Generic meds Flashcards
Aspirin trade name
ASA, Bayer
Aspirin class
Analgesic, anti-inflammatory, antipyretic, anti-platelet
Aspirin onset
15-30 minutes
Aspirin duration
4-6 hours; antiplatelet effects may persist 4-10 days
Aspirin indications
mild to moderate pain or fever, prevention of platelet aggregation in inschemia, all patients with ACS, any patient with symptoms of ischemic chest pain, unstable angina, prevention of MI or reinfarction
Aspirin contraindications
Hypersensitivity to salicylates, GI bleeding, Active ulcer disease or acute asthma (relative contraindication), hemorrhagic stroke, bleeding disorders, children with flu-like symptoms
aspirin adverse reactions
stomach irritation, heartburn or indigestion, nausea or vomiting, allergic reactions
aspirin special considerations
Pregnancy safety: Category D in third trimester, Category C in first and second
trimesters
* Is given as soon as possible to the patient with ACS.
* Aspirin is not routinely used as an analgesic in the prehospital setting.
aspirin adult dose
Mild pain and fever: 325-650 mg PO q 4 hours ACS: 160-325 mg PO non-enteric-coated tablet
(chewing is preferable to swallowing); may use rectal suppository for patients who cannot take
orally
chlorhexidine trade name
Hibiclens
Betasept
chlorhexidine class
topical antibacterial
chlorhexidine onset and duration
n/a
chlorhexidine indications
Skin prep
* Skin/wound cleansing
* Surgical hand scrub
chlorhexidine contraindications
Hypersensitivity to the medication
* Caution in patients <2 months of age
chlorhexidine adverse reactions
Anaphylaxis
* Local irritation
chlorhexidine adult dose
4 % solution; wash with 5 mL, rinse and repeat. Apply scrub x 2 minutes, dry with sterile towel
repeat as needed
chlorhexedine special considerations
n/a
Dextrose 50% (include D25%, D10%) class
carbohydrate, hypertonic solution
Dextrose 50% (include D25%, D10%) onset
1 minute
Dextrose 50% (include D25%, D10%) duration
depends on the degree of hypoglycemia
Dextrose 50% (include D25%, D10%) indications
Hypoglycemia (documented or strongly suspected)
* Altered level of consciousness
* Coma of unknown origin
* Seizure of unknown origin
Dextrose 50% (include D25%, D10%) contraindications
Intracranial or intraspinal hemorrhage
* Increased intracranial pressure
* Known or suspected stroke in the absence of hypoglycemia
* Dehydrated patients with delirium
Dextrose 50% (include D25%, D10%) adverse reactions
Warmth, pain, or burning from medication infusion
* Hyperglycemia
* Thrombophlebitis
Dextrose 50% (include D25%, D10%) adult dose
12.5-25 g slow IV (25-50 mL 50% dextrose; 50-100 mL 25% dextrose; or 125-250 mL 10%
dextrose); may repeat to max dose
Dextrose 50% (include D25%, D10%) special considerations
Pregnancy safety: Category C
* Draw blood sample before administration if possible. Perform blood glucose analysis
before administration if possible.
* Extravasation may cause tissue necrosis; use large vein and aspirate occasionally to
ensure route patency.
* Prolonged carbohydrate administration without thiamine supplementation in deficient
patients has been reported to precipitate Wernicke encephalopathy, but there are no
reported instances of a single glucose administration causing Wernicke encephalopathy.
Therefore, the paramedic should never delay glucose administration in a hypoglycemic
patient to administer thiamine first.
diphenhydraine trade name
benedryl
diphenhydramine class
antihistamine
diphenhydramine onset
max effects 1-3 hours
diphenhydramine duration
6-12 hours
diphenhydramine indications
Moderate to severe allergic reactions
* Anaphylaxis (after epinephrine)
* Acute extrapyramidal (dystonic) reactions
diphenhydramine contraindications
Patients taking nonselective MAO inhibitors (now increasingly rare)
* Hypersensitivity
* Narrow-angle glaucoma (relative)
* Newborns and nursing mothers (per manufacturer)
diphenhydramine adverse reactions
Dose-related drowsiness
* Disturbed coordination
* Hypotension
* Palpitations
* Tachycardia, bradycardia
* Thickening of bronchial secretions
* Dry mouth and throat
paradoxical excitement in children
diphendydramine adult dose
1 mg/kg (max dose 50 mg), IM/PO or slow IV
diphenhydramine special considerations
Pregnancy safety: Category C
* Use cautiously in patients with CNS depression or lower respiratory tract diseases such
as asthma.
epinephrine 1:1,000 trade name
EpiPen
epinephrine 1:1,000 Class
Sympathomimetic/bronchodilator
epinephrine 1:1,000 INdications
bronchial asthma, exacerbation of copd, allergic reactions, pediatric cardiac arrest
epinephrine 1:1,000 contraindications
patients with underlying cardiovascular disease, hypertension, pregnancy, patients with tachyarrythmias
epinephrine 1:1,000 adverse reactions
palpitations, tacycardia, anxiousness, headache, tremor
epinephrine 1:1,000 adult dose
0.3-0.5 mg
epinephrine 1:1,000 special considerations
should never be given undiluted as an iv bolus
naloxone trade name
narcan
naloxone class
opioid antagonist
naloxone onset
within 2 minutes
naloxone duration
20 -120 minutes
naloxone indications
complete or partial reversal of CNS depression induced by opioids. decreased level of consciousness or coma of unknown origin
naloxone contraindications
hypersensitivity, avoid use in mperidine induced seizures
naloxone adverse reactions
withdrawal, tachycardia, hypertension, dysrhythias, nausea and vomiting, diaphoresis, blurred vision
naloxone adult dose
IV 0.4 mg titrate for effect,
naloxone special considerations
Pregnancy safety: Category C
* Some research has demonstrated the efficacy of IN naloxone administration; however,
the optimal dose for the IN route has not been established.
