Other Drugs Flashcards
Activated Charcoal
Name/Class: ACTIVATED CHARCOAL (Actidose) / Absorbent
Description: Is a specially prepared charcoal that will adsorb and bind toxins from the gastrointestinal tract.
Indications: Acute ingested poisoning
Precautions: Administer only after emesis or in those cases where emesis is contraindicated.
Dosage/Route: 1G/Kg mixed with at least 6 to 8 oz of water, then PO or via an NG tube
Alteplase Recombinant (tPA) (activase)/Thrombolytic
Name/Class: ALTEPLASE RECOMBINANT (tPA) (Activase)/Thrombolytic
Description: Recombinant DNA–derived form of human tPA promotes thrombolysis by forming plasmin. Plasmin, in turn, degrades fibrin and fibrinogen and, ultimately, the clot.
Indications: To thrombolyse in acute myocardial infarction, acute ischemic stroke, and
pulmonary embolism.
Contraindications: Active internal bleeding, suspected aortic dissection, traumatic CPR, recent hemmorhagic stroke (6 months), intracranial or intraspinal surgery or trauma (2 month), pregnancy, uncontrolled hypertension, or hypersensitivity to thrombolytics.
Precautions: Recent major surgery, cerebral vascular disease, recent GI or GU bleeding, recent trauma, hypertension, patient > 75 years, current oral anticoagulants, or hemorrhagic
ophthalmic conditions.
Benzocaine Spray (Hurricane)
Name/Class: BENZOCAINE SPRAY (Hurricane) Topical anesthetic
Description: Stabilizes neuronal membrane, which blocks the initiation and conduction of nerve impulses
Indications: Used as a lubricant and topical anesthetic to facilitate passage of diagnostic and treatment devices. Suppresses the pharyngeal and tracheal gag reflex.
Dosage/Route: 0.5-1 second spray, repeat as needed.
Pedi: 0.25-0.5 second spray, repeat at needed
Bumetanide (Bumex)
Name/Class: BUMETANIDE (Bumex) Loop diuretic
Description: A potent loop diuretic with a rapid onset and short duration of action. Inhibits the reabsorption of sodium and chloride in the ascending limb of the loop of Henle.
Indications: Pulmonary edema, congestive heart failure
Contraindications: Hypersensitivity to bumetanide or sulfonamides, hypotension, anuria, electrolyte deficiencies, hepatic coma. Use caution: hepatic cirrhosis, ascites, disbetes, hypersensitivity to furosemide.
Dosage/Route: 0.5-1.0 mg IV slowly over 1 to 2 minutes, or IM.
Pedi: Safety and effectiveness in pediatric is not established
Calcium Chloride
Name/Class: CALCIUM CHLORIDE (Calcium Chloride)/Electrolyte
Description: Calcium chloride increases myocardial contractile force and increases ventricular automaticity.
Indications: Hyperkalemia, hypocalcemia, hypermagnesemia, and calcium channel blocker toxicity.
Contraindications: Ventricular fibrillation, hypercalcemia, and possible digitalis toxicity.
Precautions: It may precipitate toxicity in patients taking digoxin. Ensure the IV line is in a large vein and flushed before using and after calcium.
Dosage/Route: 5-10cc of (10% solution / 1Gram –10cc)/10 min, as needed or 6-8mg/Kg .
Amyl Nitrite
1 part of cyanide kit
Name/Class: AMYL NITRITE Antidote, cyanide poisoning adjunct
Description: Converts hemoglobin to methemogolobin, which reacts with cyanide and chemically binds with it, preventing any toxic effects.
Indications: Cyanide poisoning
Contraindications: None in the emergency setting
Precautions: Headache, dizziness, weakness, increased ICP, shortness of breath, orthostatic hypotension, tachycardia
Dosage/Route: 1-2 ampules crushed and inhaled for 30 seconds of each minute until sodium nitrite is prepared of administer for 30-60 seconds every 5 minutes until patient is conscious.
Sodium Nitrate
1 Part of cyanide kit
Name/Class: SODIUM NITRATE Antidote cyanide poisoning adjunct
Description: Reacts with hemoglobin to form methemoglobin, which reacts with cyanide and chemically binds with it to prevent toxic effect.
