Ma Medic Drugs Name Dose Indications Con

Front 1

ADENOSINE
Adenocard, Adenoscan
(Endogenous Nucleotide)
for
PSVT

Back 1

Adult dose (110lb+) 6mg RIVP 1-2 sec20ml flush repeat after 1-2 min if needed /12mg /12mg max total dose 30mg
pedi 0.1-0.2mg/kg max single dose 12mgs
CONTRA 2nd 3rd HB A-fib/ A-flutter V-tach
S/C monitor

Front 2

AMIODARONE
Cordarone, Pacerone
(antidysrhythmic)
suppression of V-fib refractory to D-fib
V-tach refractory to cardioversion

Back 2

dose Unstable VT/VF 300mg in 10ml ns IV/IO over 1-2mins. followed by 150mg if needed in 5min.
stable VT 150mg IV over 10min (15mg/min) may repeat Q 10min as needed. after conversion 1.0mg/min maintenance dose. max dd 2.2g IV/24hr
IV drip 0.5-1mg for malignant V-arrhythmias per MD.
CONTRA 2nd/3rd HB Hypotension, Bradycardia, Torsades. S/C admin cautiously in pt with heart failure and poor systolic function

Front 3

ATROPINE SULFATE
(Anticholinergic agent)
for

Bradycardia, Asystole Organophosphate poisoning

Back 3

Adult dose Bradydysrhythmias 0.5-1.0mg IV Q 3-5min as needed to max dose 3mg
Asystole / PEA 1mg IV Q 3-5min max dose 3mg
ET at 2-2.5 x IV dose with 2ml ns
Pedi 0.2mg/kg IV/IO/ET (min single dose 0.1mg max single dose 1.0mg) if ET follow with 2ml NS flush Asystole max dose 0.5mg child 1.0mg adolesent.
CONTRA Tachycardia, Narrow-angle glaucoma, acute hemorrhage myocardia ischemia. S/C monitor vs auscultate LS before & after each dose

Front 4

CARDIZEM
(DILTIAZEM HCL)
(Calcium channel blocker)
for
control of rapid V-rates due to A-fib/ A-flutter, PSVT, Angina, Refractory SVT (after Adenosine)

Back 4

MOA: Calcium channel blocker prolonges refractory period PRECAUTIONS: BP may drop DO NOT use for wide QRS tachy, WPW with Afib, sick sinus syndrome, or beta blockers. DOSE: 0.25mg/kg IV over 2min if inadequate response may re-bolus in 15min 0.35mg/kg IV over 2min maintenance drip 5-15mg/hour
Pedi not recommended
CONTRA hypotension, 2nd 3rd HB, Cardiogenic shock, wide complex tachs S/C use with caution in pt with renal or hepatic dysfunction

Front 5

DOPAMINE
(sympathomimetic, inotropic)
for
Hypotension, cardiogenic, septic, spinal, distributive shocks
increases BP, systemic vascular resistance, cardiac contractility & stroke volume, dilates renal & splanchnic vasculature

Back 5

Adult dose 2-20mcg/kg/min (per MD)
Pedi 2-20mcg/kg/min (per MD)
CONTRA hypovolemic shock, pheochromocytoma, VF, Tachydysrhythmias
D/I MAOIs enhance effect,Beta blockers antagonize effect, when admin with Phenytoin may cause hypotension bradycardia & seizures.

Front 6

DOPAMINE
dose effects.

Back 6

S/C Effects are dose dependent
2-4mcg/kg/min dopaminergic dilates vessels in kidneys, inc. urine output.
4-10 mcg/kg/min Beta adrenergic response inc. chronotropy & inotropy.
10-20mcg/kg/min Adrenergic response primarily alpha stimulant/ vasoconstriction.
> 20mcg/kg/min reversal of renal effects/ over ride alpha effects.

Front 7

EPINEPHRINE 1:10,000
(sympathomimetic)
for
CARDIAC ARREST, ASYSTOLE, PEA, VF (unresponsive to initial D-fib)
increase BP, stroke volume, HR.

Back 7

Adult dose Cardiac: Asystole PEA, VF
1.0mg IVP Q3-5min. ET 2.0-2.5mg (1:1000) solution Q3-5min in 10ml NS
Pedi doae Cardiac Asystole, PEA, VF
IV/ IO 0.01mg/kg ET 0.1mg/kg (1:1000) solution in 0.1ml/kg NS CONTRA HTN, hypothermia, Pulmonary edema, hypovolemic shock, coronary insufficiency.

