Activated Charcoal (Actidose/Adsorbant)
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route
|
|
Description:
Specially prepared charcoal that will adsorb and bind toxins from the gastrointestinal tract
Indications:
Acute ingested poisoning
Contraindications:
An airway that cannot be controlled
Ingestion of cyanide, iron or ethanol
Ingestion of mineral acids or methanol
Ingestion of caustic alkalis or organic solvents
Precautions:
Administer only after emesis or in those cases where emesis is contraindicated
Dosage/Route:
1 gram/kg PO or via NG tube |
| |
ASPIRIN (Acetylsalicylic Acid) Platelet Inhibitor, Anti-inflammatory
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Inhibits agents that cause the production of inflammation, pain, and fever
Inhibits platelet aggregation
Indications:
Chest pain suggestive of an MI
Contraindications:
Hypersensitivity to salicylates
Ulcer disease
Asthma
Precautions:
Allergies to other NSAIDs
Bleeding disorders
Children or teenagers with varicella or influenza like symptoms
Dosage/Route:
160 to 325 mg PO (chewable) |
| |
ATROPINE/Parasympatholytic
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Blocks the parasympathetic nervous system, specifically the vagal effects on heart rate
Does not increase contractility but may increase myocardial oxygen demand
Decreases airway secretions.
Indications:
Hemodynamically significant bradycardia
Bradyasystolic arrest
Organophosphate poisoning
Contraindications:
None in the emergency setting
Precautions:
AMI
Glaucoma
Dosage/Route:
Asystole/PEA 1 mg IV/IO q. 3 to 5 min (max. 3 doses)
Symptomatic bradycardia: 0.5 mg IV. Q. 3 to 5 min to 3 mg. Ped: 0.02 mg/kg IV, 0.03 mg/kg ET, may double and repeat IV dose in 5 min up to 1 mg. Adolescent: 1 mg x 2
Organophosphate poisoning: 2 to 5 mg IV/IM/IO to 15 min. Ped: 0.05 mglkg IV/IM/IO 10 to 15 min. |
| |
ADENOSINE/(Adenocard) Antidysrhythmic
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Naturally occurring agent that can “chemically cardiovert” PSVT to a normal sinus rhythm. It has
a half-life of 10 seconds and does not cause hypotension.
Indications:
Narrow, supraventricular tachycardia refractory to vagal maneuvers.
Contraindications:
Hypersensitivity
2nd and 3rd degree heart blocks
Sinus node disease
Asthma
Precautions:
May cause transient asytole
Dosage/Route:
6 mg rapid IVP with a 10CC saline flush. May be repeated with 12 mg rapid IVP with a 10CC saline flush
Ped: 0.1 mg/kg to a max of 6mg rapid IVP. May be repeated with 0.2 mg/kg to a max of 12mg rapid IVP. |
| |
ALBUTEROL/(Provental) Sympathomimetic Bronchodilator
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Synthetic sympathomimetic that causes bronchodilation with less cardiac effect then epinephrine that reduces secretions, pulmonary capillary leaking, and edema in the lungs during an allergic reaction.
Indications:
Bronchospasm
Asthma in COPD
Contraindications:
Hypersensitivity
Precautions:
Patient may experience, tachycardia, anxiety, nausea, cough or dizziness
Dosage/Route:
2.5 mg in 3 cc of NS via nebulizer, repeat as needed
Ped: 0.15 mg/kg in 3 cc of NS via nebulizer, repeat as needed |
| |
AMIODARONE/(Cordarone) Antidysrhythmic
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Antidysrhythmic that prolongs the duration of the action potential and refractory period.
Indications:
Life threatening recurrent ventricular and supraventricular dyrythmias
Contraindications:
Hypersensitivity
Cardiogenic shock
Severe sinus Bradycardia
2nd and 3rd degree heart blocks
Precautions:
Hepatic impairment
Nursing mothers
children
Dosage/Route:
150 to 300 mg IV over 10 minutes, then 1mg/min over the next 6 hours
Ped: 5 mg/kg IV/IO |
| |
CALCIUM CHLORIDE {Calcium Chloride)/Electrolyte
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Increases myocardial contractile force and increases ventricular automaticity.
