Paramedic Drug Cards (Region 1 La)

Front 1

Adenosine (Indications)

Back 1

Stable narrow complex tachycardia (PSVT)
Consider for ―unstable narrow complex tachycardia while preparing for cardioversion
Consider a trial regimen for stable, regular wide-complex tachycardia with monomorphic QRS of
undetermined etiology

Front 2

Adenosine (contraindications)

Back 2

Known hypersensitivity
AV blocks > than 1st degree
Sick-sinus syndrome
Bradycardias

Front 3

Adenosine (adult dosage)

Back 3

Initial: 6 mg rapid IV followed by 20 ml NS 2nd: 12 mg rapid IV followed by 20 ml NS q 1 – 2 min 3rd: 12 mg rapid IV followed by 20 ml NS q 1 – 2 min

Front 4

Adenosine (pediatric dosage)

Back 4

0.1 mg/kg max of 6mg first dose

If second dose needed, double first dose

Front 5

Adenosine (side effects)

Back 5

Facial flushing, headache, sweating, chest pain, palpitations, hypotension
Dyspnea, Dizziness, tingling, burning, or heavy sensation in arms, apprehension

Front 6

Albuterol (indications)

Back 6

Relief of bronchospasm
Asthma
COPD disease, chronic bronchitis, emphysema

Front 7

Albuterol (contraindications)

Back 7

Hypersensitivity
Symptomatic tachycardia

Front 8

Albuterol (adult dosage)

Back 8

5mg via nebulizer

Front 9

Albuterol (pediatric dosage)

Back 9

(<30 kg)
2.5mg via nebulizer

Front 10

Albuterol (side effects)

Back 10

Tachycardia, hypertension, angina
Nervousness, tremor, headache, dizziness, and insomnia Cough, dry mouth, exacerbation of symptoms
Nausea, vomiting, GI distress

Front 11

Amiodarone (indications)

Back 11

Ventricular tachycardia (with or without a pulse)

Ventricular fibrillation

Front 12

Amiodarone (contraindications)

Back 12

Sensitivity to amiodarone
Poison induced tachycardia
2° and 3° AV Blocks, bradycardias

Front 13

Amiodarone (adult dosage)

Back 13

Cardiac Arrest
Initial: 300 mg IV/IO fast push
Repeat: 150 mg IV/IO 3 – 5 min after 1st dose

Non-Cardiac Arrest (for perfusing V-Tach)
Initial: 150 mg IV/IO over 10 minutes (mix 150 mg in 100 cc, 10 drop set, 1 drop/sec)
Maintenance Infusion: 1.0 mg/min, (mix 250 mg in 250 cc, 60 drop set, 1 drop/sec)

Front 14

Amiodarone (pediatric dosage)

Back 14

Cardiac Arrest (pulseless V-tach or V-fib)
Initial: 5 mg/kg IV/IO (Max 300 mg)

Front 15

Amiodarone (side effects)

Back 15

Significant hypotension with cumulative doses > 2.2 G IV in 24 hours Flushing, chest pains, tightness in chest
Brief periods of asystole, bradycardia, and ventricular ectopy

Front 16

Atropine (indications)

Back 16

Syptomatic bradycardia

Organophosphate and some nerve agent poisoning

Front 17

Atropine (contraindications)

Back 17

2nd° Type 2 or 3rd° heart block

Front 18

Atropine (adult dosage)

Back 18

Bradycardia:
0.5 mg IV/IO q 3 – 5 min., prn to maximum 3mg

Organophosphate poisoning:
2 – 4 mg q 5 – 10 min IV/IO until SLUDGE dissipates

Front 19

Atropine (pediatric dosage)

Back 19

Bradycardia:
Initial: 0.02 mg/kg IV/IO
Repeat: 0.04 mg/kg IV/IO
Minimum dose: 0.1 mg (single)
Maximum doses: 0.5 mg (child), 2 mg (adolescent)
Total dose: 1 mg (child), 2 mg (adolescent)

Organophosphate poisoning:
Initial: 0.05 mg/kg IV/IO
Repeat: 0.05 mg/kg IV/IO q 3 – 5 min.
(Consider doubling subsequent doses for severe respiratory distress)

Front 20

Atropine (side effects)

Back 20

Pupil dilation, blurred vision, headache, restlessness confusion Tachycardia, angina, palpitations, hypertension, flushing of skin
Drying of secretions, dry mouth, difficulty swallowing

Front 21

Atrovent (indications)

Back 21

Relief of bronchospasms
Asthma
COPD disease: chronic bronchitis, emphysema

Front 22

Atrovent (contraindications)

Back 22

Hypersensitivity to atropine or its derivatives

Front 23

Atrovent (adult dosage)

Back 23

500 mcg (0.5 mg) added to nebulizer (in addition to standard albuterol dose), (oxygen flow rates of 6 – 8 ltrs./min)

Front 24

Atrovent (pediatric dosage)

Back 24

250 mcg (0.25 mg) added to nebulizer (in addition to standard albuterol dose) (oxygen flow rates of 6 – 8 ltrs./min)

Front 25

Atrovent (side effects)

Back 25

Tremor, dry mouth, blurred vision, photophobia Cough, exacerbation of symptoms Nervousness, dizziness, headache, palpitations Nausea, vomiting, GI distress
Anhidrosis (↓ sweating)

Front 26

Calcium Chloride (indications)

Back 26

Calcium channel blocker OD
Known hyperkalemia or end-stage renal disease in cardiac arrest

Front 27

Calcium Chloride (contraindications)

Back 27

Hypercalcemia
Digitalis toxicity
Cardiac arrest with ventricular fibrillation

Front 28

Calcium Chloride (adult dosage)

Back 28

Calcium Channel Blocker OD: 500mg-1000 mg IV

Cardiac arrest w/ known hyperkalemia or end stage renal disease: 8mg/kg

Front 29

Calcium Chloride (peds dosage)

Back 29

Cardiac arrest w/ known hyperkalemia: 20mg/kg

Front 30

Calcium Chloride (side effects)

Back 30

Sensation of ―heat wave‖ or tingling Metal taste in mouth
Local burning sensation

Front 31

Dextrose (indications)

Back 31

Known hypoglycemia: CBG ≤ 60
AMS of unknown origin (if hypoglycemia suspected) Chronic alcoholic rehabilitation (if malnutrition suspected) Malnutrition

Front 32

Dextrose (contraindications)

Back 32

Head injuries
Intracranial hemorrhage
Stroke (relative), administer if patient is hypoglycemic

Front 33

Dextrose (adult dosage)

Back 33

D50: 12.5 – 25 g IV/IO via a large bore, patent IV

D10 up to 250mL (25g) (dilute 50ml D50in 200ml NS. Makes 250ml of D10.)

Front 34

Dextrose (peds dosage)

Back 34

Dextrose 25% 0.5 g/kg IV/IO1

D25: remove 25ml D50 from ampule & replace with 25ml NS

Front 35

Dextrose (side effects)

Back 35

Irritation, thrombosis, or necrosis can occur if dextrose is infiltrated out of vein into tissue

Front 36

Diltiazem/Cardizem
(indications)

Back 36

SVT
Atrial Fibrillation
Atrial Flutter

Front 37

Diltiazem/Cardizem
(contraindications)

Back 37

Sick sinus syndrome
Wolff-Parkinson-White Syndrome
AV node conduction disturbances (Blocks)
Bradycardia
Impaired left ventricular function (CHF) COPD

Front 38

Diltiazem/Cardizem
(adult dosage)

Back 38

10 mg slow IV/IO, repeat x1 if needed

Front 39

Diltiazem/Cardizem
(peds dosage)

Back 39

Not recommended for peds

Front 40

Diltiazem/Cardizem
(side effects)

Back 40

Dizziness, light-headedness, headache Nausea, vomiting
Flushing, warm-feeling
Bradycardia

Front 41

Diphenhydramine/Benadryl
(indications)

Back 41

Allergy symptoms (rhinitis, urticaria, itcthing) Anaphylaxis
Dystonic reactions common with phenothiazine Sedation
Motion sickness
Anti-emetic

Front 42

Diphenhydramine/Benadryl
(contraindications)

Back 42

Hypersensitivity
Patients taking MAOI’s
Nursing mothers
Patients with lower respiratory symptoms (asthma)

Front 43

Diphenhydramine/Benadryl
(adult dosage)

Back 43

50 mg deep IM/IV/IO

Front 44

Diphenhydramine/Benadryl
(peds dosage)

Back 44

1-2 mg/kg IV/IO/IM

Front 45

Diphenhydramine/Benadryl
(side effects)

Back 45

Drowsiness, confusion, sedation, disturbed coordination Palpitation, tachycardia, bradycardia
Dry mouth and throat, thickening of bronchial secretions

Front 46

Dopamine (indications)

Back 46

Hypotension from Cardiogenic Shock
CHF (use with caution)

Front 47

Dopamine (contraindications)

Back 47

Shock due to hypovolemia
Tachycardia
Patients with pheochromocytoma (adrenal gland tumor)

Front 48

Dopamine (adult dosage)

Back 48

5 – 20 mcg/kg/min

(2 to 10mcg/kg/min if given after TCP for 2°II or 3° block)

Front 49

Dopamine (side effects)

Back 49

Tachycardias
Tissue injury with extravasations

Front 50

Epinephrine (indications)

Back 50

Allergic reaction
Anaphylaxis
Pulseless arrest
Symptomatic bradycardia

Front 51

Epinephrine (contraindications)

Back 51

Hypersensitivity
Hemorrhagic shock
Hypertension (relative)

Patients ≥ ≈ 60 years of age with a cardiac history, COPD, and/or renal failure shall not be given Magnesium Sulfate or Epinephrine without consultation from Medical Control.

Front 52

Epinephrine (adult dosage - severe allergic reaction/anaphylaxis)

Back 52

Epi 1:1000; 0.3 – 0.5mg IM (thigh is preferred site) May repeat x1 in 5 min.

Epi 1:10,000; 0.1 mg IV/IO slowly over 5 minutes. May repeat x1 PRN (med control required)

Front 53

Epinephrine (adult dosage - reactive airway)

Back 53

Moderate: Epi 1:1,000; 0.3mg IM (med control required)

Severe: Epi 1:1,000; 0.3 - 0.5mg IM (med control not required)

Front 54

Epinephrine (adult dosage - cardiac arrest)

Back 54

Epi 1:10,000; 1mg IV/IO repeat q 3 – 5 min