Pharmacology Manual: Indications/ Contraindications

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Pharmacology Manual: Indications/ Contraindications
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2013-10-26 15:52:31
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Pharmacology Manual: Indications/ Contraindications
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  1. MORPHINE SULFATE: Indications
    • 1. Moderate to severe pain, especially in burn patients or extremity fractures
    • 2. Chest pain of suspected myocardial origin
    • 3. Pulmonary edema
  2. MORPHINE SULFATE: Contraindications
    • 1. Head injury- increasing intracranial pressure
    • 2. Respiratory depression, <12 respirations
    • 3. Hypotension, Hypovolemia
  3. MIDAZOLAM: Indications
    • 1. Suppression of seizure activity
    • 2. Sedation prior to cardioversion or TC Pacing
    • 3. Agitated Delirium
    • 4. Facilitated Intubation
    • 5. Inhibit possible seizure activity due to organophosphate poisoning
  4. MIDAZOLAM: Contraindications
    • 1. Infants under 6 months
    • 2. Glaucoma
    • 3. Shock, Hypotension
    • 4. Patients taking calcium channel blockers, anti-fungal meds, or AIDS medications
    • Relative Contraindications:
    • 1. Head injury
    • 2. Alcohol intoxication or narcotic ingestion
  5. DIAZEPAM: Indications
    • 1. Sedation prior to cardioversion
    • 2. Suppression of seizure activity
  6. DIAZEPAM: Contraindications
    • 1. Acute narrow angle glaucoma
    • 2. Alcohol intoxication
    • 3. Shock, hypotension
    • Relative Contraindications:
    • 1. Head injury with depressed CNS function
  7. NAXOLONE: Indications
    Suspected narcotic overdose with respiratory rate of <12 or with decreased tidal volume
  8. NAXOLONE: Contraindications
    1. None significant due to INDICATIONS
  9. ADENOSINE: Indications
    • 1. Perfusing PSVT unresponsive to Valsalva manuever (i.e. blow on a 50 ml syringe, blow on thumb, or cough)
    • 2. Poorly perfusing PSVT in a conscious patient
    • 3. Regular and monomorphic wide-complex tachycardia
  10. ADENOSINE: Contraindications
    • 1. Hx of Sick Sinus Syndrome
    • 2. 2nd or 3rd degree heart block
    • 3. Poison or drug induced tachycardia (i.e. Persantine (dipyridamole), Tegretol (carbamepine))
  11. ALBUTEROL SULFATE: Indications
    • 1. Bronchospasm: toxic gas inhalation, pulmonary edema, drug overdose, near drowning, COPD/ Bronchitis, Acute Asthma
    • 2. Crush Syndrome: suspected hyperkalemia, crush/ entrapment more than 4 hours
  12. ALBUTEROL SULFATE: Contraindications
    None significant
  13. AMIODARONE HYDROCHLORIDE: Indications
    • 1. V-Fib
    • 2. PVT unresponsive to CPR (LAC Protocol)
  14. AMIODARONE HYDROCHLORIDE: Contraindications
    None significant for patients in cardiac arrest
  15. AMYL NITRITE: Indications
    Cyanide poisoning
  16. AMYL NITRITE: Contraindications
    None significant
  17. ASPIRIN: Indications
    Inhibit platelet aggregation in suspected myocardial ischemia
  18. ASPIRIN: Contraindications
    • 1. Active gastrointestinal bleeding or ulcer disease
    • 2. Hemorrhagic stroke
  19. ATROPINE SULFATE: Indications
    • 1. Symptomatic bradydysrhytmias
    • 2. Insecticide poisoning (organophosphates) (if HR<60, respiratory depression, and/or extreme salivation
  20. ATROPINE SULFATE: Contraindications
    None significant
  21. CALCIUM CHLORIDE: Indications
    • 1. Cardiac arrest associated with: hyperkalemia, overdose of calcium channel blockers
    • 2. Crush syndrome: suspected hyperkalemia, crush/ entrapment more than 4 hours
  22. CALCIUM CHLORIDE: Contraindications
    None significant
  23. CHARCOAL: Indications
    Suspected overdose or accidental ingestion of drugs or chemicals
  24. CHARCOAL: Contraindications
    • 1. Patients with an altered (decreased) LOC or who are at risk for decreased LOC in the field
    • 2. Absent gag reflex
    • 3. < 2 yr old
  25. DEXTROSE ORAL PREPARATIONS: Indications
    Conscious diabetic patient with s/s of hypoglycemia
  26. DEXTROSE ORAL PREPARATIONS: Contraindications
    • 1. Patients with ALOC
    • 2. Patients complaining of nausea
    • 3. Patients taking Precose (Acarbose)
  27. DEXTROSE 5% IV SOLUTION: Indications
    • 1. IV access for medication
