Paramedic Drugs

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Schwendy
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21253
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Paramedic Drugs
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2010-05-31 22:16:37
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Medic Drugs
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Medic 11 Paramedic Drugs
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  1. Albuterol
    Name/Class
    Name: Ventolin, Proventil

    Class: Sympathomimetic Bronchodilator
  2. Albuterol
    Description
    Bronchodilation with less cardiac effect than epinephrine

    Reduces mucus secretions, pulmonary leaking and edema in the lungs during allergic reactions
  3. Albuterol
    Indications
    • Bronchospasms
    • Asthma in COPD
  4. Albuterol
  5. Albuterol
    Contraindications
    Hypersensitivity
  6. Albuterol
    Precautions
    • Tachycardia
    • Anxiety
    • Nausea
    • Cough
    • Wheezing
    • Dizziness
  7. Albuterol
    Dose/Route
    2.5mg in 2.5 - 3ml NS via nebulizer
  8. Fentanyl
    Name/Class
    Name: Sublimaze

    Class: Narcotic Analgesic
  9. Fentanyl
    Description
    Potent synthetic narcotic analgesic

    Rapid & less prolonged than morphine
  10. Fentanyl
    Indications
    Induce sedation for ETI
  11. Fentanyl
    Contraindications
    MAO inhibitors within 14 days

    Myasthenia Gravis
  12. Fentanyl
    Precautions
    • Increased ICP
    • Elderly/debilitated
    • COPD
    • Respiratory problems
    • Liver/kidney insufficiency
  13. Fentanyl
    Dose/Route
    25 - 100mcg slow IV
  14. Ipatropium
    Name/Class
    Name: Atrovent

    Class: Anticholinergic
  15. Ipatropium
    Description
    • Bronchodilator
    • Dries respiratory tract secretions by blocking acetylcholine receptors
  16. Ipatropium
    Indications
    Bronchospasms due to asthma, COPD & inhaled irritants
  17. Ipatropium
    Contraindications
    • Hypersensitivity to Atropine
    • Primary treatment for bronchospasms
  18. Ipatropium
    Precautions
    • Elderly
    • Cardiovascular disease
    • HTN
  19. Ipatropium
    Dose/Route
    500mcg in 2.5 - 3ml NS via nebulizer or 2 sprays from metered dose inhaler
  20. Morphine Sulfate
    Name/Class
    Name: Morphine

    Class: Narcotic Analgesic
  21. Morphine
    Description
    • Potent analgesic & sedative
    • Causes vasodilation
    • Reduces venous return
    • Reduces myocardial 02 demand
  22. Morphine
    Indications
    • Severe pain
    • MI
  23. Morphine
    Contraindications
    • Hypersensitivity to opiates
    • Undiagnosed head or abdominal injury
    • Hypotension/volume depletion
    • Asthma
    • COPD
    • Severe respiratory depression
    • Pulmonary edema due to chemical inhalation
  24. Morphine
    Precautions
    • Elderly/debilitated
    • Children
    • Narcan should be available
  25. Morphine
    Dose/Route
    Pain: 2.5 - 15mg IV; 5 - 20mg IM/Subcutaneous

    AMI or PE: 1 - 2mg (6 - 10 min. response)
  26. Naloxone
    Name/Class
    Name: Narcan

    Class: Narcotic Antagonist
  27. Naloxone
    Description
    • Blocks effects of natrual and synthetic narcotics
    • May reverse respiratory depression
  28. Naloxone
    Indications
    • Narcotic overdose
    • Coma of unknown origin
  29. Naloxone
    Contraindications
    Non-narcotic induced respiratory depression
  30. Naloxone
    Precautions
    • Possible dependency
    • Short half life
  31. Naloxone
    Dose/Route
    .4 - 2mg IV/IM repeated 2 - 3 min. up to 10mg
  32. Diazepam
    Name/Class
    Name: Valium