Front 8

EPINEPHRINE 1:1000
for
Anaphylaxis and acute allergic reactions, Asthma

Back 8

Adult dose Asthma, Allergic reactions 0.3-0.5mg SC
Anaphylaxis 0.3-0.5mg (3-5ml 1:10,000) IV
Pedi dose Allergic reactions, Asthma 0.01mg/kg (0.01ml/kg 1:1000) SC max 0.5mg

Front 9

LIDOCAINE
(Antidysrhythmic)
for adult
VT, VF, PVCs
CONTRA 2nd 3rd HB, stokes adams syndrome, Hypotension

Back 9

Adult dose Cardiac arrest VT/VF 1.0-1.5mg/kg IVP Q3-5min max dose 3mg/kg if conversion to NSR drip at 2-4mg/min ASAP
VT with pulse 1.0-1.5mg/kg IVP then 0.50-0.75mg/kg Q 5-10min drip ASAP
PVCs with pulse 0.5-1.5mg/kg IVP additional boluses of 0,5-1.5mg/kg Q 5-10min drip ASAP
Pedi dose VF pulseless V-tach 1mg/kg IV/IO per dose drip 20-50mcg/kg/min
PVCs with pulse 1mg/kg IV/IO per dose drip 20-50mcg/kg/min

Front 10

LIDOCAINE
S/C A/R

Back 10

Half drip dose if pt is over 70yo has liver disease or is in CHF or shock.
A/R slerred speach, seizures, altered mental status, blurred vision, bradycardia,

Front 11

THIAMINE
(vitamin B1)
for
Coma, Delirium tremens, Beriberi, Wernicke's encephalopathy

Back 11

Adult dose 100mg slow IV or IM.
Pedi dose 10-25mg slow IV or IM
CONTRA NONE
S/C large IV dose may cause respiratory difficulties
A/R Hypotension from too rapid injection or too high a dose, anxiety, diaphoresis, D/I give before glucose at all times.

Front 12

CALCIUM CHLORIDE/ CALCIUM GLUCONATE
(Electrolyte)
for
Magnesium sulfate overdose, Calcium channel blocker OD, Hypocalcemia, treatment of insect bites/stings.

Back 12

Adult dose 2-4mg/kg of 10% solution slow IV over 5min may repeat in 10min max dose 1gm
Pedi dose 20mg/kg of 10% solution slow IV/ IO may repeat in 10min. max dose 1gm
CONTRA Hypercalccemia, VF during cardiac resus. Digitalis toxicity.
A/R Bradycardia, asystole, hypotension, peripheral vasodilation, coronary & cerebral artery spasm, local necrosis.
D/I may worsen dysrhythmias 2nd to digitalis, may antagonize effects of Verapamil.

Front 13

MAGNESIUM SULFATE
(electrolyte)
Seizures of eclampsia, Torsades, TCA OD induced dysrhythmias, Hypomagnesemia, Class IIa agent for refractory VF/VT s/p admin of Lidocaine doses.

Back 13

dose seizure activity assoc. with pregnancy 1-4gm IVP over 3min. for Torsades or refractory VF/VT 1-2gm IVP over 1-2min.
Pedi dose NOT RECOMMENDED. CONTRA Heart blocks, Renal diseases.
A/R Respiratory & CNS depression, hypotension, Circulatory collapse, cardiac arrest and asystole may occur, Facial flushing, diaphoresis, depressed reflexes.
S/C recommended drug not given 2hr before delivery, CALCIUM GLUCONATE OR CALCIUM CHLORIDE SHOULD BE AVAILABLE AS ANTAGONIST IF NEEDED

Front 14

NALOXONE
(Narcotic antagonist)
for
Opiate OD, Coma
Morphine, heroin, hydromorphone (Dilaudid) , Methadone, Meperidine (Demerol), Paregoric, Fentanyl (sublimase), Oxycodone (percodan), Codeine, propoxyphene (darvon),
Narcotic agonist & anatagonist Butorphanol (stadol), Pentazocine (Talwin), Nalbuphine (Nubain)

Back 14

Adult dose 0.4-2.0mg IV,IM,SC Nasal via atomizer or ET (diluted) min recommended =2.0mg Q at 5min intervals to 10mg max (med control may request higher amounts) infusion 2mg in 500ml of D5W (4mcg/ml) infuse at 0.4mg/hr (100ml/hr)
Pedi dose 0.1mg/kg dose IV, IM, SC, ET (diluted) max of 0.8mg if no response in 10min admin 0.1mg/kg dose.