    • 2. Diluting solution for IVPB meds
  28. DEXTROSE 5% IV SOLUTION: Contraindications
    Volume replacement
  29. DEXTROSE 50% IN WATER: Indications
    • 1. ALOC due to suspected hypoglycemia
    • 2. Cardiac arrest due to hypoglycemia
    • 3. Seizures due to hypoglycemia
  30. DEXTROSE 50% IN WATER: Contraindications
    Patients without documented hypoglycemia
  31. DIPHENHYDRAMINE: Indications
    • 1. Allergic reactions
    • 2. Adjunct to epinephrine during anaphylaxis
    • 3. Muscle spasms due to dystonic reactions
  32. DIPHENHYDRAMINE: Contraindications
    • 1. Acute asthma
    • 2. Glaucoma
  33. DOPAMINE: Indications
    • 1. Cardiogenic shock
    • 2. Distributive shock after fluids
  34. DOPAMINE: Contraindications
    • 1. Hypovolemia
    • 2. Tachydysrhythmias
  35. EPINEPHRINE HYDROCHLORIDE: Indications
    • 1. Cardiopulmonary arrest: V-Fib, Asystole, PEA, PVT
    • 2. Asthma/ Severe allergic reaction
    • 3. Anaphylaxis with shock
    • 4. Pediatric bradycardia
    • 5. Severe respiratory distress with stridor and croup
  36. EPINEPHRINE HYDROCHLORIDE: Contraindications
    • 1. Hypovolemia
    • 2. Hypertension
  37. FUROSEMIDE: Indications
    • 1. Pulmonary edema (not in LAC)
    • 2. Increased ICP
  38. FUROSEMIDE: Contraindications
    • 1. Hypovolemia
    • 2. Pregnancy (only used in life-threatening situations
    • 3. Hypokalemia
  39. GLUCAGON: Indications
    • 1. ALOC when hypoglycemia is suspected and an IV cannot be established
    • 2. Adjuvant tx of toxic effects of CCB or Beta blocker overdose
  40. GLUCAGON: Contraindications
    None significant
  41. LIDOCAINE HYDROCHLORIDE: Indications
    • 1. Cardiac arrest: as an alternative to Amiodarone in V-Fib or PVT
    • 2. Ventricular dysrhythmias: Stable monomorphic VT, Stable wide-complex tachycardia
  42. LIDOCAINE HYDROCHLORIDE: Contraindications
    • 1. Stokes-Adams Syndrome
    • 2. Wolff-Parkison-White Syndrome
    • 3. Severe degrees of SA, AV or intraventricular blocks
    • 4. Wide complex ventricular escape beats associated with bradycardia
  43. NITROGLYCERIN SPRAY: Indications
    • 1. Chest pain of suspected myocardial origin or myocardial ischemia
    • 2. CHF/ Cardiogenic pulmonary edema
  44. NITROGLYCERIN SPRAY: Contraindications
    • 1. S/S of cerebral hemorrhage or increased ICP
    • 2. Systolic BP <90 mmHg (<100 mmHg in LAC)
    • 3. Bradycardia <50 bpm or Tachycardia >100 bpm
    • 4. Right ventricular MI
    • 5. Viagra, Levitra in last 24 hours, Cialis in last 48 hours
  45. ONDANSETRON HYDROCHLORIDE: Indications
    N/V
  46. ONDANSETRON HYDROCHLORIDE: Contraindications
    None significant
  47. OXYGEN: Indications
    In any situation where O2 demand increases: hypoxemia, chest pain of myocardial origin, respiratory insufficiency, cardiopulmonary arrest
  48. OXYGEN: Contraindications
    None significant
  49. POTASSIUM CHLORIDE: Indications
    Potassium deficiency
  50. POTASSIUM CHLORIDE: Contraindications
    None significant
  51. PRALIDOXIME CHLORIDE: Indications
    S/S of organophosphate type nerve agent: respiratory distress/ respiratory arrest, muscle twitching, generalized weakness/ paralysis, seizure
  52. PRALIDOXIME CHLORIDE: Contraindications
    None significant
  53. RINGER'S LACTATE IV SOLUTION: Indications
    • 1. Initial fluid replacement in hypovolemia and/ or dehydration or burns
    • 2. Intravenous access for drug administration
  54. RINGER'S LACTATE IV SOLUTION: Contraindications
    None significant
  55. SODIUM BICARBONATE: Indications
    • 1. Crush Syndrome: suspected hyperkalemia, crush force/ entrapment more than 4 hours
    • 2. Cardiopulmonary arrest: suspected hyperkalemia (dialysis patient), down time more than 20 minutes
    • 3. Known pre-existing bicarbonate responsive acidosis: tricyclic OD, aspirin OD, diphenhydramine OD, cocaine OD, DKA
  56. SODIUM BICARBONATE: Contraindications
    None significant
  57. SODIUM CHLORIDE 0.9% IV SOLUTION: Indications
    • 1. Initial fluid replacement in hypovolemia, dehydration and Crush Syndrome
    • 2. IV access for drug administration
    • 3. Maintains patency of saline locks and PVAD
  58. SODIUM CHLORIDE 0.9% IV SOLUTION: Contraindications
    None significant

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