    Class: Antianxiety, Hypnotic, Anticonvulsant, Sedative
  33. Diazepam
    Description
    • Benzodiazepine sedative
    • Skeletal muscle relaxant
    • Reduces tremors
    • Reduces seizure reoccurance
    • Induces amnesia (cardioversion)
    • Relaxes muscle spasms due to orthopedic injuries
  34. Diazepam
    Indications
    • Major motor seizures
    • Status epilepticus
    • Premedication before cardioversion
    • Muscle tremors from injury
    • Acute anxiety
  35. Diazepam
    Contraindications
    • Shock
    • Coma
    • ETOH
    • Depressed vitals
    • Pregnancy
    • Neonates
  36. Diazepam
    Precautions
    • Psychosis
    • Depression
    • Myasthenia Gravis
    • Hepatic/renal insufficiency
    • Addiction
    • Elderly/very ill
    • COPD
    • Short half life
  37. Diazepam
    Dose/Route
    Seizures: 5 - 10mg IV/IM

    Anxiety: 2 - 5mg IV/IM

    PreMedication: 5 - 15mg IV
  38. Etomidate
    Name/Class
    Name: Amidate

    Class: Hypnotic
  39. Etomidate
    Description
    • Short acting hypnotic
    • No analgesic effects
    • Limited cardiovascular and respiratory effects
  40. Etomidate
    Indications
    Sedation for RSI
  41. Etomidate
    Contraindications
    Hypersensitivity
  42. Etomidate
    Precautions
    • Hypotension
    • Asthma
    • Cardiovascular disease
  43. Etomidate
    Dose/Route
    .1 - .3mg/kg IV 15 to 30 sec.
  44. Flumazenil
    Name/Class
    Name: Romazicon

    Class: Benzodiazepine Antagonist
  45. Flumazenil
    Description
    Reverses sedative, recall and psychomotor effects of benzodiazepines
  46. Flumazenil
    Indications
    Respiratory depression due to benzodiazepines
  47. Flumazenil
    Contraindications
    • Seizure prone patients during labor/delivery
    • Tricyclic antidepressant overdose
  48. Flumazenil
    Precautions
    • Hepatic impairment
    • Elderly
    • Pregnancy/Nursing mothers
    • Head injury
    • Alcohol/Drug dependency
    • Physical dependency on benzodiazepines
  49. Flumazenil
    Dose/Route
    .2mg IV over 30 sec, up to 1mg
  50. Midazolam
    Name/Class
    Name: Versed

    Class: Sedative
  51. Midazolam
    Description
    • Short-acting benzodiazepine with CNS depressant
    • Muslce relaxant
    • Anticonvulsant
    • Amterograde amnesic effects
  52. Midazolam
    Indications
    Induce sedation for cardioversion or intubation
  53. Midazolam
    Contraindications
    • Narrow-angle glaucoma
    • Shock
    • Coma
    • Acute ETOH
  54. Midazolam
    Precautions
    • COPD
    • Renal impairment
    • CHF
    • Elderly
  55. Midazolam
    Dose/Route
    • 1 - 2.5mg slow IV
    • .07 - .08mg/kg IM
  56. Succinylcholine
    Name/Class
    Name: Anectine

    Class: Depolarizing Neuromuscular Blocker
  57. Succinylcholine
    Description
    Ultra-short-acting depolarizing neuromuscular blocker
  58. Succinylcholine
    Indications
    Facilitated ETI
  59. Succinylcholine
    Contraindications
    • Family hx of malignant hyperthermia
    • Penetrating eye injury
    • Narrow-angle glaucoma
  60. Succinylcholine
    Precautions
    • Severe burn or crash
    • Electrolyte imbalances
    • Hepatic/renal impairment
    • Cardiac/pulmonary impairment
    • Fractures
    • Spinal cord injury
    • Severe anemia
    • Porphyria
  61. Succinylcholine
    Dose/Route
    1 - 1.5mg/kg IV/IM
  62. Adenosine
    Name/Class
    Name: Adenocard

