Sedative Hypnotics - Revision history

Treloars at 16:27, 1 February 2018

2018-02-01T16:27:34Z

← Older revision		Revision as of 16:27, 1 February 2018
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	\| Detrol LA\|\| Norpace\|\| Zoloft		\| Detrol LA\|\| Norpace\|\| Zoloft
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			[[Category:Medication Guidelines\|0815]]

Treloars: /* Midazolam (VERSED) / Sedative / Hypnotic */

2016-04-27T01:06:57Z

Midazolam (VERSED) / Sedative / Hypnotic

← Older revision		Revision as of 01:06, 27 April 2016
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	* An IM injection requires immediate IV access upon sedation.		* An IM injection requires immediate IV access upon sedation.
	* HYPOTENSION responds well to Trendelenburg.		* HYPOTENSION responds well to Trendelenburg.
			* Pediatrics refer to Handtevy System.


	====Ziprasidone (GEODON) / Antipsychotic====		====Ziprasidone (GEODON) / Antipsychotic====

Treloars: /* Diazepam (VALIUM) / Sedative Hypnotic */

2016-04-27T01:05:24Z

Diazepam (VALIUM) / Sedative Hypnotic

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	'''DOSAGE'''		'''DOSAGE'''
	* 2 - 20 mg Slow IVP for adults titrated to effect. If no IV access, administer 10 - 20 mg IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site. Refer to PRACTICE PARAMETER for specific dosages.		* 2 - 20 mg Slow IVP for adults titrated to effect. If no IV access, administer 10 - 20 mg IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site. Refer to PRACTICE PARAMETER for specific dosages.
	* Refer to ~~Broselow Tape~~ for pediatric dosage.		* Refer to Handtevy System for pediatric dosage.


	====Midazolam (VERSED) / Sedative / Hypnotic====		====Midazolam (VERSED) / Sedative / Hypnotic====

Treloars: /* Ziprasidone (GEODON) / Antipsychotic */

2012-02-03T20:46:22Z

Ziprasidone (GEODON) / Antipsychotic

← Older revision		Revision as of 20:46, 3 February 2012
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	* An atypical antipsychotic acting as a dopamine antagonist that also affects other neurotransmitters to reduce psychosis and acute agitation.		* An atypical antipsychotic acting as a dopamine antagonist that also affects other neurotransmitters to reduce psychosis and acute agitation.
	'''INDICATIONS'''		'''INDICATIONS'''
	* Used for the control of acute agitation in schizophrenic ~~are~~ severely agitated patients.		* Used for the control of acute agitation in schizophrenic and/or severely agitated patients.
	'''CONTRAINDICATIONS'''		'''CONTRAINDICATIONS'''
	* Persons known to have prolonged QTc intervals		* Persons known to have prolonged QTc intervals

Treloars: Created page with "==Section 8 - MEDICATION GUIDELINES== ===8.15 SEDATIVE / HYPNOTICS / ANTIPSYCHOTIC=== ====Diazepam (VALIUM) / Sedative Hypnotic==== '''DESCRIPTION''' * It is a skeletal muscl..."

2012-02-01T16:56:14Z

Created page with "==Section 8 - MEDICATION GUIDELINES== ===8.15 SEDATIVE / HYPNOTICS / ANTIPSYCHOTIC=== ====Diazepam (VALIUM) / Sedative Hypnotic==== '''DESCRIPTION''' * It is a skeletal muscl..."

New page

==Section 8 - MEDICATION GUIDELINES==
===8.15 SEDATIVE / HYPNOTICS / ANTIPSYCHOTIC===

====Diazepam (VALIUM) / Sedative Hypnotic====
'''DESCRIPTION'''
* It is a skeletal muscle relaxant that reduces tremors, induces amnesia, and reduces the incidence and recurrence of seizures.
'''INDICATIONS'''
* [[Seizure|Seizures]], [[Seizure|Status Epilepticus]], premedication prior to [[Cardioversion|cardioversion]], acute anxiety states, acute alcohol withdrawal.
'''CONTRAINDICATIONS'''
* Hypersensitivity to the medication.
'''PRECAUTIONS'''
* Due to a short half-life of the drug, seizure activity may recur.
'''DOSAGE'''
* 2 - 20 mg Slow IVP for adults titrated to effect. If no IV access, administer 10 - 20 mg IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site. Refer to PRACTICE PARAMETER for specific dosages.
* Refer to Broselow Tape for pediatric dosage.

