Paramedic Drugs Flashcards
Adenosine
Trade Name: Adenocard
Classification: Antiarrhythmic
Action/Effects: Slows supraventricular tachycardia, decreasing the electrical activity by interrupting the reentry pathways through the AV node.
Indication: PSVT Rhythm (after vagal maneuvers)
Contraindication: Hypersensitivity 2nd & 3rd degree AV heart block, Sick Sinus Syndrome, A-Fib
Side Effects: Syncope, Chest Pain, facial flushing, SOB, dizziness, hypotension
Adult Dose: 6mg IV push with 20cc NS fluid bolus, a repeat dose of 12mg in 1-2 minutes up to 2X may be given if not converted.
Pediatric Dose: 0.1mg/kg rapid IV push followed by 5cc bolus, repeat 0.2mg/kg x 1
Cautions: Half life is 5 seconds. Pediatric doses don’t exceed adult doses
Albuterol
Trade Name: Proventil, Ventolin
Classification: Bronchodilator, Sympathomimetic
Action/Effects: A beta2-adrenergic agonist which helps relax the bronchial smooth muscles
Indication: Asthma, Relief of bronchospasm with reversible obstructive airway disease.
Contraindications: These are relative to pt. symptoms: Cardiac dysrhythmias, Tachyarrhythmia’s, Angina, HTN, diabetes
Side Effects: Tremors, Dizziness, Anxiety, Palpitations, Tachycardia
Adult Dose: 2.5mg/3ml of NS
Pediatric Dose: 2.5mg in 3cc NS > 1 year old, 1.5mg in 3cc NS < 1 year old
Cautions: Be aware of prior doses/ can interact with diuretics, digoxin, betablockers, & MAO inhibitors/ can have toxicity effects on vascular system if used with tricyclic antidepressants
Amiodarone
Trade Name: Cordarone
Classification: Antiarrhythmic
Action/Effects: Prolongs phase 3 of the cardiac action potential. Amiodarone increases the refractory period of sodium and potassium channels. This intern slows the cardiac action potential.
Indication: V-Fib/V-Tach Pulseless
Contraindication: Hypersensitivity
Side Effects: Lung problems, Liver Problems, Epididymis in long term use
Adult Dose: 150-300 mg IV (Expected 300mg IV loading dose) Check your protocols. (Expected 150mg 2nd dose if needed)
Pediatric Dose: 5mg/kg IV/IO (Check your protocols for additional doses)
Amyl Nitrate
Trade Name: Vaporole
Classification: Vasodilator, Cyanide Antidote
Action/Effects: Causes oxidation of hemoglobin to the compound of methemoglobin. Vasodilatation, including coronary artery dilation. Smooth muscle relaxant
Indication: Cyanide poisoning
Contraindication: None when given for cyanide poisoning
Side Effects: Hypotension with syncope, Headache, Nausea & Vomiting
Adult Dose: 0.3ml or an Amyl Nitrate glass pearl (similar to ammonia) Break ampule & inhale for 30 seconds, then 100% O2 for 50-100 seconds, monitor blood pressure
Aspirin
Trade Name: ASA, Baby Aspirin, Bayer
Classification: Anti-platelet, Antipyretic, NSAID
Action/Effects: Decreases platelet aggregation, prolongs clotting time. Antipyretic Activity
Indication: MI, Coronary Artery Disease, Pericarditis
Contraindication: Hypersensitivity, Pt. already on anticoagulants, Bleeding Disorders
Side Effects: Heart Burn, Nausea, Wheezing, Tinnitus
Adult Dose: 160-325mg PO chewable (2-4 tablets 81mg per tablet) Expected Dose: 324mg
Cautions: Pediatrics, GI bleeds
Atropine Sulfate
Atropine Sulfate Trade Name: Atropine
Classification: Parasympatholytic, Anticholinergic agent
