Medications To Know

Medications to Know
ACLS / PALS
Epinephrine 1mg, 0.01mg/kg
Vasopressin 40 units
Atropine
o Pulseless: 1mg q3-5mins max 3mg
Symptomatic Bradycardia: 0.5mg, 0.02mg/kg with minimum 0.1mg
Amiodarone
o Pulseless: 300mg
o V-Tach with a Pulse: 150mg slow IV
o Maintenance: 5mg/kg, 1mg/kg/min
Procainamide 17mg/kg at 20mg/min up to 30mg/min
Adenosine 6mg, 12mg, 12mg; 0.1mg/kg , then 0.2mg/kg
Diltiazem 0.25mg/kg (20mg max), then 0.35mg/kg; max 25mg over 5 mins.
Defibrillation 2J/kg up to 4J/kg
Cardioversion 0.5J/kg to 1J/kg
Bicarb 1meq/kg
CaCl 20mg/kg slow IV (large bore vs central line)
Calcium gluconate 60-100mg/kg slow IV
Glucose
o Adult 1-2amp D50 (2cc/kg)
o 2-8 year old 4cc/kg of D25
o <2 year old 10cc/kg D10
Hydrocortisone
o Child: 1-2mg/kg
o Adult 100mg IV
Insulin 0.1u/kg (10 units standard adult) IV bolus and per hour
Mg2+: 20-50mg/kg IV (2-4 grams standard adult), 1g/hr if replacement, over 5-
10mins for smooth muscle relaxation/RAD (watch for hypotension with fast
admin)
Narcan 0.1mg/kg (0.5-2mg/dose) continue until

Rapid Sequence Intubation
Know specific indications and contraindications for below
(All IV push except fentanyl which is slow over 1-2mins)

Pretreatment
Lidocaine 1.5mg/kg (150mg standard adult dose)
o Use: Head Injury/Bleed, Reactive Airway Disease
Fentanyl 3mcg/kg
o Use Head Injury/CV disease/Pain/Sedation
Atropine 0.02mg/kg
o Bradycardia prevention esp. Peds <1y/o

Induction / Sedation
Etomidate 0.3mg/kg (30mg standard dose)
Ketamine 1-2mg/kg IV, 2-4mg IM (200mg standard dose)
Propofol 0.5-1.5mg/kg
Fentanyl 3-8mcg/kg
Versed 0.3mg/kg

Paralytics
Succinylcholine
o Adults: 1-1.5mg/kg
o Pediatrics: 2mg/kg
Rocuronium 0.6-1.2mg/kg
Vecuronium 0.1mg/kg

Post-Intubation
Propofol 0.05-0.2mg/kg/min (bolus 20-40mg)
Versed 10-50mcg/kg slow IV bolus load, 20-100mcg/kg/hr

Contraindications to Succinylcholine
History of malignant hyperthermia indefinite
Burns >5days until healed
Crush Injury > 5 days until healed
Spinal cord injury/stroke >5 days to 6 months
Neuromuscular disease (MS, ALS, etc.) indefinite
Intra-abdominal sepsis >5 days to resolution infection

Acute Coronary Syndrome (ACS)
ASA 324mg chewable
Nitroglycerin
o Sublingual: 0.4mg
o Paste: -1
o GTT: 10-100mcg/min
o Caution inferior and right sided MI d/t decreased preload
Lovenox 1mg/kg SQ q12hr IF GFR >30 (usually NSTEMI)
Heparin Load 60u/kg (5000u max) then 12unit/kg (1000/h)

Pressors
Levophed (Norepinephrine) 5-30mcg/min no true MAX, 0.05-0.5mcg/kg/min
Dopamine 5-20mcg/kg/min (No low dose renal exists)
Dobutamine 2-30mcg/kg/min (Not a true pressor, varying effect on BP)
Epinephrine 2-20mcg/min (bedside drip 1cc of 1:10,000 to 100cc=1mcg/cc or
1cc 1:10,000 in 9cc of NS flush, push 0.5-1cc Q3-5mins)
Phenylephrine 50-150mcg bolus, then 40-180mcg/min
Vasopressin 0.04u/min (on or off, no titration, not by itself)
Anti-Hypertensives
Labetalol 10mg IV (double q10mins up to 300mg)
Nicardipine 5-20mg/h, increase gtt q15min
Hydralazine 10mg IV
Nitroglycerin 10-100mcg/min
Nitroprusside 0.3-10mcg/kg/min
Phentolamine 5mg IV

Anaphylaxis
Epinephrine 0.01mg/kg of 1:1000 (0.01ml/kg) 0.3mg max IM (lateral thigh
preferred), drip as above using 1:10,000
Benadryl 1mg/kg, max 50mg IV
Solumedrol 2mg/kg, max 125mg IV
H2 Blockers
o Tagamet 300mg IV
o Zantac 50mg IV
o Pepcid 0.5 mg/kg

Seizures
Ativan 2-4mg IV q 1-2 mins up to 0.1mg/kg
Valium 5mg IV q5 min up to 20mg , PR 0.2-0.5mg/kg
Phenytoin 20mg/kg IV load, 50mg/min
Phosphenytoin 20PE/kg IV load 150PE/min
Phenobarbital 20mg/kg IV load, no greater than 60mg/min

Hyperkalemia Treatment (C BIG K):
Calcium gluconate or chloride (large IV/central line) 10-20cc IV over 2 mins (If
EKG changes)
Bicarbonate (NaHCO3): 50-100meq over 5-10mins
Glucose
o 1-2 amp (50-100gm) plus 10-20 units insulin, or
o 500cc D10W plus 10-20 units insulin IV over 45-60mins
Hemodialysis
Kayexalate
o Probably no benefit and possibly harmful, read this article as one stop
shop and pass on to consultants etc:
o Sterns RH, Rojas M, Bernstein P, Chennupati S. Ion-exchange resins for the
treatment of hyperkalemia: Are they safe and effective? J Am Soc Nephrol
21: 733-5, 2010.

Pediatrics
Weight:
3months: 5kg
1 year: 10kg
3 years: 15kg
5 years: 20kg
7 years: 25kg

Endotracheal Tubes
Endotracheal Tube Size: (16 + age)/4
Endotracheal Tube Depth: 3 x ETT size [ETT size: (16+age)/4]
Foley: 3 x ETT size
Chest Tube: 4 x ETT size
IV Fluids: 20cc/kg bolus
Blood: 10cc/kg

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