Indications:
Hyperkalemia
Hypocalcemia
Hypermagnesemia and calcium channel blocker toxicity
Contraindications:
Ventricular fibrillation
Hypercalcemia, and possible digitalis toxicity
Precautions:
It may precipitate toxicity in patients taking digoxin
Ensure the IV line is in a large vein and flushed before using and after calcium.
Dosage/Route:
2 to 4 mg/kg IV {10% solution) repeat at 10 min, as needed.
Ped: 60-100 mg/kg IVIIO repeat at 10 min, as needed. |
| |
DEXAMETHASONE (Decadron)/Steroid
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Long-acting synthetic adrenocorticoid with intense anti-inflammatory activity
Prevents the accumulation of inflammation generating cells at the sites of infection or injury
Indications:
Anaphylaxis
Asthma
COPD
Spinal cord edema
Contraindications:
No absolute contra indications in the emergency setting.
Precautions:
Herpes simplex
Myasthenia gravis
Hepatic or renal impairment
Diabetes
CHF
Seizures
Psychic disorders
Hypothyroidism
GI ulceration.
Dosage/Route:
4 to 24 mg IV/IM Ped: 0.5 to 1 mg/kg. |
| |
DEXTROSE 50% (D-50)/Carbohydrate
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Dextrose is a simple sugar that the body can rapidly metabolize to create energy.
Indications:
Hypoglycemia
Contraindications:
None in hypoglycemia
Precautions:
Increased ICP
Ensure good venous access
Dosage/Route:
25g (50 mL) IV. Ped: 2 to 4 mg/kg of a 25% solution IV. |
| |
DIAZEPAM (Valium)/Hypnotic, Anticonvulsant, Sedative
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Benzodiazepine sedative
Skeletal muscle relaxant that reduces tremors
Indications:
Major motor seizures
Status epilepticus
Premedication before cardioversion
Acute anxiety
Contraindications:
Hypersensitivity to the drug
Shock
Coma
Acute alcoholism, depressed vital signs
Obstetric patients, neonates
Precautions:
Psychosis
Depression
Myasthenia gravis
Hepatic or renal impairment
COPD
Due to a short half-life of the drug, seizure activity may recur
Dosage/Route:
Seizures: 5 to 10 mg IV/IM. Ped: 0.5 to 2 mg IV/IM
Acute anxiety: 2 to 5 mg IV/IM. Ped: 0.5 to 2 mg IM.
Premedication: 5 to 15 mg IV. Ped: 0.2 to 0.5 mg/kg IV. |
| |
DIGOXIN (Lanoxin)
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Rapid-acting cardiac glycoside used in the treatment of CHF and rapid atrial dysrhythmias
Increases the force and velocity of myocardial contraction and cardiac output
Decreases conduction through the AV node, thus decreasing heart rate
Indications:
Increase cardiac output in CHF
Stabilize supraventricular tachydysrhythmias
Contraindications:
Hypersensitivity
V-fib, or V-tach except due to CHF
Precautions:
Toxicity potentiated by an MI and with hypokalemia, hypocalcemia
Advanced heart disease
Incomplete heart block, corpulmonale
Hyperthyroidism, respiratory impairment
Dosage/Route:
0.25 to 0.5 mg slowly IV
Ped: 10 to 50 mcg/kg I
Description:
Rapid-acting cardiac glycoside used in the treatment of CHF and rapid atrial dysrhythmias
Increases the force and velocity of myocardial contraction and cardiac output
Decreases conduction through the AV node, thus decreasing heart rate
Indications:
Increase cardiac output in CHF
