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Paramedic San Diego Protocols > ALS Medication > Flashcards

ALS Medication Flashcards

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1
Q 
Sodium Bicarbonate (Bicarb, NaHCO2)
Onset
A

2-10 minutes

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2
Q

Dextrose/ Glucose (50%, D50/ 10%, D10, D10W)

Side effects

A
  • Local venous irritation/ infection

* Hyperglycemia

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3
Q

Cyanide KIT

Side effects

A 
Amyl Nitrate
- Hypertension, tachycardia, palpitations, syncope, headache and nausea
Sodium Thiosulfate 
- Cirrhosis of liver
- Congestive heart failure 
- Renal function impairment
Hydroxocobalamin
- Mild increase in Blood pressure
- Reddish orange skin color which clears over days
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4
Q 
Amiodarone Hydrochloride ( Cordarone, Pacerone, Nexterone) 
Onset
A

Minutes

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5
Q

Midazolam (Versed)

Contraindications

A

NONE

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6
Q

Epinephrine (Adrenalin, EPI)

Side effects

A
  • Anxiety / restlessness
  • Palpitations / tachyarrhythmias
  • Ventricular irritability
  • Increased myocardial Oxygen demand
  • Hypertension
  • Angina
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7
Q

Albuterol (Priventil, Ventilin)

Class

A

Bronchodilator: Sympathomimetic (Beta-2 specific)

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8
Q

Lidocaine (2% xylocaine)

Duration

A

10-20 minutes

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9
Q

Atrovent (Ipratropium Bromide)

Class

A

Bronchodilator: anticholinergic

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10
Q

Atrovent (Ipratropium Bromide)

Contraindications

A

NONE

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11
Q

Lidocaine (2% xylocaine)

Class

A

Anti-arrhythmic / Anesthetic

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12
Q

Naloxone (Narcan)

Contraindications

A

NONE

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13
Q

Fentanyl Citrate

Side effects

A
  • Respiratory depression / Apnea
  • Decreased LOC
  • Transient Hypotension
  • Nausea / Vomiting / Dizziness
  • Muscular rigidity
  • Bradycardia
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14
Q

Fentanyl Citrate

Contraindications

A

NONE

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15
Q

Adenosine(Adenocard)

Duration

A

1-2 minutes

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16
Q

Fentanyl Citrate

Onset

A

< 1 to 2 minutes

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17
Q

Ketamine (Ketalar)

Requirements

A

• > or equal too 15 years old
AND with GCS of 15
AND not pregnant
AND no known or suspected alcohol or drug intoxication
And have not received opioid analgesic in past 6 hours
(Prior to Medic arrival)

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18
Q

Ketamine (Ketalar)

Class

A

Anesthetic / Analgesic

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19
Q 
Dopamine Hydrochloride(Intropin) 
Contraindications
A

NONE

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20
Q 
Dopamine Hydrochloride(Intropin) 
Action
A
  • At low and medium doses, Selectively dilates blood vessels supplying the brain, kidneys, heart and GI tract.
  • At medium to high doses, Increases cardiac output by improving contractility and stroke volume, thereby increasing blood pressure.
  • At high doses, causes vasoconstriction and increased heart rate.
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21
Q

Naloxone (Narcan)

Side effects

A
  • Acute withdrawal symptoms
  • Nausea / vomiting
  • Tachycardia / hypertension
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22
Q

Epinephrine (Adrenalin, EPI)

Action

A

• On the Bronchi: bronchodilation (Beta-2)
• On the peripheral vasculature: vasoconstriction (Alpha)
• On the heart:
-Increased heart rate (Beta-1) / chronotropic
-Increased contractility / Inotropic
-Increased AV conduction/ dromotropic
-Increased automaticity / dromotropic

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23
Q

Atrovent (Ipratropium Bromide)

Action

A
  • Antagonizes the action of acetylcholine, preventing the interaction of acetylcholine with muscarinic receptors in bronchial smooth muscles causing bronchodilation
  • Dries respiratory tract secretions
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24
Q

Nitroglycerin ( NTG,Nitro)

