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69 Cards in this Set
- Front
- Back
what is the indication for adenosine?
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SVT
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what is the 1st dose dosing for adenosine (IV/IO)?
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0.1 mg/kg rapid push (max dose 6 mg)
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what is the 2nd dose dosing for adenosine (IV/IO)?
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0.2 mg/kg rapid push (max dose 12 mg)
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which drug is an adenosine receptor antagonist which reduces adenosine effectiveness?
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theophylline
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what are the indications for albumin?
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shock, trauma, burns
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what are the available forms of albumin?
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injection 5% (5 g/100 ml)
25 % (25 g/100 ml) |
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what is the dose of albumin IV/IO?
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0.5 to 1 g/kg by rapid infusion (10 to 20 ml/kg of 5% solution)
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onset of albumin?
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15 to 30 minutes
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MOA and resp SE of albumin?
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expands intravascular volume through colloid oncotic effect; monitor for signs of pulmonary edema
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what is the dose of albuterol when pt <20 kg?
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2.5 mg/dose PRN q20 mins
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what is the dose of albuterol when pt wt >20 kg
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5 mg/dose PRN q20 mins
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what is dose of continuous nebulizer for albuterol?
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0.5 mg/kg per hour continuous inhalation (maximum dose 20 mg/h)
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what is MDI dose of albuterol?
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4 to 8 puffs (inhalation) via ET tube prn q20 mins or with spacer if not intubated
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what may albuterol be combined with in nebulizer?
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ipratropium
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what are the indications of alprostadil?
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maintain patency of ductus arteriosus for ductal-dependent congenital heart disease
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what are the IV/IO doses of alprostadil?
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0.05-0.1 mcg/kg per injection for initial; 0.01-0.05 mcg/kg per minute infusion titrated to response
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actions of alprostadil?
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acts through PGE1 receptors to cause vasodilation of all arteries and arterioles (including ductus arteriosus); inhibits platelet aggregation; stimulates uterine and intestinal smooth muscle
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half life of alprostadil?
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5-10 minutes
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what is alprostadil?
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prostaglandin E1 and vasodilator
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indications of amiodarone?
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SVT, VT (with pulses), VF/pulseless VT
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what is the dose of IV/IO of amiodarone in SVT, VT (with pulses)?
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5 mg/kg load over 20 to 60 minutes (max dose 300 mg), may give up to 3 doses to max daily dose of 15 mg/kg (2.2 g in adolescents)
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what is the dose of IV/IO of amiodarone in pulseless arrest (VF/pulseless VT)?
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5 mg/kg rapid bolus (maximum dose 300 mg), repeat to maximum daily dose of 15 mg/kg (2.2 g in adolescents)
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what are the indications for amiodarone?
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SVT
VT (with pulses) VF/pulseless VT |
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Contraindications for amiodarone?
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Sinus node dysfunction, second or third degree AV block
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indications for atropine?
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symptomatic bradycardia caused by vagal stimulation or primary AV block, toxins/overdose (eg oragnophsophate, carbamate), rapid sequence intubation (RSI) (ie, age<1 year, age 1 to 5 years receiving succinylcholine, age>5 years receiving second dose of succinylcholine)
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what is the IV/IO dose of atropine symptomatic bradycardia?
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0.02 mg/kg (minimum dose 0.1 mg, max single dose 0.5 mg). May repeat dose once (maximum total dose for adolescent 3 mg). Larger doses may be needed for treatment of organophosphate poisoning
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what is the ET dose of atropine for symptomatic bradycardia?
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0.04 to 0.06 mg/kg
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what is the IV/IO dose of atropine for toxins/overdose (organophosphates, carbamate)?
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<12 0.02 to 0.05 mg/kg initially, then repeated q20-30 mins until muscarinic symptoms reverse
>12 yrs: 2 mg initially, then 1 to 2 mg q20-30 mins until muscarinic symptoms reverse |
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what are the atropine doses for rapid sequence intubation (RSI) IV/IO and IM?
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IV/IO: 0.01-0.02 mg/kg (minimum dose 0.1 mg, maximum dose 0.5 mg)
IM: 0.02 mg/kg |
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MOA of atropine?
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blocks acetylcholine and other muscarinic agonists at parasympathetic neuroeffector sites; increase heart rate + cardiac output by blocking vagal stimulation; reduces saliva production + increase saliva viscosity; causes mydriasis
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precautions re: atropine?
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doses <0.1 mg may cause paradoxical bradycardia; document clearly if used for pts with head injury b/c atropine causes the pupil to dilate
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what is the dose of calcium chloride for hypocalcemia, hyperkalemia, hypermagnesemia, calcium channel blocker overdose?
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cardiac arrest: 20 mg/kg (0.2 mL/kg) IV/IO bolus into a central venous line; may repeat if documented of suspected clinical indications persist
in a noncardiac situation: infuse over 30-60 minutes into a central line if available |
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what are the available forms of calcium chloride?
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injection 100 mg/ml (10%)
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calcium chloride versus calcium gluconate?
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20 mg/kg dose of calcium chloride 10% (0.2 mL/kg) IV or IO provides 5.4 mg/kg of elemental calcium. If only calcium gluconate is available, the equivalent dose is 0.6 mL/kg of a 10% solution (60 mg/kg)
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what is dexamethasone indicated for?
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croup and asthma
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what is the dexamethasone dose for croup po/IM/IV?
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0.6 mg/kg x1 (max dose is 16 mg)
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what is the po/IM/IV dose for dexamethasone- asthma?
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0.6 mg/kg q24h (max dose is 16 mg)
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what is the dose of dextrose for hypoglycemia?