Stabilize supraventricular tachydysrhythmias
Contraindications:
Hypersensitivity
V-fib, or V-tach except due to CHF
Precautions:
Toxicity potentiated by an MI and with hypokalemia, hypocalcemia
Advanced heart disease
Incomplete heart block, corpulmonale
Hyperthyroidism, respiratory impairment
Dosage/Route:
0.25 to 0.5 mg slowly IV
Ped: 10 to 50 mcg/kg IV |
| |
DILTIAZEM (Cardizem)/Calcium Channel Blocker
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Slow calcium channel blocker
Dilates coronary and peripheral arteries and arterioles
Increases circulation to the heart and reducing peripheral vascular resistance
Indications:
SVT
A-fib
A-Flutter
Contraindications:
Hypersensitivity
Sick sinus syndrome
2nd- or 3rd-degree heart block
Systolic BP >90, diastolic BP >60
Wide-complex tachycardia and WPW
Precautions:
CHF (especially with beta blockers)
Conduction abnormalities
Renal or hepatic impairment
Dosage/Route:
0.25 mg/kg IV over 2 min, may repeat in 15 min with 0.35 mg/kg followed by a drip of 5 to 10 mg/hr not to exceed 15 mg/hr over 24 hours. |
| |
DIPENHYDRAMINE (Benadryl)/ Antihistamine
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Blocks histamine release, thereby
Reduces bronchoconstriction, vasodilation, and edema
Indications:
Anaphylaxis
Allergic reactions,
Dystonic reactions
Contraindications:
Asthma and other lower respiratory diseases
Precautions:
Hypotension
Headache
Palpitations
Tachycardia
Sedation
Drowsiness
Dosage/Route:
25 to 50 mg IV/1M. |
| |
DOPAMINE (Intropin)/Sympathomimetic
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Naturally occurring catecholamine that increases cardiac output
Maintains renal and mesenteric blood flow while inducing vasoconstriction and increasing systolic blood pressure.
Indications:
Non-hypovolemic hypotension (70 to 100 mmHg)
Cardiogenic shock
Contraindications:
Hypovolemic hypotension without aggressive fluid resuscitation
Tachydysrhythmias
V-fib
Precautions:
Occlusive vascular disease,
Arterial embolism.
Ensure adequate fluid resuscitation of the
Hypovolemic patient
Dosage/Route:
2 to 20 mcg/kg/min. titrated to effect.
Ped: same as adult. |
| |
EPINEPHRINE (Adrenalin)/Sympathomimetic
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Naturally occurring catecholamine that increases heart rate, cardiac contractile force myocardial electrical activity, systemic vascular resistance, and systolic blood pressure
Decreases overall airway resistance and automaticity
Through bronchial artery constriction, may reduce pulmonary congestion and increase tidal volume and vital capacity
Indications:
Restore rhythm in cardiac arrest and severe allergic reactions
Contraindications:
Hypersensitivity to sympathomimetic amines
Narrow angle glaucoma
Hemorrhagic, traumatic, or cardiac shock
Coronary insufficiency
Precautions:
Elderly, debilitated patients
Hypertension, diabetes
Hyperthyroidism,
Asthma, emphysema
Dosage/Route:
Arrest: 1 mg of 1:10,000 IV q. 3 to 5 min Ped: 0.01 mg/kg 1:10,000 IV/IO q. 3 to 5 min.
Allergic reactions: 0.3 to 0.5 mg of 1:1,000 SQ q. 5 to 15 min as needed or 0.5 to 1 mg of
1:10,000 IV if subcutaneous dose ineffective or severe reaction.
