Drug_File_New[1].txt

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Drug_File_New[1].txt
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  1. Albuterol (Proventil, Ventolin) Class
    Sympathomimetic Bronchodilator
  2. Albuterol (Proventil, Ventolin)description
    Bronchodilator causing reduced mucus secretion, pulmonary capillary leaking & edema in lungs
  3. Albuterol (Proventil, Ventolin)indications (2)
    • Bronchospasm
    • Asthma in COPD
  4. Contraindications for Albuterol (Proventil, Ventolin)
    none
  5. Precautions for Albuterol (Proventil, Ventolin) (6)
    • Tachycardia
    • Anxiety
    • Nausea
    • Cough
    • Wheezing
    • Dizziness
  6. Albuterol (Proventil, Ventolin)dosage
    2.5-3 mg in 2.5 mL NS via Neb
  7. Fentanyl (Sublimaze)Class
    Narcotic Analgesic
  8. Fentanyl (Sublimaze)Description
    • Synthetic Narcotic Analgesic
    • Rapid onset, short acting
  9. Fentanyl (Sublimaze) Indication (1)
    Sedation for intubation
  10. Fentanyl (Sublimaze) Contraindication (2)
    • MAO inhibitors
    • Myasthenia Gravis
  11. Fentanyl (Sublimaze) Precautions (6)
    • ^ ICP
    • Elderly
    • Debilitated pts
    • COPD
    • Resp Probs
    • Hepatic & Renal Insufficiency
  12. Fentanyl (Sublimaze) Dosages
    25-100 mcg over 2-3 mins IV
  13. Ipratropium (Atrovent)Class
    Anticholinergic
  14. Ipratropium (Atrovent)Description
    Bronchodilator that dries resp tract secretions by blocking ACH receptors
  15. Ipratropium (Atrovent) Indications (3)
    • Asthma
    • COPD
    • Inhaled Irritants
  16. Ipratropium (Atrovent) Contraindications (2)
    • Hypersensativity to atropine or its derivatives
    • As primary treatment
  17. Ipratropium (Atrovent) Precautions (3)
    • Elderly
    • Cardiovascular Disease
    • HTN
  18. Ipratropium (Atrovent) Dosages
    500 mcg in 2.5-3 mL NS via Neb
  19. Morphine Class
    Narcotic Analgesic, PROTOTYPE OPIATE
  20. Morphine Description
    Analgesic & sedative causing some vasodilation, reducing venous return, reduced myocardial O2 demand
  21. Morphine Indications (3)
    • Pain
    • MI
    • Reduce venous return in pulmonary edema
  22. Morphine Contraindications (6)
    • Head or Abd inj
    • Hypotension/volume depletion
    • Acute Bronchial Asthma
    • COPD
    • Resp Depression
    • Pulmonary edema fr chem inhal
  23. Morphine precautions (4)
    • Elderly
    • Children
    • Debilitated
    • Keep Narcan available
  24. Morphine Dosage
    • Pain 2.5-15 mg IV: 5-20 mg IM/Sub Q
    • AMI or PE 1-2 mg/ 6-10 mins to response
  25. Nalaxone (narcan)Class
    Narcotic Antagonist
  26. Nalaxone (narcan) Description
    • Narcotic antagonist
    • Blocks Natl & Syn Narcotics
    • May reverse resp depression
  27. Nalaxone(narcan) Indications (2)
    • Narcotic OD
    • Resp depression of unknown origin
  28. Nalaxone(narcan) Contraindications (1)
    Non Narc induced resp depression
  29. Nalaxone(narcan) Precautions (2)
    • Dependancy
    • Short half life so OD state may return
  30. Nalaxone(narcan) Dosage
    0.4-2 mg IV/IM repeated 2-3 mins as needed up to 10mg
  31. Diazepam (Valium) Class
    Benzodiazepine
  32. Diazepam (Valium)Description
    Sedative, skeletal muscle relaxant
  33. Diazepam (Valium)Indications (5)
    • Motor Seizures
    • Status Epilepticus
    • Premed for painful procedures
    • Muscle tremors from injury
    • Acute anxiety
  34. Diazepam (Valium)Contraindications (6)
    • Shock
    • Coma
    • Acute Alcoholism
    • Depressed vital signs
    • Obstretic pts
    • Neonates
  35. Diazepam (Valium)Precautions (4)
    • Psychosis
    • Depression
    • Myasthenia Gravis
    • Short Half life causing seizure to return
  36. Diazepam (Valium) Dosages
    • Seizure-- 5-10 mg IV/IM
    • Anxiety-- 2-5 mg IV/IM
    • Premed-- 5-15 mg IV
  37. Etomidate (Amidate)Class
    Hypnotic
