Paramedic Pharmacology Drugs.txt

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djzteb
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Paramedic Pharmacology Drugs.txt
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2013-07-26 20:53:47
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Paramedic Pharmacology Drugs
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Drugs to study for final
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  1. Aspirin: Actions and Indications
    Action: Inhibits thromboxane A2 to prevent platelet aggregation.

    Indication: Suspected myocardial infarction.
  2. adenosine (Adenocard): Action and Indications
    Action: Slows AV conduction.

    Indication: Supraventricular tachycardias (SVT).
  3. albuterol (Proventil): Actions and Indications
    Action: Beta agonist, bronchodilator.

    • Indication: Bronchospasm
    • 1. Asthma
    • 2. Allergy
    • 3. COPD
  4. amiodarone (Cordarone): Action and Indication
    • Action: Class III anti-arrhythmic.
    • 1. Slows sinus rate.
    • 2. Increases PR and QT intervals.
    • 3. Increases refractory period AV node.

    • Indication: Fast rhythms
    • 1. V-Tach (Ventricular Tachycardia)
    • 2. V-Fib (Ventricular Fibrilation)
  5. ativan (Lorazepam): Action and Indication
    Action: Benzodiazepine, binds to GABA receptors.

    • Indication:
    • 1. Status seizures.
    • 2. Chemical restraint.
    • 3. Acute alcohol withdrawl.
    • 4. Sedation prior to cardioversion.
    • 5. Non-traumatic musculoskeletal spasms.
  6. atropine: Action and Indication
    Action: Anticholinergic (blocks muscarinic receptors in parasympathetic nervous system).

    • Indication:
    • 1. Symptomatic bradycardia.
    • 2. Organophosphate poisoning.
  7. Ipatroprium Bromide (Atrovent): Action and Indication
    Action: Anticholinergic and bronchodilator.

    • Indication: Bronchospasm
    • 1. Asthma
    • 2. COPD
    • 3. Allergy
    • 4. Anaphylaxis
  8. diphenhydramine (Benadryl): Action and Indication
    Action: Antihistamine

    • Indication:
    • 1. Acute allergic reaction.
    • 2. Acute dystonic reaction due to anti-psychotic medìcations.
  9. dextrose (D50 & D25): Action and Indication
    Action: Primary carbohydrate used by the body.

    • Indication:
    • 1. Known hypoglycemia.
    • 2. Blood glucose less than 60 mg/dL with altered mental status.
    • 3. Unconscious with unkown history.
    • 4. Status seizures unresponsive to benzodiazepines.
    • 5. Hypothermia.
  10. dopamine (Intropin): Action and Indication
    Action: Vasopressor that increases cardiac output.

    • Indication:
    • 1. Cardiogenic shock.
    • 2. Hypotension after hypovolemia has been corrected.
    • 3. Unstable bradycardia.
  11. Epinephrine: Action and Indication
    Action: Sympathomimetic, stimulates alpha and beta receptors.

    • Indication:
    • 1. Ventricular fibrilation.
    • 2. Asystole.
    • 3. PEA.
    • 4. Acute bronchial spasm due to allergy or asthma.
    • 5. Anaphylaxis.
  12. fentanyl (Sublimaze): Action and Indication
    Action: Synthetic opiod agonist w/ short duration of action and minimal histamine release.

    • Indication:
    • 1. Severe pain: trauma, burns, cancer, kidney stones, muscular spasms.
    • 2. Alternative to morphine (patients with allergy).
  13. glucagon (GlucaGen): Action and Indication
    Action: Hormone released from pancreas that stimulates release of glycogen from liver.

    • Indication:
    • 1. Hypoglycemia when dextrose not available or IV cannot be established.
    • 2. Beta blocker overdose.
    • 3. Esophageal obstruction.
  14. lasix (Furosemide): Action and Indication
    Action: Loop diuretic, inhibits Na+ reabsorption, increases K+ excretion.

    Indication: Acute pulmonary edema secondary to congestive heart failure. CHF exacerbation.
  15. Lidocaine: Action and Indication
    Action: Blocks Na+ channels in cardiac and nervous tissue, results in decreased myocardial automaticity, anesthesia, decreased cough reflex, raises fibrilation threshold.

    • Indication:
    • 1. V-Fib refractory to defibrilation.
    • 2. V-Tach w/out pulses or unstable w/ pulses.
    • 3. Wide complex tachycardia of unknown origin that is unstable.
    • 4. Significant ventricular ectopy.
    • 5. Nasal intubation.
    • 6. IO insertion.
  16. Magnesium Sulfate: Action and Indication
    Action: Corrects repolarization in cardiac tissue, blocks neuromuscular transmission in seizure patients, decreases cerebral vasospasm.

