Drug Profiles

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Drug Profiles
2011-08-23 22:28:55
drugs EMS pharms

Drug profiles for EMS
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  2. Protocol: Overdose / Toxic Ingestion
    • Indications: Toxic Ingestion
    • Class: Antidote, Adsorbent
    • MOA: Inhibits absorption by binding to certain chemicals
    • Contraindications: Ingestion of acids, alkalis, ethanol, methanol, cyanide, ferrous sulfate or other iron salts, lithium; coma; GI obstruction
    • SE: N/V/D. If aspirated into the lungs, charcoal can induce a potentially fatal form of pneumonitis
    • Route: PO
  4. Protocol: Narrow / Wide Complex Tachycardia
    • Indications: SVT
    • Class: Anti-Arrhythmic
    • MOA: Slows the conduction of electrical impulses at the AV node.
    • Contraindications: A-Fib or flutter, 2nd or 3rd degree AV block or SSS, and VT.
    • SE: Facial flushing, dyspnea, HA, N/V, chest pressure, dizziness, diaphoresis, hypotension, palpations, and chest, jaw or neck pain. Route: IV/IO
  6. Protocol: Respiratory Distress
    • Indications: Asthma, bronchitis with bronchospasm, and COPD
    • Class: Bronchodilator
    • MOA: Stimulates beta2-adrenergic receptors in lungs, resulting in relaxation of bronchial smooth muscle. Reduces bronchospasm and reduces airway resistance
    • Contraindications: Hx of hypersensitivity to sympathomimetics, caution with HTN, CVD, hyperthyroidism and diabetes.
    • SE: HA, N/V, restlessness, nervousness, tremors, dizziness, throat dryness and irritation. May increase risk of arrhythmias with Digoxin
    • Route: NEB
  8. Protocol: Narrow / Wide Complex Tachycardia, V-Fib / Pulseless V-Tach
    • Indications: VF/ pulseless VT, VT with a pulse.
    • Class: Anti-Arrhythmic
    • MOA: Acts directly on the myocardium to delay re-polarization and increase the duration of the action potential (Rate Control).
    • Contraindications: Bradycardia induced syncope, 2nd and 3rd degree AV block, severe hepatic disease, severe sinus node dysfunction, and hypersensitivity to iodine.
    • SE: Hypotension, Bradycardia, HA, N/V, and muscular incoordination.
    • Route: IV/IO, Infusion (DRIP)
  10. Protocol: Chest pain
    • Indications: Angina, AMI
    • Class: Anti-Platelet
    • MOA: Prevents the formation of a chemical which causes platelets to clump together, or aggregate, and form plugs that cause obstruction or constriction of small coronary arteries
    • Contraindications: Bleeding disorders, GI bleeding or ulceration, hepatic impairment, and Hx of hypersensitivity to ASA and NSAID’s
    • SE: GI distress, cramping, heartburn, mild nausea and allergic reaction
    • Route: PO
  12. Protocol: Bradycardia, Organophosphate Poisoning
    • Indications: Symptomatic bradycardia, AV block, and antidote for organophosphate pesticides
    • Class: Anti-Cholinergic
    • MOA: Competes with acetylcholine for common binding sites on muscarinic receptors located on exocrine glands, cardiac, smooth muscle ganglia, and intramural neurons (blocks vagal tone)
    • Contraindications: Use with caution in presence of MI and hypoxia. (Increases myocardial O2 demand) Avoid in hypothermic Bradycardia
    • SE: Dry mouth, nose, throat, decreased diaphoresis, constipation and blurred vision; tachycardia
    • Route: IV/IO
  14. Protocol: Asystole / PEA, Bradycardia, V-Fib / Pulseless V-Tach
    • Indications: OD of CaCB’s and BB’s, acute hypocalcemia, cardiac arrest and hyperkalemia
    • Class: Electrolyte
    • MOA: Increase in myocardial contractility and ventricular automaticity; positive inotropic effect
    • Contraindications: Digoxin toxicity, Hypercalcemia and VF
    • SE: Rash, flushing, feeling of warmth, N/V, diaphoresis and hypotension
    • Route: IV/IO
  16. Protocol: Altered Mental Status, Hypoglycemia
    • Indications: Hypoglycemia
    • Class: Anti-Hypoglycemic
    • MOA: Increases blood glucose concentrations
    • Contraindications: CVA, DTs
    • SE: Hyperglycemia, warmth, burning, pain and thrombosis of the peripheral veins
    • Route: IV/IO
  18. Protocol: Pain Control, Seizures, Behavioral
    • Indications: Anxiety, skeletal muscle relaxation, ETOH withdrawal, seizures; prior to cardioversion
    • Class: Benzodiazepine
    • MOA: Depressing CNS with anticonvulsive and sedative properties
    • Contraindications: Coma, CNS depression, respiratory depression, head injury
    • SE: Drowsiness, fatigue, ataxia, orthostatic hypotension, HA and N/V
    • Route: IV/IO, Rectal
  20. Protocol: Narrow / Wide Complex Tachycardia
    • Indications: A-Fib/A flutter
    • Class: Calcium Channel Blocker
    • MOA: Inhibits Ca movement across cardiac, slows conduction in AV node (rate control). Cause dilation of coronary arteries, peripheral arteries and arterioles.