  38. Etomidate (Amidate)Description
    Ultra short acting nonbarbituate hypnotic
  39. Etomidate(Amidate) Indications (1)
    Sedation for RSI
  40. Etomidate(Amidate) Contraindications
    None
  41. Etomidate(Amidate) Precautions (3)
    • Hypotension
    • Asthma
    • Cardiovascular Disease
  42. Etomidate(Amidate) Dosage
    0.1-0.3 mg/kg IV over 15-30 secs
  43. Flumazenil(Romazicon) Class
    Benzo Antagonist
  44. Flumazenil(Romazicon) Description
    Reverses sedative, recall & psychomotor effects of benzos
  45. Flumazenil (Romazicon)Indications
    Resp Depress secondary to benzos
  46. Flumazenil(Romazicon) Contraindications (3)
    • Pts currently taking for seizures or status epilepticus
    • Seizure prone pts during labor & delivery
    • Tricyclic antidepressant OD
  47. Flumazenil(Romazicon) Precautions (7)
    • Hepatic Impairment
    • Elderly
    • Pregnancy
    • Nursing Mothers
    • Head inj
    • Alcohol/drug dependancy
    • Phys Dependancy on Benzos
  48. Flumazenil(Romazicon) Dosage
    0.2mg IV over 30-60 secs to 1 mg
  49. Midazolam (Versed) Class
    Benzodiazepine/ sedative
  50. Midazolam (Versed) Description
    Short-acting benzo w/ CNS depressant, muscle relaxant, anticonvulsant, anterograde amnestic effects
  51. Midazolam (Versed)Indications
    Sedation before cardioversion or intubation
  52. Midazolam (Versed) Contraindications (4)
    • Narrow angle glaucoma
    • Shock
    • Coma
    • Alcohol Intoxication
  53. Midazolam (Versed) Precautions (4)
    • COPD
    • Renal Impairment
    • CHF
    • Elderly
  54. Midazolam (Versed)Dosages
    • 1-2mg slow IV
    • 0.07-0.08 mg/kg IM
  55. Succinylcholine (Anectine) Class
    Depolarizing Neuromuscular Blocker
  56. Succinylcholine (Anectine) Description
    Short acting depolarizing muscular blocker
  57. Succinylcholine(Anectine) Indications
    ET intubation
  58. Succinylcholine(Anectine) Contraindications (3)
    • Hx of malignant hyperthermia
    • Penetrating eye inj
    • Narrow angle glaucoma
  59. Succinylcholine(Anectine) Precautions (2)
    • Burn or Crush inj
    • Spinal cord inj
  60. Succinylcholine(Anectine) Dosage
    1-1.5 mg/kg IV/IM
  61. Adenosine (Adenocard)Class
    • Antidysrhythmic
    • Adenocard
  62. Adenosine(Adenocard) Description
    • Chemical cardioverter PSVT --> Normal Sinus
    • Half life of 10 sec
    • Doesnt cause hypotension
  63. Adenosine (Adenocard)Indications
    SVT refractory to vagal maneuvers
  64. Adenosine (Adenocard)Contraindications (3)
    • 2nd & 3rd degree heart block
    • Sinus node disease
    • Asthma
  65. Adenosine (Adenocard)Precautions (2)
    • May cause transient dysrhythmias especially in asystole
    • COPD
  66. Adenosine(Adenocard) Dosage
    • 1. 6 mg rapidly IV w/ NS flush
    • 2. 12 mg in 1-2 min, may be repeated
  67. Atropine Class
    Parasympatholytic
  68. Atropine Description
    • Blocks vagal effects on HR
    • ^ myocardial O2 demand
    • Decrease airway secretions
  69. Atropine Indications
    • Hemodynamically significant Bradycardia
    • Bradyasystolic Arrest
    • Organophosphate Poisoning
  70. Atropine Contraindications
    None in EMS setting
  71. Atropine Precautions (2)
    • AMI
    • Glaucoma
  72. Atropine Dosages
    • Symptomatic Bradycardia--0.5mg IV/1mg ET 3-5 mins to 3 mg
    • Asystole--1mg IV/ 2mg ET 3-5 min to 3 mg
    • Poisoning--2-5 mg IV/IM/IO to 15 min
  73. Epinephrine (Adrenalin) Class
    Sympathomimetic
  74. Epinephrine(Adrenalin) Description
    • Catecholamine
    • ^ tropic properties, systemic vascular resistance, systolic BP, vital capacity, tidal vol
    • May reduce pulmonary congestion
    • Decreases airway resistance & automaticity
  75. Epi (Adrenalin) Indications (2)
    • Cardiac arrest
    • Severe allergic reactions
  76. Epi (Adrenalin)contraindications (3)
    • Narrow Angle Glaucoma
