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76 Cards in this Set

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Activated Charcoal
- Antidote
Type: Adsorbent + laxative

Actions: Binds w/poison in the stomach to decrease absorption of the poison into the body

Indications: toxic ingestion
Dose/Route: varies, 25-100G +H20
SE: Constipation; abd pain; constipation; vomiting; diarrhea; temporary darkening of the stool; vomiting
AE: Avoid with corrosives, caustics, petroleum products, GIB
Adenosine (Adenocard)
- Endogenous nucleoside
Type: Antidysrhythmic
Actions: Adenosine slows conduction time through the A-V node, can interrupt the reentry pathways through the A-V node, and can restore normal sinus rhythm in patients PSVT, including PSVT associated with Wolff-Parkinson-White Syndrome.
Dose/Route:
SE: lighheadedness, paresthesias, SOB, cp, sense of impending doom, transient -> prolonged asystole, possible VF
AE: death, complications with digoxin use, with heart blocks or SSS
Drug Interactions:
- Antagonized by methylxanthines (caffeine & theophylline)
- Potentiated by Dipyridamole
- Potentiated AV-nodal blocking by Carbamazepine
Albuterol (Proventil, Ventolin)
- Bronchodilator, Beta2 Agonist, Sympathomimetic
Type: Bronchodilator, Beta2 Agonist, Sympathomimetic
Actions: Relaxes bronchial & peripheral vascular smooth muscles
Indications: Bronchospasms (prevention and/or relief)
Dose/Route: 2.5mg/3mL nebulizer; MDI: 90mcg/metered spray
SE: Restlessness, apprehension, dizziness, palpitations, tachycardia, dysrhythmias
AE: May precipitate angina or dysrhythmias. Avoid if hx of cardiac dysrhythmias or hypersensitivity with albuterol.
Amiodarone (Cordarone)
- Antidysrhythmic, multiple mechanisms of action
Type: Antidysrhythmic
Actions: prolongs action potential & refractory period
Indications: prevent or treat VF, VT
Dose/Route: varies by use 300mg IV initial dose in arrest;
SE:/AE: hypotension, headache, dizziness, bradycardia, AV conduction abnormalities, flushing, abn sensations
Contraindications: Pulmonary congestion; cardiogenic shock; hypotension; sensitivity
Aspirin (ASA)
-
Type: Analgesic, Antiinflammatory, Antipyretic, Antiplatelet
Actions: blocks pain impulses in CNS, dilates peripheral vessels, impairs platelet aggregation
Indications: pain, fever, ischemia, thromboembolism, USA, MI
Dose/Route: varies by use 325-650mg PO (pain, fever); 160-325mg (MI)
Effects: Stomach irritation, heartburn or indigestion, n/v, allergic rxn; decreased effect with antacids and steroids, can aggravate asthma
OD: respiratory distress, fever, confusion, TINNITUS
Contraindications: GIB, active ulcer, hemorrhagic stroke, bleeding disorders, children with flu-like symptoms
Atropine
- Parasympatholytic
Type: Anticholinergic
Actions: blocks vagal effects -> increased HR and AV conduction; inhibits salivary & bronchial secretion
Indications: symptomatic bradycardia, organophosphate or nerve gas poisoning, bronchospasms
Indications:
- Bradycardia (increase heart rate)
- Second and third degree heart block (improve conduction)
- PEA / Asystole
- Insecticide exposures (e.g. anti-cholinesterases, organophosphates)
and nerve gas exposure.
- For bradycardia not due to hypoxia when using Succinylcholine.
BRADYCARDIA: 0.5 mg - 1.0 mg, IV/IO
(every 3-5 min. Max -3 mg IV)

PEA /ASYSTOLE: 1.0 mg IV/IO, 2.0 mg ET,
(every 3-5 min. Max -3 mg IV, 4 mg ET)

ORGANOPHOSPHATES: 1.0 - 2.0 mg, IV/IO

SE: tachycardia, paradoxical brady when pushed too slow or under dosed; palpitations, dysrhythmias, HA, dizziness, anticholinergic effects, n/v, flushed, hot dry skin

