All Drugs Flashcards
Activated Charcoal
Name/Class: ACTIVATED CHARCOAL (Actidose) / Absorbent
Description: Is a specially prepared charcoal that will adsorb and bind toxins from the gastrointestinal tract.
Indications: Acute ingested poisoning
Precautions: Administer only after emesis or in those cases where emesis is contraindicated.
Dosage/Route: 1G/Kg mixed with at least 6 to 8 oz of water, then PO or via an NG tube
Adenosine/ adenocard
Name/Class: ADENOSINE (Adenocard)/Antidysrhythmic
Description: Adenosine is a 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, complex paroxysmal supraventricular tachycardia refractory to vagal maneuvers.
Contraindications: Atrial Fibrilation, 2nd- and 3rd-degree heart block, sinus node disease, or Acute asthma.
Precautions: It may cause transient dysrhythmias especially asystole, COPD.
Dosage/Route: 6 mg rapidly (over 1 to 2 sec) IV, then flush the line rapidly with saline. If ineffective, 12 mg in 1 to 2 mins, may be repeated.
Pedi: 0.1 mg/kg (over 1 to 2 sec) IV followed by rapid saline flush, then 0.2 mg/kg in 1 to 2 min to max 12 mg.
Albuterol (Proventil, Ventolin)
Name/Class: ALBUTEROL (Proventil, Ventolin)/Sympathomimetic Bronchodilator)
Description: Albuterol is a synthetic Sympathomimetic that causes bronchodilatation with less cardiac effect than epinephrine and reduces mucus secretion, pulmonary capillary leaking, and edema in the lungs during
allergic reactions.
Indications: Bronchospasm in Asthma and COPD, Hyperkalemia
Contraindications: Hypersensitivity to the drug.
Precautions: The patient may experience tachycardia, anxiety, nausea, cough, wheezing, and/or dizziness. Vital signs and breath sounds must be monitored; use caution with elderly, cardiac, or hypertensive patients.
Dosage/Route: 2.5 mg in 3 mL NS via nebulizer, repeat as needed. The duration of effect is 3 to 6 hours.
Hyperkalemia 20-30mg nebulizer
Alteplase Recombinant (tPA) (Activase)
Name/Class: ALTEPLASE RECOMBINANT (tPA) (Activase)/Thrombolytic
Description: Recombinant DNA–derived form of human tPA promotes thrombolysis by forming plasmin. Plasmin, in turn, degrades fibrin and fibrinogen and, ultimately, the clot.
Indications: To thrombolyse in acute myocardial infarction, acute ischemic stroke, and
pulmonary embolism.
Contraindications: Active internal bleeding, suspected aortic dissection, traumatic CPR, recent hemmorhagic stroke (6 months), intracranial or intraspinal surgery or trauma (2 month), pregnancy, uncontrolled hypertension, or hypersensitivity to thrombolytics.
Precautions: Recent major surgery, cerebral vascular disease, recent GI or GU bleeding, recent trauma, hypertension, patient > 75 years, current oral anticoagulants, or hemorrhagic
ophthalmic conditions.
AMINOPHYLLINE (Aminophylline, Somophyllin)
Name/Class: AMINOPHYLLINE (Aminophylline, Somophyllin)/Methylxanthine Bronchodilator
Description: Aminophylline is a methylxanthine that prolongs bronchodilation and decreased mucus
production and has mild cardiac and CNS stimulating effects.
Indications: Bronchospasm in asthma and COPD refractory to sympathomimetics and other
bronchodilators and in CHF.
AMIODARONE (Cordarone, Pacerone)
Name/Class: AMIODARONE (Cordarone, Pacerone)/Antidysrhythmic ( KCL Blocker)
Description: Amiodarone is an Antidysrhythmic that prolongs the duration of the action potential and refractory period and relaxes smooth muscles, reducing peripheral vascular resistance and increasing coronary blood flow.
Indications: Life-threatening ventricular and supraventricular dysrhythmias, frequently atrial fibrillation 2nd Line.
Contraindications: cardiogenic shock, severe sinus bradycardia, or advanced heart block.
Precautions: Hepatic impairment, pregnancy, nursing mothers, children.