Front 15

NITROGLYCERIN
(vasodilator)
for
CHF, Angina, HTN, Chest pain

Back 15

Adult dose Tab 0.3-0.4mg SL may repeat in 3-5min to max of 3 doses Spray 0.4mg SL 1-2 sprays Q 5min max 3 doses. drip 5ug/min increase by 5-10ug/min Q 5min until desired effect. Paste 1in
Pedi NOT RECOMMENDED
CONTRA. hypotension, hypovolemia, head injury, intracranial bleeding, D/I Vasodilators, drugs used to treat erectile dysfunction such as Viagra (sildenafil), Cialis (tadalafil), Levitra (vardenafil).

Front 16

PROCAINAMIDE
(Antidysrhythmic Class Ia)
for
Suppress PVCs/ VT with a pulse refractory to Lidocaine, PSVTs with wide-complex tach of unknown origin, drug of choice when associated with WPW.

Back 16

Adult dose 20-30mg/min max 17mg/kg. infusion 1-4mg/min
Pedi dose 2-6mg/kg IV/IO at less than 20mg/min max 17mg/kg infusion 20-80mcg/kg/min.
CONTRA 2nd & 3rd HB, Torsades, Lupus, Digitalis toxicity, Myasthenia gravis. A/R PR, QRS, & QT widening, AV block, Cardiac arrest, hypotension, seizures, Reflex tach, PVCs, VT, VF, CNS depression, Confusion. S/C Potent vasodilating & inotropic effects, Discontinue if hypotension developes, the QRS widens by 50%, hypotension with to rapid an infusion, Carefully monitor VS & ECG,

Front 17

ACTIVATED CHARCOAL
(Absorbent)
for
oral poisons

Back 17

Adult dose 1-2gm/kg PO or NGT
Pedi dose same
CONTRA comatose pt, after ingestion of corrosives, caustics, petroleum distillates. S/C often used in conjunction with Magnesium citrate.

Front 18

ALBUTEROL
(sympathomimetic, bronchodilator)
for
COPD ASTHMA

Back 18

Adult dose 2.5mg dilute 0.5ml of 0.5% solution for inhalation with 2.5ml NS in neb over 10-15min. MDI 1-2 puffs (90-180mcg) 5min between inhalations.
Pedi dose 0.01-0.03ml (0.05-0.15mg/kg dose in 2ml NS Q 20min x3.
D/I Beta-blockers are antagonistic, Tricyclic antidepressants may potentiate vasculature effects.
S/C only admin by inhalation pre-hospital.

Front 19

AMINOPHYLLINE
(Xanthine bronchodilator)
theophylline derivative
for
limited usefulness in EMS may be used inrefractory COPD, interfacility transfers, bronchospasm.

Back 19

Adult dose loading 5-6mg/kg in 60-100ml diluent over 30min IV infusion not to exceed 20mg/min. maintenance infusion first 12hrs 0.5-0.7mg/kg/hr (lower dose for elderly, CHF liver disease)
Pedi dose 5-6mg/kg in 50-100ml diluent IV infusion. Maintenance infusion first 12 hrs 1.0mg/kg/hr. S/C Therapeutic to toxic ratio is narrow! dose should be halved in pt already taking theophylline preparation.

Front 20

IPRATROPIUM BROMIDE
(Bronchodilator)
used in bronchospasm associated with COPD< Emphysema

Back 20

Adult dose 2-3 puffs via MDI 3-4xday max 12 puffs/day. ALT 500mcg NEB q 6-8hrs (may mix with Albuterol if used within 1hr)
Pedi dose <12yo 1-2 puffs MDI max 8 puffs/day ALT 250mcg NEB q6-8hrs (may mix with Albuterol if used within 1hr) CONTRA Hypersensitivity to Atropine or its derivatives.

Front 21

DEXAMETHASONE SODIUM PHOSPHATE
(Corticosteroid)
for
Anaphylaxis, Asthma, Spinal cord injury, Croup, Elevated ICP (prevention and treatment) as an adjunctto treatment for shock.

