Emergency Medications Flashcards

Practice the Mechanism of Action, Indications and Dosages of prehospital medications (146 cards)

1
Q

Mechanism of action.

Adenosine

A

Slows conduction at the AV node.

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2
Q

Indications and contraindications.

Adenosine

A

Indications:

  • SVT
  • PSVT

Relative Contraindications:

  • High degree heart block
  • COPD
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3
Q

Adult and pediatric dosages.

Adenosine

A

Adult: 6mg, 12mg, 12mg

Pediatric:

First Bolus - 0.1mg/kg
Second Bolus - 0.2mg/kg

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4
Q

Mechanism of action.

Albuterol

A

Beta 2 Agonist that causes bronchodilation.

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5
Q

Indications and contraindications.

Albuterol

A

Indications:

  • Bronchospasm
  • COPD/Asthma

Relative Contraindications:

  • Hypersensitivity
  • Tachycardia
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6
Q

Adult and pediatric dosages.

Albuterol

A

Adult: 2.5mg in 2.5ml Normal Saline

Pediatric:

<20kg = 1.25mg/20min

>20kg = 2.5mg/20min

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7
Q

Mechanism of action.

Alteplase

tPA

A

Converts plasminogen to plasmin → breaks down fibrin clots

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8
Q

Indications and contraindications.

Alteplase

tPA

A

Indications:

  • STEMI
  • Pulmonary embolism
  • CVA

Contraindications:

  • Internal hemorrhage
  • Recent surgery
  • Aneurysm
  • Significant hypertension
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9
Q

Adult and pediatric dosages.

Alteplase

tPA

A

Adult:

  • Bolus - 15mg/kg bolus/2min
  • Infusion - 0.75mg/kg/30min
  • 2nd Infusion - 0.50mg/kg/60min

Pediatric: N/A

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10
Q

Mechanism of action.

Amiodarone

A

Sodium and potassium channel blocker.

Increases action potential as an antidysrhythmic

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11
Q

Indications and contraindications.

Amiodarone

A

Indications:

  • Ventricular fibrillation
  • Pulseless ventricular tachycardia
  • Symptomatic/Stable ventricular tachycardia

Contraindications:

  • Sinus Bradycardia
  • Cardiogenic shock
  • Sinus node dysfunction
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12
Q

Adult and pediatric dosages.

Amiodarone

A

Adult:

  • V-Fib/Pulseless V-Tach - 300mg Bolus; Q3-5min 150mg Bolus; If conversion, 1mg/min infusion
  • Symptomatic/Stable V-Tach - 150mg/10min; if conversion, 1mg/min infusion

Pediatric:

  • V-Fib/Pulseless V-Tach - 5mg/kg Bolus; Q3-5min 5mg/kg MAX 300mg
  • Symptomatic/Stable V-Tach - 5mg/kg/20-60min
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13
Q

Mechanism of action.

Aspirin

A

Anti-aggregate

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14
Q

Indications and contraindications.

Aspirin

A

Indications:

  • STEMI
  • Angina

Contraindications: Allergies

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15
Q

Adult and pediatric dosages.

Aspirin

A

Adult: 160-325mg PO

Pediatric: N/A

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16
Q

Mechanism of action.

Atropine

A

Inhibits acetylcholine, which increases the heart rate.

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17
Q

Indications and contraindications.

Atropine

A

Indications:

  • Symptomatic or Unstable bradycardia
  • Beta blocker OD
  • Ca channel blocker OD

Contraindications:

  • Tachycardia
  • Hypothermic bradycardia
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18
Q

Adult and pediatric dosages.

Atropine

A

Adult: 0.5mg - 1.0mg

Pediatric: 0.02mg/kg

Minimum Dose of 0.1mg

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19
Q

Mechanism of action.

Calcium Chloride

A

Increases cardiac contractility by producing a positive inotropic effect.

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20
Q

Indications and contraindications.

Calcium Chloride

A

Indications:

  • Hypocalcemia
  • Hyperkalemia
  • Beta blocker and calcium channel blocker toxicity

Contraindications:

  • Hypercalcemia
  • Digitalis toxicity
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21
Q

Adult and pediatric dosages.

