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125 Cards in this Set

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Albuterol: Class
Sympathomimetic
Albuterol: How Supplied
Liquid
Albuterol: Route
Inhalation (nebulized), ETT (alternate route)
Albuterol: Dose
Adult: Neb-2.5 in 3cc over 5-15 mins
Pedi: Same as adult
***If pat is improving after the first alb dose, two addtn'l doses may be given.
***If no improvement after first dose, combine the 2nd and 3rd doses of albuterol w/ Atrovent.
Albuterol: Drug Action
Bronchodilation
Albuterol: Indications
1) Bronchospasm assoc w asthma and COPD
2) Bronchospasm from chemical toxins
3)Allergic reactions unresponsive to Epi or Benadryl
Albuterol: Precautions
Known heart disease
Albuterol: Side Effects
Restlessness
Hypertension
Tachycardia-palpitations
Albuterol: Contraindications
Pregnancy, except in life-threatning situations
Atropine: Class
Anticholinergic
Atropine: Route
Rapid IV Push
ETT (alternate route)
Atropine: Dose (Adult)
*PEA or asystole - 1 mg IVP (max 0.04 mg/kg)
*Symptomatic Brady - 0.5-1mg IVP (max 0.04 mg/kg)
Atropine: Dose (Pedi)
*Symptomatic Brady - 0.02mg/kg (max single dose = 0.1mg) IVP
*PEA or asystole - not used prehosp
Atropine: Drug Action
*Reverses suspected vagal tone in brady, asystole, and PEA
*Blocks acetylcholine in organophosphate poisoinings
*Reverses effects of nerve agents.
Atropine: Indications
*Symptomatic Brady
*Asystole
*Rates <60 in PEA rhythms
*Organophosphate Poisoning
*Chemical exposure due to nerveagents
Atropine: Precautions
*To avoid transient brady, administer rapidly and in the port closest to the IV site
*Notify Biotel prior to admin if pat has a hx of glaucoma, prostatic hypertrophy, or bladder neck obstruction
Atropine: Side Effects
*Tachycardia
*Dilated Pupils (may make pupil assessment unreliable)
*Anticholinergic effects: dry mouth, blurred vision
Atropine: Contraindications
Hypothermic Brady, PEA and asystole prior to rewarming
Dobutamine: Dobutrex
Class
Sympathomimetic
Dobutamine: Dobutrex
Route
IVPB
Dobutamine: Dobutrex
Dose
Adult: 2-20mcg/kg/min
***Dilution ratio = 250mg/250mL, etc...
Pedi: 2-20mcg/kg titrated to desired effect
Dobutamine: Dobutrex
Drug Action
*Stim Beta1 - inc contractility, volume, and CO
*Stim Beta2 - Bronchodilate and dec PVR
Dobutamine: Dobutrex
Indications
Pulmonary Edema with systolic BP of 70-100 and no S/S of shock
Dobutamine: Dobutrex
Precautions
*Do not admin through same line as other drugs
*Assure IV patency
*Continuously monitor HR, BP, and ECG
*Titrate so HR does not inc > 10% of baseline
Dobutamine: Dobutrex
Side Effects
*Phlebitis (inflammed vein)
*Tachycardia/tachyarrythmias
*In high doses-nervousness, n/v, cp, htn
Dobutamine: Dobutrex
Contraindications
*Suspected poison/drug induced shock
*systolic BP < 100 w/ s/s of shock
Concurrent beta-blocker use (may antagonize)
Dopamine: Intropin
Class
Sympathomimetic
Dopamine: Intropin
Route
IVPB
Dopamine: Intropin
Dose
Adult: 2-10mcg/kg/min per Biotel order
***Dilution Ratio-400mg/250mL, 800mg/500mL
Pedi: Not used prehosp
Dopamine: Intropin
Drug Action
*Low Doses: Inc perfusion to kidneys and abd organs (dopa)
*Mod Doses: Inc Beta1 (HR&For)
*High Dose: Inc Alpha
Dopamine: Intropin
Side Effects
*tissue necrosis w/ infiltration
*HTN
*Tachycardia
*Arrythmias
Dopamine: Intropin
Contraindications
Hypovolemic shock
EPI 1:1000
Class
Sympathomimetic
EPI 1:1000
Route
SQ
ETT (alt route)
EPI 1:1000
Dose (Adult)
Adult:
*Asthmatic bronchospasm unrelieved by albut or Atrov - .3-.5mgSQ
*Allergic reaction/ anaphylactic shock .3-.5mgSQ
EPI 1:1000
Dose (Pedi)
*Asthmatic Bronchospasm unrelieved by Albut or Atrov - .01mg/kg (max is .3mg/dose)
*Allergic reaction/ anaphylactic shock is same.
EPI 1:1000
Drug Action
A: Inc PVR which a)inc coronary & cerebral perf b)inc BP in anaphylaxis
B1: Inc HR & Force
B2: Bronchodilation
EPI 1:1000
Indications
*Allergic reaction/anaphylaxis
*Asthmatic bronchospasm unrelieved by Albut & Atrov
*Pedi cardiac arrest (ETT Tube Only
EPI 1:1000
Precautions
*CPR: None
*Allergic reaction/ anaphylactic shock/asthma: monitor ECG closely
*Pats on Beta-Blockers may need Glucagon or higher doses of Epi
*Massage the injection site after SQ injections
EPI 1:1000
Side Effects
*Tachycardia
*Ventric Arrythmias
*CP
*Headache
*N/V
*Flushing
EPI 1:1000
Contraindications
*CPR: None
*Asthma: heart disease, hx of
AMI, >45, arrythmias, labor
*Allergic Reaction: None
EPI 1:10,000
Class
Sympathomimetic
EPI 1:10,000
Route
IVP
ETT (alt route for adult CPR)
EPI 1:10,000
Dose (Adult)
*CPR: 1mgIVP
*Anaphylaxis: .1-.2mg slow IVP(over 1 min)
EPI 1:10,000
Dose (Pedi)
*CPR: 0.01mg/kgIVP
*Anaphyl: 0.01mg/kgslowIVP(max is .3mg/dose)
*Brady: 0.01mg/kgslowIVP(max is .3mg/dose)
EPI 1:10,000
Drug Action
*A: Inc PVR which inc coronary & cerebral perf / inc BP in anaphylaxis
*B1: Inc HR & force
*B2: Bronchodilate
EPI 1:10,000
Indication
*Cardiac arrest
*Anaphylaxis that has not responded to Epi 1:1SQ
*Pedi Brady unresponsive to other treatment
EPI 1:10,000
Precautions
*CPR: None
*Anaphylaxis: Use cautiously in pats w/ COPD, CHF, Hx AMI or heart disease, >45, HTN, arrythmias, & labor
*Monitor ECG closely
*Pats on Beta Blockers may need Glucagon or higher doses of Epi
*Do not mix with Sodium Bicarb
EPI 1:10,000
Side Effects
*CPR: None
*Anaphylaxis: Tachy, V-arryth, CP, Flushing, Headache, N/V
EPI 1:10,000
Contraindications
None
Furosemide (Lasix)
Class
Loop Diuretic
Furosemide (Lasix)
Route
Slow IVP (20mg/min)
Furosemide (Lasix)
Dose
*Adult: 40mg (if pat is taking Furosemide @ home, admin twice the pat's usual single, daily dose, up to a max of 100mg
*Pedi: not used prehosp
Furosemide (Lasix)
Drug Action
*Dec PVR (Vasodilator)
*Dec Cardiac workload and o2 demand on heart
*Inc H2O excretion by inhibiing reabsorp of water, sodium and chloride in the kidneys.
Furosemide (Lasix)
Indications
Pulmonary Edema due to CHF or kidney disease
Furosemide (Lasix)
Precautions
*Must be preceded by NTG
*Monitor ECG and BP closely
*Doc any urine output
Furosemide (Lasix)
Side Effects
*Hypotension
*Arrythmias secondary to electrolyte imbalances
*Deafness if given too rapidly
Furosemide (Lasix)
Contraindications
*systolic >110
*pregnancy
Ipratropium Bromide (Atrovent)
Class
Topical Anticholinergic
Ipratropium Bromide (Atrovent)
How
Liquid
Ipratropium Bromide (Atrovent)
Route
Inhalation (Neb)
ETT (alt route)
Dose
*All doses are combined with 2.5mg Albuterol
*Adult:Neb .5mg in 2.5mLNS
*Pedi:Neb
~<1yo - 0.25mg in 2.5mLNS
~>=1yo - 0.5mg in 2.5mLNS
Ipratropium Bromide (Atrovent)
Drug Actions
*Bronchodilator
*Dries Resp Tract Secretions
Ipratropium Bromide (Atrovent)
Indications
*Bronchospasm assoc w/ asthma or COPD, that does not respond to the first dose of albuterol
*Bronchospasm from chemical toxins.
