Emergency Medication Dosing Sheet.pdf, Study notes of History

Download Emergency Medication Dosing Sheet.pdf and more Study notes History in PDF only on Docsity! Adult ICU Emergency Medication Dosing Guidelines  ACLS Medications Usual Dose Max Dose Drug Package Comments Adenosine 6mg --- Vial May give additional 12mg dose if no conversion. Defibrillator must be present. Decrease dose to 3mg if pt on dipyridamole or carbamazepine Amiodarone 150 mg 300 mg Vial 300mg for VFib or pulseless VT Atropine 0.5 mg 0.04 mg/kg (or 3 mg) Syringe No longer recommended in asystole and PEA Epinephrine 1 mg --- Syringe Given every 3-5 minutes 2-2.5mg if given endotracheally Lidocaine 1-1.5 mg/kg 3 mg/kg (or 300 mg) Syringe For VFib or pulseless VT, If persists after initial dose, may give additional 0.5-0.75mg/kg every 5-10min to max dose Vasopressin 40 units --- Vial May replace 1st or 2nd dose of epinephrine Magnesium 1-2 g 6 g Vial For VFib/pulseless VT with Torsades only RSI Medications Usual Dose Max Dose Drug Package Comments Etomidate 0.2 mg/kg 0.4 mg/kg (or 20 mg) Vial or Syringe Give 50% usual dose in hemodynamic instability Decreases seizure threshold Midazolam 0.03 mg/kg 0.1 mg/kg (or 10 mg) Vial Active metabolite is renally eliminated Propofol 1 mg/kg 2.5 mg/kg (or 200 mg) Vial Associated with dose-related hypotension (*give in 20 mg increments) Avoid in hypovolemic patients Caution with peanut allergy (soy derivatives) Ketamine 1 mg/kg 2.5 mg/kg (or 200 mg) Vial Do not use in head injury, heart disease, or hypertensive emergency patients Rocuronium 1 mg/kg 1.2 mg/kg (or 100 mg) Vial Use adjusted BW if > 130% IBW (Paralysis within 60 seconds) Succinylcholine 1.5 mg/kg 2.0 mg/kg (200 mg) Vial Use total BW for dosing (onset within 30 seconds) Do not use if history of malignant hyperthermia or seizures, Caution if at risk for hyperkalemia (muscle disorders, burn, etc) Miscellaneous Usual Dose Max Dose Drug Package Comments Fentanyl 1 mcg/kg 2 mcg/kg (100 mcg) Ampule For analgesia if needed with RSI/procedures Vecuronium 0.1 mg/kg 0.1 mg/kg (or 10 mg) Vial Use adjusted BW if > 130% IBW Prolonged effect in renal/hepatic impairment Naloxone 0.04 mg 0.4 mg (may repeat) Vial or syringe Lower doses with re-dosing (q2-3 min) may be needed in opiate-dependent patients Drips Standard Concentration Rate options Comments Start Max Cisatracurium 200mg/250mL 0.5mcg/kg/min 10mcg/kg/min Paralytic of choice in renal or hepatic insufficiency Diltiazem 100mg/100mL 5mg/hr 15mg/hr May bolus 10-25 mg initially Dobutamine 250mg/250mL 1-5mcg/kg/min 20mcg/kg/min Does not significantly raise blood pressure but used for inotropic effects Dopamine 400mg/250mL 1-5mcg/kg/min 20mcg/kg/min Central line Epinephrine 4mg/250mL 0.5 mcg/min 10mcg/min Central line Esmolol 2500mg/250mL 25mcg/kg/min 300mcg/kg/min May bolus 50-500 mcg/kg initially Isoproterenol 1mg/250mL 0.2mcg/min 20mcg/min Contraindicated in arrhythmia and angina, caution in heart disease Lidocaine 2000mg/250mL 1-4mg/min 5mg/min Caution if history of heart block Caution in hepatic dysfunction Milrinone 40mg/200mL 0.375mcg/kg/min 0.8mcg/kg/min Accumulates in renal failure Nitroglycerin 25mg/250mL 5mcg/min 400mcg/min Increases ICP, caution in TBI Nitroprusside 50mg/250mL 0.3mcg/kg/min 10mcg/kg/min Cyanide toxicity risk with renal insufficiency and prolonged infusion Max dose 10mcg/kg/min ≤10 min Norepinephrine 8mg/250mL 1mcg/min 30mcg/min Central line Phenylephrine 30mg/250mL 20mcg/min 200mcg/min Pure alpha agonist with least effect on heart rate