Calcium Chloride

A

Adult: 500mg - 1000mg

Pediatric: 20mg/kg MAX 1G

3x stronger than Calcium Gluconate; given through a central IV, not peripheral

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22
Q

Mechanism of action.

Calcium Gluconate

A

Increases cardiac contractility.

3x less potent than Calcium Chloride.

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23
Q

Indications and contraindications.

Calcium Gluconate

A

Indications:

  • Hyperkalemia
  • Hypocalcemia
  • Beta blocker and Ca channel blocker toxicity

Contraindications:

  • Hypercalcemia
  • Digitalis toxicity
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24
Q

Adult and pediatric dosages.

Calcium Gluconate

A

Adult: 500mg - 1000mg

Pediatric: 60-100mg/kg/5-10min

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25
# Mechanism of action. Dexamethasone
**Decreases airway inflammation** by suppressing acute inflammation. ## Footnote Corticosteroid
26
# Indications and contraindications. Dexamethasone
**_Indications:_** * Anaphylaxis * Asthma/COPD * Croup * Spinal cord injury **_Relative Contraindications:_** Sepsis
27
# Adult and pediatric dosages. Dexamethasone
**_Adult:_** 10-100mg **_Pediatric:_** 0.25 - 1.0mg/kg MAX 16mg
28
# Mechanism of action. Diazepam | Valium
It is a **benzodiazepine** that enhances the effect of **GABA**, an inhibitory neurotransmitter, by binding to GABA-A receptors. ## Footnote This increases chloride influx into neurons, resulting in CNS depression, sedation, muscle relaxation, and anticonvulsant effects.
29
# Indications and contraindications. Diazepam | Valium
**_Indications:_** * Seizures * Anxiety * Cocaine OD **_Relative Contraindications:_** * Decreased respiratory function * Head injury
30
# Adult and pediatric dosages. Diazepam | Valium
**_Adult:_** 5 - 10mg **_Pediatric:_** 0.2 - 0.5 mg/kg
31
# Mechanism of action. Diltiazem
Calcium channel blocker ## Footnote Blocks calcium influx during depolarization.
32
# Indications and contraindications. Diltiazem
**_Indications:_** Atrial Fibrillation/Flutter **_Contraindications:_** * Hypotension * Cardiogenic shock
33
# Adult and pediatric dosages. Diltiazem
**_Adult_**: * First Bolus - 0.25mg/kg MAX 20mg * Second Bolus - 0.35mg/kg MAX 25mg * Infusion: 5-15mg/hr **_Pediatric_**: N/A
34
# Mechanism of action. Dobutamine
It is a **beta-1 adrenergic agonist** that stimulates beta-1 receptors in the heart, leading to **increased** myocardial contractility and heart rate, which boosts stroke volume and cardiac output.
35
# Indications and contraindications. Dobutamine
**_Indications:_** Cardiogenic shock, CHF **_Contraindications:_** * Tachydysrhythmias * Severe hypotension *(initially causes hypotension)*
36
# Adult and pediatric dosages. Dobutamine
**_Adult & Pediatric_**_:_ 2-20mcg/kg/min
37
# Mechanism of action. Dopamine
**Increases** inotropic and chronotropic effects.
38
# Indications and contraindications. Dopamine
**_Indications:_** * Cardiogenic shock * Septic shock * Distributive shock * Bradycardia **_Contraindications:_** * Hypovolemic shock * V-Fib
39
# Adult and pediatric dosages. Dopamine
**_Adult & Pediatric_**: 2-20mcg/kg/min
40
# Mechanism of action. Epinephrine
* Alpha 1 agonist * Beta 1 agonist * Beta 2 agonist
41
# Indications and contraindications. Epinephrine ## Footnote Hint: Cardiac
**_Indications:_** * Asystole * PEA * V-fib * Pulseless V-tach * Bradycardia **_Contraindications:_** * Hypertension * Hypothermia * Pulmonary edema
42