Dosage/Route: 150mg over 10 minutes pt with pulses or 300 mg pulseless IVP
Pedi: 5 mg/kg IV/IO, then 15 mg/kg/day.
ASPIRIN (Acetylsalicylic Acid)
Name/Class: ASPIRIN (Acetylsalicylic Acid) Analgesic, Antipyretic, Platelet Inhibitor, Anti-inflammatory
Description: Aspirin inhibits agents that cause the production of inflammation, pain, and fever. It relieves mild to moderate pain by acting on the peripheral nervous system, lowers body temperature in fever, and powerfully inhibits platelet aggregation.
Indications: Chest pain suggestive of an MI.
Contraindications: Hypersensitivity to salicylates, active ulcer disease, asthma.
Precautions:, Bleeding disorders, Varicies
Dosage/Route: 324 mg PO (chewable).
Atropine
Name/Class: ATROPINE/Parasympatholytic
Description: Atropine blocks the parasympathetic nervous system, specifically the vagal effects
on heart rate. May increase myocardial oxygen demand. Decreases airway secretions.
Indications: Hemodynamically significant bradycardia and organophosphate poisoning.
Contraindications: None in the emergency setting. 2nd degree type 2 and above heart blocks are class 2B (not recommended)
Precautions: AMI, glaucoma.
Dosage/Route: Symptomatic bradycardia: 0.5 mg -1 mg IV/IO. Repeat 3 to 5 min to 3 mg.
Pedi: 0.02 mg/kg IV, may repeat in 5 min up to 1 mg
Organophosphate poisoning: 2 to 5 mg IV/IM/IO q10 to 15 min.
Pedi: 0.05 mg/kg IV/IM/IO q10 to 15 min.
Benzocaine Spray (Hurricane)
Name/Class: BENZOCAINE SPRAY (Hurricane) Topical anesthetic
Description: Stabilizes neuronal membrane, which blocks the initiation and conduction of nerve impulses
Indications: Used as a lubricant and topical anesthetic to facilitate passage of diagnostic and treatment devices. Suppresses the pharyngeal and tracheal gag reflex.
Dosage/Route: 0.5-1 second spray, repeat as needed.
Pedi: 0.25-0.5 second spray, repeat at needed
BRETYLIUM (Bretylol)
Name/Class: BRETYLIUM (Bretylol)/Antidysrhythmic (KCL Blocker)
Description: Bretylium causes a release of norepinephrine, depresses ventricular fibrillation, and reduces ectopy. Bretylium suppresses ventricular tachydysrhythmias including vfib with reentry mechanisms.
Indications: Ventricular fibrillation and ventricular tachycardia refractory to lidocaine.
Contraindications: None
Dose: Dosage/Route: 5 mg/kg IV, then 10 mg/kg/15 to 30 min, to a max 30 mg/kg.
Bumetanide (Bumex)
Name/Class: BUMETANIDE (Bumex) Loop diuretic
Description: A potent loop diuretic with a rapid onset and short duration of action. Inhibits the reabsorption of sodium and chloride in the ascending limb of the loop of Henle.
Indications: Pulmonary edema, congestive heart failure
Contraindications: Hypersensitivity to bumetanide or sulfonamides, hypotension, anuria, electrolyte deficiencies, hepatic coma. Use caution: hepatic cirrhosis, ascites, disbetes, hypersensitivity to furosemide.
Dosage/Route: 0.5-1.0 mg IV slowly over 1 to 2 minutes, or IM.
Pedi: Safety and effectiveness in pediatric is not established
Butorphanol (Stadol)
Name/Class: BUTORPHANOL (Stadol)/Synthetic Narcotic Analgesic
Description: Butorphanol is a centrally acting synthetic narcotic analgesic about 5 times more potent than morphine. A schedule IV narcotic.
Indications: Moderate to severe pain.
Contraindications: Hypersensitivity, head injury, or undiagnosed abdominal pain.
Calcium Chloride
Name/Class: CALCIUM CHLORIDE (Calcium Chloride)/Electrolyte
Description: Calcium chloride 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: 5-10cc of (10% solution / 1Gram –10cc)/10 min, as needed or 6-8mg/Kg .
Amyl Nitrite
1 Part of cyanide kit
Name/Class: AMYL NITRITE Antidote, cyanide poisoning adjunct
Description: Converts hemoglobin to methemogolobin, which reacts with cyanide and chemically binds with it, preventing any toxic effects.
