Medications & Indications + Contraindications Flashcards
Acetaminophen
Indications: Pain and fever control
Contraindications: Known hypersensitivity | Severe active liver disease
AcetaZOLAMIDE (Diamox, Diamox Sequels)
Indications: Acute Mountain Sickness (treatment and prophylaxis) | Prevention of HACE (High-altitude cerebral edema)
Contraindications: Hypersensitivity to acetaZOLAMIDE or sulfa | Known hypokalemia or hyponatremia | Renal or liver dysfunction | Should not be used for the treatment of HAPE (high-altitude pulmonary edema)
Acetic Acid (Vinegar)
Indications: Otitis externa | Pain control for envenomation by jellyfish from outside the United States
Contraindications: Hypersensitivity | Perforated tympanic membranes | May increase nematocyst discharge for US jellyfish and should be used only outside the United States
Acetylcysteine (Mucomyst, Acetadote)
Indications: Acetaminophen overdose
Contraindications: Known hypersensitivity | Acute asthma
Activated charcoal
Indications: Most oral poisonings and medication overdoses in the alert patient | Can be used after evacuation of poisons
Contraindications: Known hypersensitivity | Unprotected airway | Absence of a gag reflex | Ileus | Intestinal obstruction | Do not use after ingestion of petroleum distillates, hydrocarbons, heavy metals, acids or alkalis (corrosives), alcohols, iron, lithium, solvents | Use caution in patients experiencing abdominal pain of unknown origin
Adenosine (Adenocard)
Indications: First-line drug for most forms of stable, regular, narrow-complex SVT | Can be considered for marrow-complex reentry tachycardia while preparing for cardioversion | Can be used diagnostically for stable, regular, monomorphic wide-complex tachycardia
Contraindications: Known hypersensitivity | Second- or third-degree AV block or sick sinus syndrome or other sinus node disease | Poison- or drug-induced tachycardia | Use with caution in patients with a history of seizure disorder | May induce bronchospasm in a patient with bronchoconstrictive or bronchospastic lung disease (ex: asthma and COPD)
Albumin (Albumarc, Albutein, Flexbumin)
Indications: Hypovolemia
Contraindications: Hypersensitivity | Patients at risk of hypervolemia | Use with caution in patients with renal insufficiency or anemia
Albuterol
Indications: Treatment and prevention of bronchospasm in patients with reversible obstructive airway disease | Treatment of inhaled airway/respiratory irritant agents and Hyperkalemia
Contraindications: Known hypersensitivity | Dysrhythmias (notably those caused by Digitalis) | Synergistic with other sympathomimetics
Amiodarone (Cordarone, Pacerone)
Indications: Cardiac arrest resulting from VF or pulseless VT after CPR, defibrillation, and epinephrine | Stable, regular narrow-complex tachycardia if the rhythm persists despite vagal maneuvers or adenosine or the tachycardia is recurrent | To control the ventricular rate in AF with a rapid ventricular response without preexcitation | Stable wide-complex tachycardia | Stable monomorphic VT | Polymorphic VT with a normal QT interval
Contraindications: Known hypersensitivity | Iodine hypersensitivity | Cardiogenic shock | Second- of third-degree AV block | Sick sinus syndrome or other sinuse node disease (unless a functioning artificial pacemaker is present)
Aspirin (Acetylsalicylic Acid)
Indications: New-onset chest discomfort suggestive of ACS
Contraindications: Hypersensitivity to ASA or NSAIDs | Bleeding disorders | Hemolytic anemia | Lactating mothers
Atropine sulfate
Indications: Hemodynamically unstable bradycardia | Acetylcholinesterase inhibitor poisoning (carbamates, nerve agents, organophosphates) | RSI in pediatrics | Beta blocker or calcium channel blocker overdose
Contraindications: Known hypersensitivity | Narrow-angle glaucoma | GI obstruction | Severe ulcerative colitis | Toxic megacolon | Bladder outlet obstruction | Myasthenia gravis | Hemorrhage with cardiovascular instability | Thyrotoxicosis
Benzocaine Spray (Hurricane)
Indications: Topical anesthetic (ex at larygnx, mouth, trachea, nasal cavity) to facilitate passage of diagnostic and tx devices | Suppresses the pharyngeal and tracheal gag reflex
