CLASS: antidysrhythmic
ACTIONS: slows atrioventricular conduction
INDICATIONS: symptomatic PSVT
CONTRAINDICATIONS: second or third degree heart block, sick sinus syndrome, known hypersensitivity to drug, Wolf Parkinson White syndrome
PRECAUTIONS: dysrhythmias, including blocks, are common at the time of cardioversion, use with caution in patients with asthma
SIDE EFFECTS: facial flushing, headache, SOB, dizziness, nausea
ROUTE: IV/IO; should be administered directly into a vein or into the medication administration port closest to the patient and followed by flushing of the line with IV fluid
ADULT DOSAGE: 6 mg rapid IV bolus over 1-2 seconds, if after 1-2 minutes, cardioversion doesn't occur, administer a 12 mg dose over 1-2 seconds
PEDIATRIC DOSAGE: safety in children has not been established CLASS: antidysrhythmic
ACTIONS: prolongs action potential and refractory period, slows the sinus rate, prolongs PR and QT intervals, decreased peripheral vascular resistance
INDICATIONS: life threatening cardiac dysrhythmias such as V-Tach and V-Fib
CONTRAINDICATIONS: severe sinus node dysfunction, sinus bradycardia, second and third degree AV block, hemodynamically significant bradycardia
PRECAUTIONS: heart failure
SIDE EFFECTS: hypotension, nausea, anorexia, malaise/fatigue, tremors, pulmonary toxicity, ventricular ectopic beats
ROUTE: IV/IO, PO
ADULT DOSAGE: loading dose of 150 mg over 10 mins (15 mg/min), maintenance dose of 1 mg/min for 6 hrs, then 0.5 mg/min until dysrhythmia is controlled or oral therapy begins
PEDIATRIC DOSAGE: 5 mg/kg IV/IO, maximum dose of 15 mg/kg CLASS: parasympatholytic (anticholinergic)
ACTIONS: blocks ACh receptors, increases HR, decreases GI secretions
INDICATIONS: hemodynamically significant bradycardia, hypotension secondary to bradycardia, organophosphate poisoning
CONTRAINDICATIONS: none when used in emergency situations
PRECAUTIONS: dose of 0.04 mg/kg should not be exceeded except in cases of organophosphate poisonings, hypertension, tachycardia
SIDE EFFECTS: palpitations, tachycardia, headache, dizziness, anxiety, dry mouth, pupillary dilation, blurred vision, urinary retention
ROUTE: IV/IO, ETT (2-2.5 x IV dose)
ADULT DOSAGE: Bradycardia - 0.5 mg every 3-5 mins to maximum of 0.04 mg/kg, Organophosphate Poisoning - 2-5 mg
PEDIATRIC DOSAGE: Bradycardia - 0.02 mg/kg (minimum dose of 0.1 mg), child/adolescent maximum single dose - 0.5 mg/1.0 mg, child/adolescent maximum total dose - 1.0 mg/2.0 mg CLASS: tranquilizer (benzodiazepine)
ACTIONS: anticonvulsant, skeletal muscle relaxant, sedative
INDICATIONS: major motor seizures, status epilepticus, premedication before cardioversion, skeletal muscle relaxant, acute anxiety states
CONTRAINDICATIONS: known hypersensitivity to the drug
PRECAUTIONS: can cause local venous irritation, short duration of effect, do not mix with other drugs due to precipitation problems, Flumazenil (Romazicon) should be available
SIDE EFFECTS: drowsiness, hypotension, respiratory depression and apnea
ROUTE: IV/IO (do not administer faster than 1 mL/min), IM, PR
ADULT DOSAGE: Status Epilepticus - 5-10 mg IV, Acute Anxiety - 2-5 mg IV or IM, Pre-Cardioversion - 5-15 mg IV
PEDIATRIC DOSAGE: Status Epilepticus - 0.1-0.2 mg/kg CLASS: calcium channel blocker
ACTIONS: slows conduction through AV node, causes vasodilation, decreases rate of ventricular response, decreases myocardial oxygen demand
INDICATIONS: to control rapid ventricular rates associated with a-fib and a-flutter, angina pectoris
CONTRAINDICATIONS: hypotension, wide-complex tachycardias, conduction system disturbances
