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18 Cards in this Set

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Albuterol
(Ventolin, Proventil)
Class: Sympathomimetic

How Supplied: Liquid

Route: Inhalation (nebulized)
ETT (alternate route)
May be administered via either lumen of the Combitube

Dose: Adult: Nebulizer 2.5 mg over 5-15 minutes
Pediatric: Same as adult

Drug Action: Bronchodilation (beta 2)
Albuterol
(Ventolin, Proventil)
Indications: Bronchospasm associated with asthma and COPD
Bronchospasm from chemical toxins: nerve agents, cyanide, blistering agents, choking agents
Allergic reactions unresponsive to Epinephrine or Diphenhydramine (Benadryl)

Precautions: Known heart disease

Side Effects: Restlessness
Hypertension
Tachycardia - palpations

Contraindications: Pregnancy, except in life-threatening situations
Aspirin
(Acetylsalicylate Acid)
Class: Anti-platelet aggregator, analgesic, anti-inflammatory, antipyretic

Route: Orally (chewed)

Dose: Adult: One (325mg) adult Aspirin or four (81mg) baby Aspirin
Pediatric: Not used in the prehospital setting

Drug Action: Decreases platelet stickiness
Blocks pain impulses in the CNS
Reduces fever and inflamation
Aspirin
(Acetylsalicylate Acid)
Indications: Chest pain believed to be of cardiac origin

Precautions: Any significant bleeding

Side Effects: None for prehospital

Contraindications: ASA allergy
ASA induced asthma
Dobutamine Hydrochloride
(Dobutrex)
Class:
Sympathomimetic

Route:
IV Piggyback

Dose:
Adult
2-20 mcg/kg/minute

Dilution ratio:
250mg, 500mg, or 1000mg may be added to various amounts (250mL, 500mL, or 1000mL) of NS, D5W or RL as determined by the clinical status and fluid requirements of the patient.

Pediatric:
2-20 mcg/kg titrated to desired effect

Dilution ratio:
Contact Medical Control

Drug Action:
Stimulates beta 1 receptors in the myocardium to increase myocardial contractility, stroke volume, and cardiac output
Stimulates beta 2 receptors on the smooth muscle of the bronchioles and peripheral vessels to open airways and decrease peripheral vascular resistance (preload and afterload)
Dobutamine Hydrochloride
(Dobutrex)
Indications:
Pulmonary edema with systolic B/P of 70-100 and no signs/symptoms of shock

Precautions:
Do not administer through the same IV line with other drugs, especially Sodium Bicarbonate
Assure IV patency and administer through a large peripheral vein; refer to Drug Administration Principles
Continuously monitor heart rate, B/P and ECG
Titrate so heart rate does not increase by more than 10% of baseline

Side Effects:
Phlebitis with infiltratioin
Tachycardia/tachyarrhythmias
In high doses - nervousness, nausea, vomiting, chest pain, hypertension

Contraindications:
Suspected or known poison/drug induced shock
Systolic B/P less than 100 with signs/symptoms of shock
Concurrent beta blocker use (may antagonize)
Dopamine HCL
(Intropin)
Class:
Sympathomimetic

Route:
IV piggyback

Dose:
Adult
2-10 mcg/kg/minute per Biotel order

Dilution ratio:
Use a 400mg/250mL D5W (premix) or add 400mg to 250mL NS
Use an 800mg/500mL D5W (premix) or add 800mg to 500mL NS

Once Biotel determines mcg/min, refer to the Drug Drip Chart for drops/minute

Pediatric:
Not used in the prehospital setting

Drug Action:
Low Doses:
Increse perfusion to kidneys and abdominal organs (dopaminergic) .5-2mcg

Moderate Doses:
Increases rate and force of ventricular contractions (beta 1) 2-10mcg

High Doses:
Constrict peripheral vessels (alpha) >10mcg
Dopamine HCL
(Intropin)
Indications:
Cardiogenic shock with systolic B/P between 70-90mmHg
Symptomatic bradycardias which do not respondto Atropine or transcutaneous pacing TCP

Precautions:
Assure IV patency; refer to Drug Administration Principles
Do not mix with Sodium Bicarbonate; flush tubing well between drugs
Continually monitor ECG, heart rate and B/P

Side Effects:
Tissue necrosis with infiltration
Hypertension
Tachycardia
Arrhythmias

Contraindications:
Hypovolemic shock
Furosemide
(Lasix)
Class:
Loop Diuretic

Route:
Slow IV Push (20mg/min)

Initial Dose:
Adult:
40mg
If patient is already taking Furosemide at home, administer twice the pts. usual single, daily dose, up to a maximum of 100mg.

