Shared Health Medications Flashcards
Indications and Contraindications of Olanzapine?
Indications:
-Known or suspected methamphetamine psychosis
Contraindications:
-Uncooperative patient
-Hypotension
-Seizure or acute neurological deficit
Chest pain or Dyspnea
Olanzapine
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Antipsychotic, Antimaniac
Route: Oral (PCP and Above)
Dose: 10 mg (12 years and older)
Repeat Dose: None
Notes: Lowers seizure threshold, patient must be cooperative enough to take oral medication.
Indications and Contraindications of Tranexamic Acid?
Indications:
-Major trauma and hemorrhage with or without shock within 3 hours of injury
-Post Partum hemorrhage
-Nontraumatic hemorrhage with signs of shock
Contraindications:
-True allergy to tanexamic acid
Tranexamic Acid
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Antifibrinolytic Agent
Route: Intravenous (PCP and above)
Dose: 15 mg/kg (1-12 years, max=1 g), 1 g (12 years or older)
Repeat Dose: None
Notes Mix in 100 ml of IV fluid and infuse over 10 minutes, cannot be given in the same line as oxytocin.
Indications and Contraindications of Nitroglycerin?
Indications:
-Chest pain consistent with suspicious for myocardial ischemia
-Pulmonary edema
Contraindications:
-Hypotension (SBP less than 90mmhg)
-Use if Viagra, Cialis or Levitra in the las 24 hours
-Increased intercranial pressure
-Hypersensitivity to Nitroglycerin
Nitroglycerin
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Nitrates
Route: Sublingual or Transdermal (PCP and above, 17 years and older)
Dose: Sublingual 0.4 mg, transdermal 0.4 to 9.8 mg/hr
Repeat Dose: repeat sublingual every 5 minutes as required
Notes: Nitroglycerin does not prevent thrombus from forming or getting worse. ASA always first drug in patients with ACS symptoms. Nitro is a symptom reliever. If SBO drops more than 30 mmHg stop administering. If more than 3 sublingual doses are given apply transdermal.
Indications and Contraindications of Acetylsalicylic Acid (ASA)?
Indications:
-Known or suspected acute coronary syndrome (ACS)
Contraindications:
-Active bleeding that cannot be controlled by basic measures
-True ASA allergy
-Known ASA induced Asthma
Acetylsalicylic Acid
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Antiplatelet Agent
Route: Oral (EMR and above)
Dose: 160 mg (17 years and older)
Repeat Dose: None
Notes: Instruct the patient to chew the medication.
Indications and Contraindications of Ticagrelor?
Indications:
-Known or suspected ST elevation myocardial infarction (STEMI) if patient is going directly to primary coronary intervention and only after consultation with the STEMI physician
Contraindications:
-Patiemt may be candidate forfibrinolysis
-Active bleeding that cannot be controlled by basic measures
-True allergy to Ticagrelor
Ticagrelor
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Antiplatelet Agents
Route: Oral (PCP and above)
Dose: 180 mg (2 tablets, 17 years and older)
Repeat Dose: None
Notes: Requires STEMI and Physician order.
Indications and Contraindications of Enoxaparin?
Indications:
-Known or suspected Myocardial Infarction (STEMI) after consultation with the STEMI physician
Contraindications:
-patient may be candidate for fibrinolysis with TNK
-Known hypersensitivity to enoxaparin
-Patient is known to be on an anticoagulant and has taken it that day
-History of heparin induced thrombocytopenia within the past 100 days
-Active bleeding that cannot be controlled by basic measures
Enoxaparin
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Anticoagulant
Route: IV or Subcutaneous
Dose: 0.5mg/Kg IV (max 50mg, less than 75 years old) or 1mg/Kg (less than 75, max 100mg), 0.75mg/Kg (older than 75, max75mg)
Repeat: None
Notes: Increased risk of inter cranial bleeding in patients older than 75
Indications and Contraindications of Acetaminophen?
Indications:
-Mild to Moderate pain
-Fever
Contraindications:
-True allergy to acetaminophen
-Known liver failure
-Do not administer oral medication if anaesthesia or surgery is anticipated in the next 4 hours
Acetaminophen
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Analgesic
Route: Oral
Dose: 72 hrs-12 yrs, 10-15mg/Kg (max = 650mg), or 12 yrs+, 650-1000mg
Repeat: Every 4 hours as required
Notes: Do not give to patients with liver failure, do not administer more than 4g per day
Indications and Contraindications of Ibuprofen?
