Shared Flashcard Set

Details

National Registry Drugs
drug list for NR paramedic 2013
62
Medical
Professional
01/14/2020

Additional Medical Flashcards

 


 

Cards

Term

Morphine


Duramorph

Definition

Class-Narcotic (opioid)
Action-Analgesia and sedation through binding of opiate receptors
Indications-moderate to severe pain

Contraindications-Hypotension, hypersensitivity to the drug

Doses-2-10 mg

Routes-IV, IO, IM, SQ, PO

Adverse Effects-Hypotension, Syncope, Tachycardia, Bradycardia, Apnea, Nausea, Vomitting, Respitory depression

Other-Use appropriate monitors. Naloxone is an antagonist

Term

Hydromophone


Dilaudid

Definition

Class-Narcotic (opioid)

Action-Analgesia and sedation through binding to opiate receptors

Indications-Moderate to severe pain

Contraindications-Hypersensitivity to the drug

Doses-0.5-2 mg

Routes-IV, IO, IM, SQ, PO

Adverse Effects-Nausea, Vomitting, Cramps, Respitory depression

Other-use appropriate monitors. Naloxone is an antagonist

Term

Fentanyl



Sublimaze

Definition

Class-Narcotic (opioid)

Action-Analgesic through binding to opiate receptors

Indications-Moderate to severe pain. Anesthetic

Contraindications-Hypersensitivity to the drug

Doses-50-100 mcg

Routes-IV, IO, IM, SQ, IN

Adverse Effects-Nausea, Vomitting, Cramps, Chest wall rigidity, Respitory depression

Other-Use appropriate monitors. Nalaxone is an antagonist

Term

Meperidine



Demerol

Definition

Class-Narcotic (opioid)

Action-Analgesic through binding to opiate receptors

Indications-Moderate to severe pain

Contraindications-Hypersensitivity to the drud. Patients recieving monoamine oxidase inhibitors(MAOIs)

Doses-25-100 mg

Routes-IV, IO, IM, SQ, PO

Adverse Effects-Nausea, Vomitting, Euphoria, Dysphoria, Respitory depression

Other-Use appropriate monitors. Naloxone is an antagonist

Term

Acetaminophen


Tylenol

Definition

Class-Nonnarcotic analgesic, antipyretic (para-aminophenol derivative)

Action-Exact mechanism uncertain but felt to inhibit cyclooxygenase

Inications-Mild-moderate pain, fever

Contraindications-Hypersensitivity to the drug, alcoholism, chronic liver disease, head injury, hypotension, previously taken the drug, inability to swallow, respitory distress, persistent vomitting, under 3 years of age

Doses-3-5 yo 160mg/5ml, 6-9 yo 320mg/10ml, 10 yo an up 640mg/20ml, NR 325-650 mg

Routes-PO

Adverse Effects-Not clinically significant

Other-can be liver toxic- use minimal dose necessary

Term

Ibuprofen


Motrin, Advil

Definition

Class-NSAID

Action-Anti-inflammatory and antipyretic through inhibition of prostaglandins

Indications-Mild to moderate pain, fever, inflammation

Contraindications-Hypersensitivity to the drug, bronchospasm, angioedema

Doses-200-800 mg

Routes-PO

Adverse Effects-Nausea, Vomiting, GI bleeding, Allergic reactions

Other-Commonly causes gastric upset

 

Term

Ketorolac


Torodal

Definition

Class-NSAID

Action-Anti-inflammatory and antipyretic through inhibition of prostaglandins

Indications-Mild to moderate pain, fever, inflammation, renal colic

Contraindications-Hypersensitivity to the drug, bronchospasm, angioedema

Doses-30 mg (IV and the elderly) 60 mg IM

Routes-IV, IM

Adverse Effects-Nausea, Vomiting, GI bleeding, Allergic reactions

Other-Can cause dizziness and headache

Term
Aspirin
Definition

Class-NSAID

Action-Platlet inhibitor, Anti-inflammatory and antipyretic through inhibition of thromboxane A2

Indications-Chest pain when acute myocardial infarction is suspected, Mild to moderate pain, Fever, Platelet aggregation inhibitor

Contraindications-Hypersensitivity to the drug, Bronchospasm, Angioedema, Patients receiving MAOIs

