Term
DEXTROSE 50% SOLUTION (D50)
Class
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Definition
CLASS • carbohydrate
• antihypoglycemic
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Term
DEXTROSE 50% SOLUTION (D50)
Action
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Definition
ACTION rapidly increases blood sugar level
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Term
DEXTROSE 50% SOLUTION (D50)
Indications
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Definition
INDICATIONS • hypoglycemia
• altered mental status, etiology unknown
• seizures in diabetics
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Term
DEXTROSE 50% SOLUTION (D50)
Standard Prep
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Definition
STANDARD PREP 25 gm (50% Dextrose) in 50 cc preloaded syringe
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Term
DEXTROSE 50% SOLUTION (D50)
Peds Dose
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Definition
PEDS DOSE • See Hawaii S.O.
{After you dilute the dextrose to 25% dextrose [1cc 50% dextrose to 1cc
NS], then you can calculate the amount to be given at 2cc/kg of this
diluted mixture}
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Term
DEXTROSE 50% SOLUTION (D50)
Side Effects
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Definition
SIDE EFFECTS • venous irritation
• localized tissue necrosis
• intracerebral hemorrhages in neonates
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Term
DEXTROSE 50% SOLUTION (D50)
Precautions
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Definition
PRECAUTIONS • use large bore catheter
• Undiluted D50 in neonates causes intracerebral bleeds • should be preceded by thiamine (if
available) in suspected alcoholic pts.
to avoid the possibility of inducing
encephalopathy in thiamine deficient
patients. |
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Term
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Definition
CLASS •
Pancreatic hormone
• Insulin antagonist |
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Term
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Definition
ACTION
• Converts liver glycogen to glucose to raise blood sugar level, and inhibits glycogen synthesis
• Stimulates glucagon receptors in cardiac cells (in larger doses) and may
be of benefit in beta blocker overdoses by increasing the force of
contraction ( + inotropic) and rate of contraction ( + chronotropic).
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Term
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Definition
INDICATIONS • Hypoglycemia if no IV route available
• Beta blocker overdose with profound bradycardia
• May be effective in some calcium channel blocker overdoses
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Term
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Definition
DOSAGE/ROUTE • See Hawaii S.O. - Coma
• Must be reconstituted with provided diluent. 1 mg IM or SC. May repeat in 20 min.
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Term
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Definition
STANDARD PREP 1 mg powder with 1 cc diluent. Must be reconstituted with
provided diluent prior to administration.
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Term
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Definition
Pediatric dose
See Hawaii SO |
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Term
GLUCAGON
Contraindications |
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Definition
Contraindications
Hypersensitivity |
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Term
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Definition
SIDE EFFECTS • Nausea & vomiting
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Term
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Definition
PRECAUTION • Should not be used as a first line drug for hypoglycemia
• Will be ineffective in conditions where glycogen stores are
depleted, ie. chronic hypoglycemia, starvation
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Term
Magnesium Sulfate
(MgSO4)
Classes
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Definition
CLASSES • Electrolyte
• CNS depressant
• Anticonvulsant
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Term
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Definition
ACTIONS • For treatment or prophylaxis of seizures due to toxemia of pregnancy by decreasing neuronal excitability (anticonvulsant)
• Reduces the incidence of postinfarction ventricular arrhythmias by increasing membrane stability and decreasing ventricular excitability
• May result in relaxation of bronchial and vascular smooth muscle which is probably secondary to calcium blockade
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Term
Magnesium Sulfate
(MgSO4)
Indications
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Definition
INDICATIONS • Refractory VF/VT
• Torsades de pointes
• Refractory seizures related to hypomagnesemia especially in alcoholics
• Eclampsia
• Hyper-reflexia of toxemia of pregnancy (pre-eclampsia)
• Cardiac arrhythmias due to dig toxicity
• Controversial: refractory bronchospasm not responsive to beta agonist, steroids, aminophylline
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Term
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Definition
DOSAGE/ROUTE • For acute administration during VT, 1 or 2 g of
magnesium sulfate in 10 cc over 1 to 2 minutes
• In VF should be given IV push
Follow up infusion of 0.5 - 1.0 g/hr for 24 hr
• Torsades = 2.0 g IV bolus, followed by 2nd 2.0 g bolus
If no response, followed by infusion
• Anticonvulsant = 1-4 g IV over 30 minutes, or more rapidly if seizing (over 5 minutes)
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Term
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Definition
STANDARD PREP 1 gm/2 ml, 5 gm/10 ml |
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Term
Magnesium Sulfate
(MgSO4)
Contraindication
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Definition
CONTRAINDICATION Heart block , controversy in acute MI patient |
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Term
Magnesium Sulfate
(MgSO4)
Precautions
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Definition
PRECAUTIONS • Monitor respiratory rate because respiratory depression
is a serious side effect of hypermagnesemia.