Indications:
-Mild to moderate pain
-Fever
Contraindications:
-True allergy to ibuprofen or aspirin (ASA) induced asthma
-Major trauma or other active bleeding
-Pregnancy
-End stage renal failure
-Do not administer oral medications if anaesthesia or surgery is anticipated within the next 4 hours
Ibuprofen
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Non‐steroidal anti‐Inflammatory drug (NSAIDs)
Route: Oral
Dose: 3 months-12 years, 10mg/Kg (max=400mg), 12 yrs+, 400-800mg
Repeat: Every 6 hours as required
Notes: Not safe for renal failure or pregnant patients
Indications and Contraindications of Ketoralac?
Indications:
-Moderate to severe pain from an acute illness, injury, or chronic conditions significant enough to require analgesic for safe transport
Contraindications:
-Known/suspected acute coronary syndrome
-Known/suspected intracranial injury or hemorrhage
-True allergy to ketoralac
-History of aspirin (ASA) induced asthma
-Pregnancy
-Known renal failure
Ketoralac
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Non‐steroidal anti‐Inflammatory drug (NSAIDs)
Route: Intramuscular or Intravenous
Dose:12 months-2 years 0.25 mg/kg (max=15mg), 2 yrs-17yrs 0.5mg/kg (max=30mg), 17yrs+ 30mg
Repeat Dose: None
Notes: May have a minor affect on coagulation and bleeding time
Indications and Contraindications of Fentanyl?
Indications:
-Moderate to severe pain from an acute illness, injury, or a chronic condition that requires analgesic for safe and comfortable transport
Contraindications:
-True allergy to fentanyl
-Decreased level of consciousness
-Significant head injury
-Significant drug or alcohol intoxication
-Hypoventilation or respiratory failure
-Hypotension or shock
Fentanyl
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Opioid Analgesic
Route: Intranasal, Intramuscular, or Intravenous
Dose: Less than 10 yrs 2mcg/kg (IN or IM) or 0.5-1mcg/kg (IV) (max=50mcg, hourly max=100mcg), 10+ yrs 2mcg/kg (IN or IM) or 0.5-1mcg/kg (IV) (max=100mcg, hourly max=200mcg)
Repeat: 10 minutes for IN, 30-60 min. for IM, 15-30 min. for IV
Notes: may worsen hypotension, may have depressive effects on respiratory drive
Indications and Contraindications of Ketamine?
Indications:
-Moderate to severe pain from an acute illness, injury, or chronic condition
-Adjunct when standard analgesics have not been effective
-Alternative when standard analgesic agents are contraindicated
-IN, short term for extrication when vascular access ins unavailable
Contraindications:
-Uncorrectable severe hypo-perfusion
-Risk of respiratory or CNS depression
-Previous emergence reaction from ketamine
-True allergy to ketamine
Ketamine
-Class
-Route/Dose/Repeat Dose
-Notes
Class: General Anesthetics
Route: Intravenous or Intramuscular, Intranasal for extrication without vascular access
Dose: 12 months and older 0.5 mg/kg (IV and IM), 0.5-1 mg/kg (IN)
Repeat: Follow with 0.25 mg/kg after 10 min. (IV and IN) or 15 min. (IM), repeat 0.25-0.5 mg/kg every 30 min. (IV/IN) or 60 min. (IM)
Notes: may enhance the effects of CNS depressants such as opioids
Indications and contraindications of Dimenhydrinate?
Indications
-Nausea or vomiting
-nausea and vomiting during pregnancy
-prevention of opioid induced nausea or vomiting
Contraindications
-allergy to Dimenhydrinate
Dimenhydrinate
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Antiemetic
Route: Intravenous or Intramuscular
Dose: 12 months to 10 years, 0.5 mg/kg (25mg/dose max), 10-17 years, 25-50mg, 17+, 50mg
Repeat Dose: Every 4 hours as required
Notes: Can cause drowsiness, slow push over 2 min.
Indications and Contraindications of Metoclopramide?
Indications
-nausea or vomiting
-nausea and vomiting during pregnancy
-prevention of an opioid induced nausea or vomiting
Contraindications
-allergy to metoclopramide
-known or suspected bowel obstruction
Metoclopramide
-Class
-Route/Dose/Repeat dose
-Notes
Class: Antiemetic/Prokinetic
Route: Intravenous or Intramuscular
Dose: 12 months to 10 years 0.1mg/kg (5mg/dose max), 10-17 5-10mg, 17+ 10mg
Repeat Dose: Every 6 hours as required
Notes: Ask when last bowl movement was, push over 1 to 2 min.
Indications and contraindications for Diphenhydramine?