    • Contraindications: Acute MI, 2nd or 3rd degree AV block, severe hypotension and SSS
    • SE: Hypotension, peripheral edema, dizziness, light headedness, HA, BradycardiaRoute: IV/IO, Infusion (DRIP)
  22. Protocol: Allergic Reactions, Behavioral
    • Indications: Allergic reactions, motion sickness
    • Class: Antihistamine
    • MOA: Binds and blocks H1 histamine receptors
    • Contraindications: Hypersensitivity
    • SE: Hypotension, HA, drowsiness, use caution with acute asthma patients – may thicken secretions, may have a paradoxical effect on children causing an excitable state
    • Route: IV/IO/IM
  24. Protocol: Bradycardia, Hypotension, Induced Hypothermia
    • Indications: 2nd-line drug for symptomatic bradycardia and hypotension (non-trauma shock and post-resuscitation), non-trauma pediatric hypotension
    • Class: Adrenergic agonist
    • MOA: Stimulates alpha and beta adrenergic receptors, at moderate doses (2-10 mcg/kg/min) stimulates beta1 receptors resulting in increased inotropic and increased cardiac output
    • Contraindications: Hypovolemic shock, HTN
    • SE: Tachycardia, angina, N/V, arrhythmias, skin and soft tissue necrosis, correct hypovolemia with fluid replacement before initiating dopamine, use caution in cardiogenic shock with CHF
    • Route: IV/IO, Infusion (DRIP)
  25. EPINEPHRINE 1:1,000
  26. Protocol: Allergic Reaction, Respiratory Distress
    • Indications: Anaphylaxis and allergic reactions with respiratory compromise
    • Class: Adrenergic agonist
    • MOA: Binds with alpha and beta receptors, producing increased BP, increased HR, and bronchodilation
    • Contraindications: Extreme tachycardia
    • SE: Anxiety, HA, HTN, tremors, N/V, use caution in patients with previous cardiac Hx and tachycardia
    • Route: IM
  27. EPINEPHRINE 1:10,000
  28. Protocol: Allergic Reaction, Aystsole / PEA, Bradycardia, V-Fib Pulseless V-Tach
    • Indications: Cardiac arrest, anaphylaxis
    • Class: Adrenergic agonist
    • MOA: Binds with alpha and beta receptors, producing increased BP, increased HR, and bronchodilation
    • Contraindications: Extreme tachycardia
    • SE: Anxiety, HA, HTN, tremors, N/V, use caution in patients with previous cardiac Hx and tachycardia
    • Route: IV/IO
  30. Protocol: Respiratory Distress
    • Indications: Respiratory Distress
    • Class: Adrenergic agonist
    • MOA: Alpha and beta receptor stimulator- vasoconstriction, reduction in mucous
    • Contraindications: Cardiac disease, HTN and sulfate sensitivity
    • SE: Anxiety, dizziness, HA, tachycardia, tremors, N/V
    • Route: Neb
  32. Protocol: Adult Airway RSI
    • Indications: RSI induction, induction of anesthesia
    • Class: Hypnotic, anesthesia induction agent
    • MOA: GABA like effects, exact mechanism unknown
    • Contraindications: DO NOT use during labor or lactating mothers, only use in pregnancy if benefit out weights risk
    • SE: Hypotension, Respiratory depression, N/V, arrhythmias, laryngospasm
    • Route: IV/IO
  34. Protocol: Allergic reactions, Nausea / Vomiting
    • Indications: Allergic reactions, N/V
    • Class: Antihistamine
    • MOA: Competitively inhibits action of histamine at the H2 receptor sites decreasing gastric acid secretion
    • Contraindications: Hypersensitivity
    • SE: Palpitations, flushing, tinnitus, dizziness, constipation, anorexia, dry mouth
    • Route: IV/IO
  36. Protocol: Pain Control
    • Indications: Pain
    • Class: Narcotic analgesic
    • MOA: Binds to opiate receptors
    • Contraindications: Use in caution in TBI, Respiratory depression
    • SE: Respiratory depression, hypotension, N/V, dizziness, bradycardia, palpitations
    • Route: IV/IO/IM/IN
  38. Protocol: Pulmonary Edema