Indications: Cyanide poisoning
Contraindications: None in the emergency setting
Precautions/Side Effects: Hypotension, tachycardia, fainting, nausea, vomiting
Dosage/Route: 300 mg (10 mL of a 3% solutions) slow IV push over 5 minutes or dilute 300 mg in 100 mL of saline and infuse slowly
Sodium Thiosulfate
1 part of cyanide kit
Name/Class: SODIUM THIOSULFATE Cyanide antidote
Description: Converts cyanide to the less toxic thiocyanate, which is then excreted in the urine.
Indications: Cyanide poisoning
Dosage/Route: 12.5g (50 mL of a 25% solution) IV/IO slow push over 10 minutes.
Pedi: 400 mg/kg (1.65 mL/kg of a 25% solution) IV/IO slow push.
DEXAMETHASONE (Decadron)
Name/Class: DEXAMETHASONE (Decadron)/Steroid
Description: Dexamethasone is a long-acting synthetic adrenocorticoid with intense anti-inflammatory activity. It prevents the accumulation of inflammation generating cells at the sites of
infection or injury.
Indications: Anaphylaxis, asthma, COPD, spinal cord edema.
Contraindications: No absolute contraindications in the emergency setting.
Relative contraindications: systemic fungal infections, acute infections, tuberculosis, varicella, or vaccinia or live virus vaccinations.
Precautions: Herpes simplex, keratitis, myasthenia gravis, hepatic or renal impairment, diabetes, CHF,
seizures, psychic disorders, hypothyroidism, and GI ulceration.
Dosage/Route: 4 to 24 mg IV/IM
Pedi: 0.5 to 1 mg/kg.
DIPHENHYDRAMINE (Benadryl)
Name/Class: DIPHENHYDRAMINE (Benadryl)/Antihistamine
Description: Diphenhydramine blocks histamine release, thereby reducing bronchoconstriction,
vasodilatation, and edema.
Indications: Anaphylaxis, allergic reactions, and dystonic reactions.
Contraindications: Asthma and other lower respiratory diseases.
Precautions: May induce hypotension, headache, palpitations, tachycardia, sedation, drowsiness, and/or disturbed coordination.
Dosage/Route: 25 to 50 mg IV/IM.
Pedi: 1-2mg/kg
Dextrose 50% in water (D50W)
Name/Class: DEXTROSE 50% IN WATER (D50W)/Carbohydrate
Description: Dextrose is a simple sugar that the body can rapidly metabolize to create energy.
Indications: Hypoglycemia
Contraindications: None in hypoglycemia.
Precautions: Increased ICP. Determine blood glucose level before administration. Ensure good venous access.
Dosage/Route: 25g D50W (50 mL) IV.
Pedi: 2 –4 mL/kg of a 25% solution IV (Over 1 Year) 10% solution for under 1 Year
Diazepam (Valium)
Name/Class: DIAZEPAM (Valium)/Antianxiety, Hypnotic, Anticonvulsant, Sedative
Description: Diazepam is a benzodiazepine sedative and skeletal muscle relaxant that reduces tremors, induces amnesia, and reduces the incidence and recurrence of seizures. It relaxes muscle spasms in orthopedic injuries and produces amnesia for painful procedures (cardioversion).
Indications: Major motor seizures, status epilepticus, premedication before cardioversion, muscle tremors due to injury, and acute anxiety.
Contraindications:, shock, coma, acute alcoholism, depressed vital signs, obstetric patients, neonates.
Precautions: Psychoses, depression, myasthenia gravis, Due to a short half-life of the drug, seizure activity may recur.
Dosage/Route: Seizures: 5 to 10 mg IV/IM.
Acute anxiety: 2 to 5 mg IV/IM.
Pedi: 0.5 to 2 mg IV/PR.
Premedication: 5 to 15 mg IV.
Pedi: 0.2 to 0.5 mg/kg IV.
Flumazenil (Romazicon)
Name/Class: FLUMAZENIL (Romazicon)/Benzodiazepine Antagonist
Description: Flumazenil is a benzodiazepine antagonist used to reverse the sedative, recall, and psychomotor effects of diazepam, midazolam, and the other benzodiazepines.
Indications: Respiratory depression secondary to the benzodiazepines.
Contraindications: Hypersensitivity to flumazenil or benzodiazepines; those patients who take medication for status epilepticus or seizures; seizure-prone patients during labor and delivery; tricyclic antidepressant overdose.