    • Indication:
    • 1. Torsades de Pointes.
    • 2. Seizures due to eclampsia.
    • 3. Bronchospasm unresponsive to other treatment.
  17. morphine: Action and Indication
    Action: Opiate agonist, analgesic, decreases myocardial oxygen demand.

    • Indication:
    • 1. Severe pain due to fractures, sprains and strains.
    • 2. Severe pain due to burns.
    • 3. Chest pain secondary to suspected myocardial infarction or unstable angina.
  18. naloxone (Narcan): Acion and Indication
    Action: Narcotic antagonist.

    • Indication:
    • 1. Narcotic overdose.
    • 2. Altered mental status of unknown origin.
  19. Nitroglycerin: Action and Indication
    Action: Smooth muscle relaxant, dilates coronary vessels, decreases peripheral vascular resistance.

    • Indication:
    • 1. Stable or unstable angina.
    • 2. Hypertension and acute pulmonary edema secondary to CHF w/ CPAP in place.
    • 3. Hypertension secondary to autonomic hyper-reflexia.
  20. Racemic Epinephrine: Action and Indication
    Action: Sympathomimetic binds to alpha and beta receptors to cause vasoconstriction of upper airway and bronchodilation.

    • Indication:
    • 1. Croup
    • 2. Severe stridor and/or accessory muscle use.
  21. Sodium Bicarbonate: Action and Indication
    Action: Alkalotic (basic) solution.

    • Indication:
    • 1. Patients in cardiopulmonary arrest after 10 minutes of effective CPR. **Controversial**
    • 2. Tricyclic anti-depressant overdose.
  22. methylprednisolone (Solumedrol): Action and Indication
    Action: Gluco-corticoid, anti-inflammatory, suppresses immune/allergic response.

    • Indication:
    • 1. Severe respiratory distress due to asthma.
    • 2. Severe respiratory distress due to COPD.
    • 3. Severe respiratory distress due to anaphylaxis.
  23. terbutaline (Brethine): Action and Indication
    Action: Beta agonist, bronchodilator.

    • Indication:
    • 1. Bronchospasm due to asthma.
    • 2. Bronchitis.
    • 3. Emphysema.
  24. Tetracaine: Action and Indication
    Action: Topical anesthetic.

    Indication: Eye pain due to foreign body irritation or burns.
  25. Thiamine (Vitamin B1): Action and Indication
    Action: Vitamin essential for carbohydrate metabolism.

    Indication: Administer w/ dextrose in patients with comas of unknown origin who have history of poor nutrition, untreated illness and are suspected of chronic alcoholism.
  26. Vasopressin (antidiuretic hormone): Action and Indication
    Action: Hormone produced by the hypothalamus and released by the pituitary gland. Causes vasoconstriction, increase in BP and increased coronary and cerebral perfusion.

    • Indication:
    • 1. Ventricular fibrilation.
    • 2. Ventricular tachycardia.
    • 3. PEA.
    • 4. Asystole.
  27. midazolam (Versed): Action and Indication
    Action: Benzodiazepine, binds to GABA receptors.

    • Indicatìon:
    • 1. Chemical restraint.
    • 2. Sedation prior to cardioversion.
    • 3. Sedation after intubation.
    • 4. Angulated fractures requiring repositioning in the field.
    • 5. Non-traumatic musculoskeletal spasms.
    • 6. Seizures (2nd line to Ativan).
    • 7. Pediatric seizures (IN administration).
  28. Ondansetron (Zofran): Action and Indication
    Action: Anti-emetic, selective 5HT serotonin receptor antagonist.

