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32 Cards in this Set

  • Front
  • Back
Proventil
Albuterol

CLASS: Sympathomimetic Agonist (Selective B2 adrenergic receptors)

MOA: Bronchodilation

INDIC: Asthma; Bronchospasm; COPD; Hyperkalemia

CONTRA: Caution to elderley, CVD, HTN

SIDE EFFECTS: Palpatations, anxiety, dizziness, headache, nervousness, tremor, hypertension, arrhythmias, chest pain, nausea/vomiting

DOSE: 2.5mg / 3ml normal saline nebulized (repeat as necessary)
Atropine
CLASS: Anticholinergic

MOA: Parasympatholytic, causes bronchodilation, drying of respiratory secretions, blocks acetylcholine receptors thus inhibiting parasympathetic stimulation.

INDIC: Symptomatic Bradycardia, organophosphate poisoning, nerve agent

CONTRA: Known Hypersensitivity

SIDE EFFECTS: Palpitations, anxiety, dizziness, headache, nervousness, rash, nausea, vomiting, blurred vision, tachycardia

DOSAGES: Adult- Symptomatic Bradycardia: 0.5mg IV, IO, ET. Max Dose- 3mg or 0.04mg/kg.

Adult Organophosphate Poisioning: 2mg every 5 minutes until symptoms dissipate.

Pediatric: 0.02mg/kg 1.0mg max
D50 (Dextrose 50%)
50% Dextrose in Water

CLASS: Carbohydrate

MOA: Elevates blood glucose levels rapidly

INDIC: Hypoglycemia, BGL< 60

CONTRA: IV with signs of infiltration

SIDE EFFECTS: Local venous irritation, necrosis if given through an infiltrated IV

DOSAGES: Adult: 12.5 gm

Pediatrics: D25 0.5-1ml/kg (may be premixed or eject out 25ml and draw 25ml of NS)
Aspirin (ASA)
Aspirin

CLASS: Platelet inhibitor and anti-inflammatory

INDIC: New chest pain suggestive of acute myocardial infarction. Signs and symptoms suggestive or a recent stroke (CVA)

CONTRA: Patients with known hypersensitivity to the drug.

SIDE EFFECTS: Heartburn, nausea, wheezing

DOSE: 324mg by mouth (primarily by four 81mg chewable tablets)
Flumanzenil (EMS Capt)
Romazicon

CLASS: Benzodiazepine antagonist

MOA: Reverse the effects of benzodiazepines

INDIC: To reverse central nervous system respiratory depression associated with benzodiazepines

CONTRA: Do not administer as a diagnostic agent for Benzo OD; hypersensitivity. DO NOT ADMIN WITH MIXED OD OR IF PT HAS TRICYCLIC ANTIDEPRESSANT

SIDE: Fatigue, Headache, Nervousness, Dizziness

DOSE: 0.2mg IV Q 1min. Max dose 1mg
Zofran
Ondansetron

CLASS: Anti-emetic

MOA: Selective blocking agent of serotonin 5-HT3 receptor type.

INDIC: Nausea/Vomiting

CONTRA: Hypersensitivity

SIDE: Diarrhea, headache

DOSE: 4mg IV (Adult) 0.2mg/kg IV (Pediatric)
Amiodarone
Coradarone

CLASS: Antidysrhthymic Group III

MOA: Prolongs action potential and refractory period, slows sinus rate, increases PR and QT interval, decreases PVR

INDIC: V-Fib, V-Tach, (Primary success is with wide complex tachycardias with pulse)

CONTRA: Severe sinus node dysfunction, sinus bradycardia, high degree AV blocks

SIDE: Hypotension, nausea, anorexia, malaise, tremors, ventricular ectopic beats

DOSE: Adult V-Fib/V-Tach w/o Pulse: 300mg followed by 150mg. Wide Complex Tachycardia: Drip- 150mg over 10 minutes. (Pediatrics) 5mg/kg
Lasix
Furosemide

CLASS: Potent Diuretic

MOA: Inhibits reabsorption of sodium chloride, promotes prompt dieresis, vasodilation (very small amount) potassium wasting

INDIC: CHF, Pulmonary Edema

CONTRA: Pregnancy, dehydration

SIDE: If kidneys are working; Electrolyte depletion. If kidneys are not working; little to no use.

DOSAGE: IV IO Slowly 1 mg/kg (max 2mg/kg)
Lidocaine
Xylocaine

CLASS: Antidysrhthymic

MOA: Suppresses ventricular ectopy, increases ventricular fib threshold, reduces velocity of electrical impulse.

