Classification: Opiate Antagonist

Action: Competitively blocks opiates at receptor sites

Indications: Opiate Overdose, Partial reversal of opiate effects

Contraindications: Hypersensitivity to Drug

Dose: 0.4-2.0mg

Route: IV, IO, SQ, IN, Nebulized

Side Effects: Chills, Nausea, Vomiting, Opiate Withdraw

Classification: Antiarrhythmic

Indications: Supraventricular Tachyarrhythmia's

Contraindications: Atrial Fibrillation, Torsades De Pointes

Side Effects: Facial flushing, Headache, Chest Pain, Nausea

Route: IV rapid push

Adult Dose: 6mg/12mg

Pediatric Dose: 0.1-0.2mg/kg

Mechanism of Action: Slows AV conduction and interrupts reentry pathways

Classification: Beta agonist, Sympathomimetic

Indications: Bronchospasm, Hyperkalemia, Anaphylaxis

Contraindications: Hypersensitivity, Tachycardia secondary to a heart condition

Side Effects: Tachycardia, Tremors, Anxiety

Dose: 2.5mg Nebulized, 90mcg Inhaler

Route: Inhalation

Pre-Cautions: Monitor heart rate and SPO2

Mechanism of action: Beta agonist with preference for Beta 2 adrenergic receptors

Classification: Class 3 Antiarrhythmic

Indications: V-Tach, V-Fib

Contraindications: Breastfeeding, Bradycardia, High grade Heart Block, Hypersensitivity

Side Effects: Hypotension, Bradycardia

Pre-Cautions: Constant ECG/BP monitoring

Adult Dose: 150/300mg IVP, 150mg/100ml in D5W-1mg/min

Peds Dose: 5mg/kg Bolus

Route: IV

Mechanism of Action: Prolonged repolarization, Lengthens action potential duration in all cardiac tissues

Classification: NSAID

Indications: Chest Pain, Fever

Contraindications: Hypersensitivity, Bronchospasm, Angioedema, Taking MAOIs

Side Effects: Nausea, Heart Burn

Pre-Cautions: Asthma Patients, Active Ulcer, Epigastric Upset

Adult Dose: 4 81mg tablets chewable

Route: Oral

Mechanism of Action: Prevents platelet aggregation, Anti-inflammatory and antipyretic through inhibition of thromboxane A2

Classification: Anticholinergic, Parasympatholytic

Indications: Bradycardia, Organophosphate Poisoning

Contraindications: Hypersensitivity

Side Effects: Dry Mouth, Headache, Pupillary Dilation

Pre-Cautions: Monitor Heart Rate

Adult Dose: Brady-0.5-2mg IV, OP Poisoning 2-4mg IV

Peds Dose: 0.01-0.02mg/kg IV

Route: IV, IO

Mechanism of Action: Selectively blocks muscarinic receptors inhibiting parasympathetic stimulation

Classification: Antihistamine

Indications: Anaphylaxis, Sedation

Contraindications: Hypersensitivity, Glaucoma, Pregnancy, COPD

Side Effects: Drowsiness, Dizziness, Sedation, Dry Mouth

Pre-Cautions: Give deep in muscle if using IM

Adult Dose: 25-50mg slow IVP or IM

Peds Dose: 1.25mg/kg

Route: IV, IM, IO, PO

Mechanism of Action: Nonselectively blocks H1 and H2 histamine receptors

Classification: Inotropic Agent (Electrolyte)

Indications: PEA

Contraindications: Digitalis Based Medications

Side Effects: Vasodilation, Syncope

Pre-Cautions: Extravasations may cause tissue necrosis

Adult Dose: 1-2g slow IVP

Peds Dose: N/A

Route: IV

Mechanism of Action: Increases ventricular irritability, Increases myocardial contractility, Couples electrical and mechanical events of the myocardium

Classification: Adrenal Corticosteroid

Indications: Inflammatory Conditions, Endocrine Disorders

Contraindications: Hypersensitivity, Systemic Fungal Infections

Side Effects: Anxiety, Headache, Dizziness

Pre-Cautions: May cause a psychotic reaction

Adult Dose: 10mg IVP

Peds Dose: 0.3-0.6mg/kg IVP

Mechanism of Action: Decreases inflammation by preventing white blood cells from functioning properly