    Indication: Severe nausea and vomiting.
  29. Aspirin: Contraindications
    • 1. Known sensitivity/allergy.
    • 2. Bleeding disorders.
    • 3. Hemorrhagic CVA.
  30. adenosine (Adenocard): Contraindications
    • 1. History of severe asthma.
    • 2. Torsades de Pointes.
  31. albuterol (Proventil): Contraindications
    • 1. Known sensitivity.
    • 2. Cardiac dysrhythmias associated w/ tachycardia (tachy dysrhythmias).
  32. amiodarone (Cordarone): Contraindications
    • 1. Slow rhythms: 2nd and 3rd degree AV blocks.
    • 2. Known sensitivity to the drug or iodine.
  33. ativan (Lorazepam): Contraindications
    • 1. Respiratory depression.
    • 2. Hypotension.
    • 3. Caution w/ pregnancy.
  34. atropine: Contraindications
    • 1. Atrial fibrilation.
    • 2. Atrial flutter.
    • 3. Any tachycardia.
  35. Ipatroprium Bromide (Atrovent): Contraindications
    • 1. Sensitivity to soybeans, peanuts or atropine.
    • 2. Under 12 months old.
  36. diphenhydramine (Benadryl): Contraindications
    1. Pregnant or nursing patients.
  37. dextrose (D50 & D25): Contraindications
    1. Known or suspected CVA in the absence of hypoglycemia.
  38. dopamine (Intropin): Contraindications
    • 1. Tachycardic dysrhythmias.
    • 2. Hypertension.
  39. epinephrine: Contraindications
    • 1. NO contraindications in cardiac arrest.
    • 2. Patients in labor.
    • 3. Hyperthyroidism.
    • 4. Hypovolemic shock.
    • 5. Ischemic heart disease.
  40. fentanyl (Sublimaze): Contraindications
    • 1. Respiratory depression/insufficiency.
    • 2. Uncorrected hypotension.
    • 3. Head, chest or abdominal injury (differs by system).
    • 4. Trauma red patients (differs by system).
  41. Glucagon (GlucaGen): Contraindications
    1. NONE
  42. lasix (Furosemide): Contraindications
    • 1. Known or suspected pneumonia.
    • 2. Hypovolemia.
    • 3. Hypokalemia (low potassium).
    • 4. Pregnant.
    • 5. Pediatric.
  43. lidocaine: Contraindications
    • 1. Bundle branch blocks.
    • 2. AV blocks.
    • 3. Periods of sinus arrest.
    • 4. Atrial fibrilation.
    • 5. Atrial flutter.
    • 6. Hypotension.
  44. Magnesium Sulfate: Contraindications
    1. 2nd or 3rd degree AV blocks (slow rhythms).
  45. morphine: Contraindications
    • 1. Respiratory depression/insufficiency.
    • 2. Altered mental status.
    • 3. Head injury.
    • 4. Hypotension.
    • 5. Hypovolemia.
    • 6. Recent ingestion MAO inhibitor. (Monoamine Oxidase)
  46. naloxone (Narcan): Contraindications
    1. NONE
  47. nitroglycerin: Contraindications
    • 1. Hypotension.
    • 2. Head injury.
    • 3. Known or suspected cerebral hemorrhage.
    • 4. ED medications.
    • 5. Right ventricular myocardial infarction.
  48. racemic epinephrine: Contraindications
    1. Known history of sensitivity to medication.
  49. Sodium Bicarbonate: Contraindications
    • 1. Pulmonary edema.
    • 2. Metabolic or respiratory alkalosis.
    • 3. Abdominal pain.
    • 4. Electrolyte imbalances (hypocalcemia, hypokalemia, hypernatremia).
  50. methylprednisolone (Solumedrol): Contraindications
    • 1. Known hypersensitivity.
    • 2. Caution w/ pregnancy.
  51. terbutaline (Brethine): Contraindications
    1. Known hypersensitivity
  52. tetracaine: Contraindications
    • 1. Known hypersensitivity.
    • 2. Penetrating trauma to eye.
  53. Thiamine (Vitamin B1): Contraindications
    1. Known hypersensitivity.
  54. vasopressin (antidiuretic hormone): Contraindications
    1. NONE
  55. midazolam (Versed): Contraindications
    • 1. Hypotension.
    • 2. Respiratory distress.
  56. ondansetron (Zofran): Contraindications
    • 1. Known hypersensitivity.
    • 2. Children under 2 years.
  57. Aspirin: Dose
    324 mg (4 childrens chewable Aspirin)
  58. adenosine (Adenocard): Dose
    Adult: 6 mg IV, IO (can repeat w/ 12 mg)

    Peds: 0.1 mg/kg IV, IO (can repeat w/ 0.2 mg/kg)
  59. albuterol (Proventil): Dose
    Adult: 2.5 mg w/ 3 mL saline NEBULIZER

    Peds: 2.5 mg w/ 6 mL saline NEBULIZER
  60. amiodarone (Cordarone): Dose
    • Adult:
    • Pulseless 300 mg IV, IO
    • With pulse 150 mg IV, IO

    Peds: 5 mg/kg IV, IO (slow if pulses are present)
  61. ativan (Lorazepam): Dose
    • Adult:
    • Seizure 2 mg IV, IO, IM seizure
    • Anythin else 1-2 mg

    Peds: 0.05-0.1 mg/kg IV, IO, IM.
  62. atropine: Dose
    • Adult:
    • Bradycardia 0.5 mg IV, IO
    • Organophosphate 1-2 mg until symptoms subside