Contraindications: tachycardia, hypersensitivity, narrow angle glaucoma, thyrotoxicosis; Atrial fibrillation and atrial flutter (increased conduction may speed ventricular rate excessively.)
Not used in neonatal resuscitation.
Calcium Choride 10%
Calcium Gluconate 10%
Type: Electrolyte
Actions: Enables muscular contractility and blood coagulation
Indications: Hyperkalemia, hypocalcemia, calcium channel blocker toxicity, hypermagnesemia
*also: treatment of Hydrogen Fluoride exposure
Dose/Route: 2-4mg/kg (usually 1-2G) slow IVP
Adverse Effects: Bradycardia, possible asystole, hypotension, metallic taste, severe localized necrosis and sloughing after IV infiltration or IM
May worsen dysrhythmias with digitalis
Contraindications: Hypercalcemia and hypercalciuria (hyperthyroidism, Vitamin D overdose, bone metastases), VF, Digitalis toxicity (^^?!), renal or cardiac disease
Cefazolin (Ancef, Kefzol)
Type: Antibiotic
Actions:
Indications: Respiratory Tract Infections: Due to S. pneumoniae, S. aureus and S. pyogenes.
Urinary Tract Infections: Due to E. coli, P. mirabilis.

Skin and Skin Structure Infections: Due to S. aureus (including beta-lactamase-producing strains), S. pyogenes, and other strains of streptococci.

Biliary Tract Infections: Due to E. coli, various strains of streptococci, P. mirabilis, and S. aureus.

Bone And Joint Infections: Due to S. aureus.

Genital Infections: (i.e., prostatitis, epididymitis) Due to E. coli, P. mirabilis.

Septicemia: Due to S. pneumoniae, S. aureus (including beta-lactamase-producing strains), P. mirabilis, E. coli.

Endocarditis: Due to S. aureus (including beta-lactamase-producing strains) and S. pyogenes.
Dose/Route: varies by use- 250mg-1G every 6-8 or 12 hrs for most infections
Special mixing method for IV administration.
Adverse E: Diarrhea, oral candidiasis (oral thrush), vomiting, nausea, stomach cramps, anorexia and pseudomembranous colitis.
Contraindications: Sensitivity to cephalosporins or penicillins
Clopidogrel (Plavix)
Type: Anticoagulant
Actions: Prevents platelet aggregation
Indications: prevent/minimize clotting in MI, CVA
Dose/Route: Home: 75mg PO,
(UA/NSTEMI): Initial: 300 mg loading dose, followed by 75 mg once daily for 1 to 12 months (in combination with aspirin 75 to 162 mg once daily indefinitely).
(PCI) for UA/NSTEMI or STEMI:
Loading dose: 300 to 600 mg (600 mg may be preferred for early invasive strategy with UA/NSTEMI) given as early as possible before or at the time of PCI followed by 75 mg once daily.

Adverse Effects: uncontrolled, unusual bleeding & bruising, chest pain/heaviness, sudden numbness or weakness, sudden HA, confusion, vision changes, neuro changes, pale or jaundiced skin, fever, itching
Contraindications: Bleeding or clotting disorders; hx of CVA/TIA, stomach ulcer or ulcerative colitis, kidney disease.
Multiple med interactions
Clorazepate (Tranzene)
Type: Benzodiazepene
Actions:
Indications: anxiety disorders, partial seizures, or alcohol withdrawal symptoms, off-label uses
Dose/Route:
SE: confusion, unusual thoughts or behavior;
depressed mood, thoughts of suicide or hurting yourself;
muscle twitching, tremor; or
problems with urination.

Contraindications: sensitivity to benzos, pregnancy, EtOH
Cyclobenzaprine (Flexeril)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
Dexamethasone (Decadron)
TYPE: Antiinflammatory

ACTIONS:
allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, or breathing disorders. Off-brand.

INDICATIONS:
- Moderate to severe asthma/COPD
- Severe allergic reaction.
- Croup
DOSE/ROUTE:
RESP. DISTRESS, SEVERE ALLERGIC RXN / ANAPHYLAXIS: 10 mg IV/IO, IM, or PO.

PEDIATRIC: 0.3 mg/kg IV, IO, IM or PO.

ADVERSE EFFECTS: vision problems;
swelling, rapid weight gain, SOB; seizure (convulsions);
bloody or tarry stools, hemoptysis;
pancreatitis;
low potassium; or
dangerously high blood pressure,uneven heartbeats.