Classification: Carbohydrate

Indications: Hypoglycemia

Contraindications: Hyperglycemia, Anuria, Diabetic Coma, Intracranial

or Intraspinal hemorrhage, Dehydrated patients

Side Effects: Diarrhea, Upset Stomach

Pre-Cautions: May cause local venous irritation

Adult/Peds Dose: 5ml/kg IV/IO

Route: IV, IO

Mechanism of Action: Raises blood glucose levels in the blood stream, Substrate for carbohydrate metabolism

Classification: Carbohydrate

Indications: Hypoglycemia

Contraindications: Hyperglycemia, Diabetic Coma, Intracranial Hemorrhage, Dehydrated Patients, Anuria

Side Effects: Upset stomach, Diarrhea

Pre-Cautions: Can cause local venous irriation

Adult Dose: 1 amp (25g in 50cc), 12.5-25.0g

Peds Dose: 6yo+ 1ml/kg IV/IO, 2-6yo 2-6ml/kg D25% (mix 25ml of D50 with 25ml of NS), 2yo - Use D10

Mechanism of Action: Substrate for carbohydrate metabolism, Raises glucose levels in blood stream

Classification: Muscarinic Anticholinergic (parasympatholytic)

Indications: Bronchospasm due to obstructive lung disease

Contraindications: Hypersensitivity, Cardiac Dysrhythmias

Side effects: Flu symptoms, Headache, Sinus Pain

Pre-Cautions: May worsen Arrhythmia

Adult Dose: 500mcg nebulized

Peds Dose: Only indicated for age 12+

Route: Inhaled

Mechanism of Action: Selectively blocks muscarinic receptors inhibiting parasympathetic stimulation

Classification: Benzodiazepine

Indications: Anxiety, Seizures, Sedation

Contraindications: Hypersensitivity, Glaucoma

Side Effects: Respiratory Suppression, Sedation

Pre-Cautions: May cause psychotic episodes or Hallucinations

Adult Dose: 1-4mg

Peds Dose: 0.1mg/kg

Route: IV, IM, IO, Oral, Rectal

Mechanism of Action: Binds to type A, GABA receptors, causing sedation

Classification: Beta Blocker

Indications: Angina, Hypertension

Contraindications: Severe Heart Failure, Bradycardia, Heart Block

Side Effects: Itching, Fatigue, Dizziness

Pre-Cautions- CHF patients

Adult Dose: 5mg IV every 2min (max 15mg)

Peds Dose: 1mg/kg

Route: IV, Oral

Mechanism of Action: Blocks beta 1 adrenergic receptors, suppresses norepinephrine

Classification: Alkalizing Agent

Indications: Cardiac Arrest, Hyperkalemia, Metabolic acidosis

Contraindications: Chloride loss from vomiting

Side Effects: Hypokalemia, Hypernatremia

Precautions: Careful when administering to CHF and CKD patients

Adult Dose: 1mEq/kg up to 50-100mEq (1 amp) 8.4%

Peds Dose: 1mEq/kg 4.2% infant

Route: IV, IO, Oral

Mechanism of Action: Buffers acid build up

Classification: Antidote, Phosphate Binder

Indications: Hypocalcemia, Hyperkalemia

Contraindications: Taking digoxin, Hypercalcemia

Side Effects: Constipation

Pre-Cautions: Can cause tissue necrosis

Adult Dose: 1.5-3g IV over 2-5min

Peds Dose: 60-100mg/kg

Route: IV, IO, Oral

Mechanism of Action: Raises calcium levels, helps facilitate nerve and muscle performance as well as normal cardiac function

Classification: Narcotic (opioid)

Indications: Moderate-Severe Pain

Contraindications: Hypersensitivity, Taking MAOI's

Side effects: Constipation, Nausea

Pre-Cautions: May cause respiratory depression

Dose: 25-100mg

Route: IV, IO, IM, SQ, Oral

Mechanism of Action: Analgesia through binding to opiate receptors

Classification: Cardiac glycoside · Antiarrhythmic

Indications: Atrial Fibrillation, Heart Failure

Contraindications: Ventricular Fibrillation, Hypersensitivity

Side Effects: Rash, Headache, Dizziness

Pre-Cautions: Narrow Therapeutic index

Adult Dose: 0.25-0.5mg or 8-12 mcg/kg IV over several minutes

Peds Dose: 1-24mo 30-50mcg/kg, 2-5yo 25-35mcg/kg, 5-10yo 15-30mcg/kg, 10+ 8-12mcg/kg IV

Route: IV, Oral

Mechanism of Action:  inhibition of the sodium-potassium ATPase

Classification: Class 4 antiarrhythmic, Calcium Channel Blocker

Indications: Afib with RVR, Stable Narrow Complex Tachyarrhythmia's

Contraindications: Hypotension, CHF, Cardiogenic Shock, VTach

Side Effects: Nausea, Vomiting, Dizziness

Pre-Cautions: May cause bradycardia

Adult Dose: 0.25mg/kg 15-20mg

Peds Dose: 0.25mg/kg

Route: IV, Oral

Mechanism of Action: Lowers blood pressure by relaxing vascular smooth muscle, slows AV conduction

Classification: Sympathetic Agonist

Indications: Cardiogenic Shock, Symptomatic bradycardia

Contraindications: Hypovolemia

Side effects: Palpitations, Anxiety, Hypertension

Pre-Cautions: Extravasation can cause tissue damage

Adult Dose: 2-20 mcg/kg/min

Peds Dose: 2-10mcg/kg/min

Route: IV

Mechanism of Action: Alpha and beta adrenergic agonist

Classification: Synthetic Sympathetic Agonist

Indications: CHF

Contraindications: Hypovolemia

Side effects: Palpitations, Headache, Dizziness

Pre-Cautions: Extravasation can cause tissue damage

Adult Dosage: 2-20mcg/kg/min IV

Peds Dose: 2-10mcg/kg/min IV

Route: IV

Mechanism of Action: Alpha and Beta adrenergic agonist (inotropic properties more pronounced than chronotropic properties)

Classification: Sympathomimetic

Indications: Anaphylaxis, Bronchospasm

Contraindications: Narrow-Angle Glaucoma

Side Effects: Tachycardia, Anxiety, Hypertension

Pre-Cautions: May cause tachyarrhythmia's

Adult Dose: 0.1-0.25mg IV, 0.3-0.5mg SQ,IM

Peds Dose: 0.01-0.05mg/kg IV, 0.15-0.3mg SQ,IM

Route: IV, IO, IM, SQ, ET, inhaled

Mechanism of action: Alpha and Beta adrenergic agonist, Increases heart rate and Contractility, Causes bronchodilation

Classification: Sympathomimetic

Indications: Cardiac Arrest, Symptomatic Bradycardia

Contraindications: Narrow-Angle Glaucoma

Side Effects: Tachycardia, Anxiety, Hypertension

Pre-Cautions: May cause tachyarrhythmia's

Adult Dose: 0.5-1mg IV, IO, ET

Peds Dose: 0.01mg/kg IV, IO, ET

Route: IV, IO, IM, SQ, ET, inhaled

Mechanism of action: Alpha and Beta adrenergic agonist, Increases heart rate and Contractility, Causes bronchodilation

Classification: Narcotic Analgesic (opioid)

Indications: Moderate-Severe Pain

Contraindications: Hypotension, Hypersensitivity

Side Effects: Hypotension, Respiratory Depression

Pre-Cautions: Use with caution in patients with bradycardia

Adult Dose: 25-100mcg IVP, IN

Peds Dose: 1-2mcg/kg IVP, 20-40mcg IN

Route: IV, IO, IM, SQ, IN

Mechanism of Action: Analgesia through binding to opiate receptors

Classification: Loop Diuretic

Indications: CHF, Fluid Retention, Hypertension

Contraindications: Hypersensitivity

Side Effects: Increased urination frequency

Pre-Cautions: Fluid depletion

Adult Dose: 20 to 40 mg IV (slowly over 1 to 2 minutes) or IM once

Peds Dose: 1 mg/kg IV or IM slowly

Route: IV, IM, Oral

Mechanism of Action: Acts on the loop of Henle to cause diuresis and reduces sodium absorption

