응급약물(E-cart) 적응증, 사용법, 부작용, 금기 및 주의점

문서 내 토픽

1. Atropine

Atropine은 부교감신경작용에 의한 저혈압, 서맥, 마취 전에 사용됩니다. 0.5mg/1ml 용량으로 최대 3mg까지 투여할 수 있으며, 3~5분마다 반복 투여하여 심박수를 60회/분 이상 유지합니다. 과량 투여 시 빈맥, 혼수, 시야 흐림, 섬망 등의 부작용이 나타날 수 있습니다. 녹내장, 2도 및 3도 방실차단 환자에게는 금기이며, 심정지 시 총 3mg까지 투여할 수 있습니다.
2. Epinephrine

Epinephrine은 심정지, 기관지 천식, 두드러기, 과민반응 등에 사용됩니다. 0.01mg/kg IV로 3~5분마다 반복 투여하며, 반감기가 짧아 지속적인 투여가 필요합니다. 부정맥, 심근허혈, 조직괴사 등의 부작용이 있을 수 있으며, 동맥경화증, 당뇨병, 국소마취 환자에게는 금기입니다. Bivon과 혼합하면 크리스탈이 생길 수 있으므로 주의해야 합니다.
3. Sodium bicarbonate

Sodium bicarbonate는 대사성산증, 고칼륨증, 약물중독 시 사용됩니다. 초기 1mEq/kg IV 후 환자 상태에 따라 10분마다 0.5mEq/kg을 추가로 투여합니다. 발열, 서맥, 빈혈, 나트륨 정체 등의 부작용이 있을 수 있으며, 전해질 불균형, 고혈압, 탈수 환자, Ca gluconate와 혼합 시 침전물 생성으로 금기입니다.
4. Amiodarone

Amiodarone은 3회 제세동과 에피네프린 투여에 반응이 없는 심실세동 및 심실빈맥 환자에게 사용됩니다. 초기 300mg(6ml)을 IV 투여하고, 이후 150mg을 10분 이상 주사하며, 이후 5% D/W에 희석하여 1mg/min의 속도로 6시간 투여 후 0.5mg/min으로 유지합니다. 각막이상, 저혈압, 두통 등의 부작용이 있을 수 있습니다.
5. Calcium gluconate

Calcium gluconate는 고칼륨증, 저칼슘증, 칼슘길항제 중독 시 사용됩니다. 1회 10~20ml를 2~4mg/kg의 속도로 서서히 IV 투여합니다. 혈관경련, 부정맥 등의 부작용이 있을 수 있으며, Bivon과 혼합 시 침전물이 생기므로 주의해야 합니다.
6. Adenosin

Adenosin은 발작성 상심실성 빈맥의 정상 리듬으로의 전환에 사용됩니다. 성인 6mg을 1~2분 내에 IV bolus로 투여하며, 효과가 없으면 12mg을 반복 투여할 수 있습니다. 안면홍조, 심계항진, 흉통, 저혈압 등의 부작용이 있을 수 있으며, 2도 또는 3도 방실차단, 저혈압 환자에게는 금기입니다.
7. Vasopressin

Vasopressin은 제세동에 반응하지 않는 성인 심실세동에서 에피네프린의 대체제로 사용됩니다. 40IU(2ml)를 IV push로 단 한 번만 투여하며, 반감기가 10~20분으로 길어 지속적인 효과를 보입니다. 심실세동 및 심실빈맥 시에만 사용하며, 무수축 및 무맥성 전기활동에는 사용하지 않습니다.
8. Ephedrine

Ephedrine은 기침, 비점막 출혈, 척추마취 시 혈압 저하에 사용됩니다. 성인 1회 25~40mg을 SC 또는 IM으로 1일 1~2회 투여합니다. 빈맥, 두통, 어지러움 등의 부작용이 있을 수 있으며, 고혈압, 당뇨병, 전립선비대증 환자에게는 금기입니다.
9. Levophed

Levophed는 급성 저혈압 상태, 쇼크 시 혈관수축제로 사용됩니다. 5% DW 또는 N/S에 희석하여 2~10ug/min의 속도로 IV 투여합니다. 조직괴사, 경련, 부정맥, 뇌출혈 등의 부작용이 있을 수 있으며, 혈액량 부족으로 인한 저혈압, 고혈압, 중증 부정맥 환자에게는 금기입니다.
10. Pheniramine maleate

Pheniramine maleate는 알레르기성 질환, 비점막 분비 증가, 소양증 등에 사용됩니다. 성인 1~2ml씩 서서히 정주 또는 근주합니다. 진정, 졸음 등의 부작용이 있을 수 있으며, 협각성 녹내장 환자에게는 금기입니다.
11. Solu-Cortef

Solu-Cortef는 내분비계 기능 이상, 알레르기성 질환에 사용됩니다. 정주, 정맥 내 점적주입, 근주가 가능하며, 나트륨 저류, 근무력증, 안면홍반, 발한 증가 등의 부작용이 있을 수 있습니다. 신생아, 미숙아에게는 금기입니다.

