Diazepam (Valium)

Class: Benzodiazapine, sedative-hypnotic, anitconvulsant

Indications: acute anxiety, acute alcohol withdrawl, muscle relaxant, seizure activity, agitation,analgesia for medical proceedures( cardioversion & fractures)

Contraindications: hypersensitivity, come, glacoma, shock, head injury, substance abuse

Adverse Reactions: respiratory depression, hypotension, drowsiness, ataxia, reflex tachycardia, nausea, confusion, thrombosis, phlebitis

Dose: seizure adult 5-10mg IV (5mg over 5 min) max 30mg Seizure peds: 0.2-0.5mg/kg 2-5 min max dose 10mg/kg, cardioversion 5-15mg over 5-10 min

Lorazepam (Ativan)

Class: Benzodiazepine, sedative, anticonvulsant

Indications: seizures, severe anxiety, sedation

Contraindications: acute narrow angle glacoma, coma, shock, suspected drug abuse

Adverse Reactions: respiratory depression, apnea, drowsiness, sedation, ataxia, confusion, delirium, hypotension, bradycardia

Dose: Adult 2-4mg slow IV(2mg/min) repeat 15-20 min max 8mg. Sedation:0.05 mg/kg  up to 4mg IM. Peds: 0.05-0.2 mg/kg slow IV/IO (over 2 min) repeat 15-20 min max 0.2 mg/kg

Meperidine (Demerol)

Class: Opioid analgesic

Indications: Analgesia for moderate to severe pain

Contraindications: Hypersensitivity, diarrhea from poisoning, pts  taking MAOI's during labor or delivery of a premie, undiagnosed ab pain, head injury

Adverse Reactons: Respiratory depression, sedation, apnea, circulatory depression, arrhythmias, shock, euphoria, delirium, coma, seizures, headache, nausea, vomiting, agitation, delirium, hallucinations

Dose: Adult: 50-100mg IM, SC or 25-50 mg slow IV Peds 1-2mg/kg/dose IV,IO,IM,SC

Nitrous Oxide:Oxygen (50:50)

(Nitronox)

Class: Gaseous analgesic and anestheic

Indications: Moderate to severe pain, anxiety, apprehension

Contraindications: impaired LOC, head injury, decompression sickness, undiagnosed ab pain, bowel obstruction, hypotension, shock, COPD cyanosis

Adverse Reactions: Dizziness, apnea, cyanosis, nausea, vomiting, malignant hyperthermia, drowsiness, euphoria

Dose: instrust the pt to inhale deeply throughthe mask (50:50 mixture with oxygen)

Ketorolac Tromethamine

(Toradol IM)

Class: Nonsteroidal anti-inflamatory (NSAID) analgesic

Indications: Short term management of moderate to severe pain

Contraindications: allergy to salicylates or other NSAID's, pt with history of asthma, bleeding disorders (GI related ex peptic ulcers), renal failure

Adverse Reactions: Anaphylaxis due to hypersensitivity, nausea, GI bleeding, sedation, hypotension, hypertension, rash, headache, edema

Dose: Adult:30-60mg IM Peds: not recommended

Etomidate (Amidate)

Class: Hypnotic

Indications: Use before insertion of ET tube

Contraindications: Hypersensitivity, hypotension, severe asthma, severe cardiovascular disease

Adverse Reactions: muscular fasciculations, apnea

Dose: 0.1-0.3mg/kg max 0.6mg/kg