Doses-Pediatric:not indicated, Adult: 324 mg or 325 mg chewed. NR 350-650 mg

Routes-PO

Adverse Effects-Heartburn, Wheezing, Nausea, Vomiting, GI bleeding, Allergic reactions

Other-commonly causes gastric upset, avoid enteric-coated asperin in chest pain

Term

Naloxone


Narcan

Definition

Class- Opiate antagonist

Action-Opioid antagonist w/o opiate agonist properties (it has no activity when given in the absence of an opiate agonist)

Indications-Partial reversal of opiate drug effects, opiate overdose

Contraindications-Hypersensitivity to the drug

Doses-0.4-2 mg

Routes-IV, IO, SQ, IN, Nebulizer

Adverse Effects-Fever, Chills, Nausea, Vomiting, Diarrhea, Opiate withdrawal

Other-Administer enough to reverse respitory depression and avoid full narcotic withdrawal syndrome

Term

Nalmefene



Revex

Definition

Class- Opiate antagonist

Action-Opioid antagonist w/o opiate agonist properties (it has no activity when given in the absence of an opiate agonist)

Indications-Partial reversal of opiate drug effects, opiate overdose

Contraindications-Hypersensitivity to the drug

Doses-0.5-1 mg

Routes-IV, IO, SQ, IM 

Adverse Effects-Fever, Chills, Nausea, Vomiting, Diarrhea, Opiate withdrawal

Other-Duration of effect much longer than naloxone

Term

Nalbuphine


Nubian

Definition

Class-Opiate agonist-antagonist

Action-Anelgisia and sedation through bining to opiate receptors. It also has some opiate receptor antagonistic properties 

Indications-Moderate to severe pain

Contraindications-Hypersensitivity to the drug, Opiate dependance, Respitory depression

Doses-10-20 mg

Routes-IV, IO, SQ

Adverse Effects-Sedations, Dizziness, Nausea, Vomiting, Opiate withdrawal

Other-Use with caution in patients with liver and renal disease

Term

Butorphanol


Stadol

Definition

Class-Opiate agonist-antagonist

Action-Anelgisia and sedation through bining to opiate receptors. It also has some opiate receptor antagonistic properties 

Indications-Moderate to severe pain

Contraindications-Hypersensitivity to the drug, Opiate dependance, Respitory depression

Doses-1-4 mg

Routes-IV, IO, SQ, IM, IN

Adverse Effects-Sedations, Dizziness, Nausea, Vomiting, Opiate withdrawal

Other-Use with caution in patients with liver and renal disease

Term

Diazepam


Valium

Definition

Class-Benzodiazepine

Action-Binds to Type A GABA receptors causing seation

Indications-Anxiety, Seizures, Muscle relaxation

Contraindications-History of hypersensitivity to the drug

Doses-2-10 mg

Routes-IV, IM, IO, PO, rectal

Adverse Effects-Hypotension, Sedation, Amnesia, Respitory depression, Nausea, Vomiting

Other-Incompatible with other medications because not as water soluble, Can cause irritation with injection, Flumazenil is an antagonist

Term

Midazolam


Versed

Definition

Class-Benzodiazepine

Action-Binds to Type A GABA receptors causing seation

Indications-Anxiety, Seizures, Sedation

Contraindications-History of hypersensitivity to the drug

Doses-1-5 mg

Routes-IV, IM, IO

Adverse Effects-Hypotension, Sedation, Amnesia, Respitory depression, Nausea, Vomiting

Other-Flumazenil is an antagonist

Term

Lorazepam


Ativan

Definition

Class-Benzodiazepine

Action-Binds to Type A GABA receptors causing seation

Indications-Anxiety, Seizures, Sedation

Contraindications-History of hypersensitivity to the drug

Doses-1-4 mg

Routes-IV, IM, IO, PO, rectal

Adverse Effects-Hypotension, Sedation, Amnesia, Respitory depression, Nausea, Vomiting

Other-Flumazenil is an antagonist

Term

Ketamine


Ketalar

Definition

Class-Dissociative anesthetic

Action-Causes dissociation between the cortical and limbic system

Indications-Sedation, Analgesia

Contraindications-History of hypersensitivity to the drug, Hypertension

Doses-0.5-1 mg/kg (IV), 2-4 mg/kg (IM)