Ped: 0.01 mg/kg of 1: 1,000 SQ/IO to 15 min or 0.01 mg/kg of 1:10,000 IV if SQ dose ineffective or severe. |
| |
ETOMIDATE (Amidate)/Hypnotic
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Ultra-shon-acting non barbiturate hypnotic with no analgesic effects and limited
Cardiovascular and respiratory effects
Indications:
Induce sedation for rapid sequence intubation
Contraindications:
Hypersensitivity
Precautions:
Hypotension,
Severe asthma
Cardiovascular disease
Dosage/Route:
0.1to 0.3 mg/kg IV over 15 to 30 sec. Ped: 0.2 to 0.4 mg/kg IV/IO over 30 to 60 sec. Max 20 mg. |
| |
FENTANYL (Sublimaze)/Narcotic Analgesic
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Potent synthetic narcotic analgesic similar to morphine and meperidine but with a more rapid and less-prolonged action
Indications:
Induce sedation for endotracheal intubation
Moderate to severe pain.
Contraindications:
MAO inhibitors within 14 days
Myasthenia gravis
Precautions:
Increased intracranial pressure
Elderly
COPD
Respiratory problems
Hepatic and renal insufficiency
Dosage/Route:
25 to 100 mcg slow IV (2 to 3 min) Ped: 2 mcg/kg slow IV/IM. |
| |
FLUMAZENIL (Romazicon)/Benzodiazepine Antagonist
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Benzodiazepine antagonist used to reverse the sedative, recall, and psychomotor effects of
diazepam, midazolam, and the other benzodiazepines.
Indications:
Respiratory depression secondary to the benzodiazepines
Contraindications:
Hypersensitivity to Flumazenil or benzodiazepines; those
Patients who take Flumazenil for status epilepticus or seizures
Seizure-prone patients during labor and delivery
Tricyclic antidepressant overdose
Precautions:
Hepatic impairment
Elderly
Pregnancy, nursing mothers
Head injury
Alcohol and drug dependency
Physical dependence on benzodiazepines
Dosage/Route:
0.2 mg IV over 15 sec. repeated at 0.3 mg over 30 sec. then 0.5 mg over 30 sec. every minute to desired affect or 3 mg. |
| |
Furosemide (Lasix) Diuretic
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Rapid-acting potent diuretic that inhibits sodium re-absorption by the kidneys
Indications:
CHF
Pulmonary Edema
Contraindications:
Hypersensitivity to sulfonamides
Precautions:
Infants
Elderly
Hepatic impairment
Cardiogenic Shock
Dosage/Route:
40 -120 mg slow IVP
Ped: 1mg/kg slow IVP |
| |
HALOPERIDOL (Haldol)/Antipsychotic
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Blocks dopamine receptors in the brain associated with mood and behavior
Potent antiemetic
Impairs temperature regulation
Indications:
Acute psychotic episodes
Contraindications:
Parkinson's disease
Seizure disorders
Coma
Alcohol depression
Precautions:
Elderly
urinary retention, glaucoma,
Severe cardiovascular disease, or anticonvulsant, anticoagulant, or lithium therapy
Dosage/Route:
2 to 5 mg IM. Ped: Children> 3 years, 0.015 to 0.15 mg/kg/day PO in 2 or 3 divided doses. |
| |
HEPARIN (Heparin)/ Anticoagulant
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Rapid-onset anticoagulant,
Enhancing the effects of antithrombin III and blocking the conversion of prothrombin to thrombin and fibrinogen to fibrin.
Indications:
Prevent thrombus formation in acute MI.
Contraindications:
Hypersensitivity
Active bleeding or bleeding tendencies
Recent eye, brain, or spinal surgery
Shock
Precautions:
Alcoholism
Elderly
Allergies
Indwelling catheters, elderly
Menstruation, pregnancy
Cerebral embolism
Dosage/Route:
STEMl: 60 IU/kg to 4,000 IU NSTEMl: 60 to 70 IU/kg to 5,000. |
| |
Hydromorphone hydrochloride (Dilaudid)
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
An opiate type narcotic analgesic
Indications:
Relief of moderate to severe pain.
Contraindications:
History of chronic respiratory illness
Precautions:
Excessive sedation
Respiratory depression
Circulatory depression and collapse
Dosage/Route:
Adults= 1mg slow IV repeat in 5min if B/P >90.
