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2010-08-20 11:29:40
Paramedic Drugs

Drugs that can be administered as a Paramedic
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  1. Albuterol
    • (Proventil, Ventolin) Sympathomimetic Bronchodilator
    • Des: Causes bronchodilation, less cardiac effects than epinephrine, reduces mucus secretion, pulmonary capillary leaking, and edema in the lungs during allergic rxns
    • Ind: Brochospasm and asthma in COPD
    • CI: Hypersensitivity
    • PC: Tachycardia, anxiety, nausea, cough, wheezing, or dizziness
    • Dose: 2.5mg in 2.5 to 3mL normal saline via nebulizer
  2. Fentanyl
    • (Sublimaze) Narcotic analgesic
    • Des: Narcotic analgesic with more rapid/ less prolonged action than morphine
    • Ind: Induce sedation for endotracheal intubation
    • CI: MAO inhibitors within 14 days, myasthenia gravis
    • PC: Increased intracranial pressure, elderly, debilitated, COPD, respiratory problems, hepatic and renal insufficiency
    • Dose: 25 to 100mcg slowly IV (2 to 3 min)
  3. Ipratropium
    • (Atrovent) Anticholinergic (Bronchodilator)
    • Des: causes bronchodilation, dries respiratory tract secretions by blocking acetylcholine receptors
    • Ind: Bronchospasm associated with asthma, COPD, and inhaled irritants
    • CI: Hypersensitivity to atropine, use as a primary treatment for acute bronchospasm
    • PC: Elderly, cardiovascular disease, hypertension
    • Dose: 500mcg in 2.5 to 3mL normal saline via nebulizer or 2 sprays from metered dose inhaler
  4. Morphine
    • Opiate analgesic
    • Des: Potent analgesic and sedative, causes some vasodilation, reducing venous return, and reduced myocardial O2 demand
    • Ind: moderate to severe pain, pain in MI, and to reduce venous return in pulmonary edema
    • CI: Undiagnosed head or abdominal injury, hypotension or volume depletion, acute bronchial asthma, COPD, severe respiratory depression, or pulmonary edema due to chemical inhalation
    • PC: elderly, children, debilitated; have naloxone available
    • Dose: 2.5 to 15mg IV or 5 to 20mg IM/SQ (pain), 1 to 2mg per 6 to 10 minute to response (AMI or pulmonary edema)
  5. Naloxone
    • (Narcan) Narcotic antagonist
    • Des: blocks the effects of narcotics, may reduce respiratory depression
    • Ind: narcotic overdose, coma of unknown origin
    • CI: non-narcotic induced respiratory depression
    • PC: possible dependency, shorter half-life than narcotics: pt may relapse
    • Dose: 0.4 to 2mg IV/IM (2 to 2.5 the dose ET) repeated every 2 to 3 min as needed up to 10mg.
  6. Diazepam
    • (Valium) Antianxiety, Hypnotic, Anticonvulsant, Sedative
    • Class: Benzodiazepine sedative and skeletal muscle relaxant
    • Des: reduces tremors in ortho injury, induces amnesia for painful procedures, reduces incidence and recurrence of seizures
    • Ind: Major motor seizures, status epilepticus, premed before cardioversion, muscle tremors due to injury, acute anxiety
    • CI: Shock, coma, acute alcoholism, depressed vitals, obstetric pts, neonates
    • PC: phycoses, depression, myasthenia gravis, short half life
    • Dose: 5 to 10mg IV (seizures), 2.5 to 5mg IV/IM (anxiety), 5 to 15mg IV (premed for cardioversion)
  7. Etomidate
    • (Amidate) Hypnotic
    • Class: Nonbarbiturate hypnotic
    • Des: Ultra short acting, no analgesic effects, limited cardiovascular and respiratory effects
    • Ind: Induce sedation for rapid sequence intubation
    • PC: Marked hypotension, severe asthma, severe cardiovascular disease
    • Dose: 0.1 to 0.3 mg/kg IV over 15 to 30 sec
  8. Flumazenil
    • (Romazicon) Benzodiazepine Antagonist
    • Des: Used to reverse the sedative, recall, and psychomotor effects of diazepam, midazolam, and benzodiazepines
    • Ind: Respiratory depression secondary to benzodiazepines
    • CI: Pts who take benzos for status epilepticus or seizures, seizure-prone pts during labor and delivery, tricyclic antidepressant overdose
    • PC: Hepatic impairment, elderly, pregnancy, nursing mothers, head injury, alcohol and drug dependency and physical dependence on benzodiazepines.
    • Dose: 0.2mg IV over 30 sec/min up to 1mg.
  9. Midazolam
    • (Versed) Sedative
    • Des: short-acting with CNS depressant, muscle relaxant, anticonvulsant, and anterograde amnestic effects
    • Ind: to induce sedation before cardioversion or intubation
    • CI: Narrow-angle glaucoma, shock, coma, or acute alcohol intoxication
    • PC: COPD, renal impairment, CHF, elderly
    • Dose: 1 to 2.5mg slow IV; 0.07 to 0.08mg/kg IM (usually 5mg)
  10. Succinylcholine
    • (Anectine) Depolarizing Neuromuscular Blocker
    • Des: ultra short acting depolarizing neuromuscular blocker
    • Ind: facilitated endotracheal intubation
    • CI: family hx of malignant hyperthermia, penetrating eye injury, narrow-angle glaucoma
    • PC: Severe burn or crush injury, spinal cord injury
    • Dose: 1 to 1.5mg/kg IV/IM
  11. Adenosine
    • (Adenocard) Antidisrythymic
    • Des: can chemically cardiovert PSVT to a normal sinus rythym. It has a halflife of 10 seconds and does not cause hypotension.
    • Ind: Narrow, complex paroxysmal supraventricular tachycardia refractory to vagal maneuvers
    • CI: 2nd and 3rd degree heart block, sinus node disease, or asthma
    • PC: COPD, May cause transient dysrythmias (especially asystole)
    • Dose: 6mg rapidly IV (over 1 to 2 sec), then flush the line rapidly with saline. If ineffective, 12mg in 1 to 2 min, may be repeated.
  12. Atropine
    • Parasympatholytic
    • Des: Blocks the parasympathetic nervous system, specifically the vagal effects on the heart rate. May increase myocardial oxygen demand. Decreases airway secretions
    • Ind: Hemodynamically signifcant bradycardia, bradysystolic arrest, and organophosphate poisoning
    • CI: None in emergency setting. 2nd degree type 2 and above heartblocks are class 2B (not recommended)
    • PC: AMI, glaucoma
    • Dose: 0.5mg IV/ 1mg ET. Repeat every 3 to 5 min up to 3mg.(Symptomatic bradycardia) 1mg IV or 2mg ET. May repeat every 3 to 5 min up to 3mg. (Asystole) 2 to 5mg IV/IM/IO/ 10 to 15 min (Organophospate poisoning)
  13. Epinepherine
    • (Adrenalin) Sympathomimetic
    • Des: Naturally occuring catecholamine that increases heart rate, cardiac contractile force, myocardial electrical activity, systemic vascular resistance, and systolic blood pressure, and decreases overall airway resistance and automaticity. It also, through bronchial artery constriction may reduce pulmonary congestion and increase tidal volume and vital capacity.
    • Ind: Cardiac arrest and severe allergic reactions
    • CI: Narrow angle glaucoma, hemorrhagic, traumatic, or cardiac shock
    • Dose: 1mg of 1:10,000 IV/ 3 to 5 min, 2 to 2.5mg ET 1:1,000 (Cardiac arrest) 0.3 to 0.5mg of 1:1,000 SQ/ 5 to 15 min as needed or 0.5 to 1mg of 1:10,000 IV if SQ dose ineffective or severe reaction (allergic reaction)
  14. Vasopressin
    • (Pitressin) Hormone, Vasorepressor
    • Des: A hormone with strong vasorepressive and anitdiuretic properties, but that may precipitate angina and/or AMI
    • Ind: To increase peripheral vascular resistance in arrest (CPR) or to control bleeding from esophageal
    • varices.
    • CI: PVCs or 1st stage of labor
    • PC: Epilepsy, migraine, heart failure, angina, vascular disease, hepatic impairment, elderly, and children
    • Dose: 40 units IV (arrest), 0.2 to 0.4 units/min IV drip (esophageal varices)
  15. Aspirin
    • (Acetylsalicylic Acid)[Alka-Seltzer; Bayer; Empirin; St. Joseph Children's] Analgesic, Antipyretic, Platelet Inhibitor, Antiinflammatory
    • Des: Inhibits agents that cause the production of inflammation, pain, and fever. Relieves mild to moderate pain by acting on the peripheral nervous system, lowers body temperature in fever, and powerfully inhibits platelet aggregation.
    • Ind: Chest pain suggestive of an MI.
    • CI: Active ulcer disease, asthma
    • PC: Bleeding disorders
    • Dose: 160 to 325mg PO (chewable)
  16. Dextrose 50% In Water
    • (D50W) Carbohydrate
    • Des: A simple sugar that the body can rapidly metabolize to create energy.
    • Ind: Hypoglycemia
    • CI: None in hypoglycemia
    • PC: Increased ICP. Determine blood glucose level before administration. Ensure good venous access.
    • Dose: 25g D50W (50mL) IV
  17. Furosemide
    • (Lasix) Diuretic
    • Des: rapid-acting, potent diruetic and antihypertensive that inhibits sodium reabsorption by the kidney. It's vasodilating effects reduce venous return and cardiac workload.
    • Ind: Congestive heart failure and pulmonary edema
    • CI: Fluid and electrolyte depletion states, hepatic coma, pregnancy (except in life-threatening circumstances)
    • PC: Infants, elderly, hepatic impairment, nephrotic syndrome, cardiogenic shock associated with MI, gout, patients receiving digitalis, or potassium-depleting steroids.
    • Dose: 40 to 120mg slow IV
  18. Nitroglycerin
    • (Nitrostat) Nitrate
    • Des: rapid smooth muscle relaxant that reduces peripheral vascular resistance, blood pressure, venous return, and cardiac workload.
    • Ind: Chest pain associated with angina and acute myocardial infarction, and acute pulomany edema
    • CI: Tolerance to nitrates, severe anemia, head trauma, hypotension, increased ICP, patients taking sildenafil, glaucoma, and shock.
    • PC: May induce headache that is sometimes severe, Nitro is light-sensitive and will lose potency when exposed to the air.
    • Dose: 1 tablet (0.4mg) SL (sublingually). May be repeated every 3 to 5 minutes up to 3 tablets. 1/2 inch of topical ointment or 1 spray (0.4mg) SL up to 3 sprays/ 25 min.
  19. Dobutamine
    • (Dobutrex) Sympathomimetic
    • Des: Synthetic catecholamine and beta agent that increase the rate of cardiac contraction without appreciably increase rate.
    • Ind: To increase cardiac output in CHF/ cardiogenic shock
    • CI: Ventricular Tachycardia, hypovolemia without fluid resuscitation
    • PC: Atrial fibrillation or preexisting hypertension
    • Dose: 2 to 20mcg/kg/min IV
  20. Dopamine
    • (Intropin) Sympathomimetic
    • Des: A catecholamine that increases cardiac output without appreciably increasing myocardial oxygen consumption. Maintains renal and mesenteric blood flow while inducing vasoconstriction and increasing systolic blood pressure.
    • Ind: Nonhypovolemic hypotension (70 to 100 mmHg) and cardiogenic shock
    • CI: Tachydysrhythmias, ventricular fibrillation, and increasing systolic blood pressure.
    • PC: Ensure adequate fluid resuscitation of the hypovolemic patient
    • Dose: 2 to 5 mcg/kg/min up to 20mcg/kg/min titrated to effect
  21. Isoproterenol
    • (Isuprel) Sympathomimetic
    • Des: A sympathomimetic that results in increased cardiac output by increasing the strength of cardiac contraction and somewhat increasing rate.
    • Ind: Bradycardia refractory to atropine when pacing is not available
    • CI: Cardiogenic shock
    • PC: Tachydysrhythmias, and those associated with digitalis and acute MI.
    • Dose: 2 to 10mcg/min titrated to cardiac rate
  22. Amiodarone
    • (Cordarone, Pacerone) Antidysrhythmic
    • Des: Prolongs the duration of the action potential and refractory period and relaxes smooth muscles, reducing peripheral vascular resistance and increasing coronary blood flow.
    • Ind: Life-threatening ventricular and supraventricular dysrhythmias, frequently atrial fibrillation
    • CI: Cardiogenic shock, severe sinus bradycardia, or advanced heart block
    • Dose: 150 to 300mg IV over 10 min, then 1mg/min over the next 6 hours
  23. Bretylium
    • (Bretylol) Antidysrhythmic
    • Des: Surpresses ventricular tachydysrhythmias including ventricular fibrillation with reentry mechanisms
    • Ind: Ventricular fibrillation and ventricular tachycardia refractory to lidocaine
    • CI: None
    • PC: Digitalized pts, digitalis-induced dysrhythmias
    • Dose: 5mg/kg IV, then 10mg/kg/ 15 to 30 min, to a max 30mg/kg
  24. Lidocaine
    • (Xylocaine) Antidysrhythmic
    • Des: Surpresses automaticityand raises the stimulation threshold of the ventricles. Also causes sedative, anticonvulsant, and analgesic effects.
    • Ind: Pulseless ventricular tachycardia, ventricular fibrillation, and ventricular tachycardia (w/ pulse)
    • CI: Supraventricular dysrythmias, Stokes-Adams syndrome, 2nd and 3rd degree heart blocks, and bradycardias
    • PC: Hepatic or renal impairment, CHF, hypoxia, respiratory depression, hypovolemia, myasthenia gravis, shock, elderly
    • Dose: 1 to 1.5mg/kg IV repeated every 3 to 5 min up to 3mg/kg, follow conversion with a drip of 2 to 4mg/min (Cardiac Arrest); 1 to 1.5mg/kg slow IV. May repeat at 1/2 dose every 5 to 10 min until conversion. Floow conversion with an infusion of 2 to 4mg/min (Ventricular tachycardia w/ pulse)
  25. Procainamide
    • (Pronestyl) Antiarrythmic
    • Des: Prolongs ventricular repolarization, slows conduction, and decreases myocardial excitability
    • Ind: Ventricular fibrillation and pulseless ventricular tachycardia refractory to lidocaine
    • CI: Myasthenia gravis amd 2nd or 3rd degree heart block
    • PC: Hypotension, cardiac enlargement, CHF, AMI, ventricular dysrhythmias from digitalis, hepatic or renal impairment, or bronchial asthma
    • Dose: 20 to 30mg/min IV drip
    • Stop points:
    • (1) up to 17mg/kg to effect, then 1 to 4mg/min
    • (2) ectopy resolves
    • (3) QRS complex widens more than 50% from original
    • (4) hypotension ensues
  26. Diltiazem
    • (Cardizem) Calcium Channel Blocker
    • Des: Similar to Verapamil. Dilates coronary and peripheral arteries, increasing circulation to the heart and reducing peripheral vascular resistance.
    • Ind: Supraventricular tachycardias (atrial fibrillation, atrial flutter, and PSVT refractory to adenosine) and to increase coronary artery perfusion in angina.
    • CI: Sick sinus syndrome, 2nd or 3rd degree heart block, systolic BP<90, diastolic BP<60, wide-complex tachycardia, and WPW
    • PC: CHF
    • Dose: 0.25mg/kg IV over 2 min, may repeat as needed with 0.35mg/kg followed by a drip of 5 to 10mg/hr, not to exceed 15mg/hr over 24 hours
  27. Tridil
    • (Nitroglycerin Injection) Vasodilator, Nitrate
    • Des: relaxes blood vessels, increasing blood and oxygen supply to the heart.
    • Ind: Relieve pain associated with angina that does not respond to oral treatment; to control blood pressure, and to help treat CHF
    • CI: hypotension, uncorrected hypovolemia, increased intracranial pressure, constrictive pericarditis, and pericardial tamponade
    • PC: headache, severe hypotension, reflex tachycardia
    • Dose: 0.2 to 1.5mcg/kg/min
  28. Verapamil
    • (Isoptin, Calan) Calcium Channel Blocker
    • Des: Slows AV conduction, surpresses reentry dysrhythmias, and slows ventricular responses to atrial tachydysrhythmias. Also dilates coronary arteries and reduces myocardial O2 demand.
    • Ind: PSVT refractory to adenosine, atrial flutter, and atrial fibrillation with rapid ventricular response.
    • CI: Severe hypotension, cardiogenic shock, 2nd or 3rd degree heart block, CHF, sinus node disease, and accessory AV pathways, WPW syndrome, pts using beta blockers.
    • Dose: 2.5 to 5mg IV bolus over 2 to 3 min, then 5 to 10mg after 15 to 30 min up to a max of 30mg in 30 min.
  29. Activated Charcoal
  30. Calcium Chloride
    • Electrolyte
    • Des: increases myocardial contractile force and increases ventricular automaticity.
    • Ind: Hyperkalemia, hypocalcemia, hypermagnesemia, ad calcium channel blocker toxicity
    • CI: Ventricular fibrillation, hypercalcemia, and possible digitalis toxicity
    • PC: may precipitate toxicity in pts taking digoxin, ensure the IV line is in a large vein and is flushed before and after using calcium
    • Dose: 2 to 4mg/kg IV (10% solution)/ 10min as needed
  31. Methylprednisolone
    • (Solu-Medrol) Corticosteroid, Antiinflammatory
    • Des: Effective as an antiinflammatory and used in the management of allergic reactions and in some cases shock. Can sometimes be used in the treatment of spinal cord injury.
    • Ind: Spinal cord injury, asthma, severe anaphylaxsis, COPD
    • PC: Only use a single dose prehospitally
    • Dose: 125 to 250mg IV/IM (Asthma/ COPD/ Anaphylaxis); 30 mg/kg IV over 15 min, after 45 min an indusion of 5.4 mg/kg/hr (Spinal Cord Injury)
  32. Magnesium Sulfate
    • (Magnesium) Electrolyte
    • Des: Acts as a calcium channel blocker, acting as a CNS depressant and anticonvulsant. Depresses the function of smooth, skeletal, and cardiac muscles.
    • Ind: Refractory ventricular fibrillation and pulseless ventricular tachycardia (especially torsade de pointes), AMI, eclamptic seizures
    • CI: Heart block, myocardial damage, shock, persistent hypertension, and hypocalcemia
    • PC: Other CNS depressants or neuromuscular blocking agents
    • Dose: 1 to 2g IV over 2 min (VFib or VTach); 1 to 2g IV over 5 to 30 min (AMI); 2 to 4g IV/IM (eclampsia)
  33. Phenytoin
    • (Dilantin) Anticonvulsant
    • Des: Reduces the spread of electrical discharges in the motor cortex and inhibits seizures. Also has antidysrythmic properties that counteract the effects of digitalis.
    • Ind: Seizures, status epilepticus, cardiac dysrythmias secondary to digitalis.
    • CI: Sinus bradycardia, heart block, Adams-Stokes syndrome
    • Dose: 10 to 15mg/kg slow IV (Seizures); 100mg slow IV (over 5 min) to a maximum of 1000mg (Dysrythmias)
  34. Sodium Bicarbonate
    • (NaHCO3) Alkalizing Agent
    • Des: Provides vascular bicarbonate to assist the buffer system in reducing the effects of metabolic acidosis and in the treatment of some overdoses
    • Ind: Tricyclic antidepressant and barbituate overdose, refractory acidosis, or hyperkalemia
    • PC: May precipitate calcium chloride
    • Dose: 1mEq/kg IV, then 0.5 mEq/kg/10 min
  35. Thiamine
    • Vitamin
    • Des: Vitamin B1, which is required to covert glucose into energy, it is not manufactured in the body and must be constantly provided from diet
    • Ind: Coma of unknown origin, chronic alcoholism with associated coma, and delirium tremens
    • Dose: 50 to 100mg IV/IM
  36. Diphenhydramine
    • (Benadryl) Antihistamine
    • Des: blocks histamine release, thereby reducing bronchoconstriction, vasodilation, and edema
    • Ind: Anaphylaxis, allergic reactions, and dystonic reactions
    • CI: Asthma and other lower respiratory diseases
    • Dose: 25 to 50mg IV/IM
  37. Lorazepam
    • (Ativan) Sedative
    • Des: the most potent benzodiazepine available. It has strong antianxiety, sedative, hypnotic, and skeletal muscle relaxant properties, and a relatively short half-life
    • Ind: Sedation for cardioversion and status epilepticus
    • PC: Narrow-angle glaucoma, depression or psychosis, coma, shock, acute alcohol intoxication, renal or hepatic impairment, organic brain syndrome, myasthenia gravis, GI disorders, elderly, debilitated, limited pulmonary reserve
    • Dose: 2 to 4mg IM, 0.5 to 2 mg IV (sedation); 2mg slow IV/PR (2 mg/min) (status epilepticus)
  38. Metoclopramide
    • (Reglan) Antiemitic
    • Des: a dopamine antagonist similar to procainamide but with few antidysrhythmic or anesthetic properties. Its antiemetic properties stem from rapid gastric emptying and desensitization of the vomiting reflex
    • Ind: Nausea and vomiting
    • CI: allergy to sulfite agents, seizure disorders, pheochromocytoma, mechanical GI obstruction or perforation, and breast cancer
    • PC: CHF, hypokalemia, renal impairment, GI hemorrhage, intermittent porphyria
    • Dose: 10 to 20mg IM; 10mg slow IV (over 1 to 2 min)
  39. Zofran
    • Antiemetic
    • Des: selective blocking agent of the serotonin receptor type
    • Ind: Nausea and intractible vomiting
    • PC: may mask a progressive ileus and/or gastric distension
    • Dose: single 24mg tablet ODT; 4mg IV undiluted over at least 30 seconds, preferably
  40. Chlordiazepoxide
    • (Librium) Sedative/ Hyponotic
    • Des: a benzodiazepine derivative that produces mild sedation and anticonvulsant, skeletal muscle relaxant, and prolonged hypnotic effects
    • Ind: Severe anxiety and tension, acute alcohol withdrawal symptoms (DTs)
    • CI: pregnant and nursing mothers, children under 6
    • PC: Primary depressive disorders or psychoses, acute alcohol intoxication
    • Dose: 50 to 100mg IV/IM
  41. Pancuronium
    • (Pavulon) Nondepolarizing Neuromuscular Blocker
    • Des: causes paralysis without bronchospasm or hypotension
    • Ind: to facilitate endotracheal intubation
    • CI: Tachycardia
    • Dose: 0.04 to 0.1mg/kg IV
  42. Vercuronium
    • (Norcuron) Nondepolarizing Skeletal Muscle Relaxant
    • Ind: Facilitated endotracheal intubation
    • PC: Severe obesity, myasthenia gravis, or maliginant hypothermia
    • Dose: 0.08 to 0.1mg/kg IV
  43. Butorphanol
    • (Stadol) Narcotic Analgesic
    • Des: a centrally acting synthetic narcotic analgesic about 5 times more potent than morphine. A schedule IV narcotic
    • Ind: Moderate to severe pain
    • CI: Head injury, or undiagnosed abdominal pain
  44. Meperidine
    • (Demerol) Narcotic Analgesic
    • Des: a synthetic narcotic with sedative and analgesic properties comparable to morphine but without hemodynamic side effects
    • Ind: Moderate to sever pain
    • CI: Seizure disorders, undiagnosed abdominal injury or pain
    • PC: ICP, asthma or other respiratory conditions, SVTs, prostatic hypertrophy, utheral structure, glaucoma, elderly or debilitated, renal or hepatic impairment, hypothyroidism, Addison's disease
    • Dose: 25 to 50mg IV, 50 to 100mg IM
  45. Nalbuphrine
    • (Nubain) Narcotic Analgesic
    • Des: a synthetic narcotic analgesic equivalent to morphine, though its respiratory depression does not increase with higher doses
    • Ind: Moderate to severe pain
    • CI: Undiagnosed head or abdominal injury
  46. Aminophylline
    • (Aminophylline, Somophyllin) Methylxanthine Bronchodilator
    • Des: Prolongs bronchodilation and decreases mucus production and has mild CNS and cardiac simulating effects.
    • Ind: CHF; Bronchospasm and COPD refractory to sympathomimetics and other bronchodilators
    • CI: Uncontrolled cardiac dysrhythmias
  47. Chlorpromazine
    • (Thorazine) Tranquilizer, Antipsychotic
    • Des: Phenothiazine derivatice used to managae psychotic episodesby providing stong sedation and moderate extrapyramidal symptoms
    • Ind: Acute psychotic episode, intractable hiccups, nausea/vomiting
  48. Promethazine
    • (Phenergan) Antiemetic
    • Des: An anticholinergic agent that enhances the effects of analgesics and is a potent antiemetic
    • Ind: Nausea/vomiting, motion sickness, to enhance the effects of analgesics, and to induce sedation
    • Dose: 12.5 to 25mg IV/IM/PR
  49. Terbutaline
    • (Brethine, Bricanyl) Sympathetic Agonist
    • Des: Causes bronchodilation with less cardiac effect than epinephrine
    • Ind: Bronchial asthma and bronchospasm in COPD
  50. Heparin
    • Anticoagulant
    • Des: Rapid-onset anticoagulant, enhancing the effects of antithrombin III and blocking the conversion of prothombrin to thombrin and fribrogen to fibrin
    • Ind: to prevent thrombus formation in acute MI
  51. Norepinephine
    • (Levophed) Ampathomimetic Agent
    • Des: Causes vasodilation, cardiac stimulation, and increased blood pressure, myocardial oxygen demand, and coronary
    • Ind: refractory hypotension and neurogenic shock
    • CI: hypotension due to uncorrected hypovolemia
  52. Timpotic
    • Beta blocker
    • Des: Non-selective beta-adrenergic receptor blocking agent
    • Ind: HTN, AMI, elevated ocular pressure
    • CI: Asthma, severe COPD, sinus bradycardia, 2nd or 3rd degree AV block, cardiogenic shock
    • PC: readily absorbed
    • Dose: Opthalmic, one drop per eye BID
  53. Alteplase Recombinant
    • (tPA, Activase) Thrombolytic
    • Des: Recombinant DNA- derived form of human tPA promotes thrombolysis by forming plasmin. Plasmin, in turn, degrades fibrin and fibrogen, and ultimately the clot
    • Ind: To thrombolyse in AMI, acute ischemic stroke, and pulmonary embolism
    • CI: active internal bleeding, suspected aortic dissection, traumatic CPR, recent hemmoragic stroke (6 months), intracranial or intraspinal surgery or tauma (2 months), pregnancy, uncontrolled hypertension.
    • PC: recent major surgery, cerebral vascular disease, recent GI or GU bleeding, recent trauma, hypertension, pt >75 years old, current oral anticoagulants, or hemmorhagic opthalmic conditions
    • Dose: 15mg IV, then 0.75mg/kg (up to 50mg) over 30 min, then 0.5mg/kg (up to 35mg) over 60 min (AMI and stroke)
    • 100mg IV infusion over 2 hours (pulmonary edema)
  54. Dexamethasone
    • (Decadron) Steroid
    • Des: a long-acting synthetic adrenocorticoid with intense antiinflammatory activity
    • Ind: Anaphylaxis, COPD, Asthma, and Spinal Cord Edema
    • CI: None in emergency setting
  55. Ketorolac
    • (Toradol) NSAID
    • Des: an injectable NSAID that exhibits analgesic, antiinflammatory, and antipyretic properties without sedative effects
    • Ind: Mild or moderate pain
  56. Mannitol
    • (Osmitrol) Osmotic diuretic
    • Des: an osmotic diuretic that draws water into the intravascular space through its hypertonic effects, then causes diuresis
    • Ind: cerebral edema
  57. Glucagon
    • (GlucaGen) Hormone, Antihypoclycemic
    • Des: a protein secreted by pancreatic cells that causes a breakdown of stored glycogen
    • Ind: Hypoglycemia without IV access and to reverse beta-blocker overdose
    • PC: Effective only if there are sufficient stores of glycogen in the
    • liver
    • Dose: 1mg IM/SQ repeat/5 to 20 min (Hypoglycemia)
    • 50 to 150mcg/kg IV over 1 min (Beta-blocker overdose)
  58. Oxytocin
    • (Pitocin) Hormone
    • Des: a naturally occurring hormone that causes the uterus to contract, thereby inducing labor, encouraging delivery of the placenta, and controlling postpartum hemorrhage
    • Ind: Severe postpartum hemorrhage
  59. Prochlorperazine
    • (Compazine) Antiemetic
    • Des: Has potent antiemetic properties and fewer sedative, hypotensive, and anticholinergic effects
    • Ind: Severe nausea and vomiting, or acute psychosis
    • CI: Coma or depression
  60. Racemic Epinephrine
    • Sympathomimetic Agonist
    • Des: a variation of epinephrine used only for inhalation to induce bronchodilation and to reduce laryngeal edema and mucus secretion
    • Ind: Croup
    • CI: Hypertension or epiglottitis