CCT_Drugs.txt

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Fentanyl
- • Class- Opioid agonist
- • Indication- Analgesia and Anesthesia
- • Dose- 1-2 mcg/kg Slow IVP; Infusion: 1mcg/kg/hr and may titrate
- • Onset- less than 30 seconds Duration- 30-60 minutes
- • Side Effects- Dizziness, blurred vision, depressed respiratory function, N/V, muscle rigidity
- • Special Notes: Crosses placental barrier, reversed with Narcan
Morphine Sulphate
- • Class- Opioid Agonist
- • Indication- Analgesia
- • Dose- 0.05-0.1 mg/kg IVP
- • Onset- 30-60 seconds; Duration- 30-60 minutes
- • Side Effects- Dizziness, N/V, depressed respiratory function
- • Special Notes: Reversed with Narcan
Meperidine (Demerol)
- • Class- opioid
- • Indication- Analgesia
- • Dose- 50-100 mg slow IVP or IM
- • Onset- 2-10 minutes; Duration- 60 minutes
- • Side Effects- respiratory depression,seizures, confusion, N/V
- • Special Notes- can be given IM to follow an IV
Ketamine (Ketalar)
- • Class- Anesthetic/Analgesic
- • Indication- Anesthesia/Analgesia for pediatric Asthma Pt.
- • Dose- 1-2 mg/kg IV q 10-20 minutes
- • Onset- Immediate; Duration- 10-20 minutes
- • Side Effects- HTN, Respiratory Depression, Tachycardia, Hallucination
- • Special Notes- Do not use if pt is HTN, or has increased ICP
Atenolol (Tenormin)
- • Class- Beta Blocker, anti-anginal
- • Indication- Angina, refractory CP, Acute MI
- • Dose- 5 mg slow IVP over 5 minutes, then an additional 5 mg in 10 minutes
- • Onset- 1-2 minutes; Duration- 1-2 hours
- • Side Effects- Hypotension, CHF, bronchospasm, dizziness, N/V
- • Special Notes- Use of calcium channel blockers may increase side-effects
Nitroglycerin IV
- • Class- Peripheral vasodilator; Nitrate; Antihypertensive
- • Indication- ACS, Hypertensive Emergency, CHF
- • Dose; 10-20 mcg/min, titrate by 5-10mcg every 5-10 minutes
- • Onset- 1-2 minutes; Duration- 30 minutes
- • Side Effects- Headache, hypotension, syncope, tachycardia
- • Special Notes: Caution with hypotension, hypovolemia, nonabsorbent tubing should be used when giving ntg via infusion
Amiodarone
- • Class- Class 3 Anti-Arrhythmic
- • Indication- Recurrent VF/Pulseless VT, perfusing SVT
- • Dose- “living pt” gets 150 mg, “dead pt” gets 300 mg; Infusion- Rapid infusion of 150 mg, then 360mg over 6 hours, then 540 mg over 18 hours
- • Side Effects- vasodilation, hypotension, bradycardia, AV blocks, prolonged QT interval, hepatotoxicity
- • Special Notes: Contraindicated in cardiogenic shock, 2nd or 3rd degree heart blocks, 40 day half life
Lidocaine
- • Class- Anti-Arrhythmic
- • Indication- VF, VT, ventricular arrhythmias
- • Dose- 1-1.5 mg/kg
- • Onset- 30-90 seconds; Duration- 2-4 hours
- • Side Effects- seizures, slurred speech, altered mental status
- • Special Notes- use 50% dosage in ederly patients
Procainamide
- • Class- Anti-Arrhytmic
- • Indication- cardiac arrest, VF/VT, PSVT
- • Dose- 100 mg IVP every 5 minutes to a max of 17 mg/kg; Infusion- 50 mg/minute
- • Onset- 10-30 minutes; Duration- 3-6 hours
- • Side Effects- PR, QRS, and QT widening, AV Block, hypotension, N/V
- • Special Notes- contraindicated for Digitalis toxicity, 2nd and 3rd degree AV blocks, myasthenia gravis
Cardizem
- • Class- Calcium Channel Blocker; Anti-Arrhythmic; Anti-Hypertensive
- • Indication- Rate control in A-Fib/A-Flutter; Second line treatment for SVT
- • Dose- 15-20 mg (0.25 mg/kg) IV over 2 minutes, then repeat 20-25 mg (0.35 mg/kg) in 15 minutes if needed; Infusion- should follow at 5-15 mg/min
- • Onset- 2 Minutes; Duration- 1-2 Hours
- • Side Effects- hypotension, bradycardia, N/V, CHF, dizziness
- • Special Notes- May increase Dig levels, contraindicated in WPW, Do not give in same line as lasix due to incompatibility, usually requires refrigeration
- Incompatible with Lasix
Cefazolin (Ancef)
- • Class- cephalosporin generation 1
- • Indication- systemic infection
- • Dose- 250-1000 mg IM or IV every 6-8 hours
- • Onset- rapid; Duration- 6-12 hours
- • Side Effects- phlebitis, diarrhea, rash, urticaria, pruritis, pain, induration
- • Special Notes- must be reconstituted with NS, dilute in 50-100 ml NS and infuse over 15-30 minutes, caution in patients with PCN
- allergy
- 1g/ 2g for open fracture
Furosemide (Lasix)
- • Class- Loop Diuretic
- • Indication- Diuresis, CHF with Pulmonary edema, hypertensive crisis
