pam drugs

Isotonic Crystalloid

Approximates the electrolyte concentration of the blood

Hypovolemic shock

• Congestive heart failure
• Renal failure

Monitor for circulatory overload

Rare

• Hypovolemic shock (systolic less then 90): infuse wide open until a systolic of 100 is attained, Infusion should be slowed to 100 ml/hr
• Other: as indicated by the patients condition
• and situation being treated

IV

20 ml/kg repeated as required based on hemodynamic response

Sugar solution

Glucose nutrient solution

• IV access for emergency drugs 
• For the dilution of concentrated
• drugs for IV infusion

• Should not be used as fluid replacement for hypovolemic states
• Avoid
• in head injury and stroke

• Monitor for circulatory overload
• Draw tube of blood before admin to diabetics

Rare

• Generally admin TKO
• Ped dose is the same

IV

Istotonic electrolyte

Fluid & sodium replacement

• Heat related problems
• Fresh water drowning
• Hypovolemia
• Diabetic ketoacidose

CHF

Electrolyte depletion can occur following administration of large amounts of NSS

Thirst

• Dependent on PT condition & situation being treated 
• In fresh water drowning & heat emergency is usually rapid

IV

dose is dependent on PT size and condition

Gas

Necessary for cellular metabolism

Hypoxia

Non-hypoxic PT

• Avoid hyperoxia 
• Use cautiously in pt with COPD
• Humidify when providing high flow rates

Drying of mucous membranes

• Cardiac-arrest: 100%
• Other critical PT: 100%
• Other: only administer enough to correct hypoxia

Inhalation

24-100% as required

Platelet inhibitor & anti-inflammatory

Inhibits platelet aggregation

• New chest pain suggestive of acute myocardial infarction
• Signs & symptoms suggestive of recent stroke

Pt with known hypersensitivity to the med

• Heartburn
• Nausea & Vomiting 
• Weezing

Gastrointestinal bleeding & upset stomach

160 or 325 mg by mouth chewed

Oral

10-15 mg/kg/dose

Adsorbent

Adsorbs toxic substances from the GI tract

• Most oral poisonings & medication overdoses
• can be used after evacuation of poisons

• Oral admin to comatose PT 
• after ingestion of corrosive, caustics, petroleum distillates (ineffective my induce vomiting)
• Simultaneous admin with other oral drugs
• Use caution in pt experiencing abdomen pain or know GI obstruction

If aspirated can induce a fatal form of pneumonia

Emetic

Irritates the enteric tract

Poisoning in conscious PT

• Vomiting should not be induced in any PT with impaired consciousness
• Anti-emetic poisonings
• Especially os the phenothiazine type

• Monitor & ensure PT airway 
• the risk of aspiration is increased when using

rare

oral

30 ml (1oz) followed by 15 ml/kg of warm water

• <1 year: 10 ml
• 1-12 years: 15 ml
• >12 years: 30 ml

carbohydrate

Elevates blood glucose level rapidly

Hypoglycemia

None in the emergency setting

A blood sample should be drawn before administering

Local venous irritation

25g (50 ml)

IV

• 0.5g/kg slow iv
• Should be diluted 1:1 with sterile water to form a 25% solution

Hormone (antinypolyglycemic agent)

• Causes breakdown of glycogen to glucose
• Inhibits glycogen systhesis
• Elevates blood glucose level
• Increase cardiac contractile force
• Increases heart rate

• Hypoglycemia
• Beta-blocker overdose

Hypersensitivity to the medication

• effective only if there are sufficient stores of glycogen within the liver
•  Draw blood for glucose test before administering

Few in the emergency situation

• IV: 0.25 - 0.5 units
• IM: 1mg

.03 mg/kg

Sympathomimetic (B2 selective)

Bronchodilation

• Asthma
• Reversible bronchospasm associated with copd

• Known hypersensitivity to the med
• Symptomatic tychycardia

• Blood pressure, pulse & ecg should be monitored
• Use caution in pt with known heart disease

• Palpitations
• Anxiety
• Headache
• Dizziness
• Sweating

• Meter dose inhaler: one to two sprays (90mcg per spray)
• Small volume nebulizer: 0.5 ml (2.5-5.0 mg) in 2.5 ml nss over 5-15 min
• Rotoinhaler: one 200 mcg roto cap should be placed in the inhaler and breathed by the pt

Inhalation

• < 1 year: 0.05-0.15 mg/kg dose
• 1-5 years: 1.25-2.5 every 4 to 6 hr
• 5-12 years: 2.5 mg dose every 4 to 6 hr
• >12 years: 2.5-5.0 mg dose every 6 hours

Gas

Cns depressant

• Pain of musculoskeletal origin particularly fractures & burns
• Suspected ischemic chest pain
• States if severe anxiety including hypervilation

• Pt who cannotcomprehend verbal instructions
• Pt intoxicated with alcohol or medication
• Head injury
• Pt who exhibits an altered mental status
• Copd
• Increased Oxygen con may cause resp depression
• Thoracic injury suspicous of pheumothorx 
• Abdominal pain and distension suggestive of bowel obstruction

• Use only in well ventilated area 
• Gas scavenging system is recommended
• May not operate properly in low temperature

• Headache
• Dizziness
• Giddiness
• Nausea
• Vomiting

Self administered only using 50% Nitrous oxide & 50% oxygen blender

Inhalation only

Self administered only

Sympathomimetic (b2 selective)

• Bronchodilation
• Increases heart rate

• Asthma
• Reversible bronchospasm associated with chronic bronchitis & emphysema

Pt with history of hypersensitivity to medication

Blood pressure, pulse &ecg must be constantly monitored

• Palpitations
• Tachycardia
• Anxiety
• Tremors
• Headache

• Hand nebulizer: four inhalations
• Small volume nebulizer: 0.5 ml(1:3 with saline)

Inhalation only

0.25-0.5 ml diluted with normal saline

Anticholinergic

• Causes Bronchodilation
• Dries respiratory tract secretions

• Bronchial Asthma 
• reversible broncospasm associated with chronic bronchitis & emphysema

• Hypersensitivity to the meds
• should not be used as primary acute treatment of brohchospasm

Monitor vital signs

• Palpitations
• Dizziness
• Anxiety
• Headache
• Nervousness

• 500 mcg Placed in a small volume nebulizer 
• (typically administered with a B-agonist)

Inhaled

350-500 mcg/dose

Xanthine bronchodilator

• Smooth muscle Relaxant
• Causes bronchodilation
• Has mild diuretic properties
• Increases heart rate

• Bronchial Asthma
• Reversible bronchospasm associated with chronic bronchitis & emphysema
• CHF
• Pulmonary edema

• Hypersensitivity to the med
• Hypotension
• Pt with peptic ulcer disease

• Monitor for arrhythmias
• Monitor BP
• Do not administer to Pt on chronic theophylline preparations until the Theophyiline blood level has been determaned

• Convulsions
• Tremor
• Anxiety
• Dizziness
• Vomiting
• Palpitations
• PVC
• Tachycardia

Method #1: 250-500 in 90 or 80 ml of D5W infused over 20-30 min (Approximatly 5-10 mg/kg/hr)

Method #2: 250-500 mg (5-7mg/kg) in 20ml D5W infused over 20-30 min

Slow IV

6 mg/kg loading dose to be infused over 20-30 min max dose not to exceed 12 mg/kg over 24 hours

Sympathometic (B2 selective)

Bronchodilation

• Asthma
• Reversible bronchospasm associated with COPD

• Hypersensitivity to the med
• Symptomatic tachycardia

• Blood pressure 
• Pulse &ecg should be monitored
• use caution in patients with known heart disease

• Palpitations
• Anxiety
• Headache
• dizziness
• sweating

• metered dose inhaler: One to two sprays ( 90 MCG pre spray )
• small volume nebulizer: 0.5 ml (2.5mg) in 2.5 ml normal saline over 5 to 15 minutes
• roto inhaler: one 200 MCG Radio cab should be placed an inhaler and breathe by patient

Inhalation

0.15 mcg/kg (0.03 ml/kg) in 2.5 ml of normal saline

Antihistamine

Antiemetic

• Nausea and vomiting
• Motion sickness
• to potentiate the effects of analgesics

Comatose states

Patients who have recevived a large amounts of depressants (including alcohol

use with caution in patients with sezure disorders 

Asthma

May impair mental and physical ability

Drowsines

Slow Intravenous: 12.5-25.0 mg

Intramuscular or oral: 50-100 mg

• IV
• IM
• Oral

Data Unavailable

Sympathomimetic

• Bronchodilation
• Increases heart rate
• Increases cardiac contractile force

Croup (laryngotracheobronchitis)

• Epiglottitis
• Hypersensitivity to med

• Vital signs should be constanly monitored
• Should be used only once in the prehospital setting

• Palpitations
• Anxiety
• Headache

0.25-0.75 ml of a 2.25% solution in 2.0 ml normal saline

Inhalation only (small volume nebulizer)

0.25-0.75 ml of a 2.25% solution in 2.0 ml normal saline

Sympathomimetic

Bronchodilation

• Bronchial asthma
• Exacerbation of COPD
• Allergic Reaction
• Ped cardiac arrest ( after initial epi dosage)

• PT with underlying cardiovascular disease
• Hypertension
• Pregnancy
• Pt with tachyrrhythmias

• Should be protected from light
• Blood pressure, Pulse, and ecg should be monitored

• Palpatation and tachycardia
• Anxiousness
• Headache
• Tremor

0.3-0.5 mg

IM

0.01 mg/kg up to 0.3 mg

Sympathomimetic

• Increases heart rate and automaticity
• Increases cardiac contractile force
• Increases Myocardial electrical activity
• Increases Sys
• Increases

• Cardiac arrest
• Anaphylactic Shock
• sever reactive airway disease

• Epi 1:10000 is for IV or et use
• Should not be used in pt who do not require resuscitative efforts

• Protect from light
• Can be deactivatied by alkaline solutions

• Palpitaions
• Anxiety
• Tremulousness