Paramedic Medications Flashcards
Adenosine (Adenocard)
Class: Antidysrhythmic Mechanism: Indications: Contraindications: Adverse reactions/Side Effects: Drug Interactions: Dosage and Administration: Duration of Action: Special Considerations:
Alteplase (Recombinant Tissue Plasminogen Activator [rTPA], Activase)
Class: Mechanism: Indications: Contraindications: Adverse reactions/Side Effects: Drug Interactions: Dosage and Administration: Duration of Action: Special Considerations:
Amiodarone (Cordarone, Pacerone)
Class: Mechanism: Indications: Contraindications: Adverse reactions/Side Effects: Drug Interactions: Dosage and Administration: Duration of Action: Special Considerations:
Aspirin (Acetylsalicylic Acid [ASA])
Class: Mechanism: Indications: Contraindications: Adverse reactions/Side Effects: Drug Interactions: Dosage and Administration: Duration of Action: Special Considerations:
Atropine Sulfate
Class: Mechanism: Indications: Contraindications: Adverse reactions/Side Effects: Drug Interactions: Dosage and Administration: Duration of Action: Special Considerations:
Aspirin (Acetylsalicylic Acid [ASA])
Class: Platelet inhibitor, anti-inflammatory agent
Mechanism: Thromboxane A2 inhibitor, antipyretic and analgesic properties
Indications: New onset chest discomfort suggestive of ACS
Contraindications: Hypersensitivity, relatively contraindicated in Asthma (due to 20% rate of Aspirin Induced Asthma in PT’s with asthma) and in PT’s with active ulcer disease. PT unable to swallow or maintain airway.
Adverse reactions/Side Effects: Bronchospasm, anaphylaxis, increased bleeding, GI distress
Drug Interactions: Use caution in PT’s with allergies to NSAIDs
Dosage and Administration: 162 - 324 mg PO, chewed preferred. Can administer NG/OG.
Duration of Action: Onset is 5 - 30 minutes, Peak action at 1 - 3 hours
Special Considerations: Category D Pregnancy Risk. Use cautiously in pregnant patients and consider lower dose.
Diltiazem
Class: Calcium Channel Blocker, Class IV antidysrhythmic
Mechanism: Inhibits calcium influx into myocardial and vascular smooth muscle cells, leading to arterial dilation and decrease in cardiac muscle contraction. Inhibits cardiac conduction system (mainly at AV node, some effects on SA node)
Indications: Stable narrow complex tachycardia after vagal maneuvers or adenosine, to control ventricular rate in A-fib or A-flutter.
Contraindications: Allergy, hypotension, cardiogenic shock, wide complex tachycardia (can lead to V-fib), 2nd or 3rd degree AV block, sick sinus syndrome, poison or drug induced tachycardia, A-fib or A-flutter with WPW syndrome.
Adverse reactions/Side Effects: Dizziness, headache, dyspnea, cough, dysrhythmias, heart failure, peripheral edema, bradycardia, hypotension, AV blocks, syncope, VF, VT, cardiac arrest, chest pain, nausea, vomiting, dry mouth
Drug Interactions: Caution in PT’s already on meds affecting contractility. Do not give within 2-4 hrs of IV beta-blockers
Dosage and Administration:
- Adult: 0.25 mg/kg IV over 2 minutes, with a 0.35 mg/kg IV repeat dose after 15 minutes over 2 minutes
- Peds: Not recommended
Duration of Action: Onset - 2 - 5 minutes
Special Considerations: Category C Pregnancy Risk. Use caution with renal/hepatic dysfunction.
Dexamethasone Sodium Phosphate (Decadron)
Class: Corticosteroid, adrenal glucocorticoid
Mechanism: Suppresses acute and chronic inflammation, immunosuppressive effects
Indications: Anaphylaxis, asthma, altitude illness, spinal cord injury, croup, elevated ICP, as adjunct in treatment of shock
Contraindications: Hypersensitivity, use caution in suspected systemic sepsis
Adverse reactions/Side Effects: Headache, restlessness, euphoria, psychoses, hypertension, N/V, genital/perineal burning/itching, HYPERGLYCEMIA
Drug Interactions: Calcium (reduces calcium absorption), metaraminol
Dosage and Administration: (Varies depending on use)
- Adult: 10 - 100 mg IV (1 mg/kg slow IV bolus)
- Pediatric: 0.25 to 1 mg/kg IV/IO/PO one time with max dose 16 mg
Duration of Action: Onset - Hours
Special Considerations: Category C Pregnancy Safety, use cautiously with breastfeeding women, long term use associated with toxicity and side effects
Methylprednisolone Sodium Succinate (Solu-Medrol)
Class: Corticosteroids
Mechanism: Potent synthetic glucocorticoid, suppresses acute and chronic inflammation, potentiates vascular smooth muscle relaxation by beta-adrenergic agonists
Indications: Anaphylaxis, bronchodilator for unresponsive asthma
Contraindications: Premature infants, systemic fungal infections, use with caution in patients with GI bleeding
Adverse reactions/Side Effects: Depression, euphoria, headache, restlessness, seizure, Increased ICP, pulmonary tuberculosis, hypertension, heart failure, nausea, vomiting, peptic ulcer, fluid retention, hypernatremia, hyperkalemia
Drug Interactions: Hypoglycemic responses to insulin and other hypoglycemic agents may be blunted
Dosage and Administration:
-Adult and Pediatric:
1. For asthma, COPD, anaphylaxis: 1 - 2 mg/kg slow IVP
2. Status asthmaticus/anaphylaxis: 2 mg/kg per IV/IO/IM dose up to a maximum dose of 60 mg/24 hours
Duration of Action: Onset - 1 to 2 hrs
Special Considerations: Category C Pregnancy safety, may cause fetal harm
Fentanyl Citrate (Sublimaze)
Class: Opioid analgesic, schedule II drug
Mechanism: Binds to opioid receptors, producing analgesia and euphoria
Indications: Pain management, anesthesia adjunct
Contraindications: Known hypersensitivity, use with caution in TBI patients
Adverse reactions/Side Effects: Confusion, paradoxical excitation, delirium, drowsiness, CNS depression, sedation, respiratory depression, dyspnea, apnea, bradycardia, dysrhythmias, tachycardia, hypotension, syncope, nausea, vomiting, abdominal pain, dehydration, fatigue.
