Emergency drugs

activated charcoal

1-2g/kg

Adenosine

6mg; 12mg
0.1mg/kg; 0.2 mg/kg

Albuterol for hyperkalemia

10-20mg in 4mL NS over 20-60 min

Albuterol hour long neb

10-15mg (2.5 mg/3mL)

Amiodarone
1) ACLS/PALS dead dose
2) VT with pulse
3) Afib with RVR

1) 300mg or 5mg/kg
2) 150mg IV
3) 7mg/kg IV

Ativan

2mg IVP q1-2min (max 0.1mg/kg)

Atropine

0.5mg IV; 0.02mg/kg

Budesonide (Pulmicort) - croup

2.5mg neb

Calcium chloride
1) hyperkalemia
2) Calcium channel blocker OD

1) 20mg/kg IV via CVC
2) 10mL of 10% soln

Calcium gluconate
1) hyperkalemia
2) calcium channel blocker OD

1) 60-100mg/kg slow IV
2) 20 mL of 10% soln

cardioversion
1) monophasic
2) biphasic

1) 50-100J; 0.5 - 1J/kg
2) 70-150J

cisatricurium (Nimbex)

0.15-0.2 mg/kg

clopidogrel

600mg (STEMI); 300mg (NSTEMI)

compazine (prochlorperazine)

5-10mg IV

Decadron
1) asthma
2) croup

1)10mg (some say 12-16mg)
2) 0.6 mg/kg

defibrillation
1) monophasic
2) biphasic

1) 200-300J; 2-4 J/kg
2) 120-200J; 2J/kg

Digoxin

8-12 mcg/kg load

Diltiazem

0.25mg/kg (max 20mg) IV, then 0.35 mg/kg (max 25) if not at goal

Dobutamine

2-30mcg/kg/min

Droperidol

2.5-5mg IV

Duonebs

x3; 2.5mg/3mL albuterol and 0.5mg/3mL ipratroprium

Epinephrine
1. ACLS/PALS
2. anaphylaxis
3. pressor drip

1) 1mg (0.01 mg/kg) 1:10,000
2) 0.3 mg IM (0.15mg if <30kg) 1:1,000 or 1ml of 1:10,000 in 9cc NS flush in 1-2 mL doses
3) 2-20 mcg/min

EPI Neb (asthma/croup)

0.5mL of 2.25% in 3mL

Esmolol (aortic dissection, HTN emergency)

250-500 mcg/kg IVP over 1 minute, then 50-100 mcg/kg/min

Etomidate
1. Induction
2. conscious sedation

1) 0.3 mg/kg
2) 0.15 mg/kg, may repeat at 0.1 mg/kg

Fentanyl
1) Pre-tx in RSI
2) Sedation
3) conscious sedation

1) 3mcg/kg
2) 3-8 mcg/kg
3) 2-3 mcg/kg IV, 1-2 mcg/kg IN

Flumazenil

0.2mg, after 1 minute 0.3mg, after another minute 0.5 mg

Fondaparinux

5mg if <50kg
7.5mg if 50-100kg
10mg if >100kg

glucose

D50 2cc/kg
2-8 y/o: 4cc/kg D25
<2 y/o: 10cc/kg D10

Heparin
1) ACS
2) PE

1) 60U/kg (max 4000) bolus, 12U/kg/hr (1000/hr max)
2) 80U/kg (no max), then 18U/kg/hr drip

hydralazine

10mg IV

hydrocortisone

100mg IV

hypertonic saline

300mL over 20 min for elevated ICP

Insulin

0.1 U/kg IV, drip at 0.1 U/kg/hr. Give with 1-2 amps D50 for hyperkalemia

Kayexelate

1g/kg PO or PR

Keppra

500mg IV

ketamine
1. Induction/conscious sedation
2. post-intubation sedation
3. status epilepticus
4. headache

1) 1-2 mg/kg IV (2-4 mg/kg IM)
2) 2-6 mg/kg/hr (0.1 - 0.5 mg/min)
3) 0.5-1mg/kg load, drip at 0.5 - 2mg/kg/hr
4) 0.1-0.25 mg/kg in 100mL NS over 15-30 min