    • Hemmoragic, Traumatic or Cardiac shock
    • Labor
  77. Epi (Adrenalin)Precautions
    none
  78. Epi (Adrenalin)Dosages
    • Arrest-- 1mg 1:10 IV 3-5 mins (ET 2-2.5 1:1) NO MAX
    • Allergy-- 0.3-0.5 mg 1:1 sub q 5-15 min as needed 0.5-1 1:10 IV if sub q ineffective
  79. Vasopressin (Pitressin) Class
    Hormone/Vasopressor
  80. Vasopressin (Pitressin)Description
    Hormone w/ strong vasopressive & antidiuretic properties but that may precipitate angina or AMI
  81. Indications for vasopressin(Pitressin) (2)
    • ^ peripheral resistance in arrest
    • Esophageal Varices
  82. Contraindications for Vasopressin(Pitressin)
    • PVCs
    • 1st stage of labor
  83. Vasopressin(Pitressin) precautions (8)
    • Epilepsy
    • Migraine
    • Heart failure
    • Angina
    • Vascular Disease
    • Hepatic impairment
    • Elderly
    • Children
  84. Vasopressin (Pitressin)Dosage
    • Arrest-- 40 units IV
    • Varices-- 0.2-0.4 units/min drip
  85. Aspirin Class & Trade
    • Acetylsalicylic Acid-- analgesic, antipyretic, Platelet Inhibitor, Antiinflammatory
    • Alka-saltzer, Bayer, Empirin, St Joseph's Childrens
  86. Aspirin Description
    • Inhibits agents that cause inflammation, pain & fever
    • Relieves pain by acting on the PNS
    • Lowers body Temp
    • Powerfully inhibits platelet aggregation
  87. Aspirin Indications
    Chest pain suggestive of MI
  88. Aspirin Contraindications (2)
    • Active Ulcer Disease
    • Asthma
  89. Aspirin Precautions (1)
    Bleeding disorders
  90. Aspirin Dosages
    160-325 mg PO
  91. Dextrose 50% in H20 C & T
    • Carbohydrate
    • D50W
  92. Dextrose description
    Simple sugar body can rapidly metabolize
  93. Dextrose Indication
    Hypoglycemia
  94. Dextrose Contraindication
    None in hypoglycemia
  95. Dextrose precautions (3)
    • ^ ICP
    • Chk sugar b/f administering
    • Ensure good IV
  96. Dextrose Dosage
    25g in 50mL IV
  97. Furosemide (Lasix) Class
    Diuretic
  98. Furosemide(Lasix) Description
    • Rapid acting potent diuretic & antihypertensive
    • Inhibits Na reabsorption by kidneys
    • Reduces venous return & cardiac workload
  99. Furosemide(Lasix) Indications (2)
    • CHF
    • Pulmonary Edema
  100. Furosemide (Lasix)Contraindications (3)
    • Fluid & electrolyte depleted states
    • Hepatic coma
    • Pregnancy
  101. Furosemide(Lasix) Precautions (8)
    • Infants
    • Elderly
    • Hepatic Impairment
    • Nephrotic Syndrome
    • Cardiogenic Shock assoc w/ MI
    • Gout
    • Pts receiving digitalis
    • K depleting steroids
  102. Furosemide (Lasix)Dosage
    40-120 mg slow IV
  103. Nitroglycerin (Nitrostat) Class
    Nitrate
  104. Nitro (Nitrostat)Description
    • Rapid smooth muscle relaxant
    • Reduces peripheral vascular resistance, BP, Venous Return, Cardiac Workload
  105. Nitro (Nitrostat)Indications (2)
    • Chest Pain assoc w/ angina or AMI
    • Acute pulmonary edema
  106. Nitro (Nitrostat)Contraindications (8)
    • Tolerance to nitrates
    • Severe Anemia
    • Head trauma
    • Hypotension
    • ^ ICP
    • Pts taking sildenafil
    • Glaucoma
    • Shock
  107. Nitro (Nitrostat)Precautions (2)
    • May cause headache
    • Light sensitive losing potency
  108. Nitro (Nitrostat)Dosage
    • 0.4mg SL 3-5 mins up to 3
    • 1/2" topical ointment
    • 0.4 mg spray SL
  109. Dobutamine (Dobutrex)Class
    Sympathomimetic
  110. Dobutamine (Dobutrex)description
    Catecholamine / Beta agent that ^ inotropy w/o affecting chronotropy
  111. Dobutamine (Dobutrex)Indications
    ^ cardiac output in CHF/cardiogenic shock
  112. Dobutamine (Dobutrex)Contraindications (2)
    • V-Tach
    • Hypovolemia w/o fluid resuscitation
  113. Dobutamine(Dobutrex) Precautions (2)
    • A-Fib
    • Preexisting HTN
  114. Dobutamine(Dobutrex) Dosages
    2-20 mcg/kg/min IV