Ipratropium Bromide (Atrovent)
Precautions
*Notify Biotel prior to admin if pts have a Hx of glaucom, prostatic hypertrophy, or bladder neck obstruction
Ipratropium Bromide (Atrovent)
Side Effects
Dry Mouth
Cough, worsening of symptoms
Skin Rash
Ipratropium Bromide (Atrovent)
Contraindications
*Sensitivity to soy lecithin products (soybeans, peanuts)
*Sensitivity to Atropine
*Bronchoconstriction taht is caused by allergic reaction
Morphine Sulfate
Class
Narcotic Analgesic
Morphine Sulfate
Route
Slow IVP
Morphine Sulfate
Dose
*Adult: Admin in titrated doses of 2-4mg, up to max of 10mg
*Pedi: 0.1mg/kg
Morphine Sulfate
Drug Action
*Alleviates pain
*Dec PVR - Vasodilator
*Dec Card workload & O2 dem on heart
*Coronary artery dilator
Morphine Sulfate
Indications
*pain & anxiety secondary to AMI
*CP unrelieved by Nitro
*Pulmonary Edema
*Pain Secondary to amputations or fractures
Morphine Sulfate
Precautions
*Monitor resp status and BP closely
*Notify Biotel prior to admin if pat is >65yo, debilitatd, has alt LOC, or sysBP<110
*CHF: be prepared to intubate
*Have Nalaxone (Narcan) readily available
Morphine Sulfate
Side Effects
*Resp depression
*hypotension
*Bradycardia
*N/V
Morphine Sulfate
Contraindications
*systolic BP<110, unless auth by biotel
*Head Injury
*Severe resp depression
Morphine Sulfate
Antidote
Naloxone (Narcan)
Norepinephrine Bitartrate (Levophed)
Class
Sympathomimetic
Norepinephrine Bitartrate (Levophed)
Class
sympathomimetic
Norepinephrine Bitartrate (Levophed)
Route
IVPB
Norepinephrine Bitartrate (Levophed)
Dose
Adult: 8-12mcg/min
***Dilute Add 4mg/250mLNS
OR Dilute Add 8mg/500mLNS
Pedi: Not used prehosp
Norepinephrine Bitartrate (Levophed)
Drug Action
*Potent Peripheral vasoconstrictor (primarily A; minimally B)
*Inc myocardial contractility
Norepinephrine Bitartrate (Levophed)
Indications
*Cardiogenic shock when sys BP is <70
*Post resuscitation hypotension after medical CPR's when systolic BP < 90
Norepinephrine Bitartrate (Levophed)
Precautions
*Assure IV Patency
*Continually monitor BP
*Do not mix with Sodium Bicarb
Norepinephrine Bitartrate (Levophed)
Side Effects
*Tissue necrosis with infiltration
*Hypertension
Norepinephrine Bitartrate (Levophed)
Contraindications
Hypovolemia
Vasopressin (Pitressin)
Class
Naturally occurring antidiuretic hormone
Vasopressin (Pitressin)
Route
IVP
Vasopressin (Pitressin)
Dose
Adult: CPR - 40U one time only; the replaces the first or second dose of EPI
Pedi: Currently not recommended
Vasopressin (Pitressin)
Drug Action
Potent Peripheral vasoconstrictor
Vasopressin (Pitressin)
Indications
*Alternate pressor for EPI for pats in cardiac arrest
*Low resistance shock
Vasopressin (Pitressin)
Precautions
In responsive pats, watch for the development of cardiac ischemia and angina
Vasopressin (Pitressin)
Side Effects
Chest Pain
Abdominal distress
Bronchocontriction
Vasopressin (Pitressin)
Contraindicatiosn
Responsive pats with coronary artery disease
Amiodarone (Cordarone)
Class
sodium, potassium and calcium channel blocker / Antiarrythmic Sympatholytic
Amiodarone (Cordarone)
Route
IVP
Amiodarone (Cordarone)
Dose
1.VFib/plessVtach First:300mg Second:150mg
2.SustainedVTach w/ pulse- 150mg over 10 mins
Amiodarone (Cordarone)
Drug Action
Alters the mvmt of Na,K,andCA through normal channels in all cardiac tissue which:
1)Increase the refractory period of all cardiac tissue 2)Slow repolarization. 3)Dec automaticity

It is an Alpha and Beta blocker.
