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What 4 classes is epi
Sympoathomimetic
Vasopressor
inotrope
What is the MOA for epi
Stimulates beta and alpha receptors
beta more than alpha
What is the concentration and dose for IM epi for anaphylaxis
1g/1mL
0.3-0.5
What is the duration of IM Epi
5-15 minutes
What is the RPT time and dose for IM epi anaphylaxis
0.3-0.5mg q5-15 minutes
or start drip
What are 2 indications for respiratory epi
bronchodilator
croupe
What is 2 routes and dosages for respiratory epi
0.3-0.5mg IM
0.5mg Neb in 3mL of saline over 15 minutes
What is the RPT dosage and time for respiratory IM epi
q20min x3
What is the repeat time and dosage for neb respiratory epi
q2hr
0.5mg in 3mL NS over 15 minutes
What is the pediatric dosage for IM epi and max dosage
0.01mg/kg
0.3mg MAX
What is the pediatric dosage for neb epi
0.05mg/kg in 3mL NS over 15 minutes
What are the indications for vasopressor epi drip
hypotension
unstable bradycardia
What is the concentration for vasopressor epi drip vial
1mg/10mL
What is the dosage for vasopressor epi drip
2-20mcg/min IV/IO
How do you set up the fluid bag for a vasopressor epi drip (concentration, amount in bag, volume of bag)
1mg in 500mL NS
2mcg/mL
what is the dosage for pediatric vasopressor epi drip and how do you set up the bag
1mg/500mL NS
0.1-1mcg/kg/min IV/IO
What is the indication for push dose epi 2
hypotension
bradycardia
What is the dosage for push dose epi
5-20mcg
How do you reconstitute push dose epi and from what vial do you pull from. What is the reconstituted concentration
0.1mg from 1mg/10mL vial
+ 9mL NS
10mcg/mL
What is the RPT dose and time for push dose epi
5-20mcg
q2-5min
What is the weight cutoff for push dose epi
don’t use for less than 50kg
What is the indication for cardiac epi
Cardiac arrest
What is the dosage for cardiac epi
1mg IVP
What is the RPT dose and time for cardiac epi
1mg q3-5 min
What are 4 contraindications for respiratory epi
tachycardia
hypertension
arrythmia
chest pain
What is the indication for dphenhydramine (Benadryl)
Allergy
Anaphylaxis
What is the dosage for diphenhydramine (benadryl)
25-50mg IV IO PO
What is the class for diphenhydramine (benadryl) 2 things
Antihistamine
H1 blocker
What is the MOA for diphenhydramine (benadryl) 3
H1 receptor antagonist
sedative and anticholinergetic
Reverses EPS
What is the max dose and time for diphenhydramine (benadryl)
Max 50mg
What is the duration for diphenhydramine (benadryl)
4-8hr
What are 2 considerations to think of with diphenhydramine (benadryl)
Minor sedation
Pediatric paradoxal reactions
What is the pediatric dose for diphenhydramine (benadryl)
1mg/kg
What is the duration of anaphylaxis epi
5-15min
What is the duration of respiratory epi
5-15 min
What is the duration of push dose epi
1-2min
What is the duration of cardiac epi
3-5min
What is the indication for methylprednisalone (solumedrol) 3
Anaphylaxis
Asthma
Allergy
What class is methylprednisolone (solumedrol)
Systematic corticosteroid
What is the dose for methylprednisolone (solumedrol)
125mg IV IO
What is the MOA for methylprednisolone (solumedrol)
Synthetic glococorticoid that supresses inflammation
What is the duration for methylprednisolone (solu medrol)
4hrs
Can you repeat solu medrol
no
What are 3 contraindications for methylprednisolone (solu medrol)
head Tx
systematic fungal infection
GI bleed
What is the pediatric dosage for methylprednisolone (solumedrol)
1-2mg/kg
What is the indication for acetaminophen 2
fever
mild to moderate pain
What is the class for acetaminophen 2
antipyretic
analgesic
What is the MOA for acetaminophen
Unclear
Works centrally to reduce fever and pain pathways
What is the dosage and repeat time for acetaminophen
1000mg PO
q8h
What is the pediatric dose for acetaminophen and RPT time