Routes-IV, IM

Adverse Effects-Hallucinations

Other-All monitors should be in place, Resuscitative equipment should be immediately available

Term
Nitrous Oxide
Definition

Class-Sedative/ anesthetic gas

Action-CNS depressant

Indications-Pain, Sedation

Contraindications-COPD, Pneumothorax, Bowel obstruction

Doses-Self-administered

Routes-Inhalation

Adverse Effects-Dizziness, Hallucinations, Nausea, Vomiting, Altered mental status

Other-Should not be used in any patient who cannot comprehend verbal instructions or who is intoxicated with alcohol or other medications

 

Term

Propofol


Diprivan

Definition

Class-Nonbarbiturate, nonbenzodiazepine sedative

Action-Uncertain, but appears to potentiate GABA receptors

Indications-Sedation

Contraindications-History of hypersensitivity to the drug. Hypersensitivity to egg or soy products

Doses-25-75 mcg/kg/min

Routes-IV

Adverse Effects-Pain on induction, Nausea, Vomiting, Respitory depression

Other-All monitors should be in place, Resusitative equipment should be immediately available

Term

Etomidate


Amidate

Definition

Class-Nonbarbiturate, nonbenzodiazepine sedative

Action-Uncertain, but appears to potentiate GABA receptors

Indications-Sedation

Contraindications-History of hypersensitivity to the drug. 

Doses-0.1-0.3 mg/kg

Routes-IV

Adverse Effects-Myoclonic jerks, Respitory depression, Laryngospasm

Other-Does not have analgesic properties, Calcium-channel blockers can prolong respitory depression, Can cause increased cortisol levels, All monitors should be in place, Resusitative equipment should be immediately available

Term

Haloperidol


Haldol

Definition

Class-Butyrophenone

Action-Blocks dopamine receptors associated with mood and behavior

Indications-Psychosis

Contraindications-Hypotension, Hypersensitivity to the drug

Doses-15-69yoa 5 mg, >69yoa 2.5 mg, 12-14yoa 2.5-5 mg, 6-11yoa 0.05 mg/kg max 2.5 mg, <6yoa contraindivated, NR 2-10 mg

Routes-IM, PO

Adverse Effects-Extrapyramidal reactions, Insomnia, Restlessness, Dry mouth, Hypotension, Tachycardia

Other-Hypotension more common in patients taking antihypertensives

Term

Chlorpromazine


Thorazine

Definition

Class-Phenothiazine

Action-blocks dopamine receptors associated with mood and behavior

Indications-Psychosis, Intractable hiccoughs

Contraindications-Hypotension, Hypersensitivity to the drug

Doses-25-50 mg

Routes-IM, PO

Adverse Effects-Extrapyramidal reactions, Insomnia, Restlessness, Dry mouth, Hypotension, Tachycardia

Other-Hypotensionmore common in patients taking antihypertensives

Term

Ziprasidone


Geodon

Definition

Class-Unclassified antipsychotic

Action-Inhibits uptake of serotonin and dopamine

Indications-Pyschosis, Tourette,s syndrome

Contraindications-Hypersensitivity to the drug

Doses-50-100 mcg

Routes-IM, PO

Adverse Effects-Extrapyramidal reactions, Insomnia, Restlessness, Dry mouth, Hypotension, Tachycardia

Other-Carbamazepine (Tegretol) can decrease ziprasidone levels

Term
Atropine
Definition

Class-Muscarinic anticholinergic (Parasympatholytic)

Action-Selectively blocks muscarinic receptors inhibiting parasympathetic stimulation

Indications-Bradycardia, Antidote for organophosphate poisoning, Premedication for RSI

Contraindications-Hypersensitivity to the drug

Doses-0.5-2 mg

Routes-IV, IO

Adverse Effects-Blurred vision, Dry mouth, Dilated pupils, Confusion

Other-Organophosphate poisonings may require a significantly higher dose

Term

Ipratropium


Atrovent

Definition

Class-Muscarinic anticholinergic (parasympatholytic)

Action-Selectively blocks muscarinic receptors inhibiting parsympathetic stimulation

Indications-Bronchospasm associated with obsructive lung disease (asthma, COPD)

