EMS Pharmaceuticals

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Author:
NinjaTarzan
ID:
229221
Filename:
EMS Pharmaceuticals
Updated:
2014-11-10 15:57:36
Tags:
drugs
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Description:
Summit County Pre-hospital Drug Protocols
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  1. Amiodarone
    Class & Action
    Indications & Dosage
    Side Effects & Contraindications
    • Class & Action
    • Antiarrhythmic;Prolongs duration of action potential/refractory period and relaxes smooth muscle reducing peripheral vascular resistance
    • Indications & Dosage
    • Life threatening Disrhythmias & A-fib; 150 mg given over 10 min. for PVC's and Pulsatile V-Tach, 300 mg for V-fib and Pulseless V-tach (may repeat with 150 mg once after 3-5 min)
    • Side Effects & Contraindications
    • Vasodilation, Hypotension, Bradycardia, prolonged QT; Known allergy to medication or iodine, cardiogenic shock, bradycardia, or advanced heart block  
  2. Fentanyl
    Class & Action
    Indications & Dosage
    Side Effects & Contraindications
    • Class & Action
    • Synthetic Opioid Agonist; Narcotic Analgesic
    • Indications & Dosage
    • Primary analgesic for patients with short transport times and allergy to Morphine; 50-100 mcg slow push titrated to pain control, may repeat every 5-15 min as needed. Pediatric: 1-2 mcg/kg slow push.
    • Side Effects & Contraindications
    • Respiratory depression, nausea, vomiting, bradycardia, orthostatic hypotension, decreased LOC; Known allergy, respiratory depression, uncorrected hypotension
  3. Zofran
    Class & Action
    Indications & Dosage
    Side Effects & Contraindications
    • Class & Action
    • Antiemetic; Serotonin Receptor Antagonist
    • Indications & Dosage
    • Control of Nausea/Vomiting; 4 mg, may repeat once for total of 8 mg. Pediatric: 0.1 mg/kg not to exceed 4 mg. Not to be used in children <2 years of age
    • Side Effects & Contraindications
    • Fatigue, dizziness, abdominal pain, rash, chest pain; known hypersensitivity to drug
  4. Aspirin
    Class & Action
    Indications & Dosage
    Side Effects and Contraindications
    • Non-steroidal Anti-inflammatory; Platelet inhibition.
    • Suspected Cardiac Ischemia; 324 mg.
    • Known allergy, patient currently taking Coumadin.
  5. Activated Charcoal
    Class
    Action
    Indications
    Dosage
    Side Effect
    Contraindications
    • Absorbent
    • Inhibits gastrointestinal absorption of toxics
    • Conscious patient who has ingested a poison
    • 25-50 g (Adult), 12.5-25 g (Ped)
    • ALOC, inability to swallow, Ingestion of: acid, alkali, petroleum distillate
  6. Adenosine
    Class
    Action
    Indications
    Dosage
    Side Effect
    Contraindications
    • Antiarrhythmic
    • Slows conduction throught the AV node and can interrupt re-entry pathways
    • Stable, narrow, complex SVT not responsive to vagal maneuvers (consider for unstable tachycardia prior to cardioversion); monomorphic, regular, wide complex tachycardia
    • Adults: 6 mg rapid IV push,  followed by 12 mg within 1-2 min (if unsuccessful). Peds: 0.1 mg/kg not to exceed adult dose, 0.2 mg/kg 2nd dose.
    • Facial flushing, headache, sweating, palpitations, chest pain.
    • Poision/drug induced tachycardia or 2nd or 3rd degree heart block
  7. Albuterol
    Class
    Action
    Indications
    Dosage
    Side Effect
    Contraindications
    • Sympathomimetic
    • Bronchodilator
    • Adute bronchospasm, anaphylaxis with wheezing.
    • 2.5 mg nebulized, continue until improvement or patient becomes tremulous
    • Tachycardia, palpitations, anxiousness, headache
    • Known allergy
  8. Atropine
    Class
    Action
    Indications
    Dosage
    Side Effect
    Contraindications
    • Parasympathetic blocker
    • Cholinergic blocking agent, increases SA node discharge, increases conduction through AV node
    • Hemodynamically significant Bradycardia (except 2nd degree Type II or 3rd degree block)
    • Adults: 0.5 mg every 3-5 min. Max dose of 0.04mg/kg. Peds: 0.02 mg/kg, may repeat once - min. dose: 0.1 mg, max. dose: 0.04 mg/kg.
    • Tachycardia.
    • None.
  9. Benadryl
    Class
    Action
    Indications
    Dosage
    Side Effect
    Contraindications
    • Antihistamine
    • Blocks histamine receptors, some sedative effects, anticholinergic
    • Allergic Reaction
    • Adults: 50 mg. Peds: 1 mg/kg.
