Paramedic Class Drug Cards

Front 1

Lidocaine prefiled syringe

Back 1

Indications: Ventricular Tachycardia with/without a pulse, Ventricular Fibrillation.

Contraindications: hypersensitivity to Amide - type anesthetics, Supra venttricular dysrhythmias, Stokes Adams syndrome, 2nd and 3rd degree heart block, bradycardia

Route: IV or IO

Side effects: anxiousness, dizzy, tremors, depression, seizures, fainting, changes in respirations and/or heart rate.

dosages: (adult) 2 - 1.5 mg/kg bolus or 3 - 1 mg/kg bolus to a max of 3 mg/kg
(ped) 1 - mg/kg

Front 2

Adenosine

Back 2

Indications: Narrow complex supraventricular tachycardia refractory to vegah maneuvers.

Contraindications: Hypersensitivity, 2nd & 3rd degree heart block, sinus node disease, asthma.

route: Rapid IV followed by rapid saline flush of line.

Side effects: Chest pain, transient dysrhytmias, headache, lightheadness, tingling/arms, SOB.

Dosages: (adult) 6mg rapid (1-3 sec) (if ineffective - 1-2 min) - 12 mg rapid (1-3 sec)
(ped) 0.1 mg/kg (to max of 6 mg) rapid (1-3 sec) (if ineffective 1-2 min) - 0.2 mg/kg rapid (to max of 12 mg)

Front 3

Albuterol

Back 3

Indications: Bronchospasm & asthma in COPD.

Contraindications: Hypersensitivity.

Route: Oral inhaler via MDI or NS mix via nebulizer.

Side effects: Dizziness, headache, nausea, tachycardia, cough, wheezing, anxiety, emisis(vomiting).

Dosage: (adult) Two (2) inhalations (90 mcg) MDI (2 sprays) or 2.5 mg mix with 2.5 to 3.0 ml NS via nebulizer (duration of effect 3-6 hours (repeat as needed)).
(ped): 0.15 mg/kg mix with 2.5 - 3.0 ml NS via nebulizer (duration of effect 3-6 hours (repeat as needed)).

Front 4

Amiodarone

Back 4

Indications: Life-threateing recurrent ventricular and supraventricular dysrythmias that have not responded to other anti-dysrhythmic drugs.

Contraindications: Hypersensitivity, cardiogenic shock, sever sinus bradycardia or advance heart block.

Route: (adult) IV (pedi) IV or IO

Sideeffects: Abnormal skin sensations, bitter taste in mouth, blue-green skin discoloring, dizziness, headache, nause, emesis, involuntary muscle movement and poor coordination.

Dosage: (adult) 150-300 mg IV over 10 min. then 1 mg/min over next 6 hours.
(pedi) 5 mg/kg IV/IO then repeate up to 15 mg/kg.

Front 5

Aspirin (ASA)

Back 5

Indications: Chest pain suggestive of an MI.

Contraindications: Hypersensitivity to salicylates, active ulcer disease, asthma.

Route: PO (chewable)

Sideeffects: Heart burn, nausea.

Dosage: 160 to 325 mg

Front 6

Atropine

Back 6

Indications: Hemodynamically significant bradycardia, bradyasystolic arrest, and organophosphate poisoning.


Contraindications: None in the emergency setting.

Route: IV/IO/IM

Side effects: Blurred vision, dizziness, drowsiness, nausea, nervousness, headache, dry mouth, nose and/or skin.

Dosages: (Asystole/PEA) 1 mg IV/IO every 3-5 min (max 3 doses).
(symptomatic bradycardia) 0.5 mg IV repeat 3-5 min (max 3 mg)
(Pedi) 0.02 mg/kg IV - 0.03 mg/kg ET - (may double and repeat IV dose in 5 min. up to 1 mg)
(Organophosphate poisoning) (adult) 2.5 mg IV/IM/IO 10-15 min.
(Adolesents) 1 mg x 2
(pedi) 0.05 mg/kg IV/IM/IO 10-15 min.

Front 7

Calcium Chloride

Back 7

Indications: Hyperkalemia, hypocalcemia, hypermagnesemia, calcium channel blocker toxicity.

Contraindications: Ventricular fibrillation, hypercalcemia, and possible digitalis toxicity.

Route: IV/IO

side effects: Rapid injection may cause PT. to complain of tingling sensation, calcium taste in mouth, oppression (heat wave feeling), local burning, moderate fall in B/P.

Dosage: (adult) 2-4 mg/kg IV (10% solution / repeat at 10 min as needed)
(pedi) 60-100 mg/kg IV/IO (repeat at 10 min. as needed)

Front 8

Calcium Gluconate

Back 8

Indications: Hyperkalemia, Hypermagnesemia, calcium channel blocker toxicity.

Contraindications: Ventricular fibrillation


route: IV

Side effects: Tingling sensation, chalky taste, oppression (heat wave), nausea, cutaneous calcinosis or areas of inflamation, subdermal hemorrage.

Dosages: 5-10 ml of 10% solution (repeat as nesessary at 10 min. intervals)

Front 9

Diazepam (valium)

Back 9

Indications: Major motor seizures, status epilepticus, premedication before cardiversion, muscle tremors due to injury, acute anxiety.

Contraindications: Hypersensitivity to the drug, shock, coma, acute alcoholism, depressed vital signs, obstetric PT's, neonates.

Route: IV/IM

Side effects: Drowsiness, tiredness, pain, redness or swelling at the injection site.

Dosage: (seizures) (adult) 5-10 mg IV/IM
(pedi) 0.5 - 2 mg IV/IM
(acute anxiety) (adult) 2-5 mg IV/IM
(pedi) 0.5 - 2 mg IM
(Premedication) (adult) 5-15 mg IV
(pedi) 0.2 - 0.5 mg/kg IV

Front 10

Diphenhydramine

Back 10

Indications: Anaphylaxis, allergic reaction, dystonic reactions.

Contraindications: Asthma, lower respiratory diseases.

Route: IV/IM

Side effects: Dizziness, drowsiness, excitability (especially in children), headache, nausea, nervousness, restlessness, emesis.

Dosage: 25-50 mg IV/IM

Hint 10

http://www.buzzle.com/articles/dystonic-reaction.html

dystonic reactions explained

Front 11

Dopamine

Back 11

Indications: Nonhypovolemic hypotension (systolic of 70-100 mmhg), cardiogenic shock.

contraindications: Hypovolemic hypotension without aggressive fluid resuscitation, tachydysrhythmias, ventricular fibrillation, pheochromocytoma.

Route: IV/IM

Side effects: Tachycardia, headache, nausea, emesis.

Dosage: (adult) 2-20 mg/kg/min titrated to effect.
(pedi) same as adult

Hint 11

Pheochromocytomas are a type of tumor of the adrenal glands that can release high levels of epinephrine and norepinephrine. As the name implies, the “ad-renal” glands are located near the "renal" area. In other words, the adrenal glands are small glands that are located near the top of the kidneys. One adrenal gland sits on top of each of the two kidneys.

Front 12

D-50

Back 12

Indications: Hypoglycemia

Contraindications: none in hypoglycemia

Route: IV

Side effects: Febrile response, venous thrombosis, hypervolemia.

Dosages: (adult) 25 g D50W (50 ml) IV
(pedi) 2-4 ml/kg of a 25% solution IV

Front 13

Epinephrine 1:1,000

Back 13

Indications: To restore rhythm in cardiac arrest and severe allergic reactions.

Contraindications: Hypersensitivity to sympathomimetic Amines, narrow angle glaucoma,- hemorragic, traumatic or cardiac shock, - coronary insufficiency, dysrhythmias, organic brain /or/ heart disease, or during labor.

Route: SQ/IM/Auto injecter

Side effects: Tachycardia, headache, nausea, nervousness, tremors.

Dosage and Administration
Allergic Emergencies/Anaphylaxis
Adults and Children
IM/Subcutaneous EpiPen , Twinject , prefilled syringe: Patients weighing 30 kg (66 lb) or more - 0.3 mg. EpiPen Jr , Twinject : Patients weighing 15 to 30 kg (33 to 66 lb) - 0.15 mg.
Adults
IM/Subcutaneous 1:1,000 (1 mg/mL) solution: 0.2 to 1 mg (mL), repeated every 10 to 15 min as needed. IV 1:10,000 (0.1 mg/mL) solution: 0.1 to 0.25 mg (1 to 2.5 mL), administered slowly over 5 min. Repeat every 5 to 15 min as needed.
Children
Subcutaneous 1:1,000 (1 mg/mL) solution: 0.01 mg/kg (or 0.3 mg/m 2 ) (max 0.5 mg/dose). May be repeated every 15 min for 2 doses, then every 4 h as needed. IV 1:10,000 (0.1 mg/mL): 0.3 mg (3 mL) administered slowly. Repeat every 15 min for 3 or 4 doses as needed.
Asthma
Adults and Children 4 Yr of Age and Older
Oral inhalation Primatene Mist : Start with 1 inhalation, then wait 1 min. If not relieved, use once more. Do not use again for at least 3 h (OTC). S2 : Add 0.5 mL (contents of 1 vial) of solution to nebulizer. Use 1 to 3 inhalations not more often than every 3 h (OTC).
Adults
IM/Subcutaneous 1:1,000 (1 mg/mL) solution: 0.2 to 1 mg (mL). Start with a small dose and increase if required. IV 1:10,000 (0.1 mg/mL) 0.1 to 0.25 mg (1 to 2.5 mL) injected slowly.
Children
Subcutaneous 1:1,000 (1 mg/mL) 0.01 mg/kg (or 0.3 mg/m 2 ) (max 0.5 mg/dose) every 4 h as needed.
Cardiac Arrest
Adults
IV 1:10,000 (0.1 mg/mL) solution: 0.1 to 1 mg (1 to 10 mL), repeated every 5 min, if necessary. Alternatively, in intubated patients, epinephrine can be injected via the endotracheal tube directly into the bronchial tree at the same dose as for IV injection. Intracardiac 1:10,000 (0.1 mg/mL) solution: 0.3 to 0.5 mg (3 to 5 mL). This route should only be used if there is insufficient time to establish an IV route and should only be administered by personnel well trained in this technique.
Children
IV 1:10,000 (0.1 mg/mL): 0.005 to 0.01 mg/kg.
Intraspinal
Adults
Intraspinal 1:1,000 (1 mg/mL) injection solution (preservative free, sulfite free) 0.2 to 0.4 mg added to anesthetic spinal fluid mixture. Epinephrine 1:100,000 (0.01 mg/mL) to 1:20,000 (0.05 mg/mL) is the usual concentration employed with local anesthetics.
Nasal Congestion
Adults and Children 6 yr of age and older
Topical Apply as drops, spray, or with sterile swab as needed.
Ophthalmologic Use for Producing Conjunctival Decongestion, to Control Hemorrhage, to Produce Mydriasis, to Reduce Intraocular Pressure

Ophthalmic Use concentrations of 1:10,000 to 1:1,000.

Front 14

Epinephrine 1:10,000

Back 14

Indications: To restore rhythm in cardiac arrest and severe allergic reactions.

Contraindications: Hypersensitivity to sympathomimetic Amines, narrow angle glaucoma,- hemorragic, traumatic or cardiac shock, - coronary insufficiency, dysrhythmias, organic brain /or/ heart disease, or during labor.

Route: IV/IO/ET

Side effects: Tachycardia, headache, nausea, nervousness, tremors.

Dosage and Administration
Allergic Emergencies/Anaphylaxis
Adults
IM/Subcutaneous 1:1,000 (1 mg/mL) solution: 0.2 to 1 mg (mL), repeated every 10 to 15 min as needed. IV 1:10,000 (0.1 mg/mL) solution: 0.1 to 0.25 mg (1 to 2.5 mL), administered slowly over 5 min. Repeat every 5 to 15 min as needed.
Children
Subcutaneous 1:1,000 (1 mg/mL) solution: 0.01 mg/kg (or 0.3 mg/m 2 ) (max 0.5 mg/dose). May be repeated every 15 min for 2 doses, then every 4 h as needed. IV 1:10,000 (0.1 mg/mL): 0.3 mg (3 mL) administered slowly. Repeat every 15 min for 3 or 4 doses as needed.
Asthma
Adults and Children 4 Yr of Age and Older
Oral inhalation Primatene Mist : Start with 1 inhalation, then wait 1 min. If not relieved, use once more. Do not use again for at least 3 h (OTC). S2 : Add 0.5 mL (contents of 1 vial) of solution to nebulizer. Use 1 to 3 inhalations not more often than every 3 h (OTC).
Adults
IM/Subcutaneous 1:1,000 (1 mg/mL) solution: 0.2 to 1 mg (mL). Start with a small dose and increase if required. IV 1:10,000 (0.1 mg/mL) 0.1 to 0.25 mg (1 to 2.5 mL) injected slowly.
Children
Subcutaneous 1:1,000 (1 mg/mL) 0.01 mg/kg (or 0.3 mg/m 2 ) (max 0.5 mg/dose) every 4 h as needed.
Cardiac Arrest
Adults
IV 1:10,000 (0.1 mg/mL) solution: 0.1 to 1 mg (1 to 10 mL), repeated every 5 min, if necessary. Alternatively, in intubated patients, epinephrine can be injected via the endotracheal tube directly into the bronchial tree at the same dose as for IV injection. Intracardiac 1:10,000 (0.1 mg/mL) solution: 0.3 to 0.5 mg (3 to 5 mL). This route should only be used if there is insufficient time to establish an IV route and should only be administered by personnel well trained in this technique.
Children
IV 1:10,000 (0.1 mg/mL): 0.005 to 0.01 mg/kg.
Intraspinal
Adults
Intraspinal 1:1,000 (1 mg/mL) injection solution (preservative free, sulfite free) 0.2 to 0.4 mg added to anesthetic spinal fluid mixture. Epinephrine 1:100,000 (0.01 mg/mL) to 1:20,000 (0.05 mg/mL) is the usual concentration employed with local anesthetics.
Nasal Congestion
Adults and Children 6 yr of age and older
Topical Apply as drops, spray, or with sterile swab as needed.
Ophthalmologic Use for Producing Conjunctival Decongestion, to Control Hemorrhage, to Produce Mydriasis, to Reduce Intraocular Pressure

Ophthalmic Use concentrations of 1:10,000 to 1:1,000.

Front 15

Furosemide

Back 15

Indications: Congestive heart failure and/or pulmonary edema.

contraindications: Hypersensitivity to furosemide and/or sulfonamides, fluid and/or electrolyte depleted states, hepatic coma, pregnancy (except in life threatening circumstances).

Route: IV

Side effects: Dizziness, lightheadedness.

Dosage: (adult) 40-120 mg (slow IV push)
(pedi) 1 mg/kg (slow IV push)

Hint 15

hepatic coma
n.
A coma occurring in advanced cirrhosis, hepatitis, poisoning, or other liver disease.

Front 16

Glucagon

Back 16

Indications: Hypoglycemia (without IV access), to reverse beta-blocker overdose.

Contraindications: Hypersensitivity to glucagon and/or protein compounds.

Route: Im/SC/IV

Side effects: Nausea, Emesis

Dosage: (Hypoglycemia) (adult) 1 mg IM/SC repeat 5/20 min
(pedi) 0.1 mg/kg IM/SC/IV (for children <10 kg) 1 mg/kg IM/SC/IV ( for children >10 kg)
(beta-blocker overdose) (adult) 3 mg IV over 1 min.
(pedi) need to comfirm then add?

Hint 16

Beta blockers are a type of drug used to treat high blood pressure.

Beta blocker overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.



Reference from A.D.A.M.

Back to TopPoisonous Ingredient

The specific ingredient in such drugs varies among manufacturers. The main ingredient is a beta-adrenergic blocking substance. It blocks the effects of a hormone called epinephrine on the body. Epinephrine is also called adrenaline.
.


Back to TopWhere Found

Prescription beta blockers are sold under various names, including:
Acebutolol (Sectral)
Atenolol (Apo-atenolol)
Betaxolol (Kerlone)
Bisoprolol (Zebta)
Carteolol (Cartrol)
Esmolol (Brevibloc)
Labetalol (Normodyne)
Metoprolol (Toprol)
Nadolol (Corgard)
Sotalol (Betapace)
Oxprenolol (Trasicor)
Penbutolol (Levatol)
Pindolol (Novo-pindol)
Propranolol (Inderal)
Timolol (Apo-timol)

Note: This list may not be all-inclusive.
.


Back to TopSymptoms
Airways and lungs Breathing trouble
No breathing
Wheezing (in people who have asthma)

Eyes, ears, nose, and throat Blurred vision
Double vision

Heart and blood Irregular heartbeat
Lightheadedness
Low blood pressure
Heartbeat - rapid or slow
Heart failure
Shock

Nervous system Coma
Confusion
Convulsions
Drowsiness
Excessive sweating
Fever
Nervousness
Weakness


Low blood sugar is common in children with this type of overdose, and can lead to nervous system symptoms.

Front 17

Isuprel

Back 17

Indications: Shock, ventricular arrhythmias, status asthmaticus, bronchospasm.

Contraindications: Angina, angle - closure glaucoma, digitalis intox causing heart block.

Route: IV/IM/SQ

Side effects: Sweating, Tremors, headache, rapid BP changes, hyperglycemia.

Dosages: (shock) (adult & pedi) .5-5 mcg/min IV
(Heart-block) .02 - .06 mg / .01 - .02 mg IV or 5 mcg/,in IV -/or/- .2 mg IM then 1 mg IM -/or/- .2 mg SQ then .15 - .2 mg SQ.
(status asthmaticus): (pedi) .08 - 1.4 mcg/kg/min IV

Hint 17

status asth·mat·i·cus (z-mt-ks, s-)
n.
A condition of severe, prolonged asthma.

Front 18

Lidocaine Drip

Back 18

Indications: Venttricular tachycardia with/without a pulse, ventricular fibrillation.

Contraindications: Hypersensitivity to Amide - type anesthetics, supraventricular dysrhythmias, Stokes Adams syndrome, 2nd and 3rd degree heart block, bradycardia.

Route: IV

Side effects: Anxiousness, dizziness, tremors, depression, seizures, fainting, changes in respiration and/or heart rate.

Dosages: Set drip rate 1 mg higher per min that effective bolus.
Effective bolus 0 - .5 set 1 mg/min 15 gtts per min.
Effective bolus .5 - 1.5 set 2 mg/min 30 gtts per min.
Effective bolus 1.5 - 2.5 set 3 mg/min 45 gtts per min.
effective bolus 2.5 - 3 set 4 mg/min 60 gtts per min.

Front 19

Magnesium Sulfate

Back 19

Indications: Torsade de pointes, eclamptic seizures, (in children for) status asthmaticus non-responsive to beta agents.

Contraindications: Heart block, myocardial damage, shock, presistent hypertension, hypocalcemia.

Route: IV/IM

Side effects: no or minor side effects when used in small doses.

Dosage: (adult) Diluted in 100 ml NS over 1-2 min. (in adults only).
(pedi) 25-50 mg/kg over 5-20 min.
(eclampsia) 2-4 g IV/IM

Hint 19

Adverse Reactions

The adverse effects of parenterally administered magnesium usually are the result of magnesium intoxication. These include flushing, sweating, hypotension, depressed reflexes, flaccid paralysis, hypothermia, circulatory collapse, cardiac and central nervous system depression proceeding to respiratory paralysis.

Hypocalcemia with signs of tetany secondary to Magnesium Sulfate therapy for eclampsia has been reported.

Overdosage

Magnesium intoxication is manifested by a sharp drop in blood pressure and respiratory paralysis. Disappearance of the patellar reflex is a useful clinical sign to detect the onset of magnesium intoxication. In the event of overdosage artificial ventilation must be provided until a calcium salt can be injected intravenously to antagonize the effects of magnesium.

In adults intravenous administration of 5 to 10 mEq of 10% calcium gluconate will usually reverse respiratory depression or heart block due to magnesium intoxication. In extreme cases, peritoneal or hemodialysis may be required.

Hypermagnesemia in the newborn may require resuscitation and assisted ventilation via endotracheal intubation or intermittent positive pressure ventilation as well as intravenous calcium.


Magnesium Sulfate Dosage and Administration

Magnesium Sulfate in Water for Injection is intended for intravenous use only. For the management of pre-eclampsia or eclampsia, intravenous infusions of dilute solutions of magnesium (1% to 8%) are often given in combination with intramuscular injections of 50% Magnesium Sulfate Injection, USP. Therefore, in the clinical conditions cited below, both forms of therapy are noted, as appropriate.

In Eclampsia

In severe pre-eclampsia or eclampsia, the total initial dose is 10 to 14 g of Magnesium Sulfate. To initiate therapy, 4 g of Magnesium Sulfate in Water for Injection may be administered intravenously. The rate of I.V. infusion should generally not exceed 150 mg/minute, or 3.75 mL of a 4% concentration (or its equivalent) per minute, except in severe eclampsia with seizures. Simultaneously, 4 to 5 g (32.5 to 40.6 mEq) of Magnesium Sulfate may be administered intramuscularly into each buttock using undiluted 50% Magnesium Sulfate Injection, USP. After the initial I.V. dose, some clinicians administer 1 to 2 g/hour by constant I.V. infusion.

Subsequent intramuscular doses of 4 to 5 g of Magnesium Sulfate may be injected into alternate buttocks every four hours, depending on the continuing presence of the patellar reflex, adequate respiratory function, and absence of signs of magnesium toxicity. Therapy should continue until paroxysms cease.

A serum magnesium level of 6 mg/100 mL is considered optimal for control of seizures. A total daily (24 hr) dose of 30 to 40 g Magnesium Sulfate should not be exceeded. In the presence of severe renal insufficiency, frequent serum magnesium concentrations must be obtained and the maximum dosage of Magnesium Sulfate is 20 g per 48 hours.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

Do not administer unless solution is clear. Discard unused portion.