# Adult and pediatric dosages. Epinephrine ## Footnote Hint: Cardiac
**_Adult_**: * Asystole/PEA/Pulseless V-Tach/V-Fib: 1mg IV/IO * Bradycardia/Hypotension: 2-10mcg/min * Anaphylaxis: 0.3 - 0.5mg IM **_Pediatric_**: * Asystole/PEA/Pulseless V-tach/V-Fib: 0.01mg/kg IV/IO * Bradycardia: 0.01mg/kg IV/IO * Infusion: 0.1 - 1mcg/min
43
# Mechanism of action. Furosemide
**Inhibits absorption of chloride and sodium** at proximal and distal tubules and loop of Henle. ## Footnote Causes increased urine output.
44
# Indications and contraindications. Furosemide
**_Indications:_** * CHF * Pulmonary edema * Hypertensive crisis **_Contraindications:_** * Hypovolemia * Hypotension * Electrolyte imbalances
45
# Adult and pediatric dosages. Furosemide
**_Adult_**: 0.5 - 1mg/kg; no response, double the dose **_Pediatric_**: 1mg/kg
46
# Mechanism of action. Labetalol
Alpha and beta antagonist ## Footnote Decreases blood pressure
47
# Indications and contraindications. Labetalol
**_Indication:_** Severe hypertension **_Contraindications:_** * Asthma * CHF * Shock * Bradycardia
48
# Adult and pediatric dosages. Labetalol
**_Adult_**: * 10mg IV; Repeat or double Q10min * Infusion: 2-8mg/min **_Pediatric_**: N/A
49
# Mechanism of action. Lidocaine
Sodium channel blocker ## Footnote Decreases automaticity
50
# Indications and contraindications. Lidocaine
**_Indication:_** * V-Tach * V-Fib **_Contraindication:_** * High degree heart block * Bradycardia with wide complexes
51
# Adult and pediatric dosages. Lidocaine
**_Adult_**: * Pulseless V-tach/V-Fib: 1-1.5mg/kg; Repeat .5-.75mg MAX 3mg/kg * Stable V-Tach: 1-1.5mg/kg; Repeat .5-.75mg/kg Q5-10min MAX 3mg/kg * Infusion: 1-4mg/min **_Pediatric_**: * Pulseless V-tach/V-Fib: 1mg/kg MAX 100mg * Infusion: 20-50mcg/kg/min
52
# Mechanism of action. Metoprolol
Decreases HR, conduction, contractility, and cardiac output. ## Footnote Selective Beta-1 antagonist
53
# Indications and contraindications. Metoprolol
**_Indications:_** * PSVT * A-Flutter * A-Fib *Reduces oxygen demand in STEMI patients.* **_Contraindications:_** * Heart failure * High degree heart block * Bradycardia
54
# Adult and pediatric dosages. Metoprolol
**_Adult_**: * STEMI: 2-4mg * NSTEMI/Unstable Angina: 1-5mg **_Pediatric_**: 0.1 - 0.2mg/kg MAX 5mg
55
# Mechanism of action. Nitroglycerine
* Dilates peripheral arteries. * Decreases preload and afterload. * Vasodilator
56
# Indications and contraindications. Nitroglycerine
**_Indications:_** * Acute Angina * NSTEMI * STEMI * CHF * Pulmonary Edema * Hypertension **_Contraindications:_** * Hypotension * Head Injury * Bradycardia * RV Infarction (relative)
57
# Adult and pediatric dosages. Nitroglycerine
**_Adult_**: * Tablet: 0.4mg * Spray: 1-2 Sprays MAX 3 * Infusion: 10mcg/min; Increase by 10mcg/min Q 3-5 MAX 200mcg/min **_Pediatric_**: N/A
58
# Adult and pediatric dosages. Nitropaste
**Adult**: ½'' to ¾'' (15-30mcg); cover with wrap and secure MAX 5'' (75mg) **Pediatric**: N/A
59
# Mechanism of action. Norepinephrine
Vasopressor; **Alpha and Beta agonist** causing peripheral vasoconstriction ## Footnote Positive inotropic effect and dilates coronary arteries.
60
# Indications and contraindications. Norepinephrine ## Footnote Hint: Cardiac
**_Indications:_** * Cardiogenic shock * Significant Hypotension **_Contraindications:_** Pregnancy (relative)
61
# Adult and pediatric dosages. Norepinephrine
**_Adult_**: 0.1 - 0.5mcg/kg/min **_Pediatric_**: 0.1 - 0.2mcg/kg/min
62
# Mechanism of action. Diphenhydramine
H1 histamine antagonist ## Footnote Decreases inflammatory response.
63
# Indications and contraindications. Diphenhydramine
**_Indications:_** * Allergic reaction * Anaphylaxis **_Contraindications:_** * Asthma (relative) * Hypertension (relative)
64
# Adult and pediatric dosages. Diphenhydramine
**_Adult_**: 25 - 50mg **_Pediatric_**: 1 - 2mg/kg
65
# Mechanism of action. Racemic Epinephrine
**Beta-2 agonist** for receptors in lungs and **relaxes bronchial smooth muscle**.
66
# Indications and contraindications. Racemic Epinephrine
**_Indications:_** * Croup * Laryngeal edema **_Contraindications:_** Epiglottitis
67
# Adult and pediatric dosages. Racemic Epinephrine
**_Adult_**: 5ml in 5ml NS **_Pediatric_**: * 0.25ml in 2.5ml NS (\<20kg) * 0.5ml in 2.5ml NS (20-40kg) * 0.75ml in 2.5ml NS (\>40kg)
68
# Mechanism of action. Methylprednisolone
Corticosteroid that **decreases airway inflammation**.
69
# Indications and contraindications. Methylprednisolone
**_Indications:_** * Anaphylaxis * Asthma * COPD **_Contraindications:_** Systemic fungal infections
70
# Adult and pediatric dosages. Methylprednisolone
**_Adult_**: 125mg **_Pediatric_**: 1 - 2mg/kg
71
# Mechanism of action. Rocuronium
**Antagonizes acetylcholine** at synaptic cleft. ## Footnote Non-depolarizing paralytic.
72
# Indications: Rocuronium
Rapid Sequence Intubation | RSI
73
# Adult and pediatric dosages. Rocuronium
**_Adult_**: 0.6 - 1.2mg/kg **_Pediatric_**: 0.6 - 1.2mg/kg ## Footnote *Typical is 1mg/kg*
74
# Mechanism of action. Succinylcholine
**Bind with acetylcholine** at synaptic cleft and creates fasciculations. ## Footnote Depolarizing paralytic.
75
# Indications: Succinylcholine
Rapid Sequence Intubation | RSI
76
# Adult and pediatric dosages. Succinylcholine
**_Adult & Pediatric:_** 1.5mg/kg **_Infant:_** 2mg/kg
77
# Mechanism of action. Terbutaline
Beta 2 agonist ## Footnote Relaxes smooth muscle of the bronchioles.
78
# Indications and contraindications. Terbutaline
**_Indications:_** * Asthma * COPD **_Contraindications:_** Tachydysrhythmias
79
# Adult and pediatric dosages. Terbutaline
**_Adult_**: 0.25mg SC **_Pediatric_**: N/A \<12 years old
80
# Mechanism of action. Vecuronium
**Competes with acetylcholine** at the synaptic cleft. ## Footnote Non-depolarizing paralytic
81
# Indication: Vecuronium
Rapid Sequence Intubation | RSI
82
# Adult and pediatric dosages. Vecuronium
**_Adult_**: 0.1mg/kg **_Pediatric_**: 0.1mg/kg
83
# Mechanism of action. Etomidate
**Induction agent**; hypnotic.
84
# Indications and contraindications. Etomidate
**_Indications:_** Induction for RSI **_Contraindications:_** Adrenal compromised patients
85
# Adult and pediatric dosages. Etomidate
**_Adult and Pediatric:_** 0.2 - 0.4mg/kg ## Footnote 0.3mg/kg typical dose.
86
# Mechanism of action. Fentanyl
analgesic/opiate
87
# Indications and contraindications. Fentanyl
**_Indications:_** Pain management **_Contraindications:_** Head injury (relative - use caution)
88
# Adult and pediatric dosages. Fentanyl
**_Adult and Pediatric:_** 1 - 2mcg/kg
89
# Mechanism of action. Glucagon
**Produces glycogenolysis within the liver** to access the glycogen stores to be used as energy.
90
# Indications and contraindications. Glucagon
**_Indications:_** * Hypoglycemia * Beta blocker OD * Ca channel blocker OD **_Contraindications:_** Hyperglycemia ## Footnote Be cautious in patients with liver failure as the drug may not be efficient.
91
# Adult and pediatric dosages. Glucagon
**_Adult:_** 0.5 - 1mg IM **_Pediatric:_** 0.03 - 0.1mg/kg IM
92
# Mechanism of action. Haldol
**Antipsychotic** that is a CNS depressant.
93
# Indications and contraindications. Haldol
**_Indications:_** Psychotic episodes **_Contraindications:_** * AMS * Shock * Hypoxia
94
# Mechanism of action. Heparin
**Anticoagulant** that prevents fibrogen to turn into fibrin.
95
# Indications and contraindications. Heparin
**_Indication:_** * STEMI * Pulmonary embolism * DVT **_Contraindications:_** * Bleeding * Recent surgery * Severe hypertension
96
# Adult and pediatric dosages. Heparin
**_Adult:_** * Bolus 60IU/kg * Infusion 12IU/kg/hr **_Pediatric:_** N/A
97
# Mechanism of action. Insulin
Allows the transport of glucose into the cells.
98
# Indications and contraindications. Insulin
**_Indications:_** * DKA * Hyperkalemia **_Contraindications:_** * Hypoglycemia * Hypokalemia
99
# Adult and pediatric dosages. Insulin
**_Adult:_** * Bolus 10-25IU SC, IM, IV * Infusion 0.1 IU/kg/hr **_Pediatric:_** 0.1 - 0.2 IU/kg/hr
100
# Mechanism of action. Atrovent | Ipratropium
**Anticholinergic** that produces bronchodilation and decreases mucus production.
101
# Indications and contraindications. Atrovent | Ipratropium
**_Indications:_** * COPD * Asthma **_Contraindications:_** Allergic
102
# Adult and pediatric dosages. Atrovent | Ipratropium
**_Adult and Pediatric:_** 250 - 500mcg Neb
103
# Mechanism of action. Toradol
**NSAID** that causes analgesia.
104
# Indications and contraindications. Toradol
**_Indications:_** Minor to moderate pain **_Contraindications:_** * Asthma * Bleeding disorders * Renal/liver failure
105
# Adult and pediatric dosages. Toradol
**_Adult:_** 30 - 60mg IM **_Pediatric:_** N/A
106
# Mechanism of action. Lorazepam | Ativan
**Benzodiazepine** that is a CNS depressant.
107
# Indications and contraindications. Lorazepam | Ativan
**_Indications:_** * Seizures * Anxiety **_Contraindications:_** Shock (relative)
108
# Adult and pediatric dosages. Lorazepam | Ativan
**_Adult:_** 2 - 4mg IM/IV **_Pediatric:_** 0.05 - 0.20 mg/kg IM/IV ## Footnote *Typically 0.1mg/kg*
109
# Mechanism of action. Magnesium Sulfate
Smooth muscle relaxer.
110
# Indications and contraindications. Magnesium Sulfate
**_Indications:_** * Eclampsia * Pre-term labor * Torsades de pointes * Severe asthma/COPD **_Contraindications:_** Myocardial insufficiency
111
# Adult and pediatric dosages. Magnesium Sulfate
**_Adult:_** * Eclampsia: Bolus 2 - 4G; Infusion 2G/30min * Torsades: 1 - 2G/5-20min **_Pediatric:_** * Torsades: 25 - 50mg/kg bolus MAX 2G * Status Asthmaticus: 25 - 50mg/kg/15-30min MAX 2G
112
# Mechanism of action. Mannitol
**Diuretic** that _decreases_ fluid within the intracellular space and _increases_ within the extracellular space.
113
# Indications and contraindications. Mannitol
**_Indications:_** * Head Injury (herniation) * Cerebral edema * Blood transfusion reactions **_Contraindications:_** * Hypotension * Pulmonary edema * CHF
114
# Adult and pediatric dosages. Mannitol
**_Adult:_** 0.5 - 1G/kg/10min **_Pediatric:_** 0.5 - 1G/kg/30-60min
115
# Mechanism of action. Methylprednisolone
**Corticosteroid** that decreases airway inflammation.
116
# Indications and contraindications. Methylprednisolone
**_Indications:_** * Anaphylaxis * Asthma * COPD **_Contraindications:_** Systemic Fungal Infections
117
# Mechanism of action. Midazolam | Versed
**Benzodiazepine** that causes CNS depression.
118
# Indications and contraindications. Midazolam | Versed
**_Indications:_** * Seizure * Sedation **_Contraindications:_** Shock
119
# Adult and pediatric dosages. Midazolam | Versed
**_Adult:_** 2 - 2.5mg **_Pediatric:_** 0.1 - 0.3mg/kg ## Footnote *Typically 0.1mg/kg*
120
# Mechanism of action. Morphine
Opioid that causes **analgesia**.
121
# Indications and contraindications. Morphine
**_Indications:_** * Pain management * CHF * STEMI **_Contraindications:_** * Hypotension * Decreased respiratory drive
122
# Adult and pediatric dosages. Morphine
**_Adult:_** 2 - 4mg **_Pediatric:_** 0.1 - 0.2mg/kg
123
# Mechanism of action. Naloxone
**Binds to narcotic receptor sites** inhibiting the effects of opioids.
124
# Indications and contraindications. Naloxone
**_Indications:_** Opiate OD **_Relative Contraindications:_** Caution in narcotic dependent patients ## Footnote Potentially may cause seizures.
125
# Adult and pediatric dosages. Naloxone
**_Adult:_** 0.4 - 2mg **_Pediatric:_** 0.1mg/kg
126
# Mechanism of action. Ondansetron | Zofran
**Serotonin antagonist**, which naturally causes nausea/vomiting.
127
# Indications and contraindications. Ondansetron | Zofran
**_Indications:_** Nausea/vomiting **_Contraindications:_** Long QT interval
128
# Adult and pediatric dosages. Ondansetron | Zofran
**_Adult:_** 4mg **_Pediatric:_** 0.1mg/kg
129
# Mechanism of action. Oral Glucose
**Glucose distribution** through the GI tract and buccal vasculature.
130
# Indications and contraindications. Oral Glucose
**_Indications:_** Hypoglycemia **_Contraindications:_** AMS unconscious
131
# Adult and pediatric dosages. Oral Glucose
**_Adult:_** 15G PO **_Pediatric:_** 5-15G PO
132
# Mechanism of action. Oxytocin | Pitocin
Increases contractions within the uterus.
133
# Indications and contraindications. Oxytocin | Pitocin
**_Indications:_** Postpartum hemorrhage **_Contraindications:_** N/A
134
# Adult and pediatric dosages. Oxytocin | Pitocin
**_Adult:_** 10IU IM; Infusion: 20-40mIU/min **_Pediatric:_** N/A
135
# Mechanism of action. Propofol
general anesthesia
136
# Indications and contraindications. Propofol
**_Indications:_** * Anesthesia * Induction * Sedation **_Contraindications:_** * Hypovolemia * Allergic to eggs, soy, and peanuts
137
# Adult and pediatric dosages. Propofol
**_Adult:_** Bolus: 1.5 - 3mg/kg; Infusion: 25-75mcg/kg/min **_Pediatric:_** Bolus: 2.5 - 3.5mg/kg; Infusion: 125-300mcg/kg/min
138
# Mechanism of action. Sodium Bicarbonate
Hydrogen ion buffer.
139
# Indications and contraindications. Sodium Bicarbonate
**_Indications:_** * Metabolic acidosis * Tricyclic antidepressant OD * Hyperkalemia * Prolonged crush injuries **_Contraindications:_** Respiratory/metabolic alkalosis
140
# Adult and pediatric dosages. Sodium Bicarbonate
**_Adult:_** 1mEq/kg **_Pediatric:_** 1mEq/kg
141
# Mechanism of action. Thiamine
**Vitamin B**, essential for energy metabolism.
142
# Indications and contraindications. Thiamine
**_Indications:_** * Delirium Tremens * Wernicke encephalopathy **_Contraindications:_** N/A
143
# Adult and pediatric dosages. Thiamine
**_Adult:_** 100mg **_Pediatric:_** 10 - 25mg
144
# Mechanism of action. Vasopressin
**Vasoconstrictor** that utilizes ADH for fluid retention.
145
# Indications and contraindications. Vasopressin
**_Indications:_** Second or third choice of vasopressor **Contraindications:** N/A
146
# Adult and pediatric dosages. Vasopressin
**_Adult:_** * Bolus: 40 IU * Infusion: 0.02 - 0.04 IU/min **_Pediatric:_** Bolus: 0.4 - 1 IU/kg