CONTRAINDICATIONS:
Hypersensitivity to corticosteroids.
Dextrose 50%
TYPE: Hypertonic solution

ACTIONS: Fluid and nutrient replenishment

INDICATIONS:
Hypoglycemia; Unconscious patient when history is unobtainable.
DOSE/ROUTE:
HYPOGLYCEMIA (ALTERED MENTAL STATUS): 25 g (50 cc) slow IV

PEDIATRIC DOSING * (may repeat once)
Patients greater than 10 kg: 1 ml / kg of D50% (max of 50 ml.)

Patients less than 10 kg: 2 ml / kg of D25%

ADVERSE EFFECTS:

CONTRAINDICATIONS: CVA s/s with normal BGL is a relative contraindication

intracranial or intraspinal hemorrhage is present, nor in the presence of delirium tremens if the patient is already dehydrated.

Dextrose injection without electrolytes should not be administered simultaneously with blood through the same infusion set because of the possibility that pseudoagglutination of red cells may occur.
Diazepam (Valium)
TYPE: Benzodiazepine

ACTIONS: Anxiolytic, anti-seizure
INDICATIONS: Anxiety, EtOH withdrawal, seizures, premed prior to TCP or cardioversion
DOSE/ROUTE: varies
SEIZURE: 5mg over 2mins (max of 10mg) q 10-15

CARDIOVERSION/TCP:
5-15mg IV

ADVERSE EFFECTS:
Hypotension; Reflex tachycardia, resp depression, ataxia, psychomotor impairment, confusion, nausea

CONTRAINDICATIONS: Coma, shock, CNS depression, resp depression
Dicyclomine (Bentyl, Dibent, Dicyclocot)
TYPE: Antispasmodic and anticholinergic (antimuscarinic) agent.

ACTIONS: relieves smooth muscle spasms of the muscles in the stomach and intestines.

INDICATIONS: Functional bowel or irritable bowel syndrome.
DOSE/ROUTE:
- 80-160 mg per day (in 4 equally divided doses) x2wks.

ADVERSE EFFECTS:
- Dry Mouth, dizziness, blurred vision, nausea, lightheadedness, drowsiness, weakness, nervousness

- Rare reports of dependency and/or abuse for its anticholinergic effects

CONTRAINDICATIONS:
- Evidence of prior hypersensitivity to Dicyclomine hydrochloride or other ingredients in this formulation, obstructive uropathy, obstructive disease of the gastrointestinal tract, severe ulcerative colitis,
reflux esophagitis, unstable cardiovascular status in acute hemorrhage, glaucoma, myasthenia gravis, infants less than 6 months of age, nursing mothers
Diltiazem (Cardizem)
TYPE: Calcium Channel Blocker or Antagonist

ACTIONS: slows conductions, increases AV node refractoriness, coronary and peripheral vasodilaton

INDICATIONS:
A-fib, A-flutter, MAT, PSVT
DOSE/ROUTE: varies on use
0.25mg/kg over 2mins

ADVERSE EFFECTS:
A-flutter, 1&2nd AVB, brady, hypotension, cp, CHF, V dysrhythmia, dry mouth, dyspnea, HA

CONTRAINDICATIONS:
SSS, 2nd or 3rd degree, hypotension, cardiogenic shock, WPW or short PR syndrome, IV beta blockers, VT, WCT, AMI
Diphenhydramine (Benadryl)
TYPE: Antihistamine

ACTIONS: blocks the effects of the histamine in the body.

INDICATIONS:
- second-line drug in anaphylaxis and severe allergic reactions (after epinephrine).
- acute dystonic and dysphoric reactions to anti-psychotic drugs.
DOSE/ROUTE:
ANAPHYLAXIS: 1 mg / kg to a max of 50 mg, IV or deep IM

ADVERSE/SIDE EFFECTS:
blocks the effects of the naturally occurring chemical histamine in the body.

CONTRAINDICATIONS:
Taking MAOI; narrow angle glaucoma; newborn & nursing
Diprivan (Propofol)
TYPE: Sedative-hypnotic

ACTIONS:
- induction and maintenance of general anesthesia, sedation for mechanically ventilated adults, and procedural sedation.