Action/Effects: Increases HR, Contractility, Automaticity, Conduction, & Dilation of the peripheral vessels. Works mainly on the Atrium
Indication: Symptomatic Bradycardia; Organophosphate Poisoning
Contraindication: Hypersensitivity, Tachycardia,
Relative or not functional uses:2nd & 3rd degree AV heart block
Side Effects: Increased Cardiac consumption, Dryness in mouth, Headache, Dizziness, Nausea & Vomiting
Adult Dose: Brady 0.5mg q 3-5 min IV,ET
2-5mg for Organophosphate Poisoning (Vary w/Pt. symptoms)
Pediatric Dose: 0.02mg/kg IV, ET Minimum dose 0.1mg
Cautions: A-Fib, A-Flutter, Glaucoma, & COPD
Diazepam
Trade Name: Valium
Classification: Benzodiazepine, Anticonvulsant
Action/Effects: Antianxiety & anticonvulsant activity. Acts on the CNS to relax the nervous system
Indication: Status Epilepticus, Severe Anxiety, Pacing
Contraindication: Hypersensitivity, Depressed Vital Signs, CNS depressions due to head trauma
Side Effects: Respiratory Depression, Hypotension, Slurred Speech, Confusion, Nausea, Ataxia
Adult Dose: 5-20mg IV/ET/IO
Expected Dose: 5 mg IV increasing to desired effects, smaller doses for elderly patients are needed (2-5mg)
Pediatric Dose: Pediatric 0.1mg/kg IV/ET/IO 0.5mg/kg PR
Cautions: EMT’s carry nothing to reverse a benzodiazepine over dose.
Diphenhydramine
Trade Name: Benadryl
Classification: Antihistamine
Action/Effects: Blocks histamine receptors. This is at the H1 sites. High doses may cause Anticholinergic activity.
Indication: Anaphylaxis, Allergic reaction
Contraindication: Asthma, Hypersensitivity, Pregnancy, nursing mothers
Side Effects: Thicken bronchial secretions, Hypotension, Drowsiness, Dizziness, Tremors
Adult Dose: 25-50mg IM/IV, 15-30 min onset
Expected Dose: 50mg IM
Pediatric Dose: 1-2mg/kg IM/IV
Note: Deliver IM injections into deep muscle mass & alternate sites
Dopamine
Trade Name: Intropin
Classification: Sympathomimetic, Inotrope and chronotropic effects
Action/Effects: Naturally occurring neurotransmitter. Stimulates dopaminergic, beta1/alpha1 adrenergic receptors in a dose dependant amount.
Indication: Cardiogenic shock & hypotension not resulting from
hypovolemia
Contraindication: Hypersensitivity, V-Fib, tachydysrhythmias
Side Effects: Ventricular irritability, Hypertension, Headache, Infiltration causes necrosis, Nausea, Vomiting
Adult/Pediatric Dose: 800mg in a 500cc D5W or NS
Expected Dose: 5-20mcg/kg/min titrating to increase systolic to 100; 2-5 mcg/kg/min are renal effects for lowering BP
Cautions: If possible correct hypovolemia before Dopamine treatment with a fluid bolus. 500-1000cc
DO NOT MIX with NaHCO3
Dextrose 5%
Classification: Hypotonic Solution
Action/Effects: N/A
Indication: Mixing medications (Lidocaine, Dopamine)
Contraindication:N/A
Side Effects:N/A
Adult Dose: Medication Dependent
Expected Dose: N/A
Pediatric Dose: N/A
Cautions: Use caution if used for main IV solution
Epinephrine 1-1,000
Trade Name: Adrenalin 1-1,000
Classification: Bronchodilator, Cardiac Stimulant, Sympathomimetic
Action/Effects: SQ = Bronchodilator & relief of bronchial edema, Beta 1&2 IV = Increases HR, Vasoconstricts, Alpha 1 & Beta 1
Indication: Anaphylaxis, Acute Allergic Reactions, Asthma, Shock
Side Effects: Tremors, Dizziness, Anxiety, Palpitations, Tachycardia, Acute Hypertension
Adult Dose: Anaphylaxis: 0.3-0.5mg SQ.