    • Indications: Pulmonary Edema, CHF
    • Class: Loop diuretic
    • MOA: Inhibits the absorption of Na and chloride ions and water in the loop of Henle
    • Contraindications: Known sensitivity to sulfonamides or Furosemide
    • SE: Hypotension, vertigo, dizziness, hypokalemia
    • Route: IV/IO
  40. Protocol: Asystole / PEA, Altered Mental Status, Bradycardia
    • Indications: Hypoglycemia, BB overdose
    • Class: Hormone
    • MOA: Converts glycogen to glucose and stimulating glucose synthesis
    • Contraindications: Pheochromocytoma, insulinoma
    • SE: N/V, HTN, tachycardia
    • Route: IV/IO/IM
  42. Protocol: Altered Mental Status
    • Indications: Hypoglycemia
    • Class: Carbohydrate, hypertonic solution
    • MOA: Distributed into tissues & provides a prompt increase in circulating blood sugar
    • Contraindications: Must be mentally alert and able to swallow
    • Route: PO
  44. Protocol: Behavioral / Agitated Delirium
    • Indications: Behavioral/agitated delirium
    • Class: Antipsychotic
    • MOA: Selectively blocks postsynaptic dopamine receptors.
    • Contraindications: CNS depression, coma, Parkinson’s disease, use caution with elderly
    • SE: Hypotension, tachycardia, HTN, drowsiness, respiratory depression
    • Route: IM
  46. Protocol: Respiratory Distress
    • Indications: Asthma, bronchospasm associated with COPD
    • Class: Anticholinergic, bronchodilator
    • MOA: Antagonizes the acetylcholine receptor on bronchial smooth muscle, producing bronchodilation
    • Contraindications: Peanut allergy
    • SE: Paradoxical bronchospasm, cough, headache, dizziness, dry mouth, palpitationsRoute: Neb
  48. Protocol: Pain Control
    • Indications: Mild to moderate pain
    • Class: NSAID
    • MOA: Inhibits the production of prostaglandins in inflamed tissue which decreases the responsiveness of pain receptors
    • Contraindications: History of peptic ulcer disease or GI bleed, patients with renal insufficiency, hypovolemia, pregnancy (third trimester) nursing mothers, allergy to NSAID's, CVA, head trauma, immediate surgery
    • SE: Pain at injection site, drowsiness, dizziness, N/V, abdominal pain, headacheRoute: IV/IO/IM
  50. Protocol: Respiratory Distress
    • Indications: Acute bronchospasm in asthma or COPD
    • Class: Selective Beta2 agonist
    • MOA: Relaxing muscles in the airways to improve breathing
    • Contraindications: Known sensitivity
    • SE: Hyperglycemia, hypokalemia, palpitations, sinus tachycardia, anxiety, tremor, N/V, hypertension, HA
    • Route: Neb
  52. Protocol: Adult Airway RSI, IV, Head Trauma, Narrow / Wide Complex Tachycardia, V-Fib Pulseless V-Tach
    • Indications: RSI with head trauma, IO insertion
    • Class: Anti-Arrhythmic, Sodium channel blocker
    • MOA: Blocks sodium channels increasing recovery period after repolarization
    • Contraindications: AV block
    • SE: Cardiac arrhythmias, hypotension, bradycardia, seizures
    • Route: IV/IO, Infusion (DRIP)
  54. Protocol: Wide Complex Tachycardia, V-Fib / Pulseless V-Tach, Obstetrical Emergency
    • Indications: Eclamptic seizures, polymorphic VT (torsades de pointes), Respiratory distress
    • Class: Electrolyte
    • MOA: Reduces striated muscle contractions and blocks peripheral neuromuscular transmission
    • Contraindications: AV block
    • SE: Diaphoresis, hypotension, muscle paralysis, weakness, hypothermia
    • Route: IV/IO, Infusion (DRIP)
  56. Protocol: Allergic Reaction, Respiratory Distress
    • Indications: Anaphylaxis, asthma, COPD, Acute spinal cord injury
    • Class: Corticosteroid
    • MOA: synthetic steroid that suppresses acute and chronic inflammation. In addition, it potentiates vascular smooth muscle relaxation by beta adrenergic agonists