Diphenhydramine
-Class
-Route/Dose/Repeat Dose
-Notes
Indications and Contraindications of Epinephrine?
Indications
-known or suspected anaphylaxis
-cardiopulmonary arrest
-refractory asthma (not responding to bronchodilators)
-moderate to severe croup
Contraindications
-none when using for cardiac arrest
-when using for asthma: COPD, undifferentiated respiratory failure, wheezing due to heart failure, chest pain suspicious for MI
-when using for Croup: Stridor due to epiglottis or airway obstruction
Epinephrine
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Alpha & Beta Adrenergic Agonists
Route: Autoinjector, Intramuscular, Nebulizer
Dose: Anaphylaxis: Autoinjector- 1-6yrs green device, 6+yrs orange device, 1.Anaphylaxis and 2.Asthma: Intramuscular- 0-17yrs 0.01mg/kg (1. 0.5mg 2. 0.3mg single dose max ) Croup: Nebulizer- 0-6yrs 0.5mg/kg (5ml single dose max)
Repeat Dose: Autoinjector- repeat once, Intramuscular- 1. 10-15min. 2. 20 min., Nebulizer- repeat every 2 hours
Notes: Do not mix with sodium bicarbonate, if paediatric dose is unavailable give adult dose.
Indications and contraindications of glucose?
Indications
-confirmed hypoglycemia
-suspected hypoglycemia in a known diabetic when a bgl measurement is not available
Contraindications
-none
Glucose
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Glucose‐elevating agent
Route: Oral/ Buccal
Dose: 12 months to 10 years - 12.5g, 10-17 - 12.5-25g, 17+ - 25-50g
Repeat Dose: Every 10 minutes as required (3 doses max)
Notes:If the patient has a return of responsiveness give them a complex carbohydrate.
Indications and contraindications for Dextrose?
Indications
-confirmed hypoglycemia
-suspected hypoglycemia in a known diabetic when a bgl measurement is unavailable
Contraindications
-none
Dextrose
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Glucose‐elevating agent
Route: Intravenous
Dose: 0-10 - 5ml/kg of 10% solution (100ml max dose, 10+ - 5ml/kg of 10% solution (250ml max dose)
Repeat Dose: Every 5-10 min. as required
Notes: Do not use 50% concentration in infants or children, slowly push over 1-2 min.
Indications and contraindications for Glucagon?
Indications
-confirmed hypoglycemia
-suspected hypoglycemia in a known diabetic when a bgl measurement is unavailable
Contraindications
-none
Glucagon
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Glucose‐elevating agents, Insulin antagonist
Route: Intranasal, intramuscular, or intravenous
Dose: 1mg > 20kg, 0.5mg < 20kg
Repeat Dose: Once in 15 min. if required
Indications and Contraindications for Midazolam?
Indications
-active seizures
-chemical restraint
-alcohol/benzodiazepine withdrawal
-stimulant toxicity
Advanced airway maintenance
-procedural sedation
Contraindications
-allergy to midazolam
-uncorrected hypotension
-respiratory depression
Midazolam
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Benzodiazepine, Anticonvulsant
Route: Intranasal, intramuscular, intravenous
Dose: IN/IM: 12m-10yrs 0.2 mg/kg (5mg/ dose max), 10+yrs 5 mg, IV: 12m+ 0.05-0.1 mg/kg (5mg/dose max)
Repeat Dose: IN: once in 10 minutes if necessary, IM: Every 15-30 min. as required, IV: Every 5 min. as required
Notes: Administer IV over 60 sec. push
Indications and contraindications of Lorazepam?
Indications
-severe anxiety or agitation that may interfere with safe management or transport of the patient
Contraindications
-allergy to lorazepam
-uncorrected hypotension
-respiratory depression
-CNS depression
Lorazepam
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Benzodiazepine, Anticonvulsant, Antianxiety
Route: Oral/ Sublingual
Dose10-17 - 1mg, 17-75 - 2mg, 75+ - 1mg
Repeat Dose: Once if required
Notes: closely monitory for respiratory depression
Indications and contraindications of Naloxone?
Indications
-respiratory depression due to known or suspected opioid toxicity from ingestion or administration
Contraindications
-none
Naloxone
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Opioid Antagonist/Reversal Agent
Route: Intranasal, Intramuscular, Intravenous
Dose: IN: 2mg Autoinjector, IM: 0-5 - 0.1 mg/kg (2 mg/dose max) 5+ - 0.4-2mg, IV: 0-5 - 0.1 mg/kg (2 mg/dose max) 5+ - 0.1-2mg
Repeat Dose: Every 2-3 min. as required
Notes: may cause opioid withdrawal symptoms
Indications and contraindications of calcium chloride?