• IV Calcium Chloride should be available as an antagonist.
• Concurrent use with CNS depressant requires lower dosage adjustments
• Monitor EKG
• Use with caution in renal failure patients |
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Term
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Definition
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Term
OXYTOCIN
(PITOCIN)
Actions
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Definition
ACTION • induces uterine smooth muscle contraction |
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Term
OXYTOCIN
(PITOCIN)
Indication
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Definition
INDICATION • Postpartum hemorrhage after infant and placental delivery,
in conjunction with fundal massage
• In the hospital setting only may be used to induce labor in certain cases |
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Term
OXYTOCIN
(PITOCIN)
Dosage/ Route
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Definition
DOSAGE/ROUTE 10 - 20 units in 1000 cc IV solution to run in over 15 minutes or
3 - 10 units IM, after delivery of the placenta
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Term
OXYTOCIN
(PITOCIN)
Standard Prep
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Definition
STANDARD PREP 10 USP units/ml
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Term
OXYTOCIN
(PITOCIN)
Contraindication
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Definition
CONTRAINDICATION Should not be used prior to the delivery of the fetus and the
placenta in the prehospital setting.
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Term
OXYTOCIN
(PITOCIN)
Side effects
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Definition
SIDE EFFECTS • Uterine rupture from excessive administration
• HTN
• Arrhythmias
• Anaphylaxis |
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Term
OXYTOCIN
(PITOCIN)
Precaution
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Definition
PRECAUTION • Should be used in conjunction with correct fundal massage
• Vital signs, firmness of uterus, and vaginal bleeding should
be monitored |
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Term
INSULIN
(REGULAR, HUMULIN, NPH, ULTRALENTE, AND OTHERS) CLASS
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Definition
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Term
INSULIN
(REGULAR, HUMULIN, NPH, ULTRALENTE, AND OTHERS) ACTIONS
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Definition
ACTIONS • Increase glucose transport into cells where glucose can be used for cellular metabolism
• Increase glycogen synthesis
• Insulin preparations are classified as rapid acting (Regular),
intermediate acting (NPH, Lente, Semilente), and long acting (Ultralente, Protamine Zinc)
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Term
INSULIN
(REGULAR, HUMULIN, NPH, ULTRALENTE, AND OTHERS) INDICATIONS
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Definition
INDICATIONS • Diabetes Mellitus Type I
• Diabetes Mellitus Type II, if unable to be controlled with
oral hypoglycemic agents
• Diabetic ketoacidosis
• Hyperosmolar Hyperglycemic Nonketotic Coma of Type II
Diabetes (Nonketotic hyperosmolar coma)
• Insulin and Dextrose 50% may be given together to lower
potassium levels in hyperkalemia
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Term
INSULIN
(REGULAR, HUMULIN, NPH, ULTRALENTE, AND OTHERS) DOSAGE/ ROUTE
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Definition
DOSAGE/ROUTE SC, IM, or IV and dosage as ordered by physician
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Term
INSULIN
(REGULAR, HUMULIN, NPH, ULTRALENTE, AND OTHERS) ONSET/ DURATION
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Definition
ONSET AND DURATION
TYPE OF INSULIN ONSET PEAK ACTION DURATION
Rapid or short acting (Regular) 0.5 - 1 hr 2- 5 hr 5 - 7 hr
Intermediate acting (NPH) 1 - 2 hr 4 - 12 hr 18 - 24 hr
Long acting (Ultralente, Zinc) 4 - 8 hr 10 - 30 hr 30 - 36 hr
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Term
INSULIN
(REGULAR, HUMULIN, NPH, ULTRALENTE, AND OTHERS) CONTRAINDICATIONS
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Definition
CONTRAINDICATION • hypoglycemia
• NEVER ADMINISTERED IN THE PREHOSPITAL
ENVIRONMENT BY MICTs
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Term
INSULIN
(REGULAR, HUMULIN, NPH, ULTRALENTE, AND OTHERS) ADVERSE REACTIONS
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Definition
ADVERSE REACTION • Signs and symptoms of hypoglycemia
• Allergic reaction
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Term
INSULIN
(REGULAR, HUMULIN, NPH, ULTRALENTE, AND OTHERS) PRECAUTIONS
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Definition
PRECAUTIONS • NEVER ADMINISTERED IN THE PREHOSPITAL
ENVIRONMENT BY MICTs
• Alcohol, beta blockers, MAOIs, salicylates may potentiate
the hypoglycemic effects of insulin
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Term
TERBUTALINE
Bricanyl®, Brethine®
CLASS |
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Definition
CLASS • Beta-2 agonist
• Bronchodilator |
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Term
TERBUTALINE
Bricanyl®, Brethine®
ACTION |
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Definition
ACTIONS • Stimulates B2 receptors in the smooth
muscle of the bronchial tree = bronchodilation • Stimulation of B2 adrenergic receptors in the uterus causes uterine relaxation and can suppress preterm labor (tocolytic) |
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Term
TERBUTALINE
Bricanyl®, Brethine®
INDICATIONS |
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Definition
INDICATIONS • Reversible bronchospasm, ie. bronchial asthma, chronic bronchitis, emphysema
• To stop uterine contractions in preterm labor |
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Term
TERBUTALINE
Bricanyl®, Brethine®
DOSAGE/ ROUTE |
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Definition
DOSAGE/ROUTE • See Hawaii Adult S.O. for Bronchospasm
- 2 mg via updraft nebulizer for bronchodilation (Inhalation [INH])
• 0.25 mg subcutaneous (SC) for bronchospasm and for preterm labor. May repeat in 15-20 min. for
bronchospasm only.
Onset: (SC) 6 – 15 min; INH 5 – 30 min
Duration: (SC) 1 1/2 – 4 hr; INH 3 – 6 hr |
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Term
TERBUTALINE
Bricanyl®, Brethine®
STANDARD PREP |
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Definition
STANDARD PREP 1 mg/cc ampule |
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Term
TERBUTALINE
Bricanyl®, Brethine®
Pediatric Dose |
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Definition
PEDIATRIC DOSE • 0.01 mg/kg SC (max dose 0.25 mg) for
bronchospasm
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Term
TERBUTALINE
Bricanyl®, Brethine®
Contraindication |
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Definition
CONTRAINDICATION • Hypersensitivity |
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Term
TERBUTALINE
Bricanyl®, Brethine®
Side Effects |
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Definition
SIDE EFFECTS • Hypertension, dysrhythmias, palpitations, tremors, anxiety, dizziness, n & v |
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Term
TERBUTALINE
Bricanyl®, Brethine®
Precautions |
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Definition
PRECAUTIONS • Continually monitor VS, EKG, mental status,
lung sounds, pulse oximetry
• Use supplemental O2
• Exercise care in the presence of tachycardia,
heart disease and hypertension
• Preterm labor may be defined between 20 and 37
weeks gestation |
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