    • Contraindications: Cushing’s syndrome, measles, GI bleed, known sensitivity
    • SE: Depression, headache, restlessness, hypertension, bradycardia, N/V/D, swelling
    • Route: IV/IO
  58. Protocol: Chest Pain
    • Indications: To reduce myocardial ischemia and damage in patient with acute MI
    • Class: Beta-blocker Agent
    • MOA: Beta-adrenergic blocking agent, Beta1 blocking action on the heart decreasing heart rate, conduction velocity, myocardial contractility, and cardiac output.
    • Contraindications: Heart Failure, 2 and 3-degree heart blocks, hypotension, bradycardia
    • SE: Bradycardia, atrioventricular conduction delays, hypotensionRoute: IV/IO
  60. Protocol: Behavioral / Agitated Delirium, Cardioversion, Induced Hypothermia, Seizure
    • Indications: Sedation, anxiety, skeletal muscle relaxation
    • Class: Benzodiazepine
    • MOA: Enhances the inhibitory effects of GABA receptors on chloride channels in central nervous system, hyperpolarizing membrane. Induces sleep, decreases anxiety, and impairs memory retention.
    • Contraindications: Acute-angle glaucoma, pregnant women, Hypersensitivity, Depressed vital signs, use with barbiturates, alcohol, narcotics, or other CNS depressants
    • SE: Respiratory depression, respiratory arrest, hypotension, nausea/vomiting, headache, hiccups, cardiac arrest
    • Route: IV/IO/IM/IN
  62. Protocol: Chest Pain, Pain Control,
    • Indications: Moderate to severe pain
    • Class: Opiate agonist
    • MOA: Narcotic analgesic
    • Contraindications: Respiratory depression, shock, use with caution in hypotension, acute bronchial asthma
    • SE: Hypotension, Tachycardia or bradycardia, Palpitations, Syncope, Facial flushing, Respiratory depression, Euphoria, Bronchospasm, Allergic reaction
    • Route: IV/IO/IM
  64. Protocol: Altered Mental Status, Asystole / PEA, Hypothermia, Overdose / Toxic Ingestion
    • Indications: Narcotic OD/Misuse
    • Class: Narcotic Antagonist
    • MOA: Competitive inhibition at narcotic receptor sites, reverse respiratory depression secondary to opiate drugs, completely inhibits the effect of Morphine
    • Contraindications: Use with caution in narcotic dependent patients. Use with caution in neonates of narcotic-addicted mothers
    • SE: Possible projectile vomiting with rapid admin
    • Route: IV/IO/IM/IN
  66. Protocol: Chest Pain, Hypertension, Pulmonary Edema,
    • Indications: Acute angina pectoris, Ischemic chest pain, HTN, CHF, pulmonary edema
    • Class: Vasodilator
    • MOA: Smooth muscle relaxant acting on vascular, bronchial, uterine, and intestinal smooth muscle; dilation of arterioles and veins in the periphery; reduces preload and afterload; decreases the heart work load, thereby, myocardial oxygen demand
    • Contraindications: Hypotension, hypovolemia; intracranial bleeding or head injury; administration of Viagra, Revatio, Levitra, Cialis, or similar agents in last 24 hours
    • SE: Headache, hypotension, syncope, reflex tachycardia, flushing, nausea/vomiting, diaphoresis, muscle twitching
    • Route: SL, Infusion (DRIP)
  68. Protocol: Adult Airway
    • Indications: Facilitation of nasotracheal intubation
    • Class: Topical vasoconstrictor
    • MOA: Stimulates alpha receptors in the blood vessels of the nasal mucosa which causes their constriction and thereby decreases the risk of nasal bleeding
    • Contraindications: Known allergy to medication
    • SE: Rare with single dose, rarely absorbed systemically from nasal inhalation, CV: Hypertension, palpitations, CNS: Tremors
    • Route: IN
  70. Protocol: Chest Pain, Abdominal Pain, Nausea / Vomiting
    • Indications: For prevention and control of nausea and vomiting.
