AEMT Medications from Book/Study Paper

Lorazepam COMMON TRADE NAME

Ativan

Ipatropium Bromide COMMON TRADE NAME

Atrovent

Diazepam CONTRAINDICATIONS

Do not use in patients with preexisting respiratory depression, CNS depression from head injury, hypotension, or hypersensitivity to diazepam

Midazolam Hydrochloride CONTRAINDICATIONS

Do not use in patients with preexisting respiratory depression, CNS depression from head injury, hypotension, or hypersensitivity to venzodiazepines. Glaucoma is a relative contraindication

Furosemide CONTRAINDICATIONS

Do not use in patients with renal failure, dehydration, hypokalemia, hypersensitivity to furosemide, or hypersensitivity to sulfonamides

Fentanyl Citrate CONTRAINDICATIONS

Do not use in patients with respiratory depression, hypotension, head injury, cardiac dysrhythmia, myasthenia gravis, or hypersensitivity to opiates.

Amiodarone CONTRAINDICATIONS

Do not use in patients with second and third degree heart blocks, severe bradycardia, pulmonary congestion, hypotension, or hypersensitivity to this med

Adenosine CONTRAINDICATIONS

Do not use in patients with second or third degree AC node block, sick sinus syndrome, or hypersensitivity to this med

Diltiazem CONTRAINDICATIONS

Do not use in patients with sick sinus syndrome, hypotension, high degree AV block (unless patient has pace maker), Wolff-Parkinson-White syndrome, acute myocardial infarction, ventricular tachycardia, or wide compex tachycardia of unknown origin

Calcium Chloride CONTRAINDICATIONS

Do not use in patients with ventricular fibrillation, ventricular tachycardia, digitalis toxicity, renal failure, or hypercalcemia.

Lactated Ringer's Solution INTERACTIONS

Do not use with blood product infusion

Nitrous Oxide INTERACTIONS

Do not use with sedative-hypnotic medications, narcotics, or alcohol

Calcium Chloride SIDE EFFECTS

Extremely hypertonic and may cause severe nercrosis in the event of extravasation; observe IV site closely while administering. Bradycardia, asystole, hypotension.

Naloxone SIDE EFFECTS

These are rare, but hypotension, hypertension, nausea, vomiting, and cardiac arrhythmias may occur.

50% Dextrose CLASS

carbohydrate

Glucose CLASS

carbohydrate

Glucose PRECAUTIONS

carefully monitor the patient for the potential of aspiration

Glucagon MOA

causes a release of stored glycogen and its conversion to glucose when release into the circulation. when administered, it causes an increase in blood glucose levels if the patient has adequate stores of glycogen for conversion to glucose

Nitroglycerin - Sublingual Tablets and Spray INDICATIONS

chest pain associate with acute coronary syndrome

Aspirin HOW SUPPLIED

chew-able tablets containing 81 mg/tablet.

Acetaminophen CONTRAINDICATIONS

hypersensitivity

Glucagon CONTRAINDICATIONS

hypersensitivity

Aspirin CONTRAINDICATIONS

hypersensitivity; not given to children or adolescents with suspected viral illnesses because it is associated with an increased risk of Reye's syndrome

Thiamine SIDE EFFECTS

hypotension, anxiety, nausea, vomiting, angioedema

NS (0.9% Sodium Chloride Solution) INDICATIONS

hypovolemia, heat exhaustion, heat stroke, and diabetic ketoacidosis.

Aspirin INDICATIONS

in the prehosptial setting, acute coronary syndrome and stroke

Glucagon INDICATIONS

inability to establish IV access in patients with significant hypoglycemia

Glucose CONTRAINDICATIONS

inability to maintain a patent airway

Epinephrine 1:1,000 PRECAUTIONS

inactivated by exposure to sunlight or when given with an alkaline solution. Med causes a strong sympathetic stimulus, patients may experience chest pain, palpitations, anxiety, nausea, or headache. Monitor the patient's heart rate and blood pressure.

Activated Charcoal PRECAUTIONS

inactivates other oral medications

Glucose MOA

increases blood glucose levels

Nitroglycerin - Sublingual Tablets and Spray HOW SUPPLIED

calibrated spray deliering .4 mjg/spray or as a small tablet containing .4mg/tablet

Oxygen ROUTE

inhalation via nasal cannula, face mask, nonrebreather mask, or bag-valve-mask device.

Albuteral INDICATIONS

wheezing caused by asthma, COPD, and some other conditions

Magnesium Sulfate NOTES

when magnesium sulfate is used for treatment of eclampsia, ensure that calcium gluconate or calcium chloride is readily available as an antidote in case respiratory depression occurs due to over dose of magnesium sulfate

Levalbuterol COMMON TRADE NAME

xopenex

Lidocaine Hydrochloride COMMON TRADE NAME

xylocaine

Epinephrine 1:10,000 CLASS

Sympathomimetic

Magnesium Sulfate DOSAGE Adult pulseless arrest

1-2g/10mL D5W IV

Atropine Sulfate DOSAGE - organophosphate poisoning/nerve agents

1-2mg IV/IO; repeat every one to five minutes. End point of administration is marked by drying of secretions. Determine dosing regimen based on the type of agents or poison, and the duration and amount of exposure. Consult with medical direction or poison control

Naloxone DOSAGE

1-2mg slow IV push titrated to restore respiratory rate. If no effect =, may be repeated at five-minute intervals. An intranasal formulation is also available.

Magnesium Sulfate DOSAGE Adult eclamptic seizures

1-4 g IV max 30-40 g/day

Albuterol DESCRIPTION

(Proventil, Ventolin) is a sympathetic beta agonist used to reverse bronchiolar smooth muscle constriction in patients with asthma and chronic obstructive pulmonary disease (COPD)

Glucagon CLASS

hormone with antihypoglycemic action

Sodium Bicarbonate CONTRAINDICATIONS

Do not use in patients with metabolic or respiratory alkalosis, pulmonary edema, hypernatremia, or hypokalemia

Adenosine PEDS DOSAGE

.1 mg/kg (up to 6mg) initial dose. May repeat in one to two minutes at double the initial dose. Follow each dose with a 20mL saline flush.

Diazepam DOSAGE PEDS

.1mg/kg every five to 10 minues

Glucagon DOSAGE

1 mg

Epinephrine 1:1,000 HOW SUPPLIED

1 mg/1 mL in vials, ampules, or prefilled auto injector devices.

50% Dextrose INDICATIONS

Hypoglycemia in adult patients

Lidocaine Hydrochloride DOSAGE

1-1.5 mg/kg of body weight as an intravvenous bolus, with half the original dosage, administered 20 minutes after the first dosage to a max bolus dosage of 3 mg. A bolus that treats the dysrhythmia successfully is followed by an intravenous infusion of 2-4 mg/min. Reduce the dosage by half for patients over age 70 years and those with liver disease or heart failure.

Glucose DOSAGE

15 g by mouth or applied to the buccal mucosa

Amiodarone DOSAGE ADULTS (with perfusing rhythms)

150 mg infused over 10 min, followed by an infusion of 1mg/min for six hours, and .5mg/min infusion over the next 18 hours

Activated Charcoal DOSAGE

1g/1kg orally (adults and peds)

Dopamine DOSAGE

2-20 mcg/kg/min, titrated to effects. See MOA for dosage range and effects

Ibuprofen DOSAGE

200-400 mg every six to eight hours; pediatric dosage: 5-10mg/kg every six to eight hours

50% Dextrose DOSAGE

25 g slow IV push; may be repeated in 10 to 15 minutes if blood glucose level remains below 70 mL/dL. Pediatric dosage: .5g/kg (500 mg kg) of a 25% solution (25g100mL) of said meds; 10% (10g/100mL) for neonates

Magnesium Sulfate DOSAGE ped plseless arrest and torsades

25-50 mg/kg (max of 2g) over 10-20 minutes

Lorazepam MOA

Depressed neuronal activity in the CNS. Suppresses the propagation of seizure activity in the motor cortex, thalamus, and limbic areas of the brain

Amiodarone ADULTS (with nonperfusing rhythms - cardiac arrest)

300mg IV bolus may follow with one bolus of 150mg if rhythm persists, up to a maximum of 450 mg

Amiodarone PEDS (with nonperfusing rhythms - cardiac arrest)

5mg/kg bolus

Nitroglycerin - Sublingual Tablets and Spray DOSAGE

Administer .4 mg sublingually. If chest pain persists, and the systolic blood pressure remains at lease 90mmHg, the dose may be repeated every five minutes to a total of 3 doses.

Diltiazem DOSAGE

ADULTS ONLY Bolus: 15-20 mg over two minutes. After 15 minutes, if needed, may repeat at 20-25mg over two minutes Infusion:5-15mg/hr, titraate to effect for heart rate control

Albuterol MOA

Acts on beta2 sympathetic receptors in bronchiolar smooth muscle to cause bronchodialation.

Dopamine MOA

Acts on dopaminergic alpha1 and beta1 receptors in a dose-dependent fashion. At doses below 5mcg/kg/min, acts primarily on dopaminergic receptors, causing renal, mesenteric, and cerebral vasculature dilation. At dose ranges from 5-10 mcg/kg/min, beta effects predominate, resulting in enhanced myocardial contractility, increased cardiac output, and increased systemic vascular resistance. At dosage ranges form 10-20 mcg/kg/min, alpha1 effects predominate, producing peripheral vascular constriction.

Adenosine COMMON TRADE NAME

Adenocard

Epinephrine 1:10,000 COMMON TRADE NAME

Adrenalin

Activated Charcoal CLASS

Adsorbent

Epinephrine 1:10,000 DOSAGE

Adult cardiac arrest: 1mg 1:10,000 solution IV/IO bolus every three to five minutes Adult bradycardia/hypotension:IV infusion at 2-10mcg/min Ped cardiac arrest: .01mg/kg (.1mL/kg of 1:10,000) IV/IO every three to five minutes to a max of 1mg per dose

Epinephrine 1:1,000 DOSAGE

Adult dose, .3 to .5 mg subcutaneously or intramuscularly every 15 minutes as needed; pediatric dose, .01 mg/kg

Ketamine DOSAGE

Adults 1-2 mg/kg IV/IO slow bolus Peds .5-1.5 mg/kg IV/IO slow bolus

Ketorolac Tromethamine DOSAGE

Adults 30-60 mg IM, 15-30 mg IV. Patients over 65, patients with renal impairment, and Patients over 50 kg should receive one half this dose. Peds: not recommended

Thiamine DOSAGE

Adults Only: 100 mg slow IV injection over one to two minutes

Levalbuterol DOSAGE

Adults acute asthma/status asthmaticus: 1.25mg/3mL via nebulizer. May repeat up to two times. Peds acute asthma/status asthmaticus (6-11 years of age): .31 mg via nebulizer every 6-8 hours

Furosemide DOSAGE

Adults: .5-1 mg/kg slow IV bolus over one to two minutes (not to exceed 20/mg/min while delivering the bolus). may repeat in one to two hours Not listed for peds

Atropine Sulfate DOSAGE - bradycardia

Adults: .5mg IV bolus. May repeat as needed up to a maximum of 3mg Peds: .02 mg/kg IV/IO/ET (diluted to 3 to 5mL), maximum dose .1mg, maximum single dose of .5mg for a child and 1mg for an adolescent. May repeat in five minutes for a maximum total dose of 1mg for a child and 2mg for an adolescent.

Sodium Bicarbonate DOSAGE

Adults: 1 mEq/kg IV. Repeat .5 mEq/kg IV every 10 minutes PED: same as adults

Fentanyl Citrate DOSAGE

Adults: 1-2 mcg/kg IV/IO slow bolus every 30-60 minutes prn Ped: same as adults

Midazolam Hydrochloride DOSAGE

Adults: 1-2.5 mg over two minutes. May repeat as needed up to .1mg/kg Ped:.1-.15 mg/kg IV over one to two minutes, max 5mg/dose

Lorazepam DOSAGE

Adults: 1-4 mg IV over two minutes. May repeat in 15-20 minutes as needed up to a maximum of 8mg Ped: .05 to .1 mg/kg slow IV over two to five minutes, maxium 4mg/dose. Ma repeat .05 mg/kg second dose in 10-15 minutes if needed

Diphenhydramine DOSAGE

Adults: 10-50 mg IM or slow IV every 6-8 hours, up to 400mg/day Peds: 1-2mg/kg slow IV or IO up to 50mg

Transexamic Acid DOSAGE

Adults: 1g in 100 mL of .9% NS or Ringer's given by IV infusion over 10 min followed by 1g in 500mL of .9% NS or Ringer infused over 8 hours PED: limited studies suggest that adult dosing can be used for pediatric patients. Reduce dose for patients with renal insufficiency

Morphine Sulfate DOSAGE

Adults: 2-4 mg slow IV push over one to five minutes every 5-30min as needed to manage pain PED: .1-.2 mg/kg IV (max is 15 mg)

Odansetron DOSAGE

Adults: 4mg slow IV bolus over two to five minutes every 4-6 hours PED: .1mg/kg slow IV bolus every 4-6 hours - not recommended for children under age 2

Acetaminophen DOSAGE

Adults: 50- 1000 mg every four to six hours, 4 g max per 24 hours Peds: 10-15 mg/kg every four to six hours, 40 mg/kg max per 24 hours

Ipratropium Bromide DOSAGE

Adults: 500 mcg via nebulizer every 6-8 hours Ped:125-250 mcg via nebulizer every 6-8 hours

Diazepam DOSAGE ADULT

Adults: 5mg IV/IO over two minutes, up to 10mg per dose. May repeat every 10-15 minutes as needed up to a max of 30 mg

Adenosine DOSAGE ADULTS

Adults: 6mg rapid IV bolus through a proximal IV, followed by a 20mL saline bolus to ensure that med reaches the central circulation. If there is no change in rhythm after one to two minutes, give a 12 mg rapid IV bolus. If rhythm persists one to two minutes following the second dose, one additional 12 mg rapid IV bolus may be given. Do not exceed 30 mg total

Calcium Chloride DOSAGE

Adults: 8-16mg/kg IV of 10% solution. May repeat once in 10 minutes Peds: 20 mg/kg IV of 10% solution. May repeat as needed for desired clinical effects

Acetaminophen INTERACTIONS

Alcohol increases liver toxicity

Ketarolac Tromethamine MOA

An anti inflammatory drug, also inhibits prostaglandin synthesis and thus provides a peripherally acting non-narcotic analgesic effect

Ipatropium Bromide CLASS

Anticholinergic

Atropine Sulfate CLASS

Anticholinergic (parasympatholytic)

Diphenhydramine CLASS

Antihistamine

Ibuprofen HOW SUPPLIED

Coated tablets, chewable, tablets, capsules, suspension, and elixir

Lorazepam NOTES

Be prepared for respiratory depression to occur and have resuscitation equipment available

Diphenhydramine COMMON TRADE NAME

Benadryl

Diazepam CLASS

Benzodiazepine, anticonvulsant, sedative

Lorazepam CLASS

Benzodiazepine, anticonvulsant, sedative

Albuterol CLASS

Beta2 - selective sympathomimetic bronchodilator

Thiamine COMMON TRADE NAME

Betaxin

Diltiazem MOA

Blocks calcium channels in smooth, voluntary and cardiac muscle, causing slowing of conduction in teh AV node, and dilation of the coronary and peripheral vasculature.

Atropine Sulfate MOA

Blocks the effects of acetylcholine, the principal neurotransmitter for the parasympathetic nervous system

Midazolam Hydrochloride MOA

Depresses the neuronal activity int he CNS. Suppresses the propagation of seizure activity the motor cortex, thalamas and limbic areas of the brain

Diltiazem CLASS

Calcium channel blocker

Acetaminophen HOW SUPPLIED

Capsules, tablets, chew-able tablets, suspension, elixir, and suppositories (for rectal administration)

Amiodarone CLASS

Cardiac antidysrhythmic

Adenosine CLASS

Cardiac antidysrhythmic, nucleoside (a biologic molecule that serves as a building block of RNA and DNA)

Diltiazem COMMON TRADE NAME

Cardizem

Nitrous Oxide MOA

Central nervous system depressant

50% Dextrose PRECAUTIONS

Check the blood glucose level prior to administration. A solution of 50% dextrose is hyper-tonic and causes severe tissue necrosis if infiltration occurs.

Diazepam MOA

Depresses the neurons in the CNS. Raises the seizure threshold in the motor cortex of the brain

Dopamine CONTRAINDICATIONS

Do not use in patients with hypovolemia, tachydysrhythmias, ventricular fibrillation, or pheochromocytoma

NS (0.9% Sodium Chloride Solution) DESCRIPTION

Clear liquid container water, 154 mEq per liter sodium, and approximately 154 mEq per liter of chloride to match the concentration found in the human body.

Amiodarone COMMON TRADE NAME

Cordarone

Transexamic Acid COMMON TRADE NAME

Cyklokapron

Nitrous Oxide CONTRAINDICATIONS

Decreased level of responsiveness, inability to follow instructions, traumatic brain injury, COPD, suspected pneumothorax, abdominal pain, and suspected bowel obstruction.

Adenosine MOA

Decreases electrical conduction through the AV node. It also acts directly on the sinus node to decrease automaticity to slow the heart rate. Has immediate onset but a duration of less than 10 sec

Magnesium Sulfate SIDE EFFECTS

Diaphoresis, hypotension, flushing, depressed reflexes, hypothermia, reduced heart rate, respiratory depression, diarrhea

Nitrous Oxide SIDE EFFECTS

Dizziness, decreased mental status, hallucinations, nausea, and vomiting.

Lidocaine Hydrochloride ADVERSE REACTIONS

Dizziness, drowsiness, seizures, confusion, hypotension, nausea, vomiting, cardiac arrest.

Ibuprofen INTERACTIONS

Do not given with aspirin or other NSAIDs

Transexamic Acid CONTRAINDICATIONS

Do not sue in patients with hypersensitivity to this drug, suspected subarachnoid hemorrhage, or active intravascular clotting.

Diphenhydramine CONTRAINDICATIONS

Do not use in pateints taking MAO inhibitors, newborns, nursing mothers, or those with hypersensitivity to diphenhydramine

Ipratropium Bromide CONTRAINDICATIONS

Do not use in pateints with hypersensitivity to ipratropium, atropine, alkaloid, soy protein, or peanuts

Magnesium Sulfate CONTRAINDICATIONS

Do not use in patients with heart block or myocardial damage. No contraindications in cardiac arrest

Lactated Ringer's Solution CONTRAINDICATIONS

Do not use in patients with heart failure, renal failure, or suspected hyperkalemia

Thiamine CONTRAINDICATIONS

Do not use in patients with hypersensitivity to IV of this med

Ketorolac Tromethamine CONTRAINDICATIONS

Do not use in patients with hypersensitivity to aspirin or other NSAID-type medications, bleeding disorders, renal failure, or peptic ulcer disease.

Ketamine CONTRAINDICATIONS

Do not use in patients with hypersensitivity to ketamine, intracranial hemorrhage, stroke, hypertension, or head trauma

Morphine Sulfate CONTRAINDICATIONS

Do not use in patients with hypersensitivity to opiates, hypovolemia, hypotension, head injury, increased intracranial pressure, or severe respiratory distress

Diphenhydramine SIDE EFFECTS

Drowsiness, coordination disturbances, hypotension, palpitations, tachycardia, bradycardia, thickening, of bronchial secretions, and paradoxical excitement in pediatric patients. Rapid administration may cause seizures in pediatric patients.

Nitroglycerin - Sublingual Tablets and SprayINTERACTIONS

Effects may be accentuated by alcohol use, erectile-dysfunction medications, and beta blockers.

Magnesium Sulfate CLASS

Electrolyte

Ketamine MOA

Exact mechanism of action unknown; acts on cortex and limbic receptors, producing dissociative analgesia and sedation

Glucagon INTERACTIONS

Few interactions when given in an emergency situation in therapeutic doses.

Activated Charcoal DESCRIPTION

Finely powdered activated with oxygen, commonly diluted in water for oral administration

Amiodarone ADVERSE REACTIONS

Flushing, bradycardia, dizzinesss, hypotension, headache, AV node conduction abnormalities

NS (0.9% Sodium Chloride Solution) DOSAGE

Follow your protocols. A keep-open rate is 30 mL/hour

Lidocaine Hypochloride INDICATIONS

Frequent premature ventricular complexes (PVCs) (>6/min), multifocal PVCs, PVCs that occur in pairs or runs, PVCs that occur on the downslope of the preceding T wve, refractory ventricular fibrillation, pulseless ventricular tachycardia, postelectrical defibrillation.

Aspirin SIDE EFFECTS

GI upset, bleeding, nausea, vomitting, and wheezing

Oxygen CLASS

Gas

Ibuprofen SIDE EFFECTS

Gastric irritation

Furosemide SIDE EFFECTS

Hypotension, dysrhythmia, hypochloremia, hypokalemia, hyponatremia, hypercalcemia, and hyperglycemia. Transient deafness can occur in renal impaired patients if IV bolus is given too quickly

Nitroglycerin - Sublingual Tablets and Spray CONTRAINDICATIONS

Hypotension, increased intracranial pressure, and use of erectile dysfunction medications within 24-36 hours

Odansetron SIDE EFFECTS

Hypotension, tachycardia, constipation, elevated liver enzymes, CNS depression

5% Dextrose in Water for IV CLASS

Hypotoic carbohydrate-containing solution

Epinephrine 1:10,000 SIDE EFFECTS

Headache, nausea, restlessness, weakness, dysrhytmias, hypertension, chest pain, tachycardia

50% Dextrose DESCRIPTION

High concentration (50g/100 mL) of dextrose in sterile water for IV administration

Ibuprofen PRECAUTIONS

High dose is known to cause significant gastrointestinal irritation and increases the risk of gastrointestinal bleeding

Albuteral CONTRAINDICATION

Hypersensitivity and symptomatic tachycardia

5% Dextrose in Water for IV ROUTE

IV

Glucagon ROUTE

IV

Lactated Ringer's Solution ROUTE

IV

NS (0.9% Sodium Chloride Solution) ROUTE

IV

50% Dextrose MOA

Increases glucose concentration in the blood for the reversal of acute hypoglycemia

Albuterol ROUTE

Inhalation

Nitrous Oxide ROUTE

Inhalation

Ibuprofen MOA

Inhibits inflammatory response by blocking formation of cyclo-oxygenase (COX-2), a chemical mediator of inflammatory chemicals such as prostaglandins.

Ipatropium Bromide MOA

Inhibits interaction of acetylcholine at receptor sites on bronchial smooth muscle, resulting in bronchodilation

Furosemide MOA

Inhibits the reabsorption of sodium and chloride in the kidney at the proximal tubule and the loop of Henie. IV administration also produces a modest vasodilatory effect, thus increasing venous capacitance.

50% Dextrose CONTRAINDICATIONS

Intracranial hemorrhage (TBI, stroke) and hyperglycemia

Dopamine COMMON TRADE NAME

Intropin

Lactated Ringer's Solution DOSAGE

It depends on the condition for which solution is being administered. Follow your protocols. A keep-open rate of 30 mL/hour

Ketamine COMMON TRADE NAME

Ketalar

Naloxone CONTRAINDICATIONS

Known hypersensitivity

Fuosemide COMMON TRADE NAME

Lasix

Amiodarone PEDS (with perfusing rhythms)

Loading dose 5mg/kg IV/IO over 20-60, up to 15mg/kg/day

50% Dextrose SIDE EFFECTS

Localized irritation of the vein

Furosemide CLASS

Loop diuretic

Naloxone INTERACTIONS

May cause withdrawal symptoms in patients addicted to narcotics.

Naloxone DESCRIPTION

Medication used to reverse respiratory depression associated with narcotic overdose.

Albuterol HOW SUPPLIED

Metered-dose inhaer or 2.5 mg/.5 mL nebule

Albuterol DOSAGE

Metered-dose inhaler: one or two 90 mcg sprays. The use of a spacer device is preferred when administering by a metered dose inhaler, especially in pediatric patients. Small volume nebulizer: 2.5 mg diluted in 3mL over five to 15 minutes over 6lpm; pediatric dosage, .15 mg/kg diluted in 2.5 mL normal saline.

Acetaminophen INDICATIONS

Mild to moderate pain and fever

Ibuprofen INDICATIONS

Mild to moderate pain and fever

Nitrous Oxide HOW SUPPLIED

Modified demand valve with mixer to combine 50% of each gas for inhalation.

Lactated Ringer's Solution PRECAUTIONS

Monitor closely for signs of circulatory overload

Ketamine CLASS

NMDA receptor antagonist

Ibuprofen CLASS

NSAID (analgesic and antpyretic)

Nitroglycerin - Sublingual Tablets and Spray PRECAUTIONS

NTG deteriorates rapidly when exposed to light or air. Monitor blood pressure closely and discontinue administration if they systolic blood pressure falls below 90mmHg

Morphine Sulfate MOA

Natural opiate alkaloid that acts directly on the opiate receptors in the brain. The primary effect is analgesia, but also causes vasodilation, sedation, and euphoria

Oxygen INTERACTIONS

None

Atropine Sulfate CONTRAINDICATIONS

None when in an emergency treatment of symptomatic bradycardia or organophosphate/nerve agent exposure. Use with caution in acute coronary syndromes; not effective in treating bradycardia in transplanted hearts

Ibuprofen DESCRIPTION

Nonprescription medication used for the relief of mild to moderate pain and to reduce fever

Ketorolac Tromethamine CLASS

Nonsteroidal anti inflammatory

Activated Charcoal ROUTE

Oral

Epinephrine 1:1,000 SIDE EFFECTS

Palpitations, tachycardia, anxiety, headache, dizziness, nausea, and vomiting are common side effects. Patients with underlying cardiac disease also may experience chest pain and acute myocardial infarction.

NS (0.9% Sodium Chloride Solution) PRECAUTIONS

Patients receiving large volumes of this med should be monitored carefully for fluid overload. In patients who have lost significant amounts of electrolytes, it may be more appropriate to use lactated Ringer's solution or an alternative IV fluid containing electrolyte replacement.

Oxygen PRECAUTIONS

Patients with COPD who depend on hypoxic drive for respiratory drive may experience respiratory depression if high concentrations of oxygen are administered for prolonged period of time. Oxygen is a vasoactive drug that causes cerebral and coronary artery vasoconstriction. Oxygen is not recommended for routine use in uncomplicated acute coronary syndrome Oxygen administration should be titrated to maintain an SpO2 of 95% or higher. Compressed gas cylinders may become projectile hazards.

Aspirin CLASS

Platelet aggregation inhibitor; non-steroidal anti-inflammatory; analgesic.

Thiamine MOA

Plays a vital role in carbohydrate metabolism

50% Dextrose HOW SUPPLIED

Prefilled syringe containing 25 grams of med in 50 mL

Naloxone HOW SUPPLIED

Prefilled syringe, vial, or ampule

Naloxone PRECAUTIONS

Rapid administration and large doses may cause withdrawal in narcotic-addicted patients. Many EMS systems titrate the dosage to the minimum amount needed to ensure adequate breathing rather than compete reversal of the narcotic.

Lactated Ringer's Solution SIDE EFFECTS

Rare in therapeutic dosages

Sodium Bicarbonate MOA

Reacts with free hydrogen ions to form water and carbon dioxide, thus raising pH levels. Provides sodium ion.

Magnesium Sulfate MOA

Relaxes smooth and voluntary muscle by reducing acetylcholine release at the myoneuronal junction

Fentanyl Citrate SIDE EFFECTS

Respiratory depression, hypotension, bradcycardia, nausea, vomiting, itching

Ketamine SIDE EFFECTS

Respiratory depression, hypotension, bradycardia, arrhythmias, hallucinations, tonic and clonic movements

Diazepam SIDE EFFECTS

Respiratory depression, hypotension, confusion, nausea

Lorazepam SIDE EFFECTS

Respiratory depression, hypotension, confusion, nausea

Midazolam Hydrochloride SIDE EFFECTS

Respiratory depression, hypotension, oversedation, nausea, vomiting

Morphine Sulfate SIDE EFFECTS

Respiratory depression, hypotension, sedation, tachycardia, bradycardia, palpitation, flushing, burning sensations, itching, euphoria, bronchospasm, dry mouth

Lidocaine Hydrochloride CONTRAINDICATIONS

Second degree heart block, Type 2, third degree heart block, ventricular escape rhythms, known hypersensitivity to local anesthetics including lidocaine

Nitrous Oxide DOSAGE

Self administered mixture of 50% nitrous oxide and 50% oxygen

Nitrous Oxide INDICATIONS

Severe musculoskeletal pain, and chest pain associated with acute coronary syndrome and not relieved by nitroglycerin.

NS (0.9% Sodium Chloride Solution) CONTRAINDICATIONS

Should not be given to patients with heart failure with heart failure because fluid overload may occur

5% Dextrose in Water for IV INDICATIONS

Should not be used for patients who require IV fluid replacement or in patients who are hyperglycemic.

50% Dextrose ROUTE

Slow IV push through at least an 18 g IV catheter in a large vein. Monitor the IV site for infiltration during administration

Amiodarone MOA

Slows depolarization of myocardial cells by blocking potassium and calcium channels Also has some properties similar to beta blockers. DO NOT MIX WITH SODIUM BICARBONATE

Lactated Ringer's Solution DESCRIPTION

Sterile water containing the following electrolytes: sodium 130 mEq/L, potassium 4 mEq/L, calcium 30 mEq/L, chloride 109 mEq/L, lactate 28 mEq/L

5% Dextrose in Water for IV DESCRIPTION

Sterile water containing this med (5g/100mL)

Fentanyl Citrate COMMON TRADE NAME

Sublimaze

Nitroglycerin - Sublingual Tablets and Spray DESCRIPTION

Supplied as tablets or a metered-dose spray for sublingual administration in the treatment of acute coronary syndrome.

Dopamine CLASS

Sympathomimetic

Dopamine SIDE EFFECTS

Tachycardia, hypertension, increased myocardial oxygen demand

Aspirin DOSAGE

The AHA currently recommends 160-325 mg of a chew-able. The children's type is preferred because it is chew-able which increases the rate of absorption, and does not require water to assist swallowing

Epinephrine 1:1,000 INTERACTIONS

The effects can be intensified in patients taking some antidepressants.

Oxygen SIDE EFFECTS

There are few side effects associated with short term administration of therapeutic amounts of oxygen. If used for prolonged periods of time without a humidifier, it may cause drying of the mucous membranes and nosebleeds.

Oxygen CONTRAIDICATIONS

There are no absolute contraindications to the use of oxygen. However, there are complications associated with hyperoxemia, particularly in neonates and patients resuscitated from cardiac arrest.

50% Dextrose INTERACTIONS

There are no significant interactions in emergency situations

Ketorolac Tromethamine COMMON TRADE NAME

Toradol

Epinephrine 1:1,000 CONTRAINDICATIONS

Use with caution in patients with significant cardiovascular disease or hypertension

Diphenhydramine INDICATIONS

Used for allergic reacitons, anaphylaxis and acute dystonic reactions. Be alert for respiratory depression. Use with caution in asthmatic patients.

Thiamine INDICATIONS

Used for altered mental status, delirium tremens, and hypoglycemia

Fentanyl Citrate INDICATIONS

Used for analgesia

Ketamine INDICATIONS

Used for analgesia, sedation prior to endotracheal intubation, and sedation for excited delirium

Diltiazem INDICATIONS

Used for atrial fibrillation and atrial flutter with rapid ventricular response where slowing heart rate is desired, supraventricular tachycardia refractory to adenosine, and multifocal atrial tachycardia. DO NOT MIX WITH FUROSEMIDE

Epinephrine 1:10,000 INDICATIONS

Used for cardia arrest (ventricular fririllation, ventricular tachycardia, asystole, PEA), symptomatic bradycardia, hypotension refractory to other medications, anaphylaxis, and severe reactive airway disease.

Calcium Chloride INDICATIONS

Used for hyperkalemia, hypocalcemia, hypermagnesemia, and calcium channel blocker toxicity.

Adenosine INDICATIONS

Used for narrow complex tachycardia. Not indicated for atrial fibrillation with rapid ventricular response, atrial flutter, or ventricular tachycardia because it is ineffective in converting these rhythms.

Odansetron INDICATIONS

Used for nausea and comiting

Ipratropium Bromide INDICATIONS

Used for persistent bronchospasm and exacerbation of COPD. Can be mixed with albuterol, levalbuterol, or other nebulized beta2 agonist.

Furosemide INDICATIONS

Used for pulmonary edema associated with left sided heart failure.

Magnesium Sulfate INDICATIONS

Used for seizures secondary to eclampsia, status asthmaticus refractory to beta agonist therapy, torsades de pointes, ventricular fibrillation that persists despite defibrillation and first line antidysrhythmic therapy, and suspected hypomagnesemia

Diazepam INDICATIONS

Used for seizures, behavioral emergencies, and sedation prior to cardioversion or pacing. Use port closest to the vein to avoid precipitation (formation of particulate matter int eh intravenous line)

Amiodarone INDICATIONS

Used for supraventricular tachycardia refactory to adenosine, ventricular tachycardia, or ventricular fibrillation that has not responded to defibrillation

Atropine Sulfate INDICATIONS

Used for symptomatic bradycardic rhythms, organophosphate poisoning, and certain specific nerve agent exposure.

Sodium Bicarbonate INDICATIONS

Used for tricylic antidepressant overdose, known metabolic acidosis, alkalinization for treatment of specific intoxication, rhabdomyolysis, and crush syndrome

Diazepam COMMON TRADE NAME

Valium

MIdozolam Hydrochloride COMMON TRADE NAME

Versed

Thiamine CLASS

Vitamin B1

5% Dextrose in Water for IV DOSAGE

usually administered at a keep-open rate (30mL/hour)

Morphine Sulfate COMMON TRADE NAME

Widely available generically for intravenous injection

Odansetron COMMON TRADE NAME

Zofran

Nitrous Oxide DESCRIPTION

a 50/50 mix of oxygen and nitrous oxide delivered to a modified-demand valve and mask that the patient self-administers y holding the mask and inhaling.

Epinephrine 1:1,000 DESCRIPTION

a naturally occurring hormone (adrenaline) secreted by the adrenal glands in response to sympathetic nervous system stimulation. It binds to alpha1, beta1, and beta2-adrenergic receptor sites, causing vasoconstriction, increased heart rate and force of contraction, and bronchiolar smooth muscle relaxation.

Glucagon DESCRIPTION

a pancreatic hormone that affects the blood glucose level by promoting glycogenolysis and gluconeogenesis and inhibiting glycogenesis.

Nitroglycerin - Sublingual Tablets and Spray SIDE EFFECTS

a potent a vasodilator and commonly causes an immediate headache. May cause dizziness, weakness, hypotension, tachycardia, dry mouth, nausea, and vomiting. The spray or tablets may cause a burning sensation on administration.

Aspirin DESCRIPTION

a salicylate that reduces platelet aggregation by inhibiting the release of a prostaglandin called thromboxane A2.

Odansetron MOA

a selective serotonin receptor (5-HT3 receptor) agonist. Its exact action is not well understood, but this type of serotonin receptor is present on the vagus nerve terminals and in the chemoreceptor trigger zone for vomiting located in the CNS

Glucose DESCRIPTION

a simple carbohydrate that can be absorbed across the buccal mucosa or through the gastrointestinal tract.

Fentanyl Citrate MOA

a synthetic opioid that crosses the blood-brain barrier rapidly and acts directly on the opiate receptors in the brain. Often given in concert with benzodiazepines for conscious sedation

Nitroglycerin - Sublingual Tablets and Spray CLASS

vasodialator

Epinephrine 1:10,000 MOA

acts directly and non selectively on alpha and beta receptors. Effects are dose dependent. Causes bronchodilation and vasoconstriction. concentration of 1 gram per 10000 mL. for intravenous injection in cardiac arrest. An intravenous infusion of epinephrine in a concentration of 1mg/mL used in some cases to treat severe, refractory bradycardia and refractory hypotension in anaphylactic shock.

Epinephrine 1:1,000 INDICATIONS

acute anaphylaxis

Glucose INDICATIONS

acute hyppoglycemia in a patient who is awake and can protect his own airway

Aspirin PRECAUTIONS

administer with caution in patients with asthma or seasonal allergies, stomach ulcers, liver disease, alcohol abuse, kidney disease, or coagulopathies.

Epinephrine 1:1,000 MOA

administered in anaphylaxis to cause vasoconstriction and relax bronchiolar smooth muscle

NS (0.9% Sodium Chloride Solution) SIDE EFFECTS

administration of large amounts of this med may result in hemodilution and electrolyte imbalance

Oxygen DOSAGE

administration should be titrated to maintain an SpO2 of 95% or higher. High oxygen concentrations for prolonged periods of time can cause oxygen toxicity. Therefore, ventilator patients are often kept below 50% oxygen when possible.

Sodium Bicarbonate CLASS

alkalinizing agent

Lidocaine hydrochloride NOTES

amiodarone is the preferred first-line antidysrhythmic for refractory ventricular tachycardia and ventricular fibrillation

Nitrous Oxide CLASS

analgesic and anesthetic

Acetaminophen CLASS

analgesic, antipyretic (fever reducer)

Lidocaine Hydrochloride CLASS

antidysrhythmic

Odansetron CLASS

antiemetic

Transexamic Acid CLASS

antifibrinolytic agent

Albuteral SIDE EFFECTS

anxiety, palpitations, chest discomfort, headache, and perspiration.

Midazolam Hydrochloride CLASS

benzodiazepine, antivonvulsant, sedative

Levalbuterol NOTES

beta blockers reduce the brochodilatory effect of beta2 agonists

Activated Charcoal MOA

binds with ingested toxins in the GI tract to prevent adsorption

Activated Charcoal SIDE EFFECTS

black, tarry stools and constipation

Aspirin MOA

blocks part of the chemical reaction responsible for activating platelets.

Diltiazem SIDE EFFECTS

bradycardia, hypotension, chest pain, heart blocks (first and second degree), heart failure, syncope, nausea, dry mouth, shortness of breath, headache, atrial flutter, sweating, ventricular dysrhythmias

Oxygen DESCRIPTION

colorless, odorless, tasteless gas

Transexamic Acid MOA

competitively inhibits activation of plasminogen (via binding to the kringle domain), thereby reducing conversion of plasminogen to plasmin (fibrinolysin), and other plasma proteins

Activated Charcoal CONTRAINDICATIONS

decreased level of responsiveness or increased risk of aspiration; or ingestion of corrosives, caustics, or petroleum distillates.

Lidocaine Hydrochloride MOA

decreases ventricular irritability to suppress ventricular ectopy and assist in the management of ventricular tachycardia and ventricular fibrillation. Slows conduction through the ventricles.

Levalbuterol CONTRAINDICATIONS

do not use in patients under six years of age, or those with hypersensitivity to level albuterol or racemic albuterol

Odansetron CONTRAINDICATIONS

do not use in patients with hypersensitivity to this drug

Lorazepam CONTRAINDICATIONS

do not use in patients with preexisting repsiratory depression, CNS depression from head injury, hypotension, or hypersensitivity to this drug.

Oxygen INDICATIONS

dyspnea, hypoxia; SpO2 < 95%

Levalalbuterol ADVERSE REACTIONS

dysrhythmias, palpations, anxiety, chest pain, may produce T wave and QT changes in the ECG

Ketorolac Tromethamine SIDE EFFECTS

edema, sedation, bleeding, urticaria, head ache, nausea

Calcium Chloride CLASS

electrolyte

Aspirin INTERACTIONS

few interactions for a single dose in the prehospital setting

Transexamic Acid INDICATIONS

for use in patients with hemophilia for short term use (two to eight days) to reduce or prevent hemorrhage. It cacn also be used for excessive bleeding in menstruation, surgery, or trauma cases.

Acetaminophen SIDE EFFECTS

generally well tolerated and there are no significant side effects in therapeutic doses. In large doses, the medication can be hepatotoxic

Naloxone MOA

has a higher infinity for narcotic receptor sites and, when administered, displaces the narcotic, blocking it's effects.

Calcium Chloride MOA

has a role in the function of the nervous system and voluntary muscle, cardiac contractility, and blood coagulation. in water dissociates to provide calcium and chloride ions. The calcium becomes available to the body

Albuteral PRECAUTIONS

has minimal beta1-adrenergic effects, but it may increase heart and myocardial oxygen demand. Use with caution in patients with heart disease.

Acetaminophen PRECAUTIONS

is hepatoxic in high doses and should be used with caution and should be used with caution in patients who have known liver disease.

Naloxone INDICATIONS

is indicated to reverse the respiratory depression associated with narcotic overdose

Oxygen MOA

is necessary for cellular energy production. When inhaled, oxygen molecules cross the respiratory membrane to attach to hemoglobin in red blood cells to transport to the tissues.

Glucagon PRECAUTIONS

is not effective if the patient has already depleted glycogen stores

5% Dextrose in Water for IV MOA

is used for prophylactic IV access or to dilute concentrated drugs for IV infusion

NS (0.9% Sodium Chloride Solution) CLASS

isotonic crystalloid

Lactated Ringer's Solution CLASS

isotonic crystalloid solution

Ibuprofen CONTRAINDICATIONS

known allergy to ibuprofen or other NSAIDs

Adenosine ADVERSE REACTIONS

lightheadedness, headache, chest pain, flushing, hypotension, shortness of breath, nausea, metallic taste, transient rhythm disturbances (bradydysrhythmia, sinus pause, ventricular ectopy, or asystole)

5% Dextrose in Water for IV PRECAUTIONS

may be more irritating to the tissues than the normal saline, so the IV site should be closely monitored for irritation, swelling, or redness.

Lactated Ringer's Solution MOA

meds solution is used to replace fluid and electrolytes

Sodium Bicarbonate SIDE EFFECTS

metabolic alkalosis, hypoxia, hypernatremia, seizures, increased intracellular CO2

5% Dextrose in Water for IV HOW SUPPLIED

most commonly supplied in 250 mL or 500 mL bags

Naloxone CLASS

narcotic antagonist

Glucose SIDE EFFECTS

nausea and vomiting

Ipratropium Bromide SIDE EFFECTS

nausea, vomiting, headache, tachycardia, dry mouth, blurred vision

Epinephrine 1:10,000 CONTRAINDICATIONS

no contraindications in cardia arrest. Hypovolemic shock (correct this first), hypersensitivity (relative, may use a lower dose in emergencies)

Activated Charcoal INTERACTIONS

none

Glucose INTERACTIONS

none

Acetaminophen DESCRIPTION

nonprescription is heptotoxic in high doses and should be used with caution in patients who have known liver disease

Diphenhydramine MOA

nonselectively blocks histamine (H1 and H2) receptors

Morphine Sulfate CLASS

opiate analgesic

Fentynal Citrade CLASS

opioid analgesic

Acetaminophen ROUTE

oral

Aspirin ROUTE

oral

Ibuprofen ROUTE

oral

Activated Charcoal INDICATIONS

oral ingestion of toxins

Glucose ROUTE

oral or buccal

Albuterol INTERACTIONS

other beta agonists should not be administered concurrently with albuterol.

Nitroglycerin - Sublingual Tablets and Spray MOA

potent vasodilators that increase blood flow to the coronary arteries and decrease cardiac workload by dilating the peripheral vasculature and reducing preload.

Activated Charcoal HOW SUPPLIED

premixed slurry of 50 g / 250 mL

5% Dextrose in Water for IV SIDE EFFECTS

rare when given in therapeutic doses

Glucagon SIDE EFFECTS

rare, but hypotension, dizziness, headache, nausea, and vomiting may occur

Levalbuterol MOA

selective beta2 stimulation causes dilation of the smooth muscle of the bronchioles,. Also relaxes all smooth airway muscle from the trachea to the terminal bronchioles

5% Dextrose in Water for IV INTERACTIONS

should not be used for blood product infusion

5% Dextrose in Water for IV CONTRAINDICATIONS

should not be used for patients who require IV fluid replacement or in patients who are hyperglycemic. Do not use in patients with traumatic brain injury or stroke.

Lactated Ringer's Solution INDICATIONS

significant burns and hypovolemia

Glucose HOW SUPPLIED

single does 1.3 sealed tube containing 15 g d-glucose; tube has a twist off.

Naloxone ROUTE

slow iv push

Lactated Ringer's Solution HOW SUPPLIED

solution is commonly supplied in 1,000 mL bags.

Epinephrine 1:1,000 ROUTE

subcutaneous or intramuscular injection

Nitroglycerin - Sublingual Tablets and Spray ROUTE

sublignual

Oxygen HOW SUPPLIED

supplied as a compressed in a high pressure cylinder

Glucagon HOW SUPPLIED

supplied as a kit containing the powdered medication and solvent that must be combined before administration.

Epinephrine 1:1,000 CLASS

sympathomimetic

Levalbuterol CLASS

sympathomimetic

Acetaminophen MOA

the mechanism of action is not completely understood, but acetaminophen increases the pain threshold by blocking prostaglandin synthesis and inhibits the effect of pyrogens in the CNS

NS (0.9% Sodium Chloride Solution) HOW SUPPLIED

this med is commonly supplied in 250 mL, 500 mL, and 1,000 mL bags designed to be used with an IV drip set. To avoid inadvertent fluid overload, select a container volume appropriate to the patient's condition

Nitrous Oxide PRECAUTIONS

use only in well-ventilated area to prevent sedation of the medical staff. Teratogenic; should not be used by or around pregnant patients or health care providers.

Ketorolac Tromethamine INDICATIONS

used for analgesia

Morphine Sulfate INDICATIONS

used for analgesia

Levalbuterol INDICATIONS

used for bronchospasm in adults, adolescents, and children over size years of age secondary to reversible obstructive airway disease.

Dopamine INDICATIONS

used for hypotension from vascular or cardiogenic origins

Lorazepam INDICATIONS

used for seizures behavioral emergencies, and sedation prior to cardioversion or pacing

Midazolam Hydrochloride INDICATIONS

used for seizures, behavioral emergencies, sedation prior to endotracheal intubation, and cardioversion or pacing

NS (0.9% Sodium Chloride Solution) MOA

used to expand the vascular volume temporarily by replacing water and electrolytes.