    Peds: 0.02 mg/kg IV, IO, ET
  63. Ipratroprium Bromide (Atrovent): Dose
    • Adult: 500 mcg w/ 2.5 mL saline NEBULIZER.
    • (can also be mixed w/ 2.5 mg albuterol)
    • *max 3 doses

    • Peds: 500 mcg w/ 6 mL saline NEBULIZER.
    • (can also be mixed w/ 2.5 mg albuterol)
    • *max 3 doses
  64. diphenhydramine (Benadryl): Dose
    Adult: 10-50 mg IV, IO, IM

    Peds: 1-2 mg/kg IV, IO, IM
  65. dextrose (D50 & D25): Dose
    Adult: 25 gm IV, IO

    Peds: 2 mL/kg IV, IO
  66. dopamine (Intropin): Dose
    Adult: 2-20 mcg/kg/min IV, IO

    Peds: 2-20 mcg/kg/min IV, IO
  67. epinephrine: Dose
    • Adult:
    • Cardiac arrest 1 mg 1:10 IV, IO, ET repeat every 5 min
    • Allergy/Asthma/Bronchospasm 0.3 mg 1:1 SQ, IM
    • Severe asthma/anaphylaxis 0.1-0.3 mg 1:10 IV, IO

    • Peds:
    • Cardiac arrest 0.01 mg/kg 1:10 IV, IO repeat every 5 min
    • Allergy/Asthma/Bronchospasm 0.01 mg/kg 1:1 SQ, IM repeat every 5 min
  68. fentanyl (Sublimaze): Dose
    • Adult: 1-2 mcg/kg IV, IO, IN, IM (usually 50-100 mcg)
    • *max dose 200 mcg

    Peds: 1-2 mcg/kg IV, IO, IN, IM
  69. Glucagon (GlucaGen): Dose
    • Adult:
    • Hypoglycemia 1 mg IM, IN
    • Beta blocker overdose 0.1 mg/kg up to 1 mg IV, IO
    • Esophageal obstruct 1 mg IV

    • Peds:
    • Hypoglycemia 0.1 mg/kg up to 1 mg IM, IN
    • Beta blocker overdose 0.1 mg/kg up to 1mg IV, IO
  70. lasix (Furosemide): Dose
    Adult: 20-80 mg slow IVP
  71. lidocaine: Dose
    • Adult:
    • Cardiac 1-1.5 mg/kg IV, IO (second dose half)
    • IO placement 20-40 mg slow

    • Peds:
    • Cardiac 1 mg/kg
    • IO placement 0.5 mg/kg
  72. Magnesium Sulfate: Dose
    • Adult:
    • Torsades 1-2 grams diluted IV, IO
    • Seizure 1-4 grams diluted slow IV, IO
    • Respiratory 1-2 grams diluted slow IV, IO
  73. morphine: Dose
    Adult: 2-10 mg IV, titrate to effect

    Peds: 0.1-0.2 mg/kg IV
  74. naloxone (Narcan): Dose
    Adult: 0.4-2 mg IV, IM, SQ, ET, IN, titrate to respirations

    Peds: 1 mg IV, IM, SQ, ET, IN
  75. nitroglycerin: Dose
    Adult: 0.4 mg SL, may be repeated every 5 min BP tolerating
  76. racemic epinephrine: Dose
    Adult: 5 mL w/ 3 mL saline NEBULIZER

    Peds: 0.5 mL w/ 6 mL saline NEBULIZER
  77. sodium bicarbonate: Dose
    • Adult:
    • Cardiac 1 mEq/kg IV, IO
    • TCA overdose contact physician adviser

    • Peds:
    • Cardiac 1 mEq/kg IV, IO
    • TCA overdose contact physician adviser
  78. methylprednisolone (Solumedrol): Dose
    Adult: 125 mg IV

    • Peds: 2 mg/kg IV
    • *max 125 mg
  79. terbutaline (Brethine): Dose
    Adult: 0.25 mg SQ (second dose half after 15-30 min)
  80. tetracaine: Dose
    Adult: 1-2 drops as needed

    Peds: 1-2 drops as needed
  81. Thiamine (Vitamin B1): Dose
    Adult: 100 mg slow IV, IM
  82. vasopressin (antidiuretic hormone): Dose
    Adult: 40 units IV, IO (one time dose only)
  83. midazolam (Versed): Dose
    Adult: 1-5 mg IV, IO, ET, IM, Rectal

    Peds: 0.05 mg/kg slow IV, IO, ET, IM, Rectal, IN
  84. ondansetron (Zofran): Dose
    Adult: 4 mg IV, IM

    Peds: 0.1 mg/kg IV, IM (single dose)

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