    • Class: 5-HT3 receptor antagonist
    • MOA: Blocks action of Serotonin, which is a natural substance that causes N/V.
    • Contraindications: Known allergy to this medicine or other 5-HT3 receptor antagonists.
    • SE: Chest pain, wheezing, hives/skin rash, nausea, vomitingRoute: IV/IO
  72. Protocol: Asystole / PEA, Overdose / Toxic Ingestion
    • Indications: Mild to moderate metabolic acidosis due to shock, severe dehydration, anoxia, metabolic acidosis, cardiac arrest, and to treat overdose of Tricyclic antidepressants
    • Class: Alkalizing agent, electrolyte and antacid
    • MOA: Neutralizes hydrochloric acid. Systemic and urinary alkalinizer
    • Contraindications: Metabolic and respiratory alkalosis, hypertension, convulsions, CHF, and other situations where sodium can be dangerous
    • SE: Gastric distention, hypercalcemia, metabolic acidosis, tissue sloughing at the siteRoute: IV/IO
  74. Protocol: Adult Airway RSI
    • Indications: Facilitate intubation, terminate laryngospasm, promote muscle relaxation, and facilitate electroconvulsive shock therapy
    • Class: Neuromuscular Blocker; Paralyzing Agent
    • MOA: Bind to the receptors for Acetylcholine
    • Contraindications: Acute narrow-angle glaucoma, penetrating eye injuries, inability to control airway or support ventilations with oxygen and positive pressure
    • SE: Apnea, malignant hyperthermia, arrhythmias, bradycardia, hypertension, hypotension, cardiac arrest, hyperkalemia, increased intraocular pressure, fasciculation, and exacerbation of hyperkalemia in trauma patientsRoute: IV/IO
  76. Protocol: Altered Mental Status, Seizure, Stroke, Syncope
    • Indications: Coma of unknown origin, Delirium Tremens, Beriberi, Wernicke's encephalopathy
    • Class: Vitamin B-1
    • MOA: Combines with ATP to form thiamine pyrophosphate coenzyme, a necessary component for carbohydrate metabolism. The brain is extremely sensitive to thiamine deficiency
    • Contraindications: None
    • SE: Hypotension from too rapid of an injection or too high a dose, anxiety, diaphoresis, nausea/vomiting, allergy (rare)
    • Route: IV/IO
  78. Protocol: Asystole / PEA, V-Fib / Pulseless V-Tach
    • Indications: Alternate vasopressor to the 1st or 2nd dose of Epinephrine in cardiac arrest. May be useful in cases of vasodilatory shock (septic shock)
    • Class: Antidiuretic Hormone
    • MOA: Stimulation of V1 smooth muscle receptors. Potent vasoconstrictor when given in high doses
    • Contraindications: Hypersensitivity to Vasopressin, responsive patients with coronary artery disease
    • SE: Bronchial constriction, ischemic chest pain, nausea/vomiting, abdominal pain
    • Route: IV/IO