Competitive narcotic and opiod antagonist
Ca+ channel blocker
5-10 mg q 15 min
0.4-2 mg MR q5 min
4-20 mg q 5 min
2nd Type II AV Heart Blocks
Partial/complete reversal of CNS/Respiratory depression by opiods and narcotics
Antidote for D50
Hypertension, tachydysrhythmias, fever, sweating
Vasocontsriction, headache, dizziness, dry mouth
Hypotension, tachydysrhythmias, irritability, GI upset, pulmonary edema
The max dose is appropriate as an initial dose, don't want to waste time.
Only give enough to reverse CNS/Resp depression, pts can become violent when they come out of their high.
You never want to repeat Narcan, pts need hospital intervention.
Narcans side effects are minimal, so give the pt as much as possible.
Hypoglycemia in conscious and alert pts.
Hyperglycemia in pts with a known blood glucose.
Hypoglycemia in unconscious pts.
Immediately for any unconscious pts.
No, D50 can be absorbed through the muscle surrounding the blown vein.
Yes, D50 can cause local tissure necrosis and burning at the site.
Yes, but they are minimal compared to the side effects of the hypoglycemia.
Extravasation is very unlikely and is least of your concerns in an unconsious pt.
None, in documented hypoglycemia. Use caution with a suspected intracranial bleed, D50 can increase ICP.
None, everyone can use more sugar.
Adults and Peds: 25 mg of 50% soln
Adults: 1 mg/kg 50% soln, Peds: 0.1 mg/kg 50% soln
Adults and Peds: 1mg/kg 50% soln
Adults: 1 amp of 50% soln. Pediatrics: 2ml/kg 25% soln.
Class IV antiarrhythmic
Pt with a 2nd degree Heart Block
Pt with PSVT refractory to vagal maneuvers
Pt with complete A-V dissociation
Pt with Sick Sinus Syndrome
Small peripheral IV, 6mg slow IV push, with an infusion of 12 mg in 1000mL NS over 1 hr
IV closest to heart, 6 mg rapid IV push, MR at 12mg in 1-2 min, MR 12mg dose once.
30mg slow IV in large vein over 10 min
6mg IM, MR at 12 mg IM in alternative site in 1-2 min.
Hypotension, heart attack, chest pressure, dyspnea, facial flushing
Cherry-red skin, hypertension
Pale, cool and clammy skin, hypertension and bradycardia
Wheezing, peripheral edema, hypertension
Vasopressor(low dose)2-5mcg/kg/min, Dopaminergic(medium dose)5-10mcg/kg/min, and Inotropic(high dose)>10mcg/kg/min
Inotropic(low dose)2-5mcg/kg/min, Vasopressor(medium dose)5-10mcg/kg/min, and Dopaminergic(high dose)>10mcg/kg/min
Dopaminergic(low dose)2-5mcg/kg/min, Inotropic(medium dose)5-10mcg/kg/min, and Vasopressor(high dose)>10mcg/kg/min
Short-term cardiac decompensation secondary to decreased contractility when no hypovolemia is present, increase organ perfusion.
Adrenal Gland tumor
Tachydysrhythmias, hypotension, vasoconstricion, dyspnea
Hypertension, flushing, petechiae
Bradycardia, heart blocks
Since dopamines doses are so varied, there are no signifcant side effects.
A pt with and opiod overdose who is experiencing CNS/Resp depression.
A pt who has severe uncontrolled pain from a rollover car accident with many obvious fractures and massive blood loss.
A pt who is actively seizing and is reported to have been seizing for the last 3 minutes without intermittent periods of consciousness.
A pt who is severly edamatous and volume depleted.
Class IV antiarrhythmic
Skeletal muscle relaxant, anticonvulsant, sedative/hypnotic.
Isotonic electrolyte soln.
Adults: 5-10 mg IV/IM Peds: 0.5-2 mg IV/IM
Adults: 2-5 mg IV/IM Peds: 2-5 mg IV/IM
Adults and Peds: 0.2-5mg/kg IV/IM
Adults: 0.5-2mg IV/IM Peds: 0.2-0.5mg IV/IM
Sodium Thiosulfate and Amyl Nitrate Inhalants
Epinephrine and Benadryl
Atropine and Glucagon
Anxiety, tachycardia, increased BP
Hypertension, bradycardia, cyanosis
Increased ICP, internal hemorrhage, hyperthermia
N/V, hypotension, dizziness, flushing, skin rash, tachycardia
1-2 mg IM, 2-4 mg ETT
12.5mg over 10-20 min MR at 0.5 original dose in 30 min
2-5 mg over 10-20 min, MR at 2x the original dose in 20min
400mg/kg over 10-20 min MR at 0.5 the original dose in 30 min
Amyl Nitrate Inhalants cause an increase in gluconeogenesis and glycogenolysis which increases blood glucose; overdose can lead to hyperglycemia
Amyl Nitrate Inhalants decrease conduction through the AV node, which caused decreased HR; overdose can lead to conduction disorders
Amyl Nitrate Inhalants relax blood vessels and increase blood and oxygen return to the heart while reducing workload; this can cause headache, dizzy, light-headedness; and overdose can lead to cyanosis, feeling of extreme pressure in head, weak and fast HR, unusual tired or weakness, SOB
0.3mL(1 ampule) MR q5 min if symptoms persist
3 mL(1 ampule) MR q5min if symptoms persist
0.3mL/kg MR q5min if symptoms persist
3mL/kg MR q5min if symptoms persist
A pt who is unconscious with an unknown etiology; admin rapid IV 1gm/kg.
A pt with a history of constipation x3days who is altered and complaining of severe abdominal pain; admin ETT 1gm/kg.
A conscious alert pt who called 9-1-1 stating they just took a handful of pills 5 minutes ago because their boyfriend broke up with them; admin PO 1gm/kg.
A pt who is obviously drunk and is vomiting uncontrollably, A&Ox2, and states they've had a fifth of vodka; admin PO 1gm/kg.