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IV/IO: 0.5 to 1 g/kg
D50W: 1-2 ml/kg D25W: 2-4 ml/kg D10W: 5-10 ml/kg |
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what is the dose of diphenhydramine in anaphylatic shock?
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1-2 mg/kg q4-6 hrs (max dose - 50 mg)
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class of dobutamine?
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selective B1 adrenergic agent
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what is the indication of dobutamine?
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ventricular dysfunction
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what is the dose of dobutamine for congestive HF, cardiogenic shock?
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2 to 20 mcg/kg per minute infusion (titrate to desired response)
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what are the actions of dobutamine?
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stimulates B1 receptors (predominant effect): increases HR (SA node effect), increases myocardial contractility, automaticity, and conduction velocity (ventricular effect)
stimulates B2 receptors, producing increased HR + vasodilation b/c dobutamine has intrinsic alpha adrenergic blocking effects, it increases risk of hypotension in pts w/shock complicated by excessive vasodilation (e.g. septic shock) |
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what is the class of dopamine?
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catecholamine, vasopressor, inotrope
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what are the indications for dopamine?
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ventricular dysfunction, including cardiogenic shock, distrubituve shock
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what are the doses of dopamine for cardiogenic shock, distributive shock?
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2 to 20 mcg/kg per minute infusion (titrate to response)
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what are the actions of dopamine?
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stimulates alpha-adrenergic receptors (>15 mcg/kg per minute): increases SVR via constriction of arterioles
stimulates B1 adrenergic receptors (5 to 15 mcg/kg per minute): increases HR (SA node effect), increases myocardial contractility, automaticity, + conduction velocity (ventricular effect) stimulates B2-adrenergic receptors (5 to 15 mcg/kg per minute): increases HR, decreases SVR |
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what is the class of etomidate?
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ultra short-acting nonbarbituate, nonbenzodiazepine sedative-hypnotic agent with no analgesic properties
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indications for etomidate?
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sedation for rapid sequence intubation
sedative of choice for patients with hypotension, cardiovascular disease, and multiple trauma, agent of choice for pts with head trauma |
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dose of etomidate for RSI?
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0.2-0.4 mg/kg IV/IO (max: 20 mg) infused over 30-60 seconds produces rapid sedation that lasts 10-15 minutes
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what is a precaution in regards to etomidate?
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may suppress cortisol production after a single dose, consider administration of stress dose hydrocortisone (2 mg/kg; max 100 mg)
may cause myoclonic activity (coughing, hiccups) and may exacerbate focal seizure disorders |
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what are the indications for furosemide?
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pulmonary edema + fluid overload
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what are the doses of furosemide for pulmonary edema, fluid overload?
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1 mg/kg (typical max dose is 20 mg for pts not chronically on loops)
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what are the indications + doses for hydrocortisone?
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adrenal insufficiency (may be associated with septic shock) + IV/IO dose is 2 mg/kg bolus (max dose is 100 mg)
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actions of hydrocortisone?
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widespread effects on inflammatory response
increases expression of B-adrenergic receptors to improve catecholamine responsiveness |
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what class is inamrinone (Amrinone)?
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phosphodiesterase inhibitor, inodilator
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indications of inamrinone?
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myocardial dysfunction + increased SVR (eg, cardiogenic shock, post-cardiac surgery CHF)
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what are the doses of inamrinone for myocardial dysfunction + increased SVR?
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loading dose: 0.75 to 1 mg/kg slow bolus over 5 to 10 minutes (give over longer period if pt is unstable); may repeat twice (max total loading dose is 3 mg/kg)
5 to 10 mcg/kg per minute infusion |
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what are the actions of inamrinone?
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increases myocardial contractility
reduces preload and afterload by relaxation of vascular smooth muscle |
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what is the dose of ipratropium for asthma?
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250-500 mcg (inhaled) every 20 minutes x 3 doses
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what are the indications for lidocaine? class IB antiarrhythmic
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VF/pulseless VT
wide-complex tachycardia (with pulses) rapid sequence intubation (RSI); administer before laryngoscopy to blunt increase in ICP |
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what are the IV/IO of lidocaine for VF/pulseless VT, wide-complex tachycardia (with pulses)
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initial: 1 mg/kg loading bolus; repeat bolus dose if infusion initiated more than 15 minutes after initial bolus
maintenance: 20 to 50 mcg/kg per minute infusion (to follow bolus therapy) |
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what are the ET dose of lidocaine for VF/pulseless VT, wide-complex tachycardia (with pulses)
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2 to 3 mg/kg
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what is the IV/IO dose of lidocaine for RSI?
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1 to 2 mg/kg
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what are the indications for magnesium sulfate?
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asthma (refractory status asthmaticus)
torsades de pointes hypomagnesema |
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what are the doses for IV/IO for asthma, torsades de pointes, hypomagnesemia?
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status asthmaticus: 25 to 50 mg/kg by slow infusion (15 to 30 minutes) (maximum dose 2 g)
pulseless VT with torsades: 25 to 50 mg/kg bolus (max dose 2 g) VT with pulses associated wtih torsades or hypomagnesemia; 25 to 50 mg/kg over 10 to 20 minutes (max dose 2 g) |
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special considerations with magnesium?
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have calcium chloride (or gluconate) available if needed to reverse magnesium toxicity
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what are the doses for methylprednisolone IV/IO/IM load for asthma + anaphylactic shock
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load: 2 mg/kg (max 60 mg)
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what is the IV maintenance dose for methylprednisolone for asthma, anaphylactic shock?
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0.5 mg/kg every 6 hours or 1 mg/kg every 12 hours up to 120 mg/day
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