* Seizures have been reported (no causal relationship has been established).
* Naloxone may not reverse hypotension.
* Exercise caution and use smaller doses when administering naloxone to narcotic addicts
(may precipitate withdrawal with hypertension, tachycardia, and violent behavior).
* Naloxone may make intubation, airway adjunct placement, or prolonged assisted
ventilation unnecessary.
* Administer naloxone and assess for response prior to attempting ET intubation in apneic
patients with a suspected opioid overdose.
* Rare anaphylactic reactions have been reported.
nitro trade name
nitrostat
nitro class
vasodilator
nitro onset
1-3 minutes
nitro duration
IV 3-5 minutes
SL approimately 25 minutes
nitro indications
ischemic chest pain, heart failure, acute MI, hypertensive emergencies with ACS, as local vasodilator as treatment for extravasation of vasopressor medications
nitro contraindications
Volume depletion
* Hypersensitivity
* Hypotension (SBP <90 mm Hg or 30 mm Hg below baseline)
* Head injury
* Extreme bradycardia (HR <50 beats/min)
* Extreme tachycardia (HR > 100beats/min) in the absence of heart failure
* Right ventricular infarction
* Cerebral hemorrhage
* Recent use of tadalafil (Cialis), vardenafil (Levitra), or sildenafil (Viagra)
* Aortic stenosis
nitro adverse reactions
transient headache, reflex tachycardia hypotension, nausea and vomiting, postural syncope, diaphoresis, flushing
nitro adult dose
0.4 mg SL, may repeat 3 doses every 3-5 minutes
PE, consider 0.8 mg
nitro special special consideratinos
Pregnancy safety: Category C
* Nitroglycerin is associated with increased susceptibility to hypotension in older adults.
* Nitroglycerin decomposes when exposed to light or heat.
* Must be kept in airtight containers.
* The active ingredient of nitroglycerin will sting, when administered sublingually.
* Use with caution in patients with inferior acute MI with possible right ventricular
involvement.
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* Administer IV nitroglycerin by infusion pump to ensure precise flow rate.
* Polyvinyl chloride (PVC) tubing may absorb up to 80% of available drug; non-PVC tubing
should be used.
ondansetron trade name
zofran
ondansetron class
antiemetic/serotonin-blocking agent
ondansetron onset
within 30 minutes
ondansetron duration
3-6 hours
ondansetron indications
nausea, vomiting
ondansetron contraindications
hypersensitivity, administration with apomorphine, liver disease, GI obstrucion, prolonged QT syndrome
ondansetron adverse reactions
generally well tolerated, ecg irregularities, hiccups, pruritus, flushing, chills, headache, dizziness, drowsiness, extrapyramidal symptoms, shivering, hypoxia,
ondansetron adult dose
IV up to 4 mg slow push
ondansetron special considerations
Pregnancy safety: Category B
* The use of ondansetron may mask the symptoms of adynamic ileus, GI obstruction. or
gastric distention after abdominal surgery:
* Tablets should be gently removed from the foil, not pushed through the package.
* Allow ODT to dissolve on tongue with saliva.
* Caution: May prolong QT interval.
oral glucose trade name
glutose 15, insta-glucose
oral glucose class
sugaro
oral glucose onset
rapid
oral glucose duration
n/a
oral glucose indications
hypoglycemia with altered mental status
oral glucose contraindications
airway compromise, unconsciousness/inability to control airway
oral glucose adverse reactions
possible airway obtruction
oral glucose adult dose
15 g PO
promethazine trade name
phenergan
promethazine class
phenothiazine antihistamine
promethazine onset
IV rapidp
promethazine duration
4-12 hours
promethazine indications
nausea/vomiting, motion sickness, preoperative and postoperative, obsetric (during labor) sedation, to potentiate the effects of analgesics, allergic reactions
promethazine contraindications
hypersensitivity, comatose states, CNS depression from alcohol, barbituates, or narcotics
promethazine adverse reactions
sedation, dizziness, may impair mental and physical ability, allergic reactions, dysrhythmias, n/v, hyperexcitability, dystonia, extravasation may cause massive local tissue injury, use in children may cause hallucinations, convulsions, and sudden death
promethazine adult dose
12.5-25 mg IV
promethazine special considerations
Pregnancy safety: Category C. Generally considered safe for use during labor.
* Use caution in patients with asthma, peptic ulcer, and bone marrow depression.
* Take care to avoid accidental intra-arterial injection. Deep IM injections are the
preferred route of administration.
* Dilute into > 10 mL NS and give slow IV administration over 1 minute or longer through
a running IV line while monitoring carefully for signs of infiltration. Avoid veins in the
hands or wrists.