  115. Dopamine (Inotropin)Class
    Sympathomimetic
  116. Dopamine(Inotropin) Description
    • Natl catecholamine ^ cardiac output w/o ^ myocardial O2 consumption
    • Maintains renal & mesenteric blood flow while inducing vasoconstriction & ^ systolic BP
  117. Dopamine(Inotropin) Indications (2)
    • Nonhypovolemic hypotension
    • Cardiogenic shock
  118. Dopamine(Inotropin) Contraindications (3)
    • Tachydysrhythmias
    • V-Fib
    • Pheochromocytoma
  119. Dopamine (Inotropin)Precautions
    Ensure adequate fluid resuscitation of the hypovolemic pt
  120. Dopamine (Inotropin)dosages
    2-5 mcg/kg/min up to 20 mcg/kg/min, titrated to effect
  121. Isoproterenol (Isuprel)Class
    Sympathomimetic
  122. Isoproterenol (Isuprel)Description
    Synthetic sympathomimetic resulting in ^ cardiac output by increasing inotropy & chronotropy
  123. Isoproterenol(Isuprel) Indications
    Bradycardia refractory to atropine when pacing is not available
  124. Isoproterenol(Isuprel) Contraindications
    Cardiogenic Shock
  125. Isoproterenol (Isuprel)Precautions
    Tachydysrhythmias & those associated w/digitalis & AMI
  126. Isoproterenol(Isuprel) Dosages
    Bradycardia-- 2-10 mcg/min titrated to cardiac rate
  127. Amiodarone (Cordarone, Pacerone)Class
    Antidysrhythmic
  128. Amiodarone (Cordarone, Pacerone)Description
    • Prolongs duration or action potential & refractory periods
    • Relaxes smooth muscles
    • Reduces peripheral vascular resistence
    • Increases coronary blood flow
  129. Amiodarone (Cordarone, Pacerone)Indications
    • Life threatening ventricular & superventricular dysrhythmias
    • Frequently A-Fib
  130. Amiodarone (Cordarone, Pacerone)Contraindications (3)
    • Cardiogenic Shock
    • Severe sinus bradycardia
    • Advanced heart block
  131. Amiodarone (Cordarone, Pacerone)Precautions
    None
  132. Amiodarone(Cordarone, Pacerone) Dosage
    150-300 mg IV over 10 mins then 1 mg/min for 6 hrs
  133. Bretylium (Bretylol) Class
    Antidysrhythmic
  134. Bretylium (Bretylol)Description
    Supresses V-tach dysrhythmias including V-Fib w/ reentry mechanisms
  135. Bretylium (Bretylol)Indications
    V-Fib & V-Tach refractory to Lidocaine
  136. Bretylium (Bretylol)Contraindications
    None
  137. Bretylium (Bretylol)Precautions (2)
    • Digitalized Pts
    • Digitalis-induced dysrhythmias
  138. Bretylium (Bretylol)Dosages
    5 mg/kg IV then 10 mg/kg / 15-30 mins to max of 30 mg/kg
  139. Lidocaine (Xylocaine)Class
    Antidysrhythmic
  140. Lidocaine(Xylocaine) Description
    • Antidysrhythmic that suppresses automaticity & raises stimulation threshold of ventricles
    • Causes sedation, anticonvulsant & analgesic effects
  141. Lidocaine (Xylocaine)Indication (3)
    • Pulseless V-Tach
    • V-Fib
    • V-Tach w/pulse
  142. Lidocaine (Xylocaine)Contraindications (4)
    • Supraventricular Dysrhythmias
    • Stokes-Adams Syndrome
    • 2nd & 3rd degree heart block
    • Bradycardias
  143. Lidocaine(Xylocaine) Precautions (8)
    • Hepatic or renal Impairment
    • CHF
    • Hypoxia
    • Resp Depression
    • Hypovolemia
    • Myasthenia Gravis
    • Shock
    • Elderly
  144. Lidocaine (Xylocaine)Dosages
    • Cardiac Arrest-- 1-1.5 mg/kg IV repeated 3-5 mins up to 3 mg/kg. Follow w/ drip of 2-4 mg/min
    • V-Tach w/pulse-- 1-1.5mg/kg slow IV-> 1/2 dose 5-10 mins up to 3mg/kg till conversion -> infusion of 2-4 mg/min
  145. Procainamide (Pronestyl)Class
    Antiarrhythmic
  146. Procainamide (Pronestyl)Description
    • Prolongs ventricular repolarization
    • Slows Dromotropy
    • Decreases myocardial excitability
  147. Procainamide(Pronestyl) Indications (2)
    • V-Fib
    • Pulseless V-Tach refractory to Lidocaine
  148. Procainamide (Pronestyl)Contraindications (2)
    • Myasthenia Gravis
    • 2nd or 3rd degree heart block