Pediatric:
Not used in the prehospital setting

Drug Action:
Decreases peripheral vascular resistance - VASODILATOR
Decreases cardiac workload and oxygen demand on the heart
Increases water excretion by inhibiting reabsorption of water, sodium, and chloride in the kidney
Furosemide
(Lasix)
Indications:
Pulmonary edema due to congestive heart failure or kidney disease

Precautions:
Must be preceded by NTG
Monitor ECG and B/P closely
Document any urine output

Side Effects:
Hypotension
Arrhythmias secondary to electrolyte imbalances
Deafness if given too rapidly

Contraindications:
Systolic B/P <110
Pregnancy
Ipratropium Bromide
(Atrovent)
Class:
Topical Anticholinergic

How Supplied:
Liquid

Route:
Inhalation (nebulized)
ETT (alternate route)
May be administered via either lumen of the Combitube

Dose:
All doses are combined with 2.5mg of Albuterol

Adult:
Nebulizer: 0.5mg in 2.5mL NS

Pediatric:
Nebulizer: <1 year old - 0.25mg in 2.5mL NS
1 year or older - 0.5mg in 2.5mL NS

Drug Action:
Broncholdilation
Dries respiratory tract secretions
Ipratropium Bromide
(Atrovent)
Indications:
Bronchospasm associated with asthma or COPD that does not respond to the first dose of Albuterol
Bronchospasm from chemical toxins: nerve agents, cyanide, blistering agents, choking agents

Precautions:
Notify Biotel prior to administration if patients have a history of glaucoma, prostatic hypertrophy, or bladder neck obstruction

Side Effects:
Dry Mouth
Cough, worsening of symptoms
Skin rash

Contraindications:
Sensitivity to soy lecithin products (soybeans, peanuts)
Sensitivity to Atropine
Bronchoconstriction that is caused by allergic reaction
Morphine Sulfate
Class:
Narcotic Analgesic

Route:
Slow IV Push

Dose:
Adult
Administer in titrated doses of 2-4mg, up to a maximum of 10 mg

Pediatric:
0.1mg/kg

Drug Action:
Alleviates pain
Decreases peripheral vascular resistance - VASODILATOR
Decreases cardiac workload and oxygen demand on the heart
Morphine Sulfate
Indications:
Pain and anxiety secondary to AMI
Chest pain unrelieved by Nitroglycerin
Pulmonary edema
Pain secondary to amputations or fractures

Precautions:
Monitor respiratory status and B/P closely

Notify Biotel prior to administration if patient is >65 years of age, debilitated, has altered mental status, or systolic B/P <110mmHg
CHF: be prepared to intubate
Have Nalaxone (Narcan) readily available

Side Effects:
Respiratory depression
Hypotension
Bradycardia
Nausea and vomiting

Contraindications:
Systolic B/P <110mmHg, unless authorized by Biotel
Head Injury
Severe respiratory depression

Antidote:
Naloxone (Narcan)
Nitroglycerin
(Nitrostat)
Class:
Vasodilator

Route:
Sublingual spray

Dose:
Adult:
1 spray (0.4mg)
May be repeated twice at 5 minute intervals PRN

Pediatric:
Not used in the prehospital setting

Drug Action:
Coronary and systemic (veins and arteries) vasodilator - decreases peripheral vascular resistance, preload and afterload
Decreases cardiac workload and oxygen demand
Nitroglycerin
(Nitrostat)
Indications:
Chest pain of cardiac origin
Pulmonary edema associated with congestive hear failure (CHF)

Precautions:
Monitor B/P closely
Assure pt. is sitting or lying down during administration
IV must be established before administering to suspected inferior wall MI's

Side Effects:
Hypotension
Headache
Postural hypotension/syncope
Reflex tachycardia

Contraindications:
Systolic B/P <110mmHg
Increased intracranial pressure
Use of any of the following erectile dysfunction drugs within the past 24 hours:

Sildenafil citrate (Viagra)
Tadalafil (Cialis)
Vardenafil (Levitra)
Norepinephrine Bitartrate
(Levophed)
Class:
Sympathomimetic

Route:
IV piggyback

Dose:
Adult:
8-12mcg/minute

Dilution Ratio:
Add 4mg/250mL NS (16mcg/mL) or
Add 8mg/500mL NS (16mcg/mL)

Once Biotel determines mcg/minute, refer to Drug Drip Chart for drops/minute

Pediatric:
Not used in teh prehospital setting

Drug Action:
Potent peripheral vasoconstrictor (primary alpha; minimally beta)
Increases myocardial contractility
Norepinephrine Bitartrate
(Levophed)
Indications:
Cardiogenic shock when systolic B/P is <70mmHg
Post resuscitation hypotension after medical CPR's when systolic B/P < 90mmHg

Precautions:
Assure IV patency; refer to Drug Administration Principles
Continually monitor B/P
Do not mix with Sodium Bicarbonate; flush tubing well between drugs

Side Effects:
Tissue necrosis with infiltration
Hypertension

Contraindications:
Hypovolemia