- • Dose- 0.5-1 mg/kg Slow IVP to a max of 2 mg/kg
- • Onset- 5 minutes; Duration- 5-6 hours
- • Side Effects- Hypokalemia, hypotension, dehydration
- • Special Notes- Use caution in patients with hepatic coma and hypokalemia
- If pushed too fast, causes deafness
Bumetanide (Bumex)
- • Class- Loop Diuretic
- • Indication- edema, HTN, pulmonary edema
- • Dose- 0.5-1 mg IV over 1-2 minutes, may repeat every 2-3 hours up to 10 mg in 24 hour period
- • Onset- 10-20 minutes; Duration 2-3 hours
- • Side Effects- electrolyte imbalance, dizziness, headache, N/V
- • Special Notes: 40 times stronger than lasix, usually given to pt who dont respond ti thiazide diuretics or rapid diuresis is needed, will increase the effects of non-depolarizing medications
- K⁺Sparing Diuretic, Increases effects of Verconium
Nesiritide (Natrecor)
- • Class- human B type natriuretic peptide
- • Indication- acutely decompensated CHF
- • Dose- 2 mcg/kg IV followed by infusion of 0.01 mcg/kg/min
- • Onset- 15-60 minutes; Duration- 1-2 hours after d/c of infusion
- • Side Effects- Hypotension, azotemia, headache, anxiety, N/V
- • Special Notes: d/c or decrease dose if hypotension develops
Digoxin (Lanoxin)
- • Class- Anti- Arhythmic, Anti- CHF
- • Indication- A-Fib, A-Flutter, PSVT, CHF
- • Dose- 0.5-1 mg IV over 5 minutes
- • Onset- 5-10 minutes; Duration- 12 hours
- • Side Effects- Toxicity, N/V, fatigue, Headache, diarrhea, seizures
- • Special Notes- Use caution in Renal Failure, do not use if HR less than 60
- Peaked "T" waves
Inamrinone (Inocor)
- • Class- Inotropic Dilator
- • Indication- Acute Severe CHF
- • Dose- 0.75 mg/kg Slow IVP, may repeat in 30 minutes; Infusion; 2-15 mcg/kg/min
- • Onset- 2-5 minutes; Duration- 30-50 minutes
- • Side Effects- hypotension, Idiopathic Hypertrophic Subaortic Stenosis, hypovolemia, chest pain
- • Special Notes- Do not mix with dextrose solutions or lasix
Clopidogrel (Plavix)
- • Class- anti-platelet
- • Indication- NSTEMI, anti-platelet therapy
- • Dose- 300 mg PO followed by 75 mg PO daily
- • Onset- within 24 hours; Duration 24 hours
- • Side Effects- rash, flu-like symptoms
- • Special Notes- do not use with active bleeding disorders or hepatic impairment, do not use if CABG is planned within 5 days
Heparin
- • Class- anti-coagulant
- • Indication- anti-coagulation therapy in Acute MI, DVT, and PE
- • Dose- 60 units/kg IVP up 5000 units and 12 units/kg/hour infusion (5000 Unit bolus, 1000 u/hr Maintenance)
- • Onset- 5-20 minutes; Duration- 24 hours
- • Side Effects- bleeding, allergic reaction, thrombocytopenia, itching
- • Special Notes- Do not give if platelet count is less than 100, heparin toxicity can be reversed with protamine sulphate
- Protomine Sulfate used as Antidote
Enoxaparin (Lovenox)
- • Class- low molecular weight heparin, anti-coagulant, inhibits factors 2A and XA
- • Indication- Acute Coronary Syndromes, DVT, PE
- • Dose- 1 mg/kg BID
- • Onset- 20-30 minutes; Duration- 8-12 hours
- • Side Effects- bleeding, allergic reaction, thrombocytopenia, itching
- • Special Notes- Should be given with ASA concurrently
Eptifibatide (Integrilin)
- • Class- Glycoprotein 2B/3A inhibitor, anti-coagulant
- • Indication- Acute Coronary Syndromes, NSTEMI
- • Dose- ACS: 180 mcg/kg Bolus over 1-2 minutes, then 2 mcg/kg/hour for 72-96 hours
- • Onset- Rapid; Duration- 36 hours
- • Side Effects- bleeding, allergic reaction, arrythmias, thrombocytopenia
- • Special Notes- use caution or withhold if platelet count is less than 150 or patient has any other bleeding risks
Abciximab (Reopro)
- • Class- Anti-Platelet
- • Indication- Acute coronary syndromes, unstable angina
- • Dose- 0.25 mg/kg IV then 0.125 mcg/kg/min infusion
- • Onset- 2-3 minutes; Duration- 4 hours
- • Side Effects- Bleeding, allergic reaction
- • Special Notes- Use in conjunction with heaprin
Lorazepam (Ativan)
- • Class- Benzodiazepine, anti-anxiety, hypnotic sedative
- • Indication- Sedation, Amnesia, Seizures (Best for Active Siezures)
- • Dose- 0.05 mg/kg IVP up to 4 mg (2mg Normal Dose)
- • Onset- 1-5 minutes; Duration- 6-24 hours
- • Side Effects- N/V, drowsiness, restlessness, delirium
- • Special Notes- decrease dosing in elderly, may be given rectally if no IV or IO access readily available, reversible with romazicon
Phenobarbital
- • Class- Anti- Convulsant
- • Indication- Seizures, Status Epilepsy
- • Dose- 100-250 mg Slow IVP or IM
- • Onset- 3-30 minutes; Duration- 4-6 hours
- • Side Effects- Respiratory depression, hypotension, coma, N/V
- • Special Notes- use caution in pulmonary or hepatic dysfunction
Phenytoin (Dilantin)
- • Class- Anti-Convulsant, class 1B Anti-dysrhythmic
- • Indication- seizures, digoxin toxicity
- • Dose- 15-20 mg/kg; Digoxin Toxicity- 1.25 mg/kg IV every 5 minutes to a total of 15 mg/kg
- • Onset- 5-15 minutes; Duration- Up to 24 hours
- • Side Effects- lethargy, headache, irritability, restlessness, vertigo, hypotension, bradycardia, anorexia
- • Special Notes- Caustic to veins, use larger veins, dilute in NS only
- For Digoxin Toxicity- 1.25 mg/kg
Fosphenytoin (Cerebyx)
- • Class- anticonvulsant
- • Indication- seizures (Seizure Preventative)
- • Dose- 15-20 mg/kg
- • Onset- 1-5 minutes; Duration- 6 hours
- • Side Effects- tinnitus, dizziness, somnolence, headache, parathesia, pruritis
- • Special Notes- causes increased risk of hypotension with
- rapid administration, less irritable to veins than phenytoin
Diazepam (Valium)
- • Class- Benzodiazepine, Anti-Convulsant, Sedative
- • Indication- Epilepsy, Status Epilepsy, Sedation
- • Dose- Epilepsy: 5-10 mg Slow IVP; Sedation: 5-15 mg Slow IVP
- • Onset- 1-5 minutes; Duration- 6-10 hours
- • Side Effects- respiratory depression, hypotension, drowsiness, venous irritation
- • Special Notes- reversed with romazicon, can be given rectally
Ondanesetron (Zofran)
- • Class- Anti-Emetic
- • Indication- Nausea & Vomiting
- • Dose- 4 mg Slow IVP or IM
- • Onset- 30-60 seconds; Duration- 4-6 hours
- • Side Effects- headache, dizziness, pain at injection site
- • Special Notes- may precipitate with bicarb administration
Prochlorperazine (Compazine)
- • Class- Anti-Emetic
- • Indication- Nausea & Vomiting, Psychosis
- • Dose- 2.5-10 mg Slow IVP or IM every 4 hours (5mg Normal Dose)
- • Onset- 2-5 minutes; Duration- 4-6 hours
- • Side Effects- headache, dizziness, amenorrhea, neuroleptic malignant syndrome, jaundice
- • Special Notes- contraindicated in dehydrated pediatric patients
Promethazine (Phenergan)
- • Class- Anti-Emetic, Anti-Histmine
- • Indication- Nausea & Vomiting
- • Dose- 12.5-25 mg Slow IVP diluted in 10 ml of NS
- • Onset- 2-5 minutes; Duration- 4-6 hours
- • Side Effects- Dizziness, drowsiness, respiratory depression
- • Special Notes- Never administer without diluting in NS
Captopril (Capoten)
- • Class- Anti-Hypertensive, ACE inhibitor
- • Indication- HTN, heart failure, LV Dysfunction
- • Dose- 50 mg PO
- • Onset- 50-60 minutes; Duration- 24 hours
- • Side Effects- proteinuria, thrombocytopenia, photosensitivity, chest pain
- • Special notes- max dose is 450 mg daily
Clonidine (Catapres)
- • Class- alpha agonist hypotensive agent
- • Indication- HTN
- • Dose- 0.1 mg PO Twice Daily
- • Onset- 50-60 minutes; Duration- 24 hours
- • Side Effects- fatigue, fever, headache, N/V, bradycardia, anxiety, delirium
- • Special Notes- most patients develop leg cramps shortly after admnistration
Nitroprusside (Nipride)
- • Class- peripheral vasodilator, anti-hypertensive
- • Indication- HTN crisis, after-load reduction in heart failure, MV or AV regurgitation
- • Dose- 0.1-10 mcg/kg/min and titrate every 3-5 minutes (2.5 mcg/kg/min)
- • Onset- 30-60 seconds; Duration- 1-10 minutes
- • Side Effects- reflex tachycardia, cyanide toxicity, CO2 retention
- • Special Notes- Nipride is made with fractionated cyanide, toxicity is treated with amyl nitrate
- Decreases Afterload
Metoprolol (Lopressor)
- • Class- Beta1 Blocker
- • Indication- Acute MI, HTN, atrial tachydysrhythmias
- • Dose- 5 mg slow IVP at 5 minute intervals to a max of 15 mg
- • Onset- 5 minutes; Duration- 5-8 hours
- • Side Effects- hyptension, CHF, bronchospasm, bradycardias, dizziness, chest pain, headache, N/V
- • Special Notes- do not give if Systolic BP is less than 90 or Heart Rate is less than 60, use caution in CHF, bronchospasm, or asthma
Nicardipine (Cardene)
- • Class- Anti-Hypertensive, Calcium Channel Blocker
- • Indication- HTN
- • Dose- 5-20 mg over 1 hour mixed 50 mg in 230 ml D5W
- • Onset- 1-2 minutes; Duration 12-24 hours
- • Side Effects- edema, hypotension, aortic stenosis, N/V, flusing
- • Special Notes- Do not mix with LR, change IV site every 12 hours due to irritation
- Calcium Gluconate or Calcium Chloride used as antidote.
Labetalol (Normodyne)
- • Class- Beta1 and Alpha adrenergic antagonist
- • Indication- HTN
- • Dose- 10 mg IVP over 1-2 minutes, may repeat or double every 10 minutes to a max of 150 mg
- • Onset- 5 minutes; Duration- 3-6 hours
- • Side Effects- hypotension, N/V, dizziness, sweating
- • Special Notes- keep patient supine during administration, avoid use in bronchial asthma, 2nd or 3rd degree blocks, and hepatic failure
Esmolol (Breviblov)
- • Class- Anti-Hypertensive, Anti-Arrhythmic (Beta Blocker)
- • Indication- HTN, A-Fib
- • Dose- 250-500 mcg/kg over 1 minute then infusion at 25-50 mcg/kg/min
- • Onset- 1-2 minutes; Duration- 2-3 hours
- • Side Effects- hypotension, bradycardia, dizziness, chest pain, headache
- • Special Notes- Calcium Channel Blockers exacerbate side effects
Hydralazine (Apresoline)
- • Class- Anti-Hypertensive
- • Indication- HTN
- • Dose- 10-50 mg IV or IM (20 mg Standard dose)
- • Onset- 15-30 minutes; Duration- 3-8 hours
- • Side Effects- dyspnea, headache, N/V, palpitations, angina
- • Special Notes- Avoid use in patients taking MAO Inhibitors
Albuterol
- • Class- Bronchodilator
- • Indication- Bronchospasm, COPD, Asthma
- • Dose- 1.25-2.5 mg via Nebulizer
- • Onset- 5-15 minutes; Duration- 3-4 hours
- • Side Effects- Tachydysrhythmias, anxiety, N/V
- • Special Notes- avoid use in patients with tachycardia
Metaproterenol (Alupent)
- • Class- Bronchodilator
- • Indication- Bronchospasm, COPD, Asthma
- • Dose- 10-15 mg in 3ml NS via Nebulizer
- • Onset- 5-15 minutes; Duration- 2-3 hours
- • Side Effects- tachydysrhythmias, anxiety, N/V
- • Special Notes- avoid use in patients with tachycardia
Ipratropium (Atrovent)
- • Class- Bronchodilator
- • Indication- Bronchospasm, COPD, Asthma
- • Dose- 0.5 mg in 2.5 ml of NS via Neb
- • Onset- 3-5 minutes; Duration- 2-5 hours
- • Side Effects- Dry mouth, Headache, cough
- • Special note- does not cause tachycardia like albuterol
Theophylline
- • Class- Bronchodilator
- • Indication- Bronchospasm, COPD, Asthma
- • Dose- Varies by Serum Theophylline
- • Onset- Rapid; Duration- 2-5 hours (depending on serum levels)
- • Side Effects- N/V, headache, muscle tremors, hypercalcemia
- • Special Notes- in patients with Cor Pulmonale, infusion rate should not exceed 17 mg/hr
Racemic Epinephrine
- • Class- sympathomimetic agent
- • Indication- Croup
- • Dose- 0.05 ml/kg/dose up to 5 ml diluted with 2.5 ml NS over 15 minutes via Neb
- • Onset- within 5 minutes; Duration- 2-4 hours
- • Side Effects- tachydysrhythmias, headache, N/V, palpitations
- • Special Notes- rebound airway edema may occur, be prepared to control airway
Levalbuterol (Xopenex)
- • Class- Beta2 adrenergic agonist
- • Indication- Asthma, bronchoconstriction
- • Dose- 0.63-1.25 mg every 6-8 hours
- • Onset- rapid; Duration- 6-8 hours
- • Side Effects- tachycardia, palpitations, tremors, insomnia, nervousness, N/V, headache
- • Special Notes- Doesn’t increase HR as much as albuterol
Cimetidine (Tagamet)
- • Class- Histamine (H2) antagonist
- • Indication- GERD, ulcers, peptic ulcer disease
- • Dose- 300 mg IVPB or IM
- • Onset- 10-20 min; Duration- 6 hours
- • Side Effects- diarrhea, rash, myalgias, confusion, neutropenia, gynecomastia
- • Special Notes- use smaller dose in renal diseases, rapid administration will cause hypotension and bradycardia, prolongs half-life of: valium, versed, lopressor, lidocaine
Famotidine (Pepcid)
- • Class- Histamine Blocker
- • Indication- GERD, GI ulcers
- • Dose- 20 mg IV every 12 hours
- • Onset- 5-10 minutes; Duration- 10-12 hours
- • Side Effects- Headache, dizziness, N/V, fever, fatigue
- • Special Notes- frequent dosage usually causes tinnitus
Ranitidine (Zantac)
- • Class- Histamine blocker
- • Indication- duodenal ulcers, patients who are NPO
- • Dose- 50 mg IVP or IM every 6-8 hours
- • Onset- 3-5 minutes; Duration- 6-8 hours
- • Side Effects- itching, pain at injection site, dizziness, insomnia, bradycardia
- • Special Notes- continuous zantac administration increases risk for pneumonia
Magnesium Sulphate
- • Class- replacement agent, anticonvulsant
- • Indication- Torsades, status asthmaticus, tocolysis
- • Dose- Torsades: 1-2 gm/kg IVP or IVPB; Asthma: 25-75 mg/kg IVPB up to 2 gm over 20 minutes; tocolysis- 6 gm IV load, then 2-3 gm/hr infusion
- • Onset- Immediately; Duration- 3-4 hours
- • Side Effects- hypotension, respiratory/CNS depression, flushing, sweating
- • Special Notes- Max rate is 150 mg/min, assess DTR, rapid infusion causes feeling “hot”
Oxytocin (Pitocin)
- • Class- oxytocic, lactation stimulant
- • Indication- postpartum hemmorrhage
- • Dose- 10 units IM after placental delivery or 10-40 units in 1000ml NS or LR infused at 20-100 mu/min
- • Onset- Immediate; Duration- 20 minutes
- • Side Effects- HTN, dysrhythmias
- • Special Notes- Rule out multiple fetuses prior to administration
Terbutaline (Brethine)
- • Class- Beta2 adrenergic agonist, bronchodilator
- • Indication- Asthma, Tocolysis
- • Dose- 0.25 mg SC, repeat one time in 15-30 minutes
- • Onset- 15-30 minutes; Duration 1-4 hours
- • Side Effects- tachydysrhythmias, headache, anxiety, N/V
- • Special Notes- may be given via nebulizer is patient is under 2y/o, tolerance develops with repeated dosing
Vecuronium (Norcuron)
- • Class- Non-Depolarizing skeletal muscle relaxant
- • Indication- RSI, facilitation of mechanical ventilation
- • Dose- Paralytic: 0.1 mg/kg IVP; defasciculation: 0.01 mg/kg IVP: Infusion- 0.05-0.07 mg/kg/hr
- • Onset- 1-3 minutes; Duration- 30-60 minutes
- • Side Effects- hepatic disease and long-term corticosteroid use causes longer than usual paralysis
- • Special Notes- ages 1-10 may require higher doses and shorter intervals than adults
Succinylcholine (Anectine)
- • Class- depolarizing skeletal muscle relaxant
- • Indication- RSI
- • Dose- 1-1.5 mg/kg IVP
- • Onset- Immediate; Duration- 5-10 minutes
- • Side Effects- Hyperkalemia, vomiting, intracoular pressure, cardiac dysrhythmias
- • Special Notes- contraindicated for: hx of malignant hyperthermia (Treated with Dantrolene), MD, crush injury greater than 24 hour old, hyperkalemia, severe sepsis,burns more than 8 hours old, valium decreases the neuromuscular block effects
Rocuronium (Zemuron)
- • Class- Non-Depolarizing Muscular Blocker
- • Indication- RSI, Paralysis for mechanical ventilator usage
- • Dose- 0.6-1.2 mg/kg IVP
- • Onset- 1-3 minutes; Duration- 20-30 minutes
- • Side Effects- Bronchospasm, hypotension
- • Special Notes- avoid use if patient is hepatic impaired or severe
- obesity
Midazolam (Versed)
- • Class- Benzodiazepine, Hypnotic sedative
- • Indication- sedation, induction of anesthesia, RSI, seizures
- • Dose- 0.05 mg/kg IVP; Infusion- 1-2 mcg/kg/min
- • Onset- 1-5 minutes; Duration- 2-6 hours
- • Side Effects- respiratory depression, hypotension, bradycardia, N/V
- • Special Notes- hypotension and respiratory depression likely to occur with use of opioids, may be less effective of patient is on theophylline, may be reversed with romazicon
Propofol (Diprivan)
- • Class- Anesthesia induction agent
- • Indication- anesthesia induction and maintenance, sedation of
- mechanically ventilated patient
- • Dose- 5-50 mcg/kg/min infusion
- • Onset- Immediate; Duration 5-20 minutes
- • Side Effects- hypotension, bradycardia, vivid dreams
- • Special Notes- Use caution in hemodynamically unstable patients, not a good drug for use in noisy or excessive stimulation situations such as transport, IV tubing should be changed every 12 hours, Green Urine
Etomidate (Amidate)
- • Class- CNS Agent, Non-Barbituate hypnotic without analgesic activity