Drug Interactions: Increases respiratory effects when given with other CNS depressants
Dosage and Administration:
- Adult: 50-10 mcg (1 mcg/kg) IM or IV slow push over 1-2 minutes, up to max of 150 mcg. Can be given as rapid IN push.
- Pediatric: 1 - 2 mcg/kg IM, IV or IN slow push over 1- 2 minutes. Safety in children under 2 yrs not established.
Duration of Action: Onset - 1-2 minutes, Duration 30-60 minutes
Special Considerations: Category C Pregnancy safety. Chest wall rigidity possible with high dose rapid infusion. A dose of 100 mcg of fentanyl is equivalent to 10 mg of morphine or 75 mg meperidine.
Nitroglycerin (Paste/Spray/Drip/Tabs)
Class: Mechanism: Indications: Contraindications: Adverse reactions/Side Effects: Drug Interactions: Dosage and Administration: Duration of Action: Special Considerations:
Morphine Sulfate (Roxanol, MS Contin)
Class: Opioid Analgesic, schedule II drug
Mechanism: Alleviates pain through CNS action. Suppresses fear and anxiety centers of brain. Depresses brainstem respiratory centers. Increases peripheral venous capacitance and decreases venous return. Decreases preload and afterload.
Indications: Severe heart failure, acute cardiogenic pulmonary edema, chest pain associated with AMI, analgesia for moderate to severe acute and chronic pain.
Contraindications: Head injury, exacerbated COPD, depressed respiratory drive, hypotension, undiagnosed abdominal pain, decreased LOC, suspected hypovolemia, use of MAOI (Monoamine Oxidase Inhibitors) in the last 14 days
Adverse reactions/Side Effects: Confusion, sedation, headache, CNS depression, respiratory depression, apnea, bronchospasm, dyspnea, hypotension, orthostatic hypotension, syncope, bradycardia, tachycardia, nausea, vomiting, dry mouth
Drug Interactions:
Potentiates the sedative effects of phenothiazines. CNS depressants may potentiate the effects of morphine. MAOIs may cause paradoxical excitation.
Dosage and Administration:
- Adult:
1. STEMI - 2 to 4 mg slow IV (1-5 minutes), repeat at 2 - 8 mg at 5 - 15 minute intervals
2. NSTEMI/unstable angina: 1 to 5 mg IV push if symptoms not relieved by nitrates, use caution
- Pediatric: 0.1 to 0.2 mg/kg per dose IV,IO, IM, subcutaneous. Maximum dose: 5 mg
Duration of Action: Onset - Immediate, Duration - 2 to 7 hours
Special Considerations:
Category C Pregnancy risk
Clonidine
Class: Mechanism: Indications: Contraindications: Adverse reactions/Side Effects: Drug Interactions: Dosage and Administration: Duration of Action: Special Considerations:
Ketorolac Tromethamine (Toradol)
Class: NSAID analgesic
Mechanism: Potent analgesic, no sedative or anxiolytic properties
Indications: Short-term management of moderate to severe pain
Contraindications: Allergy to salicylates or other NSAIDS. History of asthma, bleeding disorders (GI bleed, peptic ulcer disease), renal failure
Adverse reactions/Side Effects: drowsiness, dizziness, headache, sedation, bronchopasm, dyspnea, edema, vasodilation, hypotension, hypertension, nausea, GI Bleeding, diarrhea
Drug Interactions: May increase bleeding in patient’s who take anticoagulants
Dosage and Administration:
- Adult: 30 mg to 60 mg IM, 15 mg to 30 mg IV
- Pediatric: Not recommended
Duration of Action: Onset - 10 minutes, peak effect - 1 to 2 hours
Special Considerations: Pregnancy category C, use caution if pain is traumatic in origin
Zofran
Class: Mechanism: Indications: Contraindications: Adverse reactions/Side Effects: Drug Interactions: Dosage and Administration: Duration of Action: Special Considerations:
