Paramedic Drug Cards

Front 1

Adenosine (Adenocard)

Classification and Mech. of Action

Back 1

Class: Endogenous Nucleotide

Mech. of Action: Slows conduction through the AV Node, Interrupts re-entry pathways.
Slows heart rate, Acts directly on sinus pacemaker cells.
Drug of choice for PSVT
Diagnostic tool for stable, wide-complex tachycardias of unknown origin after 2 doses of lidocaine

Front 2

Adenosine (Adenocard)

Indications, Contraindications & Adverse Reactions

Back 2

Conversion of PSVT to NSR
Conversion of PSVT to WPW
Not effective in Afib/Aflutter

Contraindications
2nd or 3rd Degree heart blocks or sick sinus syndrome
A Flutter/A Fib

Adverse Reactions
Facial flusing, SOB, CP, Headache, Parethesia, Diaphoresis, Palpitations, Nausea, Metallic Taste

Front 3

Adenosine (Adenocard)

Dosage and Administration

Back 3

3 mg/ml in 2-ml flip top for IV injection

Adult: 6mg IVP; if no response after 1-2 min: 12mg IVP. Max dose of 30mg

Pedi: 0.1-0.2mg/kg IVP to max of 12mg

Front 4

Albuterol (Proventil)

Classification & Mech. Of Action

Back 4

Sympathomimetic, bronchodilator

Selective b-2 agonist which stimulates adrenergic receptors of the sympathomimetic nervous system resulting in smooth muscle relaxation in bronchial tree and peripheral vasculature

Front 5

Albuterol (Proventil)

Indications, Contraindications & Adverse Reactions

Back 5

TX of bronchospasm in patients with COPD/asthma. Prevention of exercise induced bronchospasm

Contraindications: Hypersensitivity
Tachy-dysrhythmias, esp. caused by digitalis
Synergistic w/ other sympathomimetics

Adverse Reactions: Dose-related restlessness, temors, dissiness, palpitations, tachycardia, nervousness, peripheral vasodilation, nausea, vomiting, HTN, paradoxical bronchospasm

Front 6

Albuterol (Proventil)

Supply and Dosage

Back 6

0.5% - 5mg/ml
MDI: 90 mcg/metered spray

Dose
2.5mg
Dilute solution in 2.5ml for neb tx

Front 7

Aminophylline

Class and Mech of Action

Back 7

Xanthine Bronchodilator
(theophylline derivative)

Resp. stimulator and bronchodilator

Front 8

Aminophylline

Indications, Contraindications & Adverse Reactions

Back 8

Limited use. May be used in refractory COPD

Hypersensitivity
Cardiac dysrhythmias

Tachycardia, palpitations, PVC's, Angina pectoris, headache, seizure, n/v

Front 9

Aminophylline

Supply & Dosage

Back 9

500mg/10ml ampules
500mg/20ml ampules
25 mg/ml: 250 mg/ml ampule

5-6mg/kg in 60-200 ml of ns

Front 10

Amiodarone (Cordarone)

Classification & Mech. Of Action

Back 10

Antidysrhythmic

Prolongation of Action Potential; non-competitive alpha & beta shympathetic blocking effects; calcium channel blocking effects

Front 11

Amiodarone (Cordarone)

Indications, Contraindications & Adverse Reactions

Back 11

Supression of V-Fib refrac to defib & lido
Supression of V-Tach refrac to cardioversion & lido

Contraindications
2nd or 3rd degree cardiac blocks
med induced V dysrhythmias
hypotension, bradycardia, torsades des pointes, profound sinus bradycardia

adverse reactions
hypotension, bradycardia, PEA, CHF, Abnormal Liver Functions, Thrombocytopenia

Front 12

Amiodarone (Cordarone)

Supply & Dosage

Back 12

150 mg in 3 ml vials

300mg slow IVP (1-2 min) in 10cc NS.

Front 13

Atropine (Intropin)

Classification & Mech. Of Action

Back 13

Anticholinergic agent

Parasympatholytic: Inhibits acetylcholine @ postganglionic neuroeffector sites
Increses heart rate in life-threatening bradydysrhythmias

Front 14

Atropine (Intropin)

Indications, Contraindications & Adverse Reactions

Back 14

Hemodynamically significant bradycardia
Asystole
Organophosphate poisoning
Bronchospastic pulmonary d/o

Contraindicated:
Tachycardia, Narrow-angle glaucoma, unstable cardiovascular status in acute hemorrhage and MI

Adverse Reactions
Headache, dizziness, palpitations, N/V, paradoxical bradycardia when pushed slowly or at low doses

Front 15

Atropine (Intropin)

Dosage & Supply

Back 15

Prefilled syringes: 1.0mg in 10ml

Dose
Bradydysrhythymias
0.5-1.0mg IV q 3-5 min max does of 0.04mg/kg
ET @ 2.0 mg with 2.0ml NS
Asystole
1.0mg IVP q 3-5 min as needed. max of 3mg

Front 16

Calcium Chloride/Calcium Gluconate

Classification & Mech. of Action

Back 16

Electrolyte

Increases cardiac contractile state (positive inotropic effect). May enhance ventricular automaticity

Front 17

Calcium Chloride/Calcium Gluconate

Indications, Contraindications & Adverse Reactions

Back 17

Hypocalcemia, Mag. Sulfate OD, Hyerkalemia, Calcium Channel blocker toxicity. Adjuct for tx of insect bites and stings

Contraindications: Hypercalcemia, VF during cardiac resuscitation. Digitalis toxicity

Adverse Reactions: bradycardia, asystole, hypotension, peripheral vasodilations, metallic taste, coronary & cerebral spasms

Front 18

Calcium Chloride/Calcium Gluconate

Supply & Dosage

Back 18

(100mg/ml)
10% solution in 10ml ampule

2-4mg/kg slow IV over 5 min. repeat in 10 min. max of 10gm

Front 19

Diltiazem HCL (Cardizem)

Classification & Mech. of Action

Back 19

Calcium Channel Blocker

Block influx of calcium ions into caridac muscle: prevents spasm of coronary arteries.
Arterial & Venous vasodilator
Reduces Preload & Afterload
Reduces Myocardial 02 demand

Front 20

Diltiazem HCL (Cardizem)

Indications, Contraindications & Adverse Reactions

Back 20

Control of rapid ventricular rates due to A-Fib/Flutter & PSVT
Angina Pectoris

Contraindications
Hypotension
Sick Sinus Syndrome
2nd or 3rd degree AV heart block
Cardiogenic Shock
Wide-complex tachycardias

Adverse Reactions
Bradycardia, 2nd or 3rd degree AV block, CP, CHF, Syncope, Vfib, Vtach, dry mouth, dyspnea, n/v, headache

Front 21

Diltiazem HCL (Cardizem)

Supply & Dosage

Back 21

25mg/5l vial
50/mg in 10ml vial
non-refrigerated lyo-ject

0.25mg/kg (average dose of 20mg) IV over 2 min. May rebolus in 15min @ 0.35mg/kg IV over 2 min

not for pediatrics

Front 22

Ipratropium Bromide (Atrovent)

Classification & Mech. of Action

Back 22

Bronchodilator

Blocks the action of acetycholine @ the parasympathetic sites in bronchial smooth muscles causing dilation

Front 23

Ipratropium Bromide (Atrovent)

Indications, Contraindications & Adverse Reactions

Back 23

Used in bronchospasm esp. associated with COPD & emphysema

Contraindicated
hypersensitivity to atropine or derivatives

Adverse
poorly absorbed so rarely systemic issue
poss. headache, nervousness, hypotension, cough, palpitations

Front 24

Iprotropium Bromide (Atrovent)

Supply & Dosage

Back 24

neb ampule: 0.02% (2.5ml)
MDI 18mcg per dose

adult: 2-3 puffs per MDI tid-qid
500mcg NEB q 6-8 hours. can mix with albuterol within an hour

Front 25

Dopamine (Intropin)

Classification & Mech of Action

Back 25

Sympathomimetic, Inotrope

Immediate metabolic precursor to norepinephrine
Increases systemic vascular resistance
Dilates renal & splanchnic vasculature
Increases myocardia contractility & stroke volume

Front 26

Dopamine (Intropin)

Indications, Contraindications & Adverse Reactions

Back 26

Cardiogenic/Septic/Spinal Shock
Hypotension with low cardiac output
Distributive shock
hypotension after return of circulation

Contraindicated:
Hypovolemic shock
pheochromocytoma
tachydysrhythmias
VF

Adverse Reactions
Cardiac dysrhythmias, HTN, increased myocardial 02 demand, extraversion causes tissue necrosis

Front 27

Dopamine (Intropin)

Supply & Dosage

Back 27

200mg/5ml-400mg/5l prefilled syringes, ampules for IV infusion

2-20mcg/kg/min

low dose
1-2 mcg/kg/min = beta 1 & dopaminergic effects
med dose
2-10mcg/kg/min = alpha & beta effects
High dose
greater than 10mcg/kg/min = purely alpha (vasodilation)

Front 28

Dextrose

Classification & Mech. of Action

Back 28

Carbohydrate, hypertonic solution

Rapidly increases serum glucose levels
short-term osmotic diuresis

Front 29

Dextrose

Indications, Contraindications & Adverse Reactions

Back 29

Hypoglycemia, altered LOC & seizure of unknown etiology

contraindications
intracranial hemorrhage, DT's, use with thiammine

Adverse
Extravasation causes tissue necrosis
warmth, pain, burning, thrombophlebitis

Front 30

Dextrose

Supply & Dosage

Back 30

25gn.59nk prefilled syringes (500mg/ml)

12.5-25gm slow iv q if necessary
pedi 0/5-1gm/kg/dose slow iv, may q if necessary

Front 31

Furosemide (Lasix)

Classification & Mech. of Action

Back 31

Loop diuretic

Inhibits electrolyte reabsorption & promotes excretion of sodium, potassium and chloride

Front 32

Furosemide (Lasix)

Indications, Contraindications & Adverse Reactions

Back 32

CHF, Pulmonary Edema, Hypertensive Crisis

Contraindicated
Hypovolemia, Anuria, Hypotension, hepatic coma

Adverse Reactions
exacerbates hypovolemia, hypokalemia, ECG changes, dry mouth, hypocholermia, hyponatremia, hpyerglycemia

Front 33

Furosemide (Lasix)

Dosage & Supply

Back 33

100mg/5ml
20mg/2ml
40mg/4ml

0.5-1.0mg/kg slow iv (usually start at 40
Pedi: 1mg/kg IV, IO

if patient takes lasix normally double their daily dose

Front 34

Epinephrine (Adrenalin)

Classification & Mech of Action

Back 34

Sympathomimetic

Direct alpha & beta agonist
alpha: bronchial cutaneous, renal & visceral arteriolar vasoconstriction
Beta 1: positive inotropic & chronotropic actions, increases automaticity
Beta 2: bronchial smooth muscle relaxation & dilation of skeletal vasculature. Blocks histamine release

Front 35

Epinephrine (Adrenalin)

Indications, Contraindications & Adverse Reactions

Back 35

Cardiac Arrest, Asystole, PEA, VF unresponsive to initial defib.
Severe bronchospasm, asthma, bronchiolitis
Anaphylaxsis. Acute allergic reactions

Contraindicated
HTN, hypovolemia, Pulmonary edema, Coronary insufficiency, hypovolemic shock

Adverse
HTN, dysthythmias, pulmonary edema, anxiety, psychomotor agitation, nausea, angina headache

Front 36

Epinephrine (Adrenalin)

Supply & Dosage

Back 36

1mg/ml (1:1,000) ampules
0.1mg/ml (1:10,000) prefilled syringes

epi pens: 0.3mg/ml or 0.15mg/ml

allergic reactions: 0.3-0.5mg (0.3-0.5ml 1:1,000) SC
Anaphylaxsis: 0.3-0.5mg (3-5ml 1:10,000) q 3-5 min
Cardiac Arrest, Asystole, PEA, VF: 1mg IV push (1:10.000) q 3.5min


pedi: 0.01mg/kg 1:1,000 SC max of 0.3mg
cardiac arrest 0.01mg/kg (1:10,000)

Front 37

Lidocaine HCL (2%) (Xylocaine)

Classification & Mech. of Action

Back 37

Antidysrhythmic

Decreases automaticity by slowing rate of spontaneous phase 4 depolarization

Front 38

Lidocaine HCL (2%) (Xylocaine)


Indications, Contraindications & Adverse Reactions

Back 38

Suppression of V-Tach, VF, PVC's (ventricular dysrhythmias)
Propholaxysis against recurrence after conversion from V-Tach, VF

Contraindicated
2nd or 3rd degree heart blocks without articial pacemaker
Hypotension, Stokes Adams

Adverse Reactions
Slurred Speech, Seizures, Altered Mental Status, Confusion, Lightheadedness, Blurred Vision, Bradycardia

Front 39

Lidocaine HCL (2%) (Xylocaine)

Supply & Dosage

Back 39

100mg in 5ml sol prefilled syringes
1 & 2 gram additive syringes
100mg in 5ml sol ampules
1 & 2 gram vials in 30ml sol

Cardiac Arrest VT/VF:
1.0-1.5 IVP q 3-5 min to macx of 3mg/kg
after conversion to NSR drip @ 2-4mg/min

PVC's with pulse: 0.5-1.5mg/kg IVP, additional boluses q 5-10 min. Max of 3mg/kg
drip @ 2-4mg/min ASAP

Pedi 1mg/kg
infuse @ 20-50mcg/kg/min

Front 40

Magnesium Sulfate

Classification & Mech of Action

Back 40

Electrolyte

Reduces straited muscle contractions & blocks peripheral neuromuscluar transmission by reducing ACHE @ myoneural junction
Manages seizures in eclampsia
Induces uterine relaxation
Can cause bronchodilation after beta-agnoists & anticholinergics have been used