PCP Drugs (what We Can Give) Flashcards
ASA (ASPRIN
Classification: platelet inhibitor, anti-inflammatory
Action: Blocks platelet aggregation and vasoconstriction
😊: Chest pain, atypical symptoms of cardiac arrest
☹️: Hypersensitivity or known allergy to ASA
- Recent bleeding, history of asthma, recent surgery
Side effects: wheezing, heartburn, nausea and vomiting
Dosage: 162 mg, have new patient chew tablet first
Routes: PO
Onset: 4-6hrs, half-life of 3hrs
Dextrose ( D10W)
Classification: Carbohydrate
Action: Immediate source of glucose and water to elevate BP level
😊: Suspected or known hypoglycaemia
☹️: none
Side effects: Local venous irritation and tissue necrosis
Dosage: 10ml = 10,000mg or 10 g
Routes: IV
Dimenhydrinate (Gravol)
Classification: Antiemetic, antihistamine, anticholinergic, anti-vertigo
Action: Diminishes vestibular stimulation from motion, inhibits cholinergique stimulation in vestibular and reticular system.
😊: Prevention or control of nausea, vomiting or vertigo
☹️: Known hypersensitivity or allergy to dimenhydrinate
-Glaucoma, asthma or COPD, cardiovascular disease, Prostatic hyperplasia and urinary obstruction, elderly, pregnancy
Side effects: tachycardia, thickening of bronchial sections, dizzines, excitation, headache, restlessness, anorexia, dry mouth, dysurie, blurred vision
Dosage: 1mg/kg. Max dose of 50mg. Contact medical director if patient appears to be <25kg
Routes and methods of administration: IM undiluted, IV dilute with normal saline and administer over a period of 1-2 minutes
Onset: IM 20-30mins, IV almost immediate
Elimination: metabolized in the liver. Excreted in the urine
Diphenhydramine (Benadryl)
Classification: Antihistamine
Action: H1 receptor or antagonist
Indications: relief of allergy symptoms/early anaphylaxis. Adjunct to epinephrine
Contraindications: known hypersensitivity or allergy to Benadryl. Patients under 2yrs
Cautions: glaucoma, asthma or COPD, hyperthyroidism, cardiovascular disease, elderly
Side effects: drowsiness, dizziness, nervousness, dryness of mouth, nausea
Dosage: Under 12 50mg. 6-12 25mg. 2-5 12.5mg
Routes and administration: PO conscious patients with the ability to swallow. IM administer undiluted if IV is unavailable. IV dilute with normal saline and inject over 1-2minutes max 25mg per min
Onset: PO 1-7hrs. IM 20-30hrs. IV almost immediate
Elimination: metabolized in the liver, excreted in the urine
Nitrous Oxide (Entonox)
Classification: Analgesic
Action: inhalation provides rapid pain relief and CNS depression
Indications: Relief of moderate to sever pain
Contraindications: altered mental status, acute pulmonary exéma, known pneumothorax, decompression sickness, air embolism, signs of cyanosis, inability to ventilate, patient has taken nitroglycerin within the last 5 mins, inhalation injury
Cautions: abdominal distension, shock, chronic obstructive pulmonary disease, major facial trauma, patient has taken a depressant drug, improper storage
Side effects: drowsiness, headache
Dosage: self administered, inhalation via bite stick
Epinephrine Hydrochloride (EPI)
Classification: Sympathetic, natural catecholamine with alpha and beta effects
Actions: stimulates alpha and beta adregenic receptors within the sympathetic nervous system
Indications: Signs of anaphylaxis
Contraindications: Known hypersensitivity or allergy to Epinephrine
Pregnancy, tachycardia
Side effects: nervousness, tremor anxiety, headache, cerebral hemorrhage, agitation
Dosage: 0.01mg/kg IM max of .3mg, q 5-10 minutes max of 3 doses, contact medical director for repeat orders
Onset, duration: IM 5-10 minutes, 1-4hrs
Elimination: Rapidly metabolized by enzymes in the blood, liver. Excreted in the urine
Glucagon
Classification: Insulin antagonist, glucose elevation agent
Action: Helps maintain normal blood sugar levels. Temporary increase in blood glucose levels
Indications: Hypoglycaemic emergencies when IV is unavailable
Contradictions: Known hypersensitivity or allergy to glucagon
Side effects: )nausea, vomiting) hypokaliémie, generalized allergic reaction, hypertension, hypotensions, diarrhea, increased heart rate, increased blood pressure
Dosage: weight _> 20kg: 1mg. weight _<20kg 0.5mg
Elimination: rapidly degraded by the liver kidneys and in plasma. Destroyed by the GI tract if accidentally ingested. Half life of 3-6minutes in plasma.