-Upper Airway Stridor: 2mg of 1:1,000 in 3ml of NS
-Shock treatment= Infusion: as inotrope/pressor.
4 mg in 500ml NS = 8 mcg/ml titrated to effect: Usual range 2-10 mcg/minute (0.01 - 0.1 mcg/kg/minute). (Raise BP S 70-100)
Pediatric Dose: 0.01mg/kg with a max dose of 0.3mg for anaphylaxis - 0.1mg/kg ET (1-1,000) q 3-5 min w/3-5cc flush for cardiac
Cautions: Use caution with pregnancy & preexisting heart disease
Note: Be sure you are using the correct Epinephrine. Both
Epinephrines’ can have the same uses depending route.
Epinephrine 1-10,000
Trade Name: Adrenalin 1-10,000
Classification: Sympathomimetic, Cardiac Stimulant, Bronchodilator
Action/Effects: Increases cardiac resistance, BP, Electrical activity, O2 Needs, contractility, & myocardial activity. Alpha 1 & Beta 1
Indication: Cardiac Arrest V-Fib, V-Tach, Asystole, PEA, & profound Bradycardia
Side Effects: Hypertension, Peripheral constriction
Adult Dose: 0.5-1mg IV every 3-5 minutes
(ET is 2-2 ½ time the dose w/20cc flush)
Expected Dose: 1mg IV Max: None in a life threatening emergency
Pediatric Dose: 0.01mg/kg IV/IO with a max dose of 1mg IV
0.1mg/kg ET (1-1,000) q 3-5 min w/3-5cc flush
Cautions: DO NOT mix with NaHCO3, Heat destroys this drug
Fentanyl
Trade Name: Sublimaze
Classification: Opioid Analgesic
Action/Effects: Combines with receptors sites in brain to produce potent analgesic effects.
Indication: Pain Control, 2nd drug choice for chest pain if morphine allergy. Possible sedation with approved protocol. (RSI)
Contraindication: Respiratory Depression, Hypotension, Head injury, Dysrhythmias, Myasthenia gravis (Muscles tires easy),
Hypersensitivity.
Side Effects: Respiratory depression, Bradycardia, Hypotension or Hypertension, ICP, Nausea
Adult Dose: 25-50mcg IV, IM Max: 100mcg
Ped Dose: Over 2 y/o 0.5-1mcg/kg IV/IM Slow Push (Rarely used in Prehospital)
Cautions: Use Caution with elderly, Schedule II drug (addictive)
Furosemide
Trade Name: Lasix
Classification: Loop Diuretic
Action/Effects: Inhibits the reabsorption of sodium & chloride in the kidney tubule & promotes increased urine formation & excretion
Indication: Pulmonary Edema, CHF
Contraindication: Pregnancy, Hypovolemic, & Hypokalemia
Side Effects: Dehydration, hypotension, Tinnitus/hearing impairment with long term affects
Adult Dose: 20-80mg IV SLOW push to prevent tinnitus
Pediatric Dose: 1mg/kg
Cautions: PUSH slowly & lower doses to avoid Tinnitus.
Glucagon
Trade Name: GlucaGen
Classification: Pancreatic Hormone, Insulin Antagonist
Action/Effects: Raises glucose level by using the glycogen in the liver for glucose. Stimulating glucose synthesis
Indication: Hypoglycemia
Contraindication: Hypersensitivity
Side Effects: Hypotension, Nausea, Hypokalemia
Adult Dose: 1mg IM/IV but usually given IM
Pediatric Dose: 0.02-0.03mg/kg IM/IV with max of 1mg
Cautions: Pt. may have home emergency glucagon kit
May be used w/calcium channel blocker&beta-blocker toxicity