INDIC: V-fib, V-Tach, Malignant PVC’s, Pretreatment for intubation in head injury (use if PT allergic to Amiodarone)

CONTRA: High degree heart blocks, PVC’s in conjunction with bradycardia

SIDE EFFECTS: Anxiety, drowsiness, confusion, convulsions, widening QRS

DOSE: Adult: Bolus 1.5mg/kg may repeat 0.75 mg/kg Q 5 mins (MAX 3mg/kg)
Drip Rate: 4:1 concentration 1-4mg/min (Administer after ROSC)
Pediatric: 1mg/kg
Cardizem
Diltiazem

CLASS: Calcium Channel Blocker

MOA: Slows conduction through the atrioventricular node; Causes vasodilation; Decreases rate of ventricular response; Decreases myocardial oxygen demand.

INDIC: To control rapid ventricular rates associated with atrial fibrillation and flutter; Angina pectoris

CONTRA: Hypotension; wide complex tachycardia; Conduction system disturbances. Should not be used in patients receiving IV beta blockers or with severe hypotension.

SIDE EFFECTS: Nausea and vomiting; hypotension; Dizziness

DOSAGE: Adult: 20mg IV over 2 minutes (titrate until heart rate is controlled)
Adenosine
Adenocard

CLASS: Antidysrhthmyic

MOA: Slows atrioventricular conduction

INDIC: Symptomatic SVT

CONTRA: Second or third degree heart block; sick sinus syndrome; known hypersensitivity to the drug.

SIDE EFFECTS: Facial Flushing; Headache; Shortness of Breath; Dizziness; Nausea.

DOSAGE: 1st dose 6mg RIVP (over 1-3 seconds), if no change after 1 minute- 2nd dose 12mg RIVP
Dopamine
Intropin

CLASS: Sympathomimetic

MOA: Increases Cardiac contractility; Causes peripheral vasoconstriction

INDIC: Hemodynamically significant hypotension (systolic < 90mmHg) not resulting from hypovolemia; cardiogenic shock.

CONTRA: Hypovolemia in which pre-load has not been restored.

SIDE EFFECTS: Ventricular tachydysrhtymias; Hypertension; Palpitations

DOSAGE: 5 mcg/kg/min stimulates beta adrenergic receptors (causing enhanced contractility, increased cardiac output, rise in BP)

20 mcg/kg/min MAX stimulates alpha adrenergic receptors (causing peripheral and venous constriction)
Solu-Medrol
Methylprednisolone

CLASS: Corticosteroid

MOA: Anti-inflammatory; suppresses immune response, especially in allergic reactions

INDIC: Severe anaphylaxis, Asthma, COPD

CONTRA: none in the emergency setting

SIDE EFFECTS: GI bleeding; prolonged wound healing; suppression of natural steroids

DOSAGE: 125mg IV (Adult)
Pediatrics: 1-2mg/kg
Epinephrine
Adrenalin

CLASS: Sympathetic Agonist/ Sympathomimetic

MOA: Acts on the alpha and beta adrenergic receptors. Much more beta effects than alpha. Bronchodialation; Increases heart rate, cardiac contractile force, systemic vascular resistance, and increase BP

INDIC: Bronchial Asthma; anaphylaxis; Cardiac Arrest

CONTRA: Caution in patients with known cardiovascular disease; None in life threatening situations

SIDE: Palpitations, anxiety, headache, dizziness, nausea, vomiting, possible myocardial ischemia

DOSE: Adult Allergic Rxs. / Resp. Distress: 0.3mg IM 1:1000.
Severe Anaphylaxis: 0.3-0.5 mg (3-5mL) slow IV 1:10,000
Cardiac Arrest: 1mg IV 1:10,000
Pediatric Anaphylaxis: 0.01mg/kg IM 1:1000 Max 0.3mg
Pediatric Cardiac Arrest: 0.01 mg/kg IV/IO
Benadryl
Diphenhydramine

CLASS: Antihistamine, H1 Histamine

MOA: Blocks histamine receptors, has some sedative effects.

INDIC: Anaphylaxis, Allergic Reactions, Dystonic Reactions due to phenothiazines

CONTRA: Asthma; Nursing Mothers, Hypotension

SIDE: Sedation; dries bronchial secretions; blurred vision; headache; palpitations.

DOSE: Adult: 50 mg IM or SLOW IV
Pediatric 1.5 mg/kg mg IM or SLOW IV (max 50mg)
Nitroglycerin
CLASS: Anti-anginal

MOA: Smooth muscle relaxant, reduces cardiac work, dilates coronary arteries, dilates systemic arteries

INDIC: Angina; Chest pain associated with MI, CHF

CONTRA: BP< 90 mm/Hg, Children under 12 years of age, Viagra/Levitra within 24 hours, Cialis within 48 hours. DO NOT USE with right side MI involvement (+ V4R).

