Aemt Drug Cards 72195v

Drug: OXYGEN

Class of medication: Oxidizing agent (gas)

Generic

ACTION: Reverses Hypoxia, Increases arterial oxygen, Increases hemoglobin saturation, Increases tissue oxygenation Indications: Hypoxia or anticipated hypoxia, or in any medical

Contraindications: There are no contraindications to oxygen

or trauma patient to improve respiratory efficiency.

therapy.

Dose:

Common side effects:

Route: Oral

DOSAGE: Adult: 1-6 LPM via NC; 10-15 LPM via NRB; 15 LPM via BVM Pediatric: 1-6 LPM via NC; 10-15 LPM via NRB; 15 LPM via BVM

Dry or bloody nose, skin irritation from the nasal cannula or face mask

Precautions/major interactions: Chronic obstructive pulmonary disease (COPD) and very prolonged istration of high concentrations in the newborn.

Drug: Oral Glucose

Class of medication: Monosaccharide Carbohydrate

Generic Glutose, Insta-Glucose

ACTION: After absorption from GI tract, glucose is distributed in the tissues and provides a prompt increase in circulating blood sugar

Onset: 10 min Indications: Patients with altered mental status and known

Contraindications:

history of diabetes mellitus

Unconsciousness; known diabetic who has not taken insulin for days; patient who is unable to swallow

Dose:

Route: Oral Common side effects:

DOSAGE/ROUTE:Adult: One tube or packet; repeat based on BGL Pediatric: One tube or packet; repeat based on BGL – minimum age 3 yrs

Nausea, may be aspirated by the patient without a gag reflex

Precautions/major interactions Assure patient has control of swallowing and airway.

Drug: Glucagon

Class of medication: Hormone, antihypoglycemic

Generic: GlucaGen

ACTION: Glucagon is a protein secreted by pancreatic cells that causes a breakdown of stored glycogen into glucose and inhibits the synthesis of glycogen from glucose.

Indications:

Contraindications:

Hypoglycemia without IV access.

Hypersensitivity to glucagon or protein compounds.

Dose:

Common side effects:

Route: Intramuscular Adult:1-2mg IM, repeat in 15 minutes if BGL <60. Ped:0.1 mg/kg IM, repeat in 15 minutes if BGL <60;age > 3 years

Nausea, vomiting

Precautions/major interactions Cardiovascular or renal impairment. Effective only if there are sufficient stores of glycogen in the liver.

Drug: 50% Dextrose in water (D50)

Class of medication: Monosaccharide, Carbohydrate

Generic

ACTION: Dextrose is a simple sugar that the body can rapidly metabolize to create energy. Indications: Hypoglycemia confirmed by glucometer.

Contraindications:

(Coma or seizure of unknown etiology)

None in hypoglycemia.

Dose:

Route: IV

Adult:1 amp or 25g D50WIV bolus, repeat based on BGL.

Common side effects: Tissue necrosis and phlebitis at injection site.

Precautions/major interactions: Increased I. Determine blood glucose level before istration. Ensure good venous access.

Drug: Lactated Ringer's

Class of medication: Isotonic crystalloid solution

Generic LR

ACTION: Assist in fluid replacement for dehydration or blood loss

Indications:

Contraindications:

Manage hypovolemia (uses lactate as a buffer and contains electrolytes)

CHF or renal failure

Dose:

Common side effects:

Route: IV

Adult Dose: 200-500cc Pediatric Dose:20cc/kg for fluid replacement Max:60cc/kg or 2-3 liters of fluid

Rare

Drug: 0.9% NaCl

Class of medication: Isotonic crystalloid solution

Precautions/major interactions CVA, Diabetics, Mixing with blood sets.

Generic Normal Saline

ACTION: - Electrolyte solution which equivalent osmotically to blood. - Increases the circulating volume in the vascular system. (2/3 of infused volume leaves vascular space within 1 hour.)

Indications:

Contraindications: CHF and circulatory overload, Rales for

Replaces water and electrolytes; useful in heat exhaustion, freshwater dorwning, hypovolemia, DKA

fluid bolus

Dose:

Common side effects:

Route: IV

Hypolemia 1. 1 L blood lost = 3 L of NS to infuse 2. Attempt to achieve SBP of 100 mmHg

Rare

Drug: albuterol sulfate (nebulized)

Class of medication: Sympathomimetic Bronchodilator

Generic: Proventil, Ventolin

(sympathomimetic = mimics effects of sympathetic nervous system)

Precautions/major interactions Be conservative in use of fluids with a suspected head injury patient to minimize the risk of developing cerebral edema. Judicious fluid use may be needed for hypotension associated with head injury to maintain cerebral perfusion. Check BP and lung sounds to determine if fluid overload may be developing.

ACTION: Albuterol is a synthetic sympathomimetic that causes bronchodilatation with less cardiac effect than epinephrine and reduces mucus secretion, pulmonary capillary leaking, and edema in the lungs during allergic reactions.

Indications: Bronchospasm and asthma in COPD.

