Meds - Updated.txt

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Author:
dodgybarnet
ID:
146557
Filename:
Meds - Updated.txt
Updated:
2012-06-24 19:56:37
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EMT MEDS
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EMT MEDS
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  1. Nitro Contraindications:
    • H - Hypotension
    • I - IV - cant establish
    • V - Viagra or ED drugs within 48hrs
    • H - Hypovolemia
    • I - Increased ICP
    • C - Cardiac Tamponade or pericarditis
    • B - Bradycardia <50bpm
    • R - Right ventricular infarction
    • A - Allergic to nitrates
  2. Nitro Names:
    • Nitroglycerin
    • Nitrostat
    • Nitro-Bid
    • Tridil
  3. Nitro Adult dose:
    • SL 0.3 mg tab, or
    • SL 0.4 mg spray q 5 minutes prn
    • NOTE: as long as BP remains greater than 100 mmHg
  4. Nitro Supplied:
    • 0.3 mg tablets SL
    • 0.4 mg per spray SL
  5. Nitro Indications:
    • Acute coronary syndromes (pain & ischemia with AMI without hypotension)
    • Suspected ischemic cardiac pain
  6. Nitro Side Effects:
    • Headaches
    • Hypotension
    • Lightheadedness
    • Syncope
  7. Nitro Route:
    Oral
  8. Nitro Pharmacodynamics:
    • Antianginal: relaxes vascular smooth muscle of both venous and arterial beds, resulting in a net decrease in the myocardial oxygen consumption.
    • It also dilates coronary vessels leading to redistribution of blood flow to ischemic tissue and improves collateral circulation.
    • Vasodilating: dilates peripheral vessels, decreasing venous return to the heart useful in treating pulmonary edema and he art failure. Arterial vasodilation decreases afterload, thereby decreasing left ventricular work and aiding the failing heart.
  9. Nitro Classification:
    • Nitrate
    • Anti-anginal
    • Vasodilator
  10. Nitro Note:
    • Although not common to pre hospital care, nitroglycerin can also be found in the form of a paste and a patch
    • In the event a patient presents with a Nitro patch already in place, remove the patch and administer nitroglycerin spray or tabs as per protocol
    • Also remove any Nitro patches before application or use of an AED
  11. D50W Names:
    D50W
  12. D50W Adult dose:
    • 0.5 to 1 g per kg slow IVP
    • Suspected head injury: 12.5 g D₅₀W
    • Recheck BGL in opposite limb and assess patient
    • Note: D₅₀W comes in 25 g preload (push one 25 g preload and reassess pt)
  13. D50W Supplied:
    Preload 25g in 50ml (D₅₀W)
  14. D50W Pediatric dose:
    • 0.5 to 1 g per kg of D25W slow IVP
    • Push 25 ml of medication into garbage and draw up 25 ml of Normal Saline (this will give you the correct concentration D25W)
  15. D50W Contraindications:
    Hyperglycemia
  16. D50W Indications:
    • Hypoglycemia
    • Coma of unknown origin (if unable to obtain BGL)
  17. D50W Side Effects:
    None
  18. D50W Precautions:
    • Dextrose greater than 5% is considered to hypertonic solution. It can be very irritating to the vein and could cause cerebral bleeding if not given slowly
    • Patients with increased ICP (give half dose and reassess - NEVER withhold, if the patients metabolic needs are deficient)
    • Ensure patency of IV – causes tissue sloughing if interstitial
    • IV catheter should be 18 G as solution is very viscous
  19. D50W Classification:
    • Carbohydrate
    • Antihypoglycemic
  20. D50W Pharmacodynamics:
    Rapidly metabolized calories given parenterally, which promotes glycogen stores and prevents ketosis in patients with inadequate intake
  21. D50W Route:
    Intravenous
  22. Glucagon Names:
    Glucagon
  23. Glucagon Adult dose:
    1.0 mg IM, q 15 – 20 minutes prn
  24. Glucagon Pediatric dose:
    • <5 years: 0.5 mg IM
    • >5 years: 1.0 mg IM
  25. Glucagon Supplied:
    • 1.0 mg (unit) vial,
    • 10 mg (units) vial
    • NOTE: Must be reconstituted
  26. Glucagon Indications:
    Hypoglycemia (when IV access cannot be established)
  27. Glucagon Contraindications:
    • Hypersensitivity (beef or pork proteins as glucagon is derived from beef or pork pancreas)
    • Pheochromocytoma (a neuroendocrine tumor of the medulla of the adrenal glands)
    • Hyperglycemia
  28. Glucagon Side Effects:
    • N/V
    • Hypokalemia
    • Generalized allergic reactions
  29. Glucagon Precautions:
    • After pt regains LOC - supplemental carbohydrates should be provided ASAP
    • Lowers serum potassium levels
    • Can cause:
    • - Tachycardia
    • - N/V
    • - Hypertension
  30. Glucagon Classification:
    • Hormone
    • Antihypoglycemic
  31. Glucagon Pharmacodynamics:
    • Stimulates hepatic production of glucose from glycogen stores (glycogenolysis)
    • Relaxes the musculature of the GI tract
    • Has positive inotropic and chronotropic effects
  32. Glucagon Route:
    • SQ or IM
    • IM preferred
  33. Glucagon NOTE:
    Will not be effective if there are not sufficient stores of glycogen in the liver
  34. Nitrous Names:
    • Nitrous Oxide
    • Entonox
  35. Nitrous Adult dose:
    Self administered until relief or patient drops the mask
  36. Nitrous Pediatric dose:
    Self administered until relief or patient drops the mask
  37. Nitrous Supplied:
    Compressed gas cylinder (50% nitrous oxide with 50% oxygen)
  38. Nitrous Indications:
    • Pain of musculoskeletal origin, particularly fractures
    • Burns
    • Suspected ischemic chest pain (BLS)
    • Pregnancy (only in active labor)
  39. Nitrous Contraindications:
    • C - COPD
    • U - Unable to follow commands
    • L - LOC altered
    • T - Traumatic chest injury
    • D - Distention
    • O - Obstructed Bowel
    • A - Abdominal Pain
    • P - Pneumothorax
    • D - Decompression Sickness
    • P - Pregnancy, except active labor
  40. Nitrous Side Effects:
    • Euphoria
    • Lightheadedness
    • N/V
  41. Nitrous Classification
    Gaseous analgesic and anesthetic
  42. Nitrous Pharmacodynamics:
    • Potent analgesic, weak anesthetic at these percentages
    • CNS depressant with analgesic properties
  43. Nitrous Route:
    Inhalation by demand valve and mask
  44. Nitrous Note:
    • Use in well ventilated area
    • Ensure to invert tank three times prior to use
    • Do not use outside if ambient temperature is below minus 6 degrees Celsius
    • Prolonged use can cause hypoxemia – provide supplemental oxygen

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