Indications
-hyperkalemia
-magnesium toxicity
Contraindications
-none
Calcium Chloride
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Antidote
Route: Intravenous
Dose: 10+ - 1f (mag tox) or 1-2g (hyperkalemia)
Repeat Dose: Once in 5 min. and every 30-60 min. after (hyperkalemia)
Notes: during cardiac arrest push rapid, for mag tox push over 3-5 min.
Indications and contraindications for Salbutamol?
Indications
-acute exacerbation of known asthma
-acute exacerbation of known COPD
-Dyspnea or respiratory distress where wheezing can be heard or bronchospasm is suspected
-acute anaphylaxis
Contraindications
-none
Salbutamol
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Beta 2 Agonist / Bronchodilator
Route: Metered dose inhaler or Nebulizer
Dose: MDI: 2-8 puffs, Neb.: 2.5 mg <20kg, 5 mg >20kg
Repeat Dose: As required
Notes: always use a spacer device, can cause anxiety or tremors if used too much
Indications and contraindications of Hydrocortisone?
Indications
-anaphylaxis
-asthma
-known or suspected acute adrenal insufficiency with known chronic adrenal insufficiency
Contraindications
-none
Hydrocortisone
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Corticosteroid
Route: Intravenous, Intramuscular, Subcutaneous
Dose: Anaphylaxis: 5 mg/kg (100 mg/dose max), Adrenal crisis: 2 mg/kg (100 mg/dose max)
Repeat Dose: None
Notes: IV push over 2 minutes
Indications and contraindications of Oxytocin?
Indications
-all postpartum patients will receive an IV or IM bolus
-patients with ongoing significant blood loss after delivery should receive a continuous infusion in addition to the bolus dose
Contraindications
-multiple gestations before all fetuses are delivered
-uterine inversion
Oxytocin
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Oxytocic (Uterine) Agent, Hormone)
Route: Intravenous, Intramuscular
Dose: Single: 10+ - 10 units, Continuous: 10+ - 10 units/hour for 4 hours
Repeat Dose: None
Notes: IV slow push over 2 min., mix 40 units into 1L of saline and run at 250ml/hr
Indications and contraindications of Magnesium Sulfate?
Indications
-cardiac arrest due to torsades de pointes
-known or suspected preeclampsia/eclampsia
-severe asthma not responding to bronchodilators
Contraindications
-myasthenia gravis (when treating preeclampsia/eclampsia)
Magnesium Sulfate
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Oxytocic (Uterine) Agent, Hormone
Route: Intravenous
Dose: Cardiac Arrest: 12m-17yrs 25-50 mg/kg (2g max) , 17+yrs 1-2g, Asthma: 12m-17yrs 50 mg/kg (2g max), 17+yrs 2g (Over 15 min.), Pre/eclampsia: 4g over 10-15 min. (2g over 5 min. if patient received prophylaxis)
Repeat Dose: eclampsia: 2g over 5 min. (Cumulative total 8g)
Notes: Magnesium in excess of 8g/hr may result in magnesium toxicity
What is the Brand Name for Acetaminophen?
Tylenol
What is the Brand Name for Acetylsalicylic Acid?
Aspirin
ASA
What is the Brand Name for Dimenhydrinate?
Gravol
What is the Brand Name for Enoxaparin?
Lovenox
What is the Brand Name for Epinephrine?
Adrenalin
What is the Brand Name for Ibuprofen?
Advil
Motrin
What is the Brand Name for Ketorolac?
Toradol
What is the Brand Name for Lorazepam?
Ativan
What is the Brand Name for Metoclopramide?
Maxeran
What is the Brand Name for Midazolam?
Versed
What is the Brand Name for Naloxone?
Narcan
What is the Brand Name for Oxytocin?
Syntocinon
What is the Brand Name for Salbutamol?
Ventolin
What is the Brand Name for Ticagrelor?
Brilinta
What is the Brand Name for Tranexamic Acid?
TXA
Indications and Contraindications of Diphenhydramine?
Indications
-pruritis not due to anaphylaxis
Contraindications
-none
Diphenhydramine
-Class
-Route/Dose/Repeat Dose
-Notes
Class: Antihistamine
Route: Intravenous or Intramuscular
Dose: 12m-10yrs - 1 mg/kg (50mg single dose max, 10+yrs - 25-50mg
Repeat dose: None
Notes: IV push over 90 seconds
What is the Brand Name for Diphenhydramine?
Benadryl