Indications: Cyanide poisoning
Contraindications: None in the emergency setting
Precautions: Headache, dizziness, weakness, increased ICP, shortness of breath, orthostatic hypotension, tachycardia
Dosage/Route: 1-2 ampules crushed and inhaled for 30 seconds of each minute until sodium nitrite is prepared of administer for 30-60 seconds every 5 minutes until patient is conscious.
Sodium Nitrate
1 Part of cyanide kit
Name/Class: SODIUM NITRATE Antidote cyanide poisoning adjunct
Description: Reacts with hemoglobin to form methemoglobin, which reacts with cyanide and chemically binds with it to prevent toxic effect.
Indications: Cyanide poisoning
Contraindications: None in the emergency setting
Precautions/Side Effects: Hypotension, tachycardia, fainting, nausea, vomiting
Dosage/Route: 300 mg (10 mL of a 3% solutions) slow IV push over 5 minutes or dilute 300 mg in 100 mL of saline and infuse slowly
Sodium Thiosulfate
1 Part of cyanide kit
Name/Class: SODIUM THIOSULFATE Cyanide antidote
Description: Converts cyanide to the less toxic thiocyanate, which is then excreted in the urine.
Indications: Cyanide poisoning
Dosage/Route: 12.5g (50 mL of a 25% solution) IV/IO slow push over 10 minutes.
Pedi: 400 mg/kg (1.65 mL/kg of a 25% solution) IV/IO slow push.
DEXAMETHASONE (Decadron)
Name/Class: DEXAMETHASONE (Decadron)/Steroid
Description: Dexamethasone is a long-acting synthetic adrenocorticoid with intense anti-inflammatory activity. It prevents the accumulation of inflammation generating cells at the sites of
infection or injury.
Indications: Anaphylaxis, asthma, COPD, spinal cord edema.
Contraindications: No absolute contraindications in the emergency setting.
Relative contraindications: systemic fungal infections, acute infections, tuberculosis, varicella, or vaccinia or live virus vaccinations.
Precautions: Herpes simplex, keratitis, myasthenia gravis, hepatic or renal impairment, diabetes, CHF,
seizures, psychic disorders, hypothyroidism, and GI ulceration.
Dosage/Route: 4 to 24 mg IV/IM
Pedi: 0.5 to 1 mg/kg.
DIPHENHYDRAMINE (Benadryl)
Name/Class: DIPHENHYDRAMINE (Benadryl)/Antihistamine
Description: Diphenhydramine blocks histamine release, thereby reducing bronchoconstriction,
vasodilatation, and edema.
Indications: Anaphylaxis, allergic reactions, and dystonic reactions.
Contraindications: Asthma and other lower respiratory diseases.
Precautions: May induce hypotension, headache, palpitations, tachycardia, sedation, drowsiness, and/or disturbed coordination.
Dosage/Route: 25 to 50 mg IV/IM.
Pedi: 1-2mg/kg
DOBUTAMINE (Dobutrex)
Name/Class: DOBUTAMINE (Dobutrex)/Sympathomimetic
Description: Dobutamine is a synthetic catecholamine and beta agent that increases the strength of cardiac contraction without appreciably increasing rate.
Indications: To increase cardiac output in congestive heart failure/cardiogenic shock.
Contraindications: Hypersensitivity to Sympathomimetic amines, ventricular tachycardia, and hypovolemia without fluid resuscitation.
Precautions: Atrial fibrillation or preexisting hypertension.
Dosage/Route: 2 to 20 mcg/kg/min IV.
Pedi: Same
Dextrose 50% in water (D50W)
Name/Class: DEXTROSE 50% IN WATER (D50W)/Carbohydrate
Description: Dextrose is a simple sugar that the body can rapidly metabolize to create energy.
Indications: Hypoglycemia
Contraindications: None in hypoglycemia.
Precautions: Increased ICP. Determine blood glucose level before administration. Ensure good venous access.
Dosage/Route: 25g D50W (50 mL) IV.
