CRITICAL CARE PARAMEDIC DRUG CARDS | STUDY GUIDE | WITH
COMPLETE SOLUTIONS | LATEST UPDATE | 100% CORRECT
ETOMIDATE
(AMIDATE) - --Induction agent--
Dissociative Anesthetic
RSI: 0.2-0.3 mg/kg
Onset: 30-60 seconds
Duration: 3-12 minutes
MOA: Depresses reticular activating system by stimulating GABA receptors
+ Minimal hemodynamic effects, ↓ ICP/IOP, preferred for awake sedation (fast onset,
short half-life)
- Adrenal suppression (multiple doses), apnea, N/V, ↑↓ BP, ↑↓ HR, myoclonus (muscle
jerks; pretreat with Versed)
*May cause adrenal insufficiency*
KETAMINE
(KETALAR) - --Induction agent--
Dissociative Anesthetic
RSI: 1-2 mg/kg
Maintenance: 0.1-0.5 mg/min
Onset: 60 seconds
Duration: 10-15 minutes
MOA: Interrupts pathways in cortex and limbic system; prompts release of endogenous
catecholamines
+ Sedation, analgesia, amnesia, potent bronchodilator (preferred RSI for asthmatics)
- HTN, emergence reactions (PCP like reaction)(pretreat with benzo), ↑ ICP,
hallucinations, tremors, ↑ HR/BP 2nd catecholamine release, ↑ secretions (treat with
0.01 mg/kg Atropine)
PRECEDEX
(DEXMEDETOMIDINE) - --Sedative--
,Dissociative Anesthetic
RSI: 1 mcg/kg over 10 minutes
Maintenance: 0.2-0.7 mcg/kg/hr
Onset: < 5 minutes
Reversal: Atipamezole
MOA: Alpha-2 agonist that provides sedation without any blunting of the respiratory
drive or airway reflexes
+ Respiratory stability, potent sedative/anxiolytic/analgesic properties
- Bradycardia/sinus arrest, transient HTN
*Use with caution in pts with hepatic impairments*
PROPOFOL
(DIPROVAN) - --Sedative-Hypnotic/Induction agent--
Dissociative Anesthetics
RSI: 1.5 mg/kg
Maintenance: 10-50 mcg/kg/min
Onset: 15-45 seconds
Duration: 5-10 minutes
MOA: Decreases GABA separation from receptors allowing prolonged opening of the
chloride channel which results in hyperpolarization of cell membranes
+ Use in hemodynamically stable pts, reactive airways disease (asthma, COPD, viral
URI), status epilepticus
- Apnea, ↑↓ BP, ↑↓ HR, arrhythmias, propofol infusion syndrome, ↓ CPP/MAP, pain on
injection, egg/soybean allergy
*Use lowest dose possible*
**Do not use in pts with head injury/hemodynamically unstable**
ATRACURIUM
(TRACRIUM) - --Nondepolarizing neuromuscular blocking agent--
Paralytic
RSI: 0.4-0.5 mg/kg
Maintenance: 0.08-0.1 mg/kg 20-45 mins after, then q 15-25 mins
Onset: 2-3 minutes
Duration: 60-70 minutes
, Reversal: Neostigmine - 0.03-0.07 mg/kg
MOA: Competes to attach at NII receptor site, causing extended chemical paralysis
+ Longer duration, defasiculating dose reduces ↑ ICP
- Apnea, ↑↓ BP, ↑↓ HR, prolonged paralysis
with dlong dterm duse/concurrent duse dof dcorticosteroids, drenal/hepatic ddysfunction d
*Use dcaution din dpts dwith dnervous dsystem ddisorder*
**Must dgive dpain/sedation dmeds dalso**
CISATRACURIUM
(NIMBEX) d- d d--Nondepolarizing dneuromuscular dblocking dagent--
Paralytic
RSI: d0.15-0.2 dmg/kg
Maintenance: d0.03 dmg/kg
Onset: d2-3 dminutes
Duration: d30-40 dminutes
Reversal: dNeostigmine d- d0.03-0.07 dmg/kg
MOA: dCompetes dto dattach dat dNII dreceptor dsite, dcausing dextended dchemical dparalysis
+ dLonger dduration, ddefasiculating ddose dreduces d↑ dICP
- dApnea, d↑↓ dBP, d↑↓ dHR, dprolonged dparalysis dwith dlong dterm duse/concurrent duse dof
dcorticosteroids, drenal/hepatic ddysfunction
d
*Use dcaution din dpts dwith dnervous dsystem ddisorder*
**Must dgive dpain/sedation dmeds dalso**
PANCURONIUM
(PAVULON) d- d d--Nondepolarizing dneuromuscular dblocking dagent--
Paralytic
RSI: d0.1 dmg/kg
Maintenance: d0.015-0.1 dmg/kg
Onset: d1-2 dminutes
Duration: d45-60 dminutes
Reversal: dNeostigmine d- d0.03-0.07 dmg/kg
MOA: dCompetes dto dattach dat dNII dreceptor dsite, dcausing dextended dchemical dparalysis
+ dLonger dduration, ddefasiculating ddose dreduces d↑ dICP