PRECAUTIONS: should not be used in patients recieving venous beta blockers, hypotension, must be kept refrigerated
SIDE EFFECTS: nausea/vomiting, hypotension, dizziness
ROUTE: IV/IO, IV drip
ADULT DOSAGE: 0.25 mg/kg bolus (typically 20 mg) IV over 2 mins, followed by a maintenance infusion of 5-15 mg/hr
PEDIATRIC DOSAGE: rarely used CLASS: sypathomimetic
ACTIONS: bronchodilation
INDICATIONS: bronchial asthma, COPD exacerbation, allergic reactions, pediatric cardiac arrest (after initial epinephrine dosage)
CONTRAINDICATIONS: patients with underlying cardiovascular disease, hypertension, pregnancy, patients with tachydysrhythmias
PRECAUTIONS: should be protected from light, BP, HR, and ECG results should be constantly monitored
SIDE EFFECTS: palpitations and tachycardia, anxiousness, headache, tremor
ROUTE: subcutaneous
ADULT DOSAGE: 0.3-0.5 mg
PEDIATRIC DOSAGE: 0.01 mg/kg up to 0.3 mg CLASS: sympathomimetic
ACTIONS: increases HR and automaticity, increases cardiac contractile force, increases myocardial electrical activity, increases systemic vascular resistance, increases BP, causes bronchodilation
INDICATIONS: cardiac arrest, anaphylactic shock, severe reactive airway disease
CONTRAINDICATIONS: for IV use and shouldn't be used in patients who do not require extensive resuscitation efforts
PRECAUTIONS: should be protected from light, can be deactivated by alkaline solutions
SIDE EFFECTS: palpitations, anxiety, tremulousness, nausea/vomiting
ROUTE: IV, IV drip, ETT (2-2.5 x IV dose)
ADULT DOSAGE: Cardiac Arrest - 0.5 mg-1.0 mg every 3-5 mins, Severe Anaphylaxis - 0.3-0.5 mg (3-5 mL), occasionally an epinephrine drip is required
PEDIATRIC DOSAGE: 0.01 mg/kg initially, with repeated doses (Epinephrine 1:1000 should be used at 0.1 mg/kg) CLASS: antidysrhythmic
ACTIONS: suppresses ventricular ectopic activity, increases ventricular fibrillation threshold, reduces velocity of electrical impulse through the conductive system
INDICATIONS: malignant PVC's, V-Tach, V-Fib, prophylaxis of dysrhythmias associated with fibrinolytic therapy
CONTRAINDICATIONS: high degree heart blocks, PVC's in conjunction with bradycardia
PRECAUTIONS: dosage should not exceed 300 mg/hr, monitor for CNS toxicity, dosage should be reduced by 50% in patients older than 70 yrs. or patients with liver disease, in cardiac arrest only use the bolus therapy
SIDE EFFECTS: anxiety, drowsiness, dizziness, confusion, nausea/vomiting, convulsions, widening of QRS complex
ROUTE: IV/IO bolus, IV infusion
ADULT DOSAGE: Initial Bolus - 1.0-1.5 mg/kg, additional boluses of 0.5-0.75 mg/kg can be repeated at 3-5 min intervals until dysrhythmia is suppressed or max dose of 3 mg/kg has been reached, IV Drip - 2-5 mg/min IV infusion to maintain adequate blood levels after dysrhythmia has been suppressed
PEDIATRIC DOSAGE: 1 mg/kg CLASS: tranquilizer (benzodiazepine)
ACTIONS: anticonvulsant, sedative
INDICATIONS: major motor seizure, status epilepticus, premedication before cardioversion, acute anxiety
CONTRAINDICATIONS: hypersensitivity to the drug
PRECAUTIONS: short duration of effect, do not mix with other drugs due to precipitation problems, Flumazenil (Romazicon) should be available, dilute with NaCl of D5W prior to IV administration
SIDE EFFECTS: drowsiness, hypotension, respiratory depression and apnea
ROUTE: IV, IM, PR
ADULT DOSAGE: 0.5-2.0 mg IV, may be increased to 1.0-4.0 mg IV
PEDIATRIC DOSAGE: 0.05-0.10 mg/kg (max dose of 4 mg) CLASS: anticonvulsant and antidysrhythmic
ACTIONS: CNS depressant, anticonvulsant, antidysrhythmic
