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133 Cards in this Set
- Front
- Back
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Class:
Activated Charcoal |
Absorbant
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MoA:
Activated Charcoal |
Adsorbs toxic substances from the gastrointestinal tract; onset of action is immediate.
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INDIJ:
Activated Charcoal |
Most oral poisonings and medication overdoses; can be used after evacuation of poisons.
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COINJS:
Activated Charcoal |
Oral administration to comatose patient; after ingestion of corrosives, caustics, or petroleum distillates (ineffective and may induce vomiting); simultaneous administration with other oral drugs.
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ADRS:
Activated Charcoal |
May induce nausea and vomiting; may cause constipation; diarrhea; may cause black stools.
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DI:
Activated Charcoal |
Bonds with and generally inactivates whatever it is
mixed with, eg, syrup of ipecac. |
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How Supplied:
Activated Charcoal |
25 g (black powder)/125-mL bottle (200 mg/mL); 50 g
(black powder)/250-mL bottle (200 mg/mL). |
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Dos & ADMIJ
Activated Charcoal |
Note: if not in premixed slurry, dilute with
1 part charcoal/4 parts water. Adult: 1–2 g/kg PO or via NGT. Pediatric: 1–2 g/kg PO or via NGT |
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DOA:
Activated Charcoal |
Depends on gastrointestinal function; will act until excreted.
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Special Considerations:
Activated Charcoal |
Often used in conjunction with magnesium citrate. Must be stored in a closed container. Does not adsorb cyanide,lithium, iron, lead, or arsenic.
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Class:
Albuterol |
Sympathomimetic, bronchodilator.
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MoA:
Albuterol |
Elective beta-2 agonist that stimulates adrenergic receptors of the sympathomimetic nervous system resulting in smooth muscle relaxation in the bronchial tree and peripheral vasculature.
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INDJS:
Albuterol |
Treatment of bronchospasm in patients with reversible obstructive airway disease (COPD/asthma). Prevention of exercise induced bronchospasm.
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COINJS:
Albuterol |
Known prior hypersensitivity reactions to albuterol. Tachycardia arrhythmias, especially those caused by digitalis. Synergistic with other sympathomimetics.
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ADRS:
Albuterol |
Often dose-related and include restlessness, tremors, dizziness, palpitations, tachycardia, nervousness, peripheral vasodilatation, nausea, vomiting, hyperglycemia, increased blood
pressure, and paradoxical bronchospasm |
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DI:
Albuterol |
Tricyclic antidepressants may potentiate vasculature effects. Beta-blockers are antagonistic. May potentiate hypokalemia caused by diuretics.
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How Supplied:
Albuterol |
Solution for aerosolization: 0.5% (5 mg/mL). Metered dose inhaler: 90 µg/metered spray (17-g canister with 200 inhalations). Syrup: 2 mg/5 mL.
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Dos & ADMIJ:
Albuterol |
Adult: Administer 2.5 mg (0.5 mL of 0.5% solution) added to 2 mL normal saline for inhalation by nebulizer treatment and administer over 10–15 minutes. MDI: 1–2 inhalations (90–180 µg). Five minutes between inhalations. Pediatric: (between the ages of 2 and 12) Administer 2.5 mg (0.5 mL of 0.083% solution) added to 2 mL normal saline for inhalation by nebulizer treatment and administer over 10–15 minutes. May repeat every 20 minutes, up to three times.
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DOA:
Albuterol |
Onset in 5–15 minutes with peak effect in 30 minutes to 2 hours and duration of 3–4 hours.
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Special Considerations:
Albuterol |
Pregnancy safety: Category C. Antagonized by beta-blockers (eg, Inderal, Lopressor). May precipitate angina pectoris and arrhythmias. Should only be administered by inhalation methodology in prehospital management.
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Class:
Aspirin (acetylsalicylic acid) |
Platelet inhibitor, non-steroidal anti-inflammatory agent, antipyretic
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MoA:
Aspirin (acetylsalicylic acid) |
Decreases synthesis of thrombaxanes; Inhibits platelet aggregation; Acts on hypothalamus to vasodilate peripheral vasculature; Inhibition of cyclo-oxygenase which results in decrease of prostaglandins.
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INDJS:
Aspirin (acetylsalicylic acid) |
New onset chest pain suggestive of acute myocardial infarction. Signs and symptoms suggestive of recent cerebrovascular accident.
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COINJS:
Aspirin (acetylsalicylic acid) |
Hypersensitivity. Relatively contraindicated in patients with active ulcer disease or asthma. Hemorrhagic stroke.
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ADRS:
Aspirin (acetylsalicylic acid) |
Heartburn, GI bleeding, prolonged bleeding, nausea,
and vomiting. Wheezing in allergic patients. Tinnitus. |
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DI:
Aspirin (acetylsalicylic acid) |
Use with caution in patients allergic to NSAIDs. Patients with bleeding disorders. Children with Varicella.
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How Supplied:
Aspirin (acetylsalicylic acid) |
81-mg, 160-mg, or 325-mg tablets (chewable and
standard). |
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Dos & ADMIJ:
Aspirin (acetylsalicylic acid) |
160 mg to 325 mg PO (chewed if possible).
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DOA:
Aspirin (acetylsalicylic acid) |
Onset: 30–45 minutes. Peak effect: variable. Duration:
variable. |
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Special Considerations:
Aspirin (acetylsalicylic acid) |
Pregnancy safety: Category D. Not recommended in pediatric population.
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Class:
Epinephrine |
Sympathomimetic. Endogenous Catecholamine.
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MoA:
Epinephrine |
Direct-acting alpha- and beta-agonist. Alpha:vasoconstriction, histamine inhibition. Beta-1: positive inotropic, chronotropic, and dromotropic effects. Increased automaticity, cardiac output, myocardial work and oxygen demand. Beta-2: bronchial smooth muscle relaxation and dilation of skeletal vasculature, inhibition of mucous production.
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INDJS:
Epinephrine |
Cardiac arrest (V-fib/pulseless V-tach, asystole, PEA), symptomatic bradycardia as an alternative infusion to dopamine, severe hypotension secondary to bradycardia when atropine and transcutaneous pacing are unsuccessful, allergic reactions, anaphylaxis, asthma.; severe bronchospasm exacerbation.
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COINJS:
Epinephrine |
Hypertension, hypothermia, pulmonary edema, myocardial ischemia, hypovolemic shock.
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ADRS:
Epinephrine |
Hypertension, tachycardia, arrhythmias, pulmonary edema, anxiety, restlessness, psychomotor agitation, nausea, headache, angina, CVA
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DI:
Epinephrine |
Potentiates other sympathomimetics, deactivated by alkaline solutions (ie, sodium bicarbonate), monamine oxidase inhibitors (MAOIs) may potentiate effects, beta-blockers may blunt effects.
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How Supplied:
Epinephrine |
1:1,000 solution: ampules and vials containing 1 mg/mL. 1:10,000 solution: prefilled syringes containing 1 mg in 10 mL (0.1 mg/mL). Auto-injector (EpiPen): 0.5 mg/mL (1:2,000).
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Dos & ADMIJ:
Epinephrine |
Adult: Mild allergic reactions and asthma: 0.3–0.5 mg (0.3–0.5 mL of 1:1,000) SC. Anaphylaxis: 0.1 mg (1 mL of 1:10,000) IV/IO over 5 minutes. Cardiac arrest: IV/IO dose: 1 mg (10 mL of 1:10,000 solution) every 3–5 minutes during resuscitation. Follow each dose with 20 mL flush and elevate arm for 10 to 20 seconds after dose. Higher dose: Higher doses (up to 0.2 mg/kg) may be used for specific indications (beta-blocker or calcium channel blocker overdose). Continuous infusion: Add 1 mg (1 mL of 1:1,000 solution) to 500 mL normal saline or D5W. Initial infusion rate of 1 μg/min titrated to effect (typical dose: 2–10 μg/min). Endotracheal (ET) dose: 2–2.5 mg diluted in 10 mL normal saline. Profound bradycardia or hypotension: 2–10 μg/min; titrate to patient response. Pediatric: Mild allergic reactions and asthma: 0.01 mg/kg (0.01 mL/kg) of 1:1,000 solution SC (maximum of 0.3 mL). Cardiac arrest: IV/IO dose: 0.01 mg/kg (0.1 mL/kg) of 1:10,000 solution every 3–5 minutes during arrest. All endotracheal (ET) doses: 0.1 mg/kg (0.1 mL/kg) of 1:1,000 solution. Symptomatic bradycardia: IV/IO dose: 0.01 mg/kg (0.1 mL/kg) of 1:10,000 solution. Continuous IV/IO infusion: Begin with rapid infusion, then titrate to response. Typical initial infusion: 0.1–1 μg/min. Higher doses may be effective.
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DOA:
Epinephrine |
Onset: immediate. Peak effect: minutes. Duration: several minutes.
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Special Considerations:
Epinephrine |
Pregnancy safety: Category C. May cause syncope in asthmatic children. May increase myocardial oxygen demand.
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Class:
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Bronchodilator, adrenergic beta-2 agonist.
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MoA:
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Causes bronchodilation by action on the beta-2 pulmonary receptors to relax smooth muscle as well as produce CNS and cardiac stimulation.
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INDJS:
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Used to treat or prevent bronchospasm in patients 6 years or older. Relaxes the smooth muscles of the lower airways.
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COINJS:
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Known sensitivity to the drug. Hypersensitivity to sympathomimetics, tachyarrhythmias, and severe cardiac disease.
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ADRS:
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Tremors, anxiety, insomnia, headache, dizziness, restlessness, hallucinations, flushing, irritability, vomiting, nausea, palpitations, tachycardia, hypertension, angina, hypotension, and arrhythmias.
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DI:
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Increased actions of aerosol bronchodilators, tricyclic antidepressants, MAOIs, and other adrenergics.
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How Supplied:
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Solution for inhalation 0.63 mg, 1.25 mg/3 mL.
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Dos & ADMIJ:
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For adults and pediatrics over 6 years old: 1.25 mg in 3 mL administered by the nebulizer route. For adults only: 2 puffs by MDI.
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DOA:
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Onset: 5-15 minutes, peak effect: 60–90 minutes,
duration: 6-8 hours. Metabolized in the liver. |
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Special Considerations:
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Crosses the placenta, breast milk, blood-brain barrier. Precautions should be taken with lactation, pregnancy (Class C), cardiac disorders, hyperthyroidism, diabetes mellitus, hypertension, prostatic hypertrophy, narrow-angle glaucoma, and seizures.
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Class:
Metaproterenol 5% |
Sympathomimetic
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MoA:
Metaproterenol 5% |
Beta-2 agonist acts directly on bronchial smooth muscle causing relaxation of the bronchial tree and peripheral vasculature.
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INDJS:
Metaproterenol 5% |
Bronchial asthma, reversible bronchospasm secondary to
bronchitis, COPD. |
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COINJS:
Metaproterenol 5% |
Tachyarrhythmias, hypersensitivity, tachycardias due to digitalis toxicity.
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ADRS:
Metaproterenol 5% |
Tachyarrhythmias, anxiety, nausea, vomiting, restlessness,
apprehension, palpitations, hypotension, coughing, facial flushing, diaphoresis. |
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DI:
Metaproterenol 5% |
Other sympathomimetics may exacerbate cardiovascular
effects. MAOIs may potentiate hypotensive effects. Beta-blockers may antagonize metaproterenol. |
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How Supplied:
Metaproterenol 5% |
MDI: 0.65 mg/dose/spray (15-mL inhaler). Solution: 5%
solution in bottles of 10 and 30 mL with calibrated dropper; Alupent inhalation solution unit-dose vial, 0.4% or 0.6%. |
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Dos & ADMIJ:
Metaproterenol 5% |
Adult: MDI: 2–3 inhalations every 3–4 hours (2 minutes between inhalations). Inhalation solution 5%: via hand-held nebulizer 0.2–0.3 mL diluted in 2.5 mL saline. Inhalation solution unit-dose 0.4% or 0.6% vials: intermittent positive-pressure breathing device only: one vial/treatment. Pediatric: MDI: not recommended. Inhalation solution 5%: age 6–12 years: 0.1–0.2 mL diluted in 3 mL saline.
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DOA:
Metaproterenol 5% |
Onset: 1 minute after inhalation. Peak effect: 45 minutes. Duration: 3–6 hours.
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Special Considerations:
Metaproterenol 5% |
Pregnancy safety: Category C. Monitor for hypotension or tachycardia. Use with caution in patients with diabetes mellitus and coronary artery disease.
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Class:
Naloxone |
Narcotic antagonist.
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MoA:
Naloxone |
Competes for and displaces narcotics from opiate receptor sites
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INDJS:
Naloxone |
Known narcotic overdoses.
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COINJS:
Naloxone |
Known hypersensitivity, tachycardia, hypertension, nausea, vomiting, signs of narcotic withdrawal.
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ADRS:
Naloxone |
Too rapid reversal, N/V tachycardia.
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DI:
Naloxone |
None
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How Supplied:
Naloxone |
Multi dose vial with 10 mg / 10 ml; multi dose vial with 4 mg / 10 ml
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Dos & ADMIJ:
Naloxone |
Absorption of 0.4 to 2.0 mg via nasal atomizer.
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DOA:
Naloxone |
3- 5 minutes; 20 to 120 minutes; half-life of 60 - 90 minutes.
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Special Considerations:
Naloxone |
None.
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Class:
Nitroglycerin |
Anti-anginal nitrate; vasodilator.
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MoA:
Nitroglycerin |
Smooth muscle relaxant acting on vascular, bronchial, uterine, and intestinal smooth muscle; dilation of arterioles and veins in the periphery; reduces preload and afterload; decreases the work load of the heart and, thereby, myocardial oxygen demand.
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INDIJS:
Nitroglycerin |
Acute angina pectoris, ischemic chest pain, hypertension, CHF, pulmonary edema.
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COINJS:
Nitroglycerin |
Hypotension, hypovolemia; intracranial bleeding or head injury; previous administration of Viagra, Revatio, Levitra, Cialis, or similar agents within past 24 hours.
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ADRS:
Nitroglycerin |
Headache, hypotension, syncope, reflex tachycardia, flushing, nausea, vomiting, diaphoresis, muscle twitching.
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DI:
Nitroglycerin |
Additive effects with other vasodilators; incompatible with other drugs IV. Phosphodiesterase inhibitors – may lead to profound hypotensive event
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How Supplied:
Nitroglycerin |
Tablets: 0.15 mg (1/400 grain); 0.3 mg (1/200 grain); 0.4 mg (1/150 grain); 0.6 mg (1/100 grain). NTG spray: 0.4 mg–0.8 mg under the tongue. NTG IV (Tridil).
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Dos: &ADMIJ:
Nitroglycerin |
Adult: Tablets: 0.3–0.4 mg SL; may repeat in 3–5 minutes to maximum of 3 doses. NTG spray: 0.4 mg under the tongue; 1–2 sprays. NTG IV infusion: begin at 10 to 20 μg/min; increase by 5–10 μg/min every 5 minutes until desired effect. Pediatric: Not recommended.
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DOA:
Nitroglycerin |
Onset: 1–3 minutes. Peak effect: 5–10 minutes. Duration: 20–30 minutes or if IV, 1–10 minutes after discontinuation of infusion.
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Special Considerations:
Nitroglycerin |
Pregnancy safety: Category C. Hypotension more common in geriatric population. NTG decomposes if exposed to light or heat. Must be kept in airtight containers. Active ingredient may have a stinging effect when administered.
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Class:
Oral Glucose |
Hyperglycemic; Carbohydrate
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MoA:
Oral Glucose |
Provides quickly absorbed glucose to increase blood glucose levels.
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INDJS:
Oral Glucose |
Conscious patients with S/S hypoglycemia.
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COINJS:
Oral Glucose |
Decreased level of consciousness, nausea, vomiting.
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ADRS:
Oral Glucose |
Nausea, vomiting.
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DI:
Oral Glucose |
None.
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How Supplied:
Oral Glucose |
Glucola: 300-mL bottles. Glucose pastes and gels in various forms.
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Dos & ADMIJ:
Oral Glucose |
Buccal; Adult: Should be sipped slowly by patient until clinical improvement noted. Pediatric: Same as adult.
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DOA:
Oral Glucose |
Onset: immediate. Peak effect: variable. Duration: variable.
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Special Considerations:
Oral Glucose |
As noted in indications section.
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Class:
Oxygen |
Naturally occurring atmospheric gas.
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MoA:
Oxygen |
Reverses hypoxemia. Necessary for aerobic metabolism.
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INDJS:
Oxygen |
Confirmed or expected hypoxemia, ischemic chest pain,
respiratory insufficiency, prophylactically during air transport, confirmed or suspected carbon monoxide poisoning, all other causes of decreased tissue oxygenation, decreased level of consciousness. |
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COINJS:
Oxygen |
Certain patients with COPD or emphysema who will not tolerate oxygen concentrations over 35%, hyperventilation. Oxygen should never be withheld from a patient who needs it however. Be prepared to assist with ventilations in a patient with COPD who requires high concentration, as apnea may result.
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ADRS:
Oxygen |
Decreased level of consciousness and respiratory depression in patients with chronic carbon dioxide retention. Retrolental fibroplasia if giving high concentrations to premature infants (maintain 30%-40% oxygen).
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DI:
Oxygen |
Paraquat / diaquat – increases toxicity of pesticides.
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How Supplied:
Oxygen |
Oxygen cylinders (usually green and white) of 100% compressed oxygen gas.
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Dos & ADMIJ:
Oxygen |
Adult: Cardiac arrest and carbon monoxide poisoning: 100%. Hypoxemia: 10–15 L/min via nonrebreathing mask. COPD: 1–6 L/min via nasal cannula or 28%–35% Venturi mask. Be prepared to provide ventilatory support if higher concentrations of oxygen needed. Pediatric: Same as for adult with exception of premature infant.
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DOA:
Oxygen |
Onset: immediate. Peak effect: not applicable. Duration: Less than 2 minutes.
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Special Consideration:
Oxygen |
Be familiar with liter flow and each type of delivery device used. Supports possibility of combustion.
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Class:
Atropine Sulfate |
Anticholinergic agent.
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MoA:
Atropine Sulfate |
Parasympatholytic: inhibits action of acetylcholine at postganglionic parasympathetic neuroeffector sites.
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INDJS:
Atropine Sulfate |
Although there are cardiac indications for atropine the indication for the MARK I/ NAAK kit is nerve agent exposure.
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COINJS:
Atropine Sulfate |
None in the event of a nerve agent exposure event.
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ADRS:
Atropine Sulfate |
Headache; dizziness; palpitations; nausea and vomiting; tachycardia; arrhythmias; anticholinergic effects (blurred vision, dry mouth, urinary retention); paradoxical bradycardia when pushed slowly or at low doses; flushed, hot, dry skin.
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DI:
Atropine Sulfate |
Potential adverse effects when administered with digoxin, cholinergics, physostigmine. Effects enhanced by antihistamines, procainamide, quinidine, antipsychotics, benzodiazepines, and antidepressants.
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How Supplied:
Atropine Sulfate |
Emergency Single Dose Kit containing: 2 mg in 0.7 mL autoinjector.
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Dos & ADMIJ:
Atropine Sulfate |
Adult: Nerve agent poisoning: Extremely large doses (2–4 mg or higher) may be needed. The dose of 2 mg should be repeated if symptoms remain after 10 minutes.
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DOA:
Atropine Sulfate |
Onset: immediate. Peak effect: 1–2 minutes. Duration: 2–6 hours.
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Special Considerations:
Atropine Sulfate |
Pregnancy safety: Category C. Moderate doses may cause pupillary dilation.
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Class:
Pralidoxime Chloride |
Oxime Cholinesterase reactivator.
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MoA:
Pralidoxime Chloride |
Reactivation of cholinesterase to effectively act as an antidote to nerve or organophosphate poisoning. This action breaks the bond between the nerve agent and the aceytlcholinesterase and allows for destruction of accumulated acetylcholine at the neuromuscular junction.
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INDJS:
Pralidoxime Chloride |
As an antidote in the treatment of poisoning by nerve agents.
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COINJS:
Pralidoxime Chloride |
None in the event of a nerve agent exposure event.
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ADRS:
Pralidoxime Chloride |
Dizziness, blurred vision, diplopia, headache, drowsiness, nausea, tachycardia, hyperventilation, muscular weakness, excitement, and manic behavior.
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DI:
Pralidoxime Chloride |
No direct drug interactions; however, patients with organophosphate poisoning should not be given barbiturates, morphine, theophylline, aminophylline, succinylcholine, reserpine, and phenothiazines.
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How Supplied:
Pralidoxime Chloride |
Emergency Single Dose Kit containing: One 600 mg in 2 mL autoinjector.
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Dos & ADMIJ:
Pralidoxime Chloride |
Should be administered immediately after atropine.
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DOA:
Pralidoxime Chloride |
Onset: minutes. Peak effects: variable. Duration: variable.
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Special Considerations:
Pralidoxime Chloride |
Pregnancy safety: unknown. Treatment will be most effective if given within a few hours after poisoning.
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Generic Name:
Liqui-Char |
Activated Charcoal
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Generic Name:
Proventil |
Albuterol
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Generic Name:
Ventolin |
Albuterol
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Generic Name:
Adrenalin |
Epinephrine
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Generic Name:
Xopenex |
Levalbuterol
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Generic Name:
Alupent |
Metaproterenol 5%
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Generic Name:
Narcan |
Naloxone
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Generic Name:
Nitrostat |
Nitroglycerin
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Generic Name:
Tridil |
Nitroglycerin
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Generic Name:
Insta-glucose |
Oral Glucose
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Generic Name:
2-Pam Chloride |
Pralidoxime Chloride
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Generic Name:
Protopam |
Pralidoxime Chloride
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MARK 1 / NAAK Kit
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Atropine Sulfate & Pralidoxime Chloride
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