Action

A
  • Produces vasodilation by relaxing systemic venous & arterial vessels, thereby:
  • Decreasing preload & afterload
  • Decreasing myocardial workload
  • Decreasing myocardial Oxygen consumption
  • Dilates coronary arteries
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25
Q 
Amiodarone Hydrochloride ( Cordarone, Pacerone, Nexterone) 
Contraindications
A
  • Hypotension
  • 2nd and 3rd degree heart block
  • idioventricular rhythms
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26
Q

Diphenhydramine(Benadryl)

Class

A

Antihistamine

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27
Q

Ketamine (Ketalar)

Onset

A

IV 30 seconds

IN 2 minutes

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28
Q 
Sodium Bicarbonate (Bicarb, NaHCO2)
Side effects
A

• Electrolyte / PH imbalances

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29
Q 
Morphine sulfate (MS, M50,) 
Class
A

Opioid

Narcotic Analgesic

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30
Q

Albuterol (Priventil, Ventilin)

Contraindications

A
  • None in adults

* PEDS: for croup/strider (Nebulized saline / epinephrine is indicated)

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31
Q

Atrovent (Ipratropium Bromide)

Duration

A

4-5 hours

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32
Q 
Amiodarone Hydrochloride ( Cordarone, Pacerone, Nexterone) 
Duration
A

Days

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33
Q

Cyanide KIT onset

A

Minutes

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34
Q 
Normal saline (0.9% solution sodium chloride, NS)
Contraindications
A

• Rales (except for sepsis S-143)

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35
Q 
Sodium Bicarbonate (Bicarb, NaHCO2)
Class
A

Electrolyte

Alkalinizing agent

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36
Q

Cyanide KIT Drugs

A
  • Amyl Nitrate inhaler
  • Sodium Thiosulfate 25%
  • Hydroxocobalamin
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37
Q

Diphenhydramine(Benadryl)

Duration

A

6-12 hours

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38
Q 
Sodium Bicarbonate (Bicarb, NaHCO2)
Contraindications
A

NONE

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39
Q 
Morphine sulfate (MS, M50,) 
Side effects
A
  • Respiratory depression / apnea
  • Decreased LOC
  • Transient Hypotension
  • Nausea / Vomiting
  • Pinpoint pupils
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40
Q

Ondansetron (Zofran)

Duration

A

IV/IM and ODT 2 hours

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41
Q

Aspirin, ASA ( Acetysalicylic Acid)

Onset

A

15-30 minutes

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42
Q

Ketamine (Ketalar)

contraindications

A
  • Pediatrics
  • Pregnancy
  • Severe Hypertension
  • Alcohol intoxicated
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43
Q

Albuterol (Priventil, Ventilin)

Duration

A

Up to 5 hours

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44
Q

Nitroglycerin ( NTG,Nitro)

Side effects

A
  • Orthostatic hypotension
  • Dizziness / syncope
  • Temporary pulsating headache
  • Facial flushing
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45
Q

Lidocaine Jelly 2% (Xylocaine Jelly)

Side effects

A

NONE

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46
Q

Charcoal (Activated Charcoal)

Class

A

Absorbent

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47
Q

Nitroglycerin ( NTG,Nitro)

Class

A

Vasodilator

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48
Q

Atrovent (Ipratropium Bromide)

Peak

A

1-2 hours

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49
Q 
Normal saline (0.9% solution sodium chloride, NS)
Class
A

• Electrolyte / Isotonic crystalloid

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50
Q

Acetaminophen (Ofirmev)

Onset

A

15 minutes

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51
Q

Fentanyl Citrate

Use with caution: BHPO only

A
  • Isolated head injuries
  • Acute onset severe headache
  • Drug/ETOH intoxication
  • Multiple Trauma with GCS < 15
  • Suspected Active Labor
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52
Q

Ondansetron (Zofran)

Side effects

A
  • GI symptoms, especially diarrhea

* Headache

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53
Q

Lidocaine (2% xylocaine)

Action

A
  • Depresses depolarization and automaticity in the ventricles
  • Increases the ventricular fibrillation threshold by increasing phase IV re-polarization
  • Amide-type local anesthetic
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54
Q

