Farmaci D'urgenza

www.mlcroguldedlmedlclna.
lL
Farmaci durgenza

A|essandro Mar|a Ierrazza
lnfo[mlcroguldedlmedlclna.lL
lnC18Cl:
Adrenallna
noradrenallna
uobuLamlna
uopamlna
8L1A-8LCCCAn1l:
ALenololo
MeLoprololo
ropranololo
LabeLalolo
An1l88AulCA8ulCl:
ALroplna
lsoprenallna
An1l1ACPlCA8ulCl:
ropafenone
Amlodarone
SoLalolo
ulgosslna
Ca-An1ACCnlS1l:
ullLlazem
verapamll
ulu8L1lCl L nl18CuL8lvA1l:
lurosemlde
nlLrogllcerlna
nlLroprusslaLo

AL18l:
Amlnofllllna
SomaLosLaLlna
Lparlna Sodlca
1rombollLlcl
A88kLVIA2ICNI:
A = resslone ArLerlosa
lC = lrequenza Cardlaca
LCC = LleLLrocardlogramma
lv = llbrlllazlone venLrlcolare
1v = 1achlcardla venLrlcolare
LA = ALLlvlLa LleLLrlca Senza olso
Sl = Soluzlone llslologlca 0,9
SC = Soluzlone ClucosaLa 3
lA = llbrlllazlone ALrlale
8Av = 8locco ALrlo-venLrlcolare
8SA = 8locco Seno ALrlale
1Sv = 1achlcardla SopravenLrlcolare
1Sv = Wolff arklnson WhlLe
SSS = Slck Slnus Syndrome
M = acemaker
lMA = lnfarLo Mlocardlco AcuLo
8CC = 8roncopneumopaLla Cronlca CsLruLLlva
LA = Ldema olmonare AcuLo
L = Lmbolla olmonare
CC = ClLLaLa Cardlaca
Clu = Coagulazlone lnLravascolare ulssemlnaLa
S1LMl = S1 LlevaLlon Mlocardlal lnfarcLlon
nlPSS = naLlonal lnsLlLuLe of PealLh SLroke Scale

!"#$%!&'%!
1mg/1ml (Adrenallna)
1:1000
Ind|caz|on|:
ArresLo cardlaco da lv o 1v, aslsLolla, LA
Anafllassl
uosagglo: vedl Labella
!""#$$% ' ())#*(+$%
Effetto max: 3
Contro|nd|caz|on|:
Claucoma ad angolo chluso
recauz|on|: cauLela ln presenza dl
CardlopaLla lschemlca, dlabeLe, lperLenslone
lnsufflclenza cerebro-vascolare
lperLlroldlsmo
1osslclLa dlglLallca (lnLerazlone)
Avvertenze:
MonlLorlzzare A, lC, LCC
non mescolare con sosLanze alcallne
vena dl grosso callbro o per vla endoLracheale
DCSAGGI ADkLNALINA
,-./-0.1-2/! 3.,4-252602/.,!
78 # 98
1 fl e.v. Jopo ll J sbock (J clclo Jl kcl)
pol 1 fl e.v. o clcll oltetol (oqol J-5 mlootl)
.:(:$%;(+ %
5!.
1 fl e.v. oppeoo posslblle
pol 1 fl e.v. o clcll oltetol (oqol J-5 mlootl)
./.9-6.<<-
(Jo sommlolsttote lo coso Jl oltetozlool Jelle vle oetee,
polmoootl o cltcolototle o tlscblo pet lo vlto)
-/7,.0=<326.,! tetzo meJlo Jello cosclo lo ootetolotetole
(pl slcoto, ooo tlcbleJe occessl veoosl)
.*>;$( ?@@ )AB C@D? ); *( "; E'E@@@F
G+)H(I( J EK +II( ?@@ )AB C@D? ); *( "; E'E@@@F
G+)H(I( LMEK +II( N@@ )AB C@DN ); *( "; E'E@@@F
G+)H(I( O L +II( E?@ )AB C@DE? ); *( "; E'E@@@F
,(P#$#Q# *%P% ? )(I>$( :# I% )(B;(%Q+)#I$%
!/428!/. lo fl 1.1000 (1mq lo 1 ml) vo 5Mlk Jllolto
( RISCHIO di effetti collaterali se diagnosi sbagliata)
5%Q$+Q# E "; *+ E )B + E@ ); C:%;>R(%I# E'E@@@@F
.*>;$( ?@ )AB C@D? ); *( :%;>R(%I# E'E@@@@F
G+)H(I( E )ABSTB C@D@E );STB *( :%;>R(%I# E'E@@@@F