15mg/kg
q4-6h
What is the adult max dose daily for acetaminophen
4g
Why do you caution use of acetaminophen and percocet
percocet is a combination drug
What class is acetazolamide 2
diuretic
carbonic anhydrase inhibitor
What is the MOA for acetazolamide 3
Inhibits carbonic anhydrase
Decreases H+ renal secretion
Increases Na, K, bicarb, h20 secretion
What is the prophylactic dose for acetazolamide
125mg PO
What is the treatment dose for acetazolamide
250mg PO
What is the max dose for acetazolamide and RPT time
250mg
q12h
What is the pediatric dose for acetazolamide
2.5mg/kg PO
What is the indication for acetazolamide
Acute mountain sickness
What is one contraindication for acetazolamide
Sulfa allergy
What are 3 adverse effects of acetazolamide
parasthesia
polyuria
dehydration
What is the duration for acetazolamide
4-12hr
What class is dexamethasone
systematic cortico steroid
What is the MOA for dexamethasone 3
Long acting
decreases inflammation
supresses normal immune response
What is the acute mountain sickness dose for dexamethasone
4mg PO
What is the HACE dose for dexamethasone
8mg IV IO PO
then 4mg q6h
What is the pediatric dose for dexamethasone
0.15mg/kg IV IO PO
What is the indication for dexamethasone 2
HACE
Severe acute mountain sickness
What are 4 considerations with dexamethasone (adverse effects and consideratioin)
descent is required
Restlessness
hyperglycemia
hypertension
What is the RPT time for dexamethasone
q6h
What is the duration of dexamethasone
24-72h
What class is Nifedipine
Calcium channel blocker
What is the MOA for Nifedipine 4
Inhibit Ca movement
vasodilation
reduce preload and afterload
no AV effect
What is the dosage for nifedipine ER and RPT time
30mg PO q12h
What is the normal release dose for nifedipine and RPT time
20mg PO q8h
What is the pediatric dose for nifedipine and RPT time
0.5mg/kg PO q8h
not recommended
What is the indication for nifedipine
HAPE
What are 2 considerations when using nifedipine
Descent is required
avoid hypotension
What is the duration for nifedipine
6-8h
What class is naloxone (narcan) 2
Antidote
Opioid Antagonist
What is the MOA for Naloxone (narcan)
Compettive opioid receptor inhibitor
What is the dose for naloxone
0.4-2mg IV IO IM IN
What is the pediatric dose for naloxone
0.1mg/kg IV IO IM IN up to adult dose
What is the indication for naloxone 2
respiratory depression from opioids
Unknown coma
What are 2 considerations when using naloxone
Use minimum needed
Caution in opioid dependents and neonates
What is the duration for naloxone
20-60 minutes
What is the RPT time and max dosage for naloxone
q2-3min
max 10mg
What class is flumazenil 2
Antidote
GABA (benzo) antagonist
What is the MOA for flumazenil
Inhibits activity on benzo receptor site on GABA benzo receptor complex
What is the dose for flumazenil 1st and 2nd
1st 0.2mg IV over 30 seconds
2nd 0.3mg over 30 seconds
What is the pediatric dose for flumazenil
0.01mg/kg up to adult dose
What is the indication for flumazenil
Reverse respiratory depression and sedation of benzo od
What are 3 contraindications for flumazeil
Chronic benzo use
TCA overdose
Seizure prone
What is the RPT dose for flumazenil and time
0.5mg over 30s
q1m
What is the max dose for flumazenil
3mg
What class is pralidoxme chloride (2-Pam) (duodote ATNAA) 2
Antidote
Cholinesterase reactivator
What is the MOA for pralidoxime chloride (2-pam)(duodote ATNAA)
reactivate acetylcholinesterase that has been inactiviated by poisoning
What is the dose for pralidoxime chloride (2pam)(duodote ATNAA)
600mg IM
What is the pediatric dose for pralidoxime chloride (2pam)(duodote ATNAA) and MAX dose
15mg/kg IM
max 600mgW
What is the indication for pralidoxime chloride (2pam)(duodote ATNAA) 2
Organophosphate
Nerve agent