Pedi: 2 –4 mL/kg of a 25% solution IV (Over 1 Year) 10% solution for under 1 Year
Dopamine (Inotropin)
Name/Class: DOPAMINE (Intropin)/Sympathomimetic
Description: Dopamine is a naturally occurring catecholamine that increases cardiac output without appreciably increasing myocardial oxygen consumption. It maintains renal and mesenteric blood flow while inducing vasoconstriction and increasing systolic blood pressure.
Indications: Nonhypovolemic hypotension (70 to 100 mmHg) and cardiogenic shock.
Contraindications: Hypovolemic hypotension without aggressive fluid resuscitation, tachydysrhythmias, ventricular fibrillation, and pheochromocytoma.
Precautions: Ensure adequate fluid resuscitation
of the hypovolemic patient.
Dosage/Route: 2 to 20 mcg/kg/min. 5 mcg/kg/min starting cardiac dose, titrated to effect.
Pedi: same as adult.
Diltiazem (Cardizem)
Name/Class: DILTIAZEM (Cardizem)/Calcium Channel Blocker
Description: Diltiazem is a slow calcium channel blocker similar to verapamil. It dilates coronary and peripheral arteries and arterioles, thus increasing circulation to the heart and reducing peripheral vascular resistance.
Indications: Supraventricular tachydysrhythmias (atrial fibrillation, atrial flutter, and PSVT refractory to adenosine) and to increase coronary artery perfusion in angina.
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
Dosage/Route: 0.25 mg/kg IV over 2 min, may repeat as needed with 0.35 mg/kg.
Diazepam (Valium)
Name/Class: DIAZEPAM (Valium)/Antianxiety, Hypnotic, Anticonvulsant, Sedative
Description: Diazepam is a benzodiazepine sedative and skeletal muscle relaxant that reduces tremors, induces amnesia, and reduces the incidence and recurrence of seizures. It relaxes muscle spasms in orthopedic injuries and produces amnesia for painful procedures (cardioversion).
Indications: Major motor seizures, status epilepticus, premedication before cardioversion, muscle tremors due to injury, and acute anxiety.
Contraindications:, shock, coma, acute alcoholism, depressed vital signs, obstetric patients, neonates.
Precautions: Psychoses, depression, myasthenia gravis, Due to a short half-life of the drug, seizure activity may recur.
Dosage/Route: Seizures: 5 to 10 mg IV/IM.
Acute anxiety: 2 to 5 mg IV/IM.
Pedi: 0.5 to 2 mg IV/PR.
Premedication: 5 to 15 mg IV.
Pedi: 0.2 to 0.5 mg/kg IV.
Epinephrine (Adrenalin)
Name/Class: EPINEPHRINE (Adrenalin)/Sympathomimetic
Description: Epinephrine is a naturally occurring catecholamine that increases heart rate, cardiac contractile force myocardial electrical activity, systemic vascular resistance, and systolic blood pressure and decreases overall airway resistance and automaticity. It also, through bronchial artery constriction, may reduce pulmonary congestion and increase tidal volume and vital capacity.
Indications: To restore rhythm in cardiac arrest and severe allergic reactions, COPD, Asthma
Contraindications: Narrow angle glaucoma; hemorrhagic, traumatic, or cardiac shock;
Dosage/Route: Arrest: 1 mg of 1:10,000 IV q3 to 5 min (ET: 2 to 2.5 mg 1:1,000).
Pedi: 0.01 mg/kg 1:10,000 IV/IO. All subsequent doses 0.1 mg/kg IV/IO. No max.
Adult Bradycardia (2-5mcg/min) IV Drip mix 1mg/250cc
Allergic reactions: 0.3 of 1:1,000 IM q5 to 15 min as needed or 0.5 to 1 mg of 1:10,000 IV if IM dose ineffective or severe reaction. Consider IV Drip 2-10mcg/min if severe
Pedi: 0.01 mg/kg (Max 0.5) of 1:1,000 IM/10 to 15 min or 0.01 mg/kg of 1:10,000 IV if IM dose ineffective or severe.
Asthma/COPD 0.01mg/kg to max of 0.3mg 1-1,000 SQ
Eptifibatide (Integrilin)
Name/Class: EPTIFIBATIDE (Integrilin) Glycoprotein IIb/IIIa inhibitor, platelet aggregation inhibitor
Description: Prevents the aggregation of platelets by binding to the glycoprotein IIb/IIIa receptor, preventing the binding of fibrinogen and von Willebrand factors.