Contraindications-Hypersensitivity to the drug

Doses-500 mcg

Routes-Inhaled

Adverse Effects-Blurred vision, Dry mouth, Dilated pupils, Cough, Confusion

Other-Typically administered with a beta agonist (although not as frequently)

Term

Succinylcholine


Anectine

Definition

Class-Depolarizing neuromuscular blocker

Action-Binds to acetylcholine receptors at the neuromuscular junction causing depolarization and subsequent paralysis

Indications-Rapid sequence intubation (RSI)

Contraindications-Hyperkalemia, Neuromuscular disease, Crush injury, Burns, Increased intracranial pressure, Severe trauma

Doses-1.5 mg/kg (60-150 mg) rapid IV push may repeat at 0.5 mg/kg (20-50 mg) rapid IV push, NR 1-2 mg/kg

Routes-IV, IO

Adverse Effects-Hyperkalmia, Bradycardia, Prolonged paralysis, Malignant hyperthermia, Increased intracranial pressure, muscle fasciculations, Trismus

Other-These agents should only be used by person skilled in their use, competent at complicated airway managment, and necessary resusitative equipment available


Term

Vecuronium



Nurcuron

Definition

Class-Nondepolarizing neuromuscular blocker

Action-Binds to acetylcholine receptors at the neuromuscular junction causing paralysis

Indications-Papid sequence intubation (RSI)

Contraindications-Hypersensitivty to the drug

Doses-0.05 mg/kg (2-5 mg) IVP, NR 01-0.15 mg/kg

Routes-IV, IO

Adverse Effects-Skeletal muscle weakness, Malignant hyperthermia, Apnea

Other-Thses agents should only be used by peson skilled in their use, competent at complicated airway management, and with all necessary resusitative equipment available

Term

Rocuronium



Zemuron

Definition

Class-Nondepolarizing neuromuscular blocker

Action-Binds to acetylcholine receptors at the neuromuscular junction causing paralysis

Indications-Papid sequence intubation (RSI)

Contraindications-Hypersensitivty to the drug

Doses-1 mg/kg

Routes-IV, IO

Adverse Effects-Hypertension, Hypotension, Skeletal muscle weakness, Malignant hyperthermia, Apnea

Other-Thses agents should only be used by peson skilled in their use, competent at complicated airway management, and with all necessary resusitative equipment availabl

Term
Epinephrine
Definition

Class-Sympathetic agonist

Action-α- and β- adrenergic agonist (β effects more pronounced although dose-related)

Indications-Cardiac arrest, Sympathetic bradycardia, Normovolemic hypotension, Allergies/anaphalaxis, Severe bronchospasm

Contraindications-Few in emergency setting

Doses-Cardiac Arrest 1 mg (1;100000), Anaphylaxis, Asthma 0.01 mg/kg IM (1:1000) max single dose 0.5 mg, NR 0.3-1 mg

Routes-IV, IO, IM, SQ, ET, Inhaled

Adverse Effects-Palpations, Anxiety, Tremulousness, Headache, Dizziness, Hypertension, Can worsen cardiac ischemia

Other-Two preperations are commonly available: 1:1000 (1mg/ml) 1:10000 (1mg/10ml)


Term

Norepinephrine



Levophed

Definition

Class-Sympathetic agonist

Action-α- and β- adrenergic agonist (β effects more pronounced)

Indications-Normovolemic hypotension, Septic shock, Cardiogenic shock

Contraindications-Should not be used in hypovolemia until volume replacement has occured

Doses-0.1-0.5 mcg/kg/min (titrate to effect)

Routes-IV

Adverse Effects-Palpations, Anxiety, Tremulousness, Headache, Dizziness, Hypertension, Can worsen cardiac ischemia, Reflex bradycardia

Other-Extravasation can cause localized tissue damage, Best administered through a central line

Term

Dopamine



Intropin

Definition

Class-Sympathetic agonist

Action-α- and β- adrenergic agonist 

Indications-Normovolemic hypotension, Symptomatic bradycardia, Septic shock, Cardiogenic shock

Contraindications-Should not be used in hypovolemia until volume replacement has occured

Doses-2-20 mcg/kg/min (titrate to effect)

Routes-IV

Adverse Effects-Palpations, Anxiety, Tremulousness, Headache, Dizziness, Hypertension, Can worsen cardiac ischemia, Reflex bradycardia