Can be given IM |
| |
IBUPROFEN (Nonsteroidal Antiinflammatory Drug (NSAID)
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description: Ibuprofen is the prototype
NSAID with significant analgesic and antipyretic properties It also
Inhibits platelet aggregation and increases bleeding time
Indications:
Reduce fever and relieve minor to moderate pain
Contraindications:
Sensitivity to aspirin or other NSAIDs
Active peptic ulcer, and bleeding abnormalities
Precautions:
Hypertension,
GI ulceration,
Hepatic or renal impairment,
Cardiac decompensation.
Dosage/Route:
200 to 400 mg PO q. 4 to 6 hours up to 1,200 mg/day.
Ped: 5 to 10 mg/kg PO/4 to 6 hours up to 40 mg/kg/day. |
| |
IPRATROPIUM (Atrovent)/ Anticholinergic
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Bronchodilator used in the treatment of respiratory emergencies that causes bronchial dilation
and dries respiratory tract secretions by blocking acetylcholine receptors.
Indications:
Bronchospasm associated with asthma, COPD, and inhaled irritants.
Contraindications:
Hypersensitivity to atropine or its derivatives, or as a primary treatment for acute bronchospasm
Precautions:
Elderly,
Cardiovascular disease
Hypertension
Dosage/Route:
500 mcg in 2.5 to 3 mL NS via nebulizer or 2 sprays from a metered dose inhaler. Ped: 125 to 250 mcg in 2.5 to 3 mL NS via nebulizer, or 1 or 2 sprays of a metered dose inhaler. |
| |
LIDOCAINE (Xylocaine)/ Antidysrhythmic
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Antidysrhythmic that suppresses automaticity and raises stimulation threshold of the ventricles
Causes sedation
Anticonvulsant, and analgesic effects
Indications:
Pulseless and Pulsatile V-tach
V-fib
Contraindications:
Hypersensitivity to amide-type local anesthetics
SVTsupraventricular dysrhythmias
StokesAdams syndrome
2nd- and 3rd-degree heart blocks
Bradycardias.
Precautions:
Hepatic or renal impairment
CHF
Hypoxia, respiratory depression
Hypovolemia
Myasthenia gravis
Shock
Dosage/Route:
Cardiac arrest: 1 to 1.5 mg/kg IV/IO up to 3 mg/kg, follow conversion with a drip of 1 to 4
mg/min. Ped: 1 mg/kg rapid IV/IO, to 100 mg, follow conversion with a drip of 20 to 50
mcg/kg/min.
V-Tach /w)pulse): 0.5 to 1.5 mg/kg slow IV. May repeat at one-half dose every 5 to 10 min until conversion up to 3 mg/kg. Follow conversion with an infusion of 1 to 4 mg/min. Ped: 1 mg/kg, followed by a drip at 20 to 50 mcg/kg/min. |
| |
LORAZEPAM (Ativan)/Sedative
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Potent benzodiazepine
Strong antianxiety, sedative, hypnotic, and skeletal muscle relaxant properties
Relatively short half-life
Indications:
Sedation for cardioversion and status epilepticus
Contraindications:
Sensitivity to benzodiazepines
Precautions:
Narrow-angle glaucoma
Depression or psychosis
Coma
Shock
Acute alcohol intoxication
Renal or hepatic impairment, organic brain syndrome
Myasthenia gravis
GI disorders, elderly, debilitated, limited pulmonary reserve.
Dosage/Route:
Sedation: 2 to 4 mg 1M, 0.5 to 2 mg IV. Ped: 0.03 to 0.5 mglkg IV/IM/PR up to 4 mg.