%)#!"#$%!&'%!
2mg/1ml (noradrenallna LarLraLo)
Ind|caz|on|:
Shock cardlogeno
Shock seLLlco
A11LnZlCnL: non dl prlma llnea, lndlcaLo ln assoclazlone a
llquldl e lnoLropl (dobuLamlna) se quesLl ulLlml falllscono
nellaumentare la PA.
uose: vedl Labella
!""#$$% ' EM2
CardlopaLla lschemlca o vascolopaLla perlferlca
(vasocosLrlzlone)
lperLenslone
lperLlroldlsmo
LvlLare ssoclazlone con uopamlna ad alLl dosaggl (ha gla
effeLLo vasopressorlo)
1erapla con anLldepresslvl Lrlclcllcl
Avvertenze:
roLeggere dalla luce
ln caso di stravaso 5-10mg dl fenLolamlna ln 10 cc dl Sl
Contro|nd|caz|on|:
1rombosl arLerlose (vasocosLrlzlone)
lpercapnla e lpossla grave
DCSAGGI NCkADkLNALINA
4%:+BB(% (I(R(+;#' @D?ME )ABS)(I
.BB(>:$+)#I$(' E )ABS)(I %BI( ?M10 floo o tlsposto
emoJloomlco

CCN MICkCGCCCICLA1CkL
E"; (I K?@AA *( <9 CU)ABS);F
uosoqqlo (mcq/mlo) x 7,5 V );SW *+ (I"%I*#Q#
4%:+BB(% (I(R(+;# @D?ME )ABS)(I XMU );SW
5#Q %BI( (IAQ#)#I$% *( E )ABS)(I 8 ml/h
4%:+BB(% )+Y N@ )ABS)(I KK? );SW

CCN POMPA DINFUSIONE
E"; (I ?@AA *( <9 CX@)ABS);F
uosoqqlo (mcq/mlo) x 0,66 V );SW *+ (I"%I*#Q#
4%:+BB(% (I(R(+;# @D?ME )ABS)(I @DNM@DL );SW
5#Q %BI( (IAQ#)#I$% *( E )ABS)(I 0,6 ml/h
4%:+BB(% )+Y N@ )ABS)(I K@ );SW

")*+,!-'%!
230mg/20ml (uobuLrex)
Ind|caz|on|:
SupporLo lnoLropo dl breve perlodo ln pazlenLl con :
Scompenso cardlaco a bassa porLaLa (e.g. LA con bassa
porLaLa, shock cardlogeno)
Shock seLLlco, A8uS
Lmbolla polmonare masslva (rlduce le reslsLenze
polmonarl)
uose: vedl Labella
!""#$$% ' EM2
!""#$$o max: 1010
recauz|on|:
CauLela ln presenza dl lA
Avvertenze:
MonlLorlzzare A, lC, LCC, k
+
(pu dare lpokallemla)
non sommlnlsLrare con A<90 mmPg e lpovolemla
Contro|nd|caz|on|:
SLenosl lperLroflca soLLoaorLlca
ln Lerapla lsolaLa ln pazlenLl lpovolemlcl

DCSAGGI DC8U1AMINA
4%:+BB(% (I(R(+;#' KD?)ABSTBS)(I
Aggiustamenti:2,5mcg/Kg/min ogni 10M15 floo o tlsposto
emoJloomlco
4%:# )+::()+' 15mcq/kq/mlo (20 mcq/kq/mlo lo pozleotl
betobloccotl)
.77!/1-2/!' :%:P#I*#Q# BQ+*>+;)#I$#

CCN MICkCGCCCICLA1CkL
E"; (I K?@AA *( <9 CE)BS);F
uosoqqlo (mcq/mlo) x peso (kq) x 0,06 V );SW *+ (I"%I*#Q#
)ABSTBS)(I KD? ? E@
?@ TB ZD? );SW E? );SW N@ );SW
L@ TB [ );SW EU );SW NL );SW
Z@ TB E@D? );SW KE );SW XK );SW
[@ TB END? );SW KZ );SW ?X );SW

