• Trade – Solu Medrol
• Class – Corticosteroid
• MOA – Reduces inflammation by multiple mechanisms
• Indications – Anaphylaxis, Asthma, COPD
• Contraindications – Cushing Syndrome, Fungal infection, HTN, seizures, CHF, Penetrating spinal cord injuries, Renal disease
• Side effects – depression, euphoria, headache, restlessness, HTN, Bradycardia, nausea/vomiting, swelling, diarrhea, weakness, fluid retention, paresthesia
• Dosage:

Asthma and COPD

Adult: 40-80mg/day IV 

Pedi: 1mg/kg (up to 60) IV/IO per day

Anaphylactic Shock

Adult: 0.5 – 1mg/kg IV 

Pedi: SAA

Generic Acetaminophen

Trade: Tylenol

Use: Pain/Fever

Generic Atenolol 

Trade: Tenormin

Use: HTN

Generic Pravastatin Sodium 

Trade: Pravachol 

Use:  High cholesterol 

• Trade – Magnesium Sulfate
• Class – Electrolyte, Tocolytic, Mineral
• Action – Controls seizures by blocking peripheral neuromuscular transmission. Magnesium is also a peripheral vasodilator, and an inhibitor of platelet function. 
• Indication – Torsades de Pointes, cardiac arrhythmias associated with hypomagnesemia, eclampsia and seizure prophylaxis in preeclampsia, status asthmaticus. 
• Contraindications – AV Block, GI obstruction, use caution in renal impairment. 
• Side effects – Mag Toxicity

Signs of Mag Toxicity would include flushing, diaphoresis, hypotension, muscle paralysis, weakness, hypothermia, and cardiac, CNS, or respiratory depression

• Dosages

Pulseless V-fib/ V-tach with Torsades de Pointes or Hypomagnesemia 

Adult:1 – 2 G in 10ml D5W IV,IO, over 15 mins or faster if cardiac arrest

Pediatric: 25 – 50mg/kg IV/IO over 10 – 20 mins or faster for Torsades- max single dose: 2G

Eclampsia and Seizure Prophylaxis in preeclampsia 

Adult:4-6G IV/O over 20-30 mins followed by 1-2G/Hr 

Status Asthmaticus 

Adult: 1.2-2G IV/IO over 20 mins

Pediatric:25/50mg/kg slow IV/IO over 10-20 mins
 

• Trade – ASA(Acetylsalicylic Acid)
• Class – Antiplatelet, nonnarcotic analgesic, antipyretic. 
• MOA – prevents the formation of a chemical known as thromboxane A2, which causes platelets to clump together, or aggregate, and form plugs that cause obstruction or constriction of small coronary arteries. 
• Indication – Fever, inflammation, angina, AMI, and patients complaining of pain, pressure, squeezing, or crushing in the chest that may be cardiac in origin.
• Contraindication – GI bleeding, active ulcer disease, hemorrhagic stroke, bleeding disorders, children with chickenpox or flulike symptoms. Use caution in Reye Syndrome
• Side Effects: None
• Dosing 

Myocardial Infarction

Adult: 160-325mg PO

Pedi: 3-5mg/kg per day 

Pain or fever 

Adult: 325-600mg PO every 4-6 hours

Pedi: 60-90mg/kg per day divided into doses every 4-6 hours

• Trade – Lasix
• Class – Loop Diuretic 
• MOA – Inhibits the absorption of the sodium and chloride ions and water in the loop of Henle, as well as the convoluted tubule of the nephron. This results in decreased absorption of water and increased urination 
• Indication – Pulmonary edema, CHF, HTN emergency
• Contraindications – Known Sensitivity to sulfonamides or furosemide
• Side Effects - Vertigo, dizziness, weakness, orthostatic hypotension, hypokalemia, thrombophlebitis
• Dosage:

Congestive Heart Failure and Pulmonary Edema

Adult: 20 – 40mg IV,IO slow push over 1-2 mins

Pedi: 1mg/kg IV, IO, IM

Pedi 2nd Dose: 2mg/kg IV, IO, IM

Hypertensive Emergency 

Adult: 40mg IV, IO

Pedi:  1mg/kg IV,IM

• Methylphenidate 
  • Trade – Concerta 
  • Use – ADHD
• Estradiol 
  • Trade – Climara 
  • Use – Menopaus 
• Losartan Potasium 
  • Trade – Cozaar
  • Use – High cholesterol 

• Trade – Reglan 
• Class – Antiemetic 
• MOA – promotes gastric emptying
• Indication – Nausea/vomiting, Migraine with history
• Contraindication – GI obstruction or perforation, pregnancy, under 6 yo.
• Side effects – constipation, diarrhea, dry mouth, HTN
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• Dosing
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• Adult 10-15mg IV,IO

• Pediatric 0.4-0.8mg/kg IV/IO

Trade – Pronestyl 

Class – Antiarrhythmic – NA+ blocker

MOA – Blocks influx of sodium through membrane pores, consequently suppresses atrial and ventricular arrhythmias by slowing conduction in myocardial tissue.

Indication – Alternative to amiodarone for stable monomorphic VT with normal QT interval. Reentry SVT if uncontrolled by adenosine and vagal maneuvers if BP is stable. Rapid Afib in WPW

Contraindications – AV block, QT prolongation, torsades de pointes,

Side effects – Asystole, VF, flushing, hypotension, PR prolongation, QRS widening, QT prolongation.

Dosing 

Adult – 500-600mg over 25-30 mins or 20-50mg/min ( max dose of 17mg/kg until one of the following occurs; arrhythmia resolves, hypotension, QRS widens > 50% of original width. )

Pedi 10 to 15 mg/kg slow IV,IO over 30-60 mins. 

• Trade –Xopenex
• Description:  Sympathomimetic, bronchodilator-Stimulates beta-2 receptors resulting in smooth muscle relaxation of bronchial tree and peripheral vasculature.
• Indications:  Treatment of acute bronchospasm in patients with reversible obstructive airway disease (COPD/asthma).  Bronchospasm prophylaxis in asthma patients.
• Contraindications:  Angioedema, tachydysrhythmias, and sever cardiac disease.  Avoid use in patients taking phenothiazines; may cause prolonged QT interval and dysrthythmias.  
• Dosage/Route:  1.25 mg in 3 mL

• Description: Pancuronium is a non-depolarizing neuromuscular blocker that causes paralysis without bronchospasm or hypotension, it does not cause the fasciculation's associated with polarizing agents.
• Indications: To facilitate endotracheal intubation.
• Contraindications: Tachycardia.
• Dosage/Route: 0.04 to 0.1 mg/kg IV. 
• Pedi: same as adult.