NCTI- Pharmacology- Precautions

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RunNickMarini
ID:
20364
Filename:
NCTI- Pharmacology- Precautions
Updated:
2010-05-23 23:42:04
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NCTI Pharmacology Precautions
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NCTI- Pharmacology- Precautions
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  1. Acetylsalicylic Acid
    Medical history of pre-existing ulcers, liver disease or bleeding disorders

    Due to the possible association of aspirin with Reye’s syndrome, do not give drug to children or teenagers with signs and symptoms of chickenpox (varicella) without physician consultation
  2. Morphine Sulfate
    Morphine Sulfate is an opiate derivative – Naloxone should be available to reverse any severe respiratory side effects
  3. Activated Charcoal
    • Should not be administered immediately after Syrup of Ipecac
    • Must shake vigorously prior to administration
    • Do not use charcoal with sorbitol (an added sweetener) in children < 1 yr
  4. Nitroglycerin
    Monitor blood pressure closely for signs of hypotension (before and after administration)
  5. Oxygen
    • Closely monitor patients with COPD
    • Patients with respiratory insufficiency should be monitored closely to ensure adequate ventilation
    • Non-humidified oxygen may cause drying of the mucous membranes
    • Neonates should not receive high concentrations for long periods of time
  6. Diazepam
    Use with caution in the elderly and very ill patients due to paradoxical effects
  7. Midazolam
    • Elderly patients with impaired respiratory function
    • Patients with renal failure, liver failure or COPD
  8. Naloxone
    • Give drug prior to intubation
    • Prepare to protect patient and EMS personnel due to aggressive/combative personality following rapid reversal of a narcotic overdose
    • Does not reverse narcotic-induced hypotension
    • Use with caution in narcotic addicts or chronic pain patients, as Narcan will rapidly reverse the CNS depressant effects of opiods.
  9. Glucagon
    • Only effective if liver glycogen is available, may be ineffective in chronic hypoglycemia or starvation patients
    • Use with caution in patients with cardiovascular disease or renal insufficiency/disease
  10. Dextrose 50% in water (D50W)
    • Aspirate prior to administration and after every 10-15 ml to ensure IV patency (medication will cause necrosis)
    • Cannulate largest vein possible and run IV wide open prior to and after administration
    • Relative contraindication: Use with caution in patients with increasing intracranial pressure as the added glucose may worsen the cerebral edema or potentiate cellular necrosis in hemorrhagic stroke
  11. Thiamine
    none

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