  149. Procainamide(Pronestyl) Precautions (7)
    • Hypotension
    • Cardiac Enlargement
    • CHF
    • AMI
    • Ventricular dysrhythmias fr digitalis
    • Hepatic or renal impairment
    • Bronchial Asthma
  150. Procainamide(Pronestyl) Dosage
    • 20-30 mg/min IV drip
    • Stop points-- (1) up to 17 mg/kg to effect -> 1-4 mg/min (2) Ectopy Resolves (3) QRS complex widens more than 50% then original (4) Hypotension ensues
  151. Diltiazem (cardizem)Class
    calcium channel blocker CCB
  152. Diltiazem (cardizem)Description
    • Dilates coronary & peripheral arteries & arterioles ^ circulation to the heart & reducing peripheral vascular resistance
    • CCB similar to Verapamil
  153. Diltiazem (cardizem)Indications (4)
    • A-fib
    • Atrial flutter
    • PSVT refrac to adenosine
    • ^ coronary artery perfusion in Angina
  154. Diltiazem(cardizem) Contraindications (5)
    • Sick Sinus Syndrome
    • 2nd & 3rd degree heart block
    • Systolic BP < 90
    • Diastolic BP < 60
    • Wide complex tachycardia
  155. Diltiazem (cardizem)Dosage
    0.25 mg/kg IV over 2 mins, repeat as needed w/0.35 mg/kg followed by drip of 5-10 mg/hr not exceeding 15 mg/hr over 24 hrs
  156. Diltiazem (cardizem)Precautions
    CHF w/ Beta blockers
  157. Tridil (Nitro Inj) Class
    Vasodilator/Nitrate
  158. Tridil (Nitro Inj)Description
    Relaxes blood vessels ^ blood & O2 supply to heart
  159. Tridil (Nitro Inj)Indications (3)
    • Pain Associated w/ angina that doesnt respond to oral treatment
    • Ctrl BP
    • Help treat CHF
  160. Tridil(Nitro Inj) Contraindications (5)
    • Hypotension
    • Uncorrected Hypovolemia
    • ^ ICP
    • Constrictive Pericarditis
    • Pericardial Tamponade
  161. Tridil (Nitro Inj)Precautions (3)
    • Headache
    • Severe Hypotension
    • Reflex Tachycardia
  162. Tridil(Nitro Inj) Dosage
    0.2-1.5 mcg/kg/min
  163. Verapamil (Calan, Isoptin) Class
    Calcium Channel Blocker CCB
  164. Verapamil (Calan, Isoptin)description
    • CCB slowing AV conduction
    • Supresses reentry dysrhythmias
    • Slows ventricular responses to atrial tachydysrhythmias
    • Dilates coronary arteries & reduces myocardial O2
  165. Verapamil(Calan, Isoptin) Indications (3)
    • PSVT refrac to adenosine
    • Atrial Flutter
    • A-Fib w/ rapid ventricular response
  166. Verapamil(Calan, Isoptin) Contraindications (8)
    • Severe Hypotension
    • Cardiogenic Shock
    • 2nd & 3rd Degree Heart Block
    • CHF
    • Sinus Node Disease
    • WPW Disease
    • Should not be given to those on Beta Blockers
  167. Verapamil (Calan, Isoptin)Precautions
    None
  168. Verapamil(Calan, Isoptin) Dosages
    2.5-5mg IV bolus over 2-3 mins then 5-10mg aft 15-30 min max
  169. Calcium Chloride Class
    Electrolyte
  170. Calcium Chloride Description
    Increases myocardial contractile force & automaticity
  171. Calcium Chloride Indications (4)
    • Hypercalemia
    • Hypercalcemia
    • Hypermagnesemia
    • CCB toxicity
  172. Calcium Chloride contraindications (3)
    • V-Fib
    • Hypercalcemia
    • Digitalis toxicity
  173. Calcium Chloride precautions
    • May precipitate toxicity in pts taking digoxin
    • Ensure IV is in lg vein & flushed b/f using & aft calcium
  174. Calcium Chloride Dosages
    2-4 mg/kg IV / 10 mins as needed
  175. Methylprednisolone (Solu-Medrol) Class
    Corticosteroid/ Antiiflammatory
  176. Methylprednisolone (Solu-Medrol)Description
    • Synthetic adrenal corticosteroid used for inflammation, mgmt of allergic reactions & in some cases shock
    • Sometimes used for treatment of spinal cord inj
  177. Methylprednisolone (Solu-Medrol)Indications (4)
    • Spinal Cord Inj
    • Asthma
    • Severe Anaphylaxis
    • COPD
  178. Methylprednisolone (Solu-Medrol)Contraindications
    None in emergency setting
  179. Methylprednisolone (Solu-Medrol)Precautions
