Hydroxocobalamin

Trade: Valium Class: BenzodiazepineMOA: Binds to the benzodiazepine receptor and enhances the effects of GABAIndications: Anxiety, Skeletal muscle relaxation, anticonvulsant Contraindications: Children younger then 6 months, acute angle glaucoma, CNS depression, alcohol intoxication. Side effects:  Respiratory depression, drowsiness, fatigue, headache, pain at the injection site, confusion, nausea, hypotension, cardiac arrest at high doses•Dosing:Adult: Anxiety: 2-10mg IV/IMSeizure: 5-10mg IV/IOPediatric:Anxiety: 0.2 – 0.3mg/kg IV/IMSeizure:  Older then 5 years: 1mg IV/IOOlder then 30 days less then 5 years: 0.2 to 0.5mg IV/IO                Neonate: 0.1-0.3mg/kg IV/IO

Trade: Toradol Class: NSAIDMOA: inhibits the production or prostaglandins in inflamed tissue, which decreases the responsiveness of pain receptors. Indications: Moderately severe acute painContraindications: Patients with a hx of peptic ulcer disease or GI bleed, patients with renal insufficiency, hypovolemic patients, 3rd trimester pregnancy, nursing mothers, allergy to other nsaids, stroke or head trauma, having surgery within the next 7 days.  Side effects:  headache, drowsiness, dizziness, abdominal pain, dyspepsia, N/V, Diarrhea.Dosing:Adult IV 30mgIM 60mg Senior (65 and older)/ Pediatric < 50kgsIV 15mgIM 30mg

Trade: Tegretol Class:  Anticonvulsant MOA: Binds preferably to voltage gated Sodium channels in their inactive conformation, which prevents repetitive and sustained firing of an action potential.Indications: Partial and generalized tonic – clonic seizures Contraindications: AV Block, bundle branch block, agranulocytosis, bone marrow supression, monoamine oxidase inhibitor therapySide effects: Dizziness, drowsiness, ataxia, N/V, blurred vision, confusion, headache, transient diplopia, visual hallucinations, life threatening rashes.Dosing:Adult:200mg POPediatric:6-12 years old: 100mg PO        Less then 6: 10mg/kg PO

Trade: MorphineClass: Opiate agonist/Narcotic Analgesic MOA: Binds to the opiate receptors. Reduces stimulation of the sympathetic nervous system caused by pain and anxiety. Reduction of sympathetic stimulation reduces heart rate, cardiac work, and myocardial O2 consumptionIndications: moderate to severe pain including chest pain associated with ACS, CHF, and pulmonary edema.Contraindications: Respiratory depression, shock.Side effects: Respiratory depression, hypotension, N/V, dizziness, lightheadedness, sedation, diaphoresis, euphoria, seizures, cardiac arrest, anaphylactoid reaction.Dosage:Adult  2-10mg IV/IO/IMPediatric < 110 lbs 0.025 – 0.2mg/kg IV/IO/IM

Trade: SublimazeClass: Narcotic Analgesic MOA: Binds to opiate receptors producing analgesia and euphoriaIndication: PainContraindication: Use caution in traumatic brain injury, Respiratory depression Side effects: Respiratory depression, apnea, hypotension, N/V, dizziness, sedation euphoria, Sinus bradycardia, sinus tachycardia, palpitations, HTN, diaphoresis, syncopeDosingAdult 50-100mcg IM/IVPedi 1-2mcg/kg IM/IV

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Trade – IsoptinClass – Calcium Channel blockerMOA – Blocks calcium from moving into the heart muscle cell, which prolongs conduction of the electrical impulses through the AV node.Indications – AF, HTN, paroxysmal SVT, Paroxysmal SVT prohylaxisContraindications – 2nd or 3rd degree AV block, Hypotension, cardiogenic shock, Sick sinus syndrome, WPW.Side effects – Sinus bradycardia, 1st, 2nd, or 3rd degree AV blocks, CHF, reflex tachycardia, transient asystole, hypotension.Dosing Adult 2.5-10mg IV/IO over 2 minutes. May repeat at 5-10mg every 15-30 mins to a maximum dose of 30mgPedi 1-16 years old: 0.1mg/kg IV/IO max single dose 5mg over 2mins may repeat in 30 mins to a max dose of 10mg

Trade – CyanokitMOA:  Antidote, cyanide poisoning adjunct Binds with cyanide to form nontoxic cyanocobalamin, preventing its toxic effects; excreted renallyIndications: Treatment of known or suspected cyanide poisioning.Contraindications:  None is the emergency settingSide Effects:  Hypertension, allergic reactions, GI bleeding, nausea, vomiting, dyspepsia, dyspnea, dizziness, headache, injection site reactions.Dosage:  Adult: 5 g IV infusion over 15 minutes at a rate of 15 mL/min.Pedi:  70 mg/kg IV one time, may be repeated one time at the same dose.

Trade – CardeneClass – Calcium Channel blocker MOA – Blocks calcium movement into the smooth muscle of the blood vessel walls, causing vasodilation.Indication – Angina, HTNContraindication – Aortic stenosis, hypotension, use caution in heart failure, cardiac conduction abnormalities, Cerebrovascular disease, depressed AV node conduction. Side effects – Edema, headaches, flushing, sinus tachycardia, hypotension Dosages :Adult: 5mg/hr IV/IO Pedi: 0.5 – 5 mcg/kg/min

Trade – PlavixClass – Antiplatelet MOA – Blocks platelet aggregation by antagonizing the IIb/IIIa receptors Indications – ACS, chronic coronary and vascular disease, ischemic stroke.Contraindications – Hx of intracranial hemorrhage, GI bleed or trauma.Side effects – Nausea, Abdominal pain, hemorrhage. Dosing : Unstable angina pectoris or non Q wave AMI.Adult – Loading dose 300-600mg POPedi – Not recommended for pedi patients