Naloxone Hydrochloride ( Narcan )
Classification: Narcotic Agent
Action: displaces previously administered opioids from their receptors
Indications: Opioid induced collapse
Contraindications: Known hypersensitivity or allergy to narcan
SIde effects: excitation, tachycardia, hypertension, arrhythmias, sweating
Dosage: IM: 0.8mg. IV: 0.4mg. q 5min to a max of 2.0mg
Routes: IM, IV
Onset: Im 5010 minutes, IV less than 2 minutes; 30-60minutes
Nitroglycerin
Classification: Antiangial, Vasodilator
Actions: ReducesDo cardiac oxygen demand primarily by towing plus hassles resulting in decreased blood flow to the heart from the body decreased resistance to the hearts pumping dilation of coronary arteries resulting in increased blood flow to cardiac tissue
😊: Cardiac chest pain prescription to nitroglycerine systolic blood pressure must remain a proper equal to 90 mg of mercury not prescribed nitroglycerine medical doctor must be contacted and systolic blood pressure must must remain above or equal to 100 mg of mercury
☹️ systolic blood pressure less than 90 mg of mercury or systolic blood pressure under hundred milligrams mercury non-hypersensitivity to allergy to nitrates use Viagra or Levitra in the past 24 hours cialis in the past 48
- patient is very restful hypertension some patients may not respond well to nitroglycerine not having an MI if the patient has a large truck and blood pressure consult with medical doctor
Side effects: Hypotension dizziness weakness headache nausea vomiting
Dosage: .4 mg sublingual contact medical doctors sister blood pressure drops 20 mmHg or more after administration of that he does of nitroglycerine
Onset: rapid onset 60 seconds
Duration 30 minutes
Elimination rapidly metabolized in the liver, excreted in the urine
Notes: Do not shake container prior to administration. Nitroglycerine comes in other forms that are not approved for PCP use.
If the patient has nitroglycerine patch applied or as prescribed nitroglycerine tablets it does not change the nitroglycerine protocol.
If pain is completely relieved for more than five minutes, you may initiate the chest pain protocol again if the pain returns; this is considered a new episode.
Normal Saline (N/S)
Classification: Sodium Chloride 0.9%, Sterile intravenous solution
Action: Provides electrolytes and is a source of water for hydration and for replacement
😊: Fluid Resuscitation Protocol, dilutes and delivery system for IV administration of medications
☹️: None noted for PCP score of use
Side effects: Overdose may lead to hypervolemia with pulmonary edema as well as disturbed acid-base and electrolyte balance
Dosage: Hypervolemia; MAX 2000 mL, suspected traumatic brain injury MAX 2000 mL, suspected sepsis MAX 1000 mL. Contact Medical Director for further orders in all above differentials
Routes: IV
Oral Glucose
Classification: Caloric
Action: Absorbed into bloodstream resulting in increased blood glucose levels, there by providing an increased level of glucose for use by cells.
😊: Suspected or known hypoglycemia, IV access was not required or not able to obtain
☹️: If airway management cannot be maintained oral glucose is contraindicated
- If there is a decreased mental status patient must be placed in semi-prone prior to administration. If this position cannot be achieved each other related complications and ministration is contraindicated due to the possibility of causing aspiration. Place gel into dependant buccal pouch lower cheek
Dosage: q 5 minutes to maximum of 50 g. See product details for grams of glucose and total weight of product.
Routes and method of administration: Buccal/ PO
Elimination: Glucose enter cells where it is used to provide energy. It is oxidized into carbon dioxide and water. Excreted through the lungs and kidneys
Salbutamol Ventolin
Classification: Bronchodilator sympathomimetic
Action: Relaxes the smooth muscle of the bronchial tree and peripheral vasculature by stimulating beta-adrenergic receptors of the sympathetic nervous system.
😊: Bronchospasm associated with chief complaint of shortness of breath
☹️: Known sensitivity or allergy to Ventolin
Side effects: Restlessness, apprehension, headache, arrhythmias, blood pressure changes, coughing, nausea pallor, flush, sweating.
Dosage: Less than one years old; 2.5 mg and 2.5 mL normal saline. Greater than one years old 5 mg and 5 mL normal saline.
Routes and methods of administration: Nebulizer mask with oxygen at 6-8lpm.
Onset, Duration 5 to 10 minutes, 3-4 (half life to 2.7-5hrs. Elimination metabolized in the liver in to an active metabolites.
Notes: Special considerations; careful charting of air entry lung sounds degree of respiratory distress and use of accessory muscles should be done pre-and post treatment.
Tranexamic Acid (TXA)
Classification: Hemostatic agent, anti-fibrinolytic agent.
Action: Prevents clot degradation by competing for TPA receptor sites
😊: Major trauma patients after the initiation of the Fluid Resuscitation Protocol. Signs of shock in association with the mechanism of injury or physical findings suggestive to a occult or ongoing bleeding.
☹️: Known hypersensitivity or allergies to TXA. Time is greater than 3 hours after the injury occurred. Patient is under 16 years of age
- Further hypertension if administered too quickly.
Dosage: 1g = 1000 mg
Routes and methods of administration: Piggyback 1 g infused in a 50 mL bag of normal saline. Deliver at a rate of 50 drops per minute 1 g and 10 mL normal saline. Slow IV push; deliver over 10 minutes rate of 1 mL per minute
Onset: immediate