    Class: Antidysrhythmic
  63. Adenosine
    Description
    • Chemically cardiovert PSVT to NSR
    • 10 sec. half life
  64. Adenosine
    Indications
    Narrow & complex supraventricular tachycardia refractory to vagal maneuvers
  65. Adenosine
    Contraindications
    • 2nd & 3rd degree heart blocks
    • Sinus Node disease
    • Asthma
  66. Adenosine
    Precautions
    • Transient dysrhythmias
    • COPD
  67. Adenosine
    Dose/Route
    6mg rapid IV, then flush. If ineffective, 12mg, in 1 - 2 min. repeat
  68. Atropine
    Name/Class
    Name: Atropine

    Class: Parasympatholytic
  69. Atropine
    Description
    • Blocks parasympathetic nervous system, vagal effects on heart rate
    • Decreases airway secretions
    • May increase myocardial O2 demand
  70. Atropine
    Indications
    • Bradycardia
    • Bradysystolic arrest
    • Organophosphate poisoning
  71. Atropine
    Contraindications
    None
  72. Atropine
    Precautions
    • AMI
    • Glaucoma
  73. Atropine
    Dose/Route
    Asystole/PEA: 1mg IV/IO every 3 - 5 min, 3 dose max

    Symptomatic Bradycardia: .5mg IV; 1mg ET. Repeat 3 - 5 min. to 3mg

    Organophosphate Poisoning: 2 - 5mg IV/IM/IO 10 - 15 min.
  74. Epinephrine
    Name/Class
    Name: Adrenaline

    Class: Sympathomimetic
  75. Epinephrine
    Description
    Naturally occuring catecholamine

    • Increases:
    • Heart rate
    • Cardiac contractile force
    • Myocardial electrical activity
    • Systemic vascular resistance
    • Systolic BP

    • Decreases:
    • Airway resistance
    • Automaticity

    May reduce pulmonary congestion and increase tidal volume and vital capacity through bronchial artery constriction
  76. Epinephrine
    Indications
    • Cardiac arrest
    • Severe allergic reactions
  77. Epinephrine
    Contraindications
    • Narrow-angle glaucoma
    • Hemorrhagic shock
    • Traumatic shock
    • Cardiac shock
    • Labor
  78. Epinephrine
    Precautions
    • Elderly
    • HTN
    • Diabetes
    • Hyperthyroidism
    • Parkinsons
    • Asthma
  79. Epinephrine
    Dose/Route
    Arrest: 1mg of 1:10000 IV 3 - 5 min.; 2 - 2.5mg 1:1000 ET

    Allergic Reactions: .3 - .5mg of 1:1000 subcutaneously 5 - 15 min. as needed; .5 - 1mg of 1:10000 IV if subcutaneous ineffective or severe reaction
  80. Vasopressin
    Name/Class
    Name: Pitressin

    Class: Hormone, Vasopressor
  81. Vasopressin
    Description
    • Strong vasopressive & antidiuretic properties
    • May prescipitate angina or AMI
  82. Vasopressin
    Indications
    • Increase peripheral vascular resistance in arrest
    • Control bleeding from esophageal varices
  83. Vasopressin
    Contraindications
    • PVCs
    • 1st stage of labor
  84. Vasopressin
    Precautions
    • Epilepsy
    • Migraine
    • Heart Failure
    • Angina
    • Vascular disease
    • Hepatic impairment
    • Elderly
    • Children
  85. Vasopressin
    Dose/Route
    Arrest: 40 units IV

    Esophageal Varices: .2 - .4 units/min IV drip
  86. Aspirin
    Name/Class
    Name: Acetylsalicylic Acid

    Class: Acetylsalicylic Acid
  87. Aspirin
    Description
    Acts on PNS and inhibits agents causing inflammation, pain & fever
  88. Aspirin
    Indications
    Chest pain suggestive of an MI
  89. Aspirin
    Contraindications
    • Active ulcer disease
    • Asthma
  90. Aspirin
    Precautions
    Bleeding disorders
  91. Aspirin
    Dose/Route
    160 - 325mg PO (chewable)
  92. Dextrose 50% in Water
    Name/Class
    Name: D50W