Contraindications: Hypersensitivity to the drug, history of cardiac disease, heart rate >150 in adults, heart rate >200 in pediatrics

Dose: Adult: 2.5-5.0 mg (3cc)via nebulizer continuously, x3

Common side effects: Increased pulse rate (tachycardia)

doses,if no history of cardiac disease and heart rate ≤150. Ped:2.5mg (3cc) via nebulizer continuously, x3 doses, if no history of cardiac disease and heart rate ≤200

,anxiety, nausea, cough, wheezing, tremors, and/or dizziness

Precautions/major interactions The patient may experience tachycardia, anxiety, nausea, cough, wheezing, and/or dizziness. Vital signs and breath sounds must be monitored; use caution with elderly, cardiac, or hypertensive patients.

Drug: ipatromium bromide

Class of medication:

Anticholinergic

Trade: Atrovent, Apovent, Ipraxa, Aerovent and Rinatec

ACTION: Ipratropium bromide is an anticholinergic agent. It blocks muscarinic cholinergic receptors, without specificity for subtypes, resulting in a decrease in the formation of cyclic guanosine monophosphate

Indications: Bronchospasm associated with COPD

Contraindications: Hypersensitivity to ipratropium or

Can be used alone or combined with albuterol

atropine. Use caution in patients with narrow angle glaucoma

Dose:

Common side effects Resp: coughing, sputum increased

500 mcg in 2.5 mL unit dose via SVN or in-line with ventilator device. Repeat per Medical Direction. May mix one unit of ipratropium with one unit of albuterol

CNS: dizziness, insomnia, tremor, nervousness GI: nausea GU: Urinary retention.

Precautions/major interactions •Ipratropium bromide inhalation solution is not a fast-acting medication and cannot replace fast-acting rescue inhalers. Treatment of acute episodes of bronchospasm where rescue therapy is required for rapid response

Drug: Nitroglycerine

Class of medication:

Nitrate

Trade: (Nitrostat)

ACTION: Relaxes blood vessels, decreases workload of heart Indications: Chest pain associated with angina and acute

Contraindications: Hypersensitivity, tolerance to nitrates, severe

myocardial infarction.

anemia, head trauma, hypotension, increased I, patients taking sildenafil (Viagra), glaucoma, and shock.

Dose:

Route: Oral Common side effects: Hypotension (lowers blood pressure),

Adult: 1 tablet or spray (0.4 mg) SL every 5 minutes until pain- free or 3 doses. If SBP <100, medical control. Ped:Not indicated.

headache, pulse rate changes.

Drug: epinephrine (for anaphylaxis only)

Class of medication: Sympathomimetic

Precautions/major interactions May induce headache that is sometimes severe. Nitroglycerin is light sensitive and will lose potency when exposed to the air

Generic: Adrenalin

ACTION: Epinephrine is a naturally occurring catecholamine that increases heart rate, cardiac contractile force myocardial electrical activity, systemic vascular resistance, and systolic blood pressure and decreases overall airway resistance and automaticity. It also, through bronchial artery constriction, may reduce pulmonary congestion and increase tidal volume and vital capacity

Indications: severe allergic reactions.

Contraindications:

Dose: Allergic reactions

Common side effects:

Adult:0.3 mg of 1:1000 IM (if age <50) 0.15 mg of 1:1000 IM (if age >50) Ped:0.01 mg/kg of 1:1000 IM (use Broselow); max dose 0.3 mg

Precautions/major interactions

Hypersensitivity to sympathomimetic amines, narrow angle glaucoma, hemorrhagic, organic brain or or during labor Increased heart rate, pallor, dizziness, chest pain, headache,nausea, vomiting, excitability, anxiety. Elderly, debilitated patients, hypertension, diabetes,hyperthyroidism, Parkinson’s disease, tuberculosis, asthma,emphysema, and in children < 6 year

Drug: nitrous oxide (50/50 mix)

Class of medication:

Gaseous Analgesic/Anasthetic

Generic: Nitronox

ACTION: CNS depressant Indications:

Patients that are alert and complaining of pain caused by the following: Musculoskeletal injuries/fractures, kidney stones, suspected AMI (if NTG or morphine are ineffective or contraindicated), active labor during an uncomplicated delivery, thermal burns

Contraindications:Any altered level of consciousness or head

Dose:

Common side effects Hypotension/Dizziness

Route: Self-istered via mask

injury. Chronic Obstructive pulmonary disease. Chest trauma or actual/suspected pneumothorax. Abdominal distention major facial trauma acutely psychotic patients Decompression sickness Patients who cannot self-ister

Self-ister and self-regulated by the patient, who must hold the mask to face to create an airtight seal until the pain is significantly relieved or the patient drops the mask.

Precautions/major interactions

Drug: naloxone

Class of medication: Narcotic antagonist

Must be self-istered Check machine gauges daily for proper concentrations. Monitor blood pressure and pulse oximetry values

Generic: NARCAN

ACTION: Naloxone is a pure narcotic antagonist that blocks the effects of both natural and synthetic narcotics and may reverse respiratory depression.

