Medications Flashcards
Activated Charcoal: Medication Names
SuperChar, InstaChar, Actidose, Liqui-Char
Activated Charcoal: Indications
- Poisoning by mouth
Activated Charcoal: Contraindications
- Altered mental status
- Ingestion of acids, alkalis, or petroleum products
- Active vomiting
- Inability to swallow
Activated Charcoal: Actions
Adsorbs certain poisons and prevents them from being absorbed into the body.
Activated Charcoal: Side Effects
- Black stool
- Vomiting (particularly patients who have ingested poisons that cause nausea) (if occurs and no contraindications have developed, repeat use)
Activated Charcoal: Administration/Route
Route: Oral
Administration
1. Consult medical direction
2. Check 5 rights
3. Shale container thoroughly
4. Patient may need to be persuaded to drink it, maybe provide through a covered container
5. If not drunk immediately, re-shake to mix settled charcoal prior to administration
Activated Charcoal: Dose
- Adults and children: 1 g activated charcoal/kg of body weight
- Usual adult dose: 25-50 g
- Usual pediatric dose: 12.5 - 25 g
Aspirin: Indications
All must be met.
1. Patient complains of chest discomfort or pain, or discomfort in an area commonly associated with acute coronary syndrome
2. No allergy to aspirin
3. No medications to prevent clotting
4. Able to swallow without endangering airway
5. Medical direction authorizes administration
Aspirin: Contraindications
- Allergic or sensitive to aspirin
- Unable to swallow without endangering airway
- Gastrointestinal ulcer or recent bleeding
- Known bleeding disorder
- Medical direction decides for patients (1) taking blood thinners, (2) pregnancy, (3) recent surgery
– If max dose has already been administered
Aspirin: Actions
Prevents blood from clotting as quickly by coating red blood cells (antiaggregant)
Aspirin: Side Effects
- Heartburn
- Nausea and vomiting
- Bleeding
- If allergic, bronchospasm and wheezing
Aspirin: Administration/Route
Route: Oral tablet, usually chewable
Administration
1. Consult Medical Direction
2. Check 5 rights
3. Ensure patient is alert and oriented, able to chew and swallow medication
4. Ask patient to chew tablets and swallow
Aspirin: Dose
Dose: 162 - 325 mg
*EMS usually carries chewable 81 mg tablets, so up to 4 tablets
Epi: Medication Names
Epinephrine; Epi-Pen, Epi-Pen Jr., Auvi-Q, Twinject
Epi: Indications
- Signs of severe allergic reaction, including respiratory distress or shock
- Prescribed to patient or carried on ambulance
- Medical Direction authorizes use
Epi: Contraindications
None when used in life-threatening situations
Epi: Actions
- Mimics sympathetic nervous response
- Alpha properties constrict blood vessels (improves blood pressure & reduces capillary leakage)
- Beta 2 properties relax smooth muscle of bronchioles (improves breathing and alleviates wheezing and dyspnea)
- Beta 1 properties increases heart rate and contractility, makes capillaries less permeable
Epi: Side Effects
- Increased heart rate
- Pale skin, especially at site of injection
- Dizziness
- Headache
- Chest pain
- Nausea and vomiting
- Excitability and anxiousness
Epi: Administration/Route
Route: Liquid Drug Injected Intramuscularly
Administration
1. Consult Medical Direction
2. Check 5 rights
3. Remove safety cap from auto-injector
4. Place tip of auto-injector against lateral aspect of patient’s thigh, midway between hip and knee
5. Push injector firmly against thigh until spring-loaded needle is deployed and medication is injected
6. Hold injector in place until all medication is injected (10 secs for Epi-Pen, 5 secs for Auvi-Q)
7. Place used auto-injector in sharps container
8. Do not repeat dose
9. Ensure ALS en-route for further treatment
Epi: Dose
Patients > 66 lbs: 0.3 mg
Patients < 66 lbs: 0.15 mg
MDI: Medication Names
Albuterol, Metaproterenol, Ipratropium
MDI: Indications
Must meet all.
1. Signs and symptoms of respiratory emergency
2. Prescribed medication
3. Medical Direction authorizes use
MDI: Contraindications
- Patient is unable to use device
- Not prescribed to patient
- No authorization from Medical Direction
- Patient has already taken maximum dose
MDI: Actions
Beta 2 properties dilates bronchioles (reduces airway resistance)
MDI: Side Effects
- Tachycardia
- Tremors/shakiness
- Nervousness
MDI: Administration/Route
Route: Inhaled
Administration
1. Consult Medical Direction
2. Confirm 5 rights
3. Ensure inhaler is at room temperature or warmer
4. Shake vigorously and prime if necessary
5. Have patient exhale deeply
6. Instruct patient to insert mouth piece into mouth, past teeth
7. Instruct patient to depress handheld inhaler as they inhale slowly and deeply
8. Patient must inhale all medication in one breath
9. Instruct patient to hold breath for 15-20 secs
10. Resume supplemental oxygen
11. Wait 15-30 secs and repeat if second dose is ordered
MDI: Dose
Number of inhalations are based on Medical Direction’s order
Naloxone: Medication Names
Naloxone; Narcan
Naloxone: Indications
Patient is suspected or known to have opioid intoxication present with CNS depression, respiratory depression, hypotension, and/or bradycardia
Naloxone: Contraindications
- Adequate breathing
- Able to maintain own airway
Naloxone: Actions
- Binds to opioid receptors and reverses all receptor actions of the opioid (by blocking the drug’s ability to bind with receptor site)
- Reverses effects of narcotics
Naloxone: Side Effects
- May precipitate withdrawal symptoms (nausea, vomiting, abdominal pains, agitation)
- Patients who have taken other medications with the opioids may become violent
Naloxone: Administration/Route
Route: Intranasal
Administration
1. Consult Medical Direction
2. Check 5 rights.
3. Ventilate and suction patient if necessary
4. Ensure nostrils are clear of any debris
5. Consider restraining patient prior to administration to mitigate violent behavior
6. Assemble mucosal atomizer device containing medication
7. With patient in supine and head slightly hyperextended, insert naloxone firmly into nostril
8. Press syringe plunger firmly and quickly until up to 0.5 mL has been expelled into nostril
9. Repeat for opposite nostril
Naloxone: Dose
Injection: 0.4 - 2.0 mg
Preloaded atomizer: 2.0 - 4.0 mg
Nitro: Medication Names
Nitroglycerin; Nitrostat
Nitro: Indications
All must be met.
1. Complaints of chest discomfort or pain, or discomfort in area commonly associated with acute coronary syndrome
2. History of cardiac problems
3. Prescribed nitroglycerine
4. Systolic BP > 90 mmHg
5. Medical Direction authorizes use
Nitro: Contraindications
- Hypotension or BP < 90 mmHg
- Head injury
- Patient is an infant or child
- Maximum dose has already been taken
- Take erectile dysfunction drug (Viagra, Cialis, Levitra) in past 72 hours
Nitro: Actions
- Dilates blood vessels
- Reduces workload of the heart
Nitro: Side Effects
- Headache
- Hypotension
- Pulse rate changes
Nitro: Administration/Route
Route: Sublingual Spray or Tablet
Administration
1. Consult Medical Direction
2. Confirm 5 rights
3. Instruct patient to lift tongue
4. Spray medication or place tablet under tongue
5. Instruct patient not to swallow until medication has dissolved
6. Check BP within next 2 minutes
Nitro: Dose
Most commonly prescribe dose: 0.4 mg per tablet or spray
Dose may be repeated every 5 mins for a max of 3 doses or per Medical Direction
OG: Medication Names
Oral Glucose, Glucose; Insta-glucose
OG: Indications
All must be met.
1. Altered mental status
2. Known history of diabetes mellitus
OG: Contraindications
- Unconsciousness
- Unable to swallow
- Known diabetic who has not taken insulin for days
OG: Actions
Increases blood glucose level (which increases glucose available for the brain)
OG: Side Effects
None when given properly.
May be aspirated by patient without a gag reflex.
OG: Administration/Route
Route: Gel given orally in toothpaste-like tube
Administration
1. Consult Medical Direction.
2. Confirm 5 rights
Method (1)
3. Hold back patient’s cheek
4. Squeeze small portions of the tube into the mouth between the cheek and gum
5. Lightly massage area between cheek and gum to disperse gel and increase absorption
Method (2)
6. Place small portions of OG on tongue depressor
7. Deposit medication between cheek and gum
8. Lightly massage area between cheek and gum to disperse gel and increase absorption
OG: Dose
Dose: One Tube
Oxygen: Indications
- any situation or condition in which hypoxemia or hypoxia is suspected
- SpO2 <95% or oxygen saturation is unknown
- complaints of dyspnea or exhibits signs of respiratory distress
- exhibits signs of poor perfusion (pale, cool, and clammy skin; delayed capillary refill; hypotension; decreased mental status)
- exhibits obvious signs of heart failure
- in suspected shock
Oxygen: Contraindiactions
Do not use near open flame
Oxygen: Action
Increases amount of available oxygen to the cells of the body
Oxygen: Side Effects
None
Oxygen: Administration/Route/Dose
Route: Gas for inhalation
Administration/Dose
(1) Nasal Cannula:
- 1to 6 Lpm
- Concentration 24 to 44%
(2) Nonrebreather Mask:
- 10 to 15 Lpm
- Concentration 80 to 80%
(3) Bag-Valve-Mask:
- 15 Lpm
- Concentration 100%