Status epilepticus: 2 mg slow IV/PR (2 mg/min). Ped: 0.1 mg/kg slow IV/PR (2 to 5
min). |
| |
MAGNESIUM SULFATE (Magnesium)/Electrolyte
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Electrolyte that acts as a calcium channel blocker
CNS depressant and anticonvulsant
Depresses the function of smooth, skeletal, and cardiac muscle
Indications:
Torsade de Pointes
Eclamptic seizures
Children for status asthmaticus non-responsive to beta agents
Contraindicarions:
Heart block, myocardial damage
Shock
Persistent hypertension, and hypocalcemia
Precautions:
Renal impairment
Digitalized patients
Dosage/Route:
Diluted in 100 mL, over 1 to 2 minutes (in adults only) IV/IM
Peds: 25 to 50 mg/kg over 5 to 20 min. Max dose 2 g. IV
Asthma: same as for Torsades. Eclampsia: 2 to 4 g IV /IM. |
| |
MANNITOL (Osmitrol)/Osmotic Diuretic
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Osmotic diuretic that draws water into the intravascular space through its hypertonic effects, then causes diuresis
Indications:
Cerebral edema
Contraindications:
Hypersensitivity
Pulmonary edema, CHF
Organic CNS disease
Intracranial bleeding
Shock renal failure, or severe dehydration
Precautions:
None
Dosage/Route:
0.5 to 1 g/kg over 5 to 10 min IV. Ped: 0.25 to 0.5 g/kg over 60 min. |
| |
MEPERIDINE (Demerol)/Narcotic Analgesic
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Synthetic narcotic with sedative and analgesic properties comparable to morphine but without hemodynamic side effects.
Indications:
Moderate to severe pain
Contraindications:
Hypersensitivity
Seizure disorders, or acute abdomen prior to diagnosis
Precautions:
Increased intracranial pressure
Asthma or other respiratory conditions
SVT
Prostatic hypertrophy
Urethral stricture
Glaucoma, elderly or debilitated patients
Renal or hepatic impairment
Hypothyroidism
Addison's disease
Dosage/Route:
25 to 50 mg IV, 50 to 100 mg 1M. Ped: 1 mg/kg IV/IM |
| |
METHYLPREDNISOLONE (Solu-Medrol)
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Synthetic adrenal corticosteroid
Anti-inflammatory and used in the management of allergic reactions and in some cases of shock
Indications:
Spinal cord injury
Asthma
Severe anaphylaxis
COPD
Contraindications:
No major contra indications in the emergency setting
Precautions:
Only a single dose should be given in the prehospital setting
Dosage/Route:
Asthma/COPD/anaphylaxis: 125 to 250 mg IV/IM. Ped: 1 to 2 mg/kg/dose IV/IM. |
| |
METOPROLOL (Lopressor)/Beta Blocker
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Beta-adrenergic blocking agent that reduces heart rate, cardiac output, and blood pressure
Indications:
AMI
Contraindications:
Cardiogenic shock,
Sinus bradycardia >45
2nd- or 3rd-degree heart block, PR interval> 0.24
Cor pulmonale
Asthma
COPD
Precautions:
Hypersensitivity
Hepatic or renal impairment
cardiomegaly
CHF controlled by digitalis and diuretics
AV conduction defects
Thyrotoxicosis
Diabetes
Peripheral vascular disease
Dosage/Route:
5 mg slow IV/5 min up to 3 times |
| |
MIDAZOLAM (Versed)/Sedative
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Short-acting benzodiazepine with CNS depressant
Muscle relaxant
Anticonvul-sant
Anterograde amnestic effects
Indications:
To induce sedation before cardioversion or intubation
Contraindications:
1. Hypersensitivity to benzodiazepines
2. Narrow-angle glaucoma
3. Shock
4. Coma
5. Acute alcohol intoxication
Precautions:
COPD
Renal impairment
CHF
Dosage/Route:
1 to 2.5 mg slow IV; 0.07 to 0.08 mg/kg IM (usually 5 mg). Ped: 0.05 to 0.2 mg/kg IV: 0.1 to 0.15 mg/kg IM; 3 mg IN |
| |
MORPHINE SULFATE (Morphine)/Narcotic Analgesic
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description: Morphine sulfate is a
Potent narcotic analgesic and sedative that
Causes some vasodilation that reducing venous return
Reduced myocardial oxygen demand
Indications:
Moderate to severe pain and in MI and to reduce venous return in pulmonary edema
Contraindications:
Hypersensitivity to opiates
Undiagnosed head or abdominal injury, hypotension, or volume depletion
Acute bronchial asthma
COPD
Severe respiratory depression
Pulmonary edema due to chemical inhalation
Precautions:
Elderly, children, or debilitated patients
Naloxone should be readily available to counteract the effects of morphine.
