Cardiac Meds Indications & Doses Flashcards Flashcards

Conversion of PSVT to sinus rhythm.

ADULT: 6 mg rapid IVP: if no response after 1 - 2 minutes second dose of 12 mg rapid IVP. Max dose of 18 mgs.

PEDS: 0.1mg/kg: if no response after 1 - 2 minutes second dose of 0.2 mg/kg rapid IVP. Max dose of 12 mgs.

• Suppression of VFib/Pulseless Vtach refractory to defibrillation.
• Suppression of Vtach with a pulse.

Pulseless Vtach
ADULT: 300 mg IVP: Repeat dose 150 mg IVP
PEDS: 5mg/kg slow IVP

Vtach with a pulse
ADULT: 150 mg in 100 mL NS over 10 minutes.

Chest Pain suggestive of ACS

162 mg - 324 mg PO (chewed not swallowed)

• Hemodynamically significant bradycardia
• Organophosphate poisoning

Bradydysrhythmias
ADULT: 1 mg IVP every 3 - 5 min as needed.
PEDS: 0.02 mg/kg IV/ET/IO min single dose 0.1 mg and max single dose 1.0 mg

• Hyperkalemia
• Magnesium Sulfate OD
• Calcium Channel Blocker Toxicity
• Crush Syndrome

ADULT: 500 - 1000 mg of 10% solution slowly IV over 5 minutes; may repeat in 10 minutes. Max dose 1 gram

PEDS: 20mg/kg dose of 10% solution slow IV/IO; may repeat in 10 minutes. Max dose 1 gram

• Atrial Flutter
• AFib with RVR

ADULT: Initial Bolus 0.25mg/kg (average dose 20 mg) IV over two minutes. If response is inadequate may re-bolus after 15 minutes at 0.35 mg/kg over two minutes.

PEDS: not recommended

• Cardiogenic, Septic, or Spinal Shock
• Hypotension with low cardic output states
• Distributive Shock

ADULTS: 2 - 20 mcg/kg/min

PEDS: 2 - 20 mcg/kg/min

*rates determined by physician OLMC

• Cardiac arrest, asystole, PEA, VF unresponsive to defibrillation.
• Anaphylaxis.
• Severe bronchospasm, Asthma, Bronchiolitis, acute allergic reactions.

ADULT: Cardiac: 1 mg IV push (1:10,000) every 3-5 minutes. Anaphylaxis: 0.3 - 0.5 mg (3-5mL 1:10,000) IV. Respiratory & Allergic Reactions: 0.3 - 0.5 mg (0.3 - 0.5mL 1:1000) IM

• Analgesic action of short duration during the anesthetic periods of RSI premedication, induction and maintenance.
• Narcotic analgesic supplement in general or regional anesthesia.

ADULT: 1mcg/kg to max 150 mcg slow IVP

PEDS: Not tested for <2 yo follow your protocols.

• CHF
• Pulmonary Edema

ADULTS: 0.5 - 1.0 mg/kg slow IVP

PEDS: 1 mg/kg/dose IV, IO.

*Medical Control Option

Suppression of ventricular dysthythmias (Vtach, VFib, PVC runs).

Prophylaxis against recurrence after conversion from Vtach/Vfib.

ADULTS: Cardiac arrest Vtach/Vfib: 1 - 1.5 mg/kg IV push; repeat dose 0.75 mg/kg to max dose of 3mg/kg. After conversion to NSR begin maintenance infusion at 2-4mg/min. VTach w/pulse: 1 - 1.5 mg/kg IV push; then 0.5 -0.75 mg/kg q 3 -5 minutes to max dose of 3 mg/kg, begin maintenance infusion at 2 - 4 mg/min ASAP.

• Acute asthma/Bronchospasm
• Seizures of eclampsia (toxemia of pregnancy)
• Torsades de Pointes
• Hypomagnesemia
• TCA overdose-induced dysrhythmias
• Digitalis induced dysrhythmias
• Class IIa agent for refractory Vfib and Vtach after administration of Amiodarone.

ADULT: Bronchospasm: 2 - 4 grams IV in 100 mL of NS over 5 minutes. Seizure activity with associated pregnancy: 1 - 4 grams IV over 10 minutes Torsades or refractory VF/VT: 1 - 2 grams IV over 1 - 2 minutes.

PEDS: Asthma/Bronchitis severe: 25 - 50 mg/kg over 10 minutes IV (usually mixed in 50 -100 mL of NS.

• Atrial Flutter
• Atrial Fibrillation

ADULT: 5 mg over 1 - 2 minutes slow IVP, may repeat every 3 - 5 minutes to a max of 15 mg.

*Medical Control Option

PEDS: Not recommended

• Analgesia for moderate to severe acute and chronic pain (use with caution).
• Severe CHF, PE.
• Chest pain associated with acute MI.

ADULTS: 0.1 mg/kg to max dose of 10 mg IV/IM/SC

PEDS: 0.1 - 0.2 mg/kg/dose IV/IO/IM/SC every 5 minutes titrated to max dose of 5 mg

• Acute angina pectoris.
• Ischemic chest pain.
• CHF, PE.

ADULTS: Tablets - 0.4 mg SL; may repeat in 3 - 5 minutes to max of 3 doses. NTG Spray - 0.4 mg on or under the tongue; 1 -2 sprays, may repeat in 3 - 5 minutes.

PEDS: Not recommended

• Cardiogenic shock unresponsive to fluid resuscitation
• Significant hypotension (<70 mm/Hg systolic)
• First line vasopressor in septic shock

ADULTS: 0.1 - 0.5 mcg/kg/min titrating to a BP of 90 systolic.

PEDS 0.1 - 0.2 mcg/kg/min titrating to achieve desired change in BP and systemic perfusion.

Confirmed or expected hypoxemia.

Ischemic chest pain.

Respiratory insufficiency.

Prophylactically during air transport.

Confirmed or suspected carbon monoxide poisoning.

All other causes of decreased tissue oxygenation.

Decreased level of consciousness.

ADULT: Cardiac arrest & Carbon Monoxide poisoning: 100% Hypoxemia: 10 - 15 L/min via NRB COPD: 0 - 2 L/min via NC

PEDS: same as adult EXCEPT for preemies

** Be prepared to provide ventilatory support if higher concentrations are needed with COPD patients

• Hyperkalemia
• TCA overdose
• Phenobarbital OD
• Known pre-existing bicarbonate-responsive acidosis.
• Upon ROSC after long arrest interval.
• Alkalinization for treatment of specific intoxications.

ADULTS: 1 mEq/kg IV; may repeat with 0.5 mEq/kg every 10 minutes.

PEDS: same as adults.