Classification: Insulin Antagonist (Hormone)

Indications: Hypoglycemia, Beta-Blocker Overdose

Contraindications: Hypersensitivity, Hyperglycemia

Side Effects: Nausea, Vomiting

Pre-Cautions: Less effective in patients with decreased glycogen stores

Adult Dose: Hypoglycemia-1mg IV,IM,IO,SQ BB Overdose-3-10mg or 1-5mg/kg infusion

Peds Dose: 20kg- 0.5mg IV,IM,SQ, 20kg+ 1.0mg IV,IM,SQ

Mechanism of Action: Causes breakdown of glycogen to glucose, Increases heart rate, Increases cardiac contractile force

Classification: Hormone

Indications: Postpartum Vaginal Bleeding, Labor

Contraindications: Anything other than postpartum bleeding pre-hospital

Side Effects: Intense /Frequent Contractions, Nausea

Pre-Cautions: May cause anaphylaxis or arrhythmia's 

Adult Dose: 10-20 units in 500ml IV, 3-10 units IM

Peds Dose: N/A

Route: Mechanism of Action: Oxytocic, Causes uterine contractions and lactations

Classification: Hormone - Corticosteroid

Indications: Asthma, COPD, Anaphylaxis

Contraindications: Hypersensitivity

Side Effects: Insomnia, Dizziness, Nausea

Pre-Cautions: Delayed effects

Adult Dose: 125-250mg IV,IO

Peds Dose: 0.8 to 1.6 mg/kg oral or IV

Route: Oral, IV, IO

Mechanism of Action: Suppresses immune response

Classification: Hormone

Indications: Diabetes, Hyperglycemia, DKA

Contraindications: Hypoglycemia, Normoglycemia

Side Effects: None

Pre-Cautions: Can cause hypoglycemia

Adult Dose: Varies

Peds Dose: Varies

Route: IV,SQ

Mechanism of Action: Causes glucose uptake by the cells lowering blood glucose levels

Classification: Antiemetic

Indications: Nausea, Vomiting

Contraindications: Hypersensitivity

Side Effects: Dizziness, Lightheaded

Pre-Cautions: Reduce dose with severe hepatic impairment

Adult Dose: 4-8mg IV,IM,PO,SL

Peds Dose: 2-12 y/o 40kg+ 4mg IV, 40kg- 0.1mg/kg

Route: IV,IM,PO,SL

Mechanism of Action: Reduces activity of the vagus nerve and blocks serotonin receptors in the chemoreceptor trigger zone

Classification: Nitrate

Indications: Chest Pain, CHF

Contraindications: Hypotension, Erectile Dysfunction drugs in 24 hours

Side Effects: Headache, Dizziness, Hypotension

Pre-Cautions: Monitor BP closely, tablets lose effectiveness when exposed to air

Adult Dose: 0.4mg Oral, 5-20mcg/min IV infusion

Peds Dose: 1-3mcg/kg/min IV infusion

Mechanism of Action: Relaxes vascular smooth muscle, vasodilation, decreases cardiac workload, improves coronary blood flow

Classification: Mineral/Electrolyte

Indications: Torsades De Pointes, Asthma, Hypertensive Pregnancy

Contraindications: Heart Block, Shock, Dialysis, VFib/Vtach

Side Effects: Flushing, Sweating

Pre-Cautions: Can cause cardiac conduction issues

Adult Dose: 1-2g in 10ml D5W/NS over 1-2 min

Peds Dose: 25-40mg/kg over 20 min

Route: IV,IM

Mechanism of Action: Calcium channel blocker, bronchodilator, CNS depressant

Classification: Class 1b antiarrhythmic, Local anesthetic 

Indications: VF, Vtach, Local procedure

Contraindications: Calcium Channel Blocker use

Side Effects: Drowsiness, Hypotension

Pre-Cautions: Use caution when combined with other antiarrhythmics

Adult Dose: 1.0-1.5mg/kg IV over 2-3 min

Peds Dose: 0.5-1.0mg/kg IV

Route: IV,SQ,IM

Mechanism of Action: Amide-type local anesthetic, slows depolarization and automaticity