Precautions: Hepatic impairment, elderly, pregnancy, nursing mothers, head injury, alcohol and drug dependency and physical dependence on benzodiazepines.
Dosage/Route: 0.2 mg IV over 30 sec/min, up to 1 mg.
Glucagon (GlucaGen)
Name/Class: GLUCAGON (GlucaGen)/Hormone, Anti-hypoglycemic
Description: Glucagon is a protein secreted by pancreatic cells that causes a breakdown of stored glycogen into glucose.
Indications: Hypoglycemia without IV access and to reverse beta-blocker and Calcium Channel Blocker overdose.
Contraindications: None
Precautions: Cardiovascular or renal impairment. Effective only if there are sufficient stores of glycogen in the liver.
Dosage/Route: Hypoglycemia: 1 mg IM repeat q10 to 20 min.
Pedi: 0.1 mg/kg IM/SC/IV for child < 10 kg;
Beta-blocker overdose / Calcium Channel Blocker
OD: 3mg IV over 1 min.
Pedi: 50 to 150 mcg/kg IV over 1 min.
Haloperidol (Haldol)
Name/Class: HALOPERIDOL (Haldol)/Antipsychotic
Description: Haloperidol is believed to block dopamine receptors in the brain associated with mood and behavior,is a potent antiemetic, and impairs temperature regulation.
Indications: Acute psychotic episodes.
Contraindications: Parkinson’s disease, seizure disorders, coma, alcohol depression, CNS depression, and thyrotoxicosis, and with other sedatives.
Precautions: Orthostatic Hypotension
Dosage/Route: 2 to 5 mg IM. Normally mixed with Benadryl to avoid EPS Reactions
Hydroxocobalamin
Name/Class: HYDROXOCOBALAMIN (Cyanokit) Antidote, cyanide poisoning adjunct
Description: Binds with cyanide to form nontoxic cyanocobalamin, preventing its toxic effects; excreted renally
Indications: Treatment of known or suspected cyanide poisioning.
Contraindications: None is the emergency setting
Precautions/Side Effects: Hypertension, allergic reactions, GI bleeding, nausea, vomiting, dyspepsia, dyspnea, dizziness, headache, injection site reactions.
Dosage/Route: 5 g IV infusion over 15 minutes at a rate of 15 mL/min.
Pedi: 70 mg/kg IV one time, may be repeated one time at the same dose.
Labetalol (Normodyne, Trandate)
Name/Class: LABETALOL (Normodyne, Trandate) Selective alpha and nonselective beta-adrenergic blocker, antihypertensive
Description: Blood pressure reduction without reflex tachycardia; total peripheral resistance reduced without significant alteration in cardiac output.
Indications: Moderate to sever hypertension.
Contraindications: Bronchial asthma, congestive heart failure, cardiogenic shock, second- and third-degree heart block, bradycardia
Dosage/Route: 10- 20 mg IV push over 1-2 minutes.
Lorazepam (Ativan)
Name/Class: LORAZEPAM (Ativan)/Sedative
Description: Lorazepam is the most potent benzodiazepine available. It has strong antianxiety, sedative, hypnotic, and skeletal muscle relaxant properties, and a relatively short half-life.
Indications: Sedation for cardioversion and status epilepticus.
Contraindications: Sensitivity to benzodiazepines.
Precautions: Narrow-angle glaucoma, depression or psychosis, coma, shock, acute alcohol intoxication, renal or hepatic impairment, organic brain syndrome, myasthenia gravis, GI disorders, elderly, debilitated, limited pulmonary reserve.
Dosage/Route: Sedation: 2 to 4 mg IM, 0.5 to 2 mg IV.
Pedi: 0.03 to 0.5 mg/kg IV/IM/PR up to 4 mg.
Status epilepticus: 2 mg slow IV/PR (2 mg/min).
Pedi: 0.1 mg/kg slow IV/PR (2 to 5 min).
Magnesium Sulfate
Name/Class: MAGNESIUM SULFATE (Magnesium)/Electrolyte
Description: Magnesium sulfate is an electrolyte that acts as a calcium channel blocker, acting as a CNS depressant and anticonvulsant. It also depresses the function of smooth, skeletal, and cardiac muscles.
