Field Drugs Week 1

Front 1

Atropine

Back 1

Class: Parasympatholytic / Anticholinergic
Pharmacology: Blocks acetylcholine receptor sites. + myocardial O2 demand, + HR, + conduction in AV node, stops SLUDGE

Indications: Asystole, bradycardias (causing Altered metal status, chest pain, CHF), PEA if HR<60BPM. Antidote for some organophosphate insecticide exposure and nerve gases with symptoms of SLUDGE.

Contraindications: Evolving MI, glaucoma

Side Effects: Dilates pupils, Headache, dizziness.

Dosage:
Cardiac Arrest/PEA HR<60== 1mg IV/IO or 2mg ET every 3-5 minutes to MAX 0.04mg/kg
Symptomatic Bradycardia == 0.5mg IV/IO or ET repeat every 5 minutes if needed to get HR @60BPM. MAX 0.04mg/kg
Symptomatic Insecticide exposure== 2-5mg IV/IO/IM repeat if no improvement in 5-10 minutes
Nerve Agents: 2-20mg IV/IO/IM titrate to effect

Supplied: 1mg in 10mL pre-load, Multi-dose vial 0.4mg/ml, or Auto-Injector 2mg

Front 2

Dextrose 50%

Back 2

Class: Carbohydrate
Pharmacology: Quickly elevates blood glucose levels to prevent brain injury in severe hypoglycemia

Indications: Blood sugar less than 80mg/dL or coma of unknown etiology w/ unknown blood sugar. Pretreatment of crush injury, hyperkalemia.

Contraindications: Evolving CVA. If pt is a drunk, give thiamine prior to dextrose.

Side Effects: extravasation of line will cause necrosis of tissue--aspirate syringe at least 3 times to ensure patency of line.

Dosage: 25g of 50% dextrose IVP. May repeat every 5 minutes based on blood glucose levels

Supplied: 25g in 50mL preload

Front 3

Epinephrine
AKA Adrenalin

Back 3

Class:Beta-Adrenergic Agonist
Pharmacology: Sympathomimetic/catecholamine with Alpha and Beta Effects. Potent bronchodilator, pupil dilator. Cardiovascular responses: +HR, +force, +systemic vascular resistance, +arterial BP, +myocardial O2 consumption, +automaticity.

Indications: V-fib, pulseless V-tach, Asystole, PEA, Anaphylaxis, bradycardia after atropine, asthma. Second vasopressor for adult pts with dopamine in sepsis and nuerogenic shock.

Contraindications: hypertension, ischemic heart disease

Side Effects: Tachycardia, nausea, vomiting, angina

Dosage: Arrest situation== 1mg IVP/IO 1:10,000 every 3-5 minutes
Anaphylaxis: moderate 0.3mg - 0.5mg of 1:1,000 SQ repeat in 20 minutes. SEVERE (stridor) == 0.1mg increments SLOW IV up to 0.5mg. Titrate to BP>100mmHg
Asthma==0.3mg of 1:1000 SQ repeat in 20 minutes
Bradycardias== 2-10mcg/min IV drip (place 1mg in 250cc)

Supplied: 1mg in 10mL - 1:10,000 pre-load, 1mg in 1mL 1:1,000 ampule, or 30mg in 30mL 1:1,000 vial

Front 4

Procainamide

Back 4

Class: Anti-arrhythmic/cardiac depressant
Pharmacology: suppresses depolarization in the ventricles and purkinje fibers--deceasing automaticity

Indications: PSVT (after adensosine), A-Fib with rapid rate, Pulsing or pulseless V-tach or V-Fib

Contraindications: 2nd or 3rd degree AV block, Tosades de pointes

Side Effects: bradycardia, heart block

Dosage:
WPW, pulsing V-Tach, PVST == 20mg/min
Pulseless V-Tach or V-Fib == 20mg/min or 100 mg IV at 5 minute intervals
Maintenance infusion: 1-4mg/min
MAX DOSE: 17mg/kg

Supplied: 1g/2cc or 1g/10cc