    • Sedation, palpitations, hypotension, headache, thickened bronchial secretions, blurred vision
    • Known allergy
  10. Epinephrine 1:1000
    Class
    Action
    Indications
    Dosage
    Side Effect
    Contraindication
    • Sympathomimetic
    • Positive inotrope, positive chronotrope, bronchodilation
    • Allergic reaction, anaphylaxis, bronchospasm
    • Adults: 0.5 mg every 15 min IM/SQ for 1.5 mg total. Peds: 0.01 mg/kg every 15 min for max dose of 0.3 mg.
    • Tachycardia, palpitations, ectopic beats, hypertension, headache, anxiousness
    • Underlying cardiovascular disease, angina, hypertension, pregnancy, hyperthyroidism
  11. Epinephrine 1:10,000
    Class
    Action
    Indications
    Dosage
    Side Effect
    Contraindications
    • Sympathomimetic
    • Positive inotrope, positive chronotrope, bronchodilation
    • Asystole, PEA, VF, cardiac arrest; bradycardia in peds
    • Adults: 1 mg every 3-5 min (2-2.5x dose for ETT). Peds: 0.01 mg/kg initial dose, 0.1 mg/kg of 1:1000 every 5 minutes thereafter
    • None
    • None
  12. Epinephrine Drip
    Class
    Action
    Indications
    Dosage
    Side Effect
    Contraindications
    • Sympathomimetic
    • Alpha and Beta adrenergic receptor agonist
    • Bronchial asthma, acute allergic reaction, cardiac arrest, profound symptomatic bradycardia
    • 1-4mcg/min
    • Headache, nausea, restlessness, weakness, dysrhythmias, hypertension, angina pectoris precipitation
    • Hypersensitivity, hypovolemic shock, coronary insufficiency, hypertension
  13. Dextrose50
    Class
    Action
    Indications
    Dosage
    Side Effect
    Contraindications
    • Carbohydrate
    • Quick absorption of sugar for metabolism
    • Hypoglycemic patient
    • Adults: 25 g may repeat once. Peds: 0.5 g/kg. <5 kg - dilute D25% 1:1 with sterile water, 4 ml/kg. 5-15 kg, D25% 2ml/kg. >15kg, D50% 1ml/kg.
    • None
    • None
  14. Versed
    Class
    Action
    Indications
    Dosage
    Side Effect
    Contraindications
    • Class IV Benzodiazepine
    • Sedative, hypnotic, amnesic
    • Anxiety, conscious sedation, status seizures
    • Adults: 0.1 mg/kg titrated to effect, to max. single dose of 5 mg, may be repeated once (2x dose Intranasal). Peds: give slowly over 3-5 min.
    • CNS depression, hypotension, bradycardia, respiratory depression, nausea, vomiting, headache
    • Known allergy, hypotension, acute narrow angle glaucoma
  15. Morphine
    Class
    Action
    Indications
    Dosage
    Side Effect
    Contraindications
    • Narcotic
    • CNS depression
    • Severe pain, burns, pulmonary edema and CHF
    • Adults: 2-5 mg titrated to pain relief, Peds: 0.1 mg/kg
    • Respiratory depression, nausea, vomiting, bradycardia, orthostatic hypotension, decreased LOC
    • Known opiate allergy, head/chest/abdominal injury, undiagnosed abdominal pain, signs of shock
  16. Narcan
    Class
    Action
    Indications
    Dosage
    Side Effect
    Contraindications
    • Narcotic antagonist
    • Reverses effects of narcotics
    • Suspected narcotic use
    • Adults: 2 mg titrated to effect at max. 10 mg. Peds: 0.1 mg/kg not exceeding adult dose
    • Rapid administration can cause nausea and vomiting
    • Known allergy
  17. Nitroglycerin
    Class
    Action
    Indications
    Dosage
    Side Effect
    Contraindications
    • Vasodilator
    • Dilates systemic arteries and veins reducing preload and afterload
    • Angina, suspected MI, pulmonary edema
    • 0.4 mg every 5 min until pain relieved or Systolic BP<100
    • Hypotension, headache, flushing
    • Known allergy to medication, hypotension, right ventricle infarct, ED meds used within last 24 hours
  18. Glucose
    Class
    Action
    Indications
    Dosage
    Side Effect
    Contraindications
    • Carbohydrate
    • Quick absorption of sugar for metabolism
    • Conscious hypoglycemic patients able to maintain their own airway
    • 15 g
    • 1 g/kg
    • Possible vomiting
    • None
  19. Sodium Bicarbonate
    Class
    Action
    Indications
    Dosage
    Side Effect
    Contraindications
    • Alkalinizing agent
    • Increases blood pH
    • Crush syndrome, tricyclic overdose, hyperkalemia
    • 1 mEq/kg, repeat dose at 1/2.
    • Hypokalemia
    • Alkalosis, respiratory acidosis

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