Labetalol

10mg IV q10m

Levophed (norepi)

5-30mcg/min - titrate
peds: 0.05 - 0.5mcg/kg/min

Lidocaine
1) ACLS/PALS
2) pre-treatment for RSI

1) 1-1.5mg/kg initial, then 0.5-0.75 mg/kg q5m; max dose 3mg/kg
2) 1.5 mg/kg

Lovenox

1mg/kg bid
0.75mg/kg if >75 or GFR <30
IV load 30mg in STEMI if >75

Magnesium
1)Asthma
2)ACLS
3)PALS

1) 2g over 20 minutes
2) 2-4g IV
3) 20-50mg/kg IV

Mannitol

1-1.5g/kg

methylene blue

1-2 mg/kg IV over 5 min (max 7 mg/kg)

Metoprolol

5mg IV q5m; max 15mg (may start with 2.5mg for old people)

milrinone

50mcg/kg load over 10min; then 0.375-0.75mcg/kg/min

morphine (ACS)

2.5 - 5mg IV q5-15

Naproxen

250mg

Narcan

0.1-2mg, consider anti-emetic as well; drip at 2/3 wake up dose/hr

Nicardipine

5-20mg/hr IV, can increase q15min

Nitroglycerin

0.4mg SL q5m; hold for SBP <100;
10-100mcg/min (realistically 80mcg/min)

nitroprusside

0.3-10 mcg/kg/min

Octreotide

50mcg bolus, then 50mcg/hr drip

Omeprazole (UGI bleed)

80mg over 10 minutes, then 8mg/hr drip

Pentobarbital

5mg/kg load, then 2.5 mg/kg/hr drip (max 25 mg/min)

Phenobarbital

20mg/kg IV load, then drip at <60mg/min

phentolamine

5mg IV

phenylephrine

50-150mcg bolus; then 40-180mcg/min; push dose is 1mL (1mg) in 100mL NS, give 1-2mL q3-5 min

Phenytoin

20mg/kg IV loading dose, then drip at 50mg/min max

phosphenytoin

20 PE/kg IV loading dose, then 100-150 PE/min

Precedex

1mcg/kg load then 0.4 mcg/kg/hr drip for conscious sedation

Prednisone (asthma)

50-60mg PO

procainamide

17mg/kg at 20-30mg/min

Propofol
1. Induction
2. post-intubation sedation
3. status epilepticus

1) 1mg/kg
2) 0.05-0.2 mg/kg/min (may require 40mg boluses until drip is set up)
3) 2 mg/kg IV then 0.1 - 0.2 mg/kg/min

Reglan (metoclopramide)

10 mg IV

rocuronium

1.5mg/kg

Sodium bicarb
1) hyperkalemia
2) TCA or ASA overdose

1)1mEq/kg IV (50mEq per amp)
2) 1-2mEq/kg (keep pushing until QRS narrows); drip with 3 amps in 1L D5W at 2-3cc/kg/hr

Solumedrol (anaphylaxis, asthma)

125mg IV

succinylcholine

1-1.5mg/kg; double for IM

tagamet

300mg IV (anaphylaxis)

Terbutaline

0.25 mg sc q15-30min x3 doses

tPA

100mg (first 10mg over 10 min; next 90mg over 2 hrs);
50mg over 2 minutes if suspect PE as cause of cardiac arrest

Versed
1. post-intubation sedation
2. anti-epileptic
3. status epilepticus
4. Conscious sedation

1) 10-50 mcg/kg slow IV load, then 20-100 mcg/kg/hr
2) 10mg IM if IV not available
3) 0.1mg/kg/hr
4) 0.02-0.1 mg/kg IV, 0.2-0.3 mg/kg IN

vasopressin
1) ACLS
2) drip

1) 40U
2) 0.04 U/min

vecuronium
1) pre-tx/defasciculating
2) RSI

1) 0.01mg/kg
2) 0.1mg/kg

Valium (diazepam)

5mg IVP q5min (max 20mg)
PR 0.2 - 0.5 mg/kg

zantac

50mg IV