Basics Flashcards
Epinephrine
Vasopressor
Brand Name: Epinephrine
Classification: Sympathetic agonist
Action: α and β adrenergic agonist (β effects more pronounced although dose-related)
Indications: Cardiac arrest, symptomatic bradycardia, Normovolemic hypotension, Allergies/anaphylaxis, Severe bronchospasm
Contraindications: Few in the emergency setting
Dose: 0.3-1.0 mg
Routes: IV, IO, IM, SQ, ET, inhaled
Adverse Effects: Palpitations, anxiety, tremulousness, headache, dizziness, hypertension, Can worsen cardiac ischemia
Other: Two preparations are commonly available 1:1,000 (1mg/mL) 1:10,000 (1mg/10mL)
Norepinephrine
Vasopressor
Brand Name: Levophed
Classification: Sympathetic agonist
Action: α and β adrenergic agonist (α effects more pronounced)
Indications: Normovolemic hypotension, Septic Shock, Cardiogenic shock
Contraindications: Should not be used in hypovolemia until volume replacement has occurred
Dose: 0.1-0.5 mcg/kg/min (titrate to effect)
Routes: IV
Adverse Effects: Palpitations, Anxiety, Tremulousness, Headache, Dizziness, Hypertension, Can worsen cardiac ischemia, reflex bradycardia
Other: Extravasation can cause localized tissue damage. Best administered through a central line
Albuterol
Bronchodilator
Brand Name: Ventolin, Proventil
Classification: β agonist
Action: β agonist with preference for β2 adrenergic receptors.
Indications: Bronchospasm, Allergies/anaphylaxis, Hyperkalemia
Contraindications: Hypersensitivity
Dose: 2.5 mg (SVN) 90 mcg (MDI)
(small volume nebulizer ; metered dose inhaler)
Routes: Inhalation
Adverse Effects: Palpitations, Anxiety, Tremulousness, Headache, Dizziness, Tachycardia
Other: Patient’s heart rate and SpO2 should be monitored during treatment
Ondansetron
Brand Name: Zofran
Classification: Serotonin antagonist
Action: Selectively blocks 5-HT3 serotonin receptors, including those in the CTZ and vagus nerve terminals
Indications: Nausea and Vomiting
Contraindications: Hypersensitivity
Dose: 4-8 mg
Routes: IV, IM, PO, SL
Adverse Effects: Dizziness and Lightheaded
Other: Commonly used in emergency medicine because of good safety profile
Diphenhydramine
Brand Name: Benadryl
Classification: antihistamine
Action: Nonselectively blocks H1 and H2 histamine receptors
Indications: Allergies, Extrapyramidal reactions, Parkinson’s disease, Sedation, Anaphylaxis
Contraindications: Hypersensitivity, Glaucoma, Pregnancy
Dose: 25-50 mg
Routes: IV, IM, IO, PO
Adverse Effects: Drowsiness, Dizziness, Sedation, Dry Mouth
Other: If given IM give deep in muscle
Naloxone
Brand Name: Narcan
Classification: Opiate Antagonist
Action: Opioid antagonist without opiate agonist properties (it has no activity when given in the absence of an opiate agonist
Indications: Partial reversal of opiate drug effects, Opiate overdose
Contraindications: Hypersensitivity
Dose: 0.4-2.0 mg
Routes: IV, IO, SQ, IN, Nebulizer
Adverse Effects: Fever, Chills, Nausea, Vomiting, Diarrhea, Opiate withdrawal
Other: Administer enough to reverse respiratory depression and avoid full narcotic withdrawal
Amyl Nitrite
Brand Name: Amyl nitrite
Classification: Cyanide antidote
Action: Vasodilator; oxidizes hemoglobin to methemoglobin which reacts with cyanide ion to form cyanmethemoglobin, that is enzymatically degraded
Indications: Cyanide poisoning
Contraindications: None in the emergency setting
Dose: 1-2 inhalants
Routes: Inhaled
Adverse Effects: Headache, Weakness, Dizziness, Flushing, Tachycardia, Orthostatic hypotension
Other: Headache and hypotension common, can worsen hypoxia in the setting of CO poisoning
Hydroxocobalamin
Brand Name: Cyanokit
Classification: cyanide antidote
Action: chelates cyanide from cytochrome oxidase forming cyanocobalamin (Vitamin B12)
Indications: cyanide or suspected cyanide poisoning
Contraindications: none in the emergency setting
Dose: 5-10mg
Routes: IV
Adverse: Chromaturia, red skin, rash, hypertension, nausea, headache
Other: Be prepared to continue full resuscitative measures following administration
Acetaminophen
Brand Name: Tylenol
Classification: Nonnarcotic analgesic, antipyretic
Action: unknown but approximated to be inhibiting cyclooxygenase
Indications: mild-moderate pain, fever
Contraindications: hypersensitivity, alcoholism, chronic liver disease
Dose: 325-650mg
Routes: PO, IV
Adverse Effects: Rare
Other: can be liver toxic, use minimal dosage necessary
Ibuprofen
Brand Name: Motrin, Advil
Classification: NSAID
Action: Anti-inflammatory, antipyretic through inhibition of prostaglandins
Indications: mild-moderate pain, fever, inflammation
Contraindications: hypersensitivity, bronchospasms, angioedema
Dose: 200-800mg
Routes: PO
Adverse Effects: nausea, vomiting, GI bleed, allergic reactions
Other: commonly causes gastric distress
Aspirin
Brand Name: Aspirin
Classification: NSAID
Action: Anti-inflammatory and antipyretic through inhibition of thromboxane A2
Indications: Mild-Moderate pain, Fever, Platelet Aggregation inhibitor
Contraindications: Hypersensitivity, Bronchospasm, Angioedema, Patient receiving monoamine oxidase inhibitor (MAOIs)
Dose: 350-650 mg
Routes: PO
Adverse Effects: Nausea, Vomiting, GI bleeding, Allergic reactions
Other: Commonly causes gastric upset. Avoid enteric-coated aspirin in chest pain
Glucagon
Brand Name: Glucagon
Classification: Hormone (glucagon)
Action: Elevates blood glucose levels through conversion of glycogen to glucose and other factors
Indications: Hypoglycemia and Beta-blocker overdose
Contraindications: Hypersensitivity
Dose: 0.25-0.5 units (IV); 1.0 mg (IM)
Routes: IV, IM, IO
Adverse Effects: Few in the emergency setting
Other: Less effective in patients with decreased glycogen stores (e.g., alcoholics)
Insulin
Brand Name: Humulin, NovoLog, Novolin
Classification: Hormone (insulin)
Action: causes glucose uptake by the cells thus lowering blood glucose levels
Indications: Diabetes, hyperglycemia, diabetic ketoacidosis
Contraindications: Hypoglycemia, normoglycemia
Dose: Varies
Routes: IV, SQ
Adverse: Few in the emergency setting
Other: Dosage of the various insulin types vary significantly
