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Dexamethasone is a long-acting synthetic drenocorticoid with intense anti-inflammatory activity. It prevents the accumulation of inflammation generating cells at the site of infection or injury.
Anaphalaxis, COPD, asthma, spinal cord edema.
- - Contraindications: NO absolute contraindications in the emergency setting.
- - Relative Contraindications: systemic fungal infections, acute infections, tuberculosus, vericella, or vaccinia, or live virus vaccinations.
Herpes simplex, keratitis, myasthenia gravis, hepatic or renal impairment, diabetes, CHF, seizures, psychotic disorders, hyperthyroidism, and GI ulceration
- - Dosage/Route: 4 to 24 mg IV/IM
- - Pedi: 0.5 to 1.0 mg/kg
Diphenhydramine blocks histamine release, thereby reducing bronchoconstriction, vasodilation, and edema.
Anaphalaxis, Allergic reactions, and distoric reactions
Asthma or other lower respiratory diseases.
May induce hypotension, headache, palpitations, tachycardia, sedation, drowsiness, and/or disturbed coordination.
- - Dosage/Route: 25 to 50 mg IV/IM
- - Pedi: 2 to 5 mg/kg
Methylprednisolone is a synthetic adrenal corticosteroid, effective as an anti-inflammatory and used in the management of allergic reactions and in some cases of shock. It is sometimes used in the treatment of spinal cord injury.
Spinal cord injury, asthma, severe anaphalaxis, COPD
No absolute contraindications in the emergency setting.
Only a single dose should be given in the prehospital setting
- - Dosage/Route: Asthma/COPD/Anaphalaxis: 125 to 250 mg IV/IM
- - Pedi: 1 to 2 mg/kg/dose IV/IM
- - Spinal Cord Injury: 30 mg/kg over 15 minutes
Epinephrine is a 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.
To restore rhythm in cardiac arrest, and severe allergic reactions
Narrow angle glaucoma, hemorrhagic, traumatic, or cardiac shock
- - Dosage/Route: Arrest: 1 mg of 1:10,000 IV/3 to 5 mins (ET 2 to 2.5 mg 1:1,000)
- - Pedi: 0.01 mg/kg of 1:10,000 IV/IO (ET 0.1 mg/kg 1:1,000) All subsequent doses 0.1 mg/kg IV/IO. no max
- - Adult Bradycardia: 2 to 5 mcg/min (IV drip)
- - Allergic Reactions: 0.3 to 0.5 mg of 1:1,000 subcutaneously/5 to 15 mins as needed or 0.5 to 1 mg 1:10,000 IV if subcutaneous ineffective or severe reaction.
- - Pedi: 0.01 mg/kg (Max 0.5) of 1:1,000 SQ/10 to 15 mins or 0.01 mg/kg of 1:10,000 IV if subcutaneous dose ineffective or severe
- - Asthma/COPD: 0.3 mg 1:1,000 SQ