SIDE: Headache, hypotension, syncope, tachycardia, flushing.

DOSE: Nitro Tab: 0.4mg = 1 tab every 3-5 minutes
Nitro Spray: 0.4mg = 1 spray every 3-5 minutes
Nitro Paste: 1inch transdermal = 15mg
Glucagon
CLASS: Hormone (anti-hypoglycemic agent)

MOA: Breakdown of glycogen to glucose (liver), inhibits glycogen synthesis; Elevates blood glucose level, increase heart rate.

INDIC: Hypoglycemia, beta-blocker overdose, Severe allergic reaction if PT is on beta blockers.

CONTRA: Hypersensitivity to the drug

SIDE: Few in emergency situation

DOSE: Adult: 2 mg IV
Atrovent
Ipratropium

CLASS: Anticholinergic/ Bronchodilator

MOA: Dries respiratory tract secretions

INDIC: Bronchial Asthma, Reversible bronchospasm associated with COPD

CONTRA: Hypersensitivity to the drug, glaucoma, allergy to soy products or peanuts.

SIDE: Palpitations, dizziness, anxiety, headache, nervousness

DOSAGE: 500mcg/ 2.5mL 0.9% NaCL placed in nebulizer with beta agonist (Albuterol)
(Safety in children has not been established)
Mag Sulfate
CLASS: Mineral / Electrolyte

MOA: Magnesium is a physiological Ca Channel blocker as well as a smooth muscle relaxant.

INDIC: OB: Eclampsia
Cardiovascular: Severe refractory V-fib or Pulseless V-Tach; post-myocardia infarction as prophylaxis for dysrhthmias, and torsade de pointes (multifocal V-Tach
Respiratory: Severe bronchoconstriction

CONTRA: High degree AV blocks, dialysis patients (hypermagnesemia).

SIDE: Flushing; sweating; bradycardia; decreased deep tendon reflexes, drowsiness, RESPIRATORY & CNS DEPRESSION, HYPOTENSION, hypothermia, itching.

DOSAGE: Eclampsia: 4gm over 10min
V-Fib/V-Tach (Torsades): 2gm IV/IO Push
Severe Bronchoconstriction: 2gm in 100ml D5W over 10min (pump 600ml/hr)
Calcium Chloride
CLASS: Electrolyte

MOA: Increases cardiac
contractility

INDIC: Acute hyperkalemia (elevated KI level); Acute Hypocalcemia (decreased Ca) level; Ca Channel blocker OD; Abdominal muscle spasm associated with spider bites and Portuguese Man of War stings; antidote for Mag Sulfate.

CONTRA: Patients on digitalis

SIDE: Dysrhthymias (bradycardia and asystole) **PRECIPITATES w/ SODIUM BICARB**

DOSE: Adult: 1gm IV
Pediatric: 20 mg/kg IV
Narcan
Naloxone

CLASS: Narcotic Antagonist

MOA: Reverses effects of Narcotics

INDIC: Narcotic overdoses with respiratory depression (opiates: morphine, dilauded, fentanyl, Demerol, heroin, percodan, methadone)

CONTRA: Hypersensitivity to the drug

SIDE: Rare

DOSE: Adult: 0.4-2.0 mg IV or IN titrate to effect (IM:1 ml per nare)
2 mg IM
Pediatric: 0.1mg/kg IV,ET,IM,IN (Max 2.0 mg)
Succinylcholine (EMS Capt)
Anectine

CLASS: Neuromuscular blocking agent (depolarizing)/ Paralytic

MOA: Skeletal muscle relaxants; paralytic

INDIC: To paralyze a pt for RSI to achieve intubation

CONTRA: Hypersensitivity to the drug, burns in the first 24 hrs, open globe injuries, hyperkalemia, rhabdomyolisis, crush injury

PRECAUTION: Not to be adminstered unless skilled personnel are present

SIDE: Hypotension; Bradycardia, apnea, malignant hyperthermia,

DOSE:1.5mg/kg in an adult IV
Pediatric: 2mg/kg IV
Vecuronium (EMS Capt)
Norcuron

CLASS: Paralytic (non-depolarizing)

MOA: Skeletal muscle relaxant including respiratory

INDIC: Paralysis to achieve RSI for intubation

CONTRA: Known hypersensitivity

PRECAUTION: Should not be administered unless skilled personnel are present

SIDE: Prolonged paralysis; hypotension; bradycardia

DOSE: (adult) 0.1mg/kg IV
Pediatric: 0.1mg/kg IV
Etomidate
Amidate

CLASS: Sedative/Hypnotic

MOA: Creates ultra short acting sed/hypnotic effect

INDIC: Induction agent for RSI; Sedative for other sedating measures (pacing/ cardioversion).