Indications: Unstable angina and NSTEMI (ACS) being managed medically.
Contraindications: Any prior intracranial hemorrhage, known malignant intracranial neoplasm, suspected aortic dissection, significant closed head trauma or facial trauma within 3 hours.
Precautions/Side Effects: Cerebral hemorrhage, pulmonary hemorrhage, hypotension, GI bleeding, internal bleeding, anaphylactic shock.
Dosage/Route: Medical management 180 ug/kg IV bolus over 1-2 minutes, followed by a 2 ug/kg infusion for 72-96 hours.
Etomidate (Amidate)
Name/Class: ETOMIDATE (Amidate)/Hypnotic
Description: Etomidate is an ultra–short-acting nonbarbiturate hypnotic with no analgesic effects and limited cardiovascular and respiratory effects.
Indications: Induce sedation for rapid sequence intubation.
Contraindications: None.
Precautions: Head Injury if no paralytics used, marked hypotension, severe asthma, or severe cardiovascular disease.
Dosage/Route: 0.1 to 0.3 mg/kg IV over 15 to 30 sec.
Pedi: children > 10 years, same as for adults
Fentanyl (Sublimaze)
Name/Class: FENTANYL (Sublimaze)/Narcotic Analgesic
Description: Fentanyl is a potent synthetic narcotic analgesic similar to morphine and meperidine but with a more rapid and less-prolonged action.
Indications: Induce sedation for endotracheal intubation, severe pain
Contraindications: MAO inhibitors within 14 days, myasthenia gravis.
Precautions: Increased intracranial pressure, elderly, debilitated, COPD, respiratory problems, hepatic and renal insufficiency.
Dosage/Route: 1-2mcg/kg slowly IV (2 to 3 min) Max of 200mcg
Pedi: 2 mcg/kg slow IV/IM.
Flumazenil (Romazicon)
Name/Class: FLUMAZENIL (Romazicon)/Benzodiazepine Antagonist
Description: Flumazenil is a 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 medication 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 and physical dependence on benzodiazepines.
Dosage/Route: 0.2 mg IV over 30 sec/min, up to 1 mg.
Furosemide (Lasix)
Name/Class: FUROSEMIDE (Lasix)/Diuretic
Description: Furosemide is a rapid-acting, potent diuretic and antihypertensive that inhibits sodium
reabsorption by the kidney. Its vasodilating effects reduce venous return and cardiac workload.
Indications: Congestive heart failure and pulmonary edema.
Contraindications: Hypotension
Precautions: Infants, elderly, hepatic impairment, cardiogenic shock associated with acute MI, gout, or patients receiving digitalis or potassium-depleting steroids.
Dosage/Route: 40 to 120 mg slow IV or could cause tinitis.
Pedi: 1 mg/kg slow IV.
Glucagon (GlucaGen)
Name/Class: GLUCAGON (GlucaGen)/Hormone, Anti-hypoglycemic
Description: Glucagon is a protein secreted by pancreatic cells that causes a breakdown of stored glycogen into glucose.
Indications: Hypoglycemia without IV access and to reverse beta-blocker and Calcium Channel Blocker overdose.
Contraindications: None
Precautions: Cardiovascular or renal impairment. Effective only if there are sufficient stores of glycogen in the liver.
Dosage/Route: Hypoglycemia: 1 mg IM repeat q10 to 20 min.
Pedi: 0.1 mg/kg IM/SC/IV for child < 10 kg;
Beta-blocker overdose / Calcium Channel Blocker
OD: 3mg IV over 1 min.
Pedi: 50 to 150 mcg/kg IV over 1 min.
Haloperidol (Haldol)
Name/Class: HALOPERIDOL (Haldol)/Antipsychotic
Description: Haloperidol is believed to block dopamine receptors in the brain associated with mood and behavior,is a potent antiemetic, and impairs temperature regulation.
Indications: Acute psychotic episodes.
Contraindications: Parkinson’s disease, seizure disorders, coma, alcohol depression, CNS depression, and thyrotoxicosis, and with other sedatives.
Precautions: Orthostatic Hypotension
Dosage/Route: 2 to 5 mg IM. Normally mixed with Benadryl to avoid EPS Reactions