Contraindications: Hypersensitivity to benzocaine or other “caine” anesthetics
Bumetanide (Bumex)
Indications: Pulmonary edema, heart failure
Contraindications: Hypersensitivity to bumetanide, furosemide, or sulfonamides | Hypovolemia, anuria, acid-based imbalance, electrolyte imbalance, hepatic coma | Use with caution in patients with hepatic cirrhosis, ascites, or diabetes
Calcium chloride
Indications: Hypocalcemia | Hyperkalemia | Beta blocker and calcium channel blocker toxicity | Antidote for magnesium sulfate overdose
Contraindications: Known hypersensitivity | Digoxin toxicity | Hypercalcemia | Suspected severe hypokalemia
Calcium gluconate
Indications: Topical use in hydrofluoric acid burn management | Hypocalcemia | Hyperkalemia | Beta blocker and calcium channel blocker toxicity
Contraindications: Known hypersensitivity | Digoxin toxicity | Hypercalcemia | Suspected severe hypokalemia
Cimetidine (Tagamet)
Indications: Gastric or duodenal ulcers | GERD | Adjunct in treating hives and/or itching in pts w/ an allergic reaction that’s NOT responding to H1 blockers alone (ex: diphenhydrAMINE)
Contraindications: Known hypersensitivity to cimetidine or other H2 blockers
Hetastarch (Hespan)
Indications: Hypovolemic shock, especially burn shock | Septic shock
Contraindications: No significant contraindications when used in the management of life-threatening hypovolemic states
Plasma Protein Fraction (Plasmanate)
Indications: Hypovolemic shock, especially burn shock | Hypoproteinemia (low-protein states)
Contraindications: No significant contraindications when used to treat life-threatening hypovolemic states
0.9% Sodium Chloride (Normal Saline)
Indications: Heat-related problems (heat exhaustion, heatstroke) | Freshwater drowning | Hypovolemia | Diabetic ketoacidosis | Keep open IV
Contraindications: Avoid in patients with history of heart failure or renal failure because circulatory overload can be easily induced
0.45% Sodium Chloride
Indications: Patients with diminished renal or cardiovascular function for whom rapid rehydration is not indicated
Contraindications: Cases in which rapid rehydration is indicated
Lactated Ringer Solution (Hartmann Solution)
Indications: Hypovolemic shock | Keep open IV, hypoperfusion
Contraindications: Heart failure or renal failure | Avoid use in patients with crush injuries/compartment syndrome
3% Sodium Chloride (Hypertonic Saline)
Indications: Traumatic brain injuries | Fluid resuscitation in severe sepsis | Hyponatremia
Contraindications: Hypotension | Use with caution in pediatric patients because their sodium levels shift rapidly | Rapid increases can cause significant neurologic complications
5% Dextrose in 0.45% Sodium Chloride
Indications: Heat exhaustion, diabetic disorders | KVO solution (keep veins open solution) in patients with impaired renal or cardiovascular function
Contraindications: Should NOT be used when rapid fluid resuscitation is indicated
5% Dextrose in 0.9% Sodium Chloride
Indications: Heat-related disorders | Freshwater drowning | Hypovolemia | Peritonitis
Contraindications: Should NOT be administered to patients with impaired cardiac or renal function
5% Dextrose in Lactated Ringer Solution
Indications: Hypovolemic shock | Hemorrhagic shock | Some instances of acidosis
Contraindications: Should NOT be administered to patients with impaired cardiac or renal function
Total Parenteral Nutrition
Indications: Ordered and customized to each patient based on needs identified from lab work
Contraindications: Vary based on the specific mixture
Dexamethasone sodium phosphate (Decadron)
Indications: Anaphylaxis | Acute exacerbation of bronchial asthma | AMS (Acute Mountain Sickness) | HACE (High-altitude cerbral edema) | Spinal cord injury | Croup | Elevated ICP | Adjunct in treatment of shock | COVID-19 w/ severe respiratory sxs
Contraindications: Documented hypersensitivity | Systemic fungal infection | Preterm infants
Dextran
Indications: Hypovolemic shock
Contraindications: Known hypersensitivity | Heart failure, renal failure, or known bleeding disorders
Bacteriostatic Water
Indications: Used for diluting or dissolving drugs for IV, IM, or subcutaneous injections based on the drug manufacturer’s recommendations