    Class: Carbohydrate
  93. Dextrose 50% in Water
    Description
    Simple sugar the body can rapidly metabolize and create energy
  94. Dextrose 50% in Water
    Indications
    Hypoglycemia
  95. Dextrose 50% in Water
    Contraindications
    None in hypoglycemia
  96. Dextrose 50% in Water
    Precautions
    • Increased ICP
    • Determine blood glucose before administration
    • Good venous access
  97. Dextrose 50% in Water
    Dose/Route
    25g (50ml) IV
  98. Furosemide
    Name/Class
    Name: Lasix

    Class: Diuretic
  99. Furosemide
    Description
    • Potent diuretic
    • Antihypertensive
    • Inhibits sodium reabsorption by kidneys
    • Vasodilating effects reduce venous return & cardiac workload
  100. Furosemide
    Indications
    • CHF
    • Pulmonary Edema
  101. Furosemide
    Contraindications
    • Fluid/electrolyte depletion
    • Hepatic coma
    • Pregnancy (except in life threatening circumstances)
  102. Furosemide
    Precautions
    • Infants
    • Elderly
    • Liver impairment
    • Nephrotic syndrome
    • Cardiogenic shock during acute MI
    • Gout
    • Patients receiving digitalis or potassium depleting steroids
  103. Furosemide
    Dose/Route
    40 - 120mg slow IV
  104. Nitroglycerin
    Name/Class
    Name: Nitrostat

    Class: Nitrate
  105. Nitroglycerin
    Description
    • Rapid smooth muscle relaxant
    • Reduces peripheral vascular resistance
    • Reduces BP
    • Reduces Venous return
    • Reduces cardiac workload
  106. Nitroglycerin
    Indications
    Chest pain due to angina, AMI, Acute pulmonary edema
  107. Nitroglycerin
    Contraindications
    • Tolerance to nitrates
    • Severe anemia
    • Head trauma
    • Hypotension
    • Increased ICP
    • Pts taking sildenafil
    • Glaucoma
    • Shock
  108. Nitroglycerin
    Precautions
    • Headache
    • Nitro is light sensitive, loses potency when exposed to air
  109. Nitroglycerin
    Dose/Route
    .4mg (1 table) SL repeated 3 - 5 min. up to 3 tablets; 1/2" ointment; .4mg (1 spray) SL up to 3 sprays over 25 mins.
  110. Dobutamine
    Name/Class
    Name: Dobutrex

    Class: Sympathomimetic
  111. Dobutamine
    Description
    • Synthetic catecholamine and beta agent
    • Increases strength of cardiac contraction without increasing rate
  112. Dobutamine
    Indications
    Increase cardiac output in CHF & cardiogenic shock
  113. Dobutamine
    Contraindications
    • Vtach
    • Hypovolemia w/o fluid resuscitation
  114. Dobutamine
    Precautions
    • Afib
    • Pre-existing HTN
  115. Dobutamine
    Dose/Route
    2 - 20mcg/kg/min IV
  116. Dopamine
    Name/Class
    Name: Intropin

    Class: Sympathomimetic
  117. Dopamine
    Description
    • Catecholamine
    • Increases cardiac output without increasing myocardial O2 consumption
    • Maintains renal and mesenteric blood flow
    • Induces vasoconstriction
    • Increases systolic BP
  118. Dopamine
    Indications
    • Nonhypovolemic hypotension
    • Cardiogenic shock
  119. Dopamine
    Contraindications
    • Tachydysrhythmias
    • Vfib
    • Pheochromocytoma
  120. Dopamine
    Precautions
    Adequate fluid resuscitation of the hypovolemic Pt
  121. Dopamine
    Dose/Route
    2 - 5mcg/kg/min up to 20mcg/kg/min, titrated to effect
  122. Isoprotenerol
    Name/Class
    Name: Isuprel