Back 21

Adult dose 10-100mg IV(1mg/kg slow IV bolus) call med control for variance.
Pedi dose 0.25-1mg/kg dose IV,IO,IM

Front 22

DEXTROSE
(Carbohydrate, hypertonic solution)
for
Hypoglycemia, altered level of consciousness, coma, seizure,

Back 22

Adult dose 12.5-25gm slow IV as needed.
Pedi dose 0.5-1gm/kg dose slow IV as needed.
CONTRA intracranial hemorrhage, Delirium tremens, ineffective without Thiamine. S/C admin Thiamine before D50 in known alcoholic pt, Draw blood sugar before admin, do not admin to pt with CVA unless hypoglycemia is documented.

Front 23

DIAZEPAM
Valium, Diastat
(Benzo, sedative, anticonvulsant)
for
Seizure activity, Acute anxiety, Acute alchohol withdrawal, muscle relaxant, agitation,

Back 23

Adult dose Seizure activity 5-10mg IV q10-15 prn max 30mg
for cardioversion 5-15mg IV over 5-10min prior to.
Pedi dose seizure 0.2-0.3mg/kg dose IV q 15-30min (no faster than 3mg over 5min)max 10mg/kg Rectal 0.5mg/kg via 2" rectal cath & flush with 2-3mlair S/P admin
CONTRA Glaucoma, head injury. A/R hypotension, respiratory depression, ataxia, tachycardia, thrombosis, phlebitis

Front 24

DIAZOXIDE
(Vasodilator)
for
Hypertensive crisis, especially in pre-clampsia

Back 24

Adult dose 5mg/kg IVP over 10-30sec.
Pedi dose same.
CONTRA hypotension, Labor, dissecting aortic aneurysm. A/R CVA, tachycardia, angina, dysrhythmia, cerebral ischemia, hyperglycemia. S/C admin to pt only in supine position, Extravasation can cause necrosis.

Front 25

DIPHENHYDRAMINE
BENADRYL
(Antihistamine, Anticholinergic)
for
Allergies, Allergic reactions, Anaphylaxis, Motion sickness, hay fever

Back 25

Adult dose 25-50mg IV,IM,PO
Pedi dose 1-2mg/kg IV,IO slow IM if given PO 5mg/kg in 24hrs.
CONTRA Asthma, glaucoma, Pregnancy, Hypertension, infants, pt taking MOIs A/R Sedation Hypotension, Seizures, Palpations, Dysrhthmias,

Front 26

FUROSEMIDE
LASIX
(loop diuretic)
for
CHF, Pulmonary edema, Hypertensive crisis

Back 26

Adult dose 0.5-1.0mg/kg slow IV
Pedi dose !mg/kg IV/IO
CONTRA must be able to pea Anuria, Hypovolemia, Hypotension S/C Ototoxicity & deafness can occur with rapid admin.

Front 27

GLUCAGON
(Hypoglycemic agent, pancreatic hormone, insulin antagonist)
for
Hypoglycemia, Beta-blocker overdose

Back 27

Adult dose 0.5-1mg IM,SC, slow IV q20min prn
Pedi dose 0.03-0.1mg/kg (dose not to exceed 1mg) q20min IM,IO,SC, slow IV. CONTRA Hyperglycemia. S/C should always be used in conjunction with D50 whenever possible. if pt not responding to 2nd dose must admin D50

Front 28

GLYCOPROTIEN IIb/IIa INHIBITORS
Blocks platelet aggregation & thrombus formation.
for
Unstable angina not responsive to conventional med therapy, & within 24hrs of planed angioplasty.

Back 28

Dose variable depending on brand used. CONTRA hemorrhage, surgery, trauma within last 6 weeks, Intracranial tumor, A/R Major bleeding, Intracranial bleeding, Thrombocytopenia.

Front 29

HEPARIN SODIUM
(Anticoagulant)
for
Venous thrombosis, Pulmonary embolus, Coronary occlusion, Disseminated intravascular coagulation,

Back 29

Adult dose loading dose 80units/kg IV Maintenance dose 18units/kg/hr IV
Pedi dose loading 50units/kg IV Maintenance dose 7.5units/kg/hr IV CONTRA pt on antiplatelet drug. A/R Hemorrhage, Thrombocytopenia.

