Term
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Definition
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• Positive inotropic agent |
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Term
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Definition
ACTIONS • Facilitates actin-myosin interaction in cardiac muscle and smooth muscle of tunica media
• Establishes electrical gradient to move K+ from plasma to cell in hyperkalemia
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Term
CALCIUM CHLORIDE
Indications
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Definition
INDICATIONS • Acute hyperkalemia in pts needing hemodialysis
• Hypotension from calcium channel blocker toxicity
• Wide QRS complex rhythms in hyperkalemia
• Magnesium Sulfate overdose
• Hypocalcemia
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Term
CALCIUM CHLORIDE
Dosage/ Route
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Definition
DOSAGE/ROUTE • See Hawaii S.O. for Renal Dialysis Cardiac Arrest
• In conscious patient, administer slowly ~ 1 ml/min. |
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Term
CALCIUM CHLORIDE
Standard Prep
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Definition
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Term
CALCIUM CHLORIDE
Side effects
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Definition
SIDE EFFECTS • May precipitate dig toxicity
• Cardiac arrhythmias
• May cause ventricular standstill in beating heart
• Metallic taste
• May cause pain or burning at IV site
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Term
CALCIUM CHLORIDE
Precautions
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Definition
PRECAUTIONS • Monitor VS and EKG
• Do not mix with sodium bicarbonate without flushing the line first since precipitate may form |
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Term
FENTANYL CITRATE
(SUBLIMAZE)
Class
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Definition
CLASS Narcotic Analgesic (Schedule II)
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Term
FENTANYL CITRATE
(SUBLIMAZE)
Action
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Definition
ACTION CNS Depressant, Binds to opiate receptors producing analgesia and euphoria
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Term
FENTANYL CITRATE
(SUBLIMAZE)
Indication
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Definition
INDICATION • pain
• maintenance of analgesia and adjunct to RSI
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Term
FENTANYL CITRATE
(SUBLIMAZE)
Dosage/ Route
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Definition
DOSAGE/ROUTE • 50 – 100 mcg/dose (0.05 – 0.1 mg) IM or IV/IO (slow 1-2 min)
max. dose 150 mcg (0.15 mg)
Onset: Immediate Peak: 3-5 min (IV) Duration: 30-60 min
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Term
FENTANYL CITRATE
(SUBLIMAZE)
Peds Dose
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Definition
PEDS DOSE • 1 – 2 mcg/kg IM or IV/IO (slow 1-2 min) [Need to contact BSP]
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Term
FENTANYL CITRATE
(SUBLIMAZE)
Contraindication
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Definition
CONTRAINDICATION • Hypersensitivity
• Shock
• Severe Hemorrhage |
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Term
FENTANYL CITRATE
(SUBLIMAZE)
Side effects
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Definition
SIDE EFFECTS • Respiratory depression
• Hypotension
• Bradycardia
• AMS
• N/V
• Dizziness
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Term
FENTANYL CITRATE
(SUBLIMAZE)
Precaution
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Definition
PRECAUTION • Use with caution in patients with traumatic brain injury
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Term
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Definition
CLASS Narcotic (opiate) analgesic
(Controlled Substance Schedule II)
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Term
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Definition
ACTIONS • Analgesic
• Reduces preload (increases venous capacitance) and reduces afterload (systemic vascular resistance) and decreases myocardial oxygen demand by reducing intramyocardial wall tension in pulmonary edema. Preload is reduced more effectively than afterload.
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Term
Morphine Sulfate
Indications
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Definition
INDICATIONS • Pain of AMI, burns, kidney stones, isolated extremity fractures
• Acute pulmonary edema
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Term
Morphine Sulfate
Dosage/ Route
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Definition
DOSAGE/ROUTE • See Hawaii S.O.
• Can be given IM if this route is ordered.
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Term
Morphine Sulfate
Standard Prep
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Definition
STANDARD PREP 10 mg/cc tubex
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Term
Morphine Sulfate
Peds Dose
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Definition
PEDS DOSE 0.1 mg/kg/dose SLOW IV (Dose not to exceed adult doses)
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Term
Morphine Sulfate
Contraindications
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Definition
CONTRAINDICATIONS • Allergies to opiates
• Hypovolemia/hypotension/shock
• Head injury with increased ICP when it can mask neurological deterioration (Same for CVA patient)
• Diminished LOC, coma
• Abdominal pain, unknown etiology
• Bronchial asthma
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Term
Morphine Sulfate
Side effects
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Definition
SIDE EFFECTS • Respiratory depression
• Hypotension (pronounced in geriatrics, peds, debilitated pts.)
• Decreased mental status
• Bradycardia (rare)
• Bronchospasm (rare)
N/V
Euphoria
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Term
Morphine Sulfate
Precautions
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Definition
PRECAUTIONS • Have resuscitation equipment & narcan available • Monitor VS, EKG, mental status
• Resp depression occurs before pt is aware of it
• Potentiates action of ETOH & CNS depressants
• Titrate to pt's decreased sensation of pain, not abolishment of pain
• May worsen bradycardia or heart block in Inferior MI (vagotonic effect)
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Term
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Definition
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Term
Sodium Bicarbonate Actions
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Definition
ACTION • Binds with H+ ions to form water & carbon dioxide, & with CO2 excreted by the
lungs decreases the acidity of the blood
• Cause potassium to shift into cells
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Term
Sodium Bicarbonate
Indications
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Definition
INDICATIONS • Patients with known preexisting metabolic acidosis (DKA) IIa
• Hyperkalemia I
• Tricyclic anitdepressant overdose IIa
• Phenobarbital overdose
• Alkalinize the urine in drug O.D.'s IIa
• After protracted arrests/long resuscitation IIb
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Term
Sodium Bicarbonate
Dosage/ Route
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Definition
DOSAGE/ROUTE • See Hawaii S.O. & Follow ACLS Algorithm (TCA O.D.)
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Term
Sodium Bicarbonate
Standard Prep
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Definition
STANDARD PREP 50 mEq/50 cc preloaded syringe
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Term
Sodium Bicarbonate
Peds Dose
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Definition
PEDS DOSE • See Hawaii S.O. & PALS Algorithm
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Term
Sodium Bicarbonate
Contraindication
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Definition
CONTRAINIDICATION Metabolic and Respiratory Acidosis
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Term
Sodium Bicarbonate
Side Effects
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Definition
SIDE EFFECTS • Paradoxical intracellular/tissue acidosis due to CO2 generation &
inadequate ventilations to rid CO2 which readily diffuses across cell
membranes
• Hypernatremia from large sodium load
• Hyperosmolarity from large sodium load
• May shift oxyhemoglobin dissociation curve to the left which causes a decrease in the release of O2 by hgb to the tissues
• Metabolic alkalosis
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Term
Sodium Bicarbonate
Precautions
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Definition
PRECAUTIONS • Dosing should ideally be governed by ABG values
• Bicarbonate therapy should be considered only after defib., CPR, ETT, ventilation, & trial of epinephrine
• Overly aggressive field use may result in metabolic alkalosis
• DO NOT MIX WITH CALCIUM CHLORIDE! Precipitates in line if not flushed well.
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