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21 Cards in this Set
- Front
- Back
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ADENOSINE |
CLASS: Antidysrhythmic
MOA: A naturally occurring nucleotide present in all cells of the body, it acts to slow conduction through the AV node & also dilates coronary arteries & peripheral vessels. Adenosine's half life is about 10-12 seconds & is also referred to as the “chemical cardioversion” drug. INDICATIONS: Narrow Complex Tachycardias, SVT CONTRAINDICATIONS: 2nd & 3rd degree AV blocks, also give with caution to pt’s w/ history of asthma for potential bronchospasms. SIDE EFFECTS: Transient asystole, chest pain, SOB, flushing DOSAGES: Adult: 6mg rapid IV push, followed by 20ml of NS. If no change w/ in 2 minutes, give 12mg rapid IV push, followed by 20ml of NS. If no conversion may try a third time of 12mg rapid IV push, followed by 20ml of NS. Pediatric- BASE CONTACT ONLY |
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ALBUTEROL
(PROVENTIL) |
CLASS: Sympathomimetic Bronchodilator
MOA: A beta II adrenergic receptor stimulant that affects the respiratory tract in the form of smooth muscle relaxation. INDICATIONS: Bronchospasm, asthma, emphysema & bronchitis CONTRAINDICATIONS: Hypersensitivity, use w/ caution on CHF pt’s SIDE EFFECTS: Anxiety, dizziness & tachycardia DOSAGES: Adult: BRONCHOSPASMS- 2.5mg in nebulizer over 5-15 minutes at 6-8 LPM, may repeat 2 times Pediatric- SAME AS ADULT DOSE |
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ASPIRIN
(BAYER, A.S.A.) |
CLASS: Anti-platelet
MOA: Inhibits platelet aggregation by blocking the formation of thromboxane. INDICATIONS: Chest pain of unknown etiology, MI & TIA CONTRAINDICATIONS: History of GI bleed, inter cranial hemorrhage, hypersensitivity, major surgery w/ in 2 weeks & previous thrombosis. SIDE EFFECTS: Nausea, vomiting & hemorrhage DOSAGES: Adult: 162mg PO (2 81mg tablets) Pediatric- NOT INDICATED |
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ATROPINE SULFATE
(ATROPINE) |
CLASS: Parasympathetic Blocker/ Anticholinergic/ Vagolytic
MOA: Blocks the effects of the parasympathetic nervous system by blocking the acetylcholine receptors. Used to increase heart rate in bradycardias originating above the ventricles. INDICATIONS: Bradycardia, Organophosphate Poisonings (less than 60 BPM) CONTRAINDICATIONS: None SIDE EFFECTS: Increased Heart Rate, Increased Blood Pressure DOSAGES: Adult: BRADYCARDIA- 0.5mg RIVP, MRE 5 min to max of 3mg or 0.04mg/kg, ORGANOPHOSPHATE POISONING- 2mg IV, repeat in 2mg increments as long as pt’s symptoms persist Pediatric- NOT INDICATED |
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ATROVENT
(IPRATROPIUM BROMIDE) |
CLASS: Parasympatholytic Bronchodilator
MOA: Used in the treatment of respiratory emergencies to bronchodilate & dry respiratory secretions. It acts to block acetylcholine receptors, therefore inhibiting parasympathetic stimulation. INDICATIONS: Acute bronchospasms CONTRAINDICATIONS: Hypersensitivity, allergies to peanuts & soy products SIDE EFFECTS: Nausea, vomiting, epistaxis & headache DOSAGES: Adult: BRONCHOSPASM- 0.5mg nebulized over 5-15 minutes at 6-8 LPM, may repeat 2 times Pediatric- 1 day to 12 months 0.25mg, 1 year of age & up same as adult dose, may repeat 2 times |
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CALCIUM CHLORIDE
(CaCl2) |
CLASS: Electrolyte