Dosage/Route:
MI: 2 to 4 mg IV over 1 to 5 min. q. 5 to 15 min
Pain: 2.5 to 15 mg IV; 5 to 20 mg IM/SQ.
Ped: 0.05 to 0.1 mg/kg IV; 0.1 to 0.2 mg/kg IM/SQ
AMI or PE: 1 to 2 mg/6 to 10 min to response. |
| |
NALOXONE (Narcan)
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Narcotic antagonist that blocks the effects of both natural and synthetic narcotics and may
reverse respiratory depression
Indications:
Narcotic and synthetic narcotic overdose
Coma of unknown origin
Contraindications:
Hypersensitivity to the drug
Non-narcotic-induced respiratory depression
Precautions:
Possible dependency (including newborns). It also has a half-life that is shorter than that of most narcotics; hence the patient may return to the overdose state.
Dosage/Route:
0.4 to 2 mg IV/IM (2 to 2.5 times the dose ET), q. 2 to 3 min as needed up to 10 mg.
Ped: 0.01 mg IV/IM (2 to 2.5 times the dose ET) q. 2 to 3 min as needed up to 10 mg. |
| |
NITROGLYCERIN (Nitrostat)
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Rapid acting smooth muscle relaxant that reduces peripheral vascular resistance, blood
pressure, venous return, and cardiac workload
Indications:
Chest pain associated with angina, acute MI or pulmonary edema
Contraindications:
Severe anemia
Head trauma
Increased ICP
Patient taking erectile dysfunction drugs within 24 hours
Hypotension
Precautions:
May cause headache
Dosage/Route:
1 tablet (or spray) 0.4 mg SL q. 3-5 minutes provided systolic BP > 90 |
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-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Oxygen is an odorless, colorless, tasteless gas, essential for life, It is one of the most important emergency drugs
Indications:
Hypoxia or anticipated hypoxia, or in any medical or trauma patient to improve respiratory
efficiency
Contraindications:
There are no contra indications to oxygen therapy.
Precautions:
Chronic obstructive pulmonary disease and very prolonged administration of high concentrations in the newborn
Dosage/Route:
Hypoxia: 100% by inhalation or PPV. |
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OXYTOCIN (Pitocin)
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Naturally occurring hormone that causes the uterus to contract, thereby inducing labor,
encouraging delivery of the placenta, and controlling postpartum hemorrhage
Indications:
Severe postpartum hemorrhage
Contraindications:
Hypersensitivity,
Prehospital administration before delivery of the infant or infants
Precautions:
Before delivery may induce uterine rupture and fetal dysrhythmias
Hypertension
Intracranial bleeding, or asphyxia
Uterine tone
ECG, and vital signs should be monitored during administration
Dosage/Route:
3 to 10 units IM after delivery of the placenta 10 to 20 units in 1,000 mL in NS IV titrated to effect. |
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PROMETHAZINE (Phenergan)
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Anticholinergic agent that enhances the effects of analgesics and is a potent antiemetic
Indications:
Nausea and vomiting
Motion sickness
Enhance the effects of analgesics, and to induce sedation.
Contraindications:
Hypersensitivity to phenothiazines
Precautions:
Hepatic, respiratory, or cardiac impairment
Asthma
Hypertension
Dosage/Route:
12.5 to 25 mg IV/IM Ped: 0.5 mg/kg IV/IM |
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RACEMIC EPINEPHRINE (Vaponefrin)/Sympathomimetic
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Variation of epinephrine used only for inhalation to induce bronchodilation and to reduce laryngeal edema and mucus secretion.
