• Trade – Osmitrol
• Class – Osmotic Diuretic
• MOA – Facilitates the flow of fluid out of tissues including the brain and into interstitial fluid and blood, this causes dehydration of the brain which results in decreased swelling. Reabsorption by the kidneys is limited so increased urine output takes place
• Indications – increased ICP
• Contraindications- Active intracranial bleeding, heart failure, pulmonary edema, severe dehydration, use caution with hypovolemia and renal failure.
• Side effects – Pulmonary edema, headache, blurred vision, dizziness, seizures, hypovolemia, nausea/vomiting, diarrhea, electrolyte imbalance, hypotension/HTN, sinus tachycardia, PVCs, angina, phlebitis 
• Dosage

Adult: 0.25-1g/kg

Pediatric: SAA

• Trade – Decadron
• Class – Corticosteroid 
• MOA – Reduces inflammation by multiple mechanisms
• Indication – Asthma, airway edema, acute mountain sickness, cerebral edema and multiple medical conditions requiring anti-inflammatory 
• Contraindications – Fungal infection, use caution in active infections, renal disease, penetrating spinal cord injury.
• Side effects – Depression, euphoria, headache, restlessness, HTN, Bradycardia, Nausea/vomiting, swelling, diarrhea, weakness, fluid retention, paresthesias 
• Dose

Adult: 10mg IV/PO

• Trade – Dextrose (D50, D25, D10)
• Class – Antihypoglycemic 
• MOA – Increases blood glucose concentrations
• Indications – Hypoglycemia 
• Contraindications – Intracranial and instraspinal hemorrhage, delirium tremens. 
• Side effects – Hyperglycemia, warmth, burning from IV infusion. Concentrated solutions may cause pain and thrombosis of peripheral veins. 
• Dosing –

Hyperkalemia:

Adult: 25G of dextrose 50% IV,IO

Pedi: 0.5 – 1G/kg IV/IO

Hypoglycemia: 

Adult: 10-25g dextrose 50% IV

Pedi: Older then 2 years 2ml/kg of Dextrose 50%

Pedi under years old: 2-4 ml/kg of Dextrose 10%

Bupropion 

Trade: Wellbutrin 

Use: Antidepressant 

Potassium

Trade: K-Dur

Use: Hypokalemia 

Carvedilol

Trade: Coreg

Use: HTN

Fluticasone 

Trade: Flonase

Use: Allergies 

Alprazolam

Trade: Xanax

Use: Anxiety, Panic disorder

Trazodone hydrochloride

Trade: Desyrel

Use: Depression

• Trade – Brevibloc
• Class– Beta Blocker
• MOA– Inhibits the strength of the hearts contractions, as well as heart rate. 
• Indication – ACS, MI, acute HTN, Supraventricular tachyarrhythmias
• Contraindications – COPD, Acute Bronchospasm, Bradycardia, Advanced Heart blocks, cardiogenic shock, Pulmonary Edema, 
• Side Effects – Hypotension, sinus bradycardia, AV block, Cardiac arrest, nausea/vomiting, hypoglycemia, injection site reaction
• Dosage

Adult: 500mcg/kg IV/IO over 1 minute 

Pedi: 500mcg/kg IV/IO over 1 minute 

• Trade – Glucagon
• Class – Hormone
• MOA – Converts glycogen to glucose
• Indication – hypoglycemia, beta blocker overdose
• Contraindications – Pheochromocytoma, Insulinoma 
• Side effects – Nausea/vomiting, rebound hyperglycemia, hypotension, sinus tachycardia
• Dosages

Hypoglycemia

Adult: 1mg IM, IV, IO, SQ

Pedi: Less than 44 lbs – 0.5mg IM, IV, IO, Sq

Beta Blocker/CCB Overdose

Adult: 3-10mg IV, IO

• Trade – Brethine
• Class– Adrenergic agent 
• MOA – Stimulates B2 receptor producing relaxation of bronchial smooth muscle and bronchodilation. 
• Indication – prevention and reversal of bronchospasm  
• Contraindications – known sensitivity to sympathomimetics
• Side Effects – Cardiac arrhythmias, arrhythmia exacerbation, angina, anxiety, headache, tremor, palpitations, dizziness
• Dosages

Adult: 0.25mg SQ every 20 minutes for up to 3 doses

Pedi:  0.005 to 0.01 mg/kg SQ every 20 mins for up to 3 doses

• Trade – Zofran
• Class – Antiemetic 
• MOA – Binds and blocks a receptor for the brain chemical serotonin 
• Indication – Prevention and treatment of nausea and vomiting
• Contraindication – Use caution in hypokalemia, hypomagnesemia, cardiac arrhythmias 
• Side Effects – headache, fatigue, diarrhea, dizziness, hypotension/HTN, Prolonged PR and QT intervals, Widened QRS, Bradycardia, tachycardia, syncope. 
• Dosage

Adult: 4– 8mg IV, IO, PO

Pedi: (2-16 years) 0.15 mg/kg IV,IO ( max dose 16mg)