Ondansetron (Zofran)

Contraindications

A

NONE

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55
Q

Acetaminophen (Ofirmev)

Class

A

Analgesic/ Antipyretic

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56
Q

Atropine Sulfate

Action

A
  • Competes with acetylcholine for receptor sites blocking the PNS response at SA and AV nodes.
  • Incresses heart rate by increasing electrical conduction through the heart.
  • Positive chronotropic properties with little or no inotropic effects.
  • inhibits secretions by decreasing PNS effects on bronchial, Salivary, Sweat, and GI glands.
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57
Q

Albuterol (Priventil, Ventilin)

Onset

A

5 minutes

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58
Q 
Morphine sulfate (MS, M50,) 
Use with caution: BHPO Only
A
  • Isolated head injuries
  • Acute onset severe headache
  • Drug/ETOH intoxication
  • Multiple Trauma with GCS < 15
  • Suspected Active Labor
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59
Q

Ondansetron (Zofran)

Onset

A

IV/IM and ODT up to 30 minutes

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60
Q

Cyanide KIT Duration

A

Days

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61
Q

Dextrose/ Glucose (50%, D50/ 10%, D10, D10W)

Onset

A

1 minute

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62
Q

Naloxone (Narcan)

Class

A

Opioid antagonist

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63
Q 
Calcium Chloride (10% CaCL2) 
Side effects
A
  • Decressed heart rate (may cause asystole)
  • Hypotension
  • Syncope
  • Nausea/Vomiting
  • Metallic taste
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64
Q 
Dopamine Hydrochloride(Intropin) 
Onset
A

<5 minutes

65
Q

Ketamine (Ketalar)

Duration

A

15-30 minutes

66
Q

Atropine Sulfate

Duration

A

2-6 hours

67
Q 
Calcium Chloride (10% CaCL2) 
Duration
A

May persist for 4 hours after IV/IO

68
Q

Midazolam (Versed)

Onset

A

IV/IO/IN 2 minutes

IM 15 minutes

69
Q

Aspirin, ASA ( Acetysalicylic Acid)

Action

A
  • inhibits normal tendency for platelets to accumulate inside injured or occluded coronary arteries, thereby improving blood flow through vessels to better perfuse the heart.
  • Blocks formation of Thromboxin A2
70
Q

Adenosine(Adenocard)

Onset

A

Within 30 seconds

71
Q

Adenosine (Adenocard)

Class

A

Antiarrhythmic

72
Q 
Dopamine Hydrochloride(Intropin) 
Class
A

Vasopressor: Sympathomimetic(both Alpha and Beta properties)

73
Q 
Sodium Bicarbonate (Bicarb, NaHCO2)
Action
A

• Reduces acidosis or causes alkalosis by direct release of bicarbonate ion into the circulation

74
Q

Lidocaine Jelly 2% (Xylocaine Jelly)

Action

A
  • Prohibits the initiation and conduction of impulses thereby effecting local anesthetic action
  • Decreases irritation when airway tube is inserted thereby decreasing intracranial pressure
75
Q

Charcoal (Activated Charcoal)

Duration

A

4-12 hours

76
Q

Ketamine (Ketalar)

indications

A
  • Burns
  • Envenomation injury
  • Trauma
77
Q

Charcoal (Activated Charcoal)

Indications

A
  • Acetaminophen
  • Colchicine
  • Beta Blockers
  • Calcium channel blockers
  • Salicylates
  • Valproate
  • Oral anticoagulants including rodenticides
  • Paraquat
  • Amanita Mushrooms
78
Q

Nitroglycerin ( NTG,Nitro)

Onset

A

Sublingual 2 minutes

Topical 30-60 minutes

79
Q

Adenosine(Adenocard)

Side effects

A

• Shortness of Breath/ Dyspnea
[ May cause bronchospasm in COPD patients(BHO)]
• Chest pressure / palpitations
• Facial flushing / headache
• Dizzy / lightheadedness
• Nausea
• Transient arrhythmias
( PVC’s, PAC’s, Sinus Bradycardia, AV block, Sinus tach or asystole).
Generally not treated and are quickly self limiting

80
Q

Ondansetron (Zofran)

Class

A

Antiemetic

81
Q

Diphenhydramine(Benadryl)

Contraindications

A

NONE

82
Q

Naloxone (Narcan)

Duration

A

IV 30-60 minutes

IM longer

83
Q

Charcoal (Activated Charcoal)

Contraindications

A
  • isolated alcohol
  • Heavy metal
  • Caustic agent
  • hydrocarbons
  • Iron ingestion
84
Q

Diphenhydramine(Benadryl)

Side effects

A
  • Drowsiness / Sedation(excitement in children)
  • Dry mouth/ thickened bronchial secretions
  • Hypotension
  • Palpitations / Tachycardia
85
Q 
Amiodarone Hydrochloride ( Cordarone, Pacerone, Nexterone) 
Side effects
A
  • Hypotension
  • Exacerbation of the presenting arrhythmia

AFTER DAYS OF USE

  • Liver injury
  • Pulmonary injury: pulmonary infiltrates, bronchospasm, SOB cough, Hemoptysis, Hypoxia
86
Q

Atropine Sulfate

Onset

A

IV/IO 2-4 minutes

IM 10-15 minutes

87
Q

Aspirin, ASA ( Acetysalicylic Acid)

Class

A

• Platelet aggression inhibitor

88
Q

Diphenhydramine(Benadryl)

Action

A

• Binds to histamine receptor sites, Blocking H1 and H2 receptors

  • H1 causes Bronchoconstriction, Airway swelling and vasodilation
  • H2 causes secretion of gastric acid

• Does not prevent histamine release

89
Q

Albuterol (Priventil, Ventilin)

Side effects

A
  • Tachycardia / Palpitations
  • Dizziness, headache
  • Tremors, nervousness
90
Q 
Sodium Bicarbonate (Bicarb, NaHCO2)
Duration
A

30-60 minutes

91
Q

Dextrose/ Glucose (50%, D50/ 10%, D10, D10W)

Contraindications

A

NONE

92
Q

Nitroglycerin ( NTG,Nitro)

Contradiction

A
  • Patients who have taken a sexual enhancement medication such as Viagra, Cialis, Levitra within 48 hours
  • patients taking medication for pulmonary hypertension, usually sildenafil (trade names: Revatio, Flolan, and Veletri)
93
Q

Midazolam (Versed)

Class

A

Benzodiazepine: Sedative / Anticonvulsant

94
Q

Aspirin, ASA ( Acetysalicylic Acid)

Contraindications

A

• NONE

95
Q

Naloxone (Narcan)

Action

A

• reverses respiratory depression, sedation and hypotensive effects of opioid overdose by occupying opiate receptor sites

96
Q

Epinephrine (Adrenalin, EPI)

Contraindications

A

NONE

97
Q

Acetaminophen (Ofirmev)

Peak

A

1 hour

98
Q

Adenosine(Adenocard)

Contraindications

A
  • 2nd and 3rd degree heart blocks

* Sick sinus syndrome (without pacemaker)

99
Q 
Morphine sulfate (MS, M50,) 
Duration
A

2-7 hours

100
Q

Lidocaine (2% xylocaine)

Contraindications

A
  • 2nd and 3rd degree heart block

* Idioventricular rhythms

101
Q 
Calcium Chloride (10% CaCL2) 
Onset
A

5-15 minutes

102
Q

Aspirin, ASA ( Acetysalicylic Acid)

Duration

A

Days (antiplatelet effects)

103
Q

Glucagon

Action

A
  • Increases blood glucose by converting glycogen stores in the liver to glucose
  • Inhibits synthesis of glycogen from glucose
104
Q 
Morphine sulfate (MS, M50,) 
Onset
A

1-2 minutes

105
Q

Atropine Sulfate

Side effects

A
  • Tachycardia/ Palpitations
  • Dry mouth/ nausea / vomiting
  • Pupil dilation / blurred vision
  • Flushed/ hot / dry skin
106
Q

