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.