    Class: Sympathomimetic
  123. Isoproterenol
    Description
    Increases cardiac output by increasing strength and rate of contraction
  124. Isoproterenol
    Indications
    Bradycardia refractory to Atropine when pacing is not available
  125. Isoproterenol
    Contraindications
    Cardiogenic shock
  126. Isoproterenol
    Precautions
    • Tachydysrhythmias
    • Digitalis dysrhythmias
    • AMI
  127. Isoproterenol
    Dose/Route
    2 - 10mcg/min titrated to cardiac rate
  128. Amiodarone
    Name/Class
    Name: Cordarone, Pacerone

    Class: Antidysrhythmic
  129. Amiodarone
    Description
    • Prolongs the duration of the action potential and refractory period
    • Relaxes smooth muscle
    • Reduces peripheral vascular resistance
    • Increases coronary blood flow
  130. Amiodarone
    Indications
    • Ventricular and supraventricular dysrhythmias
    • Afib
  131. Amiodarone
    Contraindications
    • Cariogenic shock
    • Sever sinus bradycardia
    • Advanced heart block
  132. Amiodarone
    Precautions
    Hepatic impairment
  133. Amiodarone
    Dose/Route
    150 - 300mg IV over 10 mins., then 1mg/min over next 6 hrs.
  134. Bretylium
    Name/Class
    Name: Bretylol

    Class: Antidysrhythmic
  135. Bretylium
    Description
    Suppresses ventricular dysrhythmias including vfib with re-entry mechanisms
  136. Bretylium
    Indications
    Vtach & Vfib refractory to lidocaine
  137. Bretylium
    Contraindications
    None
  138. Bretylium
    Precautions
    • Digitalized Pts
    • Digitalis induced dysrhythmias
  139. Bretylium
    Dose/Route
    5mg/kg IV then 10mg/kg 15 - 30 mins., max 30mg/kg
  140. Lidocaine
    Name/Class
    Name: Xylocaine

    Class: Antidysrhythmic
  141. Lidocaine
    Description
    • Raises automaticity
    • Supresses stimulation threshold of ventricles
    • Sedation
    • Anticonvulsant
    • Analgesic effects
  142. Lidocaine
    Indications
    • Vtach
    • Vfib
  143. Lidocaine
    Contraindications
    • Supraventricular dysrhythmias
    • Stokes-Adams Syndrome
    • 2nd & 3rd degree heart blocks
    • Bradycardia
  144. Lidocaine
    Precautions
    • Hepatic/Renal impairment
    • CHF
    • Hypoxia
    • Respiratory depression
    • Hypovolemia
    • Myasthenia Gravis
    • Shock
    • Elderly
  145. Lidocaine
    Dose/Route
    Cardiac Arrest: 1 - 1.5mg/kg IV repeated every 3 - 5 mins. up to 3mg/kg, follow conversion with drip of 2 - 4mg/min.

    Vtach: 1 - 1.5mg/kg slow IV; repeat at 1/2 dose every 5 - 10 mins. until conversion up to 3mg/kg; follow conversion with infusion of 2 - 4mg/min.
  146. Procainamide
    Name/Class
    Name: Pronesty

    Class: Antiarrhythmic
  147. Procainamide
    Description
    • Prolongs ventricular repolarization
    • Slows conduction
    • Decreases myocardial excitability
  148. Procainamide
    Indications
    • Vfib
    • Pulseless Vtach refractory to lidocaine
  149. Procainamide
    Contraindications
    • Hypersensitivity to procaine
    • Myasthenia Gravis
    • 2nd & 3rd degree heart blocks
  150. Procainamide
    Precautions
    • Hypotension
    • Cardiac enlargement
    • CHF
    • AMI
    • Ventricular dysrhythmias from digitalis
    • Hepatic/renal impairment
    • Asthma
  151. Procainamide
    Dose/Route
    • 20 - 30mg/min IV drip.
    • Stop Points:
    • 1. up to 17mg/kg to effect then 1 - 4 mg/min
    • 2. Ectopy resolves
    • 3. QRS complex widens more than 50% from original
    • 4. Hypotension
  152. Diltiazem
    Name/Class
    Name: Cardizem