Indications:
Croup (laryngotracheobronchitis)
Contraindications:
Hypersensitivity
Hypertension
Epiglottitis
Precautions:
May result in tachycardia and other dysrhythmias
Patient vital signs and ECG should be monitored
Dosage/Route:
0.25 to 0.75 mL of a 2.25% solution in 2 mL NS once by nebulizer Ped: same as adult |
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SODIUM BICARBONATE (NaHC03)/ Alkalizing Agent
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Provides vascular bicarbonate to assist the buffer system in reducing the effects of metabolic acidosis and in the treatment of some overdoses.
Indications:
Tricyclic antidepressant and barbiturate overdose
Refractory acidosis
Hyperkalemia
Contraindications:
None when used in severe hypoxia or late cardiac arrest.
Precautions:
May cause alkalosis if given in too large a quantity
Deactivate vasopressors
Do not give in the same line as calcium chloride
Dosage/Route:
1 mEqlkg IV/IO Ped: same as adult |
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SUCCINYLCHOLINE {Anectine)
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Ultra-short-acting depolarizing neuromuscular blocker
Indications:
Facilitated endotracheal intubation
Contraindications:
Hypersensitivity
History of malignant hyperthermia
Penetrating eye injury
Narrow -angle glaucoma
Precautions:
Severe burn or crush injury
Electrolyte imbalances
Hepatic, renal, cardiac, or pulmonary impairment
Fractures
Spinal cord injury
Dehydration
Severe anemia
Dosage/Route:
1 to 1.5 mg/kg IV/IM. Ped: 1 to 2 mg/kg IV/IM. |
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TERBUTALINE (Brethine)
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Synthetic sympathomimetic that causes bronchodilatation with less cardiac effect than
epinephrine
Indications:
Bronchial asthma and bronchospasm in COPD
Contraindications:
Hypersensitivity to the drug.
Precautions:
Palpitations
Nausea, and/or dizziness
Vital signs and breath sounds must be monitored
Use caution with cardiac or hypertensive patients
Dosage/Route:
Two inhalations with a metered dose inhaler, repeated once in 1 min or
0.25 mg SQ repeated in 15 to 30 mins. |
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VECURONIUM (Norcuron)/Nondepolarizing Skeletal Muscle Relaxant
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Nondepolarizing skeletal muscle relaxant similar to pancuronium with minimal cardiovascular effects
Indications:
Facilitated endotracheal intubation
Contraindications:
Hypersensitivity
Precautions:
Hepatic or renal impairment
Impaired fluid and electrolyte or acid/base balance
Severe obesity
Myasthenia gravis
Malignant hyperthermia
Dosage/Route:
0.08 to 0.1 mg/kg IV. Ped: same as adult. |
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VERAPAMIL (Calan)/Calcium Channel Blocker
-Description
-Indication
-Contraindications
-Precautions
-Dosage/Route |
|
Description:
Calcium channel blocker that slows AV conduction
Suppresses reentry dysrhythmias such as PSVT
Slows ventricular responses to atrial tachydysrhythmias
Dilates coronary arteries and reduces myocardial oxygen demand
Indications:
PSVT refractory to adenosine,
A-flutter, and A-fib with rapid ventricular response
Contraindications:
Severe hypotension
Cardiogenic shock
2nd- or 3rd-degree heart block
CHF
Sinus node disease, and accessory AV pathways, WPW syndrome
Do not be administered to persons taking beta blockers
Precautions:
Hepatic and renal impairment,
MI with coronary artery occlusion
Myocardial stenosis
Dosage/Route:
2.5 to 5 mg IV bolus over 2 to 3 min, then 5 to 10 mg after 15 to 30 min to a max of 20 mg.
Ped: newborn1 to 0.2 mglkg (not to exceed 2 mg)1 to 15-0.1 to 0.3 mglkg (not to exceed 5 mg). |
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