CCN POMPA DINFUSIONE
E"; (I ?@AA *( <9 C?)BS);F
)ABSTBS)(I KD? ? E@
?@ TB ED? );SW N );SW L );SW
L@ TB EDU );SW NDL );SW ZDK );SW
Z@ TB KDE );SW XDK );SW UDX );SW
[@ TB KDZ );SW ?DX );SW E@DU );SW

").!-'%!
200mg/3ml (8evlvan)
Ind|caz|on|:
8osso Josoqqlo: *%P+)(I#QB(A+ C\+:%*(;+$+R(%I#F
gittata cardiaca con compromissione renale (oliguria)
uosoqqlo meJlo o elevoto: -+*Q#I#QB(A% C(I%$Q%P%F ed M
+*Q#I#QB(A% C\+:%A%:$Q(R(%I#F
shock, Lranne lpovolemlco (se non dopo correzlone)
uose: vedl Labella
!""#$$% ' KM5
!""#$$% )+Y'10 10
CardlopaLla lschemlca, vascolopaLla perlferlca (vasocosLr)
ArlLmle mlnacclose (proarlLmlco)
Avvertenze:
ln caso dl sopradosagglo Neostigmina (0,5-2mg e.v.)
Contro|nd|caz|on|:
leocromoclLoma
ln Lerapla lsolaLa ln paz lpovolemlcl
4%:+BB(% Q#I+;#' K )ABSTBS)(I
4%:+BB( )#*(%M+;$(' ?ME@ )ABSTBS)(I
E"; (I K?@AA *( <9 C@DU)BS);F
)ABSTBS)(I K ? E@
?@ TB ZD? );SW EUDZ? );SW NZD? );SW
L@ TB [ );SW KKD? );SW X? );SW
Z@ TB E@D? );SW KLDK? );SW ?KD? );SW
[@ TB END? );SW NNDZ? );SW LZD? );SW

!,#).'%!
1mg/1ml (ALroplna solfaLo)
Ind|caz|on|:
8radlcardle e 8Av
lpoLenslone da lperLono vagale
uose: 1mg ripetibile a 5
uose max' @D@X)BSTB CA(QA+ N)BF
!""#$$% ' 2
!""#$$% )+Y' KMX45
Febbre non permette la sudorazioneIpertermia
Avvertenze:
ln caso dl sopradosagglo Neostigmina (0,5-2mg e.v.)
Contro|nd|caz|on|:
SLenosl pllorlca, lleo parallLlco, collLe ulcerosa grave
Claucoma ad angolo chluso
MlasLenla gravls

'/).#$%!&'%!
0,2 mg/1ml (lsoprenallna clorldraLo)
Ind|caz|on|:
8radlcardle emodlnamlcamenLe
slgnlflcaLlve, reslsLenLl alla aLroplna (G;%AAW( :%$$%W(:(+I()
1orslone dl punLa
uose: vedl Labella
!""#$$% ' ())#*(+$%
Effetto max: 151h
lpovolemlcl (pu dare lpoLenslone)
Avvertenze:
Contro|nd|caz|on|:
lschemla mlocardlca
1achlarlLmle
1osslclLa dlglLallca
Dosagg|o: 1-20 mcg]m|n
? "; (I E@@AA *( <9 CE@)ABS);F
uosoqqlo (mcq/mlo) x 6 V );SW *+ (I"%I*#Q#
)ABS)(I );SW )ABS)(I );SW
E L EK ZK
K EK E? [@
? N@ EU E@U
E@ L@ K@ EK@

.#).!0$%)%$
70mg/20ml (8yLmonorm)
Ind|caz|on|:
1Sv (lluLLer ALrlale, lA, 1Sv)
ArlLmle ln presenza dl WW
uose: ved| tabe||a
!""#$$% ' 1
!""#$$% )+Y' 10 20MN@
lnsufflclenza cardlaca non grave
lnsufflclenza epaLlca (meLabollsmo epaLlco)
Avvertenze:
Correggere eleLLrollLl prlma
Se QRS > 18% dose
Se PA o FC dopamina e isoproterenolo
Dose |n|z|a|e:
2 mg]kg |n S-10
Manten|mento:
0,007 mg]kg]m|n
fl ln bolo
1 fl ln 230cc
dl Sol Cluc 3
oppure 230cc dl
Sol Cluc 3 +
?@ TB E]ESK "; Z? );SW ^ ";
Z@ TB K "; E@? );SW E";
[@ TB K]ESK "; EN? );SW E"; # _";
Noo sopetote 2 ote Jl lofoslooe Jl
mooteolmeoto
o 125 ml/b
(2 ote)