Amiodarone (Cordarone)
Indication
VFib or PlessVTach refractory to shocks.
OR Sustained VTach w/ pulse
Amiodarone (Cordarone)
Precautions
Prevent foaming, do not shake and draw w/ large bore.
Protect from light.
Avoid contact with plastic.
Amiodarone (Cordarone)
Side Effects
Bradycardia
Hypotension
Heart Block
Amiodarone (Cordarone)
Contraindications
Trauma Patients
Not down ETT!
Aspirin (Actylsalicylate Acid)
Class
anti-platelet aggregator, analgesic, anti-inflammatory, antipyretic
Aspirin (Actylsalicylate Acid)
Route
Orally
Aspirin (Actylsalicylate Acid)
Dose
324mg either 4 baby aspirin (chewed) OR 1 adult aspirin.
Aspirin (Actylsalicylate Acid)
Drug Action
Decrease platelet stickiness
Blocks pain impulses in the CNS
Reduces fever and inflammation
Aspirin (Actylsalicylate Acid)
Indication
Chest Pain believed to be of cardiac origin.
Aspirin (Actylsalicylate Acid)
Precautions
Any significant bleeding
Aspirin (Actylsalicylate Acid)
Side Effects
None for prehospital
Aspirin (Actylsalicylate Acid)
Contraindications
ASA Allergy
ASA Induced Asthma
Calcium Chloride
Class
Electrolyte
Calcium Chloride
Route
CPR - IVPush
Live - SLOW IVPush (1mL/min)
Calcium Chloride
Dose
10-15mg/kg of a 10% solution
PEDI:SAA
Calcium Chloride
Drug Action
Inc myocardial contractile force and ventricular automaticity. 2)Aids in the re-entry of calcium into muscle when given for calcium channel blocker or mag sulf toxicity. 3)Balances hyperkalemia
Calcium Chloride
Indications
Calcium Channel Blocker tox and Mag Sulf Tox are the main reasons for this drug. Other reason is Beta Blocker Toxicity.
Calcium Chloride
Precautions
Incompatible with all meds. Flush well. Assure IV patent. Notify Biotel if pat is on Digoxin.
Calcium Chloride
Side Effects
1)Tissue necrosis with infiltration
2)forms precipitate if given with Sod Bicarb
3)Causes dig tox if given to a pat on dig.
4)Rapid infusion cause:brady, hypotension, and asystole.
Calcium Chloride
Contraindications
Non
Lidocaine Bolus (Xylocaine)
Class
Ventricular antiarrythmic
Lidocaine Bolus (Xylocaine)
Route
IVPush (no faster than 50mg/min in conscious pats)
Lidocaine Bolus (Xylocaine)
Dose
1)VFib or PLessVTach - 1.5mg/kg
2)Unstable VTach - 1.5mg/kg
3)Stable VTach - 1.0mg/kg
4)Non-sustained VTach or treatable PVCs - 1.0mg/kg
Lidocaine Bolus (Xylocaine)
Drug Action
Suppresses ventricular ectopy
Lidocaine Bolus (Xylocaine)
Indication
1)Ventricular Rhythms of irritability (PVCs,VTach, VFib)
2)Prevent recurrence of VFib or VTach after initial Defib or cardioverts
Lidocaine Bolus (Xylocaine)
Precautions
1)Consider reduced dose in pats >65 or those w/ hx of liver dis or CHF
2)Notify Biotel of any "caine" allergies
3)If successful and converts a ventricular arrythmia, it must be followed with a drip.
Lidocaine Bolus (Xylocaine)
Side Effects
Toxicity
1)Early:drowsy,lightheaded,blurred vision
Late:hypotension,chg in loc, seizures
Lidocaine Bolus (Xylocaine)
Contraindications
lifesustaining vent escape rhythms assoc with brady or 2 or 3 degree heart blocks.