Other-Extravasation can cause localized tissue damage, Best administered through a central line, Proposed renal benefit has been disproven

Term

Dobutamine



Dobutrex

Definition

Class-Sympathetic agonist

Action-α- and β- adrenergic agonist (inotropic properties more pronounced than chronotropic properties)

Indications-Congestive heart failure

Contraindications-Should not be used in hypovolemia until volume replacement has occured

Doses-2-20 mcg/kg/min (titrate to effect)

Routes-IV

Adverse Effects-Palpations, Anxiety, Tremulousness, Headache, Dizziness, Hypertension, Can worsen cardiac ischemia, Reflex bradycardia

Other-Extravasation can cause localized tissue damage, Best administered through a central line, Other agents preferred in cardiogenic shock

Term

Albuterol



Ventolin, Proventil

Definition

Class-β-agonist

Action-β-agonist with preference for βadrenergic receptors

Indications-Bronchospasm, Allergies/anaphylaxis, Hyperkalemia

Contraindications-Known Hypersensitivity to the medication

Doses-2.5 mg (SVN), 90 mcg (MDI)

Routes-Inhalation

Adverse Effects-Palpations, Anxiety, Tremulousness, Headache, Dizziness, Tachycardia

Other-The patient's heart rate and SpO2 should be monitored during treatment

Term

Levalbuterol



Xopenex

Definition

 

Class-β-agonist

Action-β-agonist with preference for βadrenergic receptors. It is racemic isomer of albuterol

Indications-Bronchospasm, Allergies/anaphylaxis, Hyperkalemia

Contraindications-Known Hypersensitivity to the medication

Doses-0.63 mcg (SVN)

Routes-Inhalation

Adverse Effects-Palpations, Anxiety, Tremulousness, Headache, Dizziness, Tachycardia

Other-The patient's heart rate and SpO2 should be monitored during treatment

 

Term

Metaproterenol



Alupent

Definition

Class-β-agonist

Action-β-agonist with preference for βadrenergic receptors

Indications-Bronchospasm, Allergies/anaphylaxis, Hyperkalemia

Contraindications-Known Hypersensitivity to the medication

Doses-0.2-0.3 ml of solution containing 15 mg/ml (SVN); 0.65 mg (MDI)

Routes-Inhalation

Adverse Effects-Palpations, Anxiety, Tremulousness, Headache, Dizziness, Tachycardia

Other-The patient's heart rate and SpO2 should be monitored during treatment

Term

Racemic Epinephrine



S2

Definition

Class-Sympathetic agonist

Action-Relatively nonselective β-agonist. It is a mix of both racemic isomers of epinephrine

Indications-Croup

Contraindications-Known hypersensitivity to the medication

Doses-0.25-0.75 ml of a 2.5% solution

Routes-Inhalation

Adverse Effects-Palpations, Anxiety, Tremulousness, Headache, Dizziness, Tachycardia

Other-The patient's heart rate and SpO2 should be monitored during treatment

Term

Amiodarone



Cordarone

Definition

Class-Class III antiarrhythmic

Action-Prolongs action potentialand duration in cardiac tissues through sodium, potassium, and calcium channels; blocks α- and β- adrenergic receptors

Indications-Ventricular tachycardia, Ventricular fibrillation, Narrow-complex tachycardias

Contraindications-Breast feeding, Bradycardia, High-grade heart block, Hypersensitivity to the drug

Doses-150-300 mg

Routes-IV

Adverse Effects-Hypotension, Bradycardia, Prolonged PR, QRS, and QT

Other-Constant ECG monitoring, Now first-line agent in ventricular fibrillation and tachycardia

Term

Lidocaine



Xylocaine

Definition

Class-Class IB antiarrhythmic; local anesthetic

Action-Amide-type local anesthetic; slows depolarization and automaticity

Indications-Ventricular tachycardia and fibrillation refactory to amiodarone, Local anesthetic

Contraindications-Should not be administered to patients receiving IV calcium channel blockers

Doses-1-1.5 mg/kg

Routes-IV

Adverse Effects-Drowsiness, Slurred speach, Confusion, Seizures, Hypotension

Other-Use with caution when administered with other antiarrhythmics

Term

Procainamide



Pronestyl

Definition

Class-Class IA antiarrhythmic; local anesthetic

Action-Ester-type local anesthetic; reduces automaticity and AV conduction

Indications-Ventricular tachycardia with pulse, Pre-excited atrial fibrillation

Contraindications-Should not be administered to patients receiving IV calcium channel blockers