Fentanyl Citrate

Action

A

• Potent narcotic analgesic and sedative

107
Q

Diphenhydramine(Benadryl)

Onset

A

15-30 minutes

108
Q

Fentanyl Citrate

Duration

A

30 to 60 minutes

109
Q

Albuterol (Priventil, Ventilin)

Action

A
  • Relaxes bronchial smooth muscles by stimulating beta-2 adrenergic receptors.
  • Produces bronchodilation, relieves bronchospasm, and reduces airway resistance.
110
Q

Ketamine (Ketalar)

Side effects

A

• Increased Heart Rate
• Increased Blood pressure
• Increased Respiratory Rate
• Nausea
• With higher doses and rapid infusion (“dissociative effects”)
-Euphoria (pleasant : dream-like states, vivid imagery
-Dysphoria (unpleasant: anxiety, disorientation, hallucinations)

111
Q

Albuterol (Priventil, Ventilin)

Peak

A

1 hour

112
Q

Glucagon

Side effects

A
  • Nausea / Vomiting

* Tachycardia / Hypertension

113
Q

Naloxone (Narcan)

Onset

A

IV/IN 1-2 minutes

IM 2-5 minutes

114
Q

Charcoal (Activated Charcoal)

Action

A
  • Binds and absorbs ingested toxins present in the GI tract

* Inhibits intestinal absorption, preventing systemic toxicity

115
Q

Lidocaine (2% xylocaine)

Side effets Early

A
  • Anxiety
  • Euphoria
  • Combative
  • Nausea
  • Twitching
  • Numbness
116
Q

Acetaminophen (Ofirmev)

Contraindications

A
  • < 2 years of age
  • Severe hepatic impairment
  • Severe active liver disease
  • If known or suspected total dose exceeding 4000 mg in a 24 hour period
117
Q

Atrovent (Ipratropium Bromide)

Side effects

A
  • Nervousness/ dizziness
  • Headache
  • Cough
  • Paradoxical Bronchospasm
  • Palpitations
  • Blurred Vision / Eye irritation( with direct contact with mist)
118
Q

Ketamine (Ketalar)

Action

A
  • Low & slow dosing provides strong analgesic effects acting on the limbic system and cortex to block afferent transmission of impulses associated with pain perception
  • High & rapid dosing provides fast acting dissociative anesthesia (blocks sensory perception) which can lead to distortion of sights, colors, sounds, self, and one’s environment
119
Q

Dextrose/ Glucose (50%, D50/ 10%, D10, D10W)

Action

A

• increases blood glucose by providing a quick release of free sugar into the circulation

120
Q 
Normal saline (0.9% solution sodium chloride, NS)
Action
A

• Electrolyte solution, which is osmotically equivalent to blood
• Increases the circulating volume of the vascular system
(2/3 of infused volume leaves vascular space within 1 hour)

121
Q 
Normal saline (0.9% solution sodium chloride, NS)
Side effects
A

NONE

122
Q

Acetaminophen (Ofirmev)

Action

A
  • Inhibits the synthesis of prostaglandins which transmit pain signals and induce fever.
  • Reduces pain by blocking the signals produced by prostaglandins
123
Q

Midazolam (Versed)

Action

A
  • CNS Depressant
  • Produces anterograde Amnesia then sedation
  • Stops and prevents seizures
124
Q

Lidocaine (2% xylocaine)

Onset

A

1-2 minutes

125
Q

Nitroglycerin ( NTG,Nitro)

Duration

A

Sublingual 30-60 minutes

Topical 24 hours

126
Q

Lidocaine (2% xylocaine)

Side effets Late

A
  • Seizure
  • Decreased Blood pressure
  • Coma
  • Widening QRS
  • Prolonged PRI
  • V-FIB
127
Q

Acetaminophen (Ofirmev)

Side effects

A
  • Nausea, vomiting
  • Headache, sleep problems
  • Constipation
  • itching , agitation
  • Partial or total lung collapse in pediatric patients
128
Q

Cyanide KIT Contraindications

A

NONE

129
Q

Glucagon

Class

A

Anti-hypoglycemic: Pancreatic hormone

130
Q

Fentanyl Citrate

Class

A

Analgesic: Opioid Agonist

131
Q

Epinephrine (Adrenalin, EPI)

