Pharmacology/
onset of action - Answer Binds and absorbs ingested toxins present in the GI
tract following emesis or lavage
Typically not effective unless administered within 30 minutes of ingestion
Onset of action: Immediate
Activated Charcoal
Indications - Answer Poisoning/Overdose (after emesis/lavage or in cases
where emesis /lavage may be contraindicated)
Activated Charcoal
Alternative names - Answer Actidose-Aqua, LiquiCharcoal
Activated Charcoal
Contraindications - Answer Not for use with heavy metal ingestion (lithium or
iron), hydrocarbons, caustic alkalis
ALOC (unless given by nasogastric or orogastric tube)
Activated Charcoal
Precautions and Side Effects - Answer Abdominal cramping, black stools,
constipation, nausea & vomiting Other:
Currently many physicians are choosing to lavage the stomach before charcoal.
Lavage is then followed by the administration of activated charcoal. • Not effective
with hydrocarbons - gasoline, propane, etc
Activated Charcoal
,Dosage
How supplied - Answer V. Dosage
• Adult: 1g/kg, typically 50 grams PO or gastric tube
• Pediatric: 1g/kg, typically 25 grams PO or gastric tube
VI. How Supplied
A. Bottles containing 25g/125ml or 50g/250ml
Procainamide
Pharmacology and Actions - Answer Antiarrhythmic, regarded as a cardiac
depressant
Suppresses phase 4 depolarization dereasing automaticity of the ectopic
pacemakers
Procainamide
Alternative name - Answer Pronestyl
Procainamide
Indications - Answer * PSVT (after adenosine, amiodarone and vagal
maneuvers, for stable patients)
• Stable wide complex tachycardia of unknown origin
• Atrial fibrillation and atrial flutter with rapid ventricular response rate (above
150)
• WPW syndrome
• Pulsing or pulseless ventricular tachycardia or ventricular fibrillation
Procainamide
Contraindications - Answer • Second and Third - Degree AV block
• Digitalis Toxicity
• Tosades de Pointes
• TCA overdose
Procainamide
,Precautions and Side Effects/ Cardiovascular - Answer A. Use with caution in
myocardial infarction or CHF.
B. Hypotension in patients with impaired left venticular function
C. It may cause arrhythmias in the presence of AMI, Hypokalemia, or
Hypomagnesemia
D. Use with caution with other drugs that prolong the QT interval (Amiodarone)
E. Bradycardia, heart blocks
F. Widened QRS, prolonged PR or QT interval, and ventricular ectopy
Procainamide
Precautions and Side Effects/
Neurological and other - Answer Seizures, confusion
Other:
H. Use with caution in hepatic or renal dysfunction
Procainamide
Dosage for Adult - Answer A. WPW, Pulsing V-Tach, PSVT, atrial fibrillation,
atrial flutter - 20 mg/min
B. Pulselesss V-tach or V-fib - 20 mg/min or 100 mg IV at 5 minute intervals
C. Maintenance infusion (post conversion): 1-4 mg/min
D. Max Dose: 17 mg/kg OR until reach one of the following:
a. Arrhythmia suppression
b. Hypotension
c. QRS widens by more than 50%
E. Reduce dose to 12 mg/min if cardiac or renal dysfunction
Procainamide
Dosage for Pediatric - Answer SVT, atrial flutter, ventricular tachycardia with
pulses: 15 mg/kg over 30 to 60 minutes
Procainamide
, How supplied - Answer 1g/2 mL or 1g/10 mL - to mix, place 1 g into 50 mL
buretrol to make drip
Procainamide
Special Note for this drug (Should not be.........) - Answer Note: Should not be
exposed to light.
Romazicon
Pharmacology ad Actions - Answer Antagonizes the effects of
benzodiazepines by competitive inhibition at the GABAbenzodiazepine receptor
site
• Does not compete with alcohol or narcotic sites
• Reversal of benzodiazepine effects in 1 to 2 minutes
Romazicon
Onset of Actions - Answer 1 to 3 minutes
Romazicon
Alternative name - Answer Flumazenil
Romazicon
Indications - Answer Reverse respiratory depression associated with
benzodiazepines
Romazicon
Contraindications - Answer A. Hypersensitivity
B. Cocaine or other stimulant intoxication
C. Should not be used to rule out benzodiazepine overdose
D. Not administered to patients who were given benzodiazepines for status
seizure
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