Classification: Class 1a Antiarrhythmic, Local Anesthetic

Indications: Vtach with pulse, Pre-excited atrial fibrillation

Contraindications: Calcium Channel Blockers

Side Effects: Drowsiness, Hypotension

Pre-Cautions: Carefully monitor ECG (QRS duration)

Adult Dose: 15-18mg/kg over 25-30 min

Peds Dose: 3-6mg/kg over 5 min

Route: IV

Mechanism of Action: Reduces automaticity and AV conduction, Ester-Type anesthetic

Classification: Sympathetic agonist, Vasopressor

Indications: Hypotension, Shock

Contraindications: Hypovolemic without fluid resuscitation

Side Effects: Headache, Dizziness

Pre-Cautions: Extravasation can cause tissue damage

Adult Dose: 0.1-0.5mcg/kg/min IV, titrate to effect

Peds Dose: N/A

Route: IV

Mechanism of Action: Increases cardiac contractility, causes peripheral vasoconstriction

Classification: Beta Agonist

Indications: Bronchospasm, Preterm Labor

Contraindications: Hypersensitivity

Side Effects: Tachycardia, Headache, Dizziness

Pre-Cautions: Monitor HR and SPO2 closely

Adult Dose: 0.25mg SQ, 0.5mg inhalation

Peds Dose: 0.25mg SQ, 0.5mg inhalation

Route: SQ, inhalation

Mechanism of Action: Relatively nonselective beta agonist

Classification: Depolarizing Neuromuscular Blocker (paralytic)

Indications: Rapid Sequence Intubation

Contraindications: Crush Injury, Hyperkalemia, Increased ICP

Side Effects: Bradycardia, Muscle Fasciculations

Pre-Cautions: Given after sedation

Adult Dose: 1-1.5mg/kg IVP

Peds Dose: 1-2mg/kg IVP

Route: IV,IO

Mechanism of Action: Binds to ACh receptors at the neuromuscular junction causing depolarization and subsequent paralysis

Classification: Nondepolarizing Neuromuscular Blocker (paralytic)

Indications: Rapid Sequence Intubation

Contraindications: Hypersensitivity

Side Effects: Hypotension

Pre-Cautions: Given after sedation

Adult Dose: 0.6-1.0mg/kg IVP

Peds Dose: 0.6mg/kg IVP

Route: IV,IO

Mechanism of Action: Binds to ACh receptors at the neuromuscular junction causing paralysis

Classification: Butyrophenone (antipsychotic)

Indications: Psychosis

Contraindications: Hypotension, Hypersensitivity

Side Effects: Insomnia, Dry Mouth, Hypotension

Pre-Cautions: Can worsen psychotic episode

Adult Dose: 2-5mg IM, 3-5mg Oral

Peds Dose: 0.5-2mg Oral

Route: IM,PO

Mechanism of Action: Blocks dopamine receptors associated with mood and behavior

Classification: Benzodiazepine - Short acting

Indications: Anxiety, Seizures, Sedation

Contraindications: Hypersensitivity, Narrow-Angled Glaucoma

Side Effects: Sedation, Amnesia, Hypotension

Pre-Cautions: May cause respiratory depression

Adult Dose: 1-5mg IVP, 5mg IN

Peds Dose: 0.1mg/kg IVP, 0.15mg/kg IN

Route: IV, IM, IN, IO

Mechanism of Action: Binds to Type A GABA receptors causing sedation

Classification: Benzodiazepine

Indications: Anxiety, Seizures, Sedation, Muscle Relaxation

Contraindications: Hypersensitivity, Narrow-Angled Glaucoma

Side Effects: Sedation, Amnesia, Hypotension

Pre-Cautions: May cause respiratory depression

Adult Dose: 2-10mg

Peds Dose: 1-2.5mg

Route: IV, IM, IO, Rectal

Mechanism of Action: Binds to Type A GABA receptors causing sedation

Classification: Dissociative Anesthetic

Indications: Pain, Sedation

Contraindications: Hypersensitivity, Hypertension

Side Effects: Hypotension, Bradycardia

Pre-Cautions: May cause hallucinations

Adult Dose: 0.5-1.0mg/kg IV, 2-4mg/kg IM

Peds Dose: 0.5-2mg/kg

Route: IV, IM

Mechanism of Action: Causes dissociation between the cortical and limbic system

Classification: Narcotic (opioid)

Indications: Moderate-Severe Pain

Contraindications: Hypotension, Hypersensitivity, AMS, Head Injury

Side Effects: Dizziness, Vomiting, Nausea

Pre-Cautions: May cause respiratory depression

Adult Dose: 2-10mg slow IVP

Peds Dose: 0.05-0.2mg/kg slow IVP

Route: IV,IO,IM,SQ,PO

Mechanism of Action: Analgesia and sedation through binding to opiate receptors, increases venous capacitance, vasodilates arteriols, reduces preload and afterload

Classification: Anticoagulant

Indications: Blood clots

Contraindications: Hypersensitivity

Side Effects: Nausea, Vomiting, Itching

Pre-Cautions: Can cause major bleeding

Adult Dose: 80 units/kg bolus

Peds Dose: 50-100 units/kg

Route: IV,SQ

Mechanism of Action: acts indirectly at multiple sites in both the intrinsic and extrinsic blood clotting systems to potentiate the inhibitory action of antithrombin

Classification: Carbohydrate

Indications: Hypoglycemia

Contraindications: Inability to swallow, AMS

Side Effects: Diarrhea, Vomiting

Pre-Cautions: Patient must be alert

Adult Dose: 15g

Peds Dose: 15g

Mechanism of Action: Absorbed and raises glucose levels

Classification: Osmotic Diuretic

Indications: Increased ICP, Glaucoma

Contraindications: CHF, Anuria

Side Effects: Dehyrdration

Pre-Cautions: May cause electrolyte imbalance

Adult Dose: 0.25-2g/kg as a 15 to 20% solution IV over 30 min

Peds Dose: 0.25-1g/kg as a 15 to 20% solution IV over 30 min

Route: IV, PO

Mechanism of action: Pulls fluid from the brain and eyes

Classification: Vasodilator

Indications: Hypertension, CHF

Contraindications: Hypersensitivity, ED medication within 24 hours

Side Effects: Headache, Nausea

Pre-Cautions: May cause hypotension

Adult Dose: 0.3-10mcg/kg/min IV

Peds Dose: 10mcg/kg/min IV

Route: IV

Mechanism of Action: relaxes blood vessels causing vasodilation

Classification: Medical Gas

Indications: COPD, Shock

Contraindications:

Side Effects: none

Pre-Cautions: High amounts can cause oxygen toxicity, may knock out hypoxic drive in COPD patients 

Dose: 1-6lpm NC, 5-15lpm Simple Mask, 10-15lpm NRB

Route: Inhalation

Mechanism of Action: Increases oxygen levels and binds to hemoglobin, vasoconstricts 

Classification: Antidote (Benzodiazepine antagonist)

Indications: Benzodiazepine Overdose

Contraindications: Hypersensitivity

Side Effects: Fatigue, Headache

Pre-Cautions: Use caution with benzo dependent patients

Adult Dose: 0.2mg IV over 15 sec

Peds Dose: 0.01mg/kg IV over 15 sec

Route: IV

Mechanism of Action: Competitively blocks benzodiazepines at the GABA/benzo receptor complex 

Classification: Vitamin

Indications: Vitamin B1 Deficiency

Contraindications: Hypersensitivity

Side Effects: Tenderness at injection site

Pre-Cautions: Prolonged use can cause aluminum toxicity

Adult Dose: 100mg IV, 50-100mg oral

Peds Dose: 10-25mg IV, 0.5-1mg oral

Route: IV,PO,IM

Mechanism of Action: Thiamine combines with ATP in the liver, kidneys, and leukocytes to produce thiamine diphosphate which is necessary of carbohydrate metabolism

Classification: Thrombolytic

Indications: Stroke, Heart Attack

Contraindications: Bleeding disorders, Trauma

Side Effects: Increased clotting time

Pre-Cautions: Can cause severe bleeding

Adult Dose: 0.9 mg/kg IV

Peds Dose: 2mg IV

Route: IV

Mechanism of action: Catalyzes conversion of plasminogen into plasmin