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MAGNESIUM SULFATE
- (Magnesium)/Electrolyte
- Des: electrolyte that acts as a 1)calcium channel blocker 2)CNS depressant 3)anticonvulsant. Also depresses the function of smooth, skeletal, & cardiac muscles.
- Ind: 1)refractory V-Fib 2)pulseless V-Tach (especially torsade depointes) 3)AMI 4)eclamptic seizures.
- CI: 1)HB 2)myocardial damage 3)shock 4)persistent hypertension 5)hypocalcemia.
- PC: 1)other CNS depressants 2)neuromuscular blocking agents.
- Dose: V-Fib/tachycardia: 1-2g IV over 2:00.
- Torsade de pointes: 1 to 2 g IV then infusion 0.5-1g/hr IV.
- Asthma/COPD: 1-2g over 10:00
- Eclampsia: 2-6g IV/IM over 15:00-30:00
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PHENYTOIN
- (Dilantin)/Anticonvulsant
- Des: derivative related to phenobarbital 1)reduces spread of electrical discharges in motor cortex 2)inhibits seizures 3)has antidysrhythmic properties that counteract the effects of digitalis.
- Ind: 1)seizures 2)status epilepticus 3)cardiac dysrhythmias secondary to digitalis toxicity.
- CI: 1)hypersensitivity to hydantoin products 2)seizures due to hypoglycemia 3)sinus bradycardia 4)HB 5)Adams-Stokes syndrome.
- PC: 1)hepatic or renal impairment 2)alcoholism 3)cardiogenic shock 4)elderly 5)debilitated patients 6)diabetes 7)hyperglycemia 8)bradycardia 9)HB 10)respiratory depression
- Dose: seizures, status epilepticus: 10-15 mg/kg slow IV. Ped: 8-10mg/kg slow IV.
- dysrhythmias: 100 mg slow IV (over 5:00) to a maximum 1,000 mg. Ped: 3-5mg/kg slow IV.
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SODIUM BICARBONATE
- (NaHCO3)/Alkalizing Agent
- Des: 1)provides vascular bicarbonate to assist the buffer system in reducing the effects of metabolic acidosis 2)treatment of some overdoses.
- Ind: 1)tricyclic antidepressant and barbiturate overdose 2)refractory acidosis 3)hyperkalemia.
- CI: none when used in severe hypoxia or late cardiac arrest.
- PC: 1)may cause alkalosis if given in too large a quantity 2)may deactivate vasopressors 3)may precipitate w/ calcium chloride.
- Dose: 1 mEq/kg IV, then 0.5 mEq/kg/10:00. Ped: same as adult (may be given IO).
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THIAMINE
- (Thiamine)/Vitamin
- Des: vitamin B1, wh/ is required to convert glucose into energy.
- Ind: 1)coma of unknown origin 2)chronic alcoholism w/ associated coma 3)delirium tremens.
- CI: none.
- PC: known hypersensitivity to the drug.
- Dose: 100mg IV/IM. Ped: 10-25mg IV/IM.
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