    Only a single dose should be given in prehospital setting
  180. Methylprednisolone (Solu-Medrol)Dosages
    • Asthma/COPD/Anaphylaxis -- 125-250 mg IV/IM
    • Spinal Cord Inj -- 30 mg/kg IV over 15 min, aft 45min an infusion of 5.4 mg/kg/hr
  181. Magnesium Sulfate Class
    Electrolyte
  182. Magnesium Sulfate Description
    • Electrolyte acts as CCB, CNS depressant & anticonvulsant
    • Depresses function of smooth, skeletal & cardiac muscles
  183. Magnesium Sulfate Indications (3)
    • Refractory V-Fib & pulseless V-Tach
    • AMI
    • Eclamptic Seizures
  184. Magnesium Sulfate Contraindications (5)
    • Heartblock
    • Myocardial Damage
    • Shock
    • Persistent Hypertension
    • Hypocalcemia
  185. Magnesium Sulfate Precautions (2)
    • Other CNS depressants
    • Neuromuscular blocking agents
  186. Magnesium Sulfate Dosages
    • V-Fib/Tach -- 1-2 g IV over 2 mins
    • Torsade de pointes -- 1-2 g IV followed by infusion of 0.5-1 g/hr IV
    • AMI -- 1-2 g IV over 5-30 mins
    • Eclampsia -- 2-4g IV/IM
    • Asthma -- 1-2 g IV drip
  187. Phenytoin (Dilantin) Class
    Anticonvulsant
  188. Phenytoin(Dilantin) Description
    • Related to phenobarbital that reduces spread of elec discharges in motor cortex & inhibits seizures
    • Antidysrhythmic props counter effects of digitalis
  189. Phenytoin (Dilantin)Indications (3)
    • Seizures
    • Status Epilepticus
    • Cardiac dysrhythmias secondary to digitalis toxicity
  190. Phenytoin (Dilantin)Contraindications (3)
    • Sinus Bradycardia
    • Heart Block
    • Adams-Stokes syndrome
  191. Phenytoin (Dilantin)Precautions
    None
  192. Phenytoin (Dilantin)Dosages
    • Seizure/Status Epilepticus -- 10-15 mg/kg slow IV
    • Dysrhythmia -- 100 mg slow IV (over 5 min) to a max of 1000 mg
  193. Sodium Bicarbonate Class
    • Alkalizing Agent
    • NaHCO3
  194. Sodium Bicarbonate Description
    • Provides vascular bicarbonate to assist buffer sys in reducing effects of metabolic acidosis
    • Treatment of some ODs
  195. Sodium Bicarbonate Indications (3)
    • Tricyclic Antidepressant & Barbituate OD
    • Refractory Acidosis
    • Hypercalemia
  196. Sodium Bicarbonate Contraindications
    None when used in severe hypoxia or late cardiac arrest
  197. Sodium Bicarbonate Precautions
    May precipitate w/ calcium chloride
  198. Sodium Bicarbonate Dosages
    1 mEq/kg IV, then 0.5 mEq/kg/10 min
  199. Diphenhydramine (Benadryl) Class
    Antihistamine
  200. Diphenhydramine (Benadryl) Description
    Blocks histamine release reducing bronchoconstriction, vasodilation & edema
  201. Diphenhydramine (Benadryl) Indications (3)
    • Anaphylaxis
    • Allergic Reactions
    • Dystonic Reactions
  202. Diphenhydramine (Benadryl) Contraindications (2)
    • Asthma
    • Lower resp disease
  203. Diphenhydramine (Benadryl) Precautions (7)
    • Hypotension
    • Headache
    • Palpitations
    • Tachycardia
    • Sedation
    • Drowsiness
    • Disturbed Coordination
  204. Diphenhydramine (Benadryl) Dosage
    25-50 mg IV/IM
  205. Activated Charcoal C & T
    • Adsorbent
    • Actidose
  206. Activated Charcoal Description
    Prepared charcoal that activates & binds toxin fr GI tract
  207. Activated Charcoal Indications
    Acute Ingested Poisoning
  208. Activated Charcoal Contraindications (8)
    • Compromised airway
    • cyanide ingestion
    • Mineral Acids
    • Caustic Alkalis
    • Organic Solvents
    • Iron
    • Ethanol
    • Methanol
  209. Activated Charcoal Precautions (5)
    • Hepatic Disease
    • Children under 12 w/ arthritic conds.
    • Alcoholism
    • Malnutrition
    • Thrombocytopenia
  210. Activated Charcoal Dosage
    • 325-650 mg PO/ 4-6 hrs
    • 650mg PR/4-6 hrs
  211. Lorazapam (Ativan) Class
    Sedative/ Benzodiazepam
  212. Lorazapam (Ativan)Description
    • MOST POTENT BENZO AVAIL.
    • Strong antianxiety, sedative, hypnotic & skeletal muscle relaxant props
    • Relatively short half life
  213. Lorazapam (Ativan)Indications (2)
    • Sedation for cardioversion
    • Status Epilepticus
  214. Lorazapam (Ativan)Contraindications
    Sensitivity to benzos
  215. Lorazapam (Ativan)Precautions (12)
    • Narrow angle glaucoma
    • Depression or psychosis
    • Coma
    • Shock
    • Acute Alcohol Intox
    • Renal or Hepatic Impairment
    • Organic brain syndrome
    • Myasthenia Gravis
    • GI disorders
    • Elderly
    • Debilitated
    • Limited Pulmonary reserve
  216. Lorazapam (Ativan) Dosages
    • Sedation -- 2-4 mg IM, 0.5-2mg IV
    • Status Epilepticus -- 2 mg slow IV/PR (2 mg/min)
  217. Metoclopromide (Reglan) Class
    Antiemetic
  218. Metoclopromide (Reglan) Description
    • Dopamine antagonist similar to procainamide but w/ few antidysrhythmic or anesthetic props
    • Antiemetic props fr gastric emptying & desensitization of vomiting reflex
  219. Metoclopromide (Reglan) Indications (2)
    • Nausea
    • Vomiting
  220. Metoclopromide (Reglan) Contraindications (6)
    • Allergy to sulfite agents
    • Seizure Disorders
    • Pheochromocytoma
    • Mechanical GI obstruction
    • Breast Cancer
  221. Metoclopromide (Reglan) Precautions (5)
    • CHF
    • Hypokalemia
    • Renel Impairment
    • GI hemorrhage
    • Intermittent porphyria
  222. Metoclopromide (Reglan) Dosage
    10-20 mg IM; 10 mg slow IV (over 1-2 mins)
  223. Zofran (Ondansetron) Class
    Antiemetic
  224. Zofran (Ondansetron) Description
    Selective blocking agent of serotonin 5-HT3 receptor type
  225. Zofran (Ondansetron) Indication
    Nausea & intractible vomiting
  226. Zofran (Ondansetron)Contraindication
    None
  227. Zofran (Ondansetron) Precautions
    May mask progressive ileus &/or gastric distension
  228. Zofran (Ondansetron) Dosage
    Single 24 mg tab ODT, 4 mg undiluted over @ least 30 secs
  229. Chlordiazepoxide (Librium)Class
    Sedative/ Hypnotic
  230. Chlordiazepoxide (Librium) Description
    BENZO DERIVATIVE producing mild sedation & anticonvulsant, skeletal muscle relaxant, prolonged hypnotic effects
  231. Chlordiazepoxide (Librium)Indications (2)
    • Severe anxiety & tension
    • Acute alcohol WD symptoms (DTs)
  232. Chlordiazepoxide (Librium)Contraindications (2)
    • Pregnant & nursing Mothers
    • Children under 6
  233. Chlordiazepoxide (Librium) Precautions
    • Primary depressive disorders or pyschosis
    • Acute alcohol intox
  234. Chlordiazepoxide (Librium) Dosage
    50-100 mg IV/IM
  235. Butorphanol (Stadol) Class
    Synthetic Narcotic Analgesic
  236. Butorphanol (Stadol)Description
    • Centrally acting synthetic narcotic analgesic
    • 5x more potent than morphine
    • Schedule IV Narc
  237. Butorphanol (Stadol)Indications
    Pain
  238. Butorphanol(Stadol) Contraindications (2)
    • Head Inj
    • Undiagnosed Abd pain
  239. Butorphanol (Stadol)Precautions
    none
  240. Butorphanol (Stadol)Dosage
    1 mg IV or 3-4 mg IM
  241. Meperidine (Demerol) Class
    Narcotic Analgesic
  242. Meperidine(Demerol) Description
    Synthetic Narcotic w/ sedative & analgesic props comparable to morphine but w/o hemodynamic side effects
  243. Meperidine (Demerol)Indications
    Pain
  244. Meperidine (Demerol)Contraindications (2)
    • Seizure Disorders
    • Acute abd prior to diagnosis
  245. Meperidine (Demerol)Precautions (10)
    • ^ ICP
    • Asthma or resp conds
    • Superventricular Tachycardias
    • Prostatic Hypertrophy
    • Urethral Stricture
    • Glaucoma
    • Elderly or Debilitated pts
    • Renal or Hepatic Impairment
    • Hyperthyroidism
    • Addisons Disease
  246. Meperidine(Demerol) Dosages
    • 25-50mg IV
    • 50-100 mg IM
  247. Nalbuphine (Nubain)
    Narcotic Analgesic
  248. Nalbuphine (Nubain) Description
    Equivalent to morphine w/o ^ resp depression w/ higher doses
  249. Nalbuphine(Nubain) Indications
    Pain
  250. Nalbuphine(Nubain) Contraindications
    Undiagnosed Head or abd inj
  251. Nalbuphine(Nubain) Precautions
    none
  252. Nalbuphine (Nubain)Dosages
    5 mg IV/IM/sub q repeat 2mg dose as needed to 20 mg
  253. Pancuronium (Pavulon)Class
    Nondepolarizing Neuromuscular Blocker
  254. Pancuronium (Pavulon) Description
    Nondepolarizing neuromuscular blocker causing paralysis w/o bronchospasm or hypotension
  255. Pancuronium (Pavulon)Indications
    ET intubation
  256. Pancuronium (Pavulon)Contraindications
    Tachycardia
  257. Pancuronium (Pavulon)Precautions
    none
  258. Pancuronium (Pavulon)Dosages
    0.04-0.1 mg/kg IV
  259. Vecuronium (Norcuron) Class
    Nondepolarizing Skeletal Muscle Relaxant
  260. Vecuronium (Norcuron)Description
    Nondepolarizing Neuromuscular blocker w/ minimal cardiovascular effects
  261. Vecuronium(Norcuron) Indications
    ET intubation
  262. Vecuronium(Norcuron) Contraindications
    none
  263. Vecuronium (Norcuron)Precautions (2)
    • Severe obesity
    • Myasthenia Gravis
  264. Vecuronium(Norcuron) Dosages
    0.08-0.1 mg/kg IV
  265. Chlorpromazine (Thorazine)Class
    Tranquilizer/Antipsychotic
  266. Chlorpromazine (Thorazine)Indications (3)
    • Acute Psychotic Episode
    • Intractable hiccups
    • Nausea/Vomiting
  267. Haloperidol (Haldol) Class
    Antipsychotic
  268. Haloperidol(Haldol) Indications
    Acute Psychotic Episodes
  269. Haloperidol(Haldol) Contraindications (6)
    • Parkinson's
    • Seizure Disorders
    • Coma
    • Alcohol Depression
    • CNS depression
    • Thyrotoxicosis
  270. Haloperidol(Haldol) Precautions
    Anticonvulsant, Anticoagulant or Lithium Therapy
  271. Haloperidol(Haldol) Dosages
    2-5 mg IM
  272. Promethazine (Phenergan) Class
    Antiemetic
  273. Promethazine (Phenergan)Indications (4)
    • Nausea & Vomiting
    • Motion Sickness
    • Enhance effects of analgesics
    • Induce Sedation
  274. Aminophyline (Somophyllin)Class
    Methylxanthine Bronchodilator
  275. Aminophyline (Somophyllin)Indications (3)
    • Bronchospasm in asthma
    • COPD refractory to sympathomimetics
    • CHF
  276. Aminophyline (Somophyllin)Contraindications
    Uncontrolled cardiac dysrhythmias
  277. Terbutaline (Brethine/Bricanyl)Class
    Sympathetic agonist
  278. Terbutaline (Brethine/Bricanyl)Description
    Synthetic sympathomimetic causing bronchodilation w/ less cardiac effect than epi
  279. Terbutaline(Brethine/Bricanyl) Indications (2)
    • Bronchial asthma
    • Bronchospasm in COPD
  280. ALTEPLASE RECOMBINANT/tPA (Activase) Class
    Thrombolytic
  281. Alteplase Recombinant/tPA (Activase) Indications (3)
    • AMI
    • Acute Ischemic Stroke
    • Pulmonary Embolism
  282. Alteplase Recombinant/tPA (Activase) Contraindications
    • Internal Bleeding
    • Suspected Aortic Disection
    • Traumatic CPR
    • Hemmorhagic Stroke
    • Intercranial/Intraspinal Trauma
    • Pregnancy
    • Uncontrolled Hypertension
  283. Alteplase Recombinant/tPA (Activase) Precautions
    • Recent Major Surgery
    • Cerebral Vascular Disease
    • Recent GI/GU Bleed
    • Recent Trauma
    • HTN
    • Pt >75
    • Hemmorhagic Opthalmic Cond
  284. Alteplase Recombinant/tPA (Activase) Dosages
    • MI/Stroke--15 mg/IV ->0.75 mg/kg (up to 50) over 30 mins -> 0.5 mg/kg (up to 35 mg) over 60 mins
    • Pulmonary Embolism--100 mg IV over 2 hrs
  285. What is the class and trade of Heparin?
    • Anticoagulant
    • Heparin
  286. What are indications for Heparin?
    Prevent thrombus formation in AMI
  287. Describe Heparin. . . . .
    • Rapid onset anticoagulant.
    • Enhances effects of Antithrombin III
    • Blocks conversion of Prothrombin -> Thrombin & Fibrinogen -> Fibrin
  288. What is the class of Timoptic?
    Beta Blocker
  289. Describe Timoptic. . .
    Non selective beta adrenergic receptor blocking agent
  290. What are the indications for Timoptic (3)?
    • HTN
    • MI
    • Elevated Ocular Pressure
  291. What are contraindications for Timoptic (5)?
    • Asthma
    • Severe COPD
    • Sinus Brady
    • 2nd & 3rd degree AV block
    • Cardiogenic Shock
  292. Timoptic Precautions
    Readily Absorbed
  293. Timoptic Dosages
    One drop/eye BID
  294. Norepinephrine (Levophed)Class
    Sympathomimetic Agent
  295. Norepinephrine (Levophed)Description
    • Naturally occurring catecholamine
    • Causes vasoconstriction, cardiac stimulation, ^ BP, ^ myocardial O2 demand, ^ coronary blood flow
  296. Norepinephrine (Levophed)Indications are (2)?
    • Refractory Hypotension
    • Neurogenic Shock
  297. Norepinephrine(Levophed) Contraindications are?
    Hypotension due to uncorrected Hypovolemia
  298. Norepinephrine(Levophed) Precautions
    May cause Necrosis

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