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2019 Paramedic Drug Profiles > Indications, Contraindications, Adverse Reactions, Route, & Onset > Flashcards

Indications, Contraindications, Adverse Reactions, Route, & Onset Flashcards

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1
Q

INDICATIONS
 Chest pain and/or signs and symptoms suggestive of the acute coronary syndrome
 ECG waveforms suggestive of the acute coronary syndrome

CONTRAINDICATIONS
 Known hypersensitivity to the drug
 Not recommended for use with pediatric patients

ADVERSE REACTIONS/SIDE EFFECTS
 None in the emergency setting

ROUTE OF ADMINISTRATION
 Oral - chewed

ONSET OF ACTION
 5 to 30 minutes

A

acetylsalicylic acid

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2
Q

INDICATIONS
 Supraventricular tachycardia
 Wolff-Parkinson-White (WPW) syndrome
 Monomorphic wide-complex tachycardia

CONTRAINDICATIONS
 Atrial fibrillation
 Atrial flutter
 Polymorphic ventricular tachycardia (Torsades de pointes)
 Second-degree and third-degree heart block

ADVERSE REACTIONS/SIDE EFFECTS
 Transient dysrhythmias
 Chest pain
 Palpitations
 Dyspnea
 Dizziness
 Hypotension
 Blurred vision
 Cardiac arrest
 Asystole

ROUTES OF ADMINISTRATION
 IV
 IO

ONSET OF ACTION
 Immediate

A

adenosine

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3
Q 
INDICATIONS
 Asthma
 Bronchospasm associated with chronic bronchitis and emphysema
 Hyperkalemia
CONTRAINDICATION
 Known hypersensitivity to the drug
ADVERSE REACTIONS/SIDE EFFECTS
 Tachycardia
 Hypertension
 Dysrhythmias
 Tremors
 Palpitations
 Chest pain
 Nervousness
 Anxiety
 Headache
 Nausea, vomiting
ROUTE OF ADMINISTRATION
 Nebulized for inhalation
ONSET OF ACTION
 5 to 15 minutes
A

albuterol (Proventil, Ventolin)

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4
Q

INDICATIONS
 Ventricular fibrillation
 Pulseless ventricular tachycardia
 Wide complex tachycardia
CONTRAINDICATIONS
 Cardiogenic shock
 Hemodynamically significant bradycardia
 Second-degree and third-degree heart block
 Hemodynamically significant hypotension

ADVERSE REACTIONS/SIDE EFFECTS
 Bradycardia
 Hypotension
 Heart block
 Congestive heart failure
 Headache
 Dizziness
 Nausea, vomiting

ROUTES OF ADMINISTRATION
 IV
 IO
 Infusion

ONSET OF ACTION
 1 to 3 minutes

A

amiodarone (Cordarone)

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5
Q 
INDICATIONS
 Hemodynamically significant bradycardia
 Organophosphate poisoning
 Carbamate poisoning
 Nerve agent exposure

CONTRAINDICATIONS
 Known hypersensitivity to the drug
 Tachycardia
 Hypothermic hemodynamically significant bradycardia

ADVERSE REACTIONS/SIDE EFFECTS
 Tachycardia
 Palpitations
 Flushed, hot, dry skin
 Dizziness
 Drowsiness
 Confusion
 Anxiety
 Headache
 Dilated pupils
 Blurred vision
 Dry mouth
 Nausea, vomiting
ROUTES OF ADMINISTRATION
 IV
 IO
 ET
ONSET OF ACTION
 Immediate
A

atropine sulfate

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6
Q 
INDICATIONS
 Acute hypocalcemia
 Calcium channel blocker overdose
 Beta-blocker overdose
 Hyperkalemia

CONTRAINDICATION
 None in the emergency setting

ADVERSE REACTIONS/SIDE EFFECTS
 Extravasation may cause tissue necrosis
 Syncope
 Asystole
 Bradycardia
 Dysrhythmias
 Nausea, vomiting

ROUTES OF ADMINISTRATION
 IV
 IO

ONSET OF ACTION
 1 to 3 minutes

A

calcium chloride

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7
Q

INDICATIONS
 Oral poisonings
 Oral overdoses

CONTRAINDICATIONS
 The patient cannot protect their airway
 Ingestion of
o Caustics
o Hydrocarbons
o Acids
o Corrosives
o Cyanide
o Solvents
o Iron
o Lithium
o Lead
o Petroleum substances

ADVERSE REACTIONS/SIDE EFFECTS
 Aspiration
 Nausea, vomiting

ROUTE OF ADMINISTRATION
 Oral

ONSET OF ACTION
 Immediate

A

charcoal, activated

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8
Q

INDICATIONS
 Hypoglycemia
 Unconsciousness of unknown etiology

CONTRAINDICATION
 Head injury

ADVERSE REACTIONS/SIDE EFFECTS
 Extravasation may cause tissue necrosis

ROUTES OF ADMINISTRATION
 IV
 IO
 Infusion

ONSET OF ACTION
 Less than 1 minute

A

dextrose 50%

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9
Q

INDICATIONS
 Atrial fibrillation with rapid ventricular rate
 Atrial flutter with rapid ventricular rate
 Supraventricular tachycardia second-line to administration of adenosine

CONTRAINDICATIONS
 Known hypersensitivity to the drug
 Hypotension
 Myocardial infarction
 Cardiogenic shock
 Ventricular tachycardia
 Second-degree and third-degree heart block
 Wolff-Parkinson-White (WPW) syndrome
 Not recommended for use with pediatric patients
ADVERSE REACTIONS/SIDE EFFECTS
 Hypotension
 Dysrhythmias
 Bradycardia
 Dizziness
 Weakness
 Headache
 Nausea, vomiting

ROUTES OF ADMINISTRATION
 IV
 IO
 Infusion

ONSET OF ACTION
 2 to 5 minutes

A

diltiazem (Cardizem)

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10
Q

INDICATIONS
 Allergic reaction
 Anaphylaxis
 Phenothiazine reaction with extrapyramidal symptoms

CONTRAINDICATION
 Known hypersensitivity to the drug

ADVERSE REACTIONS/SIDE EFFECTS
 Hypotension
 Dysrhythmias
 Sedation
 Euphoria
 Dizziness
 Headache
 Blurred vision
 Palpitations

ROUTES OF ADMINISTRATION
 IV
 IO
 IM

ONSET OF ACTION
 15 to 30 minutes

A

diphenhydramine (Benadryl)

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11
Q 
INDICATIONS
 Cardiogenic shock
 Hemodynamically significant bradycardia
 Hemodynamically significant hypotension
CONTRAINDICATION
 Hemodynamically significant hypovolemic shock
ADVERSE REACTIONS/SIDE EFFECTS
 Extravasation may cause tissue necrosis
 Increased myocardial oxygen demand
 Tachycardia
 Hypertension
 Dysrhythmias
 Dyspnea
 Tremors
 Palpitations
 Headache
 Nausea, vomiting

ROUTE OF ADMINISTRATION
 Infusion

ONSET OF ACTION
 1 to 4 minutes

A

dopamine

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12
Q 
INDICATIONS
 Cardiac arrest
o Asystole
o Pulseless electrical activity
o Ventricular fibrillation
o Pulseless ventricular tachycardia
 Hemodynamically significant hypotension from a cause other than hypovolemia
 Asthma
 Bronchospasm associated with chronic bronchitis and emphysema
 Allergic reaction
 Anaphylaxis
 Hemodynamically significant bradycardia

CONTRAINDICATION
 None in the emergency setting

ADVERSE REACTIONS/SIDE EFFECTS
 Extravasation of the IV/IO may cause tissue necrosis
 Tachycardia
 Increased myocardial oxygen demand
 Hypertension
 Dysrhythmias
 Dyspnea
 Palpitations
 Chest pain
 Nervousness
 Anxiety
 Dizziness
 Headache
 Tremors
 Nausea, vomiting
ROUTES OF ADMINISTRATION
 IV
 IO
 IM
 ET
 Infusion

ONSET OF ACTION
 Immediate

A

epinephrine

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13
Q 
INDICATION
 Procedural sedation for intubation
CONTRAINDICATION
 Known hypersensitivity to the drug
ADVERSE REACTIONS/SIDE EFFECTS
 Respiratory depression
 Respiratory arrest
 Laryngospasm
 Hypotension
 Hypertension
 Tachycardia
 Bradycardia
 Involuntary muscle movement
 Nausea, vomiting

ROUTES OF ADMINISTRATION
 IV
 IO

ONSET OF ACTION
 10 to 20 seconds

A

etomidate

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14
Q

INDICATIONS
 Moderate to severe pain
 Procedural sedation including intubation

CONTRAINDICATIONS
 Known hypersensitivity to the drug
 Head injury
 Decreased level of consciousness
 Respiratory depression
 Hemodynamically significant hypotension
ADVERSE REACTIONS/SIDE EFFECTS
 Central nervous system depression
 Respiratory depression
 Respiratory arrest
 Hypotension
 Bradycardia
 Tachycardia
 Dysrhythmias
 Syncope
 Dyspnea
 Nausea, vomiting

ROUTES OF ADMINISTRATION
 IV
 IO
 IM

ONSET OF ACTION
 1 to 3 minutes

A

fentanyl

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15
Q

INDICATIONS
 Pulmonary edema
 Congestive heart failure

CONTRAINDICATIONS
 Hemodynamically significant hypotension
 Hemodynamically significant hypovolemia

ADVERSE REACTIONS/SIDE EFFECTS
 Hypovolemia
 Hypokalemia

ROUTES OF ADMINISTRATION
 IV
 IO

ONSET OF ACTION
 5 to 10 minutes

A

furosemide (Lasix)

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16
Q

INDICATIONS
 Hemodynamically significant hypoglycemia
 Beta-blocker overdose

CONTRAINDICATION
 Known hypersensitivity to the drug

ADVERSE REACTIONS/SIDE EFFECTS
 Nausea, vomiting

ROUTE OF ADMINISTRATION
 IM

ONSET OF ACTION
 1 minute

A

glucagon

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17
Q

NDICATIONS
 Asthma
 Bronchospasm associated with chronic bronchitis and emphysema

CONTRAINDICATION
 Known hypersensitivity to the drug

ADVERSE REACTIONS/SIDE EFFECTS
 Tachycardia
 Tremors
 Palpitations
 Nervousness
 Anxiety
 Headache
 Nausea, vomiting

ROUTE OF ADMINISTRATION
 Nebulized for inhalation

ONSET OF ACTION
 1 to 3 minutes

A

ipratropium bromide (Atrovent)

18
Q

INDICATION
 Procedural sedation for intubation

CONTRAINDICATIONS
 Known hypersensitivity to the drug
 Not recommended for use with pediatric patients

ADVERSE REACTIONS/SIDE EFFECTS
 Respiratory depression
 Respiratory arrest
 Bradycardia
 Tachycardia
 Dysrhythmias
 Hallucinations
 Nausea, vomiting

ROUTES OF ADMINISTRATION
 IV
 IO
 IM

ONSET OF ACTION
 30 seconds

A

ketamine

19
Q

INDICATIONS
 Ventricular fibrillation
 Ventricular tachycardia
 Ventricular dysrhythmias
o Frequent premature ventricular complexes and couplets
o Monomorphic and polymorphic wide-complex tachycardia

CONTRAINDICATIONS
 Known hypersensitivity to the drug
 Premature ventricular complexes in conjunction with bradycardia
 Second-degree and third-degree heart block

ADVERSE REACTIONS/SIDE EFFECTS
 Drowsiness
 Confusion
 Anxiety
 Dizziness
ROUTES OF ADMINISTRATION
 IV
 IO
 ET
 Infusion

ONSET OF ACTION
 1 to 5 minutes

A

lidocaine

20
Q

INDICATIONS
 Seizures caused by toxicity of pregnancy (toxemia)
 Pregnancy induced hypertension (pre-eclampsia and eclampsia)
 Pre-term labor
 Torsades de pointes (polymorphic ventricular tachycardia)
 Ventricular fibrillation and pulseless ventricular tachycardia refractory to amiodarone or lidocaine
 Reactive airway conditions including bronchoconstriction and bronchospasm

CONTRAINDICATION
 Hemodynamically significant heart block

ADVERSE REACTIONS/SIDE EFFECTS
 Central nervous system depression
 Drowsiness
 Hypotension
 Respiratory depression
 Dysrhythmias

ROUTES OF ADMINISTRATION
 IV
 IO
 Infusion

ONSET OF ACTION
 Immediate

A

magnesium sulfate

21
Q 
INDICATIONS
 Acute exacerbation of asthma, chronic bronchitis, emphysema, and other reactive airway
conditions
 Anaphylaxis
 Burns involving the airway

CONTRAINDICATION
 None in the emergency setting

ADVERSE REACTIONS/SIDE EFFECTS
 None for a single dosage

ROUTES OF ADMINISTRATION
 IV
 IO

ONSET OF ACTION
 1 to 6 hours

ADULT DOSAGE
 125 mg

A

methylprednisolone (Solu-Medrol)

22
Q

INDICATIONS
 Seizure activity
 Status epilepticus
 Procedural sedation for intubation and cardioversion
 Chemical restraint for agitated (excited) delirium
- (3 only) Delirium tremens

CONTRAINDICATION
 Known hypersensitivity to the drug
- (3 only) Head injury

ADVERSE REACTIONS/SIDE EFFECTS
 Sedation
 Transient amnesia
 Respiratory depression
 Respiratory arrest
 Bradycardia
 Hypotension
 Dizziness
 Drowsiness
 Blurred vision
 Nausea, vomiting
ROUTES OF ADMINISTRATION
 IV
 IO
 IM
-(3 only) Rectal

(1) ONSETS OF ACTION
 IV/IO: 1 to 3 minutes
 IM: 15 minutes

(2) ONSETS OF ACTION
 IV/IO: 2 to 5 minutes
 IM: 15 to 30 minutes

(3) ONSETS OF ACTION
 IV/IO: 2 to 5 minutes
 IM: 15 to 30 minutes
 Rectal: variable

A

(1) midazolam (Versed) [PHX med]
(2) lorazepam (Ativan)
(3) diazepam (Valium)

23
Q

INDICATIONS
 Moderate to severe pain
 Chest pain and/or signs and symptoms suggestive of the acute coronary syndrome
 Acute cardiogenic pulmonary edema

CONTRAINDICATIONS
 Known hypersensitivity to the drug
 Head injury
 Decreased level of consciousness
 Hemodynamically significant hypotension
ADVERSE REACTIONS/SIDE EFFECTS
 Central nervous system depression
 Respiratory depression
 Respiratory arrest
 Hypotension
 Bradycardia
 Tachycardia
 Dysrhythmias
 Syncope
 Dyspnea
 Nausea, vomiting

ROUTES OF ADMINISTRATION
 IV
 IO
 IM

ONSET OF ACTION
 Immediate

A

morphine sulfate

24
Q 
INDICATIONS
 Narcotic and synthetic analgesic drug overdoses
o morphine
o heroin
o oxycodone
o methadone
o codeine
o meperidine
o fentanyl
o hydrocodone
o hydromorphone
 Unconsciousness of unknown etiology

CONTRAINDICATION
 None in the emergency setting

ADVERSE REACTIONS/SIDE EFFECTS
 Withdrawal symptoms
o Confusion
o Hypotension
o Tachycardia
o Hypertension
o Dysrhythmias
o Diaphoresis
o Nausea, vomiting
ROUTES OF ADMINISTRATION
 IV
 IM
 IO
 ET
 Intra-nasal (IN)

ONSET OF ACTION
 2 to 10 minutes

A

naloxone

25
Q

INDICATIONS
 Chest pain and signs/symptoms suggestive of the acute coronary syndrome
 Congestive heart failure with pulmonary edema

CONTRAINDICATIONS
 Hemodynamically significant hypotension
 Hypovolemia
 The patient has taken an erectile dysfunction (ED) medication in the previous 24 hours including:
o sildenafil (Viagra®)
o tadalafil (Cialis®)
o vardenafil (Levitra®)
o Or other phosphodiesterase-5 inhibitor medication in the previous 24 hours
 Not recommended for use with pediatric patients

ADVERSE REACTIONS/SIDE EFFECTS
 Hypotension
 Bradycardia
 Tachycardia
 Headache
 Dizziness
 Weakness
 Syncope
 Nausea, vomiting

ROUTE OF ADMINISTRATION
 Sublingual

ONSET OF ACTION
 1 to 3 minutes

A

nitroglycerin

26
Q

INDICATION
 Moderate to severe pain due to musculoskeletal trauma and burns

CONTRAINDICATIONS
 The patient cannot understand verbal instructions for use
 Alcohol intoxication
 Head injury
 Abdominal pain and distention
ADVERSE REACTIONS/SIDE EFFECTS
 Headache
 Dizziness
 Giddiness
 Nausea, vomiting

ROUTE OF ADMINISTRATION
 Inhaled by self-administration

ONSET OF ACTION
 Seconds

A

nitrous oxide 50%

27
Q

INDICATION
 Nausea and vomiting

CONTRAINDICATION
 Known hypersensitivity to the drug

ADVERSE REACTIONS/SIDE EFFECTS
 Headache
 Dizziness

ROUTES OF ADMINISTRATION
 Oral
 IV
 IO

ONSET OF ACTION
 5 to 10 minutes

A

ondansetron (Zofran)

28
Q

INDICATION
 Hypoglycemia

CONTRAINDICATION
 The patient cannot protect their airway

ADVERSE REACTIONS/SIDE EFFECTS
 Nausea, vomiting

ROUTES OF ADMINISTRATION
 Buccal
 Sublingual

ONSET OF ACTION
 Variable

A

oral glucose

29
Q

INDICATIONS
 Hypoxia
 Suspected hypoxia
CONTRAINDICATION
 Oxygen supports combustion with an ignition source
ADVERSE REACTIONS/SIDE EFFECTS
 Oxygen that is not humidified may dry or irritate mucous membranes in the nose and throat
ONSET OF ACTION
 Varies according to the delivery device, ventilation device, and liter flow

A

oxygen

30
Q 
INDICATION
 Postpartum hemorrhage following delivery of the newborn and placenta
CONTRAINDICATIONS
 Known hypersensitivity to the drug
 Presence of a fetus with impending delivery
 Not recommended for use with pediatric patients
ADVERSE REACTIONS/SIDE EFFECTS
 Hypotension
 Nausea, vomiting
ROUTES OF ADMINISTRATION
 Infusion
 IM
ONSETS OF ACTION
 Infusion: immediate
 IM: 3 to 5 minute
A

oxytocin

31
Q 
INDICATION
 Administered prior to insertion of the nasotracheal tube
CONTRAINDICATION
 Known hypersensitivity to the drug
ADVERSE REACTIONS/SIDE EFFECTS
 None in the emergency setting
ROUTE OF ADMINISTRATION
 Nasal
ONSET OF ACTION
 Immediate
A

phenylephrine (Neo-Synephrine)

32
Q 
INDICATIONS
 Metabolic acidosis in these conditions:
o salicylate overdose
o tricyclic antidepressant overdose
o hyperkalemia
o pre-existing or known metabolic acidosis
o acidosis refractory to effective ventilation
o prolonged cardiac arrest
CONTRAINDICATION
 None in the emergency setting
ADVERSE REACTIONS/SIDE EFFECTS
 Extravasation may cause tissue necrosis
ROUTES OF ADMINISTRATION
 IV
 IO
ONSET OF ACTION
 Immediate
A

sodium bicarbonate

33
Q 
INDICATION
 Procedural adjunct for intubation
CONTRAINDICATION
 Known hypersensitivity to the drug
ADVERSE REACTIONS/SIDE EFFECTS
 Respiratory depression
 Respiratory arrest
 Dysrhythmias
ROUTES OF ADMINISTRATION
 IV
 IO
ONSET OF ACTION
 1 minute
A

succinylcholine

34
Q 
INDICATIONS
 Delirium tremens
 Wernicke encephalopathy
 Korsakoff syndrome
 Unconsciousness of unknown etiology
 Alcoholism
 Malnutrition
CONTRAINDICATION
 None in emergency setting
ADVERSE REACTIONS/SIDE EFFECTS
 Nausea, vomiting
ROUTES OF ADMINISTRATION
 IV
 IO
 IM
ONSET OF ACTION
 Rapid
A

thiamine (vitamin B1)

35
Q 
INDICATIONS
 Cardiac arrest:
o ventricular fibrillation
o pulseless ventricular tachycardia
o asystole
o pulseless electrical activity
CONTRAINDICATION
 Not recommended for use with pediatric patients
ADVERSE REACTIONS/SIDE EFFECTS
 Nausea, vomiting
ROUTES OF ADMINISTRATION
 IV
 IO
 ET
ONSET OF ACTION
 1 to 3 minutes
A

vasopressin

36
Q 
INDICATIONS
 Atrial fibrillation with rapid ventricular rate
 Atrial flutter with rapid ventricular rate
 Supraventricular tachycardia
CONTRAINDICATIONS
 Known hypersensitivity to the drug
 Hypotension
 Myocardial infarction
 Cardiogenic shock
 Ventricular tachycardia
 Second-degree and third-degree heart block
 Wolff-Parkinson-White (WPW) syndrome
 Not recommended for use with pediatric patients
ADVERSE REACTIONS/SIDE EFFECTS
 Hypotension
 Dysrhythmias
 Bradycardia
 Dizziness
 Weakness
 Headache
 Nausea, vomiting
ROUTES OF ADMINISTRATION
 IV
 IO
ONSET OF ACTION
 2 to 5 minutes
A

verapamil

37
Q

INDICATION

Contact with hydrofluoric acid

A

calcium gluconate

38
Q

INDICATIONS
 Type 1 (insulin-dependent) diabetes mellitus
 Type 2 (non-insulin-dependent) diabetes mellitus unresponsive to diet and oral hypoglycemics

A

insulin

39
Q

INDICATIONS
Severe hypotension due to cardiogenic, septic, or neurogenic shock either refractory to intravascular fluid
boluses or in which intravascular fluid blousing is contraindicated (e.g. pulmonary edema)

A

norepinephrine

40
Q

INDICATION

Intensive care unit (ICU) sedation of intubated mechanically ventilated adult patients

A

propofol (Diprivan)

2019 Paramedic Drug Profiles (4 decks)

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