-
Morphine Sulfate
-astramorph
- ACTIONS
- alleviates pain thro CNS action
- depresses brain stem & respiratory center
- increase peripheral venous capacitance
- decrease venous return
- decrease myocardial oxygen demand
- INDICATIONS
- severe CHF
- chest pain of acute myocardial infarction
- severe acute pain
- CONTRAINDICATIONS
- head injury
- COPD
- depressed respiratory
- hypotension
- undiagnosed abdominal pain
- altered level of consciousness
- hypovolemia
- any
- MAOIs in past 14 days
- REACTIONS
- respiratory depression
- hypotension
- ALC
- bradycardia
- tachycardia
- syncope
- flushing
- dry mouth
- DOSAGE
- adult
- 2-10 mg IV slow, IM SC(max=10mg) repeat 2-8mg at 5-15min intervals/until desired response
- peds
- .1-.2mg/kg IV slow/infant is half
-
OXYGEN
- ACTIONSreverses hypoxemia
- CONTRAINDICATIONS
- certain pt with COPD & emphysema patients who will tolerate oxygen over 35%
- hyperventilation
- REACTIONS
- ALC
- respiratory depression in patient with chronic C02 retention
- retrolental fibroplasia to infants in high concentrations of 02(30-40%)
- DOSAGE
- adult & peds
- cardiac arrest and C02 poisoning=100%
- hypoxemia=10-15 l/min NRB
- COPD=1-6 l/min nasal cannula
-
Epinephrine
-adrenalin
- ACTIONSalpha & beta agonist
- alpha=vasoconstriction
- beta1=positive ino,chrono,dromotropic effects
- beta2=bronchial dilator
- INDICATIONS
- asystole
- cardiac arrest
- severe hypotension
- bradycardia
- allergic reactions
- anaphylaxis
- asthma
- CONTRAINDICATIONShypertension
- hypothermia
- pulmonary edema
- MI
- hypovolemic shock
- no contraindication in cardiac arrest
- REACTIONS
- hypertension
- tachycardia
- arrhythmias
- pulmonary edema
- anxiety
- headache
- DOSAGE
- adult
- anaphylaxis & allergic reactions=.3-.5-1mg(1:1000)
- cardiac arrest=1mg IV/IO every 3-5mins
- peds
- 0.01mg/kg IV/IO repeat 3-5mins
- use 1:1000 0.1mg/kg given ET
-
Dextrose
- ACTIONS
- rapidly increases serum glucose levels
- short term osmotic diuresis
- INDICATIONS
- hypoglycemia
- ALC
- coma of unknown origin
- seizure of unknown origin
- status epilepticus
- CONTRAINDICATIONS intracranial hemorrhage
- blood glucose level greater than 60mg/dl
- REACTIONS
- tissue necrosis
- warmth
- pain
- burning
- thrombophlebitis
- rhabdomyolysis
- hyperglycemia
- DOSAGE
- adult
- 12.5-25g slow IV, repeat as necessary
- peds
- .5-1g/kg/dose slow IV, repeat as necessary
-
Magnesium Sulfate
- ACTIONSreduces striated muscle contractions
- blocks peripheral neuromuscular transmission
- manages seizures in toxemia of pregnant patient
- induces uterine relaxation
- broncodilation
- INDICATIONS
- seizures of eclampsia(toxemia of pregnancy)
- torsade de pointes
- hypomagnesemia
- CONTRAINDICATIONS
- heart block
- myocardial heart damage
- REACTIONS
- CNS depression
- facial flushing
- diaphoresis
- depresses reflexes
- circulatory collapse
- hypotension
- DOSAGE
- adult
- eclamptic seizure=4gm IV mix/50ml of D5W
- admin over 5-10min
- may repeat once at 2g IV
- torsade de points/refractory VF=1-2g IV/50ml of D5W admin over 1-2mins followed by maintenance
- asthma & peds
- 25-50mg/kg IV/IO infusion over 10-20mins(max=2g)
-
Etomidate
-amidate
- ACTIONS
- induction of general anesthesia
- nonbarbiturate hypnotic
- INDICATIONS
- facilitate intubation
- CONTRAINDICATION
- hypersensitivity
- REACTIONS
- common nausea vomiting
- uncontrollable skeletal muscle activity
- unstable BP
- dyspnea
- dysrhythmias
- DOSAGES
- adults & peds over 10yr.2-.6mg/kg slow IV admin about 1min
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