 mg/kg) IV push over 15 minutes if needed

• Initial: 5 mg/hr
• Titrations: increase 5 mg/hr every 15 minutes to a target HR < 110
• Max dose: 15 mg/hr

125 mg (25 ml) to 100 ml NS of D5W