Contro|nd|caz|on|:
lnsufflclenza cardlaca e shock cardlogeno, A<100 (lno -)
SSS, 8Av dl ll e lll, 88Sn e 8locchl fasclcolarl, lC<30
LpaLopaLla grave, MlasLenla, 8CC

!-')"!#)%$
130mg/3ml (Cordarone)
Ind|caz|on|:
1Sv (lluLLer ALrlale, lA, 1Sv), 1v
8allenLamenLo della lrequenza venLrlcolare ln corso dl
fluLLer o lA
rofllassl dl recldlve dl arlLmle venLrlcolarl
uose: ved| tabe||a
!""#$$% ' 10
!""#$$% )+Y' N@ML@
lpoLenslone
lnsufflclenza epaLlca (meLabollsmo epaLlco)
1lreopaLle (conLlene lodlo)
Avvertenze:
ullulre SLM8L ln Soluzlone glucosaLa (SC)
Dose |n|z|a|e:
3-S mg]kg |n S-10
Manten|mento:
1S mg]kg]24h
fl ln bolo 4 fl ln 230cc dl SC
?@ TB E]ESK "; EN );SW
Z@ TB K "; EU );SW
[@ TB K]ESK "; KN );SW
ll bolo po essete fotto oocbe lo ooo flebo Jl 5C lo J0 mlo

Contro|nd|caz|on|:
lpoLenslone
SSS, 8Av dl ll e lll ln assenza dl M

/),!&)&)
40mg/4ml (8yLmobeLa)
Ind|caz|on|:
lluLLer aLrlale (magglor efflcacla), 1v
ArlLmle assoclaLe a WW
uose: ved| tabe||a
!""#$$% ' KM?
!""#$$% )+Y' N@ LW
Contro|nd|caz|on|:
lnsufflclenza cardlaca, shock cardlogeno
SSS, 8Av dl ll e lll ln assenza dl M, lC<30 bpm
C1 lungo
Asma bronchlale
vascolopaLla perlferlca
lnsufflclenza renale, lpokallemla
1lreoLosslcosl, feocromoclLoma
ulabeLe.
Avvertenze:
Dosagg|o: 1,Smg]kg in 10
eso (kg) Numero d| f|a|e
X@ TB E ] `
?@ TB E ] ^
L@ TB K ] _
Z@ TB K ] ^
U@ TB N
[@ TB N ] _

"'1)//'%!
0,3mg/2ml (Lanoxln)
Ind|caz|on|:
della Freq VenLrlcolare nelle LachlarlLmle aLrlall ln
presenza dl scompenso cardlaco
uose: ved| tabe||a
!""#$$% ' ?M10
!""#$$% )+Y' KW
Contro|nd|caz|on|:
WW (rlschlo dl degenerazlone dl una lA ln lv)
SSS, 8SA, 8Av dl grado elevaLo
8ldoLLa funzlone renale
MlocardlLe acuLa, lMA
K
+
, Mg
++
, Ca
++
, Ipossia, Ipotiroidismo ( EFFETTO)
Avvertenze:
Somministrare lentamente (5) rischio di vasocostrizlone
ConLrollare funzlone renale, eleLLrollLl, LCC, dlgosslnemla
Cardloverslone eleLLrlca: sospendere 24 h prlma
Dose |n|z|a|e: 0,2S-0,Smg (1]2-1f|) in 5
Manten|mento:
0,01-0,02mg]kg
|n 2-3 boli ev di 5

!,$%)&)&)
3mg/10ml (1enormln)
Ind|caz|on|:
lschemla mlocardlca ed lMA (ln paz.emodlnamlcamenLe
sLablll)
1achlarlLmle venLrlcolarl e SopravenLrlcolarl
lperLenslone arLerlosa ln presenza dl dlssezlone aorLlca
uose: ved| tabe||a
!""#$$% ' 5
!""#$$% )+Y' E? 18MKXW
Contro|nd|caz|on|:
lnsufflclenza cardlaca e shock carlogeno (AS < 100)
SSS, 8Av dl ll e lll grado, lC < 30
8CC, Asma
ulabeLe.
Avvertenze:
Dose |n|z|a|e:
S mg (1f|) in 10
Ripetibili dopo 10
Manten|mento per os:
50mg 15 dopo infusione
30mg 12h dopo lnfuslone
ol 100 mg/dle