INDICATIONS: anaesthesia and sedation
DOSE/ROUTE: Determined by physician/anaesthesiologist

ADVERSE EFFECTS:
- Vasodilation -> hypotension, apnea, pain on injection, especially in smaller veins, dystonia, mild myoclonic movements.
- Propofol Infusion Syndrome: metabolic derangements and organ system failures, characterized by severe metabolic acidosis, hyperkalemia, lipemia, rhabdomyolysis, hepatomegaly, cardiac and renal failure.
- *Has NOT been known to trigger malignant hyperpyrexia.*

CONTRAINDICATIONS:
- Hypersensitivity, allergies to eggs, egg products, soybeans or soy products.
Dobutamine (Dobutrex)
TYPE: Sympathomimetic

ACTIONS:
- Synthetic catecholamine that stimulates beta1, has much less effect on beta 2 and alpha adrenergic receptors --> +inotropic, w/minimal chronotropic or systemic vascular resistance

INDICATIONS:
- CHF
- Left ventricular dysfunction
DOSE/ROUTE:
- 2.5-10mcg/kg/min (max 40mcg/kg/min)

ADVERSE EFFECTS:
- Headache, dose-related tachydysrhythmias, hypertension, ventricular ectopy

CONTRAINDICATIONS:
- tachydysrhythmias (AF, AFlutter), severe hypotension, IHSS
Dopamine (Intropin)
TYPE: Sympathomimetic

ACTIONS:
- Acts on alpha1 and beta1 receptors, dose-dependent systemic effects

INDICATIONS:
- Hypotension associated with cardiogenic shock
DOSE/ROUTE:
- 1-5/5-20mcg/kg/min

ADVERSE EFFECTS:
- Dose-related tachydysrhythmias, hypertension, increased myocardial oxygen demand

CONTRAINDICATIONS:
Epinephrine (Adrenalin)
TYPE: Sympathomimetic

ACTIONS:
- stimulates alpha, beta1, and beta2 receptors -> vasoconstriction, relieve bronchial smooth muscles and increase blood pressure

INDICATIONS:
- bronchial asthma, acute allergic reaction/anaphylaxis, cardiac arrest, profound systemic bradycardia
DOSE/ROUTE:
- varied depending on use

ADVERSE EFFECTS:
- headache, nausea, restlessness, weakness, dysrhythmias (including VT and VF), hypertension, precipitation of angina, tachycardia

CONTRAINDICATIONS:
- hypersensitivity (relative contraindication), hypovolemic shock, coronary insufficiency
+ Etomidate (Amidate)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
- Fentanyl (Sublimaze)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Flumazenil (Romazicon)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
Furosemide (Lasix)
TYPE: Diuretic

ACTIONS: decreases sodium and H2O reabsorption in ascending limb of loop of Henle

INDICATIONS:
CHF, pulmonary edema
DOSE/ROUTE:
PO: 20-40mg/dose
IV: 40-80mg/dose

ADVERSE EFFECTS:
Hypotension, electrolyte imbalance(s) -> EKG disturbances, hearing loss if administered too fast

CONTRAINDICATIONS:
Anuria, hypovolemia/dehydration, severe electrolyte depletion
Glucagon
TYPE: Pancreatic hormone, insulin antagonist

ACTIONS:
- released by alpha cells of pancreas -> elevate blood sugar by increasing breakdown of liver glycogen to glucose

INDICATIONS:
- persistent hypoglycemia despite glucose supplementation,
- unable to administer glucose by other means
DOSE/ROUTE:
- 0.5-1mg IM, may repeat in 7-10mins

ADVERSE EFFECTS:
- Tachycardia, hypotension, n/v, urticaria

CONTRAINDICATIONS: hypersensitivity
Glycoprotein Inhibitors (Aggrastat, Integrilin, ReoPro)
TYPE: Anti-platelet drugs

ACTIONS:
- Prevent platelet aggregation/blood clot formation

INDICATIONS: Unstable angina, PCI
DOSE/ROUTE:
varies by use and particular drug

ADVERSE EFFECTS:
- Abnormal bleeding, decreased platelet count

CONTRAINDICATIONS: hypersensitivity, bleeding disorders
Haloperidol (Haldol)
TYPE: Antipsychotic

ACTIONS:
- Mental illness (schizophrenia), behavioral problems, agitation

INDICATIONS:
- Mental illness (schizophrenia), behavioral problems, agitation
DOSE/ROUTE:
- oral varies by patient
- 2-5mg IM

ADVERSE EFFECTS:
- drowsiness, tachycardia, dry mouth, insomnia, visual changes, muscle stiffness, dystonia, arrhythmia, sexual dysfunction, cardiac dysrhytmias including VF, VT, TDP
- potentially fatal potentially fatal neuroleptic malignant syndrome and QT prolongation