====Midazolam (VERSED) / Sedative / Hypnotic====
'''DESCRIPTION'''
* It is a skeletal muscle relaxant that reduces tremors, induces amnesia, and reduces the incidence and recurrence of seizures.
* Depresses sub-cortical levels in CNS.
'''INDICATIONS'''
* Sedation for post resuscitation combativeness, [[Head Injuries|combative head injury]], [[Intubation Endotracheal|intubations]], [[Transcutaneous Pacing Procedure|pacing]] and [[Cardioversion|cardioversion]].
* Seizures, status epilepticus.
'''CONTRAINDICATIONS'''
* Pregnancy (relative contraindication), hypersensitivity to benzodiazepines, coma, acute narrow angle glaucoma, shock, alcohol intoxication.
'''PRECAUTIONS'''
* Hypotension, COPD, CHF, chronic renal failure, chills, elderly, debilitated.
'''DOSAGE'''
* INTUBATION: Initial dose, 2-5 mg IVP then 2-4 mg every 30 seconds to 1 minute.
* SEDATION, PACING, CARDIOVERSION: Initial dose 2-5 mg IVP then 2 mg every 30 second to 1 minute IVP. Max dose= 15 mg in the intubated patient. Can be given IM.07-.mg/kg with onset in approximately 15 minutes
* An IM injection requires immediate IV access upon sedation.
* HYPOTENSION responds well to Trendelenburg.

====Ziprasidone (GEODON) / Antipsychotic====
'''DESCRIPTION'''
* An atypical antipsychotic acting as a dopamine antagonist that also affects other neurotransmitters to reduce psychosis and acute agitation.
'''INDICATIONS'''
* Used for the control of acute agitation in schizophrenic are severely agitated patients.
'''CONTRAINDICATIONS'''
* Persons known to have prolonged QTc intervals
** Only in high doses of 40-60 mg has shown a slight increase in QTc
* Known recent acute myocardial infarction
* Uncompensated heart failure
* Patients known to take other medications that also prolong the QTc interval
* Hypersensitivity to the medication.
'''PRECAUTIONS'''
* No clinically significant drug-drug interactions have been identified with other concomitantly administered EMS medications such as benzodiazepines.
'''DOSAGE'''
* 10 - 20 IM for adults based on the BARS scale for agitation.
* Not approved for use in pediatric patients.
'''ONSET OF ACTION'''
* Less than 15 minutes
* Peak effect 20-30 minutes
* Half-Life 2-5 hours

'''Behavioral Activity Rating Scale'''
{| class="wikitable"
|-
| 7|| Violent, requires restraint.
|-
| 6|| Extremely/continually active; not requiring restraint.
|-
| 5|| Signs of overt (physical or verbal) activity; calms down with instruction.
|-
| 4|| Quiet and awake (normal activity level).
|-
| 3|| Drowsy, appears sedated.
|-
| 2|| Asleep, but responds normally to verbal or physical contact.
|-
| 1|| Difficult or unable to arouse.
|}

'''Medications known to prolong the QTc (This table is not all inclusive)'''
{| class="wikitable"
|-
| Adderall|| Droperidol|| Procainamide
|-
| Amiodarone|| Effexor|| Propulsid
|-
| Anzemet|| Elavil|| Prozac
|-
| Avelox|| Erythromycin|| Seroquel
|-
| Betapace|| Haldol|| Tamoxifen
|-
| Cardene|| Lozol|| Zanaflex
|-
| Cerebyx|| Mellaril|| Zithromax
|-
| Detrol LA|| Norpace|| Zoloft
|}