Doses-20-50 mg/min

Routes-IV

Adverse Effects-Drowsiness, Slurred speach, Confusion, Seizures, Hypotension

Other-Carefully monitor ECG (QRS duration) during administration


Term

Phenytoin


Dilantin



Definition

Class-Class IB antiarrhythmic;anticonvulsant

Action-Depresses automaticity and AV conduction; reduces voltage and spread of electrical discharges in motor cortex

Indications-Life-threatening arrhythmias from digitalis toxicity, seizures

Contraindications-Bradycardia, High-grade heart block, Hypersensitivity to the drug

Doses-15-18 mg/kg

Routes-IV

Adverse Effects-Drowsiness, Dizziness, Headache, Hypotension, Arrhythmias, Nausea, Vomiting

Other-Fosphenytoin is preferred for seizure management


Term

Adenosine



Adenocard

Definition

Class-Nucleoside

Action-Slows AV conductio; short half-life

Indications-Supraventricular tachyarrhythmias

Contraindications-Atrial fibrillation, Torsades des pointes

Doses-6 mg

Routes-IV

Adverse Effects-Facial flushing, Headache, Chest pain, Nausea

Other-Should be given by rapid IV push followed by saline bolus, Arrhythmias common following administration

Term

Esmolol



Brecibloc

Definition

Class-Class II antiarrhythmic; beta-blocker

Action-Slows heart rate through selective blockage of β1 receptors; short half-life

Indications-Tachycardia

Contraindications-Asthma, Heart block, Bradycardia, Cardiogenic shock

Doses-50-100 mcg/kg/min

Routes-IV

Adverse Effects-Bradycardia, Hypotension, Congestive heart failure, Lethargy

Other-Hypotension is common but dose-related, Should not be administered to patients receiving IV calcium channel blockers

Term

Labetalol



Trandate, Normdyne

Definition

Class-Class II antiarrhythmic; beta-blocker

Action-Lowers blood pressure through nonselective blockage of β receptors (and limited blockade of α2 receptors

Indications-Hypertensive emergency

Contraindications-Asthma, Heart block, Bradycardia, Cardiogenic shock

Doses-10-20 mg

Routes-IV, PO

Adverse Effects-Bradycardia, Hypotension, Congestive heart failure, Lethargy

Other-Should not be administered to patients receiving IV calcium channel blockers

Term

Diltiazem



Cardizem

Definition

Class-Class IV antiarrhythmic; calcium channel blocker

Action-Lowers blood presure by relaxing vascular smooth muscle; slows AV conduction

Indications-Rapid ventricular rate associated with atrial fibrillation, Stable narrow-complex tachyarrhythmias

Contraindications-Hypotension, Congestive heart failure, Cardiogenic shock, Wide-complex ventricular tachycardia

Doses-0.25 mg/kg IV bolus (max 20mg), NR 15-20 mg

Routes-IV

Adverse Effects-Nausea, Vomiting, Dizziness, Headache, Hypotension

Other-Can be given as IV bolus or IV infusion, Calcium chloride can reverse some of the untoward effects


Term
Magnesium Sulfate
Definition

Class-Mineral/electrolyte

Action-Physiologic calcium-channel blocker; bronchodilator

Indications-Torsades des pointes, Asthma, Hypertensive disorders of pregnancy

Contraindications-High-degree heart blocks, Shock, Dialysis, Hypocalcemia

Doses-1-2 g

Routes-IV

Adverse Effects-Flushing, Sweating, Bradycardia, Respitory depression, Hypothermia

Other-Can cause cardiac conduction problems in conjunction with digitalis

Term

Nitroglycerin



Nitrostat

(tablet, spray)

Definition

Class-Nitrate

Action-Relaxes vascular smooth muscle causing vasodilation, ddecreased cardiac work, and improved coronary blood flow

Indications-Chest pain, Congestive heart failure

Contraindications-Hypotension, Increased intracranial pressure

Doses-0.4 mg

Routes-SL (tablet or spray)

Adverse Effects-Headache, Dizziness, Weakness, tachycardia, Hypotension

Other-Tablets will lose effectivness after exposure to air, Monitot BP closely

Term
Nitroglycerin Paste
Definition

Class-Nitrate

Action-Relaxes vascular smooth muscle causing vasodilation, ddecreased cardiac work, and improved coronary blood flow

Indications-Chest pain, Congestive heart failure

Contraindications-Hypotension, Increased intracranial pressure

Doses-0.5-1 inch

Routes-Transdermal

Adverse Effects-Headache, Dizziness, Weakness, tachycardia, Hypotension

Other-Do not get paste on your finger as this may cause a headache, Monitot BP closely

Term

Diphenhydramine



Benadryl

Definition

Class-Antihistamine

Action-Nonselctively blocks Hand Hhistamine receptors

Indications-Allergies, Extrapyramidal reactions, Parkinson's disease, Sedation, Anaphylaxis

Contraindications-Hypersensitivity to the drug, Glaucoma, Pregnancy

Doses-25-50 mg

Routes-IV, IM, IO, PO

Adverse Effects-Drowsiness, Dizziness, Sedation, Dry mouth

Other-If given IM, give deep in muscle

Term

Cimetidine



Tagamet

Definition

Class-Antihistamine

Action-Selectively blocks Hhistamine receptors

Indications-Duodenal/peptic ulcer, Anaphylaxis

Contraindications-Hypersensitivity to the drug

Doses-300 mg

Routes-IV, IM, IPO

Adverse Effects-Diarrhea, Drowsiness, Dizziness

Other-Can be used as an adjunct for severe allergic reactions and anaphylaxis

Term

Prochlorperazine



Compazine

Definition

Class-Phenothiazine

Action-Supresses the CTZ; has anthistaminic effects

Indications-Nausea, Vomiting, Anxiety, Psychosis

Contraindications-Hypersensitivity to the drug, Small children, Pregnancy

Doses-5-10 mg

Routes-IV, IM, IO, PO

Adverse Effects-Drowsiness, Dizziness, Sedation, Dry mouth, Extrapyramidal symptoms

Other-Can poteniate CNS depressants (e.g., alcohol)


Term

Promethazine



Phenergan

Definition

Class-Phenothiazine

Action-Supresses the CTZ; has anthistaminic effects

Indications-Nausea, Vomiting

Contraindications-Hypersensitivity to the drug

Doses-12.5-25 mg

Routes-IV, IM, PO

Adverse Effects-Drowsiness, Dizziness, Sedation, Dry mouth, Extrapyramidal symptoms

Other-Can poteniate CNS depressants (e.g., alcohol), Extravasation can cause local tissue injury, Rarely used

Term

Ondansetron



Zofran

Definition

Class-Serotonin antagonist

Action-Selectively blocks 5-HTserotonin receptors including those in the CTZ and vegas nerve terminals

Indications-Nausea, Vomiting

Contraindications-Hypersensitivity to the drug

Doses-4-8 mg

Routes-IV, IM, PO

Adverse Effects-Dizziness, Lightheaded

Other-Commonly used in emergency medecine because of good safety profile

Term

Vasopressin



Pitressin

Definition

Class-Hormone (analog of antidiuretic hormone)

Action-Non-adrenergic vasoconstrictor; promote fluid retention in the kidney

Indications-Cardiac arrest, Normovolemic hypotension

Contraindications-Few in emergency setting

Doses-40 units

Routes-IV

Adverse Effects-Blanching of the skin, Abdominal cramping, Nausea, Hypertension

Other-Benefits in cardiac arrest are questionable

Term

Oxytocin



Pitocin

Definition

Class-Hormone (oxytocin)

Action-Oxytocin; causes uterine contractions and lactations

Indications-Postpartum vaginal bleeding, Induction/augmentation of labor

Contraindications-Anything other than post-partum bleeding (in the prehospital setting)

Doses-10-20 units in 500 ml IV; 3-10 units (IM)

Routes-IV, IM

Adverse Effects-Anaphylaxis, Arrhythmias

Other-Ensure placenta (and possible additional baby) has delivered before administering

Term
Glucagon
Definition

Class-Hormone (glucagon)

Action-Elevates blood glucose levels through conversion of glycogen to glucose and other factors

Indications-Hypoglycemia, Beta-blocker overdose

Contraindications-Hypersensitivity to the drug

Doses-0.25-0.5 u(IV) 1 mg IM

Routes-IV, IM, IO

Adverse Effects-Few in the emergency setting

Other-Less effective in patients with decreased glcogen stores (e.g., alcoholics)


Term

Insulin



Humulin, NovoLog, Novolin

Definition

Class-Hormone (insulin)

Action-Causes glucose uptake by the cells thus lowering blood glucose levels

Indications-Diabetes, Hyperglycemia, Diabetic ketoacidosis

Contraindications-Hypoglycemia, Normoglycemia

Doses-Varies

Routes-IV, SQ

Adverse Effects-Few in the emergency setting

Other-Dosages of the various insulin types vary significantly

Term

Dextrose

50%

Definition

Class-Carbohydrate

Action-Substrate for carbohydrate metabolism

Indications-Hypoglycemia

Contraindications-None in the emergency setting

Doses-12.5-25 g

Routes-IV, PO

Adverse Effects-Local venous irritation common, Tissue injury

Other-Less concentrated solutions (e.g., 10%)equally effective with fewer side-effects

Term
Methylprednisone
Definition

Class-Hormone (analog of corticosteroid)

Action-Anti-inflammatory supresses immune response

Indications-asthma, COPD, anaphylaxis

Contraindications-Hypersensitivity to the drug

Doses-125-250 mg

Routes-IV, IO

Adverse Effects-GI bleeding, Increases blood glucose levels

Other-Effects are delayed and not typically seen in the prehospital setting

Term

Naloxone


Narcan

Definition

Class-Opiate antagonist

Action-Opiate antagonist without opiate agonist properties (it has no activity when given in the absence of an opiate agonist)

Indications-Partial reversal of opiate drug effects, Opiate overdose

Contraindications-Hypersensitivity to the drug

Doses-0.4-2 mg

Routes-IV, IO, SQ, IN, nebulizer

Adverse Effects-Fever, Chills, Nausea, Diarrhea, Opiate withdrawal

Other-administer enough to reverse respitory depresion and avoid full narcotic withdrawal syndrome

Term

Flumazenil

 

 

 

Romazicon

 

Definition

Class-Benzodiazepine antagonist

Action-Competively blocks benzodiazepines at the GABA/ benzodiazepine receptor complex

Indications-Benzodiazepine overdose

Contraindications-Hypersensitivity to the drug

Doses-0.2 mg

Routes-IV

Adverese Effects-Fatigue, Headache, Nervousness, Dizziness

Other-Administer with caution in patients dependent on benzodiazepines as life-threatening withdrawal (includingseizures) can occur


Term
Amyl nitrite
Definition

Class-Cyanide antodote

Action-Vasodilator; oxides hemoglobin to methemoglobin which reacts with cyanide ion to form cyanomethemoglodin, that is enzymatically degraded

Indications-Cyanide poisoning

Contraindications-None in the emergency setting

Doses-1-2 inhalents

Routes-Inhaled

Adverse Effects-Headache, Weakness, Dizziness, Flushing, Tachycardia, Orthostatic hypotension

Other-Headache and hypotension common, Can worsen hypoxia in the setting of carbon monoxide poisoning

Term
Sodium nitrite
Definition

 

Class-Cyanide antodote

Action-Vasodilator; oxides hemoglobin to methemoglobin which reacts with cyanide ion to form cyanomethemoglodin, that is enzymatically degraded

Indications-Cyanide poisoning

Contraindications-Should not be administered to asymptomatic patients

Doses-150-300 mg

Routes-IV

Adverse Effects-Headache, Weakness, Dizziness, Flushing, Tachycardia, Orthostatic hypotension

Other-Headache and hypotension common, Can worsen hypoxia in the setting of carbon monoxide poisoning

 

Term
Sodium thiosulfate
Definition

 

Class-Cyanide antodote

Action-Converts cyanide to thiocyanate which is removed by the kidneys

Indications-Cyanide poisoning

Contraindications-None in the emergency setting

Doses-12.5 g

Routes-IV

Adverse Effects-Nausea, Vomiting, Joint pain, Psychosis

Other-Should be administered as part of the standard (Pasadena) cyanide kit

 

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