CONTRAINDICATIONS:
- hypersensitivity, cardiac disease, alcohol or other CNS depressants
+ Heparin (LMWH)
Enoxaparin (Lovenox)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
- Heparin (Unfractionated)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Hydrocodone (Vicodin)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Hydrocodone (Vicodin)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Hydromorphone (Dilaudid)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Insulin
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Ipratropium (Atrovent)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Keflex
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Ketamine (Ketalar)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Ketorolac (Toradol)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
- Levaquin
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Lidocaine
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Lorazepam
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Magnesium sulfate
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Mannitol
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
- Meclizine (Antivert)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
- Metoprolol (Lopressor)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Metaproterenol (Alupent/Metaprel)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Methylprednisolone
(Solu-Medrol)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
- Metoclopramide (Reglan)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Midazolam (Versed)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Morphine Sulfate
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Naloxone (Narcan)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Nitroglycerin
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
+ Nitrous Oxide
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
- Olazapine (Zyprexa)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
-Ondansetron (Zofran)
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
- Opthaine / Tetracaine
TYPE:

ACTIONS:

INDICATIONS:
DOSE/ROUTE:

ADVERSE EFFECTS:

CONTRAINDICATIONS:
- Oxycodone (Percocet)
TYPE: Opioid analgesic

ACTIONS: Decreased sensory neurons' ability to propagate pain impulses to spinal cord and brain

INDICATIONS: Chronic pain
DOSE/ROUTE:
- 10-30mg orally QD for initial or maintenance
- Cancer pain: 20-240mg controlled released QD

ADVERSE EFFECTS:
- Drowsiness, constipation, n/v, itching, urine retention, especially with BPH, respiratory depression, coma

CONTRAINDICATIONS: Hypersensitivity to oxycodone or its ingredients
Pantoprazole (Protonix)
TYPE: Proton pump inhibitor

ACTIONS:
- reduced acids produced in stomach -> healing and maintenance of errosive esophagitis, relief of heartburn symptoms

INDICATIONS:
-erosive esophagitis, long-term heartburn, and other conditions involving excess stomach acid such as Zollinger-Ellison syndrome.
DOSE/ROUTE:
40mg QD (x8wks for healing or ongoing for maintenance)

ADVERSE EFFECTS:
- headache, diarrhea, abdominal pain, nausea, vomiting, flatulence, dizziness, arthralgia

CONTRAINDICATIONS:
- allergy to drug ingredients, on anticoagulants, pediatric
Prednisone
TYPE: Corticosteroid

ACTIONS:
- prevents release of substances that cause inflammation.

INDICATIONS:
- used to treat many different conditions such as allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, or breathing disorders.
DOSE/ROUTE:
- 5 mg to 60 mg per day

ADVERSE EFFECTS:
- Common side effects: Difficulty sleeping; feeling of a whirling motion; increased appetite; increased sweating; indigestion; mood changes; nervousness.

CONTRAINDICATIONS:
- systemic fungal infections and known hypersensitivity.
Prochloreperazine (Compazine)
TYPE: Dopamine antagonist

ACTIONS: Anti-emetic, antipsychotic

INDICATIONS:
- Nausea, vomiting secondary to neoplastic disease, radiation sickness, opioids, cytotoxic drugs and general anaesthetics
- treat psychotic disorders such as schizophrenia. It is also used to treat anxiety
DOSE/ROUTE:
- N/V: (1) 5-10mg oral or deep IM q 3-4hrs up to 40mg QD; 25mg BID PR; 2.5-10mg slow IVP
- similar for other usages

ADVERSE EFFECTS: extrapyramidal reaction, sedation
*Neuroleptic Malignant Syndrome (NMS),*

CONTRAINDICATIONS:
- hypersensitivity to phenothiazines.
- comatose states or in the presence of large amounts of central nervous system depressants; under 2 years of age or under 20 lbs.
Promethazine (Phenergan)
TYPE: Antihistamine

ACTIONS: Anti-emetic

INDICATIONS:
- Motion sickness, med side effects, chemotherapy, morning sickness
-Anaphylaxis, allergic Reaction, allergic rhinitis, light sedation, motion sickness, opiate adjunct, urticaria, sedation, vertigo
DOSE/ROUTE:
- IV:12.5-25mg
- PO: 25mg q 4-6hrs
- IM: 25-50mg VERY SLOW, VERY PAINFUL!
- PR: 12.5-25mg

