Term
| Medications carried per Protocol |
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Definition
| Cardizem, Dilaudid, Haldol, Ketamine, Labetalol, Nitro-bid, Pepcid, Pitressin, Sodium Bicarbonate, Valium, Xoponex, Zofran, Mag Sulfate, Midazolam, Succynocholine |
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Term
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Definition
| Studies in humans/animals show adverse effects which outweigh the benefits of the drug. High fetal risk, |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| Inhibits the influx of calcium ions during membrane depolarization of cardiac and vascular smooth muscle. Relaxes smooth muscle and slows conductions thru the AV node. |
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Term
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Definition
| 1) PSVT: conversion to sinus rhythm 2) Afib/flutter: temporary control of rapid ventricular rate. 3) HTN 4) Angina Pectoris |
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Term
| Cardizem (Contraindications) |
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Definition
1) Allergy 2) AMI and Hypotension 3) In Sick Sinus Syndrome
4) 2nd or 3rd d. Heart Block (except in presence of functioning pacemaker) 5) Don't use in Afib/Flutter assoc. with WPW or LGL syndrome
5) V-tach |
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Term
| Cardizem (Adverse Reactions) |
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Definition
| Hypotension, Aflutter, 1st/2nd d. Heart Block, Bradycardia, Chest pain, CHF, Syncope, Ventricular arrhythmias, V-fib, V-tach, N&V, Dizziness, Dyspnea, Headache |
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Term
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Definition
| Impaired hepatic or renal function |
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Term
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Definition
| 10mg slow IVP over 2 minutes (May repeat after 10 min. prn) max 20mg. |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| Anti-psychotic; Antipsychotic/Neuroleptic |
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Term
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Definition
| Acts on CNS to depress subcortical areas, midbrain, and ascending Reticular Activating System |
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Term
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Definition
| Acute psychotic disorders; severe behavioral problems in children; may be used in stimulant overdoses. |
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Term
| Haldol (Adverse Reactions) |
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Definition
| Mental depression, Respiratory depression, Cardiovascular depression, Hypotension, EKG changes with IV use (Torsades de Pointe), restlessness, Insomnia, Drowsiness, Seizures, Tachycardia |
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Term
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Definition
| Be prepared to ventilate; Extreme caution with Parkinson’s patients, Anticoagulatory therapy |
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Term
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Definition
| 5mg IV or IM; Pediatrics (contact medical control) |
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Term
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Definition
| Sedation may occur in minutes. Antipsychotic may take hours, days or weeks, |
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Term
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Definition
| 12-24 hours, but may persist for days |
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Term
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Definition
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Term
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Definition
| Use caution in elderly patients |
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Term
| Haldol (Contraindications) |
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Definition
| Hypersensitivity; Agitation secondary to hypoxia or shock; Not to be used in sedative overdoses. |
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Term
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Definition
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Term
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Definition
| Non barbiturate anesthetic |
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Term
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Definition
| Dissociative anesthetic with analgesic and hallucinogenic properties, |
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Term
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Definition
| General anesthesia in conjunction with other DAI medications; Sub anesthetic for conscious IO placement |
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Term
| Ketamine (Contraindications) |
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Definition
| Hypersensitivity; Sever untreated hypertension, Penetrating eye injury |
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Term
| Ketamine (Adverse Reactions) |
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Definition
| Nausea/vomiting; increased ICP, increased heart rate; increased blood pressure; hallucinations; abnormal behavior |
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Term
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Definition
| Make sure DAI medications are prepared prior to induction |
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Term
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Definition
| DAI Adult: 2mg/kg IBW; IV/IO max 200mg; Respiratory failure Pedi: 2mg/kg IBW, IV/IO max 54mg; Behavioral emergencies 40mg IM prn |
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Term
| Ketamine (IO sub anesthetic) |
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Definition
| Adult 0.5-1mg/kg, 100 mg max via SLOW; Pediatric 0.25 mg/kg IBW, 25mg max via SLOW |
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Term
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Definition
| 30 seconds IV; 3-4 minutes IM |
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Term
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Definition
| 10-20 minutes IV; 30-45 minutes IM |
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Term
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Definition
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Term
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Definition
| Catecholamine release has temporary effect on heart rate and blood pressure. |
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Term
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Definition
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Term
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Definition
| Antihypertensive; non-selective beta blocker |
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Term
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Definition
| dissociative anesthetic with analgesic and hallucinogenic properties; selectively blocks alpha-receptors and non selectively blocks beta-receptors; the alpha blocking actions lead to general vasodilation and reduced peripheral vascular resistance; the net cardiovascular effects are a decrease in blood pressure without reflex tachycardia or significant reduction in heart rate |
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Term
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Definition
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Term
| Labetalol (Contraindications) |
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Definition
| ASTHMA (only in the event of acute asthma attack); COPD (Only if you are treating COPD); Bradycardia, Hypotension, CHF or Cariogenic shock; and heart block >1st degree. |
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Term
| Labetalol (Adverse Reactions) |
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Definition
| 1) dizziness 2) headache 3) fatigue 4) postural hypotension 5) angina 6) bradycardia 7) CHF 8) nausea and vomiting 9) wheezing 10) dyspnea 11) increased airway resistance 12) bronchospasm |
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Term
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Definition
| 1) be prepared to ventilate 2) use with caution in patients taking antihypertensive agents 3) monitor vital signs 4) EKG 5) lung sounds 6) be alert for signs of CHF 7) heart block 8) bradycardia 9) postural hypotension 10) bronchospasm |
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Term
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Definition
| CVA, Hypertensive Emergencies, Pre-natal emergencies- 10mg slow IVP over 5 minutes, repeat q 10 minutes until desired BP is reached |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| Labetalol is passed in human breast milk; use in nursing mothers should be done cautiously |
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Term
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Definition
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Term
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Definition
| Antidysrhythmic, Electrolyte, Anticonvulsant |
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Term
| Mag Sulfate (indications) |
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Definition
| 1) Torsades de pointes 2) Seizure secondary to eclampsia 3) severe asthma 4) pre term labor |
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Term
| Mag Sulfate (contraindications) |
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Definition
| 1) Hypersensitivity 2) sinus bradycardia 3) pediatrics 4) severe HTN 5) 3rd degree HB 6)Dialysis |
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Term
| Mag Sulfate (Adverse Reactions) |
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Definition
| 1) hypotension 2) hypertension 3) dysrhythmias 4) facial flushing 5) diaphoresis 6) depressed reflexes 7) bradycardia |
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Term
| Mag Sulfate (precautions) |
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Definition
| 1) may cause circulatory collapse or cardiac and respiratory depression 2) use with caution in renal deficiency |
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Term
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Definition
1) Induced hypothermia- 1gm IVP
2) Torsades - Mix 1gm in 10ml NS IVP. Admin over 5min. May repeat X1 for total of 2gm
3) Acute Severe Asthma- mix 1 gm in 10ml NS IVP over 5min.
4) Pre-eclampsia- IV drip 5gms in 250ml D5W infused over 30 minutes 500ml/hr
5) Eclampsia - 4gm IVP over 2 minutes |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| During childbirth emergencies- Magnesium may cause hypotension and decreased respiratory drive. Use with caution. |
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Term
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Definition
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Term
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Definition
Short acting benzodiazepine
CNS depressant |
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Term
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Definition
Pre-synchronized cardioversion
External Cardiac Pacing
Seizures refractory to valium
Sedation for drug assisted intubation |
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Term
| Midazolam (Contraindications) |
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Definition
Hypersensitivity
Hypotension (MAP <70mmHG) |
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Term
| Midazolam (adverse reactions) |
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Definition
| 1) Hypotension 2) respiratory depression 3) headache 4) nausea 5) brady/tachy 6) PVC's 7) AMS 8) Laryngo/Bronchial spasms 9) dyspnea 10) drowsiness |
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Term
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Definition
Pre-synchronized cardioversion
External cardiac pacing
Seizures refractory to Valium
Sedation for drug assisted intubation |
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Term
| Midazolam (adult dosages) |
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Definition
1)TCP- 2.5mg IV/IN q 3 min. to effect max 10mg
2)Induced Hypothermia- 2.5 mg IVP, max 10mg
3)Cardioversion- 2.5mg IV/IN r. every 3-5 min. until adequate relaxation max 10mg
4) DAI - Pre intubation 5mg IV/IO; Post intubation - 2.5-10mg IVP
5) Behavioral 5mg IN, IM or IV |
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Term
| Midazolam (adult dosages con't) |
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Definition
1)Seizures (active w/o IV access) 5mg IM/IN max 10mg; (active seizing w/ IV access) 2.5mg-5mg slow IV titrate to effect.
2) head injuries (if patient combative) 2.5-5mg IVP q 3 minutes max 10mg
3) Eclampsia 2.5mg q 2 minutes IVP w/ a max of 10mg, if refractory to Mag |
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Term
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Definition
1) Synch Cardioversion 1.0mg/kg IV/IN q 3-5 min. until adequate relaxation max 5mg
2) Seizures (active seizing w/o IV access) 2.5mg IM/IN max 5mg; (active seizing w. IV access) 2.5mg IVP
3) Respiratory failure- o.1mg/kg IVP max 4mg |
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Term
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Definition
3-5 minutes dose dependent IV/IO
15 minutes IM |
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Term
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Definition
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Term
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Definition
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Term
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Definition
1) may cause apnea, esp, in children and elderly
2) effects intensified by ETOH and other CNS depressants
3) be prepared to support respirations
4) carefully monitor V/S including EKG & pulse Ox
5) 3 to 4 times stronger than Vallium
6) Use caution if MAP <70mmHg |
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Term
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Definition
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Term
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Definition
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Term
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Definition
1) Dilates arterial and venous vessels resulting in venous pooling
2) reduces preload and after load resulting in decreased myocardial workload and reduced oxygen demand
3) relaxes smooth muscle
4) dilates coronary vessels resulting in increased perfusion of the myocardium
5) relieves coronary vasospasm |
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Term
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Definition
Chest pain of suspected myocardial origin
Congestive heart failure/cardiogenic pulmonary edema |
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Term
| Nitro-Bid (contraindications) |
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Definition
S/S of neurological deficit
SBP <100mmHg
Recent use of Viagra
Cialis
Levity within the last 24 hours |
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Term
| Nitro-Bid (Adverse Reactions) |
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Definition
| Hypotension, Nausea/Vomiting, Headache, Postural Syncopy |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
Healthcare provider may experience adverse effects if accidentally handled or absorbed
Use caution in patients with possible right ventricular infarct |
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Term
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Definition
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Term
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Definition
| Histamine H2 - Receptor Antagonist |
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Term
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Definition
Competitively inhibits the action of histamine at the histamine H2- receptors
The antihistamine property functions to inhibit gastric acid secretion, and to inhibit the action of histamine from contributing to anaphylactoid reactions and/or anaphylaxis. |
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Term
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Definition
1) Allergic/Anaphylactic Reactions: in adult and pediatric patients. Pepcid is indicated even in the presence of hypotension.
2) GI bleeding: in adult patients not to be used for pediatric GI bleeding |
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Term
| Pepcid (contraindications) |
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Definition
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Term
| Pepcid (Adverse Reactions) |
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Definition
| Rare instances of arrhythmias and hypotension have been reported following rapid IV bolus. |
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Term
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Definition
1) GI bleed 20mg slow IVP over 2 minutes.
2) Allergic reaction 20mg slow IVP or IM over 2 min.
3) Pedi Allergic reaction- 0.5mg/kg IVP slow over 2min. max 20mg |
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Term
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Definition
| Admin. with a slow IVP over 2 minutes |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| Directly stimulates smooth muscle V1 receptors resulting in vasoconstriction |
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Term
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Definition
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Term
| Pitressin (contraindications) |
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Definition
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Term
| Pitressin (adverse reactions) |
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Definition
1) Ischemic chest pain
2) ADB distress
3) N/V
4) Tremors
5) Bronchial constriction
6) Uterine contraction
7) sweating |
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Term
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Definition
1) Severe hepatic disease
2) seizure disorder
3) congestive heart failure
4) impaired kidney function
5) asthma
6) migraines
7) elderly patients |
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Term
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Definition
| 40 U IV/IO to be given sequentially in the first admin of Epi |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| combines with hydrogen ions to form carbonic acid, increases blood pH |
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Term
| Sodium Bicarb (indication) |
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Definition
Overdose of tricyclic antidepressants
Prolonged arrest |
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Term
| Sodium Bicarb (contraindications) |
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Definition
| Not significant in the above situation |
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Term
| Sodium Bicarb (adverse reaction) |
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Definition
metabolic alkalosis
pulmonary edema |
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Term
| Sodium Bicarb (precautions) |
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Definition
| may deactivate vasopressors |
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Term
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Definition
PEA Bundle 1 amp
Crush Syndrome 50 mEq |
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Term
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Definition
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Term
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Definition
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Term
| Sodium Bicarb (pregnancy) |
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Definition
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Term
|
Definition
| Flush IV tubing before and after admin |
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Term
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Definition
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Term
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Definition
| Neuromuscular blocker (depolarizing) |
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Term
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Definition
| depolarizing neuromuscular block |
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Term
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Definition
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Term
| Succ's (contraindications) |
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Definition
1) Hypersensitivity
2) Hyperkalemia
3) Penetrating eye injury
4) Malignant hyperthermia
5) burns, multiple trauma and soft tissue >24 hrs old
6) suspected fractured larynx that prevents proper performance or sellick's maneuver |
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Term
| Succ's (adverse reactions) |
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Definition
1) dysrhythmias
2) prolonged apnea
3) respiratory depression
4) bronchospasm
5) increase in serum potassium
6) ICP
7) inability to perform adequate neurological exam |
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Term
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Definition
make sure all meds prepared prior to induction
Measures to control anxiety and pain must be utilized |
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Term
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Definition
| Adult- 1mg/kg max of 200mg |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
1) if consistent and dramatic temperature rise is observed, use whatever means necessary to lower patients temperature
2) muscle relaxation order: eyelids-jaw-limbs-abdominals-diaphragm-intercostal muscles
3) NO EFFECT ON CONSCIOUSNESS
4) enhances by lidocaine, procainamide, beta-blockers, and mag sulfate |
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Term
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Definition
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Term
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Definition
1) Benzodiazepine
2) CNS depressant
3) Non-barbituate sedative/hypnotic
4) anticonvulsant
5) anti-anxiety |
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Term
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Definition
Act on the brain and nerves (central nervous system) to produce a calming effect
It works by enhancing the effects of certain natural chemicals in the body (GABA) |
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Term
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Definition
| Seizures, Status Epilepticus, Acute anxiety states, skeletal muscle relaxant, management of alcohol withdrawal |
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Term
| Valium (contraindications) |
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Definition
Hypersensitivity
Use of other CNS depressants
Hypotension & various stated of shock |
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Term
| Valium (adverse reactions) |
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Definition
Headache
Cardiac arrest
Respiratory Depression
Apnea and Hypotension
Dizziness, Ataxia, Fatigue, Confusion
Transient Drowsiness |
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Term
|
Definition
Caution with hepatic dysfunction
Renal insufficiency or HX of drug addiction
Elderly/debilitated may require reduced dosage |
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Term
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Definition
Heat cramps 2.5mg IV r. X1 to 5mg max
Difficult Airway - may be substituted for Versed in 5mg increments slow IVP every 3-5 min. (max total 20mg) |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| rectal valium should be followed by tylenol suppository if patient is febrile and if tylenol suppository is available via family |
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Term
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Definition
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Term
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Definition
Bronchodilator
Beta 2 adrenergic agonist |
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Term
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Definition
| stimulates beta 2 adrenergic receptors (selective beta agonist) |
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Term
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Definition
| Bronchospasm associated with restrictive airway disease including asthma and COPD |
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Term
| Xopenex (contraindications) |
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Definition
Hypersensitivity to drug/class or components
MAO inhibitor use within 14 days
Not approved in children <6 yrs. age |
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Term
| Xopenex (adverse reactions) |
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Definition
Paradoxical bronchospasms
Possible EKG changes (flattened T waves, prolonged QT interval, ST segment depression) |
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Term
|
Definition
| caution with arrhythmias, CAD, HTN |
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Term
|
Definition
| 0.63mg q 5 minutes Max 3 doses |
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Term
|
Definition
| 5-15 minutes post inhalation |
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Term
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Definition
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Term
|
Definition
| not for use in children <6 yrs old |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| blocks serotonin, both peripherally on vagal nerve terminals and centrally in chemoreceptor trigger zone |
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Term
|
Definition
| patients experiencing nausea and vomiting |
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Term
| Zofran (contraindications) |
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Definition
| there are no absolute contraindications to the use of Zoran |
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Term
| Zofran (adverse reactions) |
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Definition
Anxiety, Dizziness, Drowsiness, Headache, Fatigue, Constipation, Diarrhea, Hypoxia, Urinary retention
Occasionally may cause: ABD pain, fever, feeling of cold, paresthesia, weakness |
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Term
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Definition
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Term
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Definition
N/V : 4mg IVP/IM
Hypertensive crisis: 4mg IVP or IM
Dysbarism & Decompression sickness: 4mg IVP/IM
Head Injury: 4mg IVP/IM
Pain Management after morphine- 4mg IVP or IM max of 8mg |
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Term
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Definition
| N/V: 2mg IV or IM r. once if necessary q. 5 min. Mx 4mg |
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Term
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Definition
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Term
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Definition
IV: 4-8 hours
IM: unknown |
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Term
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Definition
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Term
|
Definition
| Zoran may be given IM (undiluted) in absence of an IV |
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