-$,).#)&)&)
3mg/3ml (Seloken)
Ind|caz|on|:
lMA e lschemla mlocardlca
uose: ved| tabe||a
!""#$$% ' 20
!""#$$% )+Y' K@ 5MUW
Contro|nd|caz|on|:
8CC, Asma
ulabeLe.
Avvertenze:
Dose |n|z|a|e:
S mg (1f|) |n S
Ripetibili dopo 10
Manten|mento per os:
50mg 15 dopo infusione
30mg 6-12-18h dopo lnfuslone
ol 100 mg x 2 volLe/dle

.#).#!%)&)&)
3mg/3ml (lnderal)
Ind|caz|on|:
uose: ved| tabe||a
!""#$$% ' ())#*(+$%
!""#$$% )+Y' E 5
Contro|nd|caz|on|:
8CC, Asma
ulabeLe.
Avvertenze:
LvlLare brusca sospenslone (88LvL uu8A1A)
Dose |n|z|a|e:
S mg (1f|) |n bo|o
klpetlblll Jopo 2
Manten|mento:
1-3 mg]h:
5fl lo 250cc Jl 5l (0,1mq/ml) o 10-J0ml/b

&!*$,!&)&)
100mg/20ml (1randaLe)
Ind|caz|on|:
Lmergenze lperLenslve
uose: ved| tabe||a
!""#$$% ' KM5
!""#$$% )+Y' E? 2MXW
Contro|nd|caz|on|:
8CC, Asma
ulabeLe.
Avvertenze:
lpoLenslone orLosLaLlca (pz suplno per 3h dopo lnfuslone)
Dose |n|z|a|e: 20mg (4ml) in 2
Dos| success|ve:
20-80mg (4-16ml) in 2
Ripetibili ogni 10
Manten|mento:
1-2 mg]m|n (MAk 2400mg]d|e)
5fl lo 250cc Jl 5l (2mq/ml) o J0-60ml/b

"'&,'!2$-
30mg/3ml (AlLlazem,
ullzene, 1lldlem)
Ind|caz|on|:
anglna lnsLablle, anglna dl lnzmeLal
1achlcardle Sv da rlenLro
della FV nel flutter e nella FA
uose: vedl Labella
!""#$$% ' 3
!""#$$% )+Y' 5
non assoclare a beLa-bloccanLl (+$$#I*#Q# XUW *+;;+
:%:P#I:(%I#)
Avvertenze:
in caso di sopradosaggio Neostigmina (0,5-2mg e.v.)
Contro|nd|caz|on|:
lpoLenslone, Scompenso cardlaco
Dose |n|z|a|e:
0,1S-0,30 mg]kg |n 2
Manten|mento:
0,12-0,30 mg]kg]h
1 fl ln 20 cc dl Sl
3 fl ln 230cc dl Sl
(1mg/ml)
X@ TB KD?M? ); ?ME@ );SW
?@ TB NML ); LMEK );SW
L@ TB ND?MZ ); ZME? );SW
Z@ TB XDKMUDX ); [MEU );SW
U@ TB ?ME@ ); E@MK@);SW
[@ TB ?D?MEK ); ENMKL );SW

3$#!.!-'&
3mg/2ml (lsopLln)
Ind|caz|on|:
anglna lnsLablle, anglna dl lnzmeLal
1achlcardle Sv da rlenLro
della FV nel flutter e nella FA
uose: vedl Labella
!""#$$% ' E
!""#$$% )+Y' ?ME?30MLW
Epatopatia ridurre i dosaggi
M. di Duchenne pu precipitare insufficienza
resplraLorla
Avvertenze:
Contro|nd|caz|on|:
lpoLenslone, Scompenso cardlaco
Dose |n|z|a|e: 5mg (1fl) in 5 ripetibile
Manten|mento: 1-Smcg]kg]m|n
10fl lo 250cc Jl 5l (200mcq/ml)
mcg]kg]m|n 1 2 3 S (MAk)
X@ TB EK );SW KX );SW NL );SW L@ );SW
?@ TB E? );SW N@ );SW X? );SW Z? );SW
L@ TB EU );SW NL );SW ?X );SW [@ );SW
Z@ TB KE );SW XK );SW LN );SW E@? );SW
U@ TB KX );SW XU );SW ZK );SW EK@ );SW
[@ TB KZ );SW ?X );SW UE );SW EN? );SW