ADVERSE EFFECTS:
- extrapyramidal reaction, sedation, tardive dyskinesia; confusion in the elderly; drowsiness, dizziness, fatigue, more rarely vertigo; dry mouth; respiratory depression in patients under age of 2 and in those with severely compromised pulmonary function; constipation; chest discomfort/pressure. (typically in cases when patient is already taking medication for high blood pressure); euphoria (very rare, except with high IV doses and/or coadministration with opioids/CNS depressants); akathisia; aresthesia; short temper/Irritability
Rare: Seizures, neuroleptic malignant syndrome

CONTRAINDICATIONS:
- less than 2yrs old; hypersensitivity
Racemic Epinephrine (microNEFRIN)
TYPE: Sympathomimetic

ACTIONS:
-bronchodilator, beta2 stimulant, alleviates bronchospasms, increases vital capacity, reduces airway resistance; reducing laryngeal edema; inhibits histamine release

INDICATIONS:
- bronchial asthma, bronchospasms, croup (laryngotracheobronchitis), laryngeal edema
DOSE/ROUTE:
Nebulizer: 5mL (1%): 5mL NS over 15mins

ADVERSE EFFECTS:
- tachycardia, dysrhythmias, cardiac irritability

CONTRAINDICATIONS:
- hypertension, underlying cardiovascular disease, epiglottitis
Rocephin
TYPE: Cephalosporin antibiotic

ACTIONS: Fights infection

INDICATIONS: various infections
DOSE/ROUTE:
- varies, IV or IM administration

ADVERSE EFFECTS:
- diarrhea that is watery or bloody; fever or chills; skin rash, bruising, severe tingling, numbness, pain, muscle weakness;
blistering, peeling, and red skin rash; white patches or sores inside mouth or lips; pale or yellowed skin, dark colored urine, confusion or weakness; urinating less than usual or not at all;
swelling, pain, or irritation where the injection was given; or
chalky-colored stools, stomach pain just after eating a meal, nausea, heartburn, bloating, and severe upper stomach pain that may spread to your back.

CONTRAINDICATIONS: hypersensitivity to cephalosporins
Sodium bicarbonate
TYPE: Buffer, alkalinizing agent, electrolyte supplement

ACTIONS:
- buffer metabolic acidosis

INDICATIONS:
- TCA OD, ROSC, prolonged cardiac arrest, specific intoxications, DKA
DOSE/ROUTE:
1mEq/kg IV

ADVERSE EFFECTS:
Metabolic acidosis, hypoxia, rise in intracellular PCO2 -> increased tissue acidosis, hypernatremia, seizures, tissue sloughing at injection site

CONTRAINDICATIONS:
Succinylcholine (Anectine)
TYPE: Depolarizing neuromuscular blocker

ACTIONS:
- Quick onset, briefest duration of this class of drugs
- Paralytic for RSI, cardioversion or defibrillation, terminating laryngospasm, muscle relaxation
- Binds acetylcholine receptors
INDICATIONS:
DOSE/ROUTE:
- 0.3-1.1 mg/kg (25-75mg) over 10-30 sec IV; 0.04-0.07mg/kg to maintain relaxation

ADVERSE EFFECTS:
- Can cause fasciculations and some muscle contractions
- Hypotension, respiratory depression, bradycardia, dysrhythmias, excessive salivation, MALIGNANT HYPERTHERMIA, can exacerbate hyperK+ in hours post-trauma

CONTRAINDICATIONS:
- Acute trauma, hypersensitivity, skeletal muscle myopathies, inability to control airway, personal or family hx of malignant hyperthermia, acute rhabomyolysis
Terbutaline
TYPE: bronchodilator

ACTIONS:
- relaxes smooth muscles in airway

INDICATIONS:
- bronchospasms associated with airway disease
DOSE/ROUTE:

ADVERSE EFFECTS:
- allergic reaction, chest pain, dysrhythmia, headache; dizziness or lightheadedness; insomnia; tremor or nervousness; sweating; nausea, vomiting, or diarrhea; or dry mouth.