Onset

A

IV/IO 1-2 minutes

IM 5-10 minutes

132
Q 
Dopamine Hydrochloride(Intropin) 
Duration
A

Approximately 10 minutes after drip is stoped

133
Q 
Dopamine Hydrochloride(Intropin) 
Side effects
A
  • At Hugh infusion rates, hypertension and extreme vasoconstriction may occur
  • At low infusion rates, hypotension may occur
  • Tachyarrythmias/ palpations
  • Incressed myocardial oxygen demand
134
Q 
Amiodarone Hydrochloride ( Cordarone, Pacerone, Nexterone) 
Action
A
  • Blocks sodium, potassium and calcium channels in cardiac cells slowing conduction and prolongs repolarization.
  • Has alpha and beta adrenergic blocking properties causing negative inotropic effects and reduces peripheral vascular resistance(afterload).
135
Q

Dextrose/ Glucose (50%, D50/ 10%, D10, D10W)

Duration

A

Depends on degree of hypoglycemia

136
Q

Atrovent (Ipratropium Bromide)

Onset

A

Within 15-30 minutes

137
Q

Glucagon

Contraindications

A

NONE

138
Q

Epinephrine (Adrenalin, EPI)

Class

A

Catecholamine: Sympathomimetic (both Alpha and Beta effects)

139
Q

Charcoal (Activated Charcoal)

Onset

A

Immediate

140
Q

Lidocaine Jelly 2% (Xylocaine Jelly)

Contraindications

A

NONE

141
Q

Atropine Sulfate

Class

A
  • Antiarrythmic

* Anticholinergic

142
Q

Charcoal (Activated Charcoal)

Side effects

A
  • Nausea/ Vomiting
  • Constipation/ diarrhea
  • Abdominal cramping
143
Q

Epinephrine (Adrenalin, EPI)

Duration

A

IV/IO 5-10 minutes

IM 1-4 hours

144
Q

Dextrose/ Glucose (50%, D50/ 10%, D10, D10W)

Class

A

Carbohydrate

145
Q

Midazolam (Versed)

Duration

A

1-4 hours

146
Q

Atropine Sulfate

Contraindications

A

• Asystole

147
Q

Aspirin, ASA ( Acetysalicylic Acid)

Side effects

A
  • GI upset (Indigestion, Nausea/vomiting, Epigastric pain, heartburn)
  • Occult or prolonged bleeding
148
Q

Midazolam (Versed)

Side effects

A

• Respiratory depression / apnea

149
Q

Ondansetron (Zofran)

Action

A

• Blocks serotonin receptors in vagus nerve terminals and in small intestine that trigger the vomiting reflex

150
Q 
Amiodarone Hydrochloride ( Cordarone, Pacerone, Nexterone) 
 Class
A

Antiarrythmic

151
Q 
Calcium Chloride (10% CaCL2) 
Class
A

Electrolyte

152
Q

Adenosine(Adenocard)

Action

A

• Slows electrical conduction through AV node, and interrupts re-entry pathway, converting SVT to normal sinus rhythm

153
Q 
Calcium Chloride (10% CaCL2) 
Contraindications
A

NONE

154
Q 
Calcium Chloride (10% CaCL2) 
Action
A
  • Increases myocardial contractility
  • Enhances Ventricular Automaticity
  • Reverses cardio-electric changes produced by hyperkalemia
  • Shifts potassium back into cells prevent intravascular hyperkalemia
155
Q 
Morphine sulfate (MS, M50,) 
Action
A
  • CNS Depressant acting on opiate receptors in the brain

* Potent Analgesic and sedative

156
Q

Lidocaine Jelly 2% (Xylocaine Jelly)

Class

A

Topical Anesthetic

157
Q 
Morphine sulfate (MS, M50,) 
Contraindications
A

NONE

158
Q

Acetaminophen (Ofirmev)

Duration

A

Up to 4 to 6 hours

Paramedic San Diego Protocols (9 decks)

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