Front 30

LORAZEPAM
Ativan
(Benzo, Sedative, Anticonvulsant)
for
Status epilepticus, Seizures, severe anxiety, Sedation
Dose

Back 30

Adult dose when given IV/IO must dilute with = amount NS IM not to be diluted 2-4mg slow IV 2mg/min or IM may repeat in 15-20min max 8mg. for sedation 0.05mg/kg up to 4mg IM
Pedi 0.05-0.2mg/kg slow IV,IO IM may repeat in 15-20min max 0.2mg/kg

Front 31

LORAZEPAM
Ativan
(Benzo, Sedative, Anticonvulsant)
for
Status epilepticus, Seizures, severe anxiety, Sedation CONTRA S/C A/R

Back 31

CONTRA Glaucoma, Shock, Coma. S/C Monitor BP & respiratory rate, have advanced airway equipment ready,

Front 32

ASPIRIN
(platelet inhibitor, Anti-inflammatory agent)
for
CP

Back 32

Adult dose 160-325mg tabs chewable.
CONTRA GI bleeding, not for Pedi pt

Front 33

METOPROLOL
(Antianginal, antihypertensive, Beta-blocker)
for
Hypertension, Angina, A-fib/A-flutter

Back 33

Adult dose IV Hypertension 1.25-5mg q6-12hrsin pt unaable to take PO
Myocardial infarction (acute) IV 5mg q5-10min up to 3 doses
CONTRA Sinus brady, 2nd or 3rd HB except in pt with pacer, Cardiogenic shock, pregnancy 2nd or 3rd trimesters A/R CHF, Bradycardia,

Front 34

MIDAZOLAM
VERSED
(short acting Benzo, CNS depressant)
for
ET or Nasotracheal intubation

Back 34

Adult dose 0.5-2.5mg slow IVP may be repeated to a max of 0.1mg/kg
Pedi dose (6 months to 5yo) 0.05-0.1mg/kg IV max dose 5mg
(6-12yo) 0.1mg/kg IV max dose 8mg
CONTRA OD, Shock, coma, alcohol intoxication, other Benzo's or Narcotics
S/C admin ASAP to intubation, monitor VS, Never admin as IV bolus

Front 35

MORPHINE SULFATE
(opioid analgesic)
for
Pain

Back 35

Adult dose 1-3mg IV, IM, SC q5min max 10mg
Pedi 0.1-0.2mg/kg IV q5min max 5mg
CONTRA Head injury, hypotension, COPD, Undiagnosed ABD pain
S/C Naloxone should be readily available as antidote A/R Respiratory depression, Hypotension, Bradycardia, syncope

Front 36

SODIUM BICARBONATE 8.4%
(Buffer Alkalinizer)
for
Acidosis, S/P long arrest, TCA overdose, Hyperkalemia, Phenobarbital OD,

Back 36

Adult dose 1mEq/kg IV may repeat with 0.5mEq/kg q10min
Pedi same as adult
CONTRA Alkalosis, Hypocalcemia, Hypokalemia, Hypocloremia S/P GI loss & vomiting S/C must ventilate pt after admin, may worsen CHF
A/R tetany, seizures, Metabolic alkalosis, Hypokalemia, Tissue sloughing at injection site

Front 37

VASOPRESSIN
(Pitressin)
alternitive pressor to EPI for any CARDIAC ARREST/VF/ PULSELESS VT/ASYSTOLE/PEA can replace 1st or 2nd dose of EPI also used for hemodynamic support in septic shock

Back 37

MOA: non-adrenergic peripheral vasoconstrictor increase in blood flow to heart and brain PRECAUTIONS half life 10 to 20sec not recommended in CAD DOSE pulseless pt 40u IV single dose 1 time only TO REPLACE 1st or 2nd DOSE EPI can defib every 2min after admin ET dose 2-2.5 times IV dose

Front 38

VERAPAMIL
CLASS: calcium channel blocker INDICATIONS: alternative drug after Adenosine for SVT CONTRA: left ventricular dysfunction cardiogenic shock, 2nd or 3rd degree AV block, severe hypotension, severe heart failure.

Back 38

MOA: systemic vasodilation negative Inotropic effect Prolongs AV nodal conduction time. PRECAUTIONS: expect decrease in BP can be counteracted with calcium do not use with wide complex. DOSE: 2.5 to 5.0mg IV bolus over 2min with BP and ECG monitoring 2nd dose 5.0 to 10.0mg in 15 to 30min.