CONTRAINDICATIONS: tocolysis, hypersensitivity
Tetanus
TYPE: Immunizing agent

ACTIONS:
Provide immunity to tetanus
INDICATIONS:
DOSE/ROUTE:
- adult (TT): 0.5mL IM, boosters every 10yrs

ADVERSE EFFECTS:
- rare: dyspnea, urticaria, ALOC, fatigue, seizures, fever, headache, severe vomiting, aches, localized seizures

CONTRAINDICATIONS:
- allergy, fever, severe illness or infection
Thiamine (Betaxin)
- Vitamin B1
ACTIONS: Restore Vitamin B1 to therapeutic levels

INDICATIONS:
- Thiamine deficiency, beriberi
- Wernicke’s encephalopathy, infantile beriberi with acute collapse, cardiovascular disease due to thiamine deficiency, or neuritis of pregnancy if vomiting is severe.
- When giving IV dextrose to individuals with marginal thiamine status to avoid precipitation of heart failure.
DOSE/ROUTE:
- beriberi:10 to 20 mg IM TID x2wks
- severe infantile beriberi 25 mg may cautiously be given IV
- Wernicke-Korsakoff syndrome: 100 mg IV initially, followed by IM doses of 50 to 100 mg daily.
- marginal thiamine status to whom dextrose is being administered should receive 100 mg thiamine hydrochloride in each of the first few liters of IV fluid to avoid precipitating heart failure.

ADVERSE EFFECTS:
blue colored lips;
chest pain, dyspnea; black, bloody, or tarry stools;
hematemesis; hemoptysis; nausea, tight feeling in throat; sweating, feeling warm; mild rash or itching; feeling restless; or tenderness or a hard lump where a thiamine injection was given.

CONTRAINDICATIONS: Hypersensitivity
Usasyn (ampicillin and sulbactam)
TYPE: Antibiotic

ACTIONS: Fights infection

INDICATIONS:
Certain skin, intra-abdominal, or vaginal infections.
DOSE/ROUTE:
1.5-3G per 6 hrs via IV infusion or *diluted* IM injection.

ADVERSE EFFECTS:
fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; diarrhea that is watery or bloody; or fever, chills, body aches, flu symptoms; nausea, vomiting, stomach pain, bloating, gas; vaginal itching or discharge; headache; itching; swollen, black, or "hairy" tongue;
thrush (white patches or inside your mouth or throat); or
pain, swelling, or other irritation where the needle is placed.

CONTRAINDICATIONS:
Sensitivity to penicillins or cephalosporins
Vancomycin
TYPE: Antibiotic

ACTIONS:
- fight infection

INDICATIONS:
- serious infections resistant to other antibiotics
DOSE/ROUTE:
-The usual daily intravenous dose is 2 g divided either as 500 mg every 6 hours or 1 g every 12 hours. Each dose should be administered at no more than 10 mg/min or over a period of at least 60 minutes, whichever is longer. Other patient factors, such as age or obesity, may call for modification of the usual intravenous daily dose.

ADVERSE EFFECTS:
hearing loss, tinnitus; dysuria/anuria;fever, chills, body aches, flu symptoms; light-headedness, fainting; skin rash, redness, bruising, severe tingling, numbness, pain, muscle weakness; or severe stomach pain, diarrhea that is watery or bloody; dizziness; nausea; back pain; or muscle pain or tightness

*During or soon after rapid infusion of vancomycin, patients may develop anaphylactoid reactions. Rapid infusion may also cause flushing of the upper body (“red neck”) or pain and muscle spasm of the chest and back. These reactions usually resolve within 20 minutes but may persist for several hours. Such events are infrequent if vancomycin is given by a slow infusion over 60 minutes. In studies of normal volunteers, infusion-related events did not occur when vancomycin was administered at a rate of 10 mg/min or less*

CONTRAINDICATIONS:
- Hypersensitivity
- If solution contains dextrose, can cause reaction in those with corn allergies or sensitivity
Vasopressin
TYPE: Posterior Pituitary Hormone

ACTIONS:
- "Anti-diuretic hormone"
- reduces diuresis, helps kidneys reabsorb water in the body.
- At high doses, stimulates contraction of smooth muscle causing vasoconstriction, increased peristaltic activity, and gall-bladder contractions.

INDICATIONS:
- neurogenic diabetes insipidus
- postoperative abdominal distention
- facilitation of abdominal roentgenography (gotta look that up)
DOSE/ROUTE:
- Varies SQ, IM, or IV administration
- IM / SQ 5 to 10 unit 2 or 3 times daily PRN. IN solution may be given on cotton pledgets, by nasal spray, or dropper.