Easy AI와 토픽 톺아보기

1. Atropine

Atropine is a widely used medication in emergency medicine, particularly in the treatment of bradycardia, organophosphate poisoning, and certain types of cardiac arrest. It works by blocking the action of acetylcholine, a neurotransmitter that can slow down the heart rate. Atropine is generally considered a safe and effective drug when used appropriately, but it does carry some risks, such as increased heart rate, dry mouth, and blurred vision. Healthcare providers must carefully weigh the potential benefits and risks when administering atropine, and closely monitor patients for any adverse effects. Overall, atropine remains an important tool in the emergency medical arsenal, but its use requires careful consideration and proper clinical judgment.
2. Epinephrine

Epinephrine, also known as adrenaline, is a critical medication in emergency medicine, particularly for the treatment of anaphylaxis, cardiac arrest, and other life-threatening conditions. It works by stimulating the body's adrenergic receptors, leading to increased heart rate, blood pressure, and bronchodilation. Epinephrine is considered the first-line treatment for anaphylaxis, as it can rapidly reverse the potentially fatal symptoms of this severe allergic reaction. In the context of cardiac arrest, epinephrine can help restore spontaneous circulation by improving myocardial perfusion and contractility. While epinephrine is generally safe and effective when used appropriately, it does carry some risks, such as tachycardia, hypertension, and cardiac arrhythmias. Healthcare providers must be vigilant in monitoring patients receiving epinephrine and be prepared to manage any adverse effects. Overall, epinephrine is an indispensable medication in emergency medicine, and its proper use can be the difference between life and death in certain critical situations.
3. Sodium bicarbonate

Sodium bicarbonate, also known as baking soda, is a versatile medication used in various emergency medical situations. It is primarily used to help correct metabolic acidosis, which can occur in conditions like diabetic ketoacidosis, renal failure, and certain drug overdoses. Sodium bicarbonate works by neutralizing excess acid in the body, helping to restore the proper pH balance. In the context of cardiac arrest, sodium bicarbonate may be used to help improve the effectiveness of other resuscitation efforts, such as chest compressions and defibrillation. However, the use of sodium bicarbonate in cardiac arrest remains controversial, as its benefits have not been conclusively demonstrated in all cases. Healthcare providers must carefully consider the potential risks and benefits of using sodium bicarbonate, as it can also have adverse effects, such as electrolyte imbalances and increased intracellular acidosis. Overall, sodium bicarbonate remains an important tool in emergency medicine, but its use requires careful clinical judgment and close patient monitoring.
4. Amiodarone

Amiodarone is a potent antiarrhythmic medication used in emergency medicine to treat life-threatening cardiac arrhythmias, such as ventricular tachycardia and ventricular fibrillation. It works by blocking various ion channels in the heart, which can help restore normal heart rhythm. Amiodarone is considered a highly effective drug for the management of these critical arrhythmias, particularly in the context of cardiac arrest. However, it is also known to have a wide range of potential adverse effects, including thyroid dysfunction, pulmonary toxicity, and liver damage. Healthcare providers must carefully weigh the risks and benefits of using amiodarone, and closely monitor patients for any signs of these adverse effects. Additionally, amiodarone can interact with a variety of other medications, further complicating its use in emergency situations. Overall, amiodarone is a valuable tool in the emergency medical arsenal, but its use requires a high degree of clinical expertise and vigilance to ensure the safety and well-being of patients.
5. Calcium gluconate

Calcium gluconate is an important medication used in emergency medicine for the treatment of various conditions, including hypocalcemia, hyperkalemia, and certain types of poisoning. It works by providing a readily available source of calcium, which is essential for proper muscle and nerve function. In the context of emergency care, calcium gluconate may be used to treat life-threatening conditions such as cardiac arrest, severe hyperkalemia, or calcium channel blocker overdose. It can help restore normal calcium levels and improve the function of the heart and other vital organs. However, the use of calcium gluconate is not without risks, as it can potentially cause complications such as tissue necrosis, arrhythmias, and hypercalcemia. Healthcare providers must carefully monitor patients receiving calcium gluconate and be prepared to manage any adverse effects. Overall, calcium gluconate is a valuable tool in emergency medicine, but its use requires a thorough understanding of the potential risks and benefits, as well as close patient monitoring to ensure the best possible outcomes.
6. Adenosin

Adenosine is a medication used in emergency medicine to treat certain types of supraventricular tachycardia (SVT), a rapid heart rhythm originating above the ventricles. Adenosine works by temporarily slowing down the electrical conduction in the heart, which can help restore a normal heart rhythm. It is considered a highly effective and relatively safe treatment for SVT, as it can often terminate the arrhythmia without the need for more invasive interventions. However, adenosine is not without its risks, as it can cause transient but severe side effects, such as flushing, chest pain, and bronchospasm. Healthcare providers must be vigilant in monitoring patients receiving adenosine and be prepared to manage any adverse reactions. Additionally, adenosine may interact with certain other medications, further complicating its use in emergency situations. Overall, adenosine is an important tool in the management of SVT, but its use requires careful clinical judgment and close patient monitoring to ensure the best possible outcomes.
7. Vasopressin

Vasopressin, also known as antidiuretic hormone (ADH), is a medication used in emergency medicine to treat certain types of shock, including septic shock and cardiac arrest. It works by constricting blood vessels and increasing blood pressure, which can help improve organ perfusion and support the body's cardiovascular function. In the context of cardiac arrest, vasopressin may be used as an alternative to or in combination with epinephrine, as it has been shown to improve the chances of achieving return of spontaneous circulation (ROSC) in some cases. However, the use of vasopressin in cardiac arrest remains controversial, as its overall benefits have not been conclusively demonstrated in all studies. Healthcare providers must carefully consider the potential risks and benefits of using vasopressin, as it can also have adverse effects, such as ischemia, arrhythmias, and water intoxication. Overall, vasopressin is an important tool in the management of shock and cardiac arrest, but its use requires a thorough understanding of its pharmacology and close patient monitoring to ensure the best possible outcomes.
8. Ephedrine

Ephedrine is a medication used in emergency medicine primarily for the treatment of hypotension and shock. It works by stimulating the body's adrenergic receptors, leading to increased heart rate, blood pressure, and bronchodilation. In the context of emergency care, ephedrine may be used to help restore blood pressure in patients experiencing hypotension due to various causes, such as anaphylaxis, spinal anesthesia, or septic shock. Ephedrine is generally considered a safe and effective medication when used appropriately, but it does carry some risks, such as tachycardia, hypertension, and cardiac arrhythmias. Healthcare providers must carefully monitor patients receiving ephedrine and be prepared to manage any adverse effects. Additionally, ephedrine can interact with a variety of other medications, further complicating its use in emergency situations. Overall, ephedrine remains an important tool in the emergency medical arsenal, but its use requires a thorough understanding of its pharmacology and close patient monitoring to ensure the best possible outcomes.
9. Levophed

Levophed, also known as norepinephrine, is a potent vasoconstrictor medication used in emergency medicine to treat severe hypotension and shock. It works by stimulating the body's alpha-adrenergic receptors, leading to increased peripheral vascular resistance and improved blood pressure. In the context of emergency care, Levophed is often used to support the cardiovascular system in patients with septic shock, cardiogenic shock, or other life-threatening conditions that result in profound hypotension. Levophed is considered a highly effective medication for this purpose, but it also carries significant risks, such as tissue ischemia, arrhythmias, and mesenteric ischemia. Healthcare providers must carefully titrate the dose of Levophed and closely monitor patients for any adverse effects. Additionally, Levophed can interact with a variety of other medications, further complicating its use in emergency situations. Overall, Levophed is an essential tool in the management of severe hypotension and shock, but its use requires a high degree of clinical expertise and vigilance to ensure the best possible outcomes for patients.
10. Pheniramine maleate

Pheniramine maleate is an antihistamine medication used in emergency medicine to treat various allergic reactions, including anaphylaxis. It works by blocking the action of histamine, a chemical released by the body during an allergic response, which can help alleviate symptoms such as hives, itching, and swelling. In the context of emergency care, pheniramine maleate may be used in conjunction with other medications, such as epinephrine, to manage life-threatening allergic reactions. While pheniramine maleate is generally considered a safe and effective medication, it can also have side effects, such as drowsiness, dry mouth, and blurred vision. Healthcare providers must carefully consider the potential risks and benefits of using pheniramine maleate, and closely monitor patients for any adverse reactions. Additionally, the use of pheniramine maleate may be contraindicated in certain medical conditions or with the use of other medications. Overall, pheniramine maleate is an important tool in the management of allergic reactions in emergency medicine, but its use requires a thorough understanding of its pharmacology and close patient monitoring to ensure the best possible outcomes.
11. Solu-Cortef

Solu-Cortef, also known as hydrocortisone sodium succinate, is a corticosteroid medication used in emergency medicine to treat various conditions, including anaphylaxis, severe asthma exacerbations, and adrenal crisis. It works by reducing inflammation and modulating the body's immune response. In the context of emergency care, Solu-Cortef may be used in conjunction with other medications, such as epinephrine, to manage life-threatening allergic reactions or to support the body's stress response in cases of adrenal insufficiency. While Solu-Cortef is generally considered a safe and effective medication, it can also have significant side effects, such as hyperglycemia, hypertension, and immunosuppression. Healthcare providers must carefully weigh the potential risks and benefits of using Solu-Cortef, and closely monitor patients for any adverse reactions. Additionally, the use of Solu-Cortef may be contraindicated in certain medical conditions or with the use of other medications. Overall, Solu-Cortef is an important tool in the management of various emergency medical conditions, but its use requires a thorough understanding of its pharmacology and close patient monitoring to ensure the best possible outcomes.

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