- • Indication- Induction of anesthesia, RSI
- • Dose- 0.2-0.6 mg/kg IVP
- • Onset- Less than 1 minute; Duration 3-10 minutes
- • Side Effects- myoclonus, tonic movements, hiccups, vomiting
- • Special Notes- Do not use in gravid and lactating females, myoclonus is reduced with premedication utilizing benzo or opiate
Alteplase (Activase)
- • Class- Fibrinolytic
- • Indication- Acute MI less than 12 hours old, Acute Ischemic
- Stroke, Acute pulmonary embolism
- • Dose- 15 mg IVP over 2 minutes, then 0.75 mg/kg over 30minutes followed by 0.5 mg/kg over 1 hour
- • Onset- 3-5 minutes; Duration- 2-3 hours
- • Side Effects- bleeding, shock, reperfusion dysrhythmias
- • Special Notes- Avoid use in recent trauma, aneurysm, recent surgery, bleeding disorders
Anistreplase (Eminase)
- • Class- Fibrinolytic
- • Indication- Acute MI less than 12 hours old
- • Dose- 30 units IV over 2-5 minutes
- • Onset- rapid; Duration- 12 hours
- • Side Effects- reperfusion dysrhythmias, bleeding, shock, allergic reaction
- • Special Notes- Avoid use in recent trauma, aneurysm, recent surgery, bleeding disorders
Streptokinase (Streptase)
- • Class- Fibrinolytic
- • Indication- Acute MI less than 12 hours old
- • Dose- 1,500,000 units over 30 minutes followed by infusion of 100,000 units/hour
- • Onset- 5-15 minutes; Duration- 12 hours
- • Side Effects- reperfusion dysrhythmias, bleeding, shock, allergic reaction
- • Special Notes- Avoid use in recent trauma, aneurysm, recent
- surgery, bleeding disorders
Reteplase (Retavase)
- • Class- Fibrinolytic
- • Indication- Acute MI less than 12 hours old
- • Dose- 10 units over 2 minutes with a repeat dose in 30 minutes
- • Onset- 10-15 minutes; Duration- 12 hours
- • Side Effects- dysrhythmias, bleeding, hypotension, shoch, fever, allergic reaction
- • Special Notes- Avoid use in recent trauma, aneurysm, recent surgery, bleeding disorders
Tenecteplase (TNKase)
- • Class- Fibrinolytic
- • Indication- Acute MI less than 12 hours old
- • Dose- 30-50 mg IVP
- • Onset- Rapid; Duration- 10-15 hours
- • Side Effects- dysrhythmias, bleeding, hypotension, shock, CHF
- • Special Notes- do not use in patient with hx of CVA within 1 year, or bleeding disorders, aortic dissections
Dopamine
- • Class- inotropic vasopressor
- • Indication- Hypotension, Bradycardia
- • Dose- 2-20 mcg/kg/min
- • Onset- 1-3 minutes; Duration- 1-2 hours
- • Side Effects- tachydysrhythmias, HTN, N/V, headache, Ischemia
- • Special Notes- patients taking MAO inhibitors should receive 1/10 of normal dose
Dobutamine (Dobutrex)
- • Class- Beta 1 adrenergic agonist, sypmpathomimetic
- • Indication- positive inotrope, cardiac decompensation
- • Dose- 2-20 mcg/kg/min titrate so Heart Rate does not increase by 10% above baseline
- • Onset- 1-2 min; Duration- 10-15 min
- • Side effects- Tachydysrhythmias, VT, HTN, N/V, headache
- • Special Notes- contraindicated in Idiopathic Hypertrophic Subaortic Stenosis,Hemodynamic monitoring is highly recommended
Norepinephrine
- • Class- vasopressor, catecholamine, alpha and beta 1 stimulant
- • Indication- shock, hypotension (Severe)
- • Dose- 0.5-30 mcg/min
- • Onset- 1-3 minutes; Duration- 5-10 minutes
- • Side effects- VT, HTN, N/V, ischemia, decreased renal perfusion, decreases urinary output
- • Special Notes- Norepi causes tissue necrosis, if this occurs it should be treated with phentolamine
Epinephrine 1:1,000 SQ
- • Class- Sympathomimetic
- • Indication- allergic reaction, asthma
- • Dose- 0.3-0.5 mg SQ
- • Onset- Rapid; Duration- 1-3 hours
- • Side Effects- tachydysrhythmias, VT, VF, angina, HTM
- • Special Notes- contraindicated in patients with CAD
Epinephrine 1:10,000 IV Bolus
- • Class- Sympathomimetic
- • Indication- Anaphylaxis, bradycardia, hypotension
- • Dose- 0.3-0.5 mg IVP
- • Onset- immediate; Duration- 1-3 hours