0+#)/$-'"$
20mg/3ml, 230mg/23ml (Laslx)
Ind|caz|on|:
LA, Lmergenze lperLenslve
lnsufflclenza renale, lperk
uose: ved| tabe||a
!""#$$% '
vosoJllotozlooe veooso. 5
Jlotetlco. 20
!""#$$% )+Y' XMLW
Contro|nd|caz|on|:
lpoLenslone, lpovolemla
Anurla
lpoLenslone
uonne ln eLa ferLlle
Avvertenze:
MonlLorlzzare A, lC, LleLLrollLl (na, k, Ca, Mg, Cl)
Dosaggi nelledema po|monare acuto:
0,S-1 mg]kg |n 1m|n
5e ooo tlspooJe Jopo 15mlo
2 mg]kg |n 1m|n
@D? )BSTB E )BSTB K )BSTB
X@ TB E ";a K "; X ";
?@ TB E ] ` "; N "; L ";
L@ TB K "; X "; U ";
Z@ TB K ] ` "; ? "; E@ ";
U@ TB N "; L "; EK ";
a "; (I$#:+ A%)# "; *+ K@)B

%',#)1&'4$#'%!
3mg/1,3ml (venlLrln, nlLrosorblde)
Ind|caz|on|:
Scompenso cardlaco con LA e A alLa
uose: ved| tabe||a
!""#$$% ' E
!""#$$% )+Y' EM? 5
Contro|nd|caz|on|:
lpoLenslone
IMA destro ( GC)
Tamponamento cardiaco ed embolia polmonare (GC)
Lmorragla cerebrale
Dose |n|z|a|e: 5mg (1fl) in 1
Manten|mento: 0,1-2mcg]kg]m|n
Jfl lo 250cc Jl 5l (60mcq/ml)
mcg]kg]m|n 0,1 0,2S 1 2 (MAk)
X@ TB X );SW E@ );SW X@ );SW U@ );SW
?@ TB ? );SW EKD? );SW ?@ );SW E@@ );SW
L@ TB L );SW E? );SW L@ );SW EK@ );SW
Z@ TB Z );SW EZD? );SW Z@ );SW EX@ );SW
U@ TB U );SW K@ );SW U@ );SW EL@ );SW
[@ TB [ );SW KKD? );SW [@ );SW EU@ );SW

ANGINA E@);SW - ?M10ml/h ogni 5 lo bose o lA e Jolote
LA
EZD? );SW - EZD?ml/h ogni 5 lo bose o lA e
Jlspoeo

%',#).#+//'!,)
100mg/3ml (Sodlo nlLroprusslaLo)
Ind|caz|on|:
ulssecazlone aorLlca
Scompenso cardlaco con LA e A alLa

uose: ved| tabe||a
!""#$$% ' ())#:*(+$%
!""#$$% )+Y' ? E@
Contro|nd|caz|on|:
CoarLazlone aorLlca
ALrofla oLLlca dl Leber
lMA desLro ( GC)
Tamponamento cardiaco ed embolia polmonare (GC)
lnsufflclenza epaLlca, renale e cerbrovascolare
lpoLlroldlsmo
Avvertenze:
roLeggere dalla luce e dllulre ln SC 3
Dosagg|o: 1-10 mcg]kg]m|n
1 fl lo 250cc Jl 5C (400mcq/ml)
mcg]kg]m|n 1 2 S 10
X@ TB L );SW EK );SW N@ );SW L@ );SW
L@ TB [ );SW EU );SW X? );SW [@ );SW
U@ TB EK );SW KX );SW L@ );SW EK@ );SW
[@ TB EN );SW KZ );SW LZ );SW EN? );SW