CONTRA: Known hypersensitivity

SIDE: Myoclonic skeletal muscle movement; laryngospasm

DOSE: 0.1 mg/kg for sedation (repeat as needed)
0.3mg/kg IV for RSI
Pediatrics over 10: Same as adult
Not indicated in pt under 10 years old.
Sodium Bicarb
CLASS: Alkalinizing agent

MOA: Combines with excessive acids to form a weak volatile acid, increases pH

INDIC: Late management of cardiac arrest, tricyclic antidepressant OD, First line for cardiac arrest due to hyperkalemia (dialysis pt), crush injury

CONTRA: Alkalotic states

SIDE: Alkalosis

DOSE: 1 mEq/kg IV
Morphine
CLASS: Narcotic, Opioid, Analgesic

MOA: Central nervous system depressant, peripheral vasodilation, decreases sensitivity to pain (causes dilatation through histamine release)

INDIC: Severe pain, Pulmonary Edema, MI chest pain

CONTRA: Head injury, volume depletion, undiagnosed abdominal pain, hypersensitivity

SIDE: Dizziness, altered LOC

DOSE: (Adult) 2.5 mg; repeat 2.5mg q 3-5 mins; max 10mg or until relief of symptoms (burns require much more) BP > 90mm/HG
(Pediatric) 0.1 mg/kg max 5mg
Fentanyl
Sublimaze

CLASS: Narcotic analgesic

MOA: Binds to opiate receptors in the CNS, altering the response and perception of pain

INDIC: Narcotic pain relief, anti-anxiety

CONTRA: known hypersensitivity and BP<110 systolic

SIDE: Lower LOC, Low BP, N&V, bradycardia, apnea.

DOSE: (Adult) 50-75 mcg IM, IV, IO; Subsequent dose of 25 mcg q20-30 minutes to max of 200 mcg
(Pediatric) 1mcg/kg
Glucose Gel
Dextrose

CLASS: Nutritive Agent

MOA: Provides source of water and carbohydrate.

INDIC: Hypoglycemia BGL < 60 mg/dL

CONTRA: known hypersensitivity

SIDE: Cerebral hemorrhage/ ischemia, pulmonary edema

DOSE: (Adult) Oral Gel 15 gm PO
Tetracaine
CLASS: Eye Anesthetic

MOA: Causes numbness or loss of feeling to eye

INDIC: measuring of eye pressure, removal of foreign objects, sutures in eye, & certain eye exams

CONTRA: known hypersensitivity

SIDE EFFECTS: stinging, ocular irritation, redness, contact dermatitis

DOSE: (Adult) 1-2 drops to eye (doses 5-10 minutes apart). Peds consult DR.
Midazolam
Versed

CLASS: Benzodiazepine

MOA: Short acting Benzodiazepine CNS depressant

INDIC: Sedation, dystonic reaction, stimulant overdose, agitated delirium, elcectro-muscular disruption device, malignant hyperthermia, chemical restraint

CONTRA: Acute narrow angle glaucoma, shock, Low BP

SIDE: Respiratory depression, low BP, low heart rate, H/A, N&V
MAY REVERSE WITH FLUMAZENIL (ROMAZICON)

DOSE: 2.0-5.0 mg slow IV, IN, or IM. Repeat as needed.
Labetalol
CLASS: Antihypertensive, Alpha/ Beta-Adrenergic Blocker

MOA: Vasodialation, Lowers BP, Adrenergic receptor blocking agent that blocks beta-adrenergic receptors and alpha-1 adrenergic receptors selectively.

INDIC: Hypertensive Crisis

CONTRA: Bronchial Asthma, CHF, heart block, bradycardia, cardiogenic shock

SIDE: Hypotension, nausea, dizziness, sweating.

DOSE: Severe HTN- 10-20 mg IV over 1-2 minutes. May repeat or double dose q 10 minutes until a total of 150-300 mg. DRIP: Mix 200 mg (40ml) in 160 ml of D5W for Conc. 1 mg/ml. Start at 2mg/min.
Cyanokit 5G (HM6)
Hydroxocobalamin

CLASS: Cyanide Antidote, Vitamin B

MOA: Bonds to cyanide ion to form cyanocobalamin which is excreted renally.

INDIC: Cyanide poisoning, cobalamin deficiency

CONTRA: not determined

SIDE: Increased BP, rash, nausea, H/A, Red urine color

DOSE: (Adult) 5 g IV over 15 min. (Peds) 70 mg/kg over 15 min. **Add 100ml of 0.9% NaCL to each vial**