IM 5 unit initially; subsequent injections every 3-4hrs PRN. May increase the dose to 10 unit if necessary.

IV Infuse initially at 0.2 to 0.4 unit/min and increase to 0.9 unit/min PRN.

ADVERSE EFFECTS:
- Angina; abdominal cramps; nausea; vomiting; gas; gangrene; ischemic colitis; tissue necrosis (with extravasation); allergic reaction (cardiac arrest, tremor, vertigo, sweating).

CONTRAINDICATIONS: Hypersensitivity
Vercuronium (Norcuron)
TYPE:
- Non-depolarizing neuromuscular blocking agent

ACTIONS:
- For sustained neuromuscular blockade in the intubated patient.
- First line agent for Rapid Sequence Induction in the patient where Succinylcholine is contraindicated.

INDICATIONS:
DOSE/ROUTE:
- Initial dose: 0/8-0.1 mg / kg, IV/IO with maintenance infusions

ADVERSE EFFECTS:
- ongoing muscle weakness or paralysis -> respiratory insufficiency or apnea
light-headedness; itching.
- Anaphylaxis

CONTRAINDICATIONS:
- Hypersensitivity
Verapamil (Isoptin, Calan)
TYPE: Calcium Channel Blocker

ACTIONS:
- Antihypertensive, Antidysrhythmic, Anti-anginal
- Inhibits movement of Ca+ ions across cell membranes; decreases atrial automaticity, reduces AV conduction velocity, and prolongs AV nodal refractory period, depresses myocardial contractility, reduces vascular smooth muscle tone, dilates coronary arteries and arterioles in normal and ischemic tissues.
- Prevents vasoconstriction and coronary artery spasms,
- May decrease heart rate

INDICATIONS:
- Hyper
DOSE/ROUTE: 2.5-5.0mg IV bolus over 1-3mins (initial adult dose)

ADVERSE EFFECTS:
Dizziness, headache, n/v, hypotension, bradycardia, complete AV block, peripheral edema

CONTRAINDICATIONS:
- SSS, 2nd or 3rd degree heart block, sinus brady, hypotension, cardiogenic shock, severe CHF, WPW w/AF or AFlutter, on IV beta blockers, WCTs
- Vitamin K (Phytonadione)
TYPE: Fat-soluble vitamin

ACTIONS: aids in clotting

INDICATIONS: vitamin K deficiency, certain bleeding or blood clotting problems, anticoagulant-induced prothrombin deficiency caused by coumadin or indanedione derivatives
DOSE/ROUTE:
- Subcutaneous when possible
- Slow IVP when necessary 2.5mg-10mg, up to 25-50mg
* Protect from light*


ADVERSE EFFECTS:
Death after IV, IM; transient flushing sensation and odd sensations of taste; rarely dizziness; rapid, weak pulse; diaphoresis; hypotension, dyspnea, cyanosis

CONTRAINDICATIONS: hypersensitivity
- Zisprasidone (Geodon)
TYPE: Antipsychotic

ACTIONS: Changes brain chemistry

INDICATIONS: Schizophrenia, manic phase of bipolar disorder, agitation, hallucinations, paranoia, disorganized thoughts
DOSE/ROUTE: 20-80mg BID PO; 10-20mg IM up to 40mg/day

ADVERSE EFFECTS: Dizziness, drowsiness, fatigue, nausea, constipation, runny nose, weight gain, nervousness, increased appetite// Arryhthmia, increased BGL, urinary retention, orthostatic changes, muscle rigidity

CONTRAINDICATIONS:
- history of QT prolongation
- recent AMI
- uncompensated heart failure
Zosyn (Piperacillin/Tazobactam)
TYPE: Antibiotic

ACTIONS: Antibiotic

INDICATIONS: Various infections, e.g. UTI, bone & joint infections, severe vaginitis, stomach and skin infections, pneumonia
DOSE/ROUTE: varies 3.375g Q 6hrs -> 13.5g (12g piper./1.5g tazo.) x 10 days

ADVERSE EFFECTS: Diarrhea, jaundice, dark urine, fever, ALOC, weak/dizziness, tachycardia, bruising, bleeding, dry mouth, myalgia, fever, chills, aches, seizures

CONTRAINDICATIONS: