Pre-Hospital Pharmacology Wcc Airway Meds

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Test please ignore

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Something something darkside

(Not 100% correct, not sure if I need to add the times for doses or not.)

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Oxygen

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--Class: Naturally occurring atmospheric gas.
--Mechanism of action: Reverses hypoxemia
Indications: Confirmed or expected hypoxemia, ischemic chest pain, respiratory insufficiency, prophylactically during air transport, confirmed or suspected carbon monoxide posing, all other causes of decreased tissue oxygenation, decreased levels of consciousness
--Contraindications: COPD pt will not tolerate O2 concentrations >35%
--Adverse reactions: Decresed Level of consciousness in COPD pts, decreased respiratory drive in COPD pt. Dry mucus membranes
--Drug Interactions: None (Shocking)
--Dosage: Adult cardiac arrest and CO poisoning: 100% Hypoxemia 10-15lpm NRB. COPD 0-2lpm NC. Be prepared to provide ventulatory support if higher concentrations of oxygen are needed. Pediatric:Same for adult with exception of premature infant.

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Etomidate (Amidate)

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--Class: Non-barbiturate hypnotic, anesthesia induction agent.
--MOI: Short-acting hynotic that acts at the level of the reticular activating system
Indications: premeditation for tracheal intubation or cardioversion
--Contraindications:Hypersensitivity, labor/delivery.
--Adverse reactions: Apnea of short duration, respiratory depression, hypoventilation, hyperventilation, dysrhythmias, hypotension, hypertension, nausea, comiting, involuntary muscle movement, pain at injection site.
--Drug Interactions: Effects may be enhanced when given with other CNS depressants
--Dosage: Adult - 0.3mg/kg IV push
--Special considerations: pregnancy safety: Category C. Carefully monitor vital signs, Etomidate can suppress adrenal glad production of steroid hormones, which can temporarily cause gland failure. Consider decreasing dose in elderly and patients with cardiac conditions.

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Succinylcholine Chloride (Anectine)

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--Class: Neuromuscular blocker, depolarizing: Skeletal muscle relaxant.
--MOI: Ultra-short-acting depolarizing skeletal muscle relaxant that mimics acetycholine as it binds with the cholinergic receptors on the motor end plate, producing a phase 1 block as manifested by fasciclation
--Indications: RSI
--Contradications: Acute narrow-angle glaucoma, penetrating eye injuries, malignant hyperthermia, acute injury after multisystem trauma, major burns, or extensive muscle injury, inability to control airway or support ventilation with oxygen and positive pressure.
--Adverse reactions: Apnea, respiratory depression, bradydysrhythmia, tacydysrhythmia, Dysrhytmia, cardiac arrest, salivation, prolonged muscle rigidity, rhabdomyolysis, malignant hyperthermia, increased intraocular pressure, hyperkalemia (trauma patients)
--Drug Interactions: Oxycontin, beta blockers, organophoshates may potentate effects. Diazepam may reduce duration of action
--Dosage: 1.5mg/kg IV push
--Special considerations: Pregnancy safety: Category C. If the patient is conscious, explain the effects of the drug before administration. Consider premedication with atropine, particularly in pediatric age group. Premedication with lidocaine may blunt and increase in intracranial pressure during intubation. Etomidate, diazepam, or midazolam should be used in any conscious patient before underground neuromuscular blockade.

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Vecuronium Bromide (Norcuron)

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--Class: Neuromusculat blocker, nondepolarizing
--MOI: Neuromuscular agent with intermediate duration of action that competes with acetylcholine for receoptors at the motor end plate, resulting in neuromuscular blockade
--Indications: RSI
--Contraindications: Acute narrow-angle glaucoma, penetrating eye injuries, inability to control airway or support ventilations with oxygen and positive pressure, newborns, myasthenia gravis, hepatic or renal failure
--Adverse reactions: Wakness, prologed neuromuscular block, bronchospasm, apnea, dysrhythmias, bradycardia, tachycardia, PVCs, transiet hypotension, cardiac arrest, excessive salivation.
--Drug interactions: Use of inhalation anesthetics will enhance neuromuscular blockade.
--Dosage: 0.1-0.3 mg/kg.
--Special considerations: Pregnancy safety: Category C. If patient is conscious explain the effect of the medication before administration and always sedate the patient before using vecuronium. Intubation and ventilatory support must be readily available. Monitor the patient carefully. Vercuronium has no effect on consciousness or pain. Will not stop neuronal seizure activity. Pulse rate and cardiac output are increased. Decrease doses for patients with renal disease.

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Diazepam (Valium and others)

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--Class: Benzodiazepine, long-acting:sedatrive-hypnotic, anticonvulsant; schedule IV drug
--MOI: Potentates effects of inhibitory neurotransmitters. Raises the seizure threshold. Induces amnesia and sedation.|
--Indications: Acute anxiety states of agitation, acute alcohol withdrawal, muscle relaxant, seizure activity, sedation for medical procedures (Intubation, ventilated patients, cardioversion), may be helpful in acute symptomatic cocaine overdose.
--Contraindications: hypersensitivity, narrow angle glaucoma, myasthenia gravis, respiratory insufficiency, coma, head injury.
--Adverse reactions: Dizziness, drowsiness, confusion, headache, respiratory depression, hypotension, reflex tachycardia, nausea, vomiting, muscle weakness, tissue necrosis, ataxia, thrombosis, phlebitis
--Drug Interactions: Incompatible with most drugs,fluids.
--Dosage: 5-10mg Slow IV Push, Peds 0.1mg/kg Slow IV Push
--Special considerations: Pregnancy safety: Category D. Short duration for anticonvulsant effect. Reduce dose by 50% in elderly patients.

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Midazolam Hydrocholoride (Versed)

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--Class: Benzodiazepine, Short/intermediate acting;Schedule IV drug
--MOI: Reversibly interacts with gamma-amino butyric acid (GABA) receptors in the CNS causing sedative, anxiolytic, amnesic, and hypnotic effects.
--Indications: Sedation for medical procedures (Intubation, ventilated patients, cardioversion)
--Contraindications: Acute narrow-angle gaucoma, shock, coma, alcohol intoxication, overdose, depressed cital signs, concomitant use with barbituates, alcohol, narcotics, and other CNS depressants
--Adverse reactions: headache, somnolence, respiratory depression, respiratory arrest, apnea, hypotension, cardiac arrest, nausea, vomiting, pain at the injection site.
--Drug interactions: Should not be used in pt who have taken CNS depressants
--Dosage 2.5mg Slow IV Push, peds: 0.1mg/kg Slow IV Push
--Special considerations: Pregnancy safety: Category D. Administer immediately prior to intibuation procedure. Requires continuous monitoring of respiratory and cardiac function. Decrease dose by 50% in pts with hepatic and renal dysfunction.