Contraindications: Hypersensitivity to benzyl alcohol due to use as a preservative
5% Dextrose in Water
Indications: IV access for emergency drugs; Dilution of concentrated drugs for IV infusion
Contraindications: Should NOT be used as a fluid replacement for hypovolemic states
10% Dextrose in Water
Indications: Neonatal resuscitation | Hypoglycemia
Contraindications: Should NOT be used as a fluid replacement for hypovolemic states
Dextrose
Indications: Hypoglycemia | Acutely altered mental status | Coma or seizure of unknown origin | Status epilepticus
Contraindications: Documented hypersensitivity | Hyperglycemia | Severe dehydration | Anuria | Diabetic coma | Intracranial or intraspinal hemorrhage | Glucose-galactose malabsorption syndrome
Diazepam (Valium, Diastate, AcuDial)
Indications: Uncontrolled shivering associated w/ hyperthermia/heat-exposure, active seizures, chemical restraint, axetylcholinesterase inhibitor poisoning (carbamate, nerve agents, organophosphate)
Contraindications: Documented hypersensitivity | Neurologic or respiratory depression | Narrow-angle glaucoma | Myasthenia gravis | Head injury
Digoxin (Lanoxin)
Indications: Heart failure | alternative frug for reentry SVT | ventricular rate control in atrial flutter and AF
Contraindications: Known hypersensitivity | VF | VT | digitalis toxicity | Hypokalemia, hypomagnesemia, and hypercalcemia potentiate digitalis toxicity
Diltiazem (Cardizem, Dilacor, Diltiaz)
Indications: Stable narrow-QRS tachycardia; if Rhythm persists despite vagal maneuvers or administration of adenosine, or if the tachycardia is recurrent | To control the ventricular rate in patients with AF or atrial flutter without preexcitation
Contraindications: Known hypersensitivity | Hypotension | Cardiogenic shock | Wide-complex tachycardia (may lead to hemodynamic deterioration and VF) | Second- or third-degree AV block | Sick sinus syndrome or other sinus node disease | Poison- or drug-induced tachycardia | AF or atrial flutter associated with an accessory bypass tract (ex: Wolff-Parkinson-White syndrome or Lown-Ganong-Levine syndrome) | Avoid use in patients with left ventricular systolic dysfunction or decompensated heart failure | Use with extreme caution in patients taking oral beta blockers
DiphenhydrAMINE HCl (Benadryl)
Indications: Symptomatic allergic reactions | Symptomatic dystonia | Extrapyramidal signs or symptoms caused by phenothiazines | Antiemetic | Chemical restraint
Contraindications: Known hypersensitivity, newborns and premature infants, breastfeeding | Use with caution in patients with severe vomiting, asthma, narrow-angle glaucoma, benign prostatic hypertrophy, or alcohol intoxication | Use is controversial in patients with lower respiratory tract disease (including acute asthma)
DOBUTamine Hydrochloride (Dobutrex)
Indications: Heart failure with a SBP of 70 to 100 mm Hg and no signs of shock
Contraindications: Known hypersensitivity | Suspected or known poison/drug-induced shock | SBP less than 100 mm Hg and signs of shock | Idiopathic hypertrophic subaortic stenosis
DOPamine Hydrochloride (Intropin)
Indications: Refractory cardiogenic or distributive shock | Hypotension with low cardiac output states | Second-line drug from symptomatic bradycardia
Contraindications: Known hypersensitivity | Hypovolemia | Pheochromocytoma | Uncorrected tachydysrhythmias | VF
Droperidol (Inaspine)
Indications: Chemical restraint | Acute delirium or psychosis
Contraindications: Known hypersensitivity | Known or suspected prolonged QT interval | Use with extreme caution in patients with bradycardia, cardiac disease, concurrent MAOI therapy, or use of Class I and Class III antidysrhythmics or other drugs that prolong the QT interval and cause electrolyte disturbances because of its adverse cardiovascular effects
EPINEPHrine
Indications: Cardiac arrest | Bradycardia | Shock | Anaphylaxis | Sever refractory wheezing (IM) | Coup/bronchiolitis (nebulized)
Contraindications: Known hypersensitivity, coronary insufficiency, cardiac dilation | Uncontrolled hypertension | Hypothermia | Pulmonary edema | Myocardial ischemia | Hypovolemic shock