INDICATIONS: Obstetrical - eclampsia (toxemia of pregnancy), Cardiovascular - severe refractory V-Tach, post myocardial infarction as prophylaxis for dysrhythmias, torsades de pointes (multiaxial V-Tach)
CONTRAINDICATIONS: shock, heart block
PRECAUTIONS: caution should be used in patients recieving digitalis, hypotension, CaCl2 should be readily available as an antidote if respiratory, use caution in patients with renal failure
SIDE EFFECTS: flushing, respiratory depression, drowsiness
ROUTE: IV, IM
ADULT DOSAGE: 1-4 g
PEDIATRIC DOSAGE: not indicated CLASS: sympathetic blocker (beta 1 selective)
ACTIONS: selectively blocks beta 1 adrenergic receptors (cardioprotective)
INDICATIONS: suspected or definite acute myocardial infarction in patients who are hemodynamically stable
CONTRAINDICATIONS: HR < 45 BPM, systolic < 100, heart block, shock, history of asthma
PRECAUTIONS: BP, HR, and ECG results should be monitored, atropine and transcutaneous pacing should be available
SIDE EFFECTS: bradycardia, heart block, CHF, depression, bronchospasm,
ROUTE: slow IV bolus
ADULT DOSAGE: Initial bolus - 5 mg slow IV injection, may repeat (up to 2 times) 5 mg bolus in 10 mins if vitals are stable
PEDIATRIC DOSAGE: safety in children has no been established CLASS: tranquilizer (benzodiazepine)
ACTIONS: hypnotic, sedative
INDICATIONS: premedication before cardioversion, acute anxiety states
CONTRAINDICATIONS: hypersensitivity to the drug, narrow-angle glaucoma, shock
PRECAUTIONS: emergency resuscitation equipment must be available, Flumazenil (Romazicon) should be available, dilute with NaCl of D5W prior to IV administration, respiratory depression more common with midazolam than with other benzodiazepines
SIDE EFFECTS: drowsiness, hypotension, amnesia, respiratory depression and apnea
ROUTE: IV, PO, Nasal Atomizer
ADULT DOSAGE: 1.0-2.5 mg IV
PEDIATRIC DOSAGE: 0.03 mg/kg CLASS: narcotic
ACTIONS: CNS depressant, peripheral vasodilation, descreases sensitivity to pain
INDICATIONS: severe pain, pulmonary edema
CONTRAINDICATIONS: head injury, volume depletion, hypersensitivity to the drug
PRECAUTIONS: respiratory depression (naloxone should be available), hypotension, nausea
SIDE EFFECTS: dizziness, altered LOC
ROUTE: IV, IM
ADULT DOSAGE: IV - 2-5 mg followed by 2 mg every few minutes until pain is relieved or respiratory depression ensues, IM - 5-15 mg based on the patient's weight
PEDIATRIC DOSAGE: 0.1-0.2 mg/kg IV CLASS: narcotic antagonist
ACTIONS: reverses effects of narcotics
INDICATIONS: narcotic OD including: morphine, Dilaudid, fentanyl, Demerol, paragoric, methadone, heroin, Percodan, and Tylox, Sythetic Analgesic OD including: Nubain, Stadol, Talwin, Darvon, and alcoholic coma, to rule out narcotics in coma of unknown origin
CONTRAINDICATIONS: hypersensitivity to the drug
PRECAUTIONS: may cause withdrawal effects in narcotic dependent patients, short acting (should be augmented every 5 mins), should never be used as part of a "coma cocktail"
SIDE EFFECTS: rare
ROUTE: IV, IM, ETT (2-2.5x IV dose), Nasal Atomizer
ADULT DOSAGE: 1-2 mg
PEDIATRIC DOSAGE: <5 yrs - 0.1 mg/kg, >5 yrs - 2.0 mg CLASS: antianginal
ACTIONS: smooth muscle relaxant, reduces cardiac work, dilates coronary arteries, dilates systemic arteries
INDICATIONS: angina pectoris, CP associated with mycardial infarction
CONTRAINDICATIONS: children < 12 yrs, hypotension (systolic <100)
PRECAUTIONS: constantly monitor BP, syncope, drug must be protected from light, expires quickly once bottle is opened
SIDE EFFECTS: headache, dizziness, hypotension
ROUTE: sublingual
ADULT DOSAGE: one tablet (0.4 mg) repeated at 5 minute intervals to a max of 3 doses or until systolic < 100
PEDIATRIC DOSAGE: not indicated