oss|b||e |ntoss|caz|one da 1|oc|anat|

!-'%)0'&&'%!
240mg/10ml (1efamln, Amlnomal)
Ind|caz|on|:
Asma bronchlale
AnLagonlsLa del ulplrldamolo
uose: ved| tabe||a
!""#$$% ' 30
!""#$$% )+Y' N@ML@
Contro|nd|caz|on|:
ulcera ln fase aLLlva
Scompenso cardlaco
Lpllessla
Avvertenze:
dosaggl mlnorl se LraLLaLl con erlLromlclna, clmeLldlna,
allopurlnolo (lnLerazlonl)
AnLagonlsLa con dlureLlcl ansa, barblLurlcl,
carbamazeplna, slmpaLlcomlmeLlcl
Dose |n|z|a|e:
S-6 mg/kg in 20
Manten|mento:
0,4-0,9 mg]kg]h
2 fl ln 100cc dl Sl
2 fl ln 230cc dl Sl
(1,92 mg/ml)
X@ TB UX );SW UMEU );SW
?@ TB E@X );SW E@MKN );SW
L@ TB EKX );SW EKMKZ );SW
Z@ TB EXL );SW EXMNK );SW
U@ TB ELL );SW ELMNL );SW
[@ TB EUL );SW EUMX@ );SW

/)-!,)/,!,'%!
230mcg 3mg/2ml (SLllamln)
2mg/2ml (ModusLaLlna)
Ind|caz|on|:
Lmorragle acuLe gasLrlche o duodenall (ulcere, varlcl)
uose: vedl Labella
ulabeLe lnsullno-dlpendenLe (pu causare lpogllcemla
segulLa da lpergllcemla dopo 2-3 ore)
Avvertenze:
lnlezlone ev lenLamenLe con pazlenLe suplno
4%:+BB(%' ND? )ABSTBSW P#Q XUMZKW 120h (MAX)
In pompa dinfusione
1fl Jo 2mq lo 50cc Jl 5l (40 mcq/ml)
X@ TB ND? );SW
?@ TB XDX );SW
L@ TB ?DK );SW
Z@ TB LDE );SW
U@ TB ZD@ );SW
[@ TB ZD[ );SW

$.!#'%! /)"'4!
230mg/3ml (1ml = 3000 ul)
Ind|caz|on|:
Lmbolla olmonare
Lmbolla arLerlosa perlferlca
Anglna lnsLablle, lMA
Clu

uose: vedl Labella
!""#$$% ' 3
!""#$$% )+Y' 5
aLologle renall
lperLenslone arLerlosa non conLrollaLa
Avvertenze:
MonlLorlzzare a11 ognl 6 ore (1,3-2,3 volLe)
AN1I1CDC: SolfaLo dl proLamlna (Sm| 1 per 1 m| d| epar|na)
Contro|nd|caz|on|:
Lmorragla ln aLLo
Crave LromboclLopenla (rlschlo Pl1)
Dose |n|z|a|e (bo|o): 1m| (S000 UI)
Manten|mento: 5ml (25000 ul) lo 500cc Jl 5l (50 ul/ml)
3%)(IA(+Q# A%I K@);SW CE@@@ =-SWF
Jopo 6 b coottollote ol11 e moJlflcote
a11 (sec) 8o|o
Stop |nfus.
(mlootl)
Var. ve|oc
(ml/b)
k|pet|z.
a11
OX@ N@@@ =- @ ]K LW
X@MX[ @ @ ]E LW
?@MZ? @ @ /#::>I+ EKW
ZLMU? @ @ ME EKW
ULME@@ @ N@ MK LW
E@EME?@ @ L@ MN LW
JE?@ @ L@ ML LW

,#)-*)&','4'
Ind|caz|on|:
lnfarLo mlocardlco acuLo S1LMl
Lmbolla polmonare con lmpegno emodlnamlco
lcLus lschemlco*
uose: vedl Labella
lperLenslone non conLrollaLa (> 180/110 mmPg)
1raumaLlsmo recenLe (2-4 seLLlmane)
lnLervenLo chlrurglco magglore (< 3 seLLlmane)
8lanlmazlone cardlopolmonare (< 4 seLLlmane)
Lmorragla lnLerna recenLe (2-4 seLLlmane)
unLure vascolarl non comprlmlblll
recedenLe uso dl sLrepLochlnasl da 3 glornl a 2 annl
prlma (ln caso dl rluLlllzzo dl sLrepLochlnasl)
Cravldanza
ulcera pepLlca aLLlva
1raLLamenLo anLlcoagulanLe orale ln corso

Contro|nd|caz|on| genera||:
lcLus emorraglco o evenLo cerebrale enLro 1 anno
neoplasla lnLracranlca
Lmorragla ln fase aLLlva (Lranne mesLruazlonl)
SospeLLa dlssecazlone aorLlca

*nellictus ischemico dovrebbe essere eseguita solo da
petsooole speclollzzoto e ptefetlbllmeote lo ooo sttoke oolt
Contro|nd|caz|on| nellictus ischemico:
LLa >80 o < 18 annl
SLorla dl lcLus e dlabeLe
lnsorgenza del slnLoml da plu dl 3 ore o non noLo
Rapido miglioramento dei sintomi prima dellinfusione
LvenLo dl grave enLlLa (nlPSS>23)
Convulsioni allinsorgenza
SlnLoml lndlcaLlvl dl emorragla (anche con 1C negaLlva)
SommlnlsLrazlone dl eparlna nelle 48 ore precedenLl
1empo dl LromboplasLlna che supera l llmlLl superlorl
lasLrlne < 100000/mm
3

A>180/110 mmPg o necesslLa dl Lerapla endovena per
rlporLare la A enLro quesLl llmlLl
Cllcemla <30 o >400mg/dl

.37-6b<! C.;$#P;+:#F E)BS);
(20mq/20ml oppote 50mq/50ml)
E possibile diluire ulteriormente in Soluzione Fisiologica
-0. <7!0- #I$Q% L %Q# (ptotocollo occeletoto)
G%;% E? )B
5Q()( N@ )(I
?@ )B (I N@ )(I
lz < 65 kq 0,75mg/Kg
<>AA#::(\(
L@ )(I
N? )B (I L@ )(I
Pz < 65 Kg 0,50mq/kq
-0. <7!0- LMEK %Q# (ptotocollo lo J ote)
G%;% E@ )B
5Q()( L@ )(I
?@ )B (I L@ )(I
Pz < 65 Kg 0,75mg/Kg
<>AA#::(\(
EK@ )(I
X@ )B (I EK@ )(I
Pz < 65 Kg 0,50mq/kq
!)H%;(+ 5%;)%I+Q#
G%;% E@ )B
-I">:(%I# [@ )B (I EK@ )(I
.77!/1-2/!' Per la breve emivita (5) accompagnare la
sommlolsttozlooe oJ potloo soJlco pet 72b
-A$>: (:AW#)(A%
0,9 mq/kq (mox 90 mq)
G%;% E@c *#;;+ *%:#
-I">:(%I# [@c *#;;+ *%:# (I L@ )(I
.77!/1-2/!' vltote oclJo ocetllsollclllco o epotloo soJlco
oelle ptlme 24b Jopo lo ttombollsl

www.mlcroguldedlmedlclna.lL
8|b||ograf|a:
Worklng Croup of Lhe 8esusclLaLlon Councll (uk). Lmergency treatment
of anaphy|act|c react|ons. Gu|de||nes for hea|thcare prov|ders. 2008.
www.resus.org.uk/pages/reacLlon.pdf
ueakln Cu, nolan !, Soar !, Sunde k, kosLer 8W, SmlLh C8, erklns Cu.
Luropean kesusc|tat|on Counc|| Gu|de||nes for kesusc|tat|on 2010
Sect|on 4. Adu|t advanced ||fe support. kesusc|tat|on. 2010
CcL,81(10):1303-32.
1ask lorce for Lhe ulagnosls and 1reaLmenL of AcuLe and Chronlc PearL
lallure 2008 of Lhe Luropean SocleLy of Cardlology LSC Gu|de||nes for
the d|agnos|s and treatment of acute and chron|c heart fa||ure 2008.
Lur PearL !. 2008 CcL,29(19):2388-442
Luropean PearL 8hyLhm AssoclaLlon, Luropean AssoclaLlon for Cardlo-
1horaclc Surgery.Gu|de||nes for the management of atr|a| f|br|||at|on:
the 1ask Iorce for the Management of Atr|a| I|br|||at|on of the
Luropean Soc|ety of Card|o|ogy (LSC). Lur PearL !. 2010 CcL,31(19):2369-
429. Lpub 2010 Aug 29.

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