Indications: Refractory ventricular fibrillation and pulseless ventricular tachycardia (especially torsade depointes), AMI, eclamptic seizures, Asthma, COPD
Contraindications: Heart block, myocardial damage, shock, persistent hypertension, and hypocalcemia.
Precautions: CNS depressants, or neuromuscular blocking agents.
Dosage/Route: Ventricular fibrillation: 1 to 2 g IV over 2 min.
Torsade de pointes: 1 to 2 g IV .
Asthma / COPD: 1-2 Grams over 10 minutes (Mix in 50cc NS)
Eclampsia: 2 to 6 g IV/IM over 15-30 mins (Mix in 50cc NS)
Mannitol (Osmitrol)
Name/Class: MANNITOL (Osmitrol)/Osmotic Diuretic
Description: Mannitol is an osmotic diuretic that draws water into the intravascular space through its hypertonic effects, then causes diuresis.
Indications: Cerebral edema.
Contraindications: Hypersensitivity, pulmonary edema or severe dehydration
Precautions: Must give slow with filter tubing
Dosage/Route: 1.5 to 2 g/kg slow IV.
Pedi: 0.25 to 0.5 g/kg over 60 min.
METOCLOPRAMIDE (Reglan)/Antiemetic
Name/Class: METOCLOPRAMIDE (Reglan)/Antiemetic
Description: Metoclopramide is a dopamine antagonist similar to procainamide but with few
antidysrhythmic or anesthetic properties. Its antiemetic properties stem from rapid gastric emptying and desensitization of the vomiting reflex.
Indications: Nausea and vomiting.
Contraindications: Hypersensitivity, seizure disorders, GI obstruction or perforation, and breast cancer.
Precautions: CHF, hypokalemia, renal impairment, GI hemorrhage, intermittent porphyria.
Dosage/Route: 10 IM or slow IV (over 2 to 4 min).
Pedi: 1 to 2 mg/kg/dose.
Milrinone (Primacor)
Name/Class: MILRINONE (Primacor) / Cardiac Inotrope, Vasodilator
Description: Milrinone is related to amrinone and increases the strength of cardiac contraction without Increasing rate, increasing cardiac output without increasing oxygen demand.
Indications: CHF, or pediatric septic shock.
Contraindications: Hypersensitivity
Precautions: Elderly, pregnancy, and nursing mothers
Dosage/Route: CHF: 50mcg/kg IV over 10 min, then drip of 0.375 to 0.75mcg/kg/min.
Pedi: 50-75mcg/kg IV
Naloxone (Narcan)
Name/Class: NALOXONE (Narcan)/Narcotic Antagonist
Description: Naloxone is a pure narcotic antagonist that blocks the effects of both natural and synthetic narcotics and may reverse respiratory depression.
Indications: Narcotic and synthetic narcotic overdose, coma of unknown origin.
Contraindications: Hypersensitivity to the drug, non–narcotic-induced respiratory depression.
Precautions: Possible dependency (including newborns). It also has a half-life that is shorter than that of most narcotics; hence the patient may return to the overdose state.
Dosage/Route: 0.4 to 2 mg IV/IM/IN repeated/2 to 3 min as needed up to 10 mg.
Pedi: 0.01 mg IV/IM repeated/2 to 3 min as needed up to 10 mg.
Norepinephrine Bitrate (Levophed)
Name/Class: NOREPINEPHRINE BITARTRATE (Levophed) Sympathomimetic, vasopressor
Description: Potent alpha-agonist resulting in intense perpipheral vasoconstriction, positive chronotropic and increased inotropic effect (from 10% beta effect) with increased cardiac output. Alpha-adrenergic activity resulting in peripheral vasoconstriction and beta-adrenergic activity leading to inotropic stimulation of the heart and coronary artery vasodilation.
Indications: Cardiogenic shock, unresponsive to fluid resuscitation, significant hypotensive (<70 mm Hg) sates
Contraindications: Hypotensive patients with hypovolemia, pregnancy (relative)
Precautions/Side Effects: Bradycardia, hypertension, dysrhythmias, chest pain, peripheral cyanosis, tissue necrosis from extravasation.
Dosage/Route: 0.1-0.5 ug/kg/min titrated to response (average dose for 70 kg patient 7-35 ug/min).
Pedi: Begin at 0.1-2 ug/kg/min IV infusion, adjust rate to achieve desired change in blood pressure and systemic perfusion. Titrated to patient response.