- • Side Effects- tachydysrhythmias, VT, VF, angina, HTN
- • Special Notes- Avoid use in patients with CAD
Epinephrine Drip
- • Class- Sympathomimetic
- • Indication- Bradycardia, Hypotension
- • Dose- 2-10 mcg/min IV infusion
- • Onset- immediate; Duration- 1-3 hours
- • Side Effects- tachydysrhythmias, VT, VF, angina, HTN
- • Special Notes- Avoid use in patients with CAD
Phenylephrine (Neo-Synephrine)
- • Class- Vasopressor, Alpha Agonist
- • Indication- Hypotension
- • Dose- 0.1-0.5 mg slow IVP over 10-15 minutes
- • Onset- Rapid; Duration 1-2 hours
- • Side Effects- Headache, CVA, chest pain, bradycardia, HTN, respiratory distress
- • Special Notes- potentiated by atropine, antagonized by diuretics and beta-blockers, Gives a purely Alpha effect
Milrinone (Primacor)
- • Class- Inotropic Dilator
- • Indication- CHF
- • Dose- 50 mcg/kg over 10 minutes then follow with infusion at 0.375-0.75 mcg/kg/min every 15-30 minutes
- • Onset- Rapid; Duration- 2-3 hours
- • Side Effects- Hypotension, headache, angina, arrythmias
- • Special Notes- reduce maintenance infusion if renal or hepatic impaired, contraindicated in aortic or pulmonary valve disease
Vasopressin
- • Class- Antidiuretic hormone, vasopressor
- • Indication- Esophageal varices, shock, cardiac arrest
- • Dose- Cardiac Arrest: 40 units IV/IO for one dose only; Varices: 0.1-0.4 units/min; Shock: 0.04 units/min
- • Onset- 1-3 min; Duration- 20-30 min
- • Side Effects- Pain at IV site, N/V, angina, trembling
- • Special Notes- not used in pediatric cardiac arrest
Hetastarch (Hespan)
- • Class- Plasma Expander
- • Indication- shock, hypovolemia
- • Dose- 500-1000 ml not to exceed 1500 ml/day
- • Onset- 15-30 minutes; Duration- 24-48 hours
- • Side Effects- headache, N/V, submaxillary and parotid glandular enlargement, prolongation of PT/PTT, flu-like symptoms
- • Special Notes- contraindicated with bleeding disorders, renal failure with oliguria or anuria, check coagulation factors after administering
Plasmanate
- • Class- Human plasma protein fraction
- • Indication- severe hypovolemia, shock, crush injuries
- • Dose- 250-500 ml initial IV bolus
- • Onset- 3-5 minutes; Duration 36 hours
- • Side Effects- flushing, urticaria, back pain, N/V
- • Special Notes- should be given with 16 gauge catheter minimum
Blood Products
- • Whole Blood
- • PRBC
- • FFP
- • Albumin
- • Special Notes- 20 gauge minimum for administration, check patient for fever, use only NS, citrate reactions and hypercalcemia common with multiple units
Pantoprazole (Protonix)
- • Class- PPI
- • Indication- GERD associated with Erosive esophagitis
- • Dose- 40 mg IVP once daily
- • Onset- 20-30 minutes; Duration 20-30 hours
- • Side Effects- Abdominal pain, headache, imsomnia, rhinitis, back pain, flatulence
- • Special Notes- Should not be given for more than 7-10 day
Esomeprazole (Nexium)
- • Class PPI
- • Indication- GERD associated with Erosive Esophagitis
- • Dose- 20-40 mg IVP
- • Onset- 10-20 minutes; Duration- 24 hours
- • Side Effects- pruritis, dizziness, flatulence, N/V, dyspepsia, sinusitis
- • Special Notes- should be given in IV with no other medications and flushed thoroughly afterwards with NS
Lansoprazole (Prevacid)
- • Class- PPI
- • Indication- GERD associated with Erosive Esohagitis
- • Dose- 30 mg IV mixed with 5 ml of sterile water over 30 minutes
- • Onset- 30-60 minutes; Duration- 16-20 hours
- • Side Effects- pruritis, dizziness, flatulence, N/V, dyspepsia, sinusitis
- • Special Notes- should be given with an IV filter to remove impurities from re-constitution
Mannitol
- • Class- Osmotic Diuretic
- • Indication- Increased ICP, cerebral edema
- • Dose- 1-2 g/kg over 30-60 minutes
- • Onset- 30-60 minutes; Duration 3-8 hours
- • Side Effects- fluid imbalance, electrolyte loss
