Pharmacology Week One

Parasympatholytic/Anticholinergic

Blocks the parasympathetic nervous system, specifically the vagal effects on the heart. It doesn't increase heart contractility, but may increase myocardial oxygen demand. Decreases airway secretions.

Hemodynamically Significant Bradycardia/ Organophoshate Poisoning

None in the emergency setting

A-Fib/ V-Fib
Headache
ALOC
Dizziness/Weakness
May increase size of MI
Hypertension/Hypotension

0.5-1.0mg IVP/IO (repeat every 3-5 mins) (Max dose of 3.0mg)

0.02mg/kg IV/IO (Minimum single dose of 0.1mg)

2-5mg IV/IO (repeat every 10-15 mins)

0.05mg/kg IV/IO/IM

Carbohydrate

The body's principle form of glucose to use for energy

Hypoglycemia

None with hypoglycemia

Pain on injection site
Hyperglycemia
Necrosis

25g (D50) IV/IO/PO

0.5 g/kg (D25) IV/IO/PO

0.2g/kg (D10) IV/IO/PO

Sympathomimetic

Epinephrine is a naturally occurring catecholamine that increases heart rate, contractility force, myocardial electrical activity, systemic vascular resistance, and SBP. Epinephrine decreases overall airway resistance and automaticity. Also through bronchial artery constriction may reduce pulmonary congestion and increase tidal volume and vital capacity.

Restoring Cardiac Rhythms in Cardiac Arrest, Allergic Reaction/Anaphylaxis, Bradycardia refractory to dopamine

None in the emergency setting
Cardiogenic Shock
Hemmorrhagic Shock
Hypertension

HTN
Weakness/Dizziness
Headache
Syncope
Tachycardia
MI/CVA

1mg (1:10000) IV/IO (repeat every 3-5 mins PRN)
2-2.5mg ETT (1:1000) (repeat every 3-5 mins until vascular access is achieved)

0.3-0.5mg (1:1000) SC/IM (Repeat every 3-5 min PRN)
0.5-1.0mg (1:10000) IV/IO (If SC/IM ineffective)

2-10 mcg/min

0.01 mg/kg IV/IO (repeat every 3-5 mins)
0.1 mg/kg ETT (repeat every 3-5 mins until vascular access)

0.01mg/kg (1:1000)SC/IM (repeat every 10-15 mins PRN)
0.01 mg/kg (1:10000) IV/IO if SC/IM ineffective (repeat every 3-5 mins PRN)

General Anesthetic

Produces dissociative anesthetia, blocks NDMA receptors. Similar chemical makeup to PCP (shorter acting and less toxic)

Sedation/Analgesia instead of benzos

Known Hypersensitivity
Isolated Headinjury with ICP
Used in conjuction with Benzos
Hypertension

Hypertension
Tachycardia
Increased ICP

1-3 mg/kg IV/IO

0.1-0.5 mcg/min

0.1-0.3 mg Slow IV/IO Push over 1 min or IM/IN (repeat every 10 mins) Max Dose 15mg

0.5-3.0 mg/kg IV/IO

0.1-0.3 mg Slow IV/IO Push over 1 min or IM/IN (repeat every 10 mins) Max Dose 15 mg

Antiarrhythmic, Sodium Channel Blocker

- Depresses the automaticity of the Perkinje Fibers, raising the depolarization threshold in the ventricular fibers and decreases tendency to fibrillate
- Little antiarrhythmic effects on atrial muscles at sub-toxic level
- Decreased conduction rate and force of contraction, mainly at toxic levels
- Prolongs phase 4 depolarization and shortens action potential
- Tremors, restlessness, clonic convulsions, followed by respiratory depression and respiratory failure at higher levels.

Ventricular Tachycardia or Wide-Complex Tachycardia with pulses
Recurrent or refractory ventricular fibrillation/pulseless V-Tach
Following successful defribrillation
Preintubation in Head Injury pts
Pretreatment of localized pain caused byfluid boluses through IOs

Not used for supraventricular rhythms or bradycardia
Hypersensitivity to any "caines"

Sleepiness, Dizziness, Disorientation, Convulsions and Confusion
Hypotension, Bradycardia, decreased myocardial contractility and increased AV blocks at toxic levels

1-1.5 mg/kg IV bolus; may repeat every 3-5 mins at 0.5-0.75 to a total dose of 3mg/kg. May then start continuous infusion of 1-4 mcg/min
2-2.5 mg ETT Loding Dose* followed by 10ml Saline Flush

1mg/kg IV Bolus (May not exceed 100mg), may repeat at 0.5-1.0 mg/kg every 3-5 mins as needed to a total dose of 3mg/kg. May then start a continuous administration of 20-50 mcg/kg/min
ETT increase loading dose by 2-3 times

100 mg in 5ml preload syring for IVP (2% solution)
1g in 5 ml vial for mixing infusion bags (20% solution)
1g in 250ml pre-mixed bag for infusion

Gas

Enters the body via respiratory system. Transported by hemoglobin of the RBC. Used in cellular respiration

Any situation with hypoxia

None

Dry Mucous Membranes
Decrease in breathing stimulus in COPD pts
Irritation of upper resp. tract

NC: 1-6 LPM
SM: 8-10 LPM
NRB: 10-15 LPM
BVM: 15+ LPM
CPAP: 20+ LPM

Sympathomimetic

Directing-acting alpha nd beta agonist. Alpha vasoconstriction. Beta-1 positive inotropic, chromotropic and dromotropic effects. Beta-2 bronchial smooth muscle relaxation and dilation of skeletal vasculature. Useful in treating laryngeal edema. Inhibits Histamine release

Croup
Laryngotracheobronchitis
Asthma
RSV
Laryngeal Edema

Epiglottitis
Hypertension
Underlying Cardiovascular Diseas

Arrythmia
Tremors
Anxiety
Hypertension
Tachycardia

0.25-0.75 ml of 2.25% solution in 2ml of Saline

0.25-0.75 ml of 2.25% solution in 2ml of Saline