    Class: Calcium channel blocker
  153. Diltiazem
    Description
    Dilates coronary and peripheral arteries & arterioles, which increases circulation to the heart and decreases peripheral vascular resistance.
  154. Diltiazem
    Indications
    • Supraventricular tachydysrhythmias (Afib, Aflutter, PSVT)
    • Increase coronary artery perfusion in angina
  155. Diltiazem
    Contraindications
    • Sick sinus syndrome
    • 2nd or 3rd degree heart block
    • Systolic BP <90
    • Diastolic BP <60
    • Wide complex tachycardia
    • WPW
  156. Diltiazem
    Precautions
    CHF
  157. Diltiazem
    Dose/Route
    .25mg/kg IV over 2 mins., repeat as need with .35mg/kg followed by drip of 5 - 10mg/hr. Do not exceed 15mg/hr over 24hrs.
  158. Verapamil
    Name/Class
    Name: Isoptin, Calan

    Class: Calcium channel blocker
  159. Verapamil
    Description
    • Slows AV conduction
    • Suppresses re-entry dysrhythmias
    • Slows ventricular responses to atrial tachydysrhythmias
    • Dilates coronary arteries
    • Reduces myocardial O2 demand
  160. Verapamil
    Indications
    • PSVT refractory to adenosine
    • Aflutter
    • Afib with rapid ventricular response
  161. Verapamil
    Contraindications
    • Hypotension
    • Cardiogenic shock
    • 2nd & 3rd degree heart block
    • CHF
    • Sinus Node Disease
    • Accessory AV pathways
    • WPW syndrome
    • Beta blockers
  162. Verapamil
    Precautions
    Hepatic/renal impairment
  163. Verapamil
    Dose/Route
    2.5 - 5mg IV bolus over 2 - 3 mins., then 5 - 10mg after 15 to 30 mins. to a max of 30mg in 30 mins.
  164. Tridil
    Name/Class
    Name: Nitroglycerin Injection

    Class: Vasodilator, Nitrate
  165. Tridil
    Description
    • Relaxes blood vessels
    • Increases blood and O2 supply to heart
  166. Tridil
    Indications
    • Relieve pain associated with angina that does not respond to oral tx
    • Control BP
    • CHF
  167. Tridil
    Contraindications
    • Hypotension
    • Uncorrected hypovolemia
    • ICP
    • Contrictive pericarditis
    • Pericardial tamponade
  168. Tridil
    Precautions
    • Headache
    • Hypotension
    • Tachycardia
  169. Tridil
    Dose/Route
    .2 - 1.5mcg/kg/min
  170. Calcium Chloride
    Name/Class
    Name: Calcium Chloride

    Class: Electrolyte
  171. Calcium Chloride
    Description
    • Increases myocardial contractile force
    • Increases ventricular automaticity
  172. Calcium Chloride
    Indications
    • Hyperkalemia
    • Hypocalcemia
    • Hypermagnesemia
    • Calcium channel blocker toxicity
  173. Caclium Chloride
    Contraindications
    • Vfib
    • Hypercalcemia
    • Digitalis toxicity
  174. Caclium Chloride
    Precautions
    • May precipitate toxicity in Pts taking digoxin
    • IV in large vein
    • Flush before & after use
  175. Caclium Chloride
    Dose/Route
    2 - 4mg/kg IV (10% solution)/10 mins. as needed
  176. Methylprednisolone
    Name/Class
    Name: Solu-Medrol

    Class: Corticosteriod, Antiinflammatory
  177. Methylprednisolone
    Description
    • Aniinflammatory
    • Allergic reactions
    • Shock
    • Spinal cord injuries
  178. Methylprednisolone
    Indications
    • Spinal cord injury
    • Anaphylaxis
    • COPD
    • Asthma
  179. Methylprednisolone
    Contraindications
    None
  180. Methylprednisolone
    Precautions
    Only 1 dose should be given
  181. Methylprednisolone
    Dose/Route
    Asthma/COPD/Anaphylaxis: 125 - 250mg IV/IM

    Spinal cord injury: 30mg/kg IV over 15 mins., after 45 mins. an infusion of 5.4mg/kg/hr

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