- • Special Notes- disrupts the blood-brain barrier, allows other medications to penetrate into the CNS, use a filter to administer, often given with lasix to maximize effects
Insulin (Humulin R, Novolin R)
- • Class- pancreatic Hormone
- • Indication- DM, Hyperkalemia
- • Dose- DKA: 0.1 units/kg, then 0.1 units/kg/hr; Hyperkalemia: 10 units IV diluted with 50 ml D50w
- Insulin Drip- 10 units/1000 ml D5W (Always run on Pump)
- • Onset- 30-60 minutes; Duration- 6-8 hours but peaks in 2-4 hours
- • Side Effects- dry mouth, increased cough, lipoatrophy, lipohypertrophy
- • Special Notes- mix in NS 1:1 ratio and run at 1 ml/kg/hr
Methylprednisolone (SoluMedrol)
- • Class- Corticosteroid
- • Indication- inflammatory and allergic disorders, spinal cord injury
- • Dose- 40-125 ml IVP, spinal cord injury- 30 mg/kg IV over 15 min and follow with 5.4 mg/kg/hr for 23-47 hours
- • Onset- 1-2 hours; Duration- 8-24 hours
- • Side Effects- vertigo, headache, sodium/fluid retention, increases appetite, weight gain, immunosuppression
- • Special Notes- steroids cause htn, acne, cushings syndrome, increased blood glucose
Potassium Chloride
- • Class- Electrolyte
- • Indication- hypokalemia
- • Dose- Doses vary depending on serum Potassium levels
- • Onset- 15 minutes; Duration- 1-2 hours
- • Side Effects- N/V, diarrhea, abdominal pain, IV site pain
- • Special Notes- Peripheral IV rate max of 10 meq/hr, Central IV rate max of 20 meq/hr, NEVER GIVE IV PUSH! Always run on Pump
- Normal Potasium is 3.5 - 5
Fumazenil (Romazicon)
- • Class- Benzodiazepine receptor agent
- • Indication- antidote for benzo overdose or toxicity
- • Dose- 0.2-0.5 mg IV not to exceed 3 mg/hr
- • Onset- immediate; Duration 4-6 hours
- • Side Effects- seizures, N/V, agitation, withdrawal
- • Special Notes- contraindicated in status epilepticus and Incresed ICP
Calcium Chloride
- • Class- Calcium Supplement
- • Indication- hypocalcemia, hyperkalemia, Calcium Channel Blocker Overdose or Toxicity
- • Dose- 5-10 ml Slow IVP
- • Onset- 5-15 min; Duration- 4 hours
- • Side effects- Bradycardia, asystole, hypotension
- • Special Notes- 3 times more potent than calcium gluconate, IVP max rate of 1 ml/min; Precipitates with Sodium Bicarb
Calcium Gluconate
- • Class- Calcium Supplement
- • Indication- hypocalcemia, hyperkalemia, hypermagnesemia, Calcium Channel Blocker Overdose or Toxicity
- • Dose- 500-1000 mg
- • Onset- Rapid; Duration- 30 minutes
- • Side Effects- bradycardia, hypotension, arterial spasm
- • Special Notes- 1/3 strength of Calcium Chloride, IVP max rate of 1.5 ml/min, precipitates with sodium bicarb
Glucagon
- • Class- Hypoglycemia Drug
- • Indication- Hypoglycemia, Beta-Blocker OD
- • Dose- Hypoglycemia: 1 mg IM; Beta-Blocker OD: 3-5 mg IVP
- • Onset- 6-20 minutes; Duration- 4-8 hours
- • Side Effects- N/V, Hypotension with IV doses
- • Special Notes- Can also be used to remove debris from esophagus, smooth muscle relaxant
Naloxone (Narcan)
- • Opiate Antagonist
- • Indication- Opiate OD or Toxicity
- • Dose- 2 mg IV, IM, SQ
- • Onset- Rapid; Duration- 6-8 hours
- • Side Effects- withdrawal symptoms
- • Special Notes- can be repeated for max of 10 mg
Dextrose (D50, D25)
- • Class- Nutrient, replacement
- • Indication- hypoglycemia
- • Dose- 25 gm IV
- • Onset- Rapid; Duration- 2-4 hours
- • Side Effects- tissue necrosis if extravasion occurs
- • Special Notes- Contraindicated for patients with intracerebral bleeding
Thiamine (Vitamin B1)
- • Class- Nutrient
- • Indication- Malnutrition or Thiamine deficiency
- • Dose- 100 mg Slow IVP or IM
- • Onset 15-30 minutes; Duration 12-16 hours
- • Side Effects- N/V, Hypotension
- • Special Notes- Certain patients are hypersensitive to Thiamine

Author

wdzracer

8027

Card Set

CCT_Drugs.txt

Description

CCT Drugs

Updated

2010-03-21T13:00:21Z