Indications: Narcotic and synthetic narcotic overdose, coma

Contraindications:

of unknown origin

Hypersensitivity to the drug, non-narcotic induced respiratory depression.

Dose: Adult: 0.5-2 mg IV bolus titrated to patient’s respiratory

Common side effects:

response; may be given IM if unable to establish IV. Ped:0.1 mg/kg IV (max 2 mg), repeated in 5 minutes if no effect.

Abrupt reversal of narcotic depression may result in nausea, vomiting, sweating, tachycardia, increased blood pressure, tremulousness, seizures and cardiacarrest

Precautions/major interactions Possible dependency. Short also half-life than that of mostnarcotics; hence the patient may return to the overdose state.

Drug:

activated charcoal

Class of medication:

Adsorbent (binding agent)

Generic:

ACTION: Activated charcoal is a specially prepared charcoal that will adsorb and bind toxins from the gastrointestinal tract; combined with Sorbitol to promote GI motility

Indications: Acute ingested poisoning Dose: Adult: 50 gms PO Ped:1g/kg PO, max 25 gms

Contraindications:

An airway that cannot be controlled; ingestion of cyanide, mineral acids, caustic alkalis, organic solvents, iron, ethanol, methanol.

Route: Oral

Common side effects Constipation, diarrhea, temporary darkening of the stool, vomiting.

Precautions/major interactions ister only after emesis or in those cases where emesis is contraindicate

Drug: acetaminophen

Class of medication:

Non-narcotic Analgesic, Antipyretic

Trade: Tylenol, Anacin-3

ACTION: Antipyretic Activity, Analgesic Activity - Inhibition of central & peripheral prostaglandin synthesis Indications: For pain and fever control

Contraindications:

Dose:

Common side effects: When used appropriately, side effects

Adult: 1000mg PO Pediatric: 10mg/kg PO

with acetaminophen are rare. The most serious side effect is liver damage due to large doses

Hypersensitivity, children under 3 years

Precautions/major interactions Extreme caution must be used when considering the use on a suspected liver dysfunction.

Drug: ibuprofen

Class of medication:

Trade: Advil, Motrin

NSAID

Analgesic, Antipyretic, Anti-inflammatory,

ACTION: Reduces the inflammatory response through the chemotaxis. Reduces the fever by blocking the prostaglandin synthesis Indications: Fever, Pain, Inflammation Reducer

Contraindications:

Hypersensitivity

Contraindication:

Dose: Adult Dose: 200-800mg p.o. every 6-8 hours

Common side effects:

Pediatric Dose:10mg/kg p.o. max of 40mg/kg per day (liquid form)

Precautions/major interactions

Drug:

Class of medication:

Aspirin (Acetylsalicylic Acid)

G.I. intolerance, many others possible

You may want to alternate with Acetaminophen

Platelet inhibitor/Anti-inflammatory

Trade: Alka-Seltzer, Bayer, Emperin, St Joseph Children’s

ACTION: Blocks platelet aggregation Indications: Chest pain suggestive of an MI

Contraindications: Hypersensitivity to salicylates, active ulcer disease, asthma

Dose: Adult: chewable baby aspirin (81mg each) PO

Common side effects: Nausea, vomiting, heartburn, bleeding.

Pediatric: Not indicated

Wheezing is possible with an allergic reaction.

Precautions/major interactions: GI bleeding and upset Drug: Atropine (Auto Injector)

Class of medication: Parasympatholytic

Generic:

(increases heart rate)

ACTION: Atropine blocks the parasympathetic nervous system, specifically the vagal effects on the heart rate. It does not increase contractility but may increase myocardial oxygen demand. Atropine decreases airway secretions

Dose:

Adult: 2 mg IM via autoinjector Pediatric: Per medical control

Contraindications: None in an emergency setting

only

Common side effects:: Dry mouth, blurred vision, urinary retention, tachycardia, constipation, decreased sweating

Precautions/major interactions: AMI, glaucoma.

Drug: Pralidoxime (2-PAM)

Class of medication:

Cholinesterase reactivator

Generic:

ACTION: Pralidoxime reactivates cholinesterase and reinstitutes the degrading of acetylcholine and restores normal neuromuscular transmission. It is used to reverse severe organophosphate poisoning. Indications: Organophosphate poisoning

Contraindications:

Dose:

Common side effects:

Adult: 600 mg IM via (Auto Injector) Ped: Per medical control only

Carbamate insecticides (Sevin), inorganic phosphates, and organophosphates having no anticholinesterase activity, asthma, peptic ulcer disease, severe cardiac disease, or patients receiving aminophylline, theophylline, morphine, succinylcholine, reserpine, or phenothiazines blurred or double vision, difficulty in focusing eyes, difficulty in speaking, difficult or rapid breathing, dizziness, fast heartbeat, muscle stiffness or weakness, pain at the place of injection.

Precautions/major interactions Rapid istration may result in tachycardia, laryngospasm, and muscle rigidity. Excited or manic behavior may be noted after regaining consciousness