Edison Paramedic Drug Cards

Total Flash Cards » 44
 
1. 

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

 
2. 

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)

 
3. 

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.

 
4. 

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.

 
5. 

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

 
6. 

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

 
7. 

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.

 
8. 

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.

 
9. 

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.

 
10. 

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.

 
11. 

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

 
12. 

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.

 
13. 

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.

 
14. 

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.

 
15. 

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.

 
16. 

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.

 
17. 

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.

 
18. 

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.

 
19. 

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

 
20. 

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.

 
21. 

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.

 
22. 

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

 
23. 

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.

 
24. 

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.

 
25. 

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.

 
26. 

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).

 
27. 

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.

 
28. 

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.

 
29. 

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

 
30. 

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.

 
31. 

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

 
32. 

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

 
33. 

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.

 
34. 

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.

 
35. 

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

 
36. 

-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.

 
37. 

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.

 
38. 

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

 
39. 

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

 
40. 

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

 
41. 

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.

 
42. 

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.

 
43. 

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.

 
44. 

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).