MOA: An electrolyte that is necessary for myocardial contractions to occur, it increases the myocardial contractile force & enhances ventricular excitability. INDICATIONS: Calcium channel blocker overdose/poisoning if hypotension or bradycardic arrhythmias persist CONTRAINDICATIONS: V-fib, hypercalcemia & digitalis toxicity SIDE EFFECTS: Bradycardia, hypotension, cardiac arrest & syncope DOSAGES: Adult: BASE HOSPITAL ORDER ONLY- CALCIUM CHANNEL BLOCKER OVERDOSE- 1gm IV Pediatric- BASE HOSPITAL ORDER ONLY PRECAUTIONS- Flush IV tubing before and after precipitates w/ NaHCO3 (Chalk) Aspirate- causes necrosis if injected in interstitial space |
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DIPHENHYDRAMINE
(BENADRYL) |
CLASS: Antihistamine
MOA: Competes for the H1 receptor sites on effector cells w/ in the GI tract, respiratory tract & blood vessels there for blocking the release of histamines. INDICATIONS: S/S of allergic reactions/anaphalaxis, Phenothiazine OD for ataxia and/or muscle spasms CONTRAINDICATIONS: Hypersensitivity, Acute Asthma, Glaucoma, Newborns and nursing mothers SIDE EFFECTS: Fatigue, headache, sedation & sleepiness, hypotension, Tachycardia, mucus plugs DOSAGES: Adult: 50mg IM or 25mg IV slowly Pediatric- 2mg/kg IM or 1mg/kg IV slowly not to exceed adult dose PRECAUTIONS: May precipitate into asthma attack= Drying effect Dystonic reactions caused by Phenothiazines (lip smacking, pill roll, tongue extrusion, dysphagia, dysphasia) Drugs causing Dystonic Reactions= Thorazine, Haldol, Compazine, Phenergan, Stelazine, Sparine, melloril, Temaril |
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DOPAMINE
(INTROPIN) |
CLASS: Sympathomimetic
MOA: Naturally occurring catecholamine. It acts on alpha receptors to cause vasoconstriction. Increases heart rate with out increasing myocardial oxygen demand. In lower doses it maintains renal and mesenteric blood flow, medium doses increase Beta I properties & higher doses cause vasoconstriction. INDICATIONS: Cardiac Arrest post resuscitation, significant hypotension post fluid replacement CONTRAINDICATIONS: Children under 8 yrs of age, do not give IO SIDE EFFECTS: Increased Heart Rate, can cause narrow or wide complex arrhythmias DOSAGES: Syptomatic Hypotension Adult: 5-20mcg/kg/min titrate to effect(typical preparation 400mg in 250ml of NS) Post Cardiac Arrest Adult: 5-10 mcg/kg/min titrate to effect(typical preparation 400mg in 250ml of NS) Pediatric- Contraindicated in children under 8 years of age |
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EPINEPHRINE
(ADRENALINE) |
CLASS: Sympathomimetic
MOA: An Adrenergic receptor w/ both alpha & beta actions, it vasoconstricts which increases heart rate & contractility, & is used as a smooth muscle relaxant during severe bronchospasms during anaphylaxis. INDICATIONS: PEA/Asystole, Anaphylaxis, Bronchospasms CONTRAINDICATIONS: None for Cardiac Arrest, pt’s over the age of 40 or history of CAD or HTN. SIDE EFFECTS: Increased Heart Rate & Increased Blood Pressure DOSAGES: Adult: CARDIAC ARREST- 1mg IV/IO (1:10,000 Solution) repeat during each 2 min cycle of CPR. ALLERGIC REACTION/BRONCHOSPASM- 0.3mg SC (1:1,000 Solution) may repeat once after 15min Anaphylactic Shock- 0.1 mg (1:10,000) SIVP MR PRN to total dosage of 0.5 mg Pediatric- ALLERGIC REACTION/BRONCHOSPASM- 0.01mg/kg SC (1:1000) up to 0.3mg Anaphylactic Shock- 0.01 mg/kg (1:10,000) IV/IO up to 0.1 mg per dose. MR to MAX of 0.5 mg CARDIAC ARREST- 0.01mg/kg IV/IO 1 day-8 y/o ROSC-(1:10,000) 0.5 mcg/kg /min IO/IV 1 day to 8 years Neonate Bradycardia- If <60 HR after 1min 0.01mg/kg IV/IO Neonatal Hypotension- Base Station may order 0.005mg/kg (1:10,000) IV/IO every 10 minutes |
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GLUCAGON
(GLUCAGEN) |
CLASS: Pancreatic Hormone
MOA: Elevates blood glucose levels by causing a breakdown of glycogen, stored in the liver, into glucose. Can act as a smooth muscle relaxant & stimulates the sympathetic nervous system through other means besides alpha & beta receptors, which is why it is used on beta blocker overdoses. INDICATIONS: Hypoglycemia, beta blocker OD & esophageal foreign body obstruction w/ BHO CONTRAINDICATIONS: Hypersensitivity & hyperglycemia SIDE EFFECTS: Hyperglycemia, dizziness & headache DOSAGES: Adult: HYPOGLYCEMIA- 1mg IM/SC/IN, may give once ONLY BETA BLOCKER OVERDOSE- 1mg IVP Base Hospital Order ONLY FOREIGN BODY OBSTRUCTION- BASE HOSPITAL ORDER ONLY Pediatric- 0.025mg/kg IM, may repeat once after 20 minutes up to a max of 1mg |
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LIDOCAINE
(XYLOCAINE) |
CLASS: Antidysrhythmic
MOA: Used to suppress the automaticity of ectopic pacemakers in the His-Purkinje system & elevates the electrical stimulation threshold of the ventricles during diastole & also lowers the threshold for defibrillation & cardioversion. Used for numbing properties during IO Infusion and Intubation. INDICATIONS: V-tach, V-fib, intubation w/ head injury, prior to IO infusion CONTRAINDICATIONS: in 2ND & 3RD Degree AV Blocks, do not give in conjunction w/ PVC’S or Bradycardia , hypersensitivity, Stoke-Adams Syndrome, WPW SIDE EFFECTS: Irritability, Confusion, Seizures, Coma DOSAGES: Adult: PULSELESS V-tach/V-fib- 1.5mg/kg IV/IO after 2 min cycles of CPR, MRE 2min at 0.75mg/kg to a max of 3mg/kg (if suppressed begin maintenance dose of 2mg/min). V-tach/V-fib w/ PULSES- 1mg/kg IV/IO, may repeat at 0.5mg/kg to a max of 3mg/kg (if suppressed begin maintenance dose of 2mg/min). INTUBATION- prior to intubation w/ head trauma administer 1.5mg/kg. IO INFUSION- Administer 0.5mg/kg to a max of 50mg Pediatric- CARDIAC ARREST- V-fib/Pulseless V-tach- 1.0mg/kg IV/IO, may repeat at 0.5mg/kg after 5 minutes up to a max dose of 3mg/kg |
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MAGNESIUM SULFATE
(MAGNESIUM) |
CLASS: Electrolyte
MOA: Is an essential element within the body that is responsible for neurotransmission & muscle excitability. INDICATIONS: Torsades de pointes & seizures associated w/ eclampsia CONTRAINDICATIONS: Shock, hypocalcemia, hypertension & heart blocks SIDE EFFECTS: Drowsiness, respiratory depression, hypotension & circulatory collapse DOSAGES: Adult: SEIZURES/ECLAMPSIA- 4gm diluted w/ 20ml of NS over 3 to 4 minutes, Start infusion at 2 gms in 100 cc of NS at 30mL/hr IV/IO to prevent continued seizures. TORSADES DE POINTES- 2gm in 100ml of NS infused over 5 minutes. If prolonged QT is observed during Sinus Rhythm post Cardioversion Pediatric- NOT INDICATED |
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MIDAZOLAM
(VERSED) |
CLASS: Sedative/hypnotic
MOA: A short acting benzodiazepine w/ amnesic properties. It relaxes skeletal muscle during seizure activity & is used for its amnesic properties during cardioversion & pacing. INDICATIONS: Seizure activity, cardioversion & pacing CONTRAINDICATIONS: Signs of inadequate tissue perfusion, sensitivty & shock, Infants<6 months old Ca Channel Blocker use, Narcs, Alcohol, Barbituates SIDE EFFECTS: Bronchospasm, dyspnea, respiratory depression, blurred vision, d& bradycardia DOSAGES: Adult: 2.5mg IN/IV/IO MRE 5min for continued seizure activity, or 5mg IM MRE 10min Max 3 doses using any combination of IM/IN/IV/IO CARDIOVERSION/TCP- 1-2mg IV/IN conscious pts Pediatric- SEIZURES- 0.1mg/kg IV/IO MRE 5min not to exceed adult dose, or 0.2mg/kg IM/IN MRE 10min not to exceed adult dose Max 3 doses using any combination of IM/IN/IV/IO PRECAUTIONS: Antidote; Romazicon(Flumazenil) 1/2 dose for debilitated pt Synergistic effect = alcohol, narc, verapamil, diltiazem |
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MORPHINE SULFATE
(ASTRAMORPH, MS) |
CLASS: Narcotic Analgesic
MOA: It decreases systemic vascular resistance, which reduces myocardial oxygen demands. A potent CNS depressant used for pt’s experiencing pain, thereby reducing discomfort, apprehension & fear. INDICATIONS: MI, burns & isolated extremity fractures CONTRAINDICATIONS: Multi systems trauma, hypotension & respiratory distress SIDE EFFECTS: Respiratory depression, hypotension, nausea & vomiting DOSAGES: Adult: MI- 2mg increments every 3 minutes, not to exceed 10mg w/ out base contact. ISOLATED FRACTURES/BURNS- 5mg SIVP MRE 5 min w/ signs of adequate tissue perfusion, MAX 20mg. or 10mg IM Pediatric- 0.1 mg/kg IV/IO slowly, do not exceed 5mg increments, MRE 5min MAX of 20mg IV/IO 0.2mg/kg IM, MAX of 10mg IM TCP/SyncCardiovert- Titrate in 1-2mg increments up to 10mg for complaint of pain. |
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NITROGLYCERIN
(NITROSTAT) |
CLASS: Smooth Muscle Relaxant/Vasodilator
MOA: A direct vasodilator on both the arteries & veins, it increases perfusion to ischemic myocardial tissue. It reduces the work & oxygen consumption, thereby leading to pain relief. In CHF & Pulmonary Edema nitro decreases preload & afterload improving cardiac output. INDICATIONS: Chest Pain, Left sided MI, CHF, Pulmonary Edema CONTRAINDICATIONS: Inadequate tissue perfusion, right sided MI & Recent use of sexual enhancements SIDE EFFECTS: Hypotension, headache & flushing DOSAGES: Adult: Chest pain/MI- 0.4mg metered dose, may repeat as needed with signs of adequate tissue perfusion. CHF/Pulmonary Edema- 0.4mg metered dose, may repeat as needed with signs of adequate tissue perfusion. Pediatric- NOT INDICATED Precautions- Contact Base Hospital prior to admin if suspected RVMI |
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PROCAINAMIDE
(PROCAN, PRONESTYL) |
CLASS: Antidysrhythmic (Class 1a)
MOA: Is used for ventricular dysrhythmias by suppressing the automaticity of ventricular ectopic pacemakers and also slows conduction through the bundle of his. INDICATIONS: SVT w/ Suspected WPW, V-Tach CONTRAINDICATIONS: Myashenia gravis, Acute MI, Hypersensitivity & Renal Failure, Digitalis Toxicity, Torsades De Pointes, Complete Heart Block 2nd/3rd Degree Heart Block AV Block(w/out functioning artificial PM) TCA OD SIDE EFFECTS: Hypotension, Nausea, Vomiting, Confusion & Seizures DOSAGES: Suspected WPW in SVT/V-tach Wide Complex Tach Adult: Mix 1gm/250ml of NS, Give 20mg (5ml) slowly over one minute via IV push. Repeat until arrhythmia is suppressed or one of four end points have been reached: 1-max dose of 17mg/kg, 2-QRS widens by 50%, 3-inadequate tissue perfusion develops, 4- or arrhythmia has been suppressed. If suppressed- Infuse 2mg/min Pediatric- NOT INDICATED PRECAUTIONS: Potent Vasodilating Effects & negative inotropic effects' Rapid Injection may induce hypotension Use w/ caution in bronchial asthma, CHF, electrolyte imbalance |
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SODIUM BICARBONATE
(NaHCO3) |
CLASS: Electrolyte/Alkalinizing Agent(Hydrogen Ion Buffer)
MOA: Neutralizes hydrochloric acid by forming sodium chloride & CO2. And is also a systemic urinary alkalizer. INDICATIONS: Extended down time during cardiac arrest & tricyclic antidepressant overdose/poisoning CONTRAINDICATIONS: If admin in large quantities, may cause Metabolic Alkalosis SIDE EFFECTS: Metabolic alkalosis, PE, Tetany, Seizues DOSAGES: Adult: BASE HOSPITAL ORDER ONLY- CARDIAC ARREST- 1mEq/kg IV. TRICYCLIC OVERDOSE/POISONING- 1mEq/kg IV Pediatric- BASE HOSPITAL ORDER ONLY Precautions: If admin w/ CaCl2, precipitate will form. Inactivates Catecholamines (Epi/Dop) |
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DEXTROSE
(50% DEXTROSE) |
CLASS: Carbohydrate
MOA: A form of sugar used by the body in order to create energy. INDICATIONS: Hypoglycemia CONTRAINDICATIONS: Hyperglycemia SIDE EFFECTS: Hyperglycemia & tissue necrosis DOSAGES: Adult: HYPOGLYCEMIA- D50, 25gm IV/IO, MR w/ extended transport times. Ped- - Neonates (0-4 weeks), BG < 35 mg/dL: D25W (0.25 g/ml) Diluted 1:1 Give 0.5 g/kg (4 ml/kg) IV/IO - <10kg and >4 weeks, BG < 60 mg/dL: D25W (0.25 g/ml) Give 0.5 g/kg (2 ml/kg) IV/IO - >10kg and <25kg,BG < 60 mg/dL: D50W (0.5 g/mL) Diluted 1:1 Give 0.5 g/kg (2 ml/kg) IV/IO - >25kg, BG < 80 mg/dL: D50W (0.5 g/mL) Diluted 1:1 Give 0.5 g/kg (2 ml/kg) IV/IO |
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NALOXONE
(NARCAN) |
CLASS: Narcotic Antagonist
MOA: It reverses the effects of narcotics by competing for & displacing narcotic molecules from opiate receptors in the brain. It is mainly used to reverse respiratory depression caused by narcotic overdoses. INDICATIONS: ALOC w/ suspicion of narcotic use, respiratory depression & constricted pupils CONTRAINDICATIONS: Hypersensitivity SIDE EFFECTS: Nausea, vomiting, sweating & tachycardia DOSAGES: Adult: NARCOTIC OVERDOSE- 2mg IV/IM/IN, MRE 2-3 minutes PRN Max of 10mg Pediatric- NARCOTIC OVERDOSE- 0.1mg/kg IV/IM/IN, do not exceed adult dose of 2mg increments |
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VERAPAMIL
(CALAN, ISOPTIN) |
CLASS: Slow Channel Calcium Blocker
MOA: Inhibits calcium ions from entering channels of myocardial & arterial smooth muscle. It also slows conduction through the AV node & prolongs refractory period of the AV node. Decreases oxygen demand & causes coronary artery & peripheral vasodilation. INDICATIONS: Narrow SVT, adenosine ineffective CONTRAINDICATIONS: Hypotension, cardiogenic shock, pulmonary edema, v-tach, beta blockers & WPW SIDE EFFECTS: Dizzy, H/N/V, Bradycardia, Complete AV block, Hypotension, Peripheral Edema DOSAGES: Adult: 5mg IV over 3 min, MRE 15 minutes to a MAX Total Dose of 20mg Pediatric- NOT INDICATED |
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ZOFRAN
(ONDANSETRON) |
CLASS: Antiemetic
MOA: It reduces the activity of the vagus nerve, which deactivates the vomiting center located w/ in the medulla oblongata. INDICATIONS: Nausea & vomiting CONTRAINDICATIONS: Allergies to Ondansetron, Granisetron, Dolasetron or Palonosetron SIDE EFFECTS: Blurred vision, dizziness & headache DOSAGES: Adult: NAUSEA/VOMITING- 4mg ODT, or 4mg IV push greater than 30 seconds, may repeat 2 more times prior to base contact Pediatric- NAUSEA/VOMITING- for pt’s 4-8 years of age 4mg ODT, or 4mg IV (4mg is max dose prior to base contact) |
