Glucagon trade
GlucaGen
GlucaGen generic
Glucagon
Glucagon class
hormone
glucagon moa
breaks down glycogen to glucose, increases HR and myocardial contractility, improves AV conduction independent of beta blockade
glucagon onset
5-20 min
glucagon peak
30 min
glucagon duration
1-2 hrs
glucagon half life
varies
glucagon indications
hypoglycemia without iv access; beta-blocker/ca channel blocker overose
glucagon contraindications
none
glucagon side effects
hypotension, dizziness, nausea, vomitting
glucagon adult dose
1.0mg IM q 5-20
glucagon pedi dose
0.03-0.1 mg/kg IM
Glucagon beta-blocker OD and choking dose
5 mg IV
glucagon precautions
check BGL before and after, only effective if glycogen stores in liver, caution in Pt’s with cardiovascular and renal disease
glucagon interactions
few in ems
thiamine class
vitamin b1
thiamine action
converts pyruvic acid to acetyl coA in the Krebs cycle allowing for breakdown of glucose to ATP; deficiency leads to Wernicke’s encephalopathy and Korsakoff’s psychosis
thiamine onset
rapid
thiamine peak
varies
thiamine duration
varies
thiamine half life
N/A
thiamine indications
administer with D50 to severe alcoholics to prevent Wernicke’s encephalopathy and Korsakoff’s psychosis
thiamine contraindications
none
thiamine side effects
hypotension, restlessness, cardiovascular collapse, pulmonary edema
thiamine adult dose
50-100 mg iv over 5 min
thiamine pedi dose
10-25 mg iv over 5 min
thiamine precautions
give prior to dextrose to facilitate uptake
thiamine interactions
none
50% dextrose in water trade
D50
D50 generic
50% dextrose in water
d50 class
carbohydrate
d50 action
principal form of glucose used by body to create energy
d50 onset
<1 min
d50 peak
varies
d50 duration
varies
d50 half life
n/a
d50 indication
hypoglycemia
d50 contraindications
none
d50 side effects
tissue necrosis and phlebitis at injection site, warmth, pain, or burning at injection site
d50 adult dose
25 g in 50ml IV
d50 pedi dose
dilute 1:1 to make d25 and give 0.5-1.0 g/kg slow IV
d50 precautions
increased ICP, check BGL before and after, administer with 100 mg thiamine if suspected deficiency
d50 interactions
none
metoclopramide trade
reglan
reglan generic
metoclopramide
reglan class
antiemetic
reglan action
dopamine antagonist, sensitizes GI smooth muscle to Ach leading to gastric emptying without increased secretions
reglan onset
1-3 min IV, 10-15 min IM
reglan peak
1-2 hrs
reglan duration
1-3 hr
reglan half life
3-6 hrs
reglan indications
nausea, vomitting
reglan contraindications
hypersensitivity or sulfa allergies, GI bleeding, bowel obstruction or perforation
reglan side effects
dystonia, sedation, drowsiness, bradycardia
reglan adult dose
10-20 mg IM, 10 mg slow IV
reglan pedi dose
1-2 mg/kg
reglan precautions
Pt’s with CHF, hypokalemia, renal dysfunction; have benadryl ready for dystonic reaction
reglan interactions
antagonized by anticholinergics, potentiated effects with other CNS depressants
promethazine trade
phenergan
phenergan generic
promethazine
phenergan class
antiemetic
phenergan action
phenothyazine derivative; depression of CTZ in medulla for antiemetic effects
phenergan onset
5 min IV, 20 min IM
phenergan peak
varies
phenergan duration
4-6 hrs
phenergan half life
10-14 hrs
phenergan indications
nausea and vomitting, potentiate analgesics
phenergan contraindications
hypersensitivity, coma
phenergan side effects
dystonia, sedation, drowsiness, bradycardia
phenergan adult dose
12.5-25mg IV/IM
phenergan pedi dose
0.5 mg/kg IV/IM
phenergan precautions
caution with Pt’s with impaired hepatic function, asthma, hypertension; have benadryl available for dystonic reactions
phenergan interactions
alcohol and CNS depressants add to CNS depression and anticholinergic effects
ondansetron trade name
zofran
zofran generic name
ondansetron
zofran drug class
anti-emetic
zofran mechanism
serotonin R antagonist, especially at the vagal nerve terminals
zofran onset
10-30 min
zofran peak
unknown
zofran duration
unknown
zofran half-life
4 hrs
zofran indications
nausea/vomitting
zofran contraindications
hypersensitivity
zofran side effects
diarrhea, dizziness, dry mouth, prolonged QT interval
zofran adult dose
4mg over 2-5 min
zofran pedi dose
0.1mg/kg over 2-5 min
zofran precautions
lower risk of sedation and dystonia than other antiemetics
zofran interactions
may affect clearance and half-life with inducers and inhibitors of cytochrome p-450 enzymes