Paramedic Drugs

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Author:
Anglzofmyhrt
ID:
211965
Filename:
Paramedic Drugs
Updated:
2013-04-23 07:51:00
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Paramedic Drugs
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Description:
Indications, Contraindications, and Dose
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  1. *Amiodarone -- Indications
    wide complex VF/VT
  2. *Amiodarone -- Contraindications
    • 2nd & 3rd degree blocks
    • cardiogenic shock
    • pregnancy or neonates
    • severe liver disease
    • dig toxicity
  3. *Amiodarone -- Dose
    • with pulse: 150mg/10min
    • no pulse: 300mg bolus
  4. Amrinone -- Indications
    CHF
  5. Amrinone -- Contraindications
    • aortic stenosis
    • hypertrophic cardiomyopathy
  6. Amrinone -- Dose
    • 0.75 mg/kg bolus
    • 5-10 mcg/kg/min drip
  7. *Atropine -- Indications
    • bradycardia
    • organophosphate poisoning
  8. *Atropine -- Contraindications
    ischemia from 2nd & 3rd degree blocks
  9. *Atropine -- Dose
    • Brady --0.5-1mg
    • Organo -- 2-5mg q 10-15min
  10. Calcium Chloride -- Indications
    • hyperkalemia
    • hypocalcemia
    • hypermagnesemia
    • CCB toxicity
  11. Calcium Chloride -- Contraindications
    • VF
    • Dig toxicity
    • hypercalcemia
  12. Calcium Chloride -- Dose
    2-4mg q 10min of 10% solution
  13. Digoxin (Lanoxin) -- Indications
    • A-fib
    • A-flutter
    • CHF
  14. Digoxin (Lanoxin) -- Contraindications
    • bradycardia
    • VF/VT
    • dig toxicity
  15. Digoxin (Lanoxin) -- Dose
    0.2mg qd
  16. *Diltiazem (Cardizem) -- Indications
    • angina
    • A-fib
    • PSVT conversion
  17. *Diltiazem (Cardizem) -- Contraindications
    • 2nd & 3rd degree blocks
    • SSS
    • hypotension
    • wide tachy rhythms
  18. *Diltiazem (Cardizem) -- Dose
    0.25 mg/kg/2min
  19. *Dopamine -- Indications
    • cardiogenic shock
    • non hypovolemic shock
  20. *Dopamine -- Contraindications
    • hypovolemic hypotension without fluids first
    • VF
    • tachy dysrhythmias
  21. *Dopamine -- Dose
    • Renal: 2-5mcg/kg/min
    • Cardiac: 5-10mcg/kg/min
    • Pressor: 10-20mcg/kg/min
  22. Dobutamine -- Indications
    • CHF
    • cardiogenic shock
  23. Dobutamine -- Contraindications
    • VT
    • hypovolemia without fluids first
  24. Dobutamine -- Dose
    2-20mcg/kg/min
  25. *Epinephrine -- Indications
    • code
    • anaphylaxis
    • COPD
    • asthma
  26. *Epinephrine -- Contraindications
    • cardiac disease
    • HTN
    • pregnancy
    • tachydysrhythmias
  27. *Epinephrine -- Dose
    • 1:1000: 0.3-0.5mg SQ/IM
    • 1:10,000: 1mg q 3-5min
  28. *Heparin -- Indications
    • DIC
    • post-op
    • thrombosis
    • cardiac cath
  29. *Heparin -- Contraindications
    • active bleed
    • recent surgery
    • severe HTN
  30. *Heparin -- Dose
    • A -- 80u/kg bolus
    •       750-1200u/hr drip

    • P -- 50u/kg bolus
    •       18u/kg/hr drip
  31. Isoproterenol -- Indications
    • refractory bradycardia
    • status asthmaticus
  32. Isoproterenol -- Contraindications
    cardiogenic shock
  33. Isoproterenol -- Dose
    1mg in 500 D5W @ 2-20mcg/min
  34. *Lidocatine -- Indications
    VT/VF
  35. *Lidocatine -- Contraindications
    2nd & 3rd degree block
  36. *Lidocatine -- Dose
    • 1mg/kg bolus
    •      then 0.5mg/kg q 3-5min
    • 2-4mg/min drip
  37. *Metoprolol (Propanolol) -- Indications
    • HTN
    • angina
    • AMI
    • SVT
    • VT
    • CHF
    • migraines
  38. *Metoprolol (Propanolol) -- Contraindications
    • cardiogenic shock
    • bradycardia <45bpm
    • 2nd & 3rd degree HB
    • Cor Polmonale
    • asthma
    • COPD
  39. *Metoprolol (Propanolol) --Dose
    5mg q 5min SIVP max 3x
  40. Nifedipine --Indications
    prinzemetal angina
  41. Nifedipine -- Contraindications
    • ustable angina
    • recent MI
  42. Nifedipine -- Dose
    SL in HYN emergencies
  43. Norepinephrine -- Indications
    • refractory hypotension
    • ADHD
    • depression
    • schizophrenia
  44. Norepinephrine -- Contraindications
    hypovolemic shock until fuids are given
  45. Norepinephrine -- Dose
    0.5-30mcg/min (titrate to BP)
  46. Procanimide -- Indications
    refractory VF
  47. Procanimide -- Contraindications
    • 2nd & 3rd degree HB
    • myasthenia gravis
  48. Procanimide -- Dose
    • 20-30mg/min drip to effect
    •      then 1-4mg/min
  49. Prostiglandin E1 --Indications
    • maintain patent ductus arterosus in newborns
    • ED
    • critical limb ischemia
  50. *Vasopressin -- Indications
    • code
    • esophageal varices
  51. *Vasopressin -- Contraindications
    • nephritis
    • ischemic heart disease
    • 1st stage of labor
  52. *Vasopressin -- Dose
    • Code: 40u
    • EV: 0.2-0.4u/min drip
  53. *Acetylsalicylic Acid (Aspirin) --Indications
    MI
  54. *Acetylsalicylic Acid (Aspirin) -- Contraindications
    • ulcer
    • asthma
  55. *Acetylsalicylic Acid (Aspirin) -- Dose
    324mg
  56. *Adenosine --Indications
    SVT/PSVT
  57. *Adenosine -- Contraindications
    • 2nd & 3rd HB
    • severe bradycardia
  58. *Adenosine -- Dose
    6mg - 12mg - 12mg (OLMC)
  59. *Dextrose -- Indications
    hypoglycemia < 80mg/dl
  60. *Dextrose -- Contraindications
    intracranial hemmhorrage
  61. *Dextrose -- Dose
    A - 12.5-25g SIVP

    P - 0.5-1g/kg SIVP
  62. *Oxygen -- Indications
    known or suspected hypoxemia
  63. *Oxygen -- Contraindications
    COPD
  64. *Oxygen -- Dose
    enough to maintain SPO2 94-99%

    • N/C @ 2-6lpm = 24-44% O2
    • SFM @ 4-6lpm = 44-50% O2
    • PR @ 8-10lpm = 80% O2
    • NRB @ 10-15lpm = 90-95% O2
    • Venturi @ specific % of O2 based liter flow
  65. *Terbutaline (Brethine) -- Indications
    brochospasms
  66. *Terbutaline (Brethine) -- Contraindications
    tachy dysrhythmias
  67. *Terbutaline (Brethine) -- Dose
    • 0.25mg SQ repeat every 15min
    • 400mcg MDI 1-2min between puffs
  68. *Activated Charcoal --Indications
    most oral poisonings
  69. *Activated Charcoal -- Contraindications
    • acids
    • corrosives
    • petroleum distallates
  70. *Activated Charcoal -- Dose
    1-2g/kg
  71. *Glucagon -- Indications
    hypoglycemia with AMS no IV access
  72. *Glucagon -- Contraindications
    hyperglycemia
  73. *Glucagon -- Dose
    A - 1mg IM

    P - 0.1mg/kg max 1mg
  74. Syrup of Ipecac -- Indications
    induce vomiting in oral poisonings
  75. Syrup of Ipecac -- Contraindications
    • corrosives
    • petroleum distallates
  76. Syrup of Ipecac -- Dose
    A - 30ml

    P - 15ml

         **followed by several glasses of water
  77. *Fentanyl (sublimaze) -- Indications
    pain management
  78. *Fentanyl (sublimaze) -- Contraindications
    use with caution in TBI
  79. *Fentanyl (sublimaze) -- Dose
    A - 1mcg/kg SIVP max 150mcg

    P - 0.1mcg/kg
  80. *Midazolam (Versed) -- Indications
    sedation for medical procedures
  81. *Midazolam (Versed) -- Contraindications
    • glaucoma
    • shock
    • coma
    • ETOH
  82. *Midazolam (Versed) -- Dose
    A - 0.5-2.5mg SIVP repeat as nec. max 0.1mg/kg

    • P - 6mos -5yrs 0.05-0.1mg/kg max 5mg
    •      5 - 12yrs 0.1mg/kg max 8mg
  83. *Narcan (Naloxone) -- Indications
    narcotic OD with resp dep
  84. *Narcan (Naloxone) -- Contraindications
    use with caution with drug addicts
  85. *Narcan (Naloxone) -- Dose
    A - 0.4-2mg SIVP/IO/IN/ET/IM

    P - 0.1mg/kg
  86. *Morphine Roxinol, MS contin) -- Indications
    • pain control
    • CHF
    • acute cardiogenic pulmonary edema
  87. *Morphine Roxinol, MS contin) --Contraindications
    • head injury
    • COPD exacerbation
    • udiagnosed ab pain
  88. *Morphine Roxinol, MS contin) --Dose
    A - 1-3mg SIVP q 5min max 10mg

    P - 0.1-0.2mg/kg max 5mg
  89. *Nitroglycerin -- Indications
    • CP
    • HTN
    • CHF
  90. *Nitroglycerin -- Contraindications
    • hypotension <100 systolic
    • ED
    • intracranial bleed
  91. *Nitroglycerin -- Dose
    0.3mg tab or spray SL q 5min max 3
  92. *Diazepam (Valium) -- Indications
    • sedation for medical prodecures
    • seizures
  93. *Diazepam (Valium) -- Contraindications
    • glaucoma
    • shock
    • head injury
  94. *Diazepam (Valium) -- Dose
    • A - Seizures: 5-10mg IVP q 15-30min 
    •                    max 30mg
    •      Sedation: 5-15mg IVP 5-10min
    •                    before procedure         

    • P - Seizures: 0.2-0.3mg/kg q 15min
    •                   max 10mg
  95. Ipratropium (Atrovent) -- Indications
    • bronchospasms assoc. with COPD
    • emphysema
    • asthma
  96. Ipratropium (Atrovent) -- Dose
    A - 0.5mg mixed with Albuterol via NEB

    P - 0.2mg mixed with Albuterol via NEB
  97. *Albuterol (Proventil, Ventolin) -- Indications
    bronchospasms
  98. *Albuterol (Proventil, Ventolin) -- Contraindications
    hypersensitivity
  99. *Albuterol (Proventil, Ventolin) -- Dose
    A - 2.5mg (prn) via NEB

    P - 0.05-0.15mg/kg via NEB
  100. *Nitrous Oxide (nitronox) -- Indications
    • isolated Fx
    • amputations
    • burns
  101. *Nitrous Oxide (nitronox) -- Contraindications
    • AMS
    • face and head trauma
    • pneumothorax
    • COPD
    • drug intoxication
    • hypertension
  102. *Nitrous Oxide (nitronox) -- Dose
    self administered inhalation until pain free
  103. *Furosemide (Lasix) -- Indications
    • CHF
    • pulmonary edema
  104. *Furosemide (Lasix) -- Contraindications
    • hypovolemia
    • sulfa allergy
    • anuria
  105. *Furosemide (Lasix) -- Dose
    A - 0.5-1mg/kg

    P - 1mg/kg
  106. *Succinycholine (Anectine) -- Indications
    facilitate intubation
  107. *Succinycholine (Anectine) -- Contraindications
    • glaucoma
    • penetrating eye injury
  108. *Succinycholine (Anectine) -- Dose
    A - 1-1.5mg/kg IV

    P - 1-2mg/kg IV
  109. *Diphenhydramine (Benadryl) -- Indications
    • anaphalaxis
    • allergic reaction
    • acute dystonia
  110. *Diphenhydramine (Benadryl) -- Contraindications
    • asthma
    • glaucoma
    • HTN
  111. *Diphenhydramine (Benadryl) -- Dose
    A - 25-50mg IV/IM/IO

    P - 1-2mg/kg
  112. *Vecuronium (Vec, Norcuron) -- Indications
    • facilitate intubation
    • skeletal muscle relaxation
  113. *Vecuronium (Vec, Norcuron) -- Contraindications
    myasthenia gravis
  114. *Vecuronium (Vec, Norcuron) -- Dose
    0.08-0.1mg/kg SIVP
  115. *Amyl Nitrate (Poppers) -- Indications
    cyanide poisoning without IV access
  116. *Amyl Nitrate (Poppers) -- Contraindications
    smoke inhalation
  117. *Amyl Nitrate (Poppers) -- Dose
    • 1 ampule crushed & inhaled for 30 sec
    •      followed by 30 sec of O2
  118. *Sodium Bicarbonate -- Indications
    • TCA's & barbituate OD
    • acidosis refractory to ventilation
    • hyperkalcemia
    • late in cardiac arrest
  119. *Sodium Bicarbonate -- Contraindications
    • alkalotic states
    • none in cardiac arrest
  120. *Sodium Bicarbonate -- Dose
    • 1mEq/kg IV
    •      then 0.5mEq/kg/10min
  121. *Magnesium Sulfate -- Indications
    • refractory VF
    • pulseless VT
    • Torsades De Pointes
    • post AMI as prophylaxis for arrhythmias
    • eclamptic seizures
  122. *Magnesium Sulfate -- Contraindications
    • shock
    • HB
    • myocardial damage
    • persistant HTN
    • hypocalcemia
  123. *Magnesium Sulfate -- Dose
    • VT/VF -- 1-2g/2min IV
    • Torsades -- 1-2g IV
    •      followed by infusion 0.5-1g/hr
    • Eclampsia -- 2-4g IV/IM
  124. *Dexamethasone (Decadron) -- Indications
    • anaphalaxis
    • asthma
    • COPD
    • spinal cord edema
  125. *Dexamethasone (Decadron) -- Contraindications
    none in emergency setting
  126. *Dexamethasone (Decadron) -- Dose
    4-24mg IV/IM
  127. *Pralidoxine (2-pam, Protopam) -- Indications
    organophosphate poisoning
  128. *Pralidoxine (